Rhonchi

Rhonchi
Classification and external resources
ICD-10 R09.8
ICD-9-CM 786.7

Rhonchi are coarse rattling respiratory sounds, usually caused by secretions in bronchial airways. "Rhonchi" is the plural form of the singular word "rhonchus". Since the mid-1990s, it has no longer been considered appropriate terminology in auscultation of the thorax, as much confusion has been reported in the published literature which confuses this with crepitations and wheezes, so the exact nature of this term is unclear (see Fleischner Society for standardized terminology)., however it is the most important pulmonary diagnostic tool we have.

Similarly, rales are no longer used in much of Europe, North America, and Australia with regard to description of auscultatory findings. More appropriate terms for auscultation of the thorax are respiratory sounds and adventitious sounds (wheezes, crackles, pleural rubs). These have variably been associated with low-pitched, continuous sounds that are similar to wheezes or crackles. Other terminology for sounds that may be auscultated in the thorax include pulmonary murmurs, egophony, whispering pectoriloquy, and vocal fremitus.

History

In 1957, Robertson and Coope proposed the two main categories of adventitious (added) lung sounds. Those categories were "Continuous" and "Interrupted" (or non-continuous).[1] In 1976, the International Lung Sound Association simplified the sub-categories as follows:

Continuous
Wheezes (>400 Hz)
Rhonchi (<200 Hz)
Discontinuous
Fine Crackles
Coarse Crackles[2][3]

Several sources will also refer to "medium" crackles, as a crackling sound that seems to fall between the coarse and fine crackles. Crackles are defined as discrete sounds that last less than 250 ms, while the continuous sounds (rhonchi and wheezes) last approximately 250 ms. Rhonchi are usually caused by a stricture or blockage in the upper airway. These should not be confused with stridor.

See also

References

  1. ↑ Robertson, A (1957). "Rales, rhonchi, and Laennec". Lancet. 2: 417–23. doi:10.1016/S0140-6736(57)92359-0.
  2. ↑ American Thoracic Society Ad Hoc Committee on Pulmonary Nomenclature (1977). "Updated nomenclature for membership reaction". ATS News (3): 5–6.
  3. ↑ Loudon, R; Murphy, R (1984). "Lung Sounds". Am Rev Respir Dis.


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