What a medical stethoscope can help doctors hear

Posted by aijj on March 19th, 2020

Whether it is internal medicine or surgery, emergency or anesthesia, anyone who has seen a doctor at the hospital will notice that a medical stethoscope is always hanging around the doctor's neck.

ECG, ultrasound, CT, magnetic resonance ... Dazzling medical equipment is widely used in clinical practice, and you may be wondering: Is a stethoscope still useful? What can it hear?

1. detect "lung disease

The sound of breathing is called the breathing sound clinically. The doctor places a medical stethoscope on each part of the chest wall. After taking several deep inhales and exhales, the doctor can make a preliminary judgment on the health of the lungs based on the breathing sound.

Under normal circumstances, people breathe about 15 times per minute, the diameter of the bronchial tubes through which the breathing air flows are different, and the characteristics of the strength of the breathing sounds are also different.

Respiratory sounds diminish or disappear: it may be restricted breathing activity, obstructive emphysema, pneumothorax, pleural effusion, etc.

Breath sound enhancement: indicates that the sound conductivity in this area is enhanced, and there may be pulmonary consolidation (the most water content).

Prolonged breathing: May be due to partial obstruction, cramps, or stenosis of the lower respiratory tract, such as bronchitis, asthma, etc.

Intermittent breathing: May be pneumonia, tuberculosis, etc.

Respiratory sound is rough: It may be due to mild edema or infiltration of inflammation in the bronchial mucosa, which is usually early in bronchitis or pulmonary inflammation.

In addition, the lungs may make other sounds. If a sound similar to the rupture of a blister is produced during inhalation, doctors call it a wet snoring sound, which may be because there are more mucus, sputum, blood, exudates, etc. in the airway. A whistle-like or snoring sound during inhalation or exhalation is called a dry snoring sound, which may be caused by narrowing or partial obstruction of the trachea, bronchi, bronchioles.

If the pleura is inflamed and exuding, you can also hear the pleural friction sound through the stethoscope.

2. "Signals" of Heart Disease

When the human heart beats, it will make a regular “sound” sound, and the stethoscope can also determine whether the heart has a disease based on the strength, frequency, etc. of the heartbeat sound.

The content of cardiac auscultation mainly includes aspects such as heart rate, heart rhythm and heart sound.

Heart rate: Heart rate is the number of heartbeats per minute.

Heart Rhythm: Heart rhythm refers to whether the rhythm of the heart beat is tidy, and arrhythmia refers to the heart beating for a while and then slowly. You can find problems such as premature heart beat and atrial fibrillation through the heart rhythm.

Heart sound: Heart sound refers to the sound produced by the contraction of the heart muscle, the closing of the heart valve, and the blood caused by the impact of the wall of the ventricle and aorta. When the heart has a lesion, the intensity, nature, and frequency of heart sounds will change.

Cardiac murmurs often indicate abnormal heart structures such as accelerated blood flow, stenosis of the heart valve, insufficiency of the valve, ventricular septal defects, open arterial ducts, and rupture of the tendon of the papillary heart.

It's like the old house was in disrepair for years, and the storm caused the roof to creak and make the window frame rustle.

3. Probe "abdominal and surrounding blood vessels

You might not think that in addition to listening to the lungs and heart, the stethoscope can also listen to your belly that sometimes gurgles, and even "looks quiet" blood vessels.

Belly (gut sounds)

When the bowel moves, the gas and liquid in the bowel flow with it, producing a "grumbling" sound similar to water bubbling, known as bowel sounds (normal 2 to 5 times / minute). It is the main sound heard by the stethoscope in the abdomen.

In acute gastroenteritis, bowel sounds are more active; in the case of mechanical intestinal obstruction, bowel sounds are hyperactive; in the case of peritonitis, senile constipation, hypokalemia, etc., bowel sounds will weaken or disappear (auscultation for at least 5 minutes No bowel sounds are heard).

4. Blood vessels (vascular noise)

A medical stethoscope can hear the "hairdry" sound made by the blood flow of the surrounding blood vessels through the stenosis, which is called "vascular noise."

Hearing noises in the large vessels of the neck indicate carotid or vertebral artery stenosis; continuous murmurs can be heard in the lateral thyroid lobes of patients with hyperthyroidism; and systolic murmurs in the upper abdomen or lower back when renal artery stenosis is heard.

In general, the stethoscope is an important "weapon" for clinicians. It is an information transmission line that connects the doctor's brain and the patient's diseased body. It is not too much to call it the "lifeline" at a critical moment.