Auscultation

Procedure

  • Place the earplugs well in your ears [Figure 12]
    The earplugs should point forward slightly in the direction of the nose
    (the auditory canal runs in this direction).

Figure 12

  • Ensure that the diaphragm of the stethoscope is not too cold by placing it first on the back of the patient’s hand
  • Place the diaphragm on the patient’s abdomen [Figure 13]

Figure 13

  • Place the stethoscope gently but maintain good contact with the abdominal skin.
  • Avoid touching the stethoscope tube with your hands, clothing etc. This can cause background noise [Figure 14]

Figure 14

  • Listen systematically to all abdominal regions [Figure 15] and listen uninterrupted and for a sufficient amount of time (at least 30 seconds for a patient with abdominal pain).

Figure 15: auscultation points – intestines

  • Listen above the major arteries [Figure 16].

Figure 16: Auscultation points – major arteries

1 = abdominal artery
2 = bifurcation
3 = iliac arteries, left and right
4 = femoral arteries, left and right
5 = renal arteries, left and right

  • Listen at the site of any swellings

Focus points

  • Assess peristaltic noises
    – normal peristalsis
    – absent peristalsis (listen for at least 30 seconds, as heart and
      respiratory sounds can be heard)

    – increased peristalsis
    – abnormal peristaltic sounds (e.g. gurgling)
  • Determine whether murmurs can be heard
    – murmurs always indicate pathology
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