Respiratory sounds - Wikipedia, the free encyclopedia

6/24/15, 1:41

Respiratory sounds
From Wikipedia, the free encyclopedia

Respiratory sounds, breath sounds, or lung sounds refer to the specific sounds generated by the
movement of air through the respiratory system. These may be easily audible or identified through

Respiratory sounds

auscultation of the respiratory system through the lung fields[1] with a stethoscope. These include normal
breath sounds and adventitious or "added" sounds such as rales, wheezes, pleural friction rubs, stertor and
stridor.

ICD-10

R06

ICD-9

786.7 (http://www.icd9data.com/getICD9Code.ashx?
icd9=786.7)

Description and classification of the sounds usually involves auscultation of the inspiratory and expiratory
phases of the breath cycle, noting both the pitch (typically described as low, medium or high) and intensity
(soft, medium, loud or very loud) of the sounds heard.

MedlinePlus 007535
(http://www.nlm.nih.gov/medlineplus/ency/article/007535.htm)
MeSH

D012135 (http://www.nlm.nih.gov/cgi/mesh/2009/MB_cgi?
field=uid&term=D012135)

Contents
1 Abnormal breath sounds
1.1 Continued
2 Other tests of auscultation
3 References
4 External links

Abnormal breath sounds

Common types of abnormal breath sounds include the following:[2]
Name

Continuous/discontinuous Frequency/Pitch Inspiratory/expiratory

Wheeze or
continuous
rhonchi

Stridor

continuous

high (wheeze) or expiratory or

lower (rhonchi) inspiratory

high

either, mostly
inspiratory

Quality

whistling/sibilant,
musical

whistling/sibilant,
musical

Associated
conditions
Caused by narrowing
of airways, such as in
asthma, chronic
obstructive
pulmonary disease,
foreign body.

Example
Wheezing
The sound of wheezing as heard with a
stethoscope.
Problems playing this file? See media help.
Stridor
Inspiratory and expiratory stridor in a
13-month child with croup.

epiglottitis, foreign
body, laryngeal
oedema, croup

Problems playing this file? See media help.

Inspiratory
continuous
gasp

high

Crackles
(aka
discontinuous
crepitations
or rales)

high (fine) or low

(coarse),
inspiratory
nonmusical

Pleural
continuous
friction rub

low

inspiratory

whoop

pertussis (whooping
cough)

not available
Crackles
Crackles heard in the lungs of a person
with pneumonia using a stethoscope.

pneumonia,
cracking/clicking/rattling congestive heart
failure

Problems playing this file? See media help.

Hamman's
sign (or
discontinuous
Mediastinal
crunch)

inspiratory and
expiratory

nonmusical, many
repeated rhythmic
sounds

inflammation of lung
not available
linings, lung tumors

neither (heartbeat)

crunching, rasping

pneumomediastinum,
not available
pneumopericardium

Continued
Rales: Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person breathes in (inhales). They are believed to occur when air opens closed air
spaces. Rales can be further described as moist, dry, fine, and course.
Rhonchi: Sounds that resemble snoring. They occur when air is blocked or air flow becomes rough through the large airways.
Stridor: Wheeze-like sound heard when a person breathes. Usually it is due to a blockage of airflow in the windpipe (trachea) or in the back of the throat.
Wheezing: High-pitched sounds produced by narrowed airways. They are most often heard when a person breathes out (exhales). Wheezing and other abnormal sounds can
sometimes be heard without a stethoscope.[3]

Other tests of auscultation

https://en.wikipedia.org/wiki/Respiratory_sounds

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Respiratory sounds - Wikipedia, the free encyclopedia

6/24/15, 1:41

Pectoriloquy, egophony and bronchophony are tests of auscultation. For example, in whispered pectoriloquy the person being examined whispers - typically a two syllable number
as the clinician listens over the lung fields. The whisper is not normally heard over the lungs, but if heard may be indicative of pulmonary consolidation in that area. This is because
sound travels differently through denser (fluid or solid) media than the air that should normally be predominant in lung tissue. In egophony, the person being examined continually
speaks the English long-sound "E". The lungs are usually air filled, but if there is an abnormal solid component due to infection, fluid, or tumor, the higher frequencies of the "E"
sound will be diminished. This changes the sound produced, from a long "E" sound to a long "A" sound.

References
1. Respiratory sounds (https://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Respiratory+sounds) at the US National Library of Medicine Medical Subject Headings (MeSH)
2. Bohadana, Abraham (February 20, 2014). "Fundamentals of Lung Auscultation" (http://www.nejm.org/doi/full/10.1056/NEJMra1302901). New England Journal of Medicine.
doi:10.1056/NEJMra1302901 (https://dx.doi.org/10.1056%2FNEJMra1302901). PMID 24849095 (https://www.ncbi.nlm.nih.gov/pubmed/24849095). Retrieved February 28, 2015.
3. "Breath sounds: Medline Plus" (http://www.nlm.nih.gov/medlineplus/ency/article/007535.htm). NIH. Retrieved 5 May 2015.

External links
Audio Breath Sounds (http://respwiki.com/Breath_sounds) - Multiple case studies with audio files of lung sounds.
R.A.L.E. Repository (http://www.rale.ca/Recordings.htm) - sound files of breath sounds
MEDiscuss (http://www.mediscuss.org/content/respiratory-auscultation-tips-audio-mp3-examples-71.html) - Respiratory auscultation with audio examples
Wilkins R, Dexter J, Smith J (1984). "Survey of adventitious lung sound terminology in case reports". Chest 85 (4): 5235. doi:10.1378/chest.85.4.523
(https://dx.doi.org/10.1378%2Fchest.85.4.523). PMID 6705583 (https://www.ncbi.nlm.nih.gov/pubmed/6705583).
Lehrer, Steven. Understanding Lung Sounds. Elsevier 2002.
Lung Sounds (http://www.practicalclinicalskills.com/lung-sounds.aspx) - 20 recordings and waveforms
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Categories: Abnormal respiration Pulmonology
This page was last modified on 5 May 2015, at 16:06.
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