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Auscultation of Lung Sounds

Scorebuilder's Chaper 6
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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
Crackle/Rales
An abnormal, discontinuous, high-pitched popping sound heard often during inspiration. May be associated with restrictive/obstructive respiratory disorders
Crackles/Rales
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.
Rhonchi
Continuous, low pitched sound described as having a "snoring/gurgling" quality that may be heard during both inspiration and expiration
Rhonchi
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
Wheeze
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
Wheeze
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.
Bronchophony
Increased vocal resonance with greater clarity and includes spoken words (e.g. "99"). Indicates Consolidation.
Egophony
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
Stridor
Obstruction