Note these characteristics as you listen in different areas. Normal breath sounds differ over various portions of the lungs with regard to intensity, pitch, and relative duration of inspiratory and expiratory phases. Lung sounds are absent over a pneumothorax.Lung sounds may be diminished due to shallow breathing or hyperinflation, pleural disease, mucous plugging or obesity.Lung sounds may be louder in areas where lung tissue is more dense.Note the inspiratory to expiratory ratio.When abnormalities are found, listening to several breaths in that location may be necessary. Listen to inspiration and expiration in each location.Compare sounds in the apices to sounds in the bases. Compare sounds heard on one side to sounds heard in the same location on the opposite side. Auscultate all areas systematically including anterior, posterior, and lateral lung fields.The presence of chest hair may require firmer pressure to eliminate any potential interference. Use the diaphragm of the stethoscope, placed firmly and directly on the skin.Have the patient sit upright if possible, breathing slowly and deeply through an open mouth.In conjunction with percussion, auscultation helps to evaluate the surrounding pulmonary parenchyma and pleural space. Auscultation evaluates air flow through the tracheopulmonary tree, the presence of added or adventitious breath sounds, and transmission of the patient's spoken voice. Auscultation provides important information regarding the lungs and pleura.
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