What does the doctor listen to with a stethoscope? Let's learn exactly about auscultation!

You've probably seen a doctor when you go to the doctor, and they put that little cold instrument on your chest, back, or stomach and listen for a while. We call it a stethoscope. But have you ever wondered why they do that, what they hear, what they find out from those sounds? That's what we're going to talk about today. In medicine, this is called ``Auscultation.'' Simply put, it's listening to the sounds coming from inside the body.

What exactly does listening to the body mean? (Auscultation)

Simply put, ``(Auscultation)`` is when a doctor uses a stethoscope to listen to the different sounds coming from inside your heart , lungs , large blood vessels (arteries), and abdomen. A doctor listens to these sounds by placing the stethoscope directly on your chest, neck, back, and abdomen. They pay attention to many things like the different sounds, their nature, how loud they are, and when they occur.

Imagine, this is a very easy thing that does not harm the body in any way . In fact, this is a very old, but very effective method that doctors still use today to find out about your health. This is a test that is done without putting anything inside the body (non-invasive).

At what point does a doctor listen like this?

Auscultation is usually performed as part of a routine physical examination, whether you visit your doctor annually or for any other medical condition. Doctors want to hear sounds from your circulatory system , respiratory system , and gastrointestinal system to make sure they are working properly. This can help them understand your overall health, detect any underlying medical conditions, or confirm a suspected illness.

There are several ways to listen to different parts of the body, right?

Yes, the way a doctor performs this ``(Auscultation)`` can vary depending on the body system he is listening to. Let's look at the main methods.

Listening to the heart (Heart Auscultation)

In this test, the doctor listens to the sounds coming from your heart. This is also called ``Cardiac Auscultation''. This is usually done by having you sit up straight in a chair or lying down on a bed at a 45-degree angle. Sometimes you may be asked to turn slightly to the left, so that the heart sounds can be heard more clearly.

The doctor will place a stethoscope on your chest and listen to your heart sounds. There are 5 specific places on your chest where the sounds from the heart valves are most audible. The stethoscope will be placed in each of these places in turn. These places are usually located in the upper left side of your chest.

When a doctor listens to a heart murmur, they look for the following:

• Timing: How often your heart beats ( heart rate ).
• Intensity: How loud the heart beats.
• Frequency: The sharpness of the sound, or how it is called ``pitch''.
• Duration: How long does one heartbeat last?

Listening to the lungs (Lung Auscultation)

In this, the doctor listens to the sounds coming from your lungs. This is done by having you sit up straight, if possible. The doctor places the stethoscope on your chest and asks you to take a deep breath through your mouth. Then, the stethoscope is moved to different places in your lungs called ``Pulmonary Auscultation Points''. The doctor listens to the sounds coming from the top of your lungs, comparing them on both sides.

After listening to the lung sounds from the front of your body, the doctor places the stethoscope on your back. As before, they listen from top to bottom, side to side, and listen for a full breath (an inspiratory-expiratory cycle) in one place. Then, they compare the sounds heard from the front with the sounds heard from the back.

When listening to lung sounds, the doctor will pay attention to the following:

• Duration: The time it takes you to inhale and exhale.
• Frequency: The sharpness of the sound (pitch).
• Amplitude: How loud the breath sounds (loudness/intensity).
• Quality: Are there any unusual sounds, for example, wheezing ?

Listening to the large blood vessels (Arteries)

If necessary, a doctor can also listen to the large blood vessels (arteries) in your neck, abdomen, and kidneys .

Here, the doctor looks at these things:

• Bruit: This is a rough, grating sound made by blood flowing through a blood vessel. This means that blood is not flowing properly through the vessel, perhaps due to a blockage. It can also be a sign that the blood supply to a part of the body is reduced.
• Intensity: Check to see if your pulse is weak or absent. This could mean you have a blocked artery.

Abdominal Auscultation

In this test, the doctor listens to the sounds coming from your intestines. This is done by having you lie comfortably on a bed with a pillow under your head. You may also be given a small support under your knees to make it more comfortable.

The doctor places the stethoscope on your abdomen and moves it to different areas of your abdomen to listen to the sounds coming from your intestines.

When listening to abdominal sounds, doctors look for:

• Existence: Whether or not sounds are heard from the intestines.
• Quantity: If a sound is heard, how often it is heard.
• Quality: Whether the sound has any specific characteristics or is unusual.

What do doctors understand from these sounds?

Okay, now let's see what doctors find out from the sounds heard in each place.

Things that are said through the sounds of the heart

A normal, healthy heart sounds in a steady, "lub-dub" rhythm. The first sound is called `(S1)` and the second sound is called `(S2)`. This sound is heard by your doctor when your heart valves close.

