From Big Medical Encyclopedia

CREPITATION (crepitatio; lat. crepitare to creak, crackle) — the pathological phenomenon revealed by listening or palpation very similar to crackling or a small crunch.

Distinguish To. alveolar, hypodermic and bone.

Alveolar To. treats high-frequency patol, to respiratory noise (see). Reminds the sound arising during the puddling by fingers of a bunch of hair about an ear.

For listening alveolar To. (see. Auscultation ) it is necessary to press densely to skin a phonendoscope that reduces the audibility of low-frequency sounds and prevents emergence of extraneous noises from interaction of skin with a membrane of the device. Thorax hair in places of listening moisten with water or grease with fat since friction of dry hair can imitate

K. K. is heard better or only at height of a breath (it is frequent only at height of a deep breath); it is formed from the razlipaniye or a raspravleniye humidified more, than usually, walls of alveoluses and shown as short sound «flash» or «explosion».

To. has the constant structure and homogeneous caliber of sounds which is not changing in the course of breath or after cough. It is sometimes difficult to distinguish To. from small-bubbling wet rattles (see), arising in bronchioles and the smallest bronchial tubes. Unlike To., rattles are often heterogeneous on caliber (arise in bronchial tubes of different diameter), are listened from the very beginning of a breath, sometimes and in an expiratory phase, are more long on sounding and quite often change by quantity and caliber after cough. The pleural rub quite often reminds To., but it usually more rough on a timbre, differs in the bigger duration, audibility in both phases of breath and as if close sounding (noise is listened as if directly under a membrane of a phonendoscope).

The most often alveolar To. is a symptom of an acute pneumonia, accompanying phases of emergence and a rassasyvaniye of exudate. At an acute pneumonia with an inflammation of certain sites occurring at different times of a pulmonary parenchyma To. it can be listened within several days. At a lung fever she is listened only in an onset of the illness — crepitatio indux, disappears in a phase of hepatization of the struck share and again (not always) appears in a stage of permission of pneumonia when exudate resolves — crepitatio redux (see. Pneumonia ). To. it can be listened it is long at patients with long alveolites (e.g., at collagenoses). Emergence To. in patients with a thromboembolism of branches of a pulmonary artery usually confirms the beginning of «infarctive» pneumonia. Occasionally To. it is possible to listen at the very beginning of development fluid lungs (see), in auskultativny signs to-rogo wet rattles dominate.

Similar with To. on the mechanism of education the rattles listened at deep breath over atelektazirovanny sites of lungs at weakened, long lying, especially elderly, people are. Unlike true To., rattles from a raspravleniye of atelektazirovanny sites of lungs disappear after several deep breaths.

Hypodermic crepitation — palpatorny or palpatorno-auskultativny phenomenon: feeling of a crunch and crackling at a palpation (or during the pressing by a head of a phonendoscope) the body parts containing in hypodermic cellulose of accumulation of vials of free gas. It is observed at mephitic gangrene (see), hypodermic to emphysema (see) owing to wounds, spontaneous ruptures of hollow bodies, and also at administration of air to various areas of a body with to lay down. purpose.

Bone crepitation — feeling or a sound of a crunch from mutual friction of fragments of a bone in the area change (see) comes to light palpatorno and auskultativno.

To. it is observed also at crepitant tendovaginitis (see).

Bibliography: See bibliogr, to St. Respiratory noise .

V. P. Zhmurkin.