[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory) › Lung auscultation: normal breath sounds [Clinical exam](https://durgical.com/en/clinical-exam/) · [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory) # Lung auscultation: normal breath sounds - Exam technique The stethoscope lets the examiner hear air moving in and out; knowing normal sounds is the basis for spotting abnormal ones. Updated 2026-11-01 **See it in 3D:** [Trachea](https://durgical.com/en/anatomy/trachea/) · [Main bronchi](https://durgical.com/en/anatomy/right-main-bronchus/) · [Lobar bronchi](https://durgical.com/en/anatomy/lobar-bronchus/) ## Key points - Vesicular sounds: soft and low-pitched, inspiration longer than expiration, no gap between them. - Bronchial (tracheal) sounds: loud and high-pitched, expiration as long or longer, with a gap between phases; normal over the trachea and manubrium. - Bronchial breathing in the periphery: consolidation with an open bronchus. - Reduced or absent sounds: effusion, pneumothorax, obstructive atelectasis, emphysema or obesity. - Prolonged expiration: airflow obstruction. - Use the stethoscope diaphragm on bare skin at symmetric points, at least one full breath per point. ## What it is Lung auscultation assesses the sounds made by airflow in the airways. Normally vesicular sounds are heard over most of the lung, bronchovesicular sounds near the large bronchi and bronchial sounds over the trachea. Bronchial breathing where vesicular sounds belong, or absent sounds, means disease. ## Landmark anatomy - Sound arises from turbulent flow in the trachea and large bronchi; aerated lung filters it and passes mostly low tones (vesicular sounds). - When the lung becomes solid it carries the unfiltered bronchial sound to the wall. - The trachea divides into the main bronchi at about the sternal angle; between the scapulae and beside the upper sternum bronchovesicular sounds are normal. - Lobe projection matters: the back mostly overlies the lower lobes; the middle lobe and lingula are heard in front. ## Technique, step by step - Patient seated, chest bare; ask the patient to breathe through the mouth a little deeper than usual. - Use the stethoscope diaphragm pressed firmly on skin, never over clothing. - Start at the apices and work down to the bases, alternating sides at symmetric points. - Listen to at least one full inspiration and expiration at each point. - Listen over the back, the sides (axillae) and the front, including the middle lobe and lingula. - Describe intensity, relative length of inspiration and expiration, sound type and any added sounds. - If deep breathing makes the patient dizzy, pause; in very ill patients, listen with the patient lying on the side. ## Abnormal findings - Peripheral bronchial breathing: pneumonia with consolidation. - Absent sounds over one hemithorax: massive effusion, pneumothorax or atelectasis from a blocked bronchus. - Diffusely reduced sounds with prolonged expiration: COPD or asthma. - A silent chest in an asthma attack: very low flow, a sign of severity, not of improvement. ## Common errors - Listening over clothing or with the tubing rubbing creates false sounds. - Chest hair rubbing mimics crackles; wetting the hair reduces it. - Shivering and muscle contraction make noises that can be mistaken for added sounds. ## Test yourself Think of the answer, then tap the question to see it. ## What is the inspiration-to-expiration relation of vesicular breath sounds? Inspiration is longer and louder than expiration, with no gap between them. ## What does bronchial breathing over a lung base mean? The lung is consolidated and carries the bronchial sound to the wall, as in pneumonia. ## Why is a silent chest in an asthma attack alarming? It means airflow is too low to make wheezes; it signals severe obstruction and fatigue, not improvement. ## Which part of the stethoscope is used for routine lung auscultation? The diaphragm, pressed firmly on the skin, because breath sounds are relatively high-pitched. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-exam/lung-auscultation-normal-breath-sounds/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Trachea](https://durgical.com/en/anatomy/trachea/) - [Main bronchi](https://durgical.com/en/anatomy/right-main-bronchus/) - [Lobar bronchi](https://durgical.com/en/anatomy/lobar-bronchus/) ## Related - [Adventitious sounds: crackles, wheezes, rhonchi, stridor and pleural rub](https://durgical.com/en/clinical-exam/adventitious-sounds-crackles-wheezes-rhonchi-stridor-and-pleural-rub/) - [Voice sounds: bronchophony, egophony and whispered pectoriloquy](https://durgical.com/en/clinical-exam/voice-sounds-bronchophony-egophony-and-whispered-pectoriloquy/) - [Chest percussion: resonance, dullness and hyperresonance](https://durgical.com/en/clinical-exam/chest-percussion-resonance-dullness-and-hyperresonance/) - [The pleuropulmonary syndromes: the comparison table to know](https://durgical.com/en/clinical-exam/the-pleuropulmonary-syndromes-the-comparison-table-to-know/) ## Related conditions - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) - [Asthma](https://durgical.com/en/conditions/asthma/) - [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) - [Pleural effusion](https://durgical.com/en/conditions/pleural-effusion/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [Breath sounds: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/007535.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Community-acquired pneumonia in adults: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000145.htm) (MedlinePlus, U.S. National Library of Medicine, 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/lung-auscultation-normal-breath-sounds/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/lung-auscultation-normal-breath-sounds/