"late inspiratory crackles" or "inspiratory and expiratory wheezes") as well as their location, and whether they clear with coughing or not. When describing adventitious sounds, the timing of these sounds in the respiratory cycle should be noted (e.g. Continuous sounds include ronchi and wheezes. Discontinuous adventitious breath sounds include crackles (also called rales). It is important to know where these sounds are normally heard as hearing certain sounds in locations where they are not normally found may signify pathology.Ĭlick on the interactive icon for specific descriptions of these sounds, and for practice listening to these sounds.Ībnormal or adventitious breath sounds may indicate the presence of pathology and are generally divided into two categories: discontinuous and continuous sounds. Normal breath sounds include vesicular, bronchial and bronchovesicular breath sounds. Normal breath sounds are generally softer at the apices and become louder at the bases. Note these characteristics as you listen in different areas. Adventitious breath sounds are abnormal sounds that are heard over a patients lungs and airways. Normal breath sounds differ over various portions of the lungs with regard to intensity, pitch, and relative duration of inspiratory and expiratory phases. Lung sounds are absent over a pneumothorax.Lung sounds may be diminished due to shallow breathing or hyperinflation, pleural disease, mucous plugging or obesity.Lung sounds may be louder in areas where lung tissue is more dense. Note the inspiratory to expiratory ratio.When abnormalities are found, listening to several breaths in that location may be necessary. Listen to inspiration and expiration in each location.Compare sounds in the apices to sounds in the bases. Compare sounds heard on one side to sounds heard in the same location on the opposite side.Auscultate all areas systematically including anterior, posterior, and lateral lung fields.The presence of chest hair may require firmer pressure to eliminate any potential interference. Use the diaphragm of the stethoscope, placed firmly and directly on the skin. Adventitious Breath Sounds added/abnormal sounds heard over lungs and airways such as fine and coarse crackles (rales), wheezes (rhonci), pleural rubs and stridor.
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