Rhonchi are abnormal breath sounds heard when listening to a person’s lungs. They indicate air movement within the respiratory system is not flowing smoothly. These sounds are distinct from the quiet, soft sounds of normal breathing.
Characteristics and Location
Rhonchi are characterized as low-pitched, continuous sounds, often described as rumbling, snoring, or gurgling. This sound occurs when air passes through larger airways that are narrowed or obstructed. Obstructions often result from fluid, mucus, or other secretions, causing airway walls to vibrate as air passes.
They are heard during both inhalation and exhalation, though often more noticeable during exhalation. A notable characteristic of rhonchi is that they may change or clear after a person coughs, as the coughing action can temporarily dislodge the obstructing mucus. When a healthcare provider listens for rhonchi, they typically focus on areas over the larger airways, such as the trachea (windpipe), the main bronchi, and the broader lung fields.
Common Causes of Rhonchi
Rhonchi often indicate conditions leading to mucus or other blockages within larger breathing passages. One common cause is acute bronchitis, an inflammation of the bronchial tubes that often follows a viral infection. This inflammation leads to increased mucus production, narrowing airways and producing the characteristic rumbling sound.
Pneumonia, an infection that inflames lung air sacs, can also result in rhonchi due to fluid and inflammatory cell buildup within the airways. Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, frequently causes rhonchi. In COPD, persistent inflammation and excessive mucus can obstruct the airways, making breathing difficult and generating these sounds.
Cystic fibrosis, a genetic disorder, causes thick, sticky mucus that can clog the lungs, leading to chronic airway obstruction and recurrent rhonchi. Bronchiectasis, a condition where airways widen abnormally, also predisposes individuals to mucus accumulation and rhonchi. Even simple respiratory infections, such as the common cold, can lead to temporary mucus buildup in the larger airways, causing rhonchi that resolve as the infection clears.
When to Seek Medical Attention
While rhonchi can be a temporary symptom of minor illness, their presence can also indicate a more serious underlying health issue requiring professional evaluation. Seek medical attention if rhonchi are accompanied by other concerning symptoms. These include significant shortness of breath or difficulty breathing, suggesting impaired air exchange.
A persistent cough that does not improve or worsens, especially if producing discolored sputum, warrants medical review. Chest pain or discomfort, particularly if it intensifies with breathing, is another important symptom. Additionally, bluish discoloration of the lips or fingernails (cyanosis) signals a lack of oxygen and requires immediate medical care.
Distinguishing Rhonchi from Other Breath Sounds
Differentiating rhonchi from other abnormal breath sounds is important for accurate assessment. Unlike rhonchi’s low-pitched, continuous snoring quality, wheezing is a high-pitched, whistling, and musical sound. Wheezes typically arise from narrowed smaller airways, such as in asthma, and are often more pronounced during exhalation.
Crackles (rales) are distinct from rhonchi; they are discontinuous, sounding like small clicking, bubbling, or rattling noises. They are often heard during inhalation, caused by fluid in smaller airways or sudden opening of collapsed air sacs. Crackles can be either fine (high-pitched) or coarse (lower-pitched), but they lack the continuous, rumbling quality of rhonchi.
Stridor is another high-pitched sound, typically harsh and crowing, originating from an upper airway obstruction, such as the larynx or trachea. Unlike rhonchi, stridor is predominantly heard during inhalation and is often louder over the neck than the chest. Understanding these differences helps pinpoint the location and nature of respiratory issues.