hey everyone it's sarah thread sterner sorry and calm and in this video I want to demonstrate for you on a patient how to auscultate the lungs anteriorly and posteriorly in the previous video I went over an in-depth lecture about how to do this along with normal breath sounds and abnormal breath sounds so be sure to check out that video after you watch this so let's get started first I want to start out showing you the auscultation side so I wanted to use these stickers so you can see about where I'm going to go with the stethoscope and let me get over these real fast for you because these are the little landmarks of where you're going we have our right leg over here and our left leg over here and what we're doing is we're assessing the lungs the right lung has three lobes the right up or the right middle and the right lower the left lobe only half of the left lung only has two lobes the left upper and the left lower so whenever you're listening you want to start out at your apex up at the top of the lungs right above the clavicle just slightly above it right here where you see these pink stickers then you're going to go down to the second intercostal space a little bit over from where your breastbone is the sternum and this is where you're gonna start assessing the upper lobes of the lung then you're just gonna inch down a little bit and you wolf this is about the third intercostal space and you're gonna listen here then go down to the fourth intercostal space and this is one of the landmarks for the right middle lobe your fourth intercostal space so right here well listen I'm here here a right middle lobe and then we'll listen to our left upper lobe then we'll inch down a little bit and we'll listen a little bit more to that right middle lobe and then we're going to be listening to our left lobe and then we're gonna go mid-axillary over here to the side where the armpit is mid axillary axillary sixth intercostal space and we're going to be assessing our lower lobe so it's right here on him and then it's again right here and you'll listen there and then um you'll just inch down a little bit and listen at the bottom just to assess those lower lobes a little bit now let's listen to the lungs with a stethoscope okay before you begin what you want to do is you want to perform here hi Dean introduce yourself to the patient and tell them what you're going to be doing and what whenever I listen to lung sounds I like to listen directly on the skin with my stethoscope not over the gown or over their clothing because you can pick up other sounds that may sound adventitious when it's really not and you just get the best acoustic sound whenever you listen directly on the patient so you want to get your stethoscope and you want to listen with the diaphragm of your set the scope because that's what picks up the best sounds and what we're listening for is we're listening for that full cycle of inspiration and expiration and we're paying attention to what type of breath sound is it is it bronchial vesicular Branko vesicular if you're not familiar with those sounds check out my other videos because I have audio clips where you can listen to those and we're also listening for any extra sounds on top of those sounds like crackles wheezes Strider anything like that that we may be picking up and another kids this skill takes getting used to you have to practice it over and over especially when you're listening over these areas because you're gonna hear the heartbeat at the same time so you got to train your ears to listen for those correct sounds like you're the heart versus lungs so practice this on yourself and others so you can get comfortable with it so what we're gonna do is we're gonna start at the top and we're gonna work our way down and we're going to start on one side and then compare that side because we want to say say see if we're hearing the same thing on this side as we are that side so let's get started okay what I'm gonna have you do is take one breath in through your mouth and out through your mouth and if you start to get dizzy or anything let me know and we can slow down okay we're starting up at the apex right above the clavicle now we're gonna inch down to the second intercostal space and this is where we're gonna start listening to our upper lobes of our lungs so about right there then we're just gonna inch down a little bit to about the third intercostal space and listen there and we're gonna go over and compare it now we're going to go down into the fourth intercostal space and we're still gonna be in the upper lobe of the left lung but now we're gonna be in the middle lobe of the right lung so let's just go down just a little bit and then we're gonna go over here and compare and then we'll just go a little bit do maybe the fifth intercostal space just still assessing that middle lobe and I go over here and compare now we're gonna go mid axillary and we're gonna be down in our lower lobes now and this will be at the six intercostal space okay we're going to compare sides so if you just want to turn over here we're gonna go mid acts like a parasite then we're just going to go down just a little bit to say in that lower lobe and then we're going to compare sides now let's look at the posterior view of the back here over on this side we have the left lung and over here we have the right lung it's flip compared to the anterior view and what we'll do is we'll start listening up at the apex of the lungs again and that's right above slightly above that shoulder blade in this area where the green stickers are then we're going to go and we're gonna listen between c7 to t3 and c7 is where you're prominent starts so right here and we'll go a little bit below it because c7 to t3 is going to assess the upper lobes of the posterior side of the lungs so we'll go here and here then we'll go down just bed.this is about where t3 is and then we'll jump down to round t4 and from t3 to t10 we'll be assessing the lower lobes in your posterior view you have more ability to auscultate the lower lobes then compared to the anterior view where you're gonna really be assessing the upper lips so then we'll just go down listen here listen there we'll go there and then we'll just go a little bit mid-axillary almost mid-axillary and listen over on these sides and then down at the bottom and over here now let's do it with a stethoscope now we're going to listen posterior lis okay let me tell you a trick with this whenever you're listening back here as you've learned if you watch the other lectures you have the scapula back here and you have the vertebrae and what you're trying to do is to get in between that scapula and vertebra to listen to those lungs and you don't want to go over the shoulder blades of scapula while you're listening to lungs because it's really gonna muffle out your sound and you're not gonna hear a lot so what you need to do is have the patient sort of just move their arms like this to separate those shoulder blades from one another so you have some space to work with so what we're gonna do again we're gonna start from top and work our way to the bottom and we're going to compare side so we're gonna go slightly above the scapula listen to the apex then we're gonna go down in the area where c7 is which is where your prominence is then we'll work our way down to where t3 and remember this is assessing the upper lobe and then we'll go down from t3 to about t10 and assess those lower lobes so here we go and again just take a deep breath for me in and out okay and we are done with posterior okay so that is how you assess the lungs with a stethoscope now be sure to check out the other videos in this lung series like the audio files of the normal breast films vs. abnormal and the lecture that covers this material in depth and thank you so much for watching and please consider subscribing to this YouTube channel