Auscultation and Lung Sounds

Key Concepts

• Auscultation: The act of listening to lung sounds, including vesicular sounds, crackles, wheezes, and stridor.
• Intercostal Space: Listening between the ribs.
• Normal Breath Sounds: Indicate good air exchange in alveoli.

Auscultation Technique

• Ear Tips: Ensure stethoscope ear tips are inserted correctly (pointing into the ear).
• Stethoscope Diaphragm: Use the diaphragm (large side) for lung auscultation.
• Starting Point: Begin at the apices (top of the lungs) and use a side-to-side zig-zag pattern.
• Inhale and Exhale: Ensure to hear both inspiration and expiration as some sounds are phase-specific.
• Bare Skin: Place the stethoscope on bare skin to avoid muffled or extraneous sounds.
• Front and Back: Auscultate both anterior and posterior lung fields for a complete assessment.

Anterior Lung Sounds

• Similar to posterior lung assessment.
• Move in a zig-zag from top to bottom.
• Expected Sounds: Soft, clear vesicular lung sounds indicating good gas exchange.

Side Lung Sounds

• Mid-Axillary Point: Listen at the mid-axillary line; useful if posterior is inaccessible.

Types of Lung Sounds

• Bronchial Sounds: Loud, heard over trachea, like air moving through a large tube.
• Bronchovesicular Sounds: Medium intensity, heard over the sternum, a mix of bronchial and vesicular.
• Vesicular Sounds: Soft, heard over lung lobes, indicating air moving in alveoli.

Practice Questions and Answers

1. Bronchial Breath Sounds: Documented when high, harsh sounds with short inspiration and long expiration are heard over the trachea.
2. Vesicular Sounds: Expected over most lung areas.
3. Normal Breath Sounds: Soft, low-pitched, breezy vesicular sounds in peripheral lung fields.

Abnormal Lung Sounds

• Upcoming segment on abnormal lung sounds.