Certified Respiratory Therapist Practice Exam

If bronchial breath sounds are heard over the right middle lobe, what condition is likely present?

1. Pulmonary edema

2. Pneumonia

3. Atelectasis

4. Chronic bronchitis

The correct answer is: Pneumonia

Bronchial breath sounds are typically heard over the trachea and larger airways, where airflow is turbulent and audible. When these sounds are present in areas of the lung where vesicular sounds are expected, such as the peripheral lung fields, it often indicates an abnormal condition. In the case of pneumonia, the presence of inflammation and consolidation in the lung tissue can alter the normal sound transmission, leading to bronchial sounds being detected in areas like the right middle lobe. This occurs because the consolidation associated with pneumonia fills the air spaces with fluid and inflammatory cells, creating a scenario where the more superior (bronchial) sounds can be transmitted through the affected lung tissue, replacing the normally softer vesicular sounds. Pulmonary edema would typically present with different auscultatory findings, such as crackles, due to fluid in the alveoli, rather than the clear bronchial sounds indicative of pneumonia. Atelectasis, while it can cause changes in breath sounds, usually leads to diminished or absent sounds in the affected area, rather than the transmission of bronchial sounds. Chronic bronchitis would typically lead to wheezing or decreased air entry but wouldn't specifically cause bronchial breath sounds over a localized area. Therefore, the presence of bronchial breath