Pleural friction noise

Under normal physiological conditions, such pleural leaves as visceral and parietal are distinguished by a smooth surface and invariable "wet lubrication", which is used as a capillary layer of pleural fluid.

In this case, the slip of the leaves of the pleura during breathing is carried out almost silently. A variety of pathological conditions of the pleura cause modification of the physical characteristics of the pleural sheets. This becomes the reason for which the sheets begin to rub against each other more strongly. As a result, a certain additional noise is formed, which is called pleural friction.

These conditions include roughness or uneven coating of the pleura plane, which is formed as a result of pleural inflammation. The reason in this case is the deposition of fibrin, activation of connective tissue scars, adhesions and cords, which are located between the leaves of the pleura directly in the area of ​​inflammation. Such cases are also characteristic of cancer or tuberculosis dissemination of the pleura.

The pleural friction noise can be fixed both at the stage of inhalation and exhalation. Noise can be classified by strength or volume, as well as by the duration and area in which it is heard.

At the initial stage of development of dry pleurisy, the pleural friction noise will be more, if one may say so, gentle and quieter. In its timbre it can be compared with the sound that will be during the friction of silk fabric or fingers directly under the auricle.

When dry pleurisy is already in the active stage, the pleural friction noise changes. It becomes like a crepitus or fine bubbling rales, and in some cases a crunch of snow. If we talk about cases of exudative pleurisy, when the exudate is quickly absorbed due to massive deposits on the plane of the pleural sheets, the friction noise turns into a noticeably coarse noise. This noise, due to the vibration of the chest wall, can be easily detected with the help of palpation.

The duration of pleural friction noise is quite different. During certain diseases, such as rheumatic pleurisy, the pleural friction noise sometimes lasts only a few hours, then disappears and reappears after a few hours.

If we talk about dry pleurisy of tuberculous etiology, as well as exudative pleurisy directly at the stage of resorption, then this noise often lasts for a week, or even more. Certain patients who have had pleurisy have severe cicatricial changes in the pleura, and the surface of the pleural sheets becomes uneven. In this situation, the pleural friction noise can be heard for several years, and sometimes most of the life.

And this is even more interesting:

  1. Differences of pleural friction noise
  2. Pulmonary Edge Mobility II
  3. Respiratory system: palpation
  4. Dry wheezing phases
  5. Auscultation of the lungs II