Bronchovesicular breath sounds are best heard in which location and with which pattern?

• A. Heard in the peripheral lung fields; inspiration is louder than expiration.
• B. Heard in the trachea; inspiration is quieter than expiration.
• C. Heard in the lower lobes; inspiration is equal to expiration.
• D. Heard in the upper sternum; inspiration is equal to expiration.

Answer: (D)

Bronchovesicular breath sounds come from the central airways and have a middle-ground quality: the inspiratory and expiratory phases are about equal in length and intensity. This makes them best heard over the central chest where the trachea and main bronchi lie, specifically around the upper sternum anteriorly and, posteriorly, between the scapulae. So, the best match is hearing them near the upper sternum with equal inspiration and expiration. This differs from vesicular sounds, which are heard in the peripheral lungs with longer inspiration, and from bronchial sounds, which are louder and often have expiratory emphasis and are typically heard over the trachea.