15/01/2026
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π« Adventitious Lung Sounds
Adventitious lung sounds are abnormal breath sounds heard on auscultation.
They usually indicate an underlying lung or airway pathology.
πΉ Crackles (Rales)
β Discontinuous, high-pitched popping sounds
β Heard mostly during inspiration
β Why they occur
β Air moving through fluid-filled alveoli
β Sudden reopening of collapsed alveoli
β Types
β Fine crackles β Soft, hair-rubbing sound
β Coarse crackles β Louder, bubbling / gurgling sound
β Common causes
β Pneumonia
β Pulmonary edema
β ARDS (Acute Respiratory Distress Syndrome)
β Heart failure
πΉ Wheeze
β Musical, high-pitched whistling sound
β Predominantly expiratory
β May be inspiratory in severe airway obstruction
β Why it occurs
β Narrowing of airways due to
β Bronchospasm
β Mucosal edema
β Airway inflammation
β Common causes
β Asthma
β Bronchospasm
β COPD
πΉ Rhonchi
β Low-pitched, continuous, snoring-like sound
β Why it occurs
β Airflow through thick secretions
β Obstruction in large airways
β Key feature
β Often clears or changes after coughing
β Common causes
β Chronic bronchitis
β COPD
πΉ Pleural Friction Rub
β Harsh, grating, creaking sound
β Heard during both inspiration and expiration
β Why it occurs
β Inflamed parietal and visceral pleura rubbing together
β Clinical clues
β Often painful
β Pain worsens with deep breathing
β Common causes
β Pleuritis
β Pneumonia with pleural involvement
β Pulmonary embolism
β Early pleural effusion (before significant fluid accumulation)
πΉ Stridor π¨
β High-pitched, harsh sound
β Usually inspiratory
β May be biphasic depending on level of obstruction
β Why it occurs
β Upper airway obstruction at or above vocal cords
β Medical emergency sign
β Common causes
β Croup
β Epiglottitis
β Foreign body aspiration
β Laryngeal edema (e.g., anaphylaxis)
β High-Yield Clinical Tip
β Crackles β Think alveoli + fluid
β Wheeze β Think narrowed airways
β Rhonchi β Think secretions in large airways
β Pleural rub β Think inflamed pleura
β Stridor β Think upper airway emergency