AUSCULTATION.

Mediate and immediate auscultation. Methods, quiet, normal chest

sounds, tubal, bronchial, vesicular, respiratory, cardiac. Juvenile

respiratory murmur. Horse, left side, right. Ox, left side, right.

Accidental sounds, rumbling, gurgling, crepitation, friction. Sheep,

special features. Goat, force. Pig, Dog, Birds, morbid chest sounds.

Increase, general, partial. Decrease, general, partial. Absence.

Bronchial sound in excess, in improper place. Cavernous, amphoric,

mucous sounds. Râles, sonorous, sibilant, mucous, submucous,

crepitant, subcrepitant. Creaking, metallic, tinkling, gurgling,

splashing, friction. Timbre of Cough. Palpitation. Mensuration.

This is a term used in medicine to denote the mode of exploring an organ

by applying the ear over the region in which it is situated and deducing

the healthy or diseased condition by the sounds heard. First employed by

Lænnec in human medicine it was quickly availed of for the lower animals

by Delafond and Leblanc.

Auscultation is =mediate= or =immediate=. =Immediate Auscultation= is

practised by applying the ear directly upon the skin, either bare or

covered with a handkerchief. In =Mediate Auscultation= an instrument

called a stethoscope is employed to convey the sound from the surface of

the body to the ear of examiner. The common stethoscope is formed of

soft wood (cedar or ebony) or of gutta percha, is from five to seven

inches long and a quarter of an inch in the bore. The end applied on the

skin is widened into a funnel three-fourths of an inch across at the

mouth; the opposite end is flattened out to apply to the ear, is about

two inches in diameter and has a hole in the centre to convey the sound.

A flexible stethoscope is also used either with one or two ear pieces

and though less convenient in general than the common variety possesses

this advantage when the heart is being examined that it conveys the

sound without the impulse of that organ.

In mediate auscultation the ear should be closely applied to the

surface, the right ear being used for the left side and the left ear for

the right, but a preference should always be exercised in favor of that

in which the sense of hearing is most acute. If a handkerchief is used a

single fold only must be applied, otherwise the two layers may rub on

each other and produce distracting sounds. In mediate auscultation the

instrument should be held perpendicularly to the surface, accurately

applied alike to the skin and the ear, and pressed firmly on the surface

to condense the soft structures beneath the skin and render them more

conducting. If held by the hand care must be taken to avoid the

slightest movement of the fingers on the stethoscope, and long hairs

should be prevented from entering the tube as being likely to produce

additional sounds.

Among other points the following must be attended to in auscultation.

Avoid a position in which the animal can strike you with its hind limbs.

If necessary in irritable or ticklish subjects have one fore leg held

up. Select a quiet time and place, early morning or night is usually

best. Endeavor to protect the patient from the irritation of insects or

the examinations may be fruitless. Never auscultate over a contracting

muscle; the sound of muscular contraction will prevent a correct result.

If the natural sounds are indistinct increase them by exercise. The

smaller animals are examined with the greatest facility standing upon a

table or held in the upright posture with the body resting on the thighs

or on the hind feet only. Birds can be held by the wings which may be

raised and drawn inward towards the median line to expose the back and

sides of the chest.

Text book of veterinary medicine, Volume 1 (of 5) · 第 79 / 169 题