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Pleural friction rubs are the squeaking or grating sounds of the pleural linings rubbing together [1] and can be described as the sound made by treading on fresh snow. They occur where the pleural layers are inflamed and have lost their lubrication. Pleural rubs are common in pneumonia, pulmonary embolism, and pleurisy (pleuritis).
Respiratory sounds, also known as lung sounds or breath sounds, are the specific sounds generated by the movement of air through the respiratory system. [1] These may be easily audible or identified through auscultation of the respiratory system through the lung fields with a stethoscope as well as from the spectral characteristics of lung sounds. [2]
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
Breath sounds are bronchial; Possible medium, late, or pan-inspiratory crackles; Vocal resonance is increased. Here, the patient's voice (or whisper, as in whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to the healthy lung where speech sounds muffled. A pleural rub may be present. [4]
Pleural effusion involving fibrinous exudates in the fluid may be called fibrinous pleurisy, which sometimes occurs as a later stage of pleurisy. A person can develop a pleural effusion in the absence of pleurisy. For example, pneumonia, heart failure, cancer, or a pulmonary embolism can lead to a pleural effusion.
Fine crackles are soft, high-pitched, and very brief. This sound can be simulated by rolling a strand of hair between one's fingers near the ears or by moistening one's thumb and index finger and separating them near the ears. Their presence usually indicates an interstitial process, such as pulmonary fibrosis or congestive heart failure.
Ewart's sign is a set of findings on physical examination in people with large collections of fluid around their heart (pericardial effusions). [2]Dullness to percussion (described historically as "woody" in quality), egophony, and bronchial breath sounds may be appreciated at the inferior angle of the left scapula when the effusion is large enough to compress the left lower lobe of the lung ...
Occasionally, a pleural friction rub may be audible over the affected area of the lung (mostly in PE with infarct). A pleural effusion is sometimes present that is exudative (fluid that leaks out of blood vessels). [21] This is detectable by decreased percussion note, audible breath sounds, and vocal resonance.
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