Lung Auscultation Locations, Assessment, Patho for Nursing students | NCLEX

Now, for assessing the lungs, it's critical to understand the normal anatomy of the lungs.

So starting with the lobes, the right side of the lung has three lobes and the left side

only has two lobes.

Now when we're listening to the lungs, we listen in between the ribs.

This is called the intercostal space, so just think in between the ribs for intercostal

is where we listen.

Now the respiratory system sort of looks like an upside down tree.

We have the trachea, also called the windpipe, which serves as the stump of the tree, branching

off into the bronchus, the right and left.

Then to the bronchi, our smaller branches there, and the bronchioles, the very tiny

branches, eventually ending at the alveolar sacs, which I call the alveolar apples, because

this is where all the action happens.

As you know, the alveolar sac is where gas exchange occurs, exchanging CO2, that carbon

dioxide, for oxygen.

Well, if you don't know, now you know.

We breathe out that CO2 and we breathe in that oxygen.

Now it all happens here in the little capillary beds of each alveolus.

It's critical to know this when we start breaking down the patho of various diseases.

So if we have fluid in the lungs, like with pulmonary edema, typical for patients in heart

failure, where we get heavy fluid all over the body, we get really wet lungs that block

this oxygen from getting in.

Or if these little alveoli collapse, like in atelectasis, well then gas exchange can't

happen and infection settles in, resulting in pneumonia, which we cover in a separate

video.

So normally we breathe oxygen in and breathe out that CO2, that carbon dioxide, which I

call carbon di-acid, since too much of it can put your body in acidosis.

We even have a little song about this on iTunes and Google Play called Don't Stop Breathing.

It's a parody to Don't Stop Believing from Journey.

I'll play a little segment real quick.

Okay, hopefully you liked that little segment.

I'll add the full song at the end of this video, so be sure you stay till the end.

Now for auscultation locations, we have anterior, which is the front on the chest, and posterior

on the back, where we mostly assess the lower lobes on the back.

We want to position the patient upright in high Fowler's position, point the diaphragm,

the big part of the stethoscope, downward, and place it in the intercostal spaces, that

part in between the ribs.

Now normal breath sounds are known as normal vesicular breath sounds, are soft and low-pitched

breezy sounds.

This key point is a need to know for Kaplan standardized exams.

So Kaplan mentions, normal breath sounds are vesicular breath sounds, soft and low-pitched

breezy sounds heard over most of the peripheral lung fields.

Okay now for the good stuff, the assessment.

We start on the front, the anterior, basically the chest.

We want to start at the top, on the right side, above the clavicle, aka above the collarbone.

We listen for a full inhalation, and a full exhalation.

Then we move to the opposite side.

Now we want to compare the quality, the depth, as well as extra sounds.

These extra sounds are called adventitious breath sounds.

Then we move to the second ICS, midclavicular, basically meaning the middle of the clavicle.

An ICS is that intercostal space in between the ribs.

Alright guys, that wraps it up for this segment.

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