Pre-swallow sounds
Normal or vesicular breathing
Wet breathing
Rattly chest
Grunting
Crackles - fine
Crackles - coarse
Medical definition
Normal, good, unlabored respiratory pattern,
sometimes known as quiet breathing or resting
respiration(1)
Vesicular breath sounds are soft and low pitched
during inspiration and even softer during
expiration(2)
Breathing has a wet sounding quality
Rhonchal fremitus (bronchial fremitus) is a palpable
vibration produced during breathing, caused by
partial airway obstruction.(4)
A repetitive, low to medium pitch, short, explosive
sound which is produced by vocal cord closure
during expiration(6)
Inspiratory crepitations(7)
Low in pitch, bubbling sound(7)
Lay definition
When the inspiration and expiration sequence
sounds clear(3)
Breathing sounds wet
A vibration perceptible on palpation or
auscultation(5) or ‘rattly chest’ to touch when
hands are placed on the infant’s chest/back.
Vocalisation heard with expiratory breath(7)
Similar to sound of wood burning in a fireplace or
the sound of cellophane being crumpled(2)
Brief, discontinuous, popping sounds that are high
pitched. More during inspiration.
Similar to sound when strands of hair are rolled
between your fingers near your ear(2)
Discontinuous, brief, popping sounds. Similar to
the sound of Velcro being pulled apart. A bubbling
sound. More during inspiration.
Stridor
Harsh, monophonic, predominantly inspiratory
noise. Can be expiratory or biphasic(7)
Wheeze
Continuous, high-pitched adventitious lung sounds
which are superimposed on the normal breath
sounds(9)
Can cervical auscultation improve the diagnosis of aspiration in children?
Sounds definitions sheet_v1_27JAN2012
Queensland Children’s Medical Research Institute
A harsh, high-pitched, vibratory noise in the
throat, particularly when breathing in. Can be
when breathing in or out or both(8)
Flow of air through an airway sounds turbulent(7)
Coughing
A cough that sounds barking/brassy, honking,
paroxysmal, staccato or wet.(10)
Throat clearing
Expeling air from the lungs suddenly with a harsh
noise
A acute expelling of sound from the throat
Swallow sounds
Crisp & clear ‘distinct’
Quick
Loud
Description
Sounds clear(11)
Swallow occurs within 1 s
Sound is strongly audible
Initial discrete sound (IDS)
Click(12)
Bolus transit sound (BTS)
Food or fluid flushing sound(12) or
Flow sound related to turbulences of the fluid(13)
Final discrete sound (FDS)
Click(12)
Glottal release (GRS)
Short expiration burst of air(11)
Can cervical auscultation improve the diagnosis of aspiration in children?
Sounds definitions sheet_v1_27JAN2012
Queensland Children’s Medical Research Institute
Listening tips
May vary depending on whether the texture is a
fluid, puree or solid.
Soft , short sound similar to initial sound heard
when ears are ‘unblocked.’
May vary depending on whether the texture is a
fluid, puree or solid. Will be more audible on a fluid
bolus.
Soft , short sound similar to initial sound heard
when ears are ‘unblocked.’
May vary depending on whether the child is taking a
single swallow or multiple swallows. Should be more
identifiable on single swallows. May occur at the
end of a swallow series for continuous drinking or
multiple swallow (nor after each swallow) where the
airway remains closed until the end of the swallow
sequence.
May vary depending on whether the child is taking a
single swallow or multiple swallows. Should be more
identifiable on single swallows. May occur at the
end of a swallow series for continuous drinking or
multiple swallow (or after each swallow) where the
airway remains closed until the end of the swallow
sequence.
Co-ordinated
Unco-ordinated
Ordered sequence of IDS, BTS +/- FDS and GRS.
Sequence occurs within 1s.
