Normal Breath Sounds
Normal Breath Sounds
Normal Breath Sounds
Duration Insp > exp Insp = exp Insp < exp Insp = exp
Locations Most of lungs 1 & 2 interspaces; interscapular Manubrium; in lobar pneumonia Over trachea
st nd
Adventitious Breath Sounds Crackles/Rales Discontinuous Intermittent, non-musical, brief Like dots in time Fine crackles: soft, high-pitched, brief Coarse crackles: louder, lower in pitch Wheezes/Rhonchi Continuous More than 250 msec, prolonged, musical Like dashes in time Rhonchi: low-pitched w/snoring quality
Trachea Midline
Percussion Resonant
Early LHF
Midline
Resonant
Normal
Normal
Consolidation (lobar pneumonia, pulm edema, pulm hemorrhage) Atelectasis (lobar) Large pleural effusion Pneumothorax COPD
Midline
Dull
Bronchial
Increased
Adventitious sounds None or wheezes, rhonchi, crackles Late inspiratory crackles on lower lungs, wheezes Late inspiratory crackles
Absent Decreased or absent Decreased or absent Decreased or absent Can be obscured by wheezes
None None or pleural rub Pleural rub None unless bronchitis is also present Wheezes, crackles
Asthma
Midline
Resonant to hyperresonant
Decreased