2.3 Auscultation: This is such a broad topic. Auscultation starts before you put on a stethoscope. For instance listening for the prosthetic click of a heart valve as you are just taking a history. I am going to go from head to toe on auscultation. Wherever a topic is covered elsewhere, I am going to put a link that will open a new window so that as soon as you are done with that page, you can close out of that window and come back on track on this page again.

Head auscultation is no longer done. An AVM can be heard almost in any part of the body that it exists in. It has a whoosh sound and then as that calms down during diastole, a lower intensity flow sound may remain.

This is useful in the orbit.

Neck is auscultated for carotid bruits, radiating aortic valve murmurs and thyroid hums in an overactive thyroid or a large goiter.

Chest auscultation is extremely important and gives us a lot of clues. One of the frequently tested topics is wheezing. Wheezing signifies obstruction. Obstruction may be due to bronchospasm ( more prominent during expiration) or due to a fixed defect (more prominent during inspiratory phase)

Then come crackles or crepiti: These are crackling sounds heard whenever there is infiltrate or pulmonary edema or fibrosis.

Then is succussion splash. It may be due to one of the following 2. I have only heard it once in my 18 years of medical career. It is heard in HYDROPNEUMOTHORAX and in distended stomachs. You shake the patient (such a polite gesture!!) and try to hear the splash you create. I do not even know why this still appears on tests.

There are three things that are standard when you report chest auscultation. 1. Air entry, 2) nature of breath sounds and 3) extra sounds such as wheezing, crackles etc. Air entry is described a s normal , decreased or absent. It is decreased in asthma or COPD. It is absent with pleural effusion and pneumothorax.

Nature of breath sound is described as bronchial or vesicular. Bronchial is what you hear if you auscultate (listen) over the trachea. Vesicular is what you hear over the chest.