Adventitious Lung Sounds

Introduction

• Adventitious lung sounds are abnormal sounds heard during auscultation.
• Five main types: Crackles, Wheezes, Rhonchi, Stridor, and Pleura Friction Rub.

Key Questions for Identifying Lung Sounds

1. Timing: Occurrence during inspiration, expiration, or both.
2. Pitch: High or low pitched.
3. Nature: Discontinuous (individual sounds) or Continuous.
4. Location: Large Airways (trachea, bronchi) or Small Airways (alveoli, bronchioles).
5. Defining Characteristic: Unique sounds resembling harsh noises, whistling, snoring, etc.

Types of Adventitious Lung Sounds

1. Crackles

• Fine Crackles
  • Heard at the end of inspiration.
  • High-pitched and discontinuous.
  • Located in small airways.
  • Sound like popping or light crackling of a fire.
  • Causes: Congestive heart failure, atelectasis, pneumonia, pulmonary fibrosis.
• Coarse Crackles
  • Occur at the beginning of inspiration, can extend into expiration.
  • Low-pitched and discontinuous.
  • Located in large airways.
  • Sound like gurgling or bubbling, not cleared with coughing.
  • Causes: Heart failure due to pulmonary edema, severe pneumonia, bronchiectasis.

2. Wheezes

• Mainly heard on expiration but present on inspiration.
• High-pitched and continuous.
• Located throughout the respiratory system.
• Sound like squeaky musical whistling.
• Causes: Asthma, COPD, viral respiratory infections.

3. Rhonchi

• Mainly heard on expiration, can be heard on inspiration.
• Low-pitched and loud.
• Continuous, located in large airways.
• Sound like snoring or snorting, can decrease with cough or suction.
• Causes: Bronchitis, pneumonia, COPD.

4. Stridor

• Occurs on inspiration or expiration.
• High-pitched and continuous.
• Located in upper respiratory system (trachea/throat).
• Sound like screeching or squawking.
• Causes: Epiglottitis, croup, anaphylaxis, foreign body obstruction.

5. Pleura Friction Rub

• Occurs on inspiration and expiration.
• Low-pitched, can be discontinuous or continuous.
• Located in pleura layers surrounding lungs.
• Sounds like harsh grating.
• Causes: Pleurisy, pneumonia, pulmonary embolism, tuberculosis, lung cancer.

Conclusion

• Adventitious sounds signal potential respiratory issues and require careful auscultation and proper identification.
• Refer to facility or educational guidelines for classification specifics.

For further learning, additional resources are available in the provided YouTube series link.