Laennec, the inventor of the stethoscope, coined the term vesicular breath sound. Vesicular breath sounds are similar in character to the rustling of dry leaves. The expiratory phase is shorter because the breath sounds produced in the latter 2/3 of expiration are mainly composed of high-pitched sounds which are filtered out.

It is soft and low-pitched (low frequency), and the expiratory phase is shorter than the inspiratory phase. Vesicular breath sound is the normal breath sound, heard over most of the lung fields during auscultation. Normal Breath Sounds Vesicular Breath Sounds If you remember this basic concept, we shall discuss the genesis of abnormal sounds in each condition in the subsequent sections of this article. We call this changed (attenuated) sound – vesicular breath sound. While they are conducting through these tissues, some (high) frequencies of sound are absorbed (attenuated) and the character of the sound changes. The bronchial breath sounds produced at the major airways have to travel all across the tissues (through the air in the bronchi, bronchioles, alveolar walls, etc.) to reach the body surface from where we auscultate them. The breath sound normally heard on the chest wall, over the respiratory areas, is vesicular.The breath sound normally produced at the trachea is bronchial.But aren’t we told that the ‘normal’ breath sound is vesicular? Yes, we are. It is most certainly bronchial breath sound. You will know if you have auscultated at the trachea. What is the character of the produced breath sound? The velocity of air in the alveoli is not significant enough to create turbulence and audible sounds on auscultation. It is a common misconception that these alveoli produce these sounds. Are there any abnormal or adventitious sounds?īreath sounds are produced in the major airways – trachea and major bronchi.Is the character of breath sounds normal or abnormal?.Is the intensity of breath sounds high, normal, or low?.While performing auscultation, we need to answer THREE simple questions: It will be a paradox if we expect that patient to breathe harder for a long time! Remember that we tend to examine the respiratory system of a patient in great detail only when we suspect that he has a respiratory disease. Requests for deep breathing should be as infrequent as possible, as they can tire the patient. We can easily carry out auscultation while the patient is breathing normally. If the patient’s chest is hairy, then moistening that chest with warm water might be helpful. This avoidance is to prevent friction sounds that may confuse. We should avoid auscultation through clothes as far as possible.

The stethoscope should be preferably touching the patient’s bare skin.However, we can examine the anterior regions even when the patient is lying down. Preferably in a sitting position, so that all the areas of the chest are accessible for examination. The patient should be in the proper position during auscultation.A quiet environment is desirable as it makes it easier to listen to breath sounds.Let us start by looking at some requirements for effective auscultation: I have used a Littmann 3200 electronic stethoscope for recording most of the breath sounds. Please use headphones for a stethoscope-like experience. Please explore all the audio examples included in this page. You will find the description of various respiratory auscultation findings with audio examples in this article. Auscultation of breath sounds is one of the most essential and useful clinical techniques for evaluating a patient’s respiratory pathology.

Rhonchi lung sounds audio