Heart and Lung Sounds Reference Guide Aortic Pulmonic Erb's Point Tricuspid Mitral Lungs Crackles - Early Inspiratory (Rales) Auscultation Reference Signup Now. Unlock lessons and more. SignUp Patient Normal Speed play pause Patient Half Speed play pause Lesson For heart sounds listen to the synthetic sound while reviewing this lesson. Early inspiratory crackles (rales), as suggested by the title, begin and end during the early part of inspiration. The pitch is lower than late inspiratory crackles. A patient's cough may decrease or clear these lung sounds. Early inspiratory crackles suggest decreased FEV1 capacity and are characteristic of COPD. The waveform(s) seen above are a chart of sound amplitude (loudness) on the vertical axis against time on the horizontal axis. Listening Tips A summary of the key aspects of this heart or lung sound. Occur early in inspiration. Can be lower pitched than late inspiratory crackles. Coughing may decrease or clear these crackles. Auscultation Method The recommended patient position is sitting For this sound, use stethoscope's diaphragm The recommended auscultation position for the stethoscope is posterior-3l Relevant Courses If you wish to review a complete mobile concerning Crackles - Early Inspiratory (Rales) Auscultation Reference and related heart sounds, the modules(s) listed below may be useful. Each lesson includes text that explains the auscultatory sound and its clinical significance. The lesson also includes an audio track for playback. A waveform provides a great way to visualize the sounds. Finally, we also include an animation video. For heart sounds, the video illustrates heart muscle and valve movements along with blood flow. For lung sounds, the primary source of the sounds can be seen. Each module also includes a quiz. Intermediate Lung Sounds202 Crackles - Early Inspiratory (Rales) Auscultation Reference