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Respiratory sounds, also known as lung sounds or breath sounds, are the specific sounds generated by the movement of air through the respiratory system. [1] 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. [2]
In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields. These fields are intended to correlate with the lung lobes and are thus tested on the anterior (front) and posterior (back) chest walls.
Crackles are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation, and occasionally during exhalation. They are usually heard only with a stethoscope ("on auscultation"). Pulmonary crackles are abnormal breath sounds that were formerly referred to as rales. [2]
Percussion of the lung fields for dullness or hyper-resonance. Auscultation (with a stethoscope) of the lung fields for diminished or unusual breath sounds. Rales or rhonchi heard over lung fields with a stethoscope. As many heart diseases can give pulmonary signs, [20] a thorough cardiac investigation is usually included.
Upon physical examination, breath sounds (heard with a stethoscope) may be diminished on the affected side, partly because air in the pleural space dampens the transmission of sound. Measures of the conduction of vocal vibrations to the surface of the chest may be altered.
The patient may exhibit dysphonia or have diminished breath sounds, and rapid breathing is common. [3] Coughing may be present, [11] and stridor, an abnormal, high-pitched breath sound indicating obstruction of the upper airway can also occur. [12]