Pneumonia can develop as an independent disease, but in most cases, the disease becomes a complication of another infectious pathology. In the affected area are the lower segments of the lung. The doctor prescribes treatment only after the results of a complete diagnostic examination are received. Auscultation for pneumonia plays a special role. By means of it, the localization of the damaged bronchi and alveoli is determined.
This ailment is very dangerous. If you ignore the symptoms of pneumonia, irreversible consequences develop, which can be fatal. At risk are children under 5 years of age, the elderly, patients with a history of chronic diseases of the respiratory system. In the past few years, the number of cases of infection with staphylococcal and viral infections has increased.
Antibiotic drugs often do not have the desired effect. To select an effective therapeutic regimen, information is required on the type of pathogen, general condition and individual characteristics of the patient. To find out many of them, auscultation is required. This is the name of the procedure by which auscultation of the lungs is carried out. Sounds detected in this way will help identify the affected area and assess the functionality of the respiratory system.
There are two types of auscultation. The direct one is carried out by applying the ear to the affected area. For mediocre auscultation, special devices are required. These include a phonendoscope and a stethoscope. When using the latter, more accurate results are obtained. Both methods of listening are often combined . Then a stethophonendoscope is used . It consists of a membrane that amplifies the sound and plastic tubes.
Indications for appointment
Auscultation is performed not only for pneumonia. A weighty reason for her appointment can be:
- lung abscess;
- swelling in the area of the respiratory organs;
- lung infarction;
- heart failure;
- malignant or benign tumor;
- aspiration (accumulation of fluid in the pleura).
In order for the auscultatory picture in pneumonia and other pathologies to be clear, the doctor listens to the lungs in several places. As a result, specific wheezing and extraneous noises are revealed. In severe cases, the symptoms are as follows:
- cyanosis of the skin;
- herpes in the lip area;
- disorder of consciousness;
- increased breathing.
The effectiveness of the technique
Noises associated with pneumonia are divided into two categories. The main types of breathing are considered to be vesicular, stenotic, bronchial, rigid, saccadic . This diagnostic method allows you to timely identify:
- difficulties with the movement of sound waves from the small bronchi to the surface of the chest;
- obstructive type atelectasis ;
- a sharp decrease in the elasticity of the walls that form the alveoli;
- factors limiting the duration of inspiration.
Vesicular respiration increases with hyperventilation, asthenic constitution, disorders in the endocrine system, and diabetic coma. With pneumonia, uneven narrowing of the bronchi is often observed. Sputum accumulated in the airways interferes with normal breathing. As a result, the alveoli are under tension for a long period.
Saccadian wheezing is often called intermittent. In this case, breathing is a cycle of short in-breaths. The patient’s condition is exacerbated by tremors in the muscles, the flow of cold air, extensive chest injuries.
Do you need preparation
Lung auscultation is a technique that is simple and highly effective. To determine the necessary indicators, the doctor must follow clear instructions. Before starting a diagnostic study, the patient should be calm. The doctor also needs to be in silence for 5-10 minutes. This is necessary for hearing preparation. The procedure is carried out in a warm, well-ventilated area.
How is the procedure carried out
Auscultation is done in three stages. The patient takes an upright position, the body is exposed to the waist. In the first stage, the doctor listens to both lungs by applying a stethophonendoscope at parallel points that are located in the segments on the side, on the back and chest.
The second stage: identification of the main and additional murmurs in the lungs. If the latter are found, the damaged areas are re-examined. This is how the number and localization of lesions are specified . The patient should breathe deeply and calmly at this time. Usually 2-3 breaths are required.
The third stage is necessary to check the airway after coughing. Thanks to the innate reflex, the bronchi are cleared and, accordingly, the functionality of the lungs increases. The sounds that appear during this period of time help to more fully diagnose a right-sided or left-sided ailment.
This research is the first step towards recovery. Due to the large amount of mucus, characteristic sounds are drowned out by bronchial breathing. With bilateral pathology, listening begins on the right side. The patient can sit, stand, or lie down. The latter is necessary if the patient is in serious condition. The position of the hands depends on which side the affected segments are examined. The stethophonendoscope is moved from top to bottom during auscultation of the lungs.
If auscultation of the lungs is performed from the front, the apparatus is placed in the supraclavicular fossa. In this case, the membrane is in contact with the patient’s body. Listening in the lateral regions begins from the axillary fossa. With auscultation of the respiratory organs, carried out from behind, the phonendoscope is placed in the supraspinatus fossa. The study is continued by moving the device in the interscapular space.
Respiratory sounds detected during auscultation of the lungs are deciphered by a specialist. He also instructs the patient before starting the procedure. The patient must trust the doctor who will carry out the procedure. If you feel unwell, the procedure is interrupted. Deep breathing can cause severe dizziness and fainting.
When performing auscultation, the following goals are pursued:
- identification of the type of basic and additional noises;
- determination of the localization of foci of inflammation.
Deviations that are found during the diagnostic examination are eliminated through effective therapy. Auscultation for pneumonia can help detect crepitus. Cleansing the airways with focal, congestive, community-acquired and other forms of pneumonia should be correct. First, they make a few coughs, and then take a deep breath. Dry wheezing is easier to hear if the patient is in a horizontal position. If necessary , auscultation methods are introduced into the diagnostic scheme , aimed at assessing the work of the pleura.
Signs of a disease
The auscultatory picture in pneumonia consists of specific sounds. They are formed as a result of damage to the parenchymal tissue, bronchi and alveoli. Inflammation of the lungs can develop slowly or rapidly. The main features include:
- an increase in body temperature up to 39.5 degrees;
- excessive sweating at night;
- severe headache;
- unreasonable anxiety;
- debilitating wet cough;
- secretion of sputum containing destroyed erythrocytes.
In juvenile patients, pneumonia cough is often absent. Due to the swelling of functional tissue, pressure increases in all segments of the affected lung. Painful sensations occur during inhalation, physical exertion and stress. Also, with pneumonia, an increase in heart rate is recorded. The increased load on the heart and other vital organs is due to progressive oxygen deprivation. The duration of treatment depends on the intensity of the characteristic symptoms, the stage of the disease and the reactivity of the body.