Coarse lung sounds: The lazy clinician's lung sound

Most students don't like it when they follow me, because I don't accept lazy reporting of lung sounds.  When I have a student, I don't let them describe lung sounds as "coarse."  There is no such thing as coarse lung sounds.  I want a real lungsound, such as wheezes, or crackles or rhonchi.  I want specifics.  I also want location.  Do you hear crackles in the left lower lobe?  Do you hear sibilant wheezes in the left lower lobe?  Do you hear inspiratory wheezes inspiratory and expiratory (a bad sign)?  Do you hear rhonchi? 

Coarse lung sounds are most often rhonchi.  Yes, I think most people, including many of my fellow respiratory therapists, have no idea what rhonchi even is.  Most of them think it's secretions in the upper airway, but secretions in the upper airway are probably coarse crackles.  Coarse crackles is the sound fluid makes as it "rumbles" when a person inhales and exhales.  Rhonchi is the sound of air moving through air passages filled with secretions, and sound coarse.  It is most often air moving through secretion narrowed upper air passages, and this is why it is often audible.  Wheezes, if they are true bronchospasm wheezes, are almost always only audible with the aid of a stethoscope. 

Folks: There is no such thing as coarse lung sounds.  Do not be lazy and chart "Coarse." Do not be like my ignorant, lazy coworkers. 

Further reading:

1. There is no such thing as coarse lung sounds
2. Why do we listen to lung sounds?
3. Lungsound Lexicon
4. Lungsounds for Dunderheads (this might be a good read for you if you like to chart "coarse"