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physical health assessment

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Hi,

please can anybody tell me where to hear proper heart sounds and distinguish them from murmurs and bowel sounds, hypoactive bowel sounds and hyperactive bowel sounds.

thank you

JBudd, MSN

Specializes in Trauma, Teaching. Has 40 years experience.

The "proper" heart sounds are S1 and S2, best heard over the apex: "lub, dub" Murmurs are part of heart sound, heard during systole, diastole or both. If you hear a swishing sound, loud or soft between S1 or S2, it is a systolic murmur. Murmurs are abnormal sounds, and only heard if there is a problem.

Listen to the right of the sternum, at about intercostal 2 or 3, for the best sound for an aortic valve problem. To the left of the sterum, same line, for the pulmonic valve. Go down to the 5th intercostal or so, left of sternum, for tricuspid, and over to the apical area for mitral valve.

Heart sounds are lub,dub, possible swish in it. Bowel sounds are gurgles, rumbles of liquid and gas. They are intermittent, can be low or high pitched. Typically about one sound every 15 seconds, but you have to listen carefully. They sound nothing at all like heart sounds. But loud BS can occasionally be heard while listening to the heart, they are referred sounds. Generally nothing to worry about except in trauma patients.

Hypo: rare occasional high pitched sounds, Hyper: long loud and frequent.

All of this should be in your assessment book, with much more detail and pictures showing you where to listen. Our book even has links to be able to hear the sounds on the computer.

Hi, thanx,

but please if you can tell me the link so that i can also listen the abnormal heart sounds. I really want to listen it.

thank you

In my health assessment book, i just have the theory, i want to listen these sounds also. so, plz if u can tell me a trusted source so that i can listen these sounds.

thank you

SopranoKris, BSN, RN

Specializes in Critical Care. Has 6 years experience.

Then do a Google search for audio or video links to heart & lung sounds. There are great sites out there.

la_chica_suerte85, BSN, RN

Specializes in Pediatric Hematology/Oncology.

Google "Ascultation Assistant UCLA" and you'll find what comes for my program as one of the most highly recommended ascultation practice sites.

NurseGirl525, ASN, RN

Specializes in ICU.

We just watched some videos on youtube last week on bowel sounds. To get an accurate heart rate makes sure you are doing the apical heart rate which is located over the apex of the heart. On bowels sounds make sure you are starting with the ascending colon, then go up to the transverse colon, and then down to the descending colon as just one section may have say hyperactive bowel sounds. The hyperactive are much higher pitched than the others. But there is a cool youtube video where you can actually hear them.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

Hi, thanx,

but please if you can tell me the link so that i can also listen the abnormal heart sounds. I really want to listen it.

thank you

Google is your friend.

Heart Sounds

mrsboots87

Specializes in Neuro, Telemetry. Has 6 years experience.

I know Littman (the stethoscope brand) has a website with heart and lung sounds. Not sure about GI sounds though. I dont know the exact website name but it is probably littman.com or something like that. Just keep in mind that the recorded sounds will not be exactly what you hear when auscultating an actual person. They volume is amplified for easier listening, but they will give you a general guideline of what to listen for. Your best learning of sounds will come from lab practice and clinical. When you come across a sound you can't place, call your instructor over or the nurse to listen and tell you what it is.

mrsboots87

Specializes in Neuro, Telemetry. Has 6 years experience.

Also, hyper/hypo active bowel sounds actualy sound pretty much the same, its the time between gurgles that depicts if they are hypo, normal, or hyper. Listen to you own abdomen when you are very hungry and a short while after eating. For hypo would be harder to just find wihtout being in clinical though. most people wont tell you about their GI distress so that you can listen.

ETA: I guess technically, hypo would have no sound since it is essentially the absence of bowel sounds, so I take that