Crepitus

Crepitatio (crepitatio) occurs in the alveoli, what is its main difference from wheezing. Some physicians incorrectly refer to crepitus, as crepitus or subcrepative wheezing.

Crepitus it is fixed as a light cod and is similar to the sound that is formed when rubbing a small group of hair directly above the ear. The key condition for the formation of crepitus is the accumulation in the lumen of the alveoli of a small volume of liquid secretion.

At the exhalation stage, the alveolar walls stick to each other, and at the inspiratory stage they are very reluctant to splinter. For this reason, it is possible to listen to crepitus only in the final phase of inhalation. As a result, crepitus is a sound from the disintegration of a huge number of alveoli.

Crepitus is usually fixed during inflammation of the lung tissue. As an example, I can cite the I (initial) and III (final) stages of lobar pneumonia. In the latter case, the alveoli contain a certain amount of inflammatory exudate. In addition, crepitus is detected in infiltrative pulmonary tuberculosis and pulmonary infarction. It is also characteristic of congestion in the lungs, which manifests itself due to the weakening of the contraction muscles of the left ventricle of the heart, or a strong decrease in the diameter of the left venous cavity of the heart.

Crepitus is tapped in the lower lateral zones of the lungs of the old at the stage of the first deep breath. It is desirable that the patient was in the supine position.

Similar transient crepitus is also fixed with compression atelectasis.

With a pronounced inflammation of the lungs, the crepitus is fixed for a sufficiently long period of time and disappears only when a large amount of inflammatory secretion accumulates in the cavities of the alveoli, or when such a secret is completely resolved.

Crepitization, if we take into account its acoustic characteristics, sometimes resembles moist fine bubbling rales, which are formed when liquid secret accumulates in small bronchi or bronchioles.

For this reason, it is important to distinguish between crepitus and wheezing. By persistent crepitation, one can judge the presence of inflammation of the lungs, and fine bubbling non-sound wheezing can indicate inflammation in the bronchi (bronchitis).

How to distinguish wheezing from crepitations? Characteristics of wheezing are such that moist fine bubbling wheezing is fixed both at the stage of inhalation and exhalation. They tend to increase significantly or immediately disappear after coughing. In turn, the crepitus is fixed solely by inhalation and does not change after coughing.

And this is even more interesting:

  1. Differences of pleural friction noise
  2. Wet rales
  3. Dry wheezing phases
  4. Nature of wet wheezing
  5. Dry rales