LungSounds

Normal Breath Sounds
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 * Normal breath sounds** are breezy, low pitched sounds with a lengthy inspiratory phase and a shorter expiratory phase. **Normal breath sounds** heard over the posterior lung fields are also called //vesicular breath sounds//.  When heard, they can also be documented as //clear lung sounds//.

Adventitious Breath Sounds

 * Adventitious breath sounds** are heard over //normal breath sounds//. They are either discontinuous, popping sounds (crackles), or continuous, musical sounds (wheezes).  Other terms, //rales// and //rhonchi//, are often used to describe **adventitious breath sounds**, but with inconsistent meanings.

Williams and Hopper (__Understanding Medical-Surgical Nursing__) use these terms **Fine Crackles** **Coarse Crackles** **Wheezes** **Stridor** **Pleural Friction Rub**

Wilkinson and Leuven (__Fundamentals of Nursing__) use the terms **Crackles** **Rhonchi** **Wheezes** **Stridor** **Stertor**

Taber's Dictionary describes **Crackles / Rales** **Rhonchi** **Wheezes** **Friction Rub** media type="custom" key="5377791"

To remain consistent, adventitious sounds that are discontinuous will be referred to as //crackles// and adventitious sounds that are continuous will be referred to as //wheezes//.

Crackles
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 * Crackles** are discontinuous sounds made by the sudden popping open of collapsed or fluid filled small bronchioles or the alveoli. **Fine crackles** can be likened to the sound of hair rubbing together or a fire crackling in the distance.  When present, **fine crackles** are almost always heard at the latter part of inspiration.  **Crackles** caused by fluid are more //moist//.  Moist, or bubbly, **crackles** can be heard either during inspiration or expiration or both.  **Crackles** are often heard in a patient with COPD or atelectasis.

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 * Coarse Crackles** are caused by air moving over secretions. The patient exhibiting coarse crackles has pulmonary congestion.  The speaker in the video refers to coarse crackles as //rhonchi//.  Some nurses use the term //rhonchi// to refer to wheezes.  Many nurses use the term //rales// to refer only to **coarse crackles**, but not to fine crackles.  In keeping with your Med Surg textbook definitions, the term **coarse crackles** is being used.  As you watch the next video, think of these sounds as **coarse crackles** rather than //rhonchi//.

Wheezes
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 * Wheezes** are caused by air moving through constricted airways. Constricted airways occur as a result of bronchoconstriction, fluid narrowing the lumen of the airways, or a combination of both.  Wheezes are musical sounds, and can be either a high pitched whistle or a low pitched whistle.  **Wheezes** of one tone are referred to as //monophonic//.  **Wheezes** of different tones is referred to as //polyphonic//.  **Wheezes** can occur during the expiratory phase, the inspiratory phase, or both phases.  **Random wheezes** are **wheezes** that occur sporadically throughout the respiratory phases.

Stridor

 * Stridor** is caused by severe narrowing of the airways. This narrowing can be the result of bronchoconstriction, mechanical obstruction (choking), or tumor.  **Stridor** can be heard without a stethoscope.  **Stridor** is sometimes likened to the sound made by a crow.

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Notice the chest retractions and nasal flaring

More Lung Sounds Online
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Recognizing Adventitious Lung Sounds
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