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Medicine General bb8c3291

Which of the following auscultatory findings (heard over the lung fields) does the term "Rhonchi" refer to?

A
Coarse, "bubbling" sounds
B
Fine, crackling sounds heard in late inspiration
C
Wheezing sounds during both inspiration and expiration
D
All of the above
High-Yield Explanation
Rhonchi are a manifestation of obstruction of medium-sized airways, most often with secretions. In the acute setting, this manifestation may be a sign of viral or bacterial bronchitis. Chronic rhonchi suggest bronchiectasis or COPD.  In contrast to expiratory wheezes and rhonchi, stridor is a high-pitched, focal inspiratory wheeze, usually heard over the neck as a manifestation of upper airway obstruction. Crackles, or rales, are commonly a sign of alveolar disease. Processes that fill the alveoli with fluid may result in crackles, including pulmonary edema and pneumonia. Crackles in pulmonary edema are generally more prominent at the bases. Interestingly, diseases that result in fibrosis of the interstitium (e.g., IPF) also result in crackles that sound like Velcro being ripped apart.   Reference: Harrison’s P R I N C I P L E S   O F I N T E R N A L M E D I C I N E 20th edition page no 1944

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