Auscultation of the Lungs

Introduction

• Presenter: Sarah Thread Sterner
• Focus: Demonstrating how to auscultate the lungs both anteriorly and posteriorly.
• Pre-requisite: Check out the previous video for an in-depth lecture on lung auscultation, normal breath sounds, and abnormal breath sounds.

Lung Anatomy

• Right Lung: 3 lobes - Right Upper, Right Middle, Right Lower
• Left Lung: 2 lobes - Left Upper, Left Lower

Anterior Auscultation Sites

1. Apex of the Lungs
   • Located right above the clavicle.
   • Start auscultation here.
2. Second Intercostal Space
   • Near the sternum.
   • Assess upper lobes.
3. Third Intercostal Space
   • Just below the second.
4. Fourth Intercostal Space
   • Landmark for the Right Middle Lobe.
5. Mid-Axillary (6th Intercostal Space)
   • Assessing lower lobes on the side.

Posterior Auscultation

• Start at the Apex
  • Slightly above the shoulder blade.
• C7 to T3
  • Between these points to assess upper lobes.
• T3 to T10
  • Focus on lower lobes.

Auscultation Technique

• Perform Hand Hygiene and introduce yourself to the patient.
• Prefer listening directly on the skin rather than over clothing.
  • Prevents picking up extraneous sounds.
• Use the diaphragm of the stethoscope.
  • Best for picking up lung sounds.
• Listen for a full cycle of inspiration and expiration.
• Be aware of different breath sounds: bronchial, vesicular, bronchovesicular.
• Pay attention to abnormal sounds like crackles, wheezes, stridor.

Comparing Sides

• Start from the top and work your way down.
• Always compare the same areas on both sides of the body.

Tips for Posterior Auscultation

• Avoid auscultating over the scapula.
• Have the patient move their arms to better access lung sounds around the scapula.

Conclusion

• Practice regularly to distinguish between heart and lung sounds.
• Watch additional videos for audio examples of normal and abnormal breath sounds.
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