Classifying Adventitious Sounds
CONFUSION OVER TERMINOLOGY
The methods of classifying adventitious sounds have changed repeatedly over the years, resulting in continuing confusion in the literature and in the clinical setting. The familiar terms used by Laënnec were replaced by terms that later physicians thought were more aesthetic or clearer. For example, the term rhonchus was substituted for rale because the latter was associated with the “death rattle” sound. Later, attempts were made to classify adventitious sounds on the basis of their acoustic qualities or their similarities to musical tones.
CURRENT CLASSIFICATION SYSTEM
In 1977, the American Thoracic Society adopted a system of classifying adventitious sounds on the basis of acoustical qualities, timing, and frequency waveforms. This system divides adventitious sounds into two classifications: crackles and wheezes. These two classifications are further subdivided into two categories: discontinuous and continuous.
Discontinuous, explosive sounds that are loud and lowpitched are called coarse crackles. (♦Sound 81) Previously, these sounds were called rales or coarse rales.