Respiratory sounds, also known as lung sounds or breath sounds, are the specific sounds generated by the movement of air through the

respiratory system The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies grea ...

. These may be easily audible or identified through

auscultation Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory system, circulatory and resp ...

of the respiratory system through the lung fields with a

stethoscope The stethoscope is a medicine, medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, with either one or two tubes connected t ...

as well as from the spectral characteristics of lung sounds. These include normal breath sounds and added sounds such as

crackles Crackles are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human or animal with a respiratory disease during inhalation, and occasionally during exhalation. They are usually heard only with a stethosco ...

wheeze A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower ...

s, pleural friction rubs, stertor, and

stridor Stridor () is an extra-thoracic high-pitched breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree. It is different from a stertor, which is a noise originating in the pharynx. Stridor is a physical sig ...

. Description and classification of the sounds usually involve auscultation of the inspiratory and expiratory phases of the breath cycle, noting both the pitch (typically described as low (≤200 Hz), medium or high (≥400 Hz)) and intensity (soft, medium, loud or very loud) of the sounds heard.

Normal breath sounds

Normal breath sounds are classified as vesicular, bronchovesicular, bronchial or tracheal based on the anatomical location of auscultation. Normal breath sounds can also be identified by patterns of sound duration and the quality of the sound as described in the table below:

Abnormal breath sounds

Common types of abnormal breath sounds include the following:

Continued

*Rales: Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person inhales. They are believed to occur when air opens alveoli. Rales can also be described as moist, dry, fine, and coarse. *Rhonchi are coarse rattling respiratory sounds, usually caused by secretions in bronchial airways. The sounds resemble snoring. "Rhonchi" is the plural form of the singular word "rhonchus". *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.

Other tests of auscultation

Pectoriloquy, egophony and bronchophony are tests of

that utilize the phenomenon of vocal resonance. Clinicians can utilize these tests during a physical exam to screen for pathological lung disease. For example, in whispered pectoriloquy, the person being examined whispers 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" ( /i/). 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 ( /eɪ/).

History

In 1957, Robertson and Coope proposed the two main categories of adventitious (added) lung sounds. Those categories were "Continuous" and "Interrupted" (or non-continuous). In 1976, the International Lung Sound Association simplified the sub-categories as follows: :Continuous ::Wheezes (>400 Hz) ::Rhonchi (<200 Hz) :Discontinuous ::Fine crackles ::Coarse crackles Several sources will also refer to "medium" crackles, as a crackling sound that seems to fall between the coarse and fine crackles. Crackles are defined as discrete sounds that last less than 250 ms, while the continuous sounds (rhonchi and wheezes) last approximately 250 ms. Rhonchi are usually caused by a stricture or blockage in the upper airway. These are different from

References

External links

OnTheWard Respiratory Sounds
- Multiple recordings of various respiratory sounds
Audio Breath Sounds
- Multiple case studies with audio files of lung sounds.

- Sound files of breath sounds

- Respiratory auscultation with audio examples * * Lehrer, Steven. Understanding Lung Sounds. Elsevier 2002.
Lung Sounds
- 20 recordings and waveforms {{Physical exam Symptoms and signs: Respiratory system Pulmonology