Overview
- Breath sounds are normally heard on auscultating the chest, and their intensity and character can be used to assess for the presence of pulmonary pathology.
How to Assess
- Ask the patient to take deep breaths in and out through their mouth. Auscultate from left to right, noting symmetry of breath sounds.
- Auscultate the chest anteriorly and posteriorly, as well as in the axillae and supraclavicular fossae.
Types of Breath Sounds
- Vesicular breath sounds - soft, non-musical, heard in inspiration and early expirationNormal breath sounds
- Bronchial breath sounds - hollow sounds similar to those normally heard over the tracheaConsolidation or fibrosis
Reduced Breath Sounds
Listen For
- Reduced intensity of breath sounds, either focally or generally over the chest.
Causes of Decreased Breath Sounds
- Shallow breathing - e.g. due to anxiety or CNS depression
- Obstruction - foreign body, tumour, asthma, COPD
- Pleural effusion
- Pneumothorax
- Obesity
Bronchial Sounds
Listen for
- Hollow breath sounds, similar to those normally heard over the trachea.
Significance
- Created by a patent airway surrounded by consolidated or otherwise hyperdense lung tissue.
Causes of Bronchial Breath Sounds
- Pneumonia
- Atelectasis (e.g. an area above a pleural effusion)
- Pulmonary fibrosis
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