Which of the following sounds can typically be heard without the use of a stethoscope?

Lung or breath sounds are the noises a person makes as they breathe in and out. These sounds include regular breathing, but wheezing or crackling can also occur. A doctor may listen to an individual’s lungs to check for underlying health problems.

An individual’s respiratory system comprises many parts, including:

• the lungs
• the airways, such as the trachea and bronchial tubes
• blood vessels and muscles
• the ribs
• the diaphragm

When a person breathes, these parts work together to provide the body with oxygen. During breathing, an individual’s lungs can make a variety of sounds. And while certain lung sounds are typical and indicate that the lungs are working correctly, other lung sounds can indicate an underlying health condition.

This article will explore the different lung sounds and what may be causing them. It also discusses potential treatment options and when to speak with a doctor.

When a doctor listens to a person’s lungs, they note the frequency, intensity, and quality of the sounds they hear. These factors can help them determine whether the sounds from the lungs are regular or not.

Breath sounds can differ depending on where they occur in the respiratory system. Healthcare professionals classify them in the following ways:

• Normal lung or vesicular breath sound: A doctor can hear this sound over most of the chest with a stethoscope, a device for listening to a person’s internal body sounds. Vesicular breath sounds occur when air flows into and out of the lungs during breathing. The sound is soft, low pitched, and rustling in quality. It is also continuous, more intense, and high pitched during inhalation than exhalation.
• Bronchial breath sound: The bronchial breath sound is audible over the trachea as a person breathes out. The sound is loud, hollow, and high pitched. However, if a doctor hears a bronchial breath outside the trachea, it could indicate a health issue.
• Normal tracheal breath sound: A doctor can hear this sound over the trachea. It is very loud, harsh, and high pitched.

Wheezing is a high pitched, continuous sound. A doctor may be able to hear a person wheezing with or without a stethoscope.

Health experts classify wheezes into three groups:

• Monophonic wheezes: This type of wheeze produces one note and occurs during inhalation or exhalation. A monophonic wheeze can have a constant or varied frequency, and it may have a long duration or occur during both phases of respiration.
• Polyphonic wheezes: A polyphonic wheeze has multiple notes and occurs during exhalation. They can also increase in pitch towards the end of exhalation.
• Squawks: A squawk is a brief wheeze that occurs during inhalation.

Wheezing can result from blockages or when a person’s airways become constricted. Causes of wheezing can include:

Crackles, also known as rales, are intermittent sounds generally audible during inhalation. They can sound similar to bubbling, popping, or clicking noises.

Experts define a crackle as:

• Fine: These occur in the small airways and are soft and high pitched. Fine crackles may occur more frequently during a breath than coarse crackles and only happen during inhalation.
• Medium: These result from air bubbling through mucus in the small bronchi — two tubes that carry air from the trachea to the lungs. The bronchi branch off into smaller and smaller passageways, which eventually lead to air sacs called alveoli.
• Coarse: Coarse crackles occur in the larger bronchi tubes and are loud, low pitched, and last longer than fine crackles. They mainly occur during inhalation but can also happen during exhalation.

Crackles occur as a result of small airways suddenly snapping open. They may indicate that a person’s lungs have fluid inside them or are not inflating correctly.

Causes of crackling include:

Rhonchi are low pitched, continuous sounds that sound similar to snoring. They occur due to blockages in the large airways of the lungs.

Rhonchi can occur during exhalation or exhalation and inhalation, but not inhalation alone.

They happen due to the movement of fluid and other secretions in the large airways. This can result from conditions such as asthma and viral infections in the upper respiratory system.

Stridor is a high pitched sound that develops in the upper airway. It mainly occurs when a person inhales and can mostly be audible in the neck.

They develop due to an obstruction in the upper respiratory tract. The sound comes from air squeezing past a narrowed area of the upper respiratory tract.

Causes of stridor include:

• laryngomalacia, where an infant’s larynx tissue is soft and floppy
• vocal cord lesions
• tracheomalacia, a condition that causes the cartilage of an infant’s trachea to be weakened and soft
• bronchomalacia, a condition where an infant has weakened cartilage in their bronchial tubes
• compression due to swelling or lesions

Pleural rub is a creaking, grating, rubbing sound that occurs due to inflamed pleural surfaces rubbing against each other. The pleurae are membranes that cover a person’s lungs and aid respiration.

