Lung sounds chart how to#

If you hear it loud and clear their, then the noise you heard in the lower airways was this same sound. To hear this noise, all you have to do is take your stethoscope and set it over the throat. ( Dana Oakes, 'Clinical Practitioner's Pocket Guide to Respiratory Therapy,' describes it this way). However, some RT books describe stridor as any noise inspiratory and expiratory that is heard in the throat. Only, it usually gets charted as a wheeze, so no one ever talks about it. And, despite contrary belief, it is a common lung sound in adults too. It can be the result of croup or post extubation. It is usually caused because of swelling near the vocal cords. Stridor is usually an audible inspiratory high-pitched sound. As I wrote in my last post, any lung sound that is audible is not a wheeze: it is rhonchi. Sometimes these secretions are embedded by the vocal cords, and produce an audible sound. However, sometimes those secretions are further embedded in the upper airway, and this causes the COARSE sound you hear.

You have the patient cough and usually this goes away. Rhonchi can also produce a bubbly sound over the throat and upper airway, which almost sounds like fluid is in there. Yet, three weeks later and after the insurance company is out $10,000 because of useless breathing treatments, the patient still has those treatments ordered.Īnd all of that because the doctor heard rhonchi and had no idea it was not a wheeze. Yet, as soon as the RT does the STAT breathing treatment, the patient feels no better and the peek flow is the same before and after. Even many doctors chart this is coarse or as a wheeze and assume it is bronchospasm. This is probably the toughest lung sound to pick out because it's not taught very well in school. What you are hearing is secretions rumbling on inspiratoin and expiration. In a lot of patients you have that loud sound on inspiratory and expiratory.

If you are charting coarse, you should actually be charting rhonchi. How do you best describe this sound? a) a wheeze b) rhonchi c) crackles d) a and c.ĭo you want to know what the answer was? It was (drum roll please) 'b' rhonchi. There was a practice NBRC test that asked this question: You are listening to lung sounds and you hear a coarse sound throughout on inspiration and expiration. Today I want to discuss rhonchi and coarse. And because it comes from the small bronchial tubes in the lungs, it is NEVER heard audibly. The low pitched coarseness of rhonchi is usually in the upper, larger airways where sound travels better, and it produces a noise that is more easily heard.Ī wheeze, for definition purposes, is not a low pitched coarse sound but high pitched whistling sound. Why do I say this? Because rhonchi is usually heard over a wheeze and is usually hard throughout the lungs. But if it's continuous throught all the lungfields, it is probably not a wheeze. if you can isolate it to one particular lobe, its more likely a wheeze. The majority of the time, however, a coarse wheeze is actually rhonchi. But, so, where is it? RUL? RML? RLL? LUL? LLL? It could be a coarse wheeze or coarse rhonchi. What is coarse? Is it a coarse wheeze? Is is rhonchi? Actually, it could be both. Allow me to share this information with you: there is no such lung sound as coarse. On a side note, someone in my RT department (we won't name names) keeps charting 'Coarse' under lungsounds. Some books say that a crackle is either fine, medium or coarse, while others say it's rhonchi, rhales and fine crackles.

To be fair, however, different books can describe the same sounds differently.

Lung sounds chart how to#

I know this might sound hilarious, but there are some people who have listened to lungs for 20 years and still have no clue how to describe them. The rest of this week I thought I would discuss some of the basic lungsounds.