Auscultation
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- For the ancient monasterial worker, see Auscultare
Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope. Auscultation is normally performed for the purposes of examining the circulatory system and respiratory system (heart sounds and breath sounds), as well as the gastrointestinal system (bowel sounds).
The technical term was invented by René-Théophile-Hyacinthe Laënnec, a French physician. It is based on the Latin verb auscultare "to listen". However the act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. Laënnec's contribution was to document formally the procedure and relevant findings in his book "De l'auscultation médiate", published in 1819. Laënnec's contribution to the field went further, not only documenting clinical findings, but inventing the requisite device in the form of the first stethoscope, a wooden trumpet that allowed him to listen to female patients without having to place his ears to their breasts.
Auscultation is a skill that requires substantial clinical experience, and good listening skills. Heart sounds are rather faint, especially when an acoustic stethoscope is used. Recently, electronic stethoscopes by Thinklabs, Welch Allyn, 3M, and others have become available, making heart and lung sounds more clearly audible to the clinician. The electronic stethoscope also allows for recording of sounds and transmission for the purposes of telemedicine, or remote diagnosis. Thinklabs uses a novel electronic diaphragm detection system to convert sounds into electronic signals. Welch-Allyn uses a piezo-electric sensor on a metal shaft inside the chestpiece; while 3M uses a conventional microphone. These advances are likely to ensure that auscultation remains a primary screening tool for clinicians, as a precursor to more costly tests such as ultrasound.
Doctors listen to three main organs/ organ systems during auscultation: the heart, 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 and crackles are identified. The gastrointestinal system is auscultated to note the presence of bowel sounds.
Learning the accurate and reliable interpretation of auscultation findings has been improved by recent technological advances. There is a web site, the Auscultation Assistant[1], which "provides heart sounds, heart murmurs, and breath sounds in order to help medical students and others improve their physical diagnosis skills".
