Start Quiz
Vesicular Breath Sounds
These are the soft breath sounds that are best heard at the periphery in normal, healthy lungs, most prominently during inspiration. This is what you hear when you describe the lungs as “clear to auscultation.”
Stridor
Stridor is caused by upper airway obstruction. This sound is similar to wheezing in that it is high pitched and continuous. However, stridor is inspiratory, whereas wheezing is either expiratory or both inspiratory and expiratory, and stridor is louder over the neck than over the lungs.
Bronchial Breath Sounds
Also known as tubular breath sounds or tracheal breath sounds, these are more coarse-sounding breath sounds. These can normally be appreciated by auscultating with the stethoscope placed directly over the trachea; however, they are abnormal when heard over other parts of the lung. Bronchial breath sounds are heard when a consolidation or collapsed lung tissue transmits sound from the trachea or central airway to the periphery (thus “tracheal” breath sounds). They are 96% specific for pneumonia but only 14% sensitive.
Rhonchi
Low pitched and continuous. The pathophysiology is thought to be similar to wheezing; however, secretions may also play a role. Often heard in COPD, can also be present in asthma.
Credit: Shutterstock
Wheezing
High pitched and continuous, can be only expiratory or both inspiratory and expiratory. Wheezing represents airway obstruction – the sound is made by the vibrations of the walls of the narrowed airway. Classic for asthma and chronic obstructive pulmonary disease (COPD), it can also be heard in other diseases such as congestive heart failure (CHF), sometimes referred to as “cardiac asthma.”
Whispered Pectoriloquy
A clinical lung assessment technique where whispered words (typically "one-two-three" or "99") are heard loudly and clearly through a stethoscope placed on the chest wall, indicating lung consolidation.
- Normal - whispered sounds are barely audible or indistinct
- Abnormal - they become intense over abnormal, solid, or fluid-filled tissue.
Broncophony
Bronchophony is considered positive when spoken words (e.g., "ninety-nine") sound unusually loud, clear, and distinct through a stethoscope on the chest wall. A positive result indicates lung consolidation or density (e.g., pneumonia, tumor). A negative result is normal, where sounds are muffled or indistinct. Negative Positive
Broncophony vs. Whispered Pectoriloquy
Bronchophony and whispered pectoriloquy are both tests for vocal resonance indicating lung consolidation (e.g., pneumonia). Bronchophony is the increased intensity and clarity of spoken words (e.g., "ninety-nine"), while whispered pectoriloquy is the heightened, clear transmission of whispered words (e.g., "one-two-three"). Both signify that sound travels better through consolidated, fluid-filled tissue than air. Whispered pectoriloquy is often considered a more sensitive or extreme indicator of consolidation compared to simple bronchophony.
Crackles
Also known as “rales,” these discontinuous sounds represent alveoli snapping open and therefore are predominantly inspiratory. Crackles can be further subdivided into course and fine crackles.
- Coarse crackles: These sound coarser because of a lower frequency (i.e., fewer crackles per second). Most commonly caused by pulmonary edema, pneumonia, or atelectasis.
- Fine crackles: Often heard in interstitial lung disease. “Velcro” rales are characteristic of interstitial pulmonary fibrosis.
Broncophony vs Whispered Pectoriloquy
Bronchophony and whispered pectoriloquy are both tests for vocal resonance indicating lung consolidation (e.g., pneumonia). Bronchophony is the increased intensity and clarity of spoken words (e.g., "ninety-nine"), while whispered pectoriloquy is the heightened, clear transmission of whispered words (e.g., "one-two-three"). Both signify that sound travels better through consolidated, fluid-filled tissue than air. Whispered pectoriloquy is often considered a more sensitive or extreme indicator of consolidation compared to simple bronchophony.
End of Quiz
References:
Physical Exam Pearls: Overview of High-Yield Topics in Physical Examination Pearls. In: Kaufman MS, Ganti L, Chang D, Lora A. eds. First Aid for the® Medicine Clerkship, 4th Edition. McGraw Hill; 2021. Accessed February 17, 2026. https://accessmedicine.mhmedical.com/content.aspx?bookid=3493§ionid=287805207
Refresh the browser to start the quiz over
Lung Sounds Quiz
Fritz Sticht
Created on February 17, 2026
Start designing with a free template
Discover more than 1500 professional designs like these:
View
Microlearning: Graphic Design
View
Microlearning: Enhance Your Wellness and Reduce Stress
View
Microlearning: Teaching Innovation with AI
View
Microlearning: Design Learning Modules
View
Video: Responsible Use of Social Media and Internet
View
Mothers Days Card
View
Momentum: First Operational Steps
Explore all templates
Transcript
Start Quiz
Vesicular Breath Sounds
These are the soft breath sounds that are best heard at the periphery in normal, healthy lungs, most prominently during inspiration. This is what you hear when you describe the lungs as “clear to auscultation.”
Stridor
Stridor is caused by upper airway obstruction. This sound is similar to wheezing in that it is high pitched and continuous. However, stridor is inspiratory, whereas wheezing is either expiratory or both inspiratory and expiratory, and stridor is louder over the neck than over the lungs.
Bronchial Breath Sounds
Also known as tubular breath sounds or tracheal breath sounds, these are more coarse-sounding breath sounds. These can normally be appreciated by auscultating with the stethoscope placed directly over the trachea; however, they are abnormal when heard over other parts of the lung. Bronchial breath sounds are heard when a consolidation or collapsed lung tissue transmits sound from the trachea or central airway to the periphery (thus “tracheal” breath sounds). They are 96% specific for pneumonia but only 14% sensitive.
Rhonchi
Low pitched and continuous. The pathophysiology is thought to be similar to wheezing; however, secretions may also play a role. Often heard in COPD, can also be present in asthma.
Credit: Shutterstock
Wheezing
High pitched and continuous, can be only expiratory or both inspiratory and expiratory. Wheezing represents airway obstruction – the sound is made by the vibrations of the walls of the narrowed airway. Classic for asthma and chronic obstructive pulmonary disease (COPD), it can also be heard in other diseases such as congestive heart failure (CHF), sometimes referred to as “cardiac asthma.”
Whispered Pectoriloquy
A clinical lung assessment technique where whispered words (typically "one-two-three" or "99") are heard loudly and clearly through a stethoscope placed on the chest wall, indicating lung consolidation.
Broncophony
Bronchophony is considered positive when spoken words (e.g., "ninety-nine") sound unusually loud, clear, and distinct through a stethoscope on the chest wall. A positive result indicates lung consolidation or density (e.g., pneumonia, tumor). A negative result is normal, where sounds are muffled or indistinct. Negative Positive
Broncophony vs. Whispered Pectoriloquy
Bronchophony and whispered pectoriloquy are both tests for vocal resonance indicating lung consolidation (e.g., pneumonia). Bronchophony is the increased intensity and clarity of spoken words (e.g., "ninety-nine"), while whispered pectoriloquy is the heightened, clear transmission of whispered words (e.g., "one-two-three"). Both signify that sound travels better through consolidated, fluid-filled tissue than air. Whispered pectoriloquy is often considered a more sensitive or extreme indicator of consolidation compared to simple bronchophony.
Crackles
Also known as “rales,” these discontinuous sounds represent alveoli snapping open and therefore are predominantly inspiratory. Crackles can be further subdivided into course and fine crackles.
Broncophony vs Whispered Pectoriloquy
Bronchophony and whispered pectoriloquy are both tests for vocal resonance indicating lung consolidation (e.g., pneumonia). Bronchophony is the increased intensity and clarity of spoken words (e.g., "ninety-nine"), while whispered pectoriloquy is the heightened, clear transmission of whispered words (e.g., "one-two-three"). Both signify that sound travels better through consolidated, fluid-filled tissue than air. Whispered pectoriloquy is often considered a more sensitive or extreme indicator of consolidation compared to simple bronchophony.
End of Quiz
References:
Physical Exam Pearls: Overview of High-Yield Topics in Physical Examination Pearls. In: Kaufman MS, Ganti L, Chang D, Lora A. eds. First Aid for the® Medicine Clerkship, 4th Edition. McGraw Hill; 2021. Accessed February 17, 2026. https://accessmedicine.mhmedical.com/content.aspx?bookid=3493§ionid=287805207
Refresh the browser to start the quiz over