An individual’s pleurae can become inflamed due to certain health conditions that cause pain or tenderness. Causes of pleural rub include:

• pneumonia
• pulmonary embolism, a blood clot that travels to an artery in the lungs
• malignant pleural disease, a buildup of fluid and cancerous cells that gathers between the chest wall and the lungs
• pleurisy, when the pleurae become inflamed

When a doctor wants to listen to a person’s lungs, they will generally use a stethoscope, which they place on various parts of a person’s chest and back to check for different lung sounds.

They may also tap an individual’s back to listen for nodules or fluid buildup. This technique involves placing the stethoscope below a person’s rib cage and tapping down their back. This helps the healthcare professional listen for any changes in pitch when tapping.

They may also use other listening tools, such as computerized lung sound analysis devices, for diagnosis. Doctors can also request blood tests, CT scans, or X-rays during diagnosis.

The treatment for atypical lung sounds will depend on the cause and severity of their symptoms.

An individual with irregular lung sounds may require antibiotics if there is an infection. Doctors may also recommend anti-inflammatories to treat conditions involving inflammation.

A person with a long-term lung condition may require regular medications or treatments.

If there are more serious symptoms, treatment in the hospital and possibly surgery may be necessary.

Anyone who experiences unusual or atypical lung sounds should speak with a doctor. Certain lung sounds can indicate serious health conditions.

While lung sounds are usually typical, some may indicate a person has an underlying health condition.

If an individual notices any unusual lung sounds, they should speak with a doctor. There are various methods that healthcare professionals can use to determine why irregular lung sounds occur.

Seek urgent medical attention if a person has difficulty breathing or stops breathing.

The sounds a person makes while breathing can be a good indicator of their lung health. Doctors classify these sounds according to their intensity and pitch and whether they occur when breathing in or out.

Bronchial breath sounds are loud, harsh breath sounds with a midrange pitch. They can be normal or abnormal, depending on where the sound emanates from and when it occurs in the breathing cycle.

This article describes what bronchial sounds are and the features that classify them as normal or abnormal. We also list different types of abnormal breathing sounds along with their associated causes and treatments.

Bronchial sounds, or “tubular sounds,” are the type of sounds that a person may make while breathing. Bronchial sounds are loud and harsh with a midrange pitch and intensity.

A doctor will use a stethoscope to listen for sounds. They typically emanate from the following areas:

• the larynx, or voice box
• the trachea, or windpipe
• the bronchi, which are the major air passages of the lungs that diverge from the windpipe

The two main types of breath sounds are bronchial and vesicular. Doctors define these categories based on the sound’s intensity and pitch, as well as the relative duration of its inspiratory and expiratory phases.

It is normal for a doctor to hear bronchial sounds over the trachea as a person breathes out. However, bronchial sounds emanating from other areas could signal an underlying issue with the lungs.

Normal lung tissue, called pulmonary tissue, contains air, which muffles sounds. However, it is possible for the pulmonary tissue to fill with fluid, and fluid conducts sounds more efficiently than air. As such, hearing bronchial sounds within the lungs themselves could signal fluid in the lungs.

Abnormal breathing sounds include:

• Rales: Rales are slight bubbling, clicking, or rattling sounds in the lungs. The sounds occur as incoming air opens up closed air spaces in the lungs. As such, a person may notice these sounds as they breathe in.
• Rhonchi: Rhonchi are harsh, rattling sounds that resemble snoring. They occur as a result of blockage or inflammation of the large airways.
• Stridor: Stridor is a high pitched sound that occurs as a result of blocked airflow in the windpipe or the back of the throat.
• Wheezes: Wheezes are high pitched sounds that occur due to a narrowing of the airways.

There are three types of bronchial breath sounds:

Tubular sounds

Tubular breath sounds are a type of high pitched bronchial breath sound. The following conditions can produce tubular breath sounds:

• Consolidation: Consolidation is the medical term for when air spaces within the lungs fill with liquid.
• Pleural effusion: This condition occurs due to a buildup of excess fluid in the tissue layers surrounding the lungs. Doctors refer to these layers as pleura.
• Pulmonary fibrosis: The hallmarks of this lung disease are damage to and scarring of the lung tissue.
• Atelectasis: People may refer to this as the collapse of a lung or part of a lung.
• Mediastinal tumor: This tumor develops within the mediastinum, which is the area of the chest that separates the lungs.

