Most medical practitioners often ask themselves where they are supposed to listen to lung sounds. Listening to lung sounds has been found to be quite a challenge by most physicians. For example, if the patient is obese, the sounds are normally not clear.
In most medical schools, students are taught different techniques of listening to lung sounds based on the instructor’s experience. One of the most difficult and vital skills an MD should learn and master is how to analyze lung sounds. The following guidelines can help you in the analysis of lung sounds.
Begin the analysis above the collarbone and then palpate from side to side as you move towards the coastal angle along the mid-axillary line. From here, examine the patient’s thorax to check if there are configuration and symmetry.
The next step is to thoroughly examine the posterior thorax and analyze the presence of any bone deformities. If there are any abnormal curvatures, they can result in breathing difficulties. Don’t forget to check whether the trachea is mid-lined or deviated.
Where to Listen to Lung Sounds
When the doctor places the stethoscope in the right position, it will filter all unwanted sounds from other body processes like gastrointestinal activities. You can therefore easily detect your patient’s breathing patterns.
If the stethoscope is placed on a bone, nothing will be heard. On the other hand, if it is placed at the right place, you will be able to diagnose the patient with ease. Since the medical field is an art which centers on sciences, the final decision will always lay with you the doctor or nurse.
The Anatomy of the Thorax and Respiratory System
When learning how to listen to lung sounds using a stethoscope, you have to be familiar with some details of the anatomy. These include:
- The lobes on both lungs. There are three on the right and two on the left.
- The anterior viewpoint of the lungs is situated from the top part of the rib cage (directly on top of the collarbone) to the sixth intercostal space.
- The diaphragm is just below the thoracic cavity. It curves so as the lungs can expand.
The mentioned parameters don’t change during inhalation.
With this information, you will never think about placing the stethoscope on the sternum because all that will be heard is the heartbeat. If you place the stethoscope below the sixth intercostal space, you’ll be able to hear intestinal sounds. The best position for auscultation is in the posterior chest because there are fewer bones and muscles that can disperse sound.
Check the video below to learn how to carry out the lung and thorax exam.
This is the process of listening to body sounds while differentiating normal from abnormal sounds. Lung auscultation is done to help in the diagnosis of a particular disorder. When you want to listen to lung sounds, minimize external sounds. For example, turn off the TV and restrict the patient from speaking.
Make sure that you are placing the stethoscope directly on the patient’s skin. The process will be more challenging if the stethoscope is placed on clothes. Ask the patient to take deep breaths each time you adjust the position of the stethoscope.
Normal breathing sounds will differ with the position of the stethoscope. For example, when placed over the trachea, you should hear a hollow, high-pitched sound known as the bronchial breath sound. It’ll be abnormal for such sounds to be heard while the stethoscope has been placed away from the trachea and the larger bronchi.
Vesicular breath sounds will be heard over lung tissues while bronchovesicular breath sounds are heard over the big diameter airways. When trying the process for the first time, it is advisable to begin with children or slim people because their breath is more conspicuous.
Always auscultate all over the anterior and posterior parts of the thorax. The process will help pull the scapulae apart, therefore exposing more lung tissues. Listen carefully for any abnormal sounds like wheezes, stridor, crackles and a friction rub.
When auscultating the posterior chest, make sure that the patient is seated upright and is leaning forward slightly with their arms resting on their laps. The assessment can also be conducted when the patient is seated or in a supine position.
Importance of Listening in the Correct Locations
If you are wondering why listening to lungs is done with a lot of attention, it is because all medical practitioners are required to offer safe and effective medical care services.
When auscultation is conducted on the required parts of the body, the doctor will be able to identify what is wrong with the patient and place them under the right type of medication. This way, the condition can be dealt with at an early stage, reducing further complications.
During respiration assessment, the doctor should begin by visualizing the patient and noting what they think could be causing the breathing difficulties. There are various steps that can help the doctor through the whole process in a logical and organized manner. The first step is to visualize. It is followed by palpation, percussion and finally auscultation.
As a medical practitioner, you need to know where to listen to lungs sounds. Moreover, make sure that your stethoscope is placed in the proper positions.