Breathing noises

Breathing noises are the sounds that occur during breathing. The doctor or nurse can listen to their ear directly to the chest wall patient or by using a stethoscope, the phonendoscope (see Auscultation). When listening lung sounds, you need to pay attention to the attitude to the phases of breath (inhale, exhale), localization and distribution, character and power.
Breathing noises divided into two main groups: vesicular and bronchial breathing. The emergence of vesicular respiration is determined by the voltage of the walls of the pulmonary alveoli in the result of the inflow of air into them. So it shall be heard throughout the breath and only at the very beginning of exhalation by spadenia alveoli). The intensity of vesicular respiration different depending on age, fatness and pathological processes in the lungs. In children vesicular respiration is usually enhanced, clear bugged out (puerile breathing).
This type of breathing is kept up to 12-14 years old and explained, apparently, by the subtlety of the chest wall and the relative narrowness of the bronchi.
The weakening of vesicular breathing in pathology may be due to the difficult passage of air in the alveoli during narrowing of the upper respiratory tract or large bronchi; inadequate extension of the lungs during breathing by limiting the mobility of the chest when reflex effects (pain in the chest) or pathological changes of the bone-muscular system (ossification rib cartilage, paralysis of the respiratory muscles), at very high standing of the diaphragm. The weakening of vesicular respiration occurs when emphysema, in the initial phase of lobar pneumonia, and congestion in the pleural cavity fluid, pushing the light from the chest tumor, the fusion of the pleura , etc. In some cases weakened vesicular breath heard throughout the lungs (pulmonary emphysema, narrowing of the upper respiratory tract), in others - on one side or even in a limited area of the chest (focal pneumonia, vpotnye pleurisy, lung atelectasis). Local weakening vesicular respiration is best revealed by comparing the strength of breath on symmetric parts of the thorax on the right and on the left.
Strengthening vesicular respiration is due to the great power of the unfolding of the alveoli during inhalation (for example, physical work, sometimes with fever, as a compensatory phenomenon near poorly ventilated lung area). Hard vesicular respiration is coarser, reinforced, a little rough with extended expiration; observed in the narrowing of the bronchi clearance, bronchitis, bronchopneumonia.
Intermittent, or skadrowane, breathing characterized by intermittent, jerky breath by the release of air in the alveoli in a few receptions observed in non-uniform reduction of respiratory muscles.
Bronchial breathing characterized by a peculiar sound phenomenon, reminiscent of the sound "h", and exhale loudly and coarser than a breath. Bronchial breath is associated with the passage of air through the glottis and generated by the turbulence of the air. Because when you exhale glottis more narrowed, than in breathing, the sound generated in this phase, is stronger, harder and longer. Bronchial breath, prislushivayutsya outside the scope of the trachea and major bronchi, indicates the presence of pathological changes: condensed lung tissue or cavity connected with the bronchus. In the first case physiological bronchial breath better is compacted cloth, the second - physiological bronchial breath strengthened with the resonance of cavities. Most often bronchial breathing occurs as a result of inflammatory processes in the lungs, accompanied by the seal of the share or its part (lobar pneumonia), compression of the lung (exudate, tumor, etc.,). A variant of bronchial breathing is empiricheskie breath, reminiscent of the sound that is produced if a strong blow on the throat empty glass vessel. Empiricheskie breath heard above the cavity in light of significant size and with a smooth surface inside.
Mixed, broncho-vesicular breathing characterized by the presence of vesicular breath on the bronchial breath and exhale. In norm shall be heard above the upper right lung, diseases - lung tuberculosis, bronchial pneumonia.