Auscultation
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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 The stethoscope is a medicine, medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, with either one or two tubes connected t ...
. Auscultation is performed for the purposes of examining the circulatory and
respiratory system The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies grea ...
s (
heart The heart is a muscular Organ (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...
and breath sounds), as well as the alimentary canal. The term was introduced by René Laennec. 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 go together in
physical examination In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a Disease, medical condition. It generally consists of a series of ...
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 (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...
, the
lungs The lungs are the primary organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the backbone on either side of the heart. Their function in the respiratory syste ...
, and the gastrointestinal system. When auscultating the heart, doctors listen for abnormal sounds, including heart murmurs, gallops, and other extra sounds coinciding with heartbeats. Heart rate is also noted. When listening to lungs, breath sounds such as wheezes, 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 Echocardiography, also known as cardiac ultrasound, is the use of ultrasound to examine the heart. It is a type of medical imaging, using standard ultrasound or Doppler ultrasound. The visual image formed using this technique is called an ec ...
, 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 The stethoscope is a medicine, medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, with either one or two tubes connected t ...
. 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 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 regurgitations, 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

* Breath sounds * Heart sounds * Intestinal sound * Palpation, the practice of examining a patient through the use of hands * Percussion (medicine) * Pericardial friction rub * Triangle of auscultation


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