![]() Note that the posterior thorax is primarily lower lobes. For example, less locations are needed on a client with a smaller thorax (e.g., infants). The number of locations depends on the size of the thorax. See Figure 3.11 for the placement pattern. Step 3:Place the stethoscope’s diaphragm on the chest in about four to eight locations on each side of the posterior thorax and then at three locations on the right lateral thorax and at two locations on the left lateral thorax so that you listen to all lung lobes. Also be aware that older adults may have difficulty taking a big breath. You should notify them that they can take a break and breathe normally if they need to. Keep in mind that breathing a bit more deeply may trigger shortness of breath or dizziness for some clients.Instruct the client to breathe through the mouth because this makes it easier for you to listen to lung sounds, particularly if there is any nasal congestion or obstructions.Step 2: Ensure the client is in an upright position and ask them to take a big breath in and out through the mouth each time they feel the stethoscope on their posterior thorax. Step 1: Perform hand hygiene and cleanse the stethoscope. Lung sounds.Posterior and Lateral Thorax – AuscultationĪuscultating the posterior and lateral thorax involves the following steps (see Video 3.5): Physical signs in patients with chronic obstructive pulmonary disease. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. We link primary sources - including studies, scientific references, and statistics - within each article and also list them in the resources section at the bottom of our articles. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Some warning signs of heart failure include: Heart failure is a chronic condition in which the heart does not pump enough blood to meet the body’s needs. Those with COPD often have audible wheezes or longer periods of exhalation with decreased breath sounds. ![]() Chronic obstructive pulmonary disease (COPD)ĬOPD refers to a group of diseases that cause breathing-related problems due to airflow blockages. Lungs affected by pneumonia may make bubbling, crackling, and rumbling sounds during inhalation. A viral, bacterial, or fungal infection can cause pneumonia. Pneumonia is an infection of one or both lungs, which causes the air sacs found in the lungs to fill up with pus or fluid. It is essential to listen for sounds characteristic of pneumonia, since bronchitis can sometimes develop into pneumonia. Those with bronchitis may wheeze or have rhonchi that improves with coughing. It usually develops due to a viral infection. Bronchitisīronchitis occurs when the lungs’ airways swell and produce mucus in the lungs. People with asthma may have normal vesicular breath sounds but with prolonged expiration, or they may have audible wheezes in various places around the chest. Below are some conditions that can cause these sounds: AsthmaĪsthma is a chronic condition that causes airways to become inflamed and narrowed. Listen for the quality and intensity of the breath sounds, as well as for the presence of abnormal sounds, or discrepancies between the sounds on either side of the chest.Ībnormal or adventitious breath sounds can be a sign of an underlying condition. ![]() ![]() It is important to hear at least one complete breath cycle at each site. Again, listen for one full breath in each position, moving the stethoscope from the top of the chest and working down. If they are lying down, roll them onto the other side. Repeat step four, moving the stethoscope downwards to listen for sounds at different points in the lungs.Stay in this position for one inhalation and one exhalation. Ask the person to take deep breaths through an open mouth and listen for the sounds.Warm up a stethoscope by rubbing it between the hands and then placing over the apex of the lungs.If the person cannot sit, lie them on their side. Move into a quiet room and have the person sit down. ![]()
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