Rales

Introduction

Welcome to our rales page. On this page we provide a definition of rales, including its clinical significance. We then compare rales against rhonchi with audio recordings and text. Finally, there is a link to the rales training lessons available on this site.

Our rales lesson can be found in this course. Secondly, our reference index is designed to provide quick access to stridor sounds, with audio tracks, listening guides and waveforms. Use this link for quick reference to heart and lung sounds.

Definition

Rales are abnormal lung sounds characterized by discontinuous clicking or rattling sounds. They can sound like salt dropped onto a hot pan or like cellophane being crumpled. Rales are believed to be caused by the opening of closed air spaces.

What about crackles? Crackles and rales mean the same thing. Refer to our 'crackles' page for more information on fine vs coarse crackles, along with patient recordings for each.

Rales Lung Sounds

Rales Sound Features

Listen for fine crackles, which are discontinuous, popping sounds similar to Velcro being pulled apart.

Rales Causes

When alveoli suddenly pop open with the presence of secretions, rales sounds are thought to be produced.

Rales Audio

The following recordings provide examples of what rales sounds like.

The patient's position is seated.

Waveform

Compare To Rhonchi

Rhonchi Listening Tips

Listen for lower pitched, snoring or rattle-like sounds.

Rhonchi Causes

Rhonchi are caused by secretions or obstructions in the large airways.

Rhonchi Audio

The following recordings provide examples of what rhonchi sounds like.

Rhonchi Audio

The patient's position is seated.

Respiratory Sounds Reference Guide

Our auscultation reference guide provides quick access to this sound as well as many other adventitious sounds. Each sound is described also with an audio recording and waveform.

Lung Sounds Reference Guide

Quick Links to Other Breath Sounds

While we have many breath sound lessons and quick references on this website. Please use the links below.

Vesicular Breath Sounds
Bronchial Breath Sounds
Adventitious Breath Sounds
Adventitious Lung Sounds
Wheezing
Rhonchi
Fine and Coarse Crackles
Rales
Egophony
Auscultate
Auscultation Lung Sounds Audio

Related Lessons

Basics of Lung Sounds
The goal of this basic course in lung sounds is to improve auscultation observational skills. We focus on describing important breath sounds and in providing recordings of each. Many students find that waveform tracings aid in learning lung sounds; we have included dynamic (moving cursor) waveforms with each lesson. The anatomy pages use illustrations to reveal an example of each lung sound (anatomy not yet available on smartphones).

Lesson List

1	Vesicular - Normal
2	Crackles - Fine (Rales)
3	Crackles - Coarse (Rales)
4	Wheeze
5	Rhonchi - Low Pitched Wheezes
6	Bronchial
7	Pleural Rubs
8	Bronchovesicular

Intermediate Lung Sounds
The goal of this intermediate course is to expand your observational skills when auscultating breath sounds. The course lessons include voiced sounds: bronchophony, egophony and whispered pectoriloquy. We also provide auscultation lessons on several types of wheezes, crackles and stridor. Each of these lung sound lessons includes audio, text and dynamic waveform. The anatomy pages use illustrations to reveal an example of each lung sound (anatomy not yet available on smartphones).

Lesson List

1	Vesicular - Diminished
2	Bronchophony - Healthy
3	Bronchophony - Abnormal
4	Egophony - e
5	Egophony - a
6	Whispered Pectoriloquy - Healthy
7	Whispered Pectoriloquy - Abnormal
8	Wheeze - Expiratory
9	Wheeze - Monophonic
10	Wheeze - Polyphonic
11	Crackles - Early Inspiratory (Rales)
12	Crackles - Late Inspiratory (Rales)
13	Stridor

Authors and Reviewers

These authors contributed the sound recordings and text descriptions found in this section: Diane Wrigley, PA, William French, and David Lieberman.
Medical review by Dr. Barbara Erickson, PhD, RN, CCRN.
Special thanks for the medical leadership of Dr Raymond Murphy.

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 12/11/2022

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)