Let’s talk about auscultation. Of course
you want to auscultate the heart to see if
there’re murmurs or valve problems and so
forth. But you also want to put your stethoscope
over various blood vessels because, just like
a garden hose when you bend it and you get
that sound of the turbulent flow in the garden
hose, the same thing happens in a blood vessel.
When it’s narrowed, the blood velocity increases,
there’s turbulent blood flow on the other
side of the narrowing and you get with each
systole – with each squeeze of the ventricle
– you get a sound called a bruit, from the
French word meaning noise, over that vessel.
Let me give you an example. If there were
a narrowing in the carotid artery and I put
my stethoscope here over the carotid artery,
what I would hear with each beat of the heart
is this: whoosh, whoosh, whoosh, whoosh. That
tells me that there’s turbulent flow secondary
to a severe narrowing in the carotid artery.
And you can also listen in the mid-abdomen
for bruits because of narrowing in the aorta
or the renal arteries. And you can also listen
in the groin for narrowings in the femoral
So it’s important to listen to each of these
areas to see if a bruit is present because
the bruit implies that there’s significant
arterial narrowing or stenosis that is leading
to an area of turbulent blood flow that makes
the sound of the bruit.
Now, again, where are we going to listen?
We’re going to listen over the carotid arteries.
We’re going to listen of course over the
heart to hear if we hear any murmurs that
suggest valve problems. We’re going to listen
over the abdominal aorta and we’re going
to listen over the femoral artery in the groin.