Chest Auscultation

Chest Auscultation  is the evaluation of breath sounds with the aid of a stethoscope. The stethoscope amplifies the breath sounds; these may be listened to through the bell (better for low frequency sounds) or diaphragm (better for high frequency sounds). 

The examination should begin on the front (anterior) chest at the upper lobes and move down over the chest wall. The two sides of the chest should be directly compared, at each position of auscultation. One full inspiration and expiration should be evaluated in each position. The examination should proceed to the back (posterior) chest, again progressing from the upper to the lower lobes. Finally, the examination should involve listening to the lateral chest walls.

Different sounds may be heard on auscultation.

According to MedlinePlus (2021), the 4 most common abnormal sounds that might be heard are:

• "Rales [also known as fine crackles]. Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person breathes in (inhales). They are believed to occur when air opens closed air spaces. Rales can be further described as moist, dry, fine, or coarse.

• Rhonchi [also known as coarse crackles]. Sounds that resemble snoring. They occur when air is blocked or air flow becomes rough through the large airways.

• Stridor. Wheeze-like sound heard when a person breathes. Usually it is due to a blockage of airflow in the windpipe (trachea) or in the back of the throat.

• Wheezing. High-pitched sounds produced by narrowed airways. Wheezing and other abnormal sounds can sometimes be heard without a stethoscope".

Auscultation may also reveal absent or reduced sounds.

According to MedlinePlus (2021) this may be due to:

• "Air or fluid in or around the lungs (such as pneumonia, heart failure, and pleural effusion)

• Increased thickness of the chest wall

• Over-inflation of a part of the lungs (emphysema can cause this)

• Reduced airflow to part of the lungs"

• Pneumothorax

To read in more detail about performing chest auscultation and interpreting findings click on the link here to read an article from the Nursing Times Journal:  How to perform chest auscultation and interpret the findings 

To learn more about a complete respiratory examination, please visit the Respiratory Examination and Assessment page.

For further information on interpreting chest auscultation findings and sounds, please visit the article from the Nursing Times Journal further up the page.

Click on the button below to navigate to the 'Take a Test' area of ClinicalSkills.net. Please make sure you're logged into ClinicalSkills.net already with your SHU account, otherwise you may not be able to open and take the test. Once you have reached the 'Take a Test' area, select 'Local Tests' and then click on the test called 'Chest Auscultation' to begin. You will need to score 80% or more to pass. Make sure you've read the contents of this page thoroughly and watched the videos before taking the test as many of the answers will be found within there!

Here you can access the paper version of the checklist, which you can open here (and print if required). To access this you need to be logged into Google Drive using your SHU account.

Respiratory Examination- OSCE Guide

www.geekymedics.com/respiratory-examination-2/

Paediatric Respiratory Examination- OSCE Guide

www.geekymedics.com/paediatric-respiratory-examination-osce-guide/

Royal Marsden Manual of Clinical Nursing Procedures (9th Edition) Chest Auscultation page xlix -lvi

ProQuest Ebook Central - Reader 

How to perform chest auscultation and interpret the findings. Nursing times:

www.nursingtimes.net/clinical-archive/assessment-skills/how-to-perform-chest-auscultation-and-interpret-the-findings-06-01-2020/ 

References

MedlinePlus (National Library of Medicine (US)) (2021, April 17). Medical Encyclopaedia: Breath Sounds. MedlinePlus. https://medlineplus.gov/ency/article/007535.htm 

Date reviewed: 

Next review: August 2023