Do You Have Crackly Lungs? Crackles in the lungs when breathing can be a scary symptom. Surgery: Surgery is typically reserved for severe medical situations in which a tumor needs to be removed or fluid needs to be drained from the lungs. The type of surgery will depend on the underlying pathology. The following are the common goals and expected outcomes for Excess Fluid Volume: Patient is normovolemic as evidenced by urine output greater than or equal to 30 mL/hr. Patient has balanced intake and output and stable weight. Patient maintains HR 60 to 100 beats/min. Patient has clear lung sounds as manifested by absence of pulmonary crackles.
There are many conditions and diseases that afflict the respiratory system. To go along with these issues, there are specific medical terms that you will need to know. Check out the following to get going.
Common respiratory conditions
Of all the most common respiratory conditions, the bronchial tubes get the big daddy: asthma. Asthma is attacks of paroxysmal dyspnea (sudden onset of wheezing and difficulty breathing) with airway inflammation and wheezing due to contraction of the bronchi, leading to airway obstruction if severe enough. The condition affects millions of people of all ages.
Asthma comes from the Greek astma, meaning “to pant.”
The lungs have all sorts of wild and wacky conditions associated with them. Atelectasis, for example, is the imperfect expansion of air sacs of the lungs. Emphysema is the distention of the alveoli with swelling and inflammation of lung tissue.
Crackling In Lungs After Pneumonia
Pneumonia is the acute inflammation and infection of the alveoli. A couple of different varieties exist: Lobar pneumonia involves distribution of infection in one or more lobes of a lung, whereas pneumocystis carinii pneumonia (PCP) is an infectious disease caused by P. carinii, the infectious agent. It is fungal in origin and is common in AIDS patients.
Pneumonia can be distributed in different ways, for example, confining itself to only one lobe, as is often the case with a viral infection, versus presenting a “cotton-wool” appearance on x-ray, with scattered white spots throughout the lungs, as with PCP. It can be caused by many different infectious agents such as viruses, bacteria, and what are known as atypical agents, such as Mycoplasma, a common cause of pneumonia in teenagers and young adults.
When you breathe, you don’t just breathe in air. Sometimes foreign particles sneak in. Dust is the most common culprit. Pneumoconiosis is an abnormal condition of dust in the lungs. Differing types of pneumoconiosis include the following:
- Anthracosis: Coal dust (black lung disease)
- Asbestosis: Asbestos particles in lungs
- Silicosis: Silica dust or glass (grinder’s disease)
Speaking of foreign matter hanging out in the lungs, the pleura (that membrane that covers the lungs) can also be affected by foreign matter, namely fluid. Pleurisy is an inflammation of the pleura. Pleural effusion is the escape of fluid into the pleural cavity.
Examples of a pleural effusion include empyema and Hemothorax, which is blood in the pleural cavity typically caused by a trauma, and is not quite as common but obviously a serious problem — just ask anyone who works in the ER. Other greatest hits of pleural effusion include lung malignancy and congestive heart failure, due to the increased pressure of blood backing up in the pulmonary vessels.
But wait! There’s more fluid and pus! It can be a pusapalooza in those lungs, and can often develop into very serious conditions, like these three:
- Pulmonary abscess: Localized area of pus formation in the lungs
- Pulmonary edema: Swelling and fluid in the air sacs and bronchioles, caused by poor blood supply to the heart muscle
- Pulmonary embolism: Floating clot or other material blocking the blood vessels of the lung
There is such a great chance for foreign particles, dust, or communicable disease, the lungs and its buddies are susceptible to a wide range of conditions. Here are some more examples: Elementos de estadistica descriptiva miguel gomez pdf descargar.
- Adenoiditis: Inflammation of the adenoids
- Atelectasis: Incomplete expansion of the lungs
- Bronchiectasis: Dilatation of the bronchi
- Bronchitis: Inflammation of the bronchi
- Laryngitis: Inflammation of the larynx
- Laryngotracheobronchitis: Croup
- Pneumothorax: Air between the lung and chest wall
- Pulmonary neoplasm: A new growth in the lung, which can be malignant or benign depending on the composition
- Rhinitis: Inflammation of mucous membranes of nose
- Tonsillitis: Inflammation of the tonsils
- Tracheitis: Inflammation of the trachea
Respiratory diseases and pathology
One of the most frightening respiratory diseases is tuberculosis, also known as TB. Because of its communicable nature, this infectious disease, which is caused by acid-fast bacilli spread by inhalation of infected droplets, always causes a commotion when reported to health officials.
