Auscultation

What is auscultation?

The medical definition of auscultation is listening to the sounds of your heart, lungs, arteries and belly (abdomen). Your healthcare provider will usually use a stethoscope to listen to the sounds of your body. They’ll place the stethoscope directly onto your chest, back and abdomen. They’ll listen for different sounds, quality, volume, timing and more.

Auscultation is a safe and easy way to diagnose potential medical conditions. It’s noninvasive and one of the oldest techniques healthcare providers use today.

What is a stethoscope?

A stethoscope is a tool used for listening to the sounds of your body. French physician René Laennec invented the instrument in 1816. A stethoscope has a bell and a diaphragm. Your healthcare provider will use the bell to hear low-pitched sounds. They’ll use the diaphragm to hear high-pitched sounds. The bell and diaphragm are connected by rubber tubes to earpieces that your healthcare provider places in their ears.

When is auscultation performed?

Your healthcare provider uses auscultation during routine physical examinations. They want to check the sounds of your circulatory system, respiratory system and gastrointestinal system. They’ll use auscultation to confirm or rule out various medical conditions.

What are the different types of auscultation?

Your healthcare provider may perform a heart auscultation, a lung auscultation, arteries auscultation or an abdominal auscultation.

Heart auscultation

Your healthcare provider will listen to the sounds your heart makes through a heart or cardiac auscultation. To auscultate your heart, they’ll usually have you sit up or lay comfortably at a 45-degree angle. They may ask you to turn toward your left side or position you in another way to hear your heart clearly.

Your healthcare provider will place a stethoscope on your chest to listen to your heart sounds. They’ll move the stethoscope to the four areas of your chest where they can hear your heart valve sounds the best. These heart auscultation points are all in your upper left chest area.

Your healthcare provider will listen for:

• Timing: Timing is how frequently your heart beats.
• Intensity: Intensity is how loud your heart beats.
• Frequency: Frequency, or pitch, measures sound waves and vibrations.
• Duration: Duration measures the length of your heartbeats.

Lung auscultation

Your healthcare provider will listen to the sounds your lungs make through a lung auscultation. To auscultate your lungs, they’ll have you sit upright. You’ll be asked to take deep breaths through your mouth. Your healthcare provider will first place a stethoscope on your chest. They’ll move the stethoscope to different auscultation points on your chest. They’ll start at the top of your lungs and move downward. They’ll compare the sounds of each lung.

Then your healthcare provider will place the stethoscope on your back. They’ll again start at the top and work their way down, going from side to side. They’ll listen to one complete breath cycle at each auscultation site. They’ll compare the sounds they hear between the front and back of your lungs.

Your healthcare provider will listen for:

• Duration: Duration measures the length of your inhales and exhales.
• Frequency: Frequency, or pitch, measures sound waves and vibrations.
• Amplitude: Amplitude is the level of loudness or intensity in your breaths.
• Quality: Quality listens for any distinctive characteristics or abnormal sounds such as wheezing.

Arteries auscultation

Your healthcare provider can also listen to arteries of your neck, abdomen and kidneys if necessary.

Your healthcare provider will listen for:

• Bruit: A bruit is a sound that indicates turbulent blood flow in your arteries. Bruits could mean that you have poor circulation in a certain part of your body.
• Intensity: Your provider will check to see if your pulse is weak or absent. This could mean that you have a blocked artery.

Abdominal auscultation

Your health provider will listen to the sounds your intestines make through an abdominal auscultation. To auscultate your abdomen, they’ll have you lay down comfortably on your back. Your head will be propped up on a pillow. You may have a positioner placed under your knees for comfort.

Your healthcare provider will place a stethoscope on your abdomen. They'll move the stethoscope over different regions of your abdomen to listen to the sounds your bowels make.

Your healthcare provider will be listening for:

• Existence: Existence notes the presence of any bowel sounds or not.
• Quantity: Quantity is how frequently or not bowel sounds are heard.
• Quality: Quality listens for any distinctive characteristics or abnormal sounds.

What do the results of auscultations mean?

