Differences Between Normal and Abnormal Breath Sounds
NORMAL BREATH SOUND
Normal breath sounds are produced from air vibrations through the airway of the larynx to the alveoli, with a clean nature
• Normal breath sounds:
a) Bronchial: often referred to as "Tubular sound" because this sound is produced by air through a tube, the sound is loud, loud, with soft gusts. The expiration phase can be longer rather than inspiration, and there will be no stop between the two phases. Normal sounds above the trachea or suprasternal notch area.
b) Bronchovesicular: is a combination of bronchial and vesicular breath sounds. His voice was loud and with moderate intensity. Inspiration is as long as expiration. This sound is heard in the thoracic region where the bronchi is closed by the chest wall.
c) Vesicular: sounds soft, smooth, like a breeze. Inspiration is longer than expiration, expiration sounds like a puff.
ADDITIONAL / ABNORMAL VOICES
1. Crackles
Is a different, non-continuous sound due to the delay in reopening the airway that closes. Sounds during: inspiration.
Fine crackles
Sounded during: end of inspiration. Sound character: burst, break.
Cause: air passes through a moist area in the alveoli or bronchioles/closure of a small airway. Sounds like swiped hair.
Crude Krekels
Sounds during: expiration. Sound character: raucous, wet, weak, rough, cut friction sound.
Causes: presence of fluid or secretions in the large airway. Maybe it will change when the client coughs.
2. Wheezing (wheezing)
It is a sound like whistling, continuous, which has a longer duration than krekels. Sounds during: inspiration and expiration, clinically clearer during expiration.
Cause: due to air passing through a narrowed / partially blocked airway. Can be removed by coughing.
With the character of a loud voice, the continuous sound associated with air flow through a narrowed airway (as in asthma and chronic bronchitis). Wheezing can occur due to changes in temperature, allergens, physical exercise, and irritants to the bronchi.
3. Ronchi
Is a deep noise. Sounds during: expiration.
Causes: movement of air through the narrowed airway due to breathing obstruction. Obstruction: obstruction due to secretions, odema, or tumors.
Example: snoring sound.
- Dry Ronchi: an additional sound that sounds continuous especially expiration time with the presence of mucus/secretions in the bronchi. Some are high pitch, for example in asthma and low pitch due to increased secretions in the large bronchi which can also be heard during inspiration.
- Wet Ronchi (crepitation): an additional sound that sounds not continuous at the time of inspiration such as the sound of a dry branch burning, caused by a secret in the alveoli or bronchioles. The wet rash can be smooth, medium and rough. Smooth and moderate Ronki can be caused by fluid in the alveoli for example in pneumonia and pulmonary edema, while rough ronki for example in bronkiekstatis.
Difference between Ronchi and wheezing.
Wheezing comes from the bronchi and bronchioles which are smaller in channels, sounding high-pitched and whistling. It is usually clear in asthma patients.
Ronchi comes from the bronchi and bronchioles that are larger in the canal, have a low voice, sonor. It's usually clear to snoring.
4. Pleural friction rub
Is an additional sound arising from inflammation in the pleura so that the pleural surface becomes rough.
Sound characteristics: rough, wrinkled, accompanied by complaints of pleural pain. Sounds during: end of inspiration and beginning of expiration. Cannot be removed by coughing. Sounds very good on the anterior lateral surface under the thorax.
Sounds like the friction of the fingers firmly near the ear, clearly heard at the end of inspiration and the onset of expiration, and usually accompanied by complaints of pleural pain. This sound can disappear when the breath is held. Often found in pneumonia, pulmonary infarction, and tuberculosis.
