Pleural Rubs

When auscultation is performed, pleural rubs can often be heard as creaking or grating sounds. These are produced by two inflamed surfaces rubbing against each other - similar to walking on fresh snow or the sound of leather-on-leather. Coughing does not affect these noises and they will usually change in intensity with respiration cycle (aimilarly increasing at inspiration, decreasing at expiration). A crucial distinction between them and pericardial friction rubs is that those continue even when patient holds their breath whilst a pleural rub stops immediately thereafter.

Patient Recording

Patient Recording - Half Speed

Position

The patient's position should be seated.

Listening Tips

Features:Plural rubs are creaking or grating sounds that have been described as being similar to walking on fresh snow or a leather-on-leather type of sound. Pleural rubs stop when the patient holds a breath

Waveform (Phonocardiogram)

Authors and Sources

Authors and Reviewers

EKG heart rhythm modules: Thomas O'Brien.
EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language EKG: Breena R. Taira, MD, MPH
Medical review: Dr. Jonathan Keroes, MD
Heart sounds and mentorship: W. Proctor Harvey, MD
Medical review: Dr. Pedro Azevedo, MD, Cardiology
Last Update: 1/8/2023

Sources

Electrocardiography for Healthcare Professionals, 5th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH

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Pleural Rubs | Lessons with Audio and Video | #77