Lung Sounds

I'm sorry, but those terms are only used in nursing school and thus best defined by--textbooks. If I asked anyone where I worked, MD's or RN's (excluding pulmonologists) what a vesicular breath sound was, no one would know. And I fully admit I would have to look it up in my textbooks as well.

In the real world, you describe lung sounds as clear, essentially clear, rhonchi, wheezing on inspiration or expiration or both, or rales (crackles) in the bases.

Although, now that this has been brought up, just to show off and make others think I know something they don't, I'm going to look up those definitions and start putting them on my assessment flowsheet. Even better, when asked, I'm going to say something like, "You know, vesicular..." and then just walk away and get some coffee.

ok.....rales and crackles are completely different though

ok.....rales and crackles are completely different though

Nope. Rales is the old name for crackles (and I always use rales because crackels sounds too gross). They result from the delayed reopening of deflated airways and sound just like, well, Rice Crispies and milk. Usually from fluid collecting in the lower bases r/t pneumonia or CHF.

sorry i confused rhonchi with rales. Rhonchi sounds like snoring. My bad!

I do that sometimes too. Interestingly, the modern med/surg book I used to define "rales" no longer mentions rhonchi as an adventitious breath sound and yet it's used all the time in clinical practice, as I'm sure you know. In a real old Fundamentals of Nursing book I have, rhonchi is basically described as you described it and also says that it is often cleared with coughing. I use it all the time to indicate a tracheal kind of congestion that a person loses when they cough.

We were taught that vesicular is just a fancy schmancy way of saying Lung sounds are clear.

We were taught that vesicular is just a fancy schmancy way of saying Lung sounds are clear.

Exactly, that's why I'm going to start using it. I think I'll note it like this:

"Lungs vesicular in all fields." Just the idea that I make others run to a dictionary before arguing with me makes me feel warm all over.

Exactly, that's why I'm going to start using it. I think I'll note it like this:

"Lungs vesicular in all fields." Just the idea that I make others run to a dictionary before arguing with me makes me feel warm all over.

i like the way you think

could someone put bronchovesicular and vesicular breathe sounds in an easier explanation than a text book can provide?

tracheal breath sounds are heard over the trachea. these sounds are harsh and sound like air is being blown through a pipe.

bronchial sounds are present over the large airways in the anterior chest near the second and third intercostal spaces; these sounds are more tubular and hollow-sounding than vesicular sounds, but not as harsh as tracheal breath sounds.

bronchovesicular sounds are heard in the posterior chest between the scapulae and in the center part of the anterior chest. bronchovesicular sounds are softer than bronchial sounds, but have a tubular quality.

vesicular sounds are soft, blowing, or rustling sounds normally heard throughout most of the lung fields.

to put this all in easier terms- the larger the airway is where you're listening, the louder and higher pitched the sounds will be. so these terms really refer not as much to what you're hearing, but where you're hearing it. but like previous posters said, these terms are not usually used in "the real world" of nursing. what you really need to know are rhonchi, crackles, wheezes and clear vs. diminished (and what each of those mean for the patient)

In the reality of daily practice I start dividing up breath sounds into clear or not clear.

If not clear, it is usually from rhonchi, crackles(hard to hear with those cheapy disposable stethecopes in the rooms) and wheezes.

The textbooks have a way of making simple things sound much harder than they are.

wow. thanks! I do remember learning that it is those terms are WHERE, now that you mention it!

Here is the best way to learn lung sounds: listen to everyone you can!

And here is a website with actual sounds for you to listen to.

http://www.rale.ca/

Good luck. You'll get better with a little practice.