Type |
Characteristic |
Intensity |
Pitch |
Description |
Location |
Normal |
tracheal |
loud |
high |
harsh;
not routinely auscultated |
over the trachea |
vesicular |
soft |
low |
. |
most of the lungs |
bronchial |
very
loud |
high |
sound
close to stethoscope; gap between insp & exp sounds |
over the manubrium (normal) or consolidated areas |
bronchovesicular |
medium |
medium |
. |
normally in 1st & 2nd ICS anteriorly and between scapulae
posteriorly; other locations indicate consolidation |
Abnormal |
absent/decreased |
. |
. |
heard
in ARDS, asthma, ateletasis, emphysema, pleural effusion, pneumothorax |
. |
bronchial |
. |
. |
indicates
areas of consolidation |
. |
Adventitious |
crackles (rales) |
soft
(fine crackles) or loud (coarse crackles) |
high
(fine crackles ) or low (coarse crackles) |
discontinuous,
nonmusical, brief; more commonly heard on inspiration; assoc. w/ ARDS,
asthma, bronchiectasis, bronchitis, consolidation, early CHF,
interstitial lung disease |
may sometimes be normally heard at ant. lung bases after max.
expiration or after prolonged recumbency |
wheeze |
high |
expiratory |
continuous
sounds normally heard on expiration; note if monophonic (obstruction of
1 airway) or polyphonic (general obstruction); assoc. w/ asthma, CHF,
chronic bronchitis, COPD, pulm. edema |
can be anywhere over the lungs; produced when there is
obstruction |
rhonchi |
low |
expiratory |
continuous
musical sounds similar to wheezes; imply obstruction of larger airways
by secretions |
. |
stridor |
. |
inspiratory |
musical
wheeze that suggests obstructed trachea or larynx; medical emergency |
heard loudest over trachea in inspiration |
pleural rub |
. |
insp.
& exp. |
creaking
or brushing sounds; continuous or discontinuous; assoc. w/ pleural
effusion or pneumothorax |
usually can be localized to particular place on chest wall |
mediastinal crunch |
. |
not
synchronized w/ respiration |
crackles
synchronized w/ heart beat; medical emerg.; assoc. w/ pneumomediatstinum |
best heard w/ patient in left lateral decubitus position |
|