Cavernous sounds

Cavernous breath sounds are low pitched bronchial breath sounds. Doctors may hear cavernous breath sounds in a person who has one of the following conditions:

• a lung abscess
• cancerous changes in the lung
• lung damage resulting from the condition bronchiectasis

Amphoric sounds

Amphoric respiration is a type of abnormal bronchial breathing that creates a strong reverberating sound with high pitched overtones. It indicates damage to the air sacs within the lungs, which are called the alveoli.

Various health conditions can cause abnormal lung sounds. These conditions include those below.

Pneumonia

Pneumonia is an infection in one or both lungs that causes the alveoli to fill with pus or fluid. The condition can occur as a result of a viral, bacterial, or fungal infection.

The symptoms of pneumonia include:

• a cough, which typically produces yellow, green, or bloody mucus
• shortness of breath
• rapid, shallow breathing
• sharp or stabbing chest pain that worsens when breathing deeply or coughing
• fever
• chills
• nausea and vomiting
• appetite loss
• diarrhea
• fatigue
• confusion

Treatment

The treatment for pneumonia depends on whether the condition is due to a viral, bacterial, or fungal infection.

A doctor may prescribe antibiotics to treat bacterial pneumonia, whereas fungal pneumonia will require treatment with antifungal medication.

Antibiotics are not effective against viral infections. Therefore, a doctor may prescribe antiviral medications to treat cases of viral pneumonia.

Heart failure

Heart failure is a chronic condition in which the heart does not pump enough blood to all areas of the body.

Some possible warning signs of heart failure include:

• shortness of breath
• persistent wheezing or coughing
• increased heart rate
• swelling in the legs, feet, or ankles
• tiredness
• lack of appetite
• nausea
• confusion

Treatment

Some treatment options for heart failure include:

• lifestyle changes, such as dietary and exercise changes
• medications
• devices, such as pacemakers or cardiac resynchronization therapy (CRT) devices
• surgery

Chronic obstructive pulmonary disease (COPD)

COPD is an umbrella term for lung diseases that can restrict airflow in and out of the lungs, causing breathing difficulties.

The symptoms of COPD include:

• frequent wheezing or coughing
• shortness of breath
• difficulty taking a deep breath
• overproduction of mucus, phlegm, or sputum

Treatment

Some treatment options for COPD include:

• medication
• pulmonary rehabilitation
• supplemental oxygen

In addition, a person can help reduce their symptoms by quitting smoking, if applicable, and avoiding secondhand tobacco smoke and other air pollutants.

Bronchitis

Bronchitis is the medical term for inflammation of the bronchial tubes, which carry oxygenated air into the alveoli of the lungs.

Bronchitis can be either chronic or acute. Chronic bronchitis is one of the diseases that sits under the umbrella of COPD.

The symptoms of bronchitis include:

• a cough, which typically produces mucus
• shortness of breath
• wheezing
• a sore throat
• blocked or runny nose
• headaches
• aches and pains
• tiredness

Bronchitis is usually due to a viral infection, but it can also develop as a result of a bacterial infection.

Treatment

The treatment options for bronchitis include:

• fluids
• rest
• acetaminophen to treat fever
• a humidifier to moisten the air
• inhaled medications to alleviate wheezing
• antibiotics to help clear a bacterial infection

A person who experiences concerning breath sounds may wish to ask their doctor the following questions:

• What is causing these sounds?
• Are there treatment options for this condition?
• What actions can I take to help manage the condition?
• Do I require any additional tests to determine the cause of the sounds?

Bronchial breath sounds are loud, harsh breathing sounds with a midrange pitch. Doctors usually associate them sounds with exhalation, as their expiratory length is longer than their inspiratory length.

Bronchial breath sounds are normal as long as they occur over the trachea while the person is breathing out. Sounds that emanate from another location may indicate a problem with the lungs.

There are three types of abnormal bronchial breath sounds: tubular, cavernous, and amphoric. Other abnormal breath sounds include rales, rhonchi, stridor, and wheezing. These can sometimes indicate an underlying respiratory issue that requires attention.

Anyone who is concerned about abnormal breath sounds should see their doctor for a diagnosis and any necessary treatment.