semiotécnica de auscultación pulmonar

For pulmonary auscultation, two things need to be clear: first, the semiotics, and second, knowing how to recognize the main pulmonary crackles. The key to the semiotics of good pulmonary auscultation will be, first, to use the scapula as a reference point, knowing that auscultating directly over the scapula will prevent me from hearing the lung sounds.

Therefore, I will try to auscultate around it. In this way, we can see that the scapula occupies a good part of the thorax. Therefore, in this case, what I will ask the patient to do is to place their hands towards their opposite shoulders so that the scapula opens up and allows me to access

a greater amount of lung during auscultation. To do this, I will then establish eight auscultation points on each side of the lung, taking advantage of the points where the scapula is not located. These points will be mainly at the level of the apices, at the level of the scapulovertebral spaces, and the evaluation of the bases.

So, in this case, I can have eight points of focus on each side of the thorax. The important thing will be... My auscultation should always be bilateral, so after auscultating one area, I will immediately evaluate the contralateral area, assessing the type of rales that appear and the volume. Lung sounds are also low-frequency sounds, so

initially they can be difficult to appreciate. A good tip to try to solve this is to ask the patient to breathe through their mouth. When they do this, you will notice how the volume of respiration increases, making it easier to perceive. Regarding the anterior chest wall, it should be taken into account that the heart represents