Hi everyone, I seem to have trouble with finding those heart and lung sounds on larger patients. It feels like nothing is exactly where it should be and where stuff can be found, it is always super quiet and I can't really tell what it is.
Thanks to covid, this clinical is pretty much my first time doing assessments on adult patients. Are there any tips and tricks I can use? Getting lost in someone's rolls when trying to find their heart sounds is embarrassing to say the least, and I don't want to be unable to do accurate assessments on people just because they're larger
That type of junky cough that gets better when they clear their throat.
The sound of the lungs of a patient with this type of cough (before they clear their throat)—has a distinct sound.
What is that sound called? It’s not stridor. Rhonchi?
Can someone explain to me why we can find dual upstroke carotid pulse on physical examination?
Like this: https://www.researchgate.net/figure/Cardiac-auscultation-areas_fig1_325773991
When doing medical/trauma patient assessment, what do you listen for when you auscultate the mid clavicular and mid axillary regions? And how long should I listen for?
Hi guys Anknight here, a deck which has only heart sounds ,Lung sounds and different high yield sounds we are expected to know while auscultating, once you start with this the deck you can try applying it in your clinical rotations and see whether you have developed the art of correctly identifying the murmur/breath sounds /etc. This will help you in your clinics and in USMLE as a UG and MD exam as well. Most importantly it will help you become a better diagnostician. The deck will be posted on r/Anki and r/medschoolankiindia
Hey y’all, I’m not too bad at these when the vignette gives hints, but play some audio and my mind goes blank.
Is Comlex like Step where the vignette isn’t enough to answer these q’s? If so, anyone have any tips to learn via sound?
Thanks for any help.
Hey all, I'm curious, and my research has so far proven futile.
(Personal context: My first Asthma attack was when I was 6, and once I hit 18-20, it leveled off. I'm in my mid-30s now. I'm a trained vocalist who had to stop singing years ago because of a Hiatus Hernia and severe GERD. About 8 weeks ago, I had a Nissen Fundoplication and the surgeon also sutured the hernia closed. This has had little to no practical effect on what I'm going to ask about, but the GERD might have caused damage, hence the mention.)
I typically experience a higher-pitched expiratory wheeze, which at least feels like it comes more from the upper end of my lower respiratory tract (ie. between the larynx, and where the main bronchi branch off).
In the last year, with no preceding attacks or worsening of my condition, and only based on my sporadic blue puffer usage (salbutamol/albuterol), my doctors put me on QVAR and then Flovent, with little to no discernable improvement in the wheeze. (I'm on disability for other reasons, and have not been prescribed, nor been able to afford a Peak Flow Meter out of pocket. I will be getting one soon, with a settlement of sorts FINALLY on the horizon.) I am using my blue puffer a TOUCH less than I used to, down from 1-2 times a week, to maybe once every 7-10 days. Even still though, I have this expiratory high pitch wheeze. When I do take the blue puffer, the wheeze lessens to some extent, but it's still present.
To me, it's pretty concerning because the consistent wheeze comes across as a sign of something still not being addressed or investigated, but whenever any GP I've seen in 3 different clinics now (because hunting down a good doc for my other conditions is super-difficult) has listened to my chest, they will tell me it sounds clear and write off my concern without any explanation.
Has anyone experienced anything similar? Are there resources for like, comparing wheeze sounds/patterns to specific areas of the lungs affected by conditions? Am I just being hyperbolic and anxious?
Hello,
when we auscultate someone who has a severe scoliosis, would we expect to hear decreased breath sounds on the concave side due to « compression » og the lung or decreased breath sounds on the convex side because of less chest excursion on that side?
I had a patient who had generalized decreased breath sounds on the convex side, and I’m just wondering about why that would be. He also had less chest excursion when I palpated his chest during breathing.
Thank you 🙏
Med student here, need of advice
Does anyone know of any good website that has heart and lung sounds?
I used to use easyauscultation but now it's under a paywall (which is absurd but what the heck)
Hi everyone! I'm a bit confused about the left sternal border. As I understood left sternal border it's 3rd intercostal space, then Left LOWER sternal border is Tricuspid area? I'm confused because, when they say left sternal border I generally interpret it even as Pulmonic area (lol logically it's also left sternal border). Please clarify it to me. TIA
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Is anyone able to give me an auscultation masterclass? Auscultation of the chest and making different respiratory diagnoses remains a very weak area for me. I struggle even to know what normal should sound like and find it hard to label something normal rather than decreased breath sounds or bronchial breathing. I find the practicalities of noisy wards, immobile patients unable to sit forward and large habitus difficult and in complete honesty, often can hear really nothing at all =#
Hello all, fresh new nursing student as of 4 weeks ago. I have ZERO clinical experience and really want to get everything right. I am having some trouble with the heart and lung sounds during the physical assessment. I can hear it on the simulated dummies in the lab and I can hear my own but when I go to practice on my fiance I don't hear very much if anything! I don't feel confident in giving someone an assessment and have to start doing them in 2 weeks.
