Differences of pleural friction noise

The listening area for pleural friction noise is directly dependent on the location of the area of ​​its inflammation. As a rule, this type of noise can most often be found in the inferolateral areas of the chest, where active movement of the lungs takes place during breathing. In some cases, such noise is also recorded in the zone of the tops of the lungs, if they develop a severe tuberculous process, which is then transferred to the pleural sheets.

When an inflammatory zone is found in the pleura, which is located next to the heart, pleuropericardial noise can be detected. This type of noise can be heard not only at the stages of inhalation and exhalation, but also in cases of systole and diastole of the heart. Compared with intracardiac noise, this type of noise is better heard directly at the height of a deep breath, when the pleura leaves more closely in contact with the heart shirt.

In order to distinguish the pleural friction noise from such types of noise as fine bubbling wheezing and crepitus, the following signs can be used:

1) the nature of wheezing changes after coughing, or disappear for a certain period of time, during which the pleural friction noise does not change;

2) if the stethoscope press the patient's chest more, the pleural friction noise will be stronger, but the wheezing will remain unchanged;

3) crepitus can be heard only at the height of inhalation, and the pleural friction noise is heard in both stages of breathing;

4) if the big belly bulges when the abdomen is pulled in and out, when the mouth is closed and the nose is specifically clamped, then the pleural friction noise, due to the fact that the diaphragm and pleural sheets are displaced, can be heard with the naked ear. As for wheezing and crepitation, then, since the air does not move through the bronchi, these sounds will be absent.

And this is even more interesting:

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