The lung sound terminology used by physicians is not well standardized and the recommendations of the ATS/ACCP nomenclature subcommittee are not widely accepted. Most did not use a qualifying adjective to describe ALS, and there was little agreement among those who did. The majority of participants recognized the normal breath sounds but not the pleural friction rub. The terms "wheeze" and "stridor" were used only in describing continuous ALS however, the term "rhonchi" was frequently used to describe continuous and discontinuous ALS. 2 They are correlated to numerous pathologies, including bronchiectasis, chronic obstructive pulmonary disease (COPD), edema, and fibrosis. We focus on describing important breath sounds and in providing recordings of each. Crackles, also known as crepitations and rales, correspond to short, discontinuous, and non-stationary sounds. They are believed to occur when air opens alveoli. The goal of this basic course in lung sounds is to improve auscultation observational skills. Other physicians preferred the term "rales" in describing discontinuous ALS. Rales: Small clicking, bubbling, or rattling sounds in the lungs. Coarse crackles are adventitious (abnormal) lung sounds (also called breath sounds) that present like gurgling or bubbling sounds. Pulmonary physicians used the terms "crackles" and "rales" with equal frequency to describe discontinuous adventitious lung sounds (ALS) and not at all to describe continuous ALS. The participants listened to the lung sounds at the 1988 American College of Chest Physicians annual convention and wrote "free form" answers. We report the terms used by 223 pulmonary physicians and 54 physicians in other specialties to describe eight recorded examples of lung sounds.
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