An introduction to using the stethoscope History What

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An introduction to using the stethoscope • History • What it is • How

An introduction to using the stethoscope • History • What it is • How to care for it • Normal and abnormal breath sounds • Added sounds • Surface marking of the lungs

Immediate auscultation

Immediate auscultation

Stethoscope – what do you hear? • Breath sounds • Added sounds from lung

Stethoscope – what do you hear? • Breath sounds • Added sounds from lung • Added sounds from elsewhere

Stethoscope – what do you hear? Breath sounds • Vesicular • Bronchial May be

Stethoscope – what do you hear? Breath sounds • Vesicular • Bronchial May be modified in volume– increased or decreased

Stethoscope – what do you hear? Added sounds from the lungs • Crackles –

Stethoscope – what do you hear? Added sounds from the lungs • Crackles – ‘wet sounds’ [crepitations] • Wheezes – ‘dry sounds’ [rhonchi]

Stethoscope – what do you hear? Added sounds from elsewhere • Pleura – rub

Stethoscope – what do you hear? Added sounds from elsewhere • Pleura – rub [creaky shoe] • Chest wall – fractured rib • Superficial tissues – surgical emphysema • Clothes!!

How do you describe what you hear? • What heard • Where heard •

How do you describe what you hear? • What heard • Where heard • When heard E. g. Inspiratory crackles at the left base

Where do you listen? Over the lungs! Other structures may interfere • Superficial –

Where do you listen? Over the lungs! Other structures may interfere • Superficial – breast, fat, scapulae • Underlying - liver, heart

Surface anatomy • Vertebra prominens - C 7 • Sternal notch – overlies trachea

Surface anatomy • Vertebra prominens - C 7 • Sternal notch – overlies trachea • Manubrio sternal angle - T 4/5, bifurcation of trachea, 2 nd costal cartilage, upper order of atria, aortic arch • Xiphoid process – T 9

Warning! You cannot tell everything from your stethoscope. The history and other physical signs

Warning! You cannot tell everything from your stethoscope. The history and other physical signs derived from observation, palpation and percussion are essential to make a diagnosis.

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