Chest auscultation: How to maximize its diagnostic value in lung disease

Chest auscultation is a universally available diagnostic tool that may be under appreciated in these days of 'high-tech' medicine. Abnormal breath sounds are marked by an unusual location, loudness, or pitch. Adventitious lung sounds are discontinuous (crackles) or continuous (wheezes and rhonchi). Fine crackles occur as many small bronchioles - collapsed from fibrosis, pneumonia, or congestion - snap open at once. They are higher-pitched and less intense than coarse crackles, which may be audible throughout inspiration. Often occurring in smaller bronchi, wheezes tend to be polyphonic, higher-pitched, and more intense than rhonchi, which have a monophonic snoring or moaning quality.