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KhRYPY

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CRYPS - additional respiratory noise caused by narrowing of the airways or the presence of pathological contents in them. There are wet and dry rales.

Wet rales are formed as a result of foaming of a liquid (exudate, transudate, blood, etc.) in the respiratory tract or in the pathological lung cavities by the stream of inhaled air. As a rule, they are better heard in the inspiratory phase; Depending on the caliber of the bronchi or the volume of cavities containing a liquid, they can be small, medium and large bubble. Fine-bubbling wheezing resemble the noise of gas bubbles in a glass of sparkling water, medium and large bubble - the sound of bursting air bubbles blown into the water through a straw, respectively, with a very narrow or wider lumen. Fine bubbling rales are most often heard in case of focal pneumonia, pulmonary infarction, beginning pulmonary edema (congestive rales), sometimes in the acute phase of bronchiolitis. In pneumonia, wheezing is heard over a limited area of ​​the lung, does not disappear and does not change after coughing and changing the position of the body; with pulmonary edema, moist rales are determined from two sides or over the lowest parts of the lungs, depend on the position of the body, disappear after the use of diuretics. With bronchiolitis, wheezing non-sound, scattered, change after coughing, usually combined with dry wheezing. Medium bubble rales are defined over pathological cavities that are small in size (lung abscesses, bronchiectasis), as well as developed pulmonary edema, when the transudate reaches the level of small and medium bronchi. The so-called crackling rales, resembling the crackling of torn matter, which are more often caused by splitting of collapsed alveolar passages in the foci of pneumosclerosis, around the site of atelectasis, in areas of fibrosis of the lung tissue (for sarcoidosis, lung fibrillation, etc.) are usually referred to medium-bubble rales. Large bubble wheezes are heard over relatively large cavities containing fluid and connected to the bronchus (cavity, abscess), as well as with accumulation of transudate or liquid sputum in the lumen of the large bronchi.

Dry rales always indicate a narrowing of the lumen of the bronchi, which may be due to deformation of their walls (with pneumosclerosis), compression by a tumor, but more often with inflammatory or allergic edema of the mucous membrane, the presence of lumps or strands of viscous sputum and bronchospasm (with bronchitis, bronchial asthma). ); usually heard on the exhale (rarely in the phase of inhalation). Dry rales have a musical timbre, can be buzzing, buzzing (with viscous sputum in large and medium bronchi), whistling (with bronchospasm, narrowing of the small bronchi). The abundance and nature of dry rales change significantly after coughing. In bronchial asthma, dry rales are often heard from a distance, have a rich timbre ("playing the accordion"). Listening of dry rales in dynamics is used not only in diagnostics, but also to evaluate the effect of used bronchodilators and expectorant drugs.