Published
That's exactly what it sounded like! I only heard it in the upper lobes though. Both times I've heard it I only heard it there. I think it makes sense that I wouldn't hear it today as there is a lung mass in the lower right lobe of today's patient, but not sure why I wouldn't have heard it on my work patient.
So what is this sound telling me then? Is this related to her CHF? That's a different sound normally.
a pleural friction rub is the abrasive/scraping sound of the pleura's two layers sliding against each other. It usually seen in pleurisy.
Yes. Always on bare skin. I ran EMS for a while so although there was the rare case I didn't do on bare skin, I'm pretty familiar with the fabric rubbing sound. However, hospital gowns are so easy to move out of the way, there really is no excuse not to place the stethoscope on the skin.
It would be fairly unusual to hear a loud pleural rub under normal (non-forced) expiration, as they tend to be more prominent during inspiration. With CHF and large pleural effusions you could hear a rub but likely not at the apex.
I would consider rhonchi vs coorifice crackles/rales as more likely options.
Great site: Learn Lung Sounds
Audio Reference guide:
http://www.easyauscultation.com/lung-sounds-reference-guide.aspx
LCinTraining
308 Posts
I only heard it once before on a patient at work and showing my nurse she didn't hear it. So today at clinical my patient had the same sound. It was an expiratory sound. Deep tone, almost slow rumble. Kind of like a growl. Patient was awake. So not snoring and I did not hear it without auscultation.