So much so, in fact, that before antibiotics, hospitals built solely for the treatment of TB were quite common. TB is a bit more under control today and is treated with a specific antibiotic regime, usually over a long-term (6-month) period.
Diphtheria is another infectious disease of the upper respiratory tract, affecting the throat. Influenza, that pesky flu, is a highly infectious respiratory disease that is viral in origin. Though for most people nowadays it involves some time off work and chicken soup, the flu can be deadly if not treated, or in high-risk groups like small children and the elderly. Legionnaires’ disease is a form of lobar pneumonia caused by the bacterium Legionella pneumophilia.
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Tired yet? Hang in there. There are a few more respiratory diseases you should know. Here’s the lowdown:
- Adult respiratory distress syndrome (ARDS) is respiratory failure in an adult as a result of disease or injury.
- Bronchogenic carcinoma is a cancerous tumor arising from the bronchus. This tumor can metastasize (spread) to brain, liver, and other organs.
- Chronic obstructive pulmonary disease (COPD) refers to any persistent lung disease that obstructs the bronchial airflow. Examples include asthma, chronic bronchitis, and emphysema.
- Cor pulmonale is a serious cardiac disease associated with chronic lung disorders such as emphysema.
- OSA, or obstructive sleep apnea, occurs when the pharynx collapses during sleep leading to absence of breathing.
- Pulmonary edema means fluid accumulation in the alveoli and bronchioles.
- Pulmonary embolism is a blood clot, fat clot, or air carried in blood circulation to pulmonary artery where it blocks the artery.
- URI is upper respiratory tract infection of pharynx, larynx, and trachea. LRI (lower respiratory infection) usually refers to an infection of everything that’s left — bronchi and lungs. It’s hard to have a LRI without the URI, but you can have the URI by itself.
Respiratory sounds | |
---|---|
Other names | Breath sounds, lung sounds |
1) area for normal tracheal sound, 2) area for ascultation of upper lung fields, 3) area for normal bronchial sound. Blue marks ascultation area and red line marks heart. | |
Specialty | Respirology |
Respiratory sounds refer to the specific sounds generated by the movement of air through the respiratory system. These may be easily audible or identified through auscultation of the respiratory system through the lung fields[1] with a stethoscope as well as from the spectral chacteristics of lung sounds.[2] These include normal breath sounds and adventitious or 'added' sounds such as rales, wheezes, pleural friction rubs, stertor and stridor.
Description and classification of the sounds usually involve auscultation of the inspiratory and expiratory phases of the breath cycle, noting both the pitch (typically described as low, medium or high) and intensity (soft, medium, loud or very loud) of the sounds heard.
- 1Abnormal breath sounds
Abnormal breath sounds[edit]
Common types of abnormal breath sounds include the following:[3]
Name | Continuous/discontinuous | Frequency/Pitch | Inspiratory/expiratory | Quality | Associated conditions | Example | |||
---|---|---|---|---|---|---|---|---|---|
Wheeze or rhonchi | continuous | high (wheeze) or lower (rhonchi) | expiratory or inspiratory | whistling/sibilant, musical | Caused by narrowing of airways, such as in asthma, chronic obstructive pulmonary disease, foreign body. |
| |||
Stridor | continuous | high | either, mostly inspiratory | whistling/sibilant, musical | epiglottitis, foreign body, laryngeal oedema, croup |
| |||
Inspiratory gasp | continuous | high | inspiratory | whoop | pertussis (whooping cough) | see New England Journal of Medicine, Classic Whooping Cough sound file, Supplement to the N Engl J Med 2004; 350:2023-2026 | |||
Crackles (aka crepitations or rales) | discontinuous | high (fine) or low (coarse), nonmusical | inspiratory | cracking/clicking/rattling | pneumonia, pulmonary edema, tuberculosis, bronchitis |
| |||
Pleural friction rub | discontinuous | low | inspiratory and expiratory | nonmusical, many repeated rhythmic sounds | inflammation of lung linings, lung tumors | not available | |||
Hamman's sign (or Mediastinal crunch) | discontinuous | neither (heartbeat) | crunching, rasping | pneumomediastinum, pneumopericardium | not available |
Continued[edit]
- Rales: Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person breathes in (inhales). They are believed to occur when air opens closed air spaces. Rales can be further described as moist, dry, fine, and coarse.