Your healthcare provider will hear different sounds during a heart auscultation, a lung auscultation, arteries auscultation and an abdominal auscultation.

Heart auscultation

Normal heart sounds have a steady, two-beat rhythm to them. The first sound is called S1, or a lub. The second sound is called S2, or a dub. Your healthcare provider can hear these sounds when your heart valves are closing.

Your healthcare provider may hear various abnormal sounds in your heart:

• Murmurs: A heart murmur is an abnormal sound your healthcare provider may hear between heartbeats. A murmur makes a swishing sound. Murmurs happen because of turbulent or abnormal blood flow across your heart valves. There are various types of heart murmurs. Some may be a sign of a serious heart condition.
• Pericardial friction rub: A pericardial friction rub makes a high-pitched, squeaky sound. The noise sounds like two pieces of leather being rubbed together. This sound may be a sign of a heart condition called pericarditis.

Lung auscultation

The different auscultation points of your lungs produce different normal sounds. But typically normal lung sounds are soft and hollow. They can be heard clearly when you inhale.

Your healthcare provider may hear various abnormal sounds:

• Stridor: A blockage in your upper respiratory tract causes stridor. It sounds loud and high-pitched. Stridor occurs due to turbulent blood flow passing through a blocked upper respiratory tract. It may be caused by epiglottitis, anaphylaxis or vocal cord dysfunction.
• Wheeze: The collapse of your airways causes wheezing. It sounds like high-pitched hissing. Wheezing may be a sign that mucus is preventing your lungs from filling completely. It may be due to asthma, chronic obstructive pulmonary disease (COPD) or pulmonary edema.
• Rhonchi: Blockages in your airways cause rhonchi. It sounds like snoring. Rhonchi may be due to pneumonia, COPD or cystic fibrosis.
• Crackles: Crackles are also called rales. It sounds like two strands of hair being rubbed together. A buildup of fluid in your airways causes crackles. This may be due to a lung infection, such as pneumonia, or a heart condition, such as congestive heart failure.
• Pleural rub: A pleural rub sounds like two pieces of sandpaper being rubbed together. It can be a sign that tissues around your lungs are irritated. A pleural rub can be a sign of pleurisy, pneumothorax or pleural effusion.
• Squawk: A squawk is also called a short wheeze or squeak. Fluctuations in your airways can cause a squawk. A squawk sounds like a mix between wheezes and crackles. A squawk may be a sign of pulmonary fibrosis, bronchiolitis or pneumonia.

Abdominal auscultation

Normal bowel sounds make a low-pitched gurgling noise. The noise occurs every five to 10 seconds as your intestines push food through your system. This means your gastrointestinal tract is functioning properly.

Your healthcare provider will auscultate your abdomen to check for any abnormal sounds:

• No sounds: If your intestines don’t make any sounds for more than two minutes, it may be a sign you have an ileus. When the contents of your intestines build up and burst through your intestinal wall, an ileus can form.
• Reduced sounds: If your bowel sounds are quieter or less frequent, it may be a sign your intestinal activity is slowing or you have constipation.
• Increased sounds: If your bowel sounds are louder or more active, it may be a sign your intestinal activity is increasing or you have diarrhea.
• Grumbling or high-pitched sounds: If your bowels are making grumbling sounds or high-pitched noises, you may have a bowel obstruction.

What is the triangle of auscultation?

The triangle of auscultation is a small region on your back where three back muscles meet. These muscles are the trapezius, latissimus dorsi and scapula. When you cross your arms and lean forward, these muscles thin out and the triangle of auscultation is better exposed. Your healthcare provider can hear your lung sounds more clearly when they place a stethoscope on this area.

A note from Cleveland Clinic

Your healthcare provider uses auscultation to listen to your heart, lung, arteries and abdominal sounds. Auscultation is a tool they can use to make sure you’re healthy and/or figure out what’s going on inside your body. Depending on what they hear, you may need additional tests. Auscultation is a great way to give your healthcare provider a basic idea of your health status and whether or not you need further treatment.