|
Crackles, crepitations, or rales ( or ) are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation. They are often heard only with a stethoscope ("on auscultation"). Bilateral crackles refers to the presence of crackles in both lungs. Basal or basilar crackles (not to be confused with the basilar artery of the brain) are crackles apparently originating in or near the base of the lung. Bibasal or bibasilar crackles refer to crackles at the bases of both the left and right lungs. Bilateral basal crackles also refers to the presence of ''basal'' crackles in both lungs. Crackles are caused by the "popping open" of small airways and alveoli collapsed by fluid, exudate, or lack of aeration during expiration. The word "rales" derives from the French word ''râle'' meaning "rattle". Crackles can be heard in patients with pneumonia, atelectasis, pulmonary fibrosis, acute bronchitis, bronchiectasis, interstitial lung disease or post thoracotomy or metastasis ablation. Pulmonary edema secondary to left-sided congestive heart failure can also cause rales. ==Terminology== René Laennec developed the term 'râles' ('rattles' in French) to describe the added breath sounds which are now referred to as 'crackles'. He described them using unusual daily examples, such as 'whistling of little birds', 'crackling of salt on a heated dish', 'cooing of the woodpidgeon' etc. but soon realised that he was unable to use this term in front of his patients because it conjured the association of 'le râle de la mort', which translates to 'death rattle' i.e. the noise that people who are about to die make when they can no longer clear secretions. Therefore at the bedside, he used the Latin equivalent, 'rhonchus'. This was not clearly understood by his translator, John Forbes, and the terminology became very confusing after the publication of ''De L'Auscultation Mediate''. Therefore in 1977, a standardization was established by the American Thoracic Society and American College of Chest Physicians. As a result of this, the term 'râles' was abandoned, and 'crackles' became its official substitute. Therefore these sounds should be correctly described as crackles.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Crackles」の詳細全文を読む スポンサード リンク
|