What might you expect to hear upon auscultation of a patient with severe COPD during a physical exam?

In a patient with severe Chronic Obstructive Pulmonary Disease (COPD), auscultation typically reveals decreased breath sounds along with the presence of wheezing. This occurs due to several physiological changes in the lungs associated with COPD, including airway obstruction and inflammation.

The decrease in breath sounds can be attributed to the hyperinflation of the lungs often seen in severe cases, where air becomes trapped during expiration, resulting in less movement of air in and out of the lungs. As airflow becomes limited, particularly during exhalation, the sounds generated are reduced, leading to diminished breath sounds. Additionally, wheezing is a characteristic finding in COPD, resulting from the narrowing of airways and turbulence of airflow, which creates a high-pitched sound during breathing.

Other findings, which may not necessarily occur in this context, include increased breath sounds or rhonchi, which are typically associated with secretions in the airways. In patients with severe COPD, the primary findings are more indicative of obstructive patterns, as airflow limitation predominantly leads to wheezing and decreased breath sounds rather than an increase in overall lung sounds.