Auscultation is the most important examination technique for assessing air flow through the tracheobronchial tree. Auscultation involves (1) listening to the sounds generated by breathing, (2) listening for any adventitious (added) sounds, and (3) if abnormalities are suspected, listening to the sounds of the patient’s spoken or whispered voice as they are transmitted through the chest wall. Before beginning auscultation, ask the patient to cough once or twice to clear mild atelectasis or airway mucus that can produce unimportant extra sounds.
Listen to the breath sounds with the diaphragm of your stethoscope after instructing the patient to breathe deeply through an open mouth. Always place the stethoscope directly on the skin. Clothing alters the characteristics of the breath sounds and can introduce friction and added sounds.
Use the ladder pattern suggested for percussion, moving from one side to the other and comparing symmetric areas of the lungs. Listen to at least one full breath in each location. If you hear or suspect abnormal sounds, auscultate adjacent areas to assess the extent of any abnormality. If the patient becomes lightheaded from hyperventilation, allow the patient to take a few normal breaths.
Note the intensity of the breath sounds, which reflects the air flow rate at the mouth, and may vary from one area to another. Breath sounds are usually louder in the lower posterior lung fields. If the breath sounds seem faint, ask the patient to breathe more deeply. Shallow breathing or a thick chest wall can both alter breath sound intensity.
Is there a silent gap between the inspiratory and expiratory sounds?
Listen for the pitch, intensity, and duration of the inspiratory and expiratory sounds. Are vesicular breath sounds distributed normally over the chest wall? Are breath sounds diminished, or are there bronchovesicular or bronchial breath sounds in
unexpected places? If so, in what distribution?
责任编辑：admin
上一篇：没有了
下一篇：医学文章阅读——Percussion for Examination of the Posterior Chest
微信公众号搜索“译员”关注我们，每天为您推送翻译理论和技巧，外语学习及翻译招聘信息。