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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.
A coin test (or a bell metal resonance) is a medical diagnostic test used to test for a punctured lung. A punctured lung can cause air or fluid to leak into the pleural cavity, leading to, for example, pneumothorax or hydrothorax. In a coin test, a coin held against the chest is tapped by another coin on the side where the puncture is suspected.
A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory airways during breathing. [1] For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened.
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]
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.
Understanding Lung Sounds 3rd edition (2002) by Steven Lehrer is a book and audio CD that guides the student through the skills of lung auscultation. It provides a complete overview of lung examination, anatomy, physiology, and pathology.
Children often present with excessive drooling and stridor (high pitched breathing sounds). [3] Classic triad of choking symptoms in children is coughing, wheezing, and diminished breath sounds, however, a 10-year review showed that this grouping of symptoms was present together in only about 60% of patients. [14]