Auscultation

Auscultation is the act of listening to sounds produced inside the body as part of a physical examination — one of the four classic examination methods alongside inspection, palpation, and percussion. It is almost always performed with a stethoscope, whose diaphragm picks up high-pitched sounds and whose bell picks up low-pitched ones.

Cardiac auscultation assesses heart rate, rhythm, and the heart sounds produced by closing valves, including murmurs and extra sounds. The apical pulse is auscultated at the fifth left intercostal space at the midclavicular line. Pulmonary auscultation compares breath sounds systematically from side to side. Normal sounds include vesicular sounds over most lung fields; adventitious (abnormal) sounds include crackles (rales), wheezes, rhonchi, stridor, and pleural friction rubs, each pointing toward different problems such as fluid in the airways, narrowed bronchi, or pleural inflammation. Abdominal auscultation evaluates bowel sounds and vascular bruits.

Auscultation matters because it is fast, noninvasive, and information-dense: diminished breath sounds may suggest a pleural effusion or pneumothorax, wheezing suggests obstructive disease, and a new murmur can signal valve dysfunction — findings that guide which tests come next.

The NPTE-PT and NPTE-PTA exams test pulmonary auscultation within cardiopulmonary examination — identifying normal versus adventitious breath sounds and their implications for therapy. The CCMA exam tests auscultation as an examination method and as part of vital signs, including apical pulse measurement.