Auscultation of the lungs

Auscultation of lungs is a research technique of external respiration that can be performed almost in any conditions. This technique tries to illustrate the current condition of lung and diagnose possible diseases.

For nearly 200 years the method of an auscultation occupied the main place in the clinical diagnosis of diseases of respiratory organs and cardiovascular system. This method allowed to carry out diagnostics and differential diagnosis of many diseases so far.  In due time auscultation became an innovative break in the clinical inspection of the patient and divided all history of medicine into two stages: before the emergence of an auscultation and after.

There are two types of auscultation: immediate (an ear to a thorax) and mediocre (by means of a stethoscope). Immediate auscultation is not practiced in the modern medicine. The mediocre is preferable in relation to the hygienic features.

Listening is conducted out in standing or sitting position of the patient. In most of the cases, the doctor listens to symmetric sites of a thorax, starting from tops of lungs and moving to the lower departments. In the course of respiration, there is respiratory noise, which is possible to be heard through a thorax. Respiratory noises subdivide into the main and padding.

Main noises:

– Vesicular noise of respiration across all pulmonary fabric;

– Bronchial noise of respiration (over large bronchial tubes, a trachea, and a throat);

In case of pathological changes of the main noise appear rales. The crepitation or the main noise cannot be heard in the place of routine localization. Listening allows determining duration, depth, timbre, loudness and, the main thing – localization of pathological noises.

Padding noises.

The pleural rub is characteristic of dry (fibrinous) pleurisy. It can arise during dissemination of a pleura by metastasis of cancer, renal failure (uremia) or a sharp d’equation of an organism.

The crepitation represents the secondary respiratory noises, which is formed due to simultaneous unglue of a large number of the alveolus. On the sounding, the crepitation reminds a crash of cellophane or the rustling sound arising when grinding of the bunch of hair near the ear.

The wet rattles are formed when passing an air stream through a secret, foaming of mobile liquid and education on its surface of instantly bursting bubbles.

Special kind of auscultation is the bronchophony. When this procedure is provided, the patient is asked to whisper the words containing the hissing sounds. If when listening separate words (strengthening of a bronchophony) are defined, so consolidation of pulmonary fabric really exists and there are resonance-inducing cavities, reported with a bronchial tube.

Nowadays auscultation, as a method, is gradually forced out by hardware techniques of a research. The result of the inspection is not precise and gives more likely a reason to assume this or that disease. Results of listening have to be surely confirmed with other, objective methods of diagnostics (roentgenography, a bronchoscopy or a tomography).