1. 20 examples of cardiac and pulmonary auscultation
Main cardiac auscultation areas
a) Right base (2nd
ICS) b) Left base (2nd
ICS)
c) Lower left sternal border (4th
ICS) d) apex (e) xiphoid
Track Type Auscultatory area
1. Normal heart sound apex
2. Third heart sound S3 (physiological) apex
3. Fourth heart sound apex
4. AS right base
5. MR apex
6. Midsystolic click apex
7. VSD lower right sternal border
8. ASD left base
9. MS apex
10. AR mid left sternal border (3rd
ICS)
11. Normal tracheal sound trachea, interscapular
12. Fine crackles with deciduous bronchial sound right middle lobe
14. Coarse crackles right lower lobe
15. Bronchial sound left lower lobe
16. Inspiratory stridor trachea
17. Rhonchus right lower lobe
18. Wheezing left lower lobe
19. Fine crackles lung base
20. Pleural friction right middle lobe
Possible causes
2. Normal in children who have increased diastolic volumes; usually not heard past
the age of 30
3. (lt ventricular origin) severe hypertension; AS; CMP; MI
4. Congenital malformations of valve cusps; RF; calcification
5. Chronic RF, acute bacterial endocarditis, myocardial ischemia or infarction,
calcification, MVP
6. MVP
7. Cong malformation (children), trauma, MI
8. Cong malformation (children), trauma
9. RF
10. Bacterial endocarditis, trauma, RF, cong malformation
13. Atelectasis
14. Resolving pneumonia, pulmonary edema
15. Pneumonia
16. Narrowing of the upper airways (laryngeal ca, vocal cord edema, Fob aspiration
17. Chronic bronchitis
18. Bronchial asthma
19 pul fibrosis, myocardial insuffiency
20 pleurisy, pul infarction