• Respiratory Auscultation

    Abnormal Vocal Sounds (Resonance)


    Patient is asked to speak a word, usually '99' to produce resonance.

    NORMAL: As a vocal sound is transmitted from the larynx down through the trachea, the bronchi, the alveoli and then to the chest wall, the sound becomes less distinct and much softer than when heard directly.

    ABNORMAL: If bronchophony is present, the sound remains very clear and very loud. Bronchophony occurs over areas of the lung in which the alveoli are filled with fluid or replaced by solid tissue. It can be heard in consolidation due to pneumonia, collapse, or tumours.

    Listen to the audio of bronchophony:
    Patient is telling 'ninety nine'


    Egophony (also aegophony) is an increased resonance of voice sounds heard when auscultating the lungs, often caused by compressed lung tissue due to pleural effusion, or consolidation due to infection (pneumonia) or tumor.

    While listening on the chest with a stethoscope, the patient is asked to say 'e'. If we hear it like the sound of 'a' then the patient has egophony.

    The sound here assumes a 'nasal quality'. To demonstrate this, just try closing your nose with your fingers and then say 'e'. You will hear 'a', which is how it will be heard in a patient with egophony. It is due to better transmission of high-frequency sounds across the abnormal tissues mentioned above, with lower frequencies being filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice, when auscultated over the affected area.

    Listen to the audio of egophony:
    Patient is telling 'eee'

    mp3 audio clips used in this article can be downloaded from our downloads section. Please remember that these are for teaching-learning purposes only.
    Comments 39 Comments
    1. physiostudent's Avatar
      physiostudent -
      Greatly informative and takes you through the basics brilliantly.Cheersphysiostudent
    1. Christine's Avatar
      Christine -
      Brilliant. Studying pulmonary auscultation for a uni assignment. Great work
    1. Natasha's Avatar
      Natasha -
      thanks for the informative article.It tackles the nuances of resp auscultation in a very lucid manner.Good for beginners
    1. Manju CA, RN's Avatar
      Manju CA, RN -
      Excellent.It is a very good article for nurses to know about various Lung sounds.
    1. Mary's Avatar
      Mary -
      Wow, this is my dream come true... I want more auscultation explanations!
    1. Che's Avatar
      Che -
      Recommended site for identifying lung sounds. Thumbs up!
    1. Popcorn's Avatar
      Popcorn -
      Super Thank you!
    1. majid zakir's Avatar
      majid zakir -
      awesome...big help.
    1. pgv's Avatar
      pgv -
      thanx you very much,it's a great work.
    1. Paras bhardwaj's Avatar
      Paras bhardwaj -
      Thank you,Breath sounds explained here are really helpful.
    1. Luci's Avatar
      Luci -
      I find it incredibly difficult to distinguish between all of the above, so this was really helpful, thank you
    1. Mark's Avatar
      Mark -
      Daria loves this site and all articles
    1. Lew's Avatar
      Lew -
      Thanks for all the audio clips in this article. Best I have heard on the internet.
    1. ANIRUDDHA LAHA's Avatar
      THANKS for giving me such nice audio clips.
    1. Subhashini's Avatar
      Subhashini -
      Thanks for this wealth of information on breath sounds!
    1. Unregistered's Avatar
      Unregistered -
      Thank you - nurse working in minor illness - different doctors can use different terms for the same thing - was getting confusing! Great to have some clarity! Very helpful.
    1. klvn26's Avatar
      klvn26 -
      Thank you Sir for the explanations and sound clips..i still find it tough to differentiate them though...hopefully will be able to do so with experience, will work on it ^^
    1. Unregistered's Avatar
      Unregistered -
      Really great..
    1. Aneurysm's Avatar
      Aneurysm -
      What I love the most in your explanation is the attention to detail. You know what mistakes we commonly do as undergraduates and have focused on that... not many people write with this clarity. Please do write on more such topics. Thanks!
    1. erixo75's Avatar
      erixo75 -
      I'm a IMG preparing for USMLE step 2 CK, this is really useful for every year media questions are increasingly being incorporated. Thanks a million !
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