Breath Sounds

Amongst many tutorials of breath sounds available on net, I found these sounds quite close to reality



Note that we don't much differentiate between wheezes and rhonci now a days and concentrate on wheezes only in video. Crackles here are typical of interstitial lung disease. In the later half of crackles portion a squeak is heard towards the end. This is typical of bronchiolitis accompanying ILD like in BOOP.

No a bit about terminology which is often confusing
Breathsound are divided into Vesicular breath sounds(Normal) and Adventitious breath sounds (abnormal). Adventitious breath sounds are divided in Continuos lung sound(>80 ms) and Discontinuos lung sounds(<20 ms). Continuous lung sounds consist of Wheeze and Rhonchi.
Wheeze is high pitched musical sounds especially produced in the setting of Bronchospasm ,mucosal edema or excessive secretions.
Rhonchi is lowpitched sonorous sound and may have gurgling quality.they originate in larger airways when there is excessive secretions,abnormal airway collapsibility due to repetitive rupture of surfactant film covering alveoli.
Rhonchi frequently clear after cough post tussive clearing. Always ask patient to turn aside and cough if u hear abnormal breath sounds.

Now coming to discontinuos sound those are Crackles or rales
Coarse >10 ms and fine crackles <10 ms. Fine crackles are soft and high piched sounds,crisp in nature,they are formed by explosive opening of small airways, (terminal bronchioles to alveoli) commonly seen in acute pulmonary edema and Interstial lung disease(post tussive rale they donot clear infact become more afer coughing), Coarse crepts are caused by air bubbling through fluid they are loud and low pitched sounds produced in Pneumonia,Bronchiectasis and possibly chronic bronchitis and generally clear or diminish after coughing.