View source for Auscultation

{{Short description|Listening to the internal sounds of the body, usually using a stethoscope}}
{{For|the ancient monasterial worker|Auscultare}}
{{redirect|Auscultate|the album by Salt|Auscultate (album)}}
{{Infobox interventions
 |Name        = Auscultation
 |Image       = Standardized-Patient-Program-examining-t he-abdomen.jpg
 |Caption     = A doctor auscultating a patient's abdomen
 |ICD10       =
 |ICD9        =
 |MeshID      = D001314
 |MedlinePlus = 002226
 |OtherCodes  =
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}}
{{listen|filename=Emily's heartbeat.wav|title=Emily's heartbeat|description=Sounds heard on auscultation of a healthy 16-year-old's heart while holding her breath, as heard with a [[stethoscope]] at the tricuspid valve|format=[[wav]]}}
'''Auscultation''' (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a [[stethoscope]]. Auscultation is performed for the purposes of examining the [[circulatory system|circulatory]] and [[respiratory system]]s ([[heart sounds|heart]] and [[breath sounds]]), as well as the [[alimentary canal]].

The term was introduced by [[René Laennec]].  The act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. Auscultation and [[palpation]] go together in [[physical examination]] and are alike in that both have ancient roots, both require skill, and both are still important today. Laënnec's contributions were refining the procedure, linking sounds with specific pathological changes in the chest, and inventing a suitable instrument (the stethoscope) to mediate between the patient's body and the clinician's ear.

Auscultation is a skill that requires substantial clinical experience, a fine stethoscope and good listening skills. Health professionals (doctors, nurses, etc.) listen to three main organs and organ systems during auscultation: the [[heart]], the [[lungs]], and the gastrointestinal system. When auscultating the heart, doctors listen for abnormal sounds, including [[heart murmurs]], gallops, and other extra sounds coinciding with heartbeats. [[Heart rate]] is also noted. When listening to lungs, breath sounds such as [[wheezes]], crepitations and crackles are identified. The gastrointestinal system is auscultated to note the presence of bowel sounds.

[[Stethoscope#Electronic|Electronic stethoscopes]] can be recording devices, and can provide noise reduction and signal enhancement.  This is helpful for purposes of [[telehealth#Telecardiology|telemedicine]] (remote diagnosis) and teaching. This opened the field to [[computer-aided auscultation]]. [[Ultrasonography]] (US) inherently provides capability for computer-aided auscultation, and portable US, especially portable [[echocardiography]], replaces some stethoscope auscultation (especially in cardiology), although not nearly all of it (stethoscopes are still essential in basic checkups, listening to bowel sounds, and other primary care contexts).

== Auscultogram ==
The sounds of auscultation can be depicted using symbols to produce an auscultogram.  It is used in cardiology training.<ref>{{cite book |author=Constant, Jules |title=Bedside cardiology |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=1999 |pages=123 |isbn=0-7817-2168-7 }}</ref>
[[File:Phonocardiograms from normal and abnormal heart sounds.png|thumb|[[Phonocardiogram]]s (also known as auscultograms) of common [[heart murmur]]s.]]
{{See also|phonocardiogram}}

[[File:Physician auscultating.JPG|thumb|left|Illustration from 1906 depicting a physician who has placed a Laennec wooden stethoscope between his left ear and the corseted patient's back to ausculate.]]
== Mediate and immediate auscultation ==
[[File:Laennec - Théobald Chartran.jpg|thumb|[[René Laennec|Laennec]] auscultates a patient before his students.]]

Mediate auscultation is an antiquated medical term for listening (auscultation) to the internal sounds of the body using an instrument (mediate), usually a [[stethoscope]].  It is opposed to immediate auscultation, directly placing the ear on the body.

== Doppler auscultation ==

It was demonstrated in the 2000s that Doppler auscultation using a handheld [[Doppler ultrasonography#Blood vessels|ultrasound transducer]] enables the auscultation of valvular movements and blood flow sounds that are undetected during cardiac examination with a stethoscope. The Doppler auscultation presented a sensitivity of 84% for the detection of [[aortic regurgitation]]s, while classic stethoscope auscultation presented a sensitivity of 58%. Moreover, Doppler auscultation was superior in the detection of impaired ventricular relaxation. Since the physics of Doppler auscultation and classic auscultation are different,  it has been suggested that both methods could complement each other.<ref>{{cite journal |vauthors=Mc Loughlin MJ, Mc Loughlin S | year = 2012 | title = Cardiac auscultation: Preliminary findings of a pilot study using continuous Wave Doppler and comparison with classic auscultation | journal = Int J Cardiol | volume = 167| issue = 2 | pages = 590–591| doi = 10.1016/j.ijcard.2012.09.223 | pmid = 23117017 }}</ref><ref>{{cite book |author=McLoughlin, Mario Jorge |author2=McLoughlin, Santiago|title=Cardiac Auscultation With Continuous Wave Doppler Stethoscope: A new method 200 years after Laennec's invention|publisher=Mario J Mc Loughlin|edition=1|date=5 January 2013|language=en|url=https://www.amazon.com/Cardiac-Auscultation-Continuous-Doppler-Stethoscope-ebook/dp/B00AXFB2IG/}}</ref>{{page needed|date=July 2017}}

==See also==
* [[Breath sounds]]
* [[Heart sounds]]
* [[Intestinal sound]]
* [[Palpation]], the practice of examining a patient through the use of hands
* [[Percussion (medicine)]]
* [[Pericardial friction rub]]
* [[Triangle of auscultation]]

==References==
{{Reflist}}

==External links==
{{Commons category}}
{{EB9 Poster|Auscultation}}
{{AmCyc Poster|Auscultation}}
{{Wiktionary|auscultare}}
* [http://www.med.ucla.edu/wilkes/intro.html The Auscultation Assistant] {{Webarchive|url=https://web.archive.org/web/20120606134941/http://www.med.ucla.edu/wilkes/intro.html |date=2012-06-06 }}, - "provides heart sounds, heart murmurs, and breath sounds in order to help medical students and others improve their physical diagnosis skills"
* [https://web.archive.org/web/20100112111621/http://www.mediscuss.org/content/respiratory-auscultation-tips-audio-mp3-examples-71.html MEDiscuss] - Respiratory auscultation with audio examples
* [https://web.archive.org/web/20070829110332/http://www.blaufuss.org/ Blaufuss Multimedia] - Heart Sounds and Cardiac Arrhythmias
* [http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review.htm Independent Stethoscope Review] - Comparative review of stethoscopes, including frequency response graphs.
* [http://www.practicalclinicalskills.com/ Auscultation Lessons and Reference Guide] - Compilation of 100+ Heart and Lung Sounds and Phonocardiograms
* [https://www.youtube.com/watch?v=tnUnllH7kHM/Continuous Wave Doppler Auscultation] - Cardiac Continuous Wave Doppler audio and video examples

{{Physical exam}}
{{Cardiovascular system symptoms and signs}}
{{Authority control}}

[[Category:Audible medical signs]]
[[Category:Veterinary diagnosis]]
[[Category:Physical examination]]