Ronchi
Explain
rhonchi lung auscultation breath sounds diagram

This medical anatomical diagram illustrates the standard stethoscope placement locations for auscultation of heart and lung sounds. The image consists of two panels: an anterior (front) view and a posterior (back) view of a semi-transparent human torso. In the anterior view, labels A and B are positioned over the apical regions of the right and left lungs, respectively, while label E is located at the lower left costal margin, corresponding to the cardiac apex and mitral valve area. Visible internal structures include the lungs, heart, liver, and intestinal tract. In the posterior view, labels C and D are placed in the interscapular region at the level of the upper thoracic spine, typically used for assessing posterior bronchial and vesicular breath sounds. This view highlights the vertebral column, ribs, and scapulae, with a red glow emphasizing the spinal region. This illustration serves as an educational guide for clinical physical examination techniques, demonstrating the relationship between surface landmarks and underlying thoracic and abdominal viscera.

An anatomical diagram illustrating the placement of the LEOSound lung-sound monitor and its bio-acoustical sensors on a patient. The illustration includes two views: an anterior (front) view and a posterior (back) view. In the anterior view, a recording device is secured to the mid-thorax by a black chest belt and a neck strap. A blue tracheal microphone is positioned on the neck near the trachea. In the posterior view, two additional microphones are attached using adhesive pads to the inferior region of the left (red microphone) and right (yellow microphone) scapula. The system is designed for mobile, long-term recording and automated analysis of respiratory sounds such as coughing and wheezing. The diagrams emphasize the standardized anatomical landmarks required for optimal auscultation and data collection in clinical or home settings.

This educational graphic illustrates standardized auscultation locations and lung sound recording protocols. Panel (a) presents anatomical diagrams of the thorax showing eight specific auscultation points (L1–L8). Right-side locations include the second intercostal space (ICS) on the midclavicular line (L1), the fifth ICS on the midclavicular line (L2), the fourth ICS on the midaxillary line (L3), and the tenth ICS on the midaxillary line (L4). Left-side locations (L5–L8) mirror these positions. Panel (b) compares two digital recording methodologies. The Littmann 3200 protocol demonstrates a sequential approach, capturing 15.8-second recordings from L1 through L8 one by one. In contrast, the AccurSound (HF-Type-1) protocol depicts a simultaneous multi-channel approach, recording from six locations (L1, L2, L4, L5, L6, L8) concurrently for a continuous 30-minute duration. The diagram highlights how these recordings are truncated into 15-second segments for analysis. This visual is designed to explain standardized pulmonary physical examination techniques and data acquisition for digital stethoscopes.

A comparison chart consisting of three time-domain waveforms (a, b, and c) illustrating heart sound (HS) localization within real recorded high-flow lung sound (LS) data. Subfigure (a) presents the raw acoustic signal, showing amplitude fluctuations with periodic bursts corresponding to mechanical cardiac events obscured by respiratory noise. Subfigures (b) and (c) demonstrate the performance of two different computational methods for identifying cardiac segments. The black waveforms represent the sound signal, while the overlaid red rectangular pulses indicate the identified temporal boundaries of heart sound components. Subfigure (b) shows the output of the HHA method, characterized by wider, continuous red blocks that capture the duration of heart sound complexes. Subfigure (c) displays the result of the SSA method, showing fragmented, narrower red pulses that often miss segments or produce discontinuous localization. This clinical signal processing diagram is used in cardiology and pulmonology research to evaluate algorithms for separating cardiac and respiratory sounds in auscultation data.
| Sound | Pitch | Duration | Character |
|---|---|---|---|
| Rhonchi | Low (<200 Hz) | Continuous (>250 ms) | Gurgling/snoring quality |
| Wheezes | High (>400 Hz) | Continuous | Musical/whistling |
| Stridor | High | Continuous, inspiratory | Focal, heard over neck |
| Crackles (Rales) | Varied | Discontinuous | Popping/crackling |
| Feature | Rhonchi | Wheezes |
|---|---|---|
| Pitch | Low (<200 Hz) | High (>400 Hz) |
| Mechanism | Secretions / fluid films in medium airways | Airway wall flutter from narrowing |
| Clears with cough? | Yes | No |
| Typical cause | Bronchitis, COPD, bronchiectasis | Asthma, CHF, airway obstruction |
What are crackles and how do they differ from rhonchi?
| Feature | Fine Crackles | Coarse Crackles |
|---|---|---|
| Pitch | Higher | Lower |
| Duration | Shorter | Longer |
| Intensity | Softer | Louder |
| Timing | Late inspiration | Early/throughout inspiration |
| Transmitted to mouth? | No | Yes |
| Clear with coughing? | Yes (if postural) | Rarely disappear entirely |
| Causes | Heart failure, interstitial fibrosis (IPF), pulmonary edema | Bronchitis, COPD, secretions |
| Condition | Type of Crackle |
|---|---|
| Heart failure (pulmonary edema) | Fine, bilateral basal |
| Interstitial lung disease / IPF | Fine, late inspiratory ("Velcro") |
| Pneumonia | Fine or coarse (alveolar filling) |
| Bronchitis / COPD | Coarse (secretions in airways) |
| Atelectasis (bedridden) | Fine, clear with deep breaths |
| Emphysema | Altered elastic recoil crackles |
| Feature | Crackles | Rhonchi |
|---|---|---|
| Sound quality | Non-musical, explosive pops | Musical, low-pitched, continuous |
| Duration | Discontinuous (<250 ms each) | Continuous (>250 ms) |
| Frequency | Varied (fine = high; coarse = low) | Low (<200 Hz) |
| Mechanism | Explosive opening of collapsed small airways | Secretions/fluid films vibrating in medium-sized airways |
| Phase | Predominantly inspiratory | Both inspiratory and expiratory |
| Clears with cough? | Fine: yes (transiently); Coarse: rarely | Yes - a hallmark feature |
| Typical diseases | Heart failure, ILD, pneumonia (fine); Bronchitis, COPD (coarse) | Bronchitis, COPD, bronchiectasis |
| Airways involved | Small airways and alveoli | Medium-sized bronchi |
| Sound | Type | Pitch | Cause | Clears with cough? |
|---|---|---|---|---|
| Fine crackles | Discontinuous | High | ILD, heart failure, edema | Sometimes |
| Coarse crackles | Discontinuous | Low | Bronchitis, COPD, secretions | Rarely |
| Rhonchi | Continuous | Low (<200 Hz) | Secretions in medium airways | Yes |
| Wheezes | Continuous | High (>400 Hz) | Airway wall flutter (asthma, CHF) | No |
| Stridor | Continuous | High | Upper airway obstruction | No |
| Pleural rub | Grating | - | Pleural inflammation | No |