Disordered sequence of IDS, BTS +/- FDS and GRS
and/or missing sound component
Post-swallow sounds
Normal or vesicular breathing
Wet breathing
Rattly chest
Grunting
Medical definition
Normal, good, unlabored respiratory pattern,
sometimes known as quiet breathing or resting
respiration(1)
Vesicular breath sounds are soft and low pitched
quality during inspiration and even softer during
expiration(2)
Breathing has a wet sounding quality
Rhonchal fremitus (bronchial fremitus) is a
palpable vibration produced during breathing,
caused by partial airway obstruction.(4)
Lay definition
When the inspiration and expiration sequence
sounds clear(3)
Breathing sounds wet
A vibration perceptible on palpation or
auscultation(5) or ‘rattly chest’ to touch when
hands are placed on the infant’s chest/back.
Vocalisation heard with expiratory breath(7)
Crackles - fine
A repetitive, low to medium pitch, short,
explosive sound which is produced by vocal cord
closure during expiration(6)
Inspiratory crepitations(7)
Crackles - coarse
Low in pitch, bubbling sound(7)
Similar to sound when strands of hair are rolled
between your fingers near your ear(2)
Stridor
Harsh, monophonic, predominantly inspiratory
noise. Can be expiratory or biphasic(7)
A harsh, high-pitched, vibratory noise in the
throat, particularly when breathing in. Can be
Can cervical auscultation improve the diagnosis of aspiration in children?
Sounds definitions sheet_v1_27JAN2012
Queensland Children’s Medical Research Institute
Similar to sound of wood burning in a fireplace or
the sound of cellophane being crumpled(2)
Wheeze
Coughing
Continuous, high-pitched adventitious lung
sounds which are superimposed on the normal
breath sounds(9)
A cough that sounds barking/brassy, honking,
paroxysmal, staccato or wet.(10)
Throat clearing
when breathing in or out or both(8)
Flow of air through an airway sounds turbulent(7)
Expeling air from the lungs suddenly with a harsh
noise
A acute expelling of sound from the throat
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Stedman's Medical Dictionary. 28 ed. Baltimore, Maryland: Lippincott Williams & Wilkins; 2006. p. 677.
Easy Auscultation. 2010 [16.01.12]; Available from: http://www.easyauscultation.com.
Rommel N. Diagnosis of oropharyngeal disorders in young children [Doctor of Philosophy]. Kindergeneeskunde: Katholieke
Universiteit Leuven; 2002.
Dorland's Illustrated Medical Dictionary. 32 ed.
Encyclopedia and dictionary of medicine, nursing and allied health. 7 ed2003.
Poole SR, Chetham M, Anderson M. Grunting respirations in infants and children. Pediatr Emerg Care. 1995;11(3):158-61.
O'Callaghan C, Stannard W. Paediatric Respiratory Examination: BMJ books; 2001.
Weir K. Children's Feeding Skills Questionaire. In: Hospital RCs, editor. Brisbane2005.
Meslier N, Charbonneau G, Racineux J-L. Wheezes. Eur Respir J. 1995;8(11):1942-48.
Chang AB, Landau L, Asperen P, Glasgow N, Robertson C, Merchant J, et al. Cough in children: definitions and clinical evaluation.
Position statement for the Thoracic Society of Australia and New Zealand. Med J Aust. 2006;184:398-403.
Cichero JAY, Murdoch BE. Acoustic signature of the normal swallow: characterization by age, gender, and bolus volume. Ann Otol
Rhinol Laryngol. 2002;111(7 Pt 1):623-32.
Vice FL, Heinz JM, Giuriati G, Hood M, Bosma JF. Cervical auscultation of suckle feeding in newborn infants. Dev Med Child Neurol.
1990;32(9):760-8.
Moriniere S, Boiron M, Alison D, Makris P, Beutter P. Origin of the sound components during pharyngeal swallowing in normal
subjects. Dysphagia. [Research Support, Non-U.S. Gov't]. 2008;23(3):267-73.
Can cervical auscultation improve the diagnosis of aspiration in children?
Sounds definitions sheet_v1_27JAN2012
Queensland Children’s Medical Research Institute