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Auscultation means listening to the sounds the lungs make through a stethoscope. In a few quiet minutes a physiotherapist can judge whether air is moving freely into every part of the lung, and whether there is fluid, mucus or airway narrowing. It helps decide which treatment you need — and, repeated before and after, shows whether that treatment is working.
What it is
Auscultation is a core bedside assessment in which the clinician listens to breath sounds and any added (adventitious) sounds over the chest wall. It complements inspection, palpation and percussion, and — repeated over time — acts as a simple, immediate outcome measure of a patient's respiratory state.1
Breath sounds
| Finding | What it suggests |
|---|---|
| Normal (vesicular) | Air moving freely to that region |
| Bronchial breathing | Consolidation (e.g. pneumonia) transmitting sound |
| Reduced or absent | Pleural effusion, pneumothorax, collapse, or severe hyperinflation |
Added (adventitious) sounds
Standardised nomenclature (ERS/CORSA) keeps terminology consistent between clinicians:2
| Sound | Typical cause |
|---|---|
| Wheeze (continuous, musical) | Airway narrowing — asthma, COPD |
| Fine crackles (late inspiratory) | Pulmonary oedema, interstitial fibrosis |
| Coarse crackles (early/mid) | Airway secretions, bronchiectasis |
| Pleural rub | Inflamed pleural surfaces |
How it is done
In a quiet room the diaphragm of the stethoscope is placed directly on the skin and the chest is examined systematically — anterior, posterior and lateral zones — comparing side with side at each level while the patient breathes deeply through an open mouth.
Use in cardiorespiratory physiotherapy
- Localises secretions or reduced ventilation to target airway clearance and positioning.
- Monitors response — auscultating before and after treatment shows whether crackles have cleared or air entry improved.
- Detects deterioration early (a new wheeze, a silent zone) so care can be escalated.
Cautions
Auscultation is subjective and shows moderate inter-rater agreement, so it is always interpreted alongside other findings and, where needed, imaging. Stethoscopes are cleaned between patients as part of infection control.3
References & evidence base
- Sarkar M, Madabhavi I, Niranjan N, Dogra M. Auscultation of the respiratory system. Ann Thorac Med 2015;10(3):158–168.
- Pasterkamp H, Brand PLP, Everard M, et al. Towards the standardisation of lung sound nomenclature. Eur Respir J 2016;47(3):724–732.
- Bohadana A, Izbicki G, Kraman SS. Fundamentals of lung auscultation. N Engl J Med 2014;370(8):744–751.
References are numbered in citation order (Vancouver/BMJ style) and were current at the time of writing. Guidelines are living documents — verify against the latest version before clinical use.
Everything starts with an assessment — your symptoms, breathing, exercise tolerance and daily function measured properly, so what follows is built on your lungs rather than an average.
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