The Art and Science of the Medical Auscultation: Respiratory Sounds

Abstract

Auscultation of the chest is a very old diagnostic method. Originally, it was performed by the examiner directly hearing into the patient's chest, and this practice dates back to the time of Hippocrates. The original description of lung sounds was based on comparing acoustic phenomena that was heard in the chest with gross lesions autopsy. Subsequently, the interpretation of these findings is based on functional rather than anatomical analysis. Auscultation became an invaluable diagnostic method. With the advent of radiological images, increasingly sophisticated, computerized tests of lung function, rapid arterial blood gas analysis, endoscopic studies airway and percutaneous biopsies of pleura and lung; the practice, with method and timing of chest auscultation, has lost presence. In addition, the nomenclature of respiratory sounds is sometimes confusing and the terminology proposed by international committees, little known. One objective of the article is to give a pathophysiological basis of noise based on modern computer-assisted studies which have enabled accurate recording and sound analysis techniques. The other objective is to provide a practical and useful tool to understand and correlate what you hear, with the pathophysiological basis, the underlying condition that generates the phenomena and streamline the diagnostic work.