Which breath sounds are normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

• A. Vesicular breath sounds
• B. Bronchial breath sounds
• C. Adventitious breath sounds
• D. Tracheal breath sounds

Answer: (A)

Vesicular breath sounds are the normal sounds heard over the majority of the lung surface. They arise as air moves through the small airways and alveoli during inspiration, giving a soft, low-pitched sound that lasts longer on inspiration than expiration. Because they reflect air moving through the peripheral airways, these sounds fill most of the lung fields. However, in areas where the central airways lie close to the chest wall—the upper back between the scapulae and just under the sternum near the manubrium—the sound of air moving through larger airways is more prominent, producing bronchial or tracheal-type sounds rather than the vesicular type. Therefore, vesicular breath sounds are normally heard across the lungs except for those central regions where the larger airways dominate the sound.