I have a Littman Classic iii and my hearing is just fine. Any advice, links, tips would be VERY much appreciated.
Hello, fellow Redditors! I've been struggling with them mofking crackles and wheezes, so I decided to put up a deck with all the normal and adventitious breath sounds, using mainly this NEJM article, Bates Guide to Physical Examination, and some other sources. There are tons of audio files + .gifs/images, and the deck is structured similarly to the "Cardio Auscultation Sounds" from BG's Zanki expansion! I hope this helps someone!
Download: https://drive.google.com/open?id=1_BYgrLxuXSiHsY5DLeYYGJgaJMF-raV_
Total card count: 91 cards.
Any feedback is much appreciated!
Uworld gives contradictory explanations with respect to the auscultation findings.
It mentions clear lung fields as a differentiating feature to rule out PE in one of the question explanations while mentioning bibasilar crackles/lung sounds as a feature to rule in pulmonary embolism in a different explanation.
As far as i understand, pulmonary embolism can present with either findings.My question is how do we decide which auscultatory finding is more specific for PE?
TIA.
Can you guys please help me, i have an exam tomorrow. How can you tell apart systole from diastole in auscultation if the patient has tachycardia?
Any resources for cardiac auscultation ?
Hi all,
So I volunteered to do a CE on thoracic auscultation in dogs and cats. I was wondering if y’all had some references of audio with each heart murmur and abnormal lung sounds. I have seen a few on YouTube that seemed good, but didn’t know if there was more that can be imbedded in a PowerPoint. Would I need to contact the creator of the video/audio for approval to use in the PowerPoint? Also, if anyone has done one before, any advice?
Clearly it is highly exclusionary to suggest doctors who are actively reading the forum are 'auscultating' when many of the best specialities don't even use stethoscopes.
As the body says I was practicing some assessments and I thought I heard a bruit. It sounded like wind going through a tunnel. I have never actually heard one and I have not learned anything more in school than to “ask your instructor” if you hear anything abnormal as I’m only starting my 2nd year. I’m not even sure if that is what I heard.
For some background: my dad has COPD (early stage), diabetes, High BP (takes medication for hypertension but said he has not taken his meds lately because they cause him to cough), smoker, aprox 5’6 and 160 lbs, and history of stroke in the family (his mother).
If this is indeed what I heard what does this mean? Could this cause him to have a stroke if there is a blockage in the carotid artery? I really don’t know anything other than that this could be abnormal. His vitals were in normal ranges (even BP was only slightly elevated about 130/85 but really good considering he hasn’t been taking his medication). Not sure if that is relevant but I thought I would throw it in.
I have convinced him to at least go to the doctor to try a new BP Med if he doesn’t like his current one and to have have it checked out after Christmas just to be on the safe side. I just lost my mom last year to cancer and I’m so terrified to lose my dad because I know he isn’t the spitting image of health.
This only takes a couple minutes to read. Anyone have any thoughts about the legitimacy or lack thereof of the claims?
https://preview.redd.it/79tzc64xquo51.png?width=1326&format=png&auto=webp&s=5041df183da3fe00132df78981be533601201e25
https://play.google.com/store/apps/details?id=com.ha.HeartMurmurLabyrinth
https://reddit.com/link/fa4ra5/video/t8u3rj3qkdj41/player
So, this year we will start practicing palpation and auscultation to move from theoretical lectures to practical work.
Pretty essential for medical studies, but I learned that we will actually be practicing on each other, in small groups of students. I have no problem practicing on another students, but I can't help but feel uncomfortable, knowing that the other students will be practicing on me, among others, abdominal palpation ( the groups are gender-mixed ).
I am honestly not very comfortable with the idea of being just in a small top in front of the opposite gender, even if I know I have to, and that it is a way to learn.
How did you all deal with those kind of things?
Can someone explain why is it that in normal respiratory sounds inspiration is three times longer than expiration, when inspiration is essentially shorter than expiration?
