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Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the
circulatory The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, t ...
and respiratory systems (
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to ...
and
breath sounds Respiratory sounds, also known as lung sounds or breath sounds, refer to the specific sounds generated by the movement of air through the respiratory system. These may be easily audible or identified through auscultation of the respiratory system ...
), as well as the alimentary canal. The term was introduced by
René Laennec René-Théophile-Hyacinthe Laennec (; 17 February 1781 – 13 August 1826) was a French physician and musician. His skill at carving his own wooden flutes led him to invent the stethoscope in 1816, while working at the Hôpital Necker ...
. The act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. (Auscultation and
palpation Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...
go together in physical examination and are alike in that both have ancient roots, both require skill, and both are still important today.) Laënnec's contributions were refining the procedure, linking sounds with specific pathological changes in the chest, and inventing a suitable instrument (the stethoscope) to mediate between the patient's body and the clinician's ear. Auscultation is a skill that requires substantial clinical experience, a fine stethoscope and good listening skills. Health professionals (doctors, nurses, etc.) listen to three main organs and organ systems during auscultation: the
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to ...
, the lungs, and the gastrointestinal system. When auscultating the heart, doctors listen for abnormal sounds, including
heart murmurs Heart murmurs are unique heart sounds produced when blood flows across a heart valve or blood vessel. This occurs when turbulent blood flow creates a sound loud enough to hear with a stethoscope. Turbulent blood flow is not smooth. The sound di ...
, gallops, and other extra sounds coinciding with heartbeats. Heart rate is also noted. When listening to lungs, breath sounds such as
wheezes A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract ...
, crepitations and crackles are identified. The gastrointestinal system is auscultated to note the presence of bowel sounds. Electronic stethoscopes can be recording devices, and can provide noise reduction and signal enhancement. This is helpful for purposes of telemedicine (remote diagnosis) and teaching. This opened the field to
computer-aided auscultation Computer-aided auscultation (CAA), or computerized assisted auscultation, is a digital form of auscultation. It includes the recording, visualization, storage, analysis and sharing of digital recordings of heart or lung sounds. The recordings are o ...
. Ultrasonography (US) inherently provides capability for computer-aided auscultation, and portable US, especially portable
echocardiography An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in th ...
, replaces some stethoscope auscultation (especially in cardiology), although not nearly all of it (stethoscopes are still essential in basic checkups, listening to bowel sounds, and other primary care contexts).


Auscultogram

The sounds of auscultation can be depicted using symbols to produce an auscultogram. It is used in cardiology training.


Mediate and immediate auscultation

Mediate auscultation is an antiquated medical term for listening (auscultation) to the internal sounds of the body using an instrument (mediate), usually a stethoscope. It is opposed to immediate auscultation, directly placing the ear on the body.


Doppler auscultation

It was demonstrated in the 2000s that Doppler auscultation using a handheld
ultrasound transducer Ultrasonic transducers and ultrasonic sensors are devices that generate or sense ultrasound energy. They can be divided into three broad categories: transmitters, receivers and transceivers. Transmitters convert electrical signals into ultrasoun ...
enables the auscultation of valvular movements and blood flow sounds that are undetected during cardiac examination with a stethoscope. The Doppler auscultation presented a sensitivity of 84% for the detection of
aortic regurgitation Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a cons ...
s, while classic stethoscope auscultation presented a sensitivity of 58%. Moreover, Doppler auscultation was superior in the detection of impaired ventricular relaxation. Since the physics of Doppler auscultation and classic auscultation are different, it has been suggested that both methods could complement each other.


See also

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Breath sounds Respiratory sounds, also known as lung sounds or breath sounds, refer to the specific sounds generated by the movement of air through the respiratory system. These may be easily audible or identified through auscultation of the respiratory system ...
*
Heart sounds Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a steth ...
*
Intestinal sound A stomach rumble, also known as a bowel sound, peristaltic sound, abdominal sound, bubble gut or borborygmus (pronounced ; plural borborygmi), is a rumbling, growling or gurgling noise produced by movement of the contents of the gastro-intestinal ...
*
Palpation Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...
, the practice of examining a patient through the use of hands *
Percussion (medicine) Percussion is a technique of clinical examination. Overview Percussion is a method of tapping on a surface to determine the underlying structures, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of ...
*
Pericardial friction rub A pericardial friction rub, also pericardial rub, is an audible medical sign used in the diagnosis of pericarditis. Upon auscultation, this sign is an extra heart sound of to-and-fro character, typically with three components, two systolic and ...
*
Triangle of auscultation The triangle of auscultation is a relative thinning of the musculature of the back, situated along the medial border of the scapula which allows for improved listening to the lungs. Boundaries It has the following boundaries: * medially, by th ...


References


External links


The Auscultation Assistant
- "provides heart sounds, heart murmurs, and breath sounds in order to help medical students and others improve their physical diagnosis skills"

- Respiratory auscultation with audio examples
Blaufuss Multimedia
- Heart Sounds and Cardiac Arrhythmias

- Comparative review of stethoscopes, including frequency response graphs.
Auscultation Lessons and Reference Guide
- Compilation of 100+ Heart and Lung Sounds and Phonocardiograms
Wave Doppler Auscultation
- Cardiac Continuous Wave Doppler audio and video examples {{Authority control Audible medical signs Veterinary diagnosis Physical examination