- Rhonchi: Sounds that resemble snoring. They occur when air is blocked or air flow becomes rough through the medium-sized airways, most often with secretions. Since the mid-1990s, it has no longer been considered appropriate terminology in auscultation of the thorax, as much confusion has been reported in the published literature which confuses this with crepitations and wheezes, so the exact nature of this term is unclear.
- Stridor: Wheeze-like sound heard when a person breathes. Usually it is due to a blockage of airflow in the windpipe (trachea) or in the back of the throat.
- Wheezing: High-pitched sounds produced by narrowed airways. They are most often heard when a person breathes out (exhales). Wheezing and other abnormal sounds can sometimes be heard without a stethoscope.[4]
Other tests of auscultation[edit]
Pectoriloquy, egophony and bronchophony are tests of auscultation. For example, in whispered pectoriloquy the person being examined whispers - typically a two syllable number as the clinician listens over the lung fields. The whisper is not normally heard over the lungs, but if heard may be indicative of pulmonary consolidation in that area. This is because sound travels differently through denser (fluid or solid) media than the air that should normally be predominant in lung tissue. In egophony, the person being examined continually speaks the English long-sound 'E'. The lungs are usually air filled, but if there is an abnormal solid component due to infection, fluid, or tumor, the higher frequencies of the 'E' sound will be diminished. This changes the sound produced, from a long 'E' sound to a long 'A' sound.
History[edit]
In 1957, Robertson and Coope proposed the two main categories of adventitious (added) lung sounds. Those categories were 'Continuous' and 'Interrupted' (or non-continuous).[5] In 1976, the International Lung Sound Association simplified the sub-categories as follows:
- Continuous
- Wheezes (>400 Hz)
- Rhonchi (<200 Hz)
- Discontinuous
- Fine crackles
- Coarse crackles[6][7]
Several sources will also refer to 'medium' crackles, as a crackling sound that seems to fall between the coarse and fine crackles. Crackles are defined as discrete sounds that last less than 250 ms, while the continuous sounds (rhonchi and wheezes) last approximately 250 ms. Rhonchi are usually caused by a stricture or blockage in the upper airway. These are different to stridor.
References[edit]
- ^Respiratory+sounds at the US National Library of Medicine Medical Subject Headings (MeSH)
- ^Sengupta, Nandini; Sahidullah, Md; Saha, Goutam (August 2016). 'Lung sound classification using cepstral-based statistical features'. Computers in Biology and Medicine. 75 (1): 118–129. doi:10.1016/j.compbiomed.2016.05.013. PMID27286184.
- ^Bohadana, Abraham (February 20, 2014). 'Fundamentals of Lung Auscultation'. New England Journal of Medicine. 370 (8): 744–751. doi:10.1056/NEJMra1302901. PMID24552321.
- ^'Breath sounds: Medline Plus'. NIH. Retrieved 5 May 2015.
- ^Robertson, A (1957). 'Rales, rhonchi, and Laennec'. Lancet. 2: 417–23. doi:10.1016/S0140-6736(57)92359-0.
- ^American Thoracic Society Ad Hoc Committee on Pulmonary Nomenclature (1977). 'Updated nomenclature for membership reaction'. ATS News (3): 5–6.
- ^Loudon, R; Murphy, R (1984). 'Lung Sounds'. Am Rev Respir Dis.
Mansy, H.A., Royston, T.J., Balk, R.A. et al. Med. Biol. Eng. Comput. (2002) 40: 526. https://doi.org/10.1007/BF02345450
External links[edit]
Classification |
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External resources |
- Audio Breath Sounds - Multiple case studies with audio files of lung sounds.
- R.A.L.E. Repository - sound files of breath sounds
- MEDiscuss - Respiratory auscultation with audio examples
- Wilkins R, Dexter J, Smith J (1984). 'Survey of adventitious lung sound terminology in case reports'. Chest. 85 (4): 523–5. doi:10.1378/chest.85.4.523. PMID6705583.
- Lehrer, Steven. Understanding Lung Sounds. Elsevier 2002.
- Lung Sounds - 20 recordings and waveforms
Medical Terms For Lung Sounds
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