| Type |
Characteristic |
Intensity |
Pitch |
Description |
Location |
| Normal |
tracheal
tracheal
|
loud |
high |
harsh; not routinely auscultated |
over the trachea |
| vesicular |
soft |
low |
.
|
most of the
lungs |
bronchial
normal
|
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)
crackle1
coarse crackles
fine 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
wheeze1
wheeze2
asthma
|
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
stridor |
. |
inspiratory |
musical wheeze that suggests
obstructed trachea or larynx; medical emergency |
heard loudest
over trachea in inspiration |
pleural
rub
pleural rub 1
pleural rub 2
|
. |
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 |
| |
