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Lung Assessment Nursing | Lung Auscultation | Assessing Lung Sounds Part 2



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hey everyone it's sarah thread sterner

sorry and calm and in this video I want

to demonstrate for you on a patient how

to auscultate the lungs anteriorly and

posteriorly in the previous video I went

over an in-depth lecture about how to do

this along with normal breath sounds and

abnormal breath sounds so be sure to

check out that video after you watch

this so let's get started

first I want to start out showing you

the auscultation side so I wanted to use

these stickers so you can see about

where I'm going to go with the

stethoscope and let me get over these

real fast for you because these are the

little landmarks of where you're going

we have our right leg over here and our

left leg over here and what we're doing

is we're assessing the lungs the right

lung has three lobes the right up or the

right middle and the right lower the

left lobe only half of the left lung

only has two lobes the left upper and

the left lower so whenever you're

listening you want to start out at your

apex up at the top of the lungs right

above the clavicle just slightly above

it right here where you see these pink

stickers then you're going to go down to

the second intercostal space a little

bit over from where your breastbone is

the sternum and this is where you're

gonna start assessing the upper lobes of

the lung then you're just gonna inch

down a little bit and you wolf this is

about the third intercostal space and

you're gonna listen here then go down to

the fourth intercostal space and this is

one of the landmarks for the right

middle lobe your fourth intercostal

space so right here well listen I'm here

here a right middle lobe and then we'll

listen to our left upper lobe then we'll

inch down a little bit and we'll listen

a little bit more to that right middle

lobe and then we're going to be

listening to our left lobe and then

we're gonna go mid-axillary over here to

the side where the armpit is mid

axillary axillary sixth intercostal

space and we're going to be assessing

our lower lobe so it's right here on him

and then it's again right here and

you'll listen there and then um you'll

just inch down a little bit and listen

at the bottom just to assess those lower

lobes a little bit now let's listen to

the lungs with a stethoscope okay before

you begin what you want to do is you

want to perform here

hi Dean introduce yourself to the

patient and tell them what you're going

to be doing and what whenever I listen

to lung sounds I like to listen directly

on the skin with my stethoscope not over

the gown or over their clothing because

you can pick up other sounds that may

sound adventitious when it's really not

and you just get the best acoustic sound

whenever you listen directly on the

patient so you want to get your

stethoscope and you want to listen with

the diaphragm of your set the scope

because that's what picks up the best

sounds and what we're listening for is

we're listening for that full cycle of

inspiration and expiration and we're

paying attention to what type of breath

sound is it is it bronchial vesicular

Branko vesicular if you're not familiar

with those sounds check out my other

videos because I have audio clips where

you can listen to those and we're also

listening for any extra sounds on top of

those sounds like crackles wheezes

Strider anything like that that we may

be picking up and another kids this

skill takes getting used to you have to

practice it over and over especially

when you're listening over these areas

because you're gonna hear the heartbeat

at the same time so you got to train

your ears to listen for those correct

sounds like you're the heart versus

lungs so practice this on yourself and

others so you can get comfortable with

it so what we're gonna do is we're gonna

start at the top and we're gonna work

our way down and we're going to start on

one side and then compare that side

because we want to say say see if we're

hearing the same thing on this side as

we are that side so let's get started

okay what I'm gonna have you do is take

one breath in through your mouth and out

through your mouth

and if you start to get dizzy or

anything let me know and we can slow

down okay we're starting up at the apex

right above the clavicle

now we're gonna inch down to the second

intercostal space and this is where

we're gonna start listening to our upper

lobes of our lungs

so about right there then we're just

gonna inch down a little bit to about

the third intercostal space and listen

there and we're gonna go over and

compare it now we're going to go down

into the fourth intercostal space and

we're still gonna be in the upper lobe

of the left lung but now we're gonna be

in the middle lobe of the right lung so

let's just go down just a little bit and

then we're gonna go over here and

compare and then we'll just go a little

bit do maybe the fifth intercostal space

just still assessing that middle lobe

and I go over here and compare now we're

gonna go mid axillary and we're gonna be

down in our lower lobes now and this

will be at the six intercostal space

okay we're going to compare sides so if

you just want to turn over here we're

gonna go mid acts like a parasite then

we're just going to go down just a

little bit to say in that lower lobe and

then we're going to compare sides now

let's look at the posterior view of the

back here over on this side we have the

left lung and over here we have the

right lung it's flip compared to the

anterior view and what we'll do is we'll

start listening up at the apex of the

lungs again and that's right above

slightly above that shoulder blade in

this area where the green stickers are

then we're going to go and we're gonna

listen between c7 to t3 and c7 is where

you're prominent starts so right here

and we'll go a little bit below it

because c7 to t3 is going to assess the

upper lobes of the posterior side of the

lungs so we'll go here and here then

we'll go down just

bed.this is about where t3 is and then

we'll jump down to round t4 and from t3

to t10 we'll be assessing the lower

lobes in your posterior view you have

more ability to auscultate the lower

lobes then compared to the anterior view

where you're gonna really be assessing

the upper lips so then we'll just go

down listen here listen there we'll go

there and then we'll just go a little

bit mid-axillary almost mid-axillary and

listen over on these sides and then down

at the bottom and over here now let's do

it with a stethoscope now we're going to

listen posterior lis okay let me tell

you a trick with this whenever you're

listening back here as you've learned if

you watch the other lectures you have

the scapula back here and you have the

vertebrae and what you're trying to do

is to get in between that scapula and

vertebra to listen to those lungs and

you don't want to go over the shoulder

blades of scapula while you're listening

to lungs because it's really gonna

muffle out your sound and you're not

gonna hear a lot so what you need to do

is have the patient sort of just move

their arms like this to separate those

shoulder blades from one another so you

have some space to work with so what

we're gonna do again we're gonna start

from top and work our way to the bottom

and we're going to compare side so we're

gonna go slightly above the scapula

listen to the apex then we're gonna go

down in the area where c7 is which is

where your prominence is then we'll work

our way down to where t3 and remember

this is assessing the upper lobe and

then we'll go down from t3 to about t10

and assess those lower lobes so here we

go

and again just take a deep breath for me

in and out

okay and we are done with posterior okay

so that is how you assess the lungs with

a stethoscope now be sure to check out

the other videos in this lung series

like the audio files of the normal

breast films vs. abnormal and the

lecture that covers this material in

depth and thank you so much for watching

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