Auscultation
Auscultation of the heart requires excellent hearing and the ability to distinguish subtle differences in pitch and timing. Hearing-impaired health care practitioners can use amplified stethoscopes. High-pitched sounds are best heard with the diaphragm of the stethoscope. Low-pitched sounds are best heard with the bell. Very little pressure should be exerted when using the bell. Excessive pressure converts the underlying skin into a diaphragm and eliminates very low-pitched sounds. ★ Major auscultatory findings include - • Heart sounds • Murmurs • Rubs Heart sounds are brief, transient sounds produced by valve opening and closure; they are divided into systolic and diastolic sounds. Murmurs are produced by blood flow turbulence and are more prolonged than heart sounds; they may be systolic, diastolic, or continuous. Rubs are high-pitched, scratchy sounds often with 2 or 3 separate components, which may vary according to body position; during tachycardia, the sound may be almost continuous.
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