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Scorebuilder's Chaper 6

Abnormal Breath Sounds

Sounds that are heard outside of their normal location or phase of respiration (e.g. crackle/rales, pleural friction rub, rhonchi, stridor, bronchial breath sounds, decreased/diminished breath sounds, absent breath sounds, voice sounds)

Adventitious Breath Sounds

Abnormal sounds heard with inspiration and/or expiration that can be continuous or discontinuous


An abnormal, discontinuous, high-pitched popping sound heard often during inspiration. May be associated with restrictive/obstructive respiratory disorders


Often heard at the base of the lungs with interstitial lung disease, atelectasis, pneumonia, bronchioectasis, and pulmonary edema. Typically also represents fibrosis or pleural effusion.

Wet Crackles/Rales

Typically represents the movement of fluid or secretions during inspiration (and/or expiration) and are low-pitched like the sound of hairs being rubbed together

Dry Crackles/Rales

Occurs from the sudden opening of closed airways

Pleural Friction Run

Dry, crackling sound heard during both inspiration and expiration. Occurs when inflamed visceral and parietal pleurae rub together. Heard over the spot where patient feels pleuritic pain.


Continuous, low pitched sound described as having a "snoring/gurgling" quality that may be heard during both inspiration and expiration


Caused by air passing through an airway which is obstructed by inflammatory secretions or liquid, bronchial spasm or neoplasms in the smaller or larger airways


Continuous musical or whistling sound composed of a variety of pitches heard during both inspiration and expiration, but variable from minute to minute and area to area


Arise from turbulent airflow and the vibrations of walls of small airways due to to narrowing by bronchospasm, edema, collapse, secretions, neoplasms or foreign body

Bronchial Sounds

Abnormal when heard in locations where vesicular sounds are normally present. Pneumonia may produce these sounds

Decreased or diminished sounds

A less audible sound may indicate severe congestions, emphysema, or hypoventilation

Absent breath sounds

May indicated pneumothorax or lung collapse

Voice Sounds

Increase in loudness and distinctness of spoken sounds. Include bronchophony, egophony, and whispered pectoriloquy. Indicates consolidation, atelectasis or fibrosis.


Increased vocal resonance with greater clarity and includes spoken words (e.g. "99"). Indicates Consolidation.


A form of bronchophony in which the spoken long "E" changes to a long, nasal sounding "A". Indicates consolidation or pleural effusion

Whispered Pectoriloquy

Recognition of whispered words "1,2,3". Indicates consolidation/interstitial pneumonia.

Normal Breath Sounds

Tracheal and bronchial sounds (over trachea) and vesicular breath sounds

Tracheal and Bronchial Sounds

Loud, tubular sounds normally heard over the trachea. Inspiratory is



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