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20 examples of cardiac and pulmonary auscultation
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20 examples of cardiac and pulmonary auscultation

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20 examples of cardiac and pulmonary auscultation Document Transcript

  • 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