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▲{{refimprove|date=May 2015}}
{{Infobox medical condition (new)
| name = Respiratory sounds
| synonyms = Breath sounds, lung sounds
| image =
| caption =
| field = [[Respirology]]
| pronounce =
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| alt =
}}
'''Respiratory sounds''',
Description and classification of the sounds usually involve
== Normal breath sounds ==
Normal breath sounds are classified as vesicular, bronchovesicular, bronchial or tracheal based on the anatomical location of auscultation.<ref name=":0">{{Cite book|last=Bickley|first=Lynn S|title=Bates' Guide to Physical Examination and History-Taking|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|year=2013|isbn=978-1609137625|pages=311–312|language=English}}</ref><ref name=":02">{{Citation|last1=Zimmerman|first1=Barret|title=Lung Sounds|date=2021|url=http://www.ncbi.nlm.nih.gov/books/NBK537253/|work=StatPearls|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=30725938|access-date=2021-11-11|last2=Williams|first2=Donna}}</ref> Normal breath sounds can also be identified by patterns of sound duration and the quality of the sound as described in the table below:<ref name=":0" />
{| class="wikitable"
|+
!Name
!Location where heard normally
!Quality of sound
!Sound duration
!Example
|-
|tracheal
|over the [[trachea]]
|very loud
|expiratory sound duration is equivalent to inspiratory sound
|
|-
|bronchial
|over the [[manubrium]]
|loud, high pitched
|expiratory sound duration is longer than inspiratory sound
|
|-
|bronchovesicular
|anteriorly between the 1st and 2nd intercostal space;
posteriorly in-between the scapulae
|intermediate
|expiratory sound duration is about equivalent to inspiratory sound
|
|-
|vesicular
|over most of both lungs
|soft, low pitched
|expiratory sound duration is shorter than inspiratory sound
|
|}
==Abnormal breath sounds==
Common types of abnormal breath sounds include the following:<ref>{{Cite journal|title = Fundamentals of Lung Auscultation|last = Bohadana|first = Abraham|date = February 20, 2014|journal = New England Journal of Medicine|doi = 10.1056/NEJMra1302901|pmid = 24552321|volume=370|issue = 8|pages=744–751| s2cid=17871815 |url = https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1060&context=internalmedicine_facpub}}<!--https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1060&context=internalmedicine_facpub}}--></ref>
{| class="wikitable"
|-
! Name
! Continuous/discontinuous
! Frequency/
! Inspiratory/expiratory
! Quality
! Common Causes
! Example
|-
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| high (wheeze) or lower (rhonchi)
| expiratory or inspiratory
| whistling/sibilant
| Caused by narrowing of airways, such as in [[asthma]], [[chronic obstructive pulmonary disease]], foreign body.
| {{listen
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| continuous
| high
| inspiratory, expiratory, or both<ref>{{Cite journal |last1=Leung |first1=Alexander K. C. |last2=Cho |first2=Helen |date=1999-11-15 |title=Diagnosis of Stridor in Children |url=https://www.aafp.org/afp/1999/1115/p2289.html |journal=American Family Physician |volume=60 |issue=8 |pages=2289–2296 |pmid=10593320 |issn=0002-838X}}</ref>
| whistling/sibilant
|[[epiglottitis]], foreign body, laryngeal [[oedema|edema]], [[croup]]
| {{listen
| filename = Stridor NP OGG 2.ogg
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| see New England Journal of Medicine, [http://www.nejm.org/action/showMediaPlayer?doi=10.1056%2FNEJMp038243&aid=NEJMp038243_attach_1&area= Classic Whooping Cough sound file], Supplement to the N Engl J Med 2004; 350:2023-2026
|-
| [[Crackles]] (
| continuous
| high (fine) or low (coarse)
| inspiratory
| cracking/clicking/rattling<ref>{{Cite web |title=Breath sounds: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/007535.htm |access-date=2022-05-06 |website=medlineplus.gov |language=en}}</ref>
| pneumonia, pulmonary edema, tuberculosis, bronchitis, heart failure
| {{listen
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|low
|inspiratory and expiratory
|
|inflammation of lung linings, lung tumors
|''not available''
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| [[pneumomediastinum]], [[pneumopericardium]]
| ''not available''
|-
|Grunting
|Continuous
|low
|expiratory
|snoring
|surfactant deficiency, pneumonia, cardiac abnormalities<ref name="Elsevier">{{Citation |last1=McGann |first1=Kathleen A. |title=21 - Respiratory Tract Symptom Complexes |date=2018-01-01 |url=https://www.sciencedirect.com/science/article/pii/B9780323401814000219 |work=Principles and Practice of Pediatric Infectious Diseases (Fifth Edition) |pages=164–172.e2 |editor-last=Long |editor-first=Sarah S. |publisher=Elsevier |language=en |isbn=978-0-323-40181-4 |access-date=2022-05-06 |last2=Long |first2=Sarah S. |editor2-last=Prober |editor2-first=Charles G. |editor3-last=Fischer |editor3-first=Marc}}</ref>
|
|}
===Continued===
*Rales: Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person
*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".<ref
*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.<ref>{{Cite web |title=Stridor: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/003074.htm |access-date=2022-05-30 |website=medlineplus.gov |language=en}}</ref>
*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.<ref>{{cite web | url=https://www.nlm.nih.gov/medlineplus/ency/article/007535.htm | title=Breath sounds: Medline Plus | publisher=NIH | access-date=5 May 2015}}</ref>
==Other tests of auscultation==
[[File:Physical Exam - Stethoscope.jpg|thumb|A clinician auscultating the posterior lung of a patient.]][[Pectoriloquy]], [[egophony]] and [[bronchophony]] are tests of [[auscultation]] that utilize the phenomenon of [[vocal resonance]].<ref name=":02"/> 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
==History==
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:Discontinuous
::Fine crackles
::Coarse crackles<ref>{{cite journal|last1=American Thoracic Society Ad Hoc Committee on Pulmonary Nomenclature|title=Updated nomenclature for membership reaction|journal=ATS News|date=1977|issue=3|pages=5–6}}</ref><ref>{{cite journal|last1=Loudon|first1=R|last2=Murphy|first2=R|title=Lung Sounds|journal=Am Rev Respir Dis|date=1984|volume=130|issue=4|pages=663–73|doi=10.1164/arrd.1984.130.4.663|doi-broken-date=
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 [[stridor]].
==See also==
*[[Imaging Lung Sound Behavior with Vibration Response Imaging]]
==References==
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| MeshID = D012135
}}
*
* [http://www.rale.ca/Recordings.htm R.A.L.E. Repository] - sound files of breath sounds
* [https://web.archive.org/web/20100112111621/http://www.mediscuss.org/content/respiratory-auscultation-tips-audio-mp3-examples-71.html MEDiscuss] - Respiratory auscultation with audio examples
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