Differentiating between lung and bowel sounds

  1. They say the only stupid question is the one you never ask so here goes nothing...

    when auscultating lung sounds laterally, is it possible to hear bowel sounds (stomach, mainly, gurgling) while auscultating or am I wrong. Because it didn't sound like a crackle or pleural rub or anything... it sounded quite like a bowel sound square and simple. I wasn't too low wither I was above the nipple laterally hence why I was surprised to hear something like that. What made me believe it wasn't a crackle as well is the fact that it appeared and disappeared.

    is this possible? What could cause it!?

    also does anyone have any great resources on learning the specifics of lung auscultation techniques?
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  2. 12 Comments

  3. by   Flatline
    I was just in a meeting where you could hear my bowel sounds, mainly gurgling, from across the conference room so yes, you can sometimes hear them while ausculating the lungs.
  4. by   Double-Helix
    It’s definitely possible to hear a sound from the digestive track when you’re over the lungs. The esophagus also runs through the chest, so it’s very possible you heard a burp or similar sound as air refluxed, or transmitted sounds from the stomach.
  5. by   KatieMI
    It can be caused my many things, among them:

    - high staying of diaphragm
    - lung which is not fully distended by air (pneumonia, fibrosis)
    - pleural effusions (fluid conducts sound vawes much better than air)
    - hiatal hernia (very common)
    - other diaphragmal hernias (less common)
    - acute diaphragmal injury (even less common)

    Similarly, one can hear breathing sounds and vascular sounds/murmurs over abdomen very clearly while bowel sounds are absent for some reason.

    Only one reliable way to improve assessment skills is to do assessments, every single time you get a chance. Speak with your coworkers/preceptor so that yuo could see "interesting" patients, if nobody minds it.
  6. by   traumaRUs
    Moved to student assistance forum
  7. by   Summer Days
    And it can be especially true for the pt with morbid obesity or one with ESLD with distended abd.
  8. by   amoLucia
    Quote from LifetimeLearnerS
    They say the only stupid question is the one you never ask so here goes nothing...
    And you asked a very good question. This here retiree knew the answer, but I too continue to learn more little bits of info, even though I have no opp'ty to use them.

    TY for the good question, and TY y'all for all the good responses.
  9. by   Lev <3
    I have heard bowel sounds up in the lungs. The bowel is hollow and that tympany can travel. Lungs sounds can disappear too mind you. Ever heard of "scattered wheezes?"
  10. by   ~♪♫ in my ♥~
    Quote from Lev <3
    Lungs sounds can disappear too mind you.
    Ain't that the truth?

    Some of those late-stage COPDers - combined with my generally crappy hearing - sometimes have absent breath sounds in the bases.
  11. by   LifetimeLearnerS
    No what are those?
  12. by   LifetimeLearnerS
    And they are commonly referred to as diminished, right?

    I had a patient with minimal wheezing in the middle lobes who after many deep breaths and a follow up assessment was completely clear. He was on 2L of o2 & in semi fowlers is that possible!?
  13. by   LifetimeLearnerS
    No what are those!??
  14. by   la_chica_suerte85
    Quote from LifetimeLearnerS
    And they are commonly referred to as diminished, right?

    I had a patient with minimal wheezing in the middle lobes who after many deep breaths and a follow up assessment was completely clear. He was on 2L of o2 & in semi fowlers is that possible!?
    Yes, it is possible. If you hear coarse lung sounds where you should be hearing bronchovesicular sounds, you just have them cough and clear their secretions and, voila, clear lung sounds. Also, wheezing is a bronchial issue and it is possible that the deep breaths allowed them to relax enough for the restriction of air flow to stop and the wheezing to disappear, just like you would hope a breathing treatment would do the same for someone with asthma.

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