Breath Sounds

Stridor

A continuous adventitious sound comprised of a very high-pitched wheeze that can be heard with inspiration and expiration and also indicated upper airway obstruction. If heard without a stethoscope can indicate an emergency.

Crackle (Formerly Rale)

A discontinuous adventitious sound heard with a stethoscope that "bubbles" or "pops." Typically represents the movement of fluid or secretions during inspiration (wet) or occur from the sudden opening of closed airways (dry). Those that occur during the latter half of inspiration typically represent atelectasis, fibrosis, pulmonary edema, pr pleural effusion. THose secondary to the movement of secretions are usually low-pitched and can be heard during inspiration and/or expiration.

Decreased or Diminished Sounds

A less audible sound may indicate severe congestion, emphysema, or hypoventilation.

Bronchial Breath Sounds

Abdominal breath sounds when heard in locations that vesicular sounds are normally present. Pneumonia may produce these sounds.

Absent BReath Sounds

Absent lung sounds may indicate pneumothorax or lung collapse.

Rhonchi

These are continuous adventitious breath sounds that are low-pitched and occur with both inspiration and expiration. They are associated with an obstructive process of the larger or more central airways with quality similar to snoring.

Normal Tracheal and Bronchial Sounds

These are loud and tubular sounds with a high-pitch noted during inspiration and expiration, pausing between the two components.

Vesicular Breath Sounds

These are normal, soft, and low-pitched sounds heard over the more distal airways primarily during inspiration. During expiration the soft sound id diminished and only heard during the beginning of expiration.

Abnormal Breath Sounds

Sounds heard outside of their normal location or phase of respiration.

Adventitious Breath Sounds

These are abnormal breath sounds heard using a stethoscope with inspiration and/or expiration. These sounds can be continuous or discontinuous sounds.

Wheeze

These are continuous adventitious breath sounds that are high-pitched and varying in duration. These are usually heard through expiration but may also be present on inspiration. They are typically a sign of airway obstruction from retained secretions or due to bronchoconstriction or bronchospasm with quality similar to whistling. Found with inspiration occur with movement of air through secretions.

Egophony

While auscultating lung segments the patient repeatedly says the letter "E." If when auscultating the distal segments sound like an "A," fluid is expected in the air spaces of lung parenchyma.

Whispering Pectoriloquy

While auscultating lung segments the patient repeatedly whispers words. The clearly audible and less audible words indicate the same findings as bronchophony testing.

Bronchophony

While auscultating lung segments throughout the chest the patient repeatedly says "99." If the word is clearly audible in distal lung fields the test is positive for consolidation. In the word is less audible, softer, or weaker sounding, the test is positive for hyperinflation.