Breath Sounds

Breath Sounds

A stethoscope is used to determine the quality, character and intensity of breath sounds, vocal resonance and adventitious sounds.Normal breath sounds

Normal breath sounds are of two types: (1) over the trachea, and (2) over lung tissue. Two tracheal sounds are heard: (1) on inspiration of low pitch, and (2) on expiration - at a higher pitch and for longer. The two are separated by a pause, and are blowing in quality. The stethoscope diaphragm is placed near the root of the neck. Two lung tissue sounds are heard:
1 On inspiration - A 'wind through trees' sound heardthroughout inspiration.
2 On expiration - A very short low pitched sound or no sound at all.
There is no pause between the two and they are rustling in quality. They are often referred to as vesicular breath sounds. The stethoscope diaphragm is placed on various parts of the chest wall, covering each side equally Abnormal breath sounds

• Tracheal breath sounds heard over lung tissue areas (often referred to as bronchial breathing). This is due to transmission of these sounds by fluid or consolidation (e.g. in pneumonia). The sound is muffled by pleural effusion.
• Absence of lung tissue sounds occurs when transmission of sound is impeded (e.g. in pneumothorax, lung tissue collapse or pleural effusion). In severe asthma airflow obstruction may be so extensive as to prevent transmission of breath sounds and this is known as 'silent chest'.

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