Auscultation

• Breath sounds

  • Sounds different depending on the location you listen to
  • Normal breath sounds are not exactly the same person to person
• Generation of breath sounds

  Air flowing
• Types of breath sounds


  • Normal
  • Reduced
  • Absent
  • Bronchial
• Crackles

  • Early inspiration= Large airway highly compliant, lose secretions
  • Early to mid inspiration= narrowed airways are less compliant, indicating harsher secretions
  • Late inspirations= opening of poorly compliant bronchioles and alveoli, heavy secretions
  • Expiratory= result of air forcing its way through obstruction
• Crackle types

  • Coarse- bronchiectasis
  • Fine- fibrosing alveolitis
  • Dependant fine crackles- pulmonary oedema
• Wheeze types


  • Inspiration- obstruction
  • Expiration
  • Monophonic- one wheeze, one larger airway effected
  • Polyphonic- multiple airways, smaller more distal airways effected
• Early, middle or late expiration wheeze


  • Early- milder, not as irritated
  • Late- more severe
• Stridor


  High pitched wheeze from disrupted airflow by a larynx or trachea blockage
• Pleural rub


  • Sounds like boots crunching on snow
  • Usually localised
  • Indicates frication from inflammation of pleural surface
• Normal voice sounds


  Low pitched mumble
• Increased (resonant) and decreased voice sounds


  Indicate consolidation
• Upper zone extends down to 4th rib