Clinical Utility of Chest Auscultation in Common Pulmonary Disease

What is the typical pitch range of wheezes?

What is the typical duration range of wheezes?

Which of the following lung sounds is typically associated with secretions in large airways?

Which of the following lung sounds is typically associated with abnormal lung tissue?

Which of the following lung sounds is typically associated with bronchitis or atelectasis?

Which of the following lung sounds is typically associated with heart failure?

What is a key characteristic of the 'silent chest' in severe asthma?

What lung condition can be mistaken for wheezing when originating in the neck?

Which technique can help differentiate between true wheezes and laryngeal sounds?

In what lung condition might you hear pleural rubs primarily during expiration?

What is a characteristic feature of rhonchi when assessing abnormal lung sounds?

How can you differentiate transmitted voice sounds from abnormally located bronchovesicular breath sounds?

Which statement about crackles (rales) is correct?

Which of the following conditions can cause crackles?

Which characteristic best describes wheezes?

According to the American Thoracic Society, how should the term 'rhonchi' be used?

Which of the following is NOT a characteristic of adventitious (added) breath sounds?

What is the primary focus of auscultation during a pulmonary examination?

Wheezes: relatively high-pitched (≥400 Hz) with hissing or shrill quality (>80 ms), arise in narrowed airways of asthma, COPD, and bronchitis
Rhonchi: relatively low-pitched (150–200 Hz) with snoring quality (>80 ms), often used to describe sounds from secretions in large airways that may change with coughing

Fine late inspiratory crackles that persist from breath to breath suggest abnormal lung tissue
Crackles in dependent portions of the lungs may occur after prolonged recumbency
Clearing of crackles after coughing or position change suggests inspissated secretions, seen in bronchitis or atelectasis

Wheezes or rhonchi may change with deep breathing or coughing
Beware of the silent chest, in which air movement is minimal, a clinical emergency
Findings predictive of COPD include combinations of symptoms and signs, especially dyspnea and wheezing, plus >70 pack-years of smoking, history of bronchitis or emphysema, and decreased breath sounds

Detection of adventitious sounds is an important focus of the examination, often leading to diagnosis of cardiac and pulmonary conditions
The most common adventitious sounds are crackles (or rales), wheezes, and rhonchi
Crackles can arise from abnormalities of the lung parenchyma (pneumonia, interstitial lung disease, pulmonary fibrosis, atelectasis, heart failure) or of the airways (bronchitis, bronchiectasis)