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It is the process of listening to sounds of the body with the aid of a stethoscope. If they are heard over the lung fields, this is a sign of pneumonia. The expiratory phase is sometimes a bit longer than the inspiratory phase. They have a high pitch with loud and long expirations. They are heard only over the trachea in healthy patients. They have a medium pitch and the expiratory phase is usually equal to the inspiratory phase of breathing. They are heard over the main bronchus area and over the upper right posterior lung field. They are more prominent in thin people or children and can be diminished in obese or very muscular patients.ĩ. They are low pitch, soft, and usually have short expirations. It’s a harsh or high-pitched respiratory sound that is caused by an obstruction of the upper airway. It is usually the loudest over the lower lateral anterior surface. This sound can be heard during inspiration and expiration. It is a dry, rubbing, or grating sound, usually caused by inflammation of the pleural surfaces. Note: Don’t forget to clean your stethoscope in between patients. Document the findings in the patient’s chart. Also compare the anterior to the posterior side.ĩ. Then repeat the process on the posterior side.Ĩ. Start at the apices and then move downward towards the lung bases. Always listen to the patient’s anterior side first. As the patients breathes, listen to the sounds and try to identify their intensity, location, strength, pattern, and duration.ħ. Instruct the patient to take slow, deep breaths through an open mouth.Ħ. Hold the diaphragm of the stethoscope firmly against the patient’s skin with a moderate amount of pressure. They should fit comfortably and snuggly in your ears.ĥ. Place the eartips of the stethoscope in your ears and adjust them as desired. If the diaphragm (face) of the stethoscope is cold, warm it by rubbing the surface to avoid startling the patient.Ĥ. In this case, the target area is the lungs.ģ. Stand close to the patient in order to gain access to the target area. Explain the procedure to the patient to establish trust and rapport.Ģ. In other words, the inspiratory phase of breathing is three times longer than the expiratory phase.ġ. This means that a patient with diminished breath sounds will have an I:E ratio of 3:1. Patients with an increased chest wall thicknessĮach of these examples make it more difficult to hear lung sounds during auscultation which is the root cause of the diminished classification.Īlso note that during diminished breath sounds, the inspiratory phase is usually much longer than the expiratory phase. Patients with air or fluid around the lungs.There are several causes of diminished breath sounds. That isn’t to say that this is always the case. They are also present in patients with severe obstructive conditions. These sounds are often present in patients with decreased lung volumes. Consolidation in the patient’s right lower lobeĪs previously mentioned, diminished breath sounds are soft, distant lung sounds with a lower volume and intensity. So by using what we know about breath sounds, as well as the process of elimination, you can easily determine that the correct answer has to be D. And for the TMC Exam, you must remember that patient with pneumonia usually show signs of consolidation.Ī pneumothorax or pleural effusion are not identified by bronchial breath sounds which means that we can rule those out immediately. To get this one right, you had to know that bronchial breath sounds are sometimes heard in patients with pneumonia. However, if you hear bronchial breath sounds over the lung periphery, this is an abnormal finding. Consolidation in the patient’s right lower lobeīronchial breath sounds are normal when heard over the trachea. Pleural effusion in the patient’s right lower lobeĭ. This would indicate which of the following?Ĭ. 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