Abnormal and Adventitious Sounds

Crackles/rales Fine, crackle-like sounds, usually on inspiration

• Alveolar High pitched
• Bronchial Low pitched
Rhonchi Coarse, harsh, over fluid (usually on expiration)
Wheezes Squeaky, musical on inspiration or expiration
Friction rub Grating sound of pleurae rubbing together, generally on the
anterior side
Assessment Questions Regarding Respiratory
Status
Time Pattern
• When did the breathing sound start?
• How long did it last?
• Is there a pattern to the occurrences?
Quality
• How would you describe it?
Relieving factors
• What makes it better?
Aggravating factors
• What makes it worse?
Other
• What other symptoms are also present?
• Is there any coughing?
• Is there any difficulty breathing?

Abnormal Breath Sounds

• Chest X-ray
• Pulmonary function tests
• Blood tests (including an arterial blood gas)
• CT scan of the chest
• Analysis of a sputum sample