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 Respiratory sounds, also known as lung sounds or breath sounds, are 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 throu ...

), as well as the

alimentary canal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. ...

. 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 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

, 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 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. The sound differs from normal heart sounds by t ...

, gallops, and other extra sounds coinciding with heartbeats.

Heart rate Heart rate is the frequency of the cardiac cycle, heartbeat measured by the number of contractions of the heart per minute (''beats per minute'', or bpm). The heart rate varies according to the body's Human body, physical needs, including the nee ...

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 Medical ultrasound includes diagnostic techniques (mainly imaging) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, ...

(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. Phonocardiograms from normal and abnormal heart sounds

Phonocardiograms from normal and abnormal heart sounds

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

. 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 ultrasou ...

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 conse ...

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.

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

Auscultogram

Mediate and immediate auscultation

Doppler auscultation

See also

References

External links