However, sometimes you may hear unusual sounds like this:

• Murmurs: These are unusual sounds that can be heard while the heart is beating. They are like a ``swishing sound'' made by a slow flowing stream of water. They are caused by turbulent blood flow as blood flows through the heart's valves. There are many types of ``murmurs'', and some can be a sign of serious heart disease.
• Pericardial Friction Rub: This is a high-pitched, grating sound. It sounds like two pieces of leather rubbing together. This can be a sign of a heart condition called ``pericarditis.''
• Abnormal Heartbeats: Examples include `(Atrial Fibrillation)` (irregular heartbeat), `(Tachycardia)` (more than 100 beats per minute), and `(Bradycardia)` (less than 60 beats per minute).

Things to say about lung sounds

The normal sounds heard from different parts of your lungs are also slightly different. But, in general, healthy lungs have a soft, hollow sound. Your doctor will hear this sound when you breathe in.

However, you may also hear unusual sounds like this:

• Stridor: This sound occurs when there is a blockage in your upper respiratory tract. It is a loud, high-pitched, sharp sound. It can be caused by epiglottitis, anaphylaxis (a severe allergic reaction), or vocal cord dysfunction.
• Wheeze:This whistling sound occurs when your airways become narrow. It's a high-pitched, whistling sound. It can mean that your lungs aren't filling up completely with air because of something like mucus. This can be heard in conditions like `(Asthma)` (asthma), `(Chronic Obstructive Pulmonary Disease - COPD)` (pulmonary edema)` (fluid in the lungs).
• Rhonchi: This sound is caused by obstruction of the airways. It is similar to snoring. It is heard in conditions such as `(Pneumonia)` (Pneumonia), `(COPD)`, `(Cystic Fibrosis)`.
• Crackles/Rales: These sound like two strands of hair rubbing together. They occur when fluid builds up in the airways due to a lung infection, such as pneumonia, or a heart condition such as congestive heart failure.
• Pleural Rub: This sounds like sandpaper rubbing together. This could mean that the tissues around your lungs are irritated. It could be a sign of a condition such as pleurisy, pneumothorax, or pleural effusion.
• Squawk: This is also called a short whistling or croaking sound. This sound can be caused by changes in your airways. It sounds like a combination of wheezing and crackling. It can be a symptom of conditions such as `(Pulmonary Fibrosis)`, `(Bronchiolitis)`, `(Pneumonia)`.

Imagine, all these sounds are like the sounds coming from different instruments in a musical ensemble inside your body. Sometimes, one of those instruments can be a bug. That bug is what the doctor is touching.

Things that are said through stomach sounds

A normal, healthy bowel sound is a low, rumbling sound. This sound is usually heard every 5 to 10 seconds. It means that food is moving through your intestines and that your digestive system (GI Tract) is functioning properly.

When a doctor listens to stomach sounds, they look for abnormalities such as:

• Loss of sound: If you don't hear any sounds from your intestines for more than two minutes, it could be a sign of a condition called ``Ileus.'' This is when the contents of the intestines accumulate and the bowels temporarily stop moving.
• Decreased sound: If the sounds heard from the intestines are quiet, if they are very low, it may mean that the bowel function has decreased, or that you have ``(Constipation)``.
• Increased noise: If you hear loud, frequent sounds from your intestines, it could mean that your intestines are working harder, or that you have diarrhea.
• Grunting or high-pitched sounds: If you hear gurgling or high-pitched sounds coming from your intestines, you may have a bowel obstruction.

What is this "Triangle of Auscultation"?

This is a bit medically sound, but it's easy to understand. The "Triangle of Auscultation" is a small area on your back. This is where three of the muscles in your back (trapezius, latissimus dorsi, and scapula) meet. When you cross your arms across your chest and bend forward, these muscles stretch and become thinner. This triangular area is then exposed. When a doctor holds a stethoscope in this position, the sounds coming from your lungs can be heard very clearly.

What are the 5 main places to listen to the heart?

There are 5 main places that doctors listen to with a stethoscope to assess the health of the heart. These are located in specific areas of the chest, related to the heart valves.

They are:

• Aortic Area: This is located to the right of your chest bone (sternum), between the second and third ribs.
• Pulmonic Area: This is also on the right, like the great aorta, but on the left side.
• Erb's Point: This is located on the left side of the body, in the space between the third and fourth ribs. (Some `(Murmurs)` can be heard best from this area.)
• Tricuspid Area: This is located between the fourth and fifth ribs.
• Mitral Area: This is located at the apex of the heart, that is, at the lowest point of the heart.

So, what do we have to learn from this?

You may not realize it, but your body is constantly making sounds. It's like a biological symphony! However, sometimes some of these "musical instruments" can be out of tune. Those out of tune sounds, that is, unusual sounds, can tell a doctor a lot about your health. Or, they can give them clues to diagnose a medical condition by doing further tests.

The most important thing is, if a doctor listens to your body this way and finds something unusual, don't be afraid to ask questions about it. It's your right to ask for clarification on what it is, why it's happening, and what to do next.

So, the next time a doctor puts a stethoscope to your body and listens, you know they're doing something very important!

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