Grotberg: Vibrating the lung cells makes them promote inflammation which damages the lung. The pitch you hear is the frequency of oscillation of the balloon material, which for a lung would be the airway tube made of cells. An asthmatic lung airway is similar because it is constricted to a small narrow passageway. Grotberg: Wheezing is very much like the sound from a deflating balloon when you make it squeal by stretching the outlet. What exactly is happening when a sick patient wheezes as they exhale? That is a 180-degree thought reversal from interpreting them as only a “sign” of disease.īreak this down for us a bit more. We’ve seen evidence of this in our experiments. So wheezes and crackles actually “cause” disease. The cells respond with inflammation, which, itself, is a disease. They make the sound, and that mechanical event is also pounding away on the lung tissue. The physical mechanisms that cause wheezing and crackling, while smaller forces than a cough, are similar. Ouch!Īs an extreme example, the loudest sound a lung generates is a severe cough, which can cause, in rare instances, a pneumothorax (ruptured lung), i.e. If you clap hard enough, your hands will hurt. Grotberg: Well, for a sound to be created, a mechanical event must occur, like clapping your hands. You’ve found that sounds could represent more than just the presence of a disease. Pulmonary edema is a common example, often a byproduct of heart failure. Crackles, on the other hand, are only heard by a stethoscope and are a sign of too much fluid in the lung. Patients who wheeze can be so loud you can hear it standing next to them. Grotberg: Typically, wheezing is found in asthma and emphysema. These wheezes and crackles are signs of what diseases? There are normal sounds of air movement, but also there can be abnormal sounds, like wheezes during expiration (breathing out) and crackles during inspiration (breathing in). For the lungs, typically the patient is asked to breathe in and out deeply. Grotberg: Two important organs being monitored are the heart and the lungs. When doctors pull out a stethoscope, what are they listening for? He answered some questions about the research. And they represent a paradigm shift for how doctors understand what they hear through a stethoscope. The findings could eventually change how lung diseases are treated, he says. Exploring this in humans is a research goal. His conclusion is based on evidence from experiments on microfluidic chips and on animal models. Listen to rales here on the Medzcool YouTube channel.James Grotberg, professor of biomedical engineering at the College of Engineering and professor of surgery at the Medical School, recently published a study describing how the mechanics that produce those noises with every breath are likely a cause of injury and inflammation. Rales are usually broken up into more specific types, based on the way they sound. When these tiny sacs are damaged or weighed down with fluid or mucus, they can make a crackling sound as they attempt to fill with air. These are tiny sacs of air and inflate and deflate with each breath. This usually occurs in the smaller parts of the lungs, like the alveoli. These sounds are formed when air moves into closed spaces. The terms rales or crackles have been used interchangeably and are usually a matter of preference, not a difference in the condition. Rales are a higher-pitched sound sometimes called crackles or bibasilar crackles. Listen to rhonchi here on the Medzcool YouTube channel. The sound you hear is the the sound the air makes as it moves around the blockage. These sounds are produced when there is something blocking the airway, like fluid. Rhonchi can either come and go on and inhale or exhale or be heard continuously. It can be heard on an inhale or exhale, and it’s often compared to the sound of snoring. This low-pitched sound that usually starts in the larger airways in the lungs. The difference between the two is in the pitch and the exact cause of the sound. Rales and rhonchi can both be coarse, even crackling sounds.
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