Sounding
the sounding is the part of the clinical examination which consists in listening, using a Stéthoscope (mediate sounding), or simply to the ear, various noises produced by the bodies of the human body, in particular those emitted by the Cœur, the Poumon S and the Bronche S, the Intestin S, the Carotide S and the femoral Artère S. This method of medical diagnosis was developed by Rene Laennec in 1816.
It is an error to qualify sounding a clinical examination not calling upon hearing.
Pulmonary sounding
Preferentially made on the posterior face of the thorax, can also be done into former. One seeks there the presence of the normal pulmonary noises and adventitious noises (abnormal). The principal normal pulmonary noise is the
murmur vésiculaire . It is the reflection of the air intake in the lungs and is decreased in several pneumopathies.
Normal noises
- Murmurs vésiculaires on the whole of the thorax
- Noise bonchovésiculaire
Face former of the thorax: bilaterally on the 2nd space intercostale close to the body of the sternum
Face posterior of the thorax: bilaterally on 2nd, 3rd, the 4th spaces intercostales close to the junction
coasts (head, collar) with the spinal column
- Noises tracheobronchic on the level of the sternum
- Noises tracheic on the level of the trachea
Adventitious noises
sound
- Ronchis or rails or whirr
Description
- Tonality low, frequency smaller than 200Hz.
- Prevalence with the expiry.
- noise which resembles that one hears when one blows in the neck of a bottle
and with whirrs.
it can disappear if the person produces an effective cough, or if its secretions were
aspired
- Sibilances (audible with the stethoscope only)
Description
- Have an acute tonality, around 400Hz
- Prevailing with the expiry
- Noise which resembles that one hears when that one deflates a balloon
which one grips the orrifice.
Description
- Soft Sounds, of high tonality, very briefs.
- Audible especially at the end of the inspiration.
They do not disappear if the person coughs. One can compare them with
noise which a wick of hair makes that one rolls between its fingers.
Description
- Strong, basic tonality, longer Sounds.
- Audible especially at the time of the inspiration and at the beginning of expiry.
they can decrease if the person coughs, if it changes position or following
a bronchial aspiration.
it can compare them with a wood fire which sparkles or with but that one makes burst.
They also resembles gargouillements.
Description
- Very surface Noise, which resembles the crépitants much.
it occurs at the end of the expiry.
it can compare them with the noise which two make morceux leather rubbed one
against the other.
it is especially audible with the circumference of the lines axillaires former lefts or right-hands side.
Text of reference
- Treated mediate sounding of Rene Laennec, 1819
See too