Crackles - wikipedia Crackles For other meanings, see Crackle. Crackles Classification and external resources Specialty Pulmonology ICD - 10 R09. 8 ICD - 9 - CM 786.7 ( edit on Wikidata ) Crackles Crackles heard in the lungs of a person with pneumonia using a stethoscope. Problems playing this file ? See media help. Crackles, crepitations, or rales ( / ˈrɑːlz / ( listen ) RAHLZ or / ˈrælz / RALZ ) are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation. They are often heard only with a stethoscope ( `` on auscultation '' ). Bilateral crackles refers to the presence of crackles in both lungs. Basal or basilar crackles ( not to be confused with the basilar artery of the brain ) are crackles apparently originating in or near the base of the lung. Bibasal or bibasilar crackles refer to crackles at the bases of both the left and right lungs. Bilateral basal crackles also refers to the presence of basal crackles in both lungs. Crackles are caused by the `` popping open '' of small airways and alveoli collapsed by fluid, exudate, or lack of aeration during expiration. The word `` rales '' derives from the French word râle meaning `` rattle ''. Crackles can be heard in patients with pneumonia, atelectasis, pulmonary fibrosis, acute bronchitis, bronchiectasis, interstitial lung disease or post thoracotomy or metastasis ablation. Pulmonary edema secondary to left - sided congestive heart failure can also cause rales. Contents 1 Terminology 2 The sound of crackles 3 See also 4 References 5 External links Terminology René Laennec adopted the existing word râles ( which has been translated as ' rattles ', ' groans ', and otherwise ) to describe the added breath sounds which are now referred to as ' crackles '. He described them using unusual daily examples, such as ' whistling of little birds ', ' crackling of salt on a heated dish ', ' cooing of the woodpidgeon ', etc. but soon realised that he was unable to use this term in front of his patients because it conjured the association of le râle de la mort, which translates to ' death rattle ' ( i.e., the noise that people who are about to die make when they can no longer clear secretions ). Therefore, at the bedside, he used the Latin word ' rhonchus ' ( which originally meant a snore ). This was not clearly understood by his translator, John Forbes, and the terminology became very confusing after the publication in the 1830s of Forbes 's English translation of Laennec 's De L'Auscultation Mediate. The difficulty of translating râle itself had been remarked upon in a British review of Laennec 's work in 1820. The terminology of ' rales ' and ' rhonchi ' in English remained variable until 1977, when a standardization was established by the American Thoracic Society and American College of Chest Physicians. As a result of this, the term ' râles ' was abandoned, and ' crackles ' became its recommended substitute. Therefore, these sounds should be correctly described as ' crackles '. The term ' rales ' is still common in English - language medical literature, but cognizance of the ATS / ACCP guidelines calls for ' crackles '. The sound of crackles Crackles are caused by explosive opening of small airways and are discontinuous, nonmusical, and brief. Crackles are much more common during the inspiratory than the expiratory phase of breathing, but they may be heard during the expiratory phase. Crackles are often associated with inflammation or infection of the small bronchi, bronchioles, and alveoli. Crackles that do not clear after a cough may indicate pulmonary edema or fluid in the alveoli due to heart failure, pulmonary fibrosis, or acute respiratory distress syndrome. Crackles that partially clear or change after coughing may indicate bronchiectasis. Crackles are often described as fine, medium, and coarse. They can also be characterized as to their timing : fine crackles are usually late - inspiratory, whereas coarse crackles are early inspiratory. 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. The sounds from interstitial pulmonary fibrosis have been described as sounding like opening a Velcro fastener. Coarse crackles are somewhat louder, lower in pitch, and last longer than fine crackles. Their presence usually indicates an airway disease, such as bronchiectasis. They can also be described as unilateral or bilateral, as well as dry or moist / wet. See also Bronchophony Egophony Rhonchi Consumption Whooping cough Croup Pulmonary edema Pertussis toxin Allergic asthma Russell 's viper References Jump up ^ Jones, Daniel ( 2003 ) ( 1917 ), Peter Roach, James Hartmann and Jane Setter, eds., English Pronouncing Dictionary, Cambridge : Cambridge University Press, ISBN 3 - 12 - 539683 - 2 CS1 maint : Uses editors parameter ( link ) Jump up ^ Laennec, R.T.H. ( 1819 ), De l'Auscultation Médiate, ou Traité du Diagnostic des Maladies des Poumons et du Coeur, Paris : Brosson & Chaudé. The complete title of this book, often referred to as the `` Treatise '' is : De l'Auscultation Médiate ou Traité du Diagnostic des Maladies des Poumons et du Coeur ( On Mediate Auscultation or Treatise on the Diagnosis of the Diseases of the Lungs and Heart ). Jump up ^ ' Laennec, R.T.H. ; Forbes, John, Sir, A Treatise on the Diseases of the Chest and on Mediate Auscultation ( 1835 ). New York : Samuel Wood & Sons ; Philadelphia : Desilver, Thomas & Co... Jump up ^ `` Laennec 's new system of diagnosis '', The Quarterly Journal of Foreign Medicine and Surgery and of the Sciences Connected with Them, 2 : 51 -- 68, 1820. ^ Jump up to : `` Report of the ATS - ACCP Ad Hoc Subcommittee on pulmonary nomenclature ''. ATS News. 3 : 5 -- 6. 1977. ^ Jump up to : Forgacs P ( 1978 ). `` The functional basis of pulmonary sounds '' ( PDF ). Chest. 73 ( 3 ) : 399 -- 405. PMID 630938. doi : 10.1378 / chest. 73.3. 399. Jump up ^ `` rale '' at Dorland 's Medical Dictionary Jump up ^ Wrongdiagnosis.com > Crackles Book Source Details : * Book Title : Alarming Signs and Symptoms : Lippincott Manual of Nursing Practice Series * Author ( s ) : Springhouse * Year of Publication : 2007 External links Audio Breath Sounds - Multiple case studies with audio files of lung sounds. R.A.L.E. Repository - sound files of breath sounds Symptoms and signs relating to the respiratory system ( R04 -- R07, 786 ) Medical examination and history taking Auscultation Stethoscope Respiratory sounds Stridor Wheeze Crackles Rhonchi Stertor Squawk Pleural friction rub Fremitus Bronchophony Terminal secretions Elicited findings Percussion Pectoriloquy Whispered pectoriloquy Egophony Breathing Rate Apnea Prematurity Dyspnea Hyperventilation Hypoventilation Hyperpnea Tachypnea Hypopnea Bradypnea Pattern Agonal respiration Biot 's respiration Cheyne -- Stokes respiration Kussmaul breathing Ataxic respiration Other Respiratory distress Respiratory arrest Orthopnea / Platypnea Trepopnea Aerophagia Asphyxia Breath holding Mouth breathing Snoring Other Chest pain In children Precordial catch syndrome Pleurisy Clubbing / Hippocratic fingers ( Schamroth 's window test ) Cyanosis Cough Sputum Hemoptysis Epistaxis Silhouette sign Post-nasal drip Hiccup COPD Hoover 's sign asthma Curschmann 's spirals Charcot -- Leyden crystals chronic bronchitis Reid index sarcoidosis Kveim test pulmonary embolism Hampton hump Westermark sign pulmonary edema Kerley lines Hamman 's sign Golden S sign Retrieved from `` https://en.wikipedia.org/w/index.php?title=Crackles&oldid=801884868 '' Categories : Symptoms and signs : Respiratory system Hidden categories : CS1 maint : Uses editors parameter Articles with hAudio microformats Articles including recorded pronunciations ( English ) All articles with unsourced statements Articles with unsourced statements from December 2016 Talk Contents About Wikipedia Català Deutsch Español فارسی Français Polski Svenska ไทย Türkçe Edit links This page was last edited on 22 September 2017, at 14 : 48. 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Question: where do you hear crackles in the lungs
Answer: the base of the lung