User:B12Braggart/Respiratory sounds
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[edit]Respiratory sounds refer to the specific sounds generated by the movement of air through the respiratory system[citation needed]. These may be easily audible or identified through auscultation of the respiratory system through the lung fields with a stethoscope as well as from the spectral characteristics of lung sounds. These include normal breath sounds and adventitious or "added" sounds such as crackles, wheezes, pleural friction rubs, stertor, and stridor.
Description and classification of the sounds usually involve auscultation of the inspiratory and expiratory phases of the breath cycle, noting both the pitch (typically described as low (≤200hz), medium or high (≥400hz)) and intensity (soft, medium, loud or very loud) of the sounds heard[1].
Article body
[edit]Normal breath sounds
[edit]According to the Bates' Guide to Physical Examination and History-Taking 11th ed., normal breath sounds are classified as vesicular, bronchovesicular, bronchial or tracheal based on the anatomical location of auscultation[2].
| Name | Location where heard normally | Quality of Sound | Sound Duration | Graphical representation | 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 equivalent to inspiratory sound | ||
| vesicular | over most of both lungs | soft, low pitched | expiratory sound duration is shorter than inspiratory sound |
Abnormal breath sounds
[edit]Common types of abnormal breath sounds include the following:
Other tests of auscultation
[edit]Pectoriloquy, egophony and bronchophony are tests of auscultation that utilize the phenomenon of vocal resonance[1]. 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 - typically a two syllable number as the clinician listens over the lung fields. The whisper is not normally heard over the lungs, but if heard may be indicative of pulmonary consolidation in that area. This is because sound travels differently through denser (fluid or solid) media than the air that should normally be predominant in lung tissue. In egophony, the person being examined continually speaks the English long-sound "E" (/i/). The lungs are usually air filled, but if there is an abnormal solid component due to infection, fluid, or tumor, the higher frequencies of the "E" sound will be diminished. This changes the sound produced, from a long "E" sound to a long "A" sound (/eɪ/).
Nomenclature
[edit]- ^ a b Zimmerman, Barret; Williams, Donna (2021), "Lung Sounds", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30725938, retrieved 2021-11-11
- ^ Bickley, Lynn S (2013). Bates' Guide to Physical Examination and History-Taking. Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 311–312. ISBN 978-1609137625.