Weber Chapter 3 - Auscultation Techniques and Body Sound Classification

Auscultation

An assessment technique using a stethoscope to listen to heart sounds, blood flow, bowel sounds, and air movement in the respiratory tract.

Stethoscope

A device needed for auscultation because body sounds are not audible to the human ear without amplification.

Characteristics of Body Sounds

Intensity (loud/soft), Pitch (high/low), Duration (length), Quality (musical, crackling, raspy).

Bell of the Stethoscope

Used when held lightly to detect low-pitched sounds (extra heart sounds, murmurs, bruits).

Diaphragm of the Stethoscope

Used when held firmly to detect high-pitched sounds (breath, bowel, normal heart sounds).

Resonance

Loud, low, long, hollow → normal lung.

Hyperresonance

Very loud, low, long, booming → lung with emphysema.

Tympany

Loud, high, moderate length, drumlike → gastric bubble or puffed-out cheek.

Dullness

Medium intensity, medium pitch, moderate length, thud-like → liver, diaphragm, pleural effusion.

Flatness

Soft, high, short, flat → muscle, bone, sternum, thigh.

Earpiece Fit

Should be snug but comfortable, pointing down toward the nose.

Stethoscope Tubing Length

Flexible, 12-14 inches, to avoid sound loss.

Diaphragm Holding Technique

Should be held firmly on skin → detects high-pitched sounds (normal heart, breath, bowel).

Bell Holding Technique

Should be held lightly on skin → detects low-pitched sounds (abnormal heart, murmurs, bruits).

Dos of Auscultation

Warm diaphragm/bell before use, explain what you're listening for, expose skin (don't auscultate through clothing), use diaphragm for high-pitched sounds, use bell for low-pitched sounds, eliminate environmental noise.

Don'ts of Auscultation

Don't press too hard with the bell (acts like diaphragm), don't listen through clothing.