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R Thomson 209 Useful background: Effect of pulmonary disease on lung sounds Respiratory Mechanisms Origin Acoustics Relevance sound fi Basic sounds o Normal Turbulent Central Low-pass Regional lung move airwys filtered ventilation, sound vortices (expiration), noise airway lobar to (vary < caliber segmental 100 to airway 1,000 Hz) (inspiration) o Normal Turbulent Pharynx, Noise with Upper tracheal move, flow larynx, resonances airway sound impinging trachea, (vary n walls airways three,000 Hz) Lung illness Breath sounds Adventitious lung sound fi Pneumonia o Bronchial or o Inspiratory crackles absent o Harsh/ bronchial o Late inspiratory crackles fi Atelectasis fi Pneumothorax o Absent o None fi Emphysema o Diminished o Early inspiratory crackles fi Chronic bronchitis o Normal o Wheezes and crackles fi Pulmonary fibrosis o Harsh o Inspiratory crackles fi Congestive heart o Diminished o Inspiratory crackles failure fi Pleural effusion o Diminished o None fi Asthma o Diminished o Wheezes Source: Mangione S. 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