"coarse" lung sounds

  1. My preceptor has used a new term that I am not familair with. "Coarse" lung sounds, which are NOT the same as crackles...

    Coarse lung sounds indicate secretions whereas crackles indicate pulmonary edema. Why? Can anyone give more info on these sounds? I've heard of crackles but have never heard of "coarse" lung sounds.

    Thanks for the tips
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    About RNbethy

    Joined: Apr '12; Posts: 119; Likes: 20
    from CA


  3. by   VickyRN
  4. by   GinaCat
    it's very hard learning breath sounds because I noticed that many people call the same things different names. I think she is describing rhonchi. You've probably heard that term?

    Rhonchi is a term (also called "course breath sounds") that usually refers to upper airway congestion. the sound of air passing through secretions, which is best heard in the upper airways. but if it's bad i have heard it described as "scattered rhonchi" which just means you can hear it throughout the lung fields, not necessarily that it exists all the way to the bases. I believe it's heard w/ inspiration AND expiration. kind of a rattling sound.

    Crackles are heard just at the end of expiration (as the lungs expand enough to open up the alveoli). Yes, there are course crackles and fine crackles depending on how much fluid you are hearing. and are typically heard at the bases. obviously the higher you are hearing them, the bigger the problem.

    i hope that helps! i have spent a lot of time studying breath sounds. i was a new grad about a year ago and the vocabulary used among my coworkers was different from what i learned in school. so i understand where you are coming from!
  5. by   classicdame
    I believe it is an old term and rarely used. Ask her if there is another term for that sound because you could not find it described in your text. Ask her to please point it out on a patient if the sound is heard. Try to sound as if you are trying to learn, not criticize. Lung sounds can be intimidating until you hear a bunch and can discern between them. GOOD LUCK
  6. by   BostonFNP
    Unfortunately I still see this documented (and may be guilty of it myself once or twice) quite often, most often used to describe diffuse rhonchous sounds that are not isolated or poorly localizable.

    I agree its not the best way of documenting. I would much rather someone document coarse then CTAB as many students an nurses do as it at least is evidence something was heard.
  7. by   RNbethy
    Thanks for all your replies; they have been very helpful. This explains why I didn't get her question right when she asked me about the "coarse" breath sounds.
    Do you think it would sound rude if I sent an email to my preceptor and ask her:

    Just wondering if those "coarse" breath sounds we documented last day may also be called rhonci? I'm confused with the term "Coarse" because I've never used it before.

    Pls let me know your thoughts I don't want to sound like a know it all, but I want her to know why I may have been thinking the way I was....
  8. by   AgentBeast
    Ronchi are in the Bronchi! To distinguish between Ronchi and Crackles (either fine or coarse) have the patient cough. If the condition improves it's ronchi if it stays the same it's crackles.

    FYI Coarse Crackles is the replacement term for Rales

    and Fine Crackles is the replacement term for Crepitations.