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UNUSUAL SOUNDS EMANATING FROM THE CHEST: CAUSE AND DIAGNOSTIC SIGNIFICANCE OF BUBBLING, CLICKING, CRUNCHING, KNOCKING AND TAPPING SOUNDS; WITH A REPORT OF TWO CASES OF INTERSTITIAL EMPHYSEMA OF LUNG AND MEDIASTINUM

UNUSUAL SOUNDS EMANATING FROM THE CHEST: CAUSE AND DIAGNOSTIC SIGNIFICANCE OF BUBBLING, CLICKING,... Abstract Bubbling, clicking, crunching, knocking and tapping sounds emanating from the chest are rarely encountered in civilian practice and their significance is not generally appreciated. With the current great military mobilization physicians will undoubtedly encounter these sounds in many instances of thoracic wounds in military personnel and in civilians. It appears pertinent, therefore, to emphasize their mechanism of production and their diagnostic significance. Tapping, clicking and snapping metallic sounds were encountered by Rees and Hughes1 and Smith2 in soldiers with wounds of the left side of the chest during the last war. These sounds varied in intensity from ones audible only with the stethoscope applied over the precordium to those which could be heard 6 to 8 feet (183 to 244 cm.) from the patient. They were synchronous with the heart beat but varied in relation to the cardiac cycle. Some were audible only during systole, others only during References 1. Rees, W. A., and Hughes, G. S.: Wounds of the Chest as Seen at an Advanced Operating Centre , Lancet 1:55-59, 1918.Crossref 2. Smith, S. M.: Pericardial Knock , Brit. M. J. 1:78, 1918.Crossref 3. Munden, W. P. H.: Pericardial Knock , Brit. M. J. 1:174, 1918.Crossref 4. Lister, W. A.: Pericardial Knock Associated with Spontaneous Pneumothorax , Lancet 1:1225-1226, 1928.Crossref 5. Hamman, L.: Spontaneous Interstitial Emphysema of the Lungs , Tr. A. Am. Physicians 52:311-509, 1937. 6. McGuire, J., and Bean, W. B.: Spontaneous Interstitial Emphysema of the Lung Am. J. M. Sc. 197:502-509, 1939Crossref 7. Macklin, C. C.: Transport of Air Along Sheaths of Pulmonic Blood Vessels from Alveoli to Mediastinum: Clinical Implication , Arch. Int. Med. 64:913-926 ( (Nov.) ) 1939Crossref 8. Impediment to Circulation Occasioned by Pulmonic Interstitial Emphysema and Pneumomediastinum , J. Michigan M. Soc. 39:756-759, 1940. 9. Gumbiner, B., and Cutter, M. M.: Spontaneous Pneumomediastinum in the New Born , J. A. M. A. 117:2050-2054 ( (Dec. 13) ) 1941.Crossref 10. Scadding, J. G., and Wood, P.: Systolic Click Due to Left-Sided Pneumothorax , Lancet 2:1208-1211, 1939.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

UNUSUAL SOUNDS EMANATING FROM THE CHEST: CAUSE AND DIAGNOSTIC SIGNIFICANCE OF BUBBLING, CLICKING, CRUNCHING, KNOCKING AND TAPPING SOUNDS; WITH A REPORT OF TWO CASES OF INTERSTITIAL EMPHYSEMA OF LUNG AND MEDIASTINUM

Archives of Internal Medicine , Volume 71 (3) – Mar 1, 1943

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Publisher
American Medical Association
Copyright
Copyright © 1943 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1943.00210030111011
Publisher site
See Article on Publisher Site

Abstract

Abstract Bubbling, clicking, crunching, knocking and tapping sounds emanating from the chest are rarely encountered in civilian practice and their significance is not generally appreciated. With the current great military mobilization physicians will undoubtedly encounter these sounds in many instances of thoracic wounds in military personnel and in civilians. It appears pertinent, therefore, to emphasize their mechanism of production and their diagnostic significance. Tapping, clicking and snapping metallic sounds were encountered by Rees and Hughes1 and Smith2 in soldiers with wounds of the left side of the chest during the last war. These sounds varied in intensity from ones audible only with the stethoscope applied over the precordium to those which could be heard 6 to 8 feet (183 to 244 cm.) from the patient. They were synchronous with the heart beat but varied in relation to the cardiac cycle. Some were audible only during systole, others only during References 1. Rees, W. A., and Hughes, G. S.: Wounds of the Chest as Seen at an Advanced Operating Centre , Lancet 1:55-59, 1918.Crossref 2. Smith, S. M.: Pericardial Knock , Brit. M. J. 1:78, 1918.Crossref 3. Munden, W. P. H.: Pericardial Knock , Brit. M. J. 1:174, 1918.Crossref 4. Lister, W. A.: Pericardial Knock Associated with Spontaneous Pneumothorax , Lancet 1:1225-1226, 1928.Crossref 5. Hamman, L.: Spontaneous Interstitial Emphysema of the Lungs , Tr. A. Am. Physicians 52:311-509, 1937. 6. McGuire, J., and Bean, W. B.: Spontaneous Interstitial Emphysema of the Lung Am. J. M. Sc. 197:502-509, 1939Crossref 7. Macklin, C. C.: Transport of Air Along Sheaths of Pulmonic Blood Vessels from Alveoli to Mediastinum: Clinical Implication , Arch. Int. Med. 64:913-926 ( (Nov.) ) 1939Crossref 8. Impediment to Circulation Occasioned by Pulmonic Interstitial Emphysema and Pneumomediastinum , J. Michigan M. Soc. 39:756-759, 1940. 9. Gumbiner, B., and Cutter, M. M.: Spontaneous Pneumomediastinum in the New Born , J. A. M. A. 117:2050-2054 ( (Dec. 13) ) 1941.Crossref 10. Scadding, J. G., and Wood, P.: Systolic Click Due to Left-Sided Pneumothorax , Lancet 2:1208-1211, 1939.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1943

References