Auscultation of lungs is an important diagnostic method

Nowadays, innovative research methods are emerging, based on long-term developments and multimillion-dollar investments. However, a good doctor does not neglect the simplest but most informative ways to identify pathologies, such as auscultation of the lungs, percussion of the heart or palpation of the abdomen. Carrying out these manipulations is of great importance in the diagnosis of diseases.

I would like to elaborate on the method, which is translated as "listening", and is called auscultation of the lungs. It is performed with a stethoscope (tube) or a phonendoscope. Previously, doctors tried to listen to the chest by simply applying an ear to the body, but once Rene Laennec could not hear anything from a young patient with a heavy weight, then he twisted a sheet of paper into a tube, put one end to the girl's breast, and the other to his ear. The doctor was pleasantly surprised, the audibility was better than ever.

The method is based on catching those sounds that are formed in the larynx and lungs, and then transmitted to the surface of the chest.

Auscultation of lungs, general rules

• Convenient position of the doctor.
• Position of the patient sitting or standing.
• The room where the procedure is performed should be warm and quiet, it is noticed that after 5 minutes spent in complete silence, the hearing becomes aggravated.
• It is desirable that the listening surface is devoid of hair, since they give friction and the appearance of extraneous noise.
• The phonendoscope or the socket of the stethoscope is applied to the surface of the body tightly, but without superfluous efforts.
• The doctor should have listening skills and a phonendoscope, to which he is accustomed.
• The lungs are heard first at the front, then - behind, and then - along the lateral lines, from the top to the bottom and to the sides.

Determination of the type of breathing

• Vesicular is normal, it is listened to by inhalation and on one third of the exhalation, resembles the sound "f".
• Rigid - the sound "F" is heard on the breath and exhalation, this type is typical for children under 6 years old.
• Bronchial - resembles the sound of "x".
• Amphoric - this sound can be produced by blowing air into the narrow neck of an empty vessel. This auscultatory picture is associated with the presence of a cavity (cavity, abscess) in the lungs.
• Saccredited - an intermittent, multi-phase inhalation is heard, which is associated with a foreign body and a tumor in the large bronchus or trachea.

Auscultation of lungs, pathological noises

All of them are associated with diseases of the respiratory system.

• Chryps can be dry (wheezing, wheezing, buzzing) - this phenomenon occurs when the lumen of the bronchi narrows or sputum is accumulated in them. Also, wheezing can be wet (small, medium, large bubbles), they are listened to if there is liquid sputum in the lungs.
• Crepitation is a kind of crunch that occurs during the inspiration phase and speaks of a pathological process in the alveoli.
• The noise of friction of the pleura is also a crunch, however, he listens to both inhalation and exhalation. Occurs in the pathology of the pleura.

A distinctive feature of wheezing is that they can disappear if there has been a clearing of the lungs from sputum, that is, after a cough. Christs and crepitations can not be heard if the nose and mouth are closed, and the stomach is in motion, whereas it is under such conditions that the pleural friction noise is heard.

Auscultation of lungs, comparison of domestic and western schools

Two classifications of noise in the pathology of the respiratory system in children have some differences. Thus, the division of wheezing in European literature is simplified, the character of dry wheezing is not specified, and in the description of wet there is no concept of "medium-bubbly". In a specially conducted research work, doctors Zaikov, Katilov and Dmitriev found that our doctors more adhere to the Western model of diagnosis, omitting a detailed description of the auscultatory picture. The authors propose to revise and amend the existing classification. This must be done for a better understanding between medical colleagues from different countries and states.