Subject: NCM132/ RLE102
Lung Breath Sounds / Adventitious Sounds
BREATH SOUNDS
1. Vesicular Breath Sounds:
2. Bronchial Breath Sounds:
3. Bronchovesicular Breath
Sounds:
CHARACTERISTICS
- Soft, low-pitched, and heard
throughout inspiration and
early expiration. Duration of
inspiration is longer than
expiration.
- Loud, high-pitched, and
heard mainly during
expiration. Inspiratory and
expiratory phases are nearly
equal.
- Intermediate intensity and
pitch, with equal inspiratory
and expiratory phases.
LOCATION
- Heard over most of the lung
fields, except for the upper
portion of the back.
- Normally heard over the
trachea and mainstem
bronchi. Abnormal if heard
in peripheral lung fields,
suggesting consolidation or
compression of lung tissue.
- Typically heard over the
main bronchi and upper
posterior thorax.
IPPA
- Normal vesicular breath
sounds are expected during
auscultation. They indicate
normal air movement
through the smaller airways
and alveoli.
- May indicate consolidation,
atelectasis, or compression of
lung tissue if heard in areas
outside the trachea and
mainstem bronchi.
- Expected over the major
bronchi; abnormal if heard in
peripheral lung fields, which
could suggest pathology such
as pneumonia or early
atelectasis.
-
BREATH SOUNDS CHARACTERISTICS
4. Crackles (formerly known as
Rales):
- Discontinuous, brief,
popping sounds, which can
be fine or coarse.
5. Wheezes:
- Continuous, musical, high-
pitched sounds, which can
be inspiratory or expiratory.
6. Rhonchi: - Continuous, low-pitched,
snoring, or rattling sounds.
LOCATION
- Can be heard during
inspiration and/or
expiration. Fine crackles are
often heard during late
inspiration, while coarse
crackles are heard
throughout inspiration.
- Typically heard during
expiration but can occur
during inspiration.
- Heard mainly during
expiration.
IPPA
- May indicate fluid
accumulation or secretions
in the airways or alveoli,
commonly associated with
conditions like pneumonia,
pulmonary fibrosis, or heart
failure.
- May suggest narrowing of
airways due to
inflammation, constriction,
or mucus accumulation.
Commonly associated with
asthma, COPD, or
bronchitis.
- Often associated with
obstructive conditions such
as bronchitis or bronchial
obstruction due to mucus.
IPPA may reveal coarse,
low-pitched sounds upon
auscultation.
BREATH SOUND CHARACTERISTICS
7. Stridor:
- High-pitched, crowing
sound heard mainly during
inspiration.
8. Coarse Crackles:
- Loud, bubbling,
discontinuous sounds often
likened to the sound of
Velcro being pulled apart.
They occur throughout
inspiration and may persist
into early expiration.
LOCATION
-Typically heard over the upper
airway (trachea or larynx).
- Typically heard over larger
airways during both
inspiration and expiration.
IPPA
- Suggestive of upper airway
obstruction, such as croup,
epiglottitis, or foreign body
aspiration. Inspection may
reveal visible signs of
respiratory distress, such as
retractions or cyanosis.
These detailed descriptions
provide a comprehensive
understanding of each
breath sound's
characteristics, locations,
and their implications
during IPPA assessments.
- Coarse crackles suggest the
presence of large amounts of
fluid or mucus in the
airways or alveoli,
indicating conditions such
as pulmonary edema,
pneumonia, or
bronchiectasis.
BREATH SOUNDS
9. Asthmatic Wheezes:
10. Croup Breath Sounds:
11. COVID-19 Breath Sounds:
CHARACTERISTICS
- High-pitched, musical,
continuous sounds, usually
heard during expiration but
can also occur during
inspiration.
- Harsh, barking cough often
accompanied by inspiratory
stridor.
- Variable, depending on the
severity of respiratory
involvement. May include
LOCATION
- Predominantly heard over
peripheral lung fields.
- is typically heard over the
upper airway (trachea and
larynx).
- Crackles may be heard over
affected lung fields,
typically in the lower lobes.
IPPA
- Wheezes in asthma result
from narrowed airways due
to bronchospasm,
inflammation, and mucus
production. During IPPA,
inspection may reveal signs
of respiratory distress such as
increased respiratory rate and
use of accessory muscles.
- suggests upper airway
obstruction, commonly
caused by inflammation of
the larynx and trachea
(laryngotracheobronchitis),
commonly seen in croup.
Palpation may reveal
subglottic narrowing or
edema.
- Auscultation may reveal
bilateral crackles, indicative of
pulmonary involvement.
Inspection may show signs of
respiratory distress, such as
tachypnea and the use of
accessory muscles. Percussion
may reveal dullness over

BREATH SOUNDS
12. Smoker's Breath Sounds:
crackles, diminished breath
sounds, or normal breath
sounds.
CHARACTERISTICS
- Diminished vesicular breath
sounds or wheezes,
depending on the extent of
smoking-related lung
damage.
LOCATION
- Diffuse, but typically heard
over peripheral lung fields.
consolidated areas.
IPPA
- Diminished breath sounds
may suggest air trapping and
emphysema, while wheezes
may indicate bronchial
constriction from chronic
bronchitis. Inspection may
reveal signs of chronic
respiratory disease such as
barrel chest and cyanosis.
Understanding these specific
breath sounds and their
associated characteristics,
locations, and IPPA findings
can aid in the assessment and
diagnosis of various
respiratory conditions.
Sources:
https://www.youtube.com/@medzcool

https://www.youtube.com/watch?v=VtnMRG0ORLs&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=1

https://www.youtube.com/watch?v=LHqqvrm2j6g&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=2

https://www.youtube.com/watch?v=T4qNgi4Vrvo&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=3

https://www.youtube.com/watch?v=YgDiMpCZo0w&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=4

https://www.youtube.com/watch?v=JSdEK79J4dw&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=5

https://www.youtube.com/watch?v=aSor2XBc9K8&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=6

https://www.youtube.com/watch?v=E9iNwFF6R1Y&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=7
https://www.youtube.com/watch?v=WfkWMfE9VTY&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=8

https://www.youtube.com/watch?v=3Kkp6ZM35As&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=9

https://www.youtube.com/watch?v=7oTfvJff7go&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=10

https://www.youtube.com/watch?v=C1q6ATkMtm0&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=11

https://www.youtube.com/watch?v=5lvo8icHQxc&list=PL3n8cHP87ijAalXtLG2YbDpuwjxuJRR-A&index=13

https://www.medicalnewstoday.com/articles/adventitious-breath-sounds-types-causes-and-locations#types

https://www.ncbi.nlm.nih.gov/books/NBK470309/#:~:text=Eupnea%20refers%20to%20normal%2C%20unlabored,chest%20wall%2C%20and%20respiratory%20muscles.

https://medlineplus.gov/ency/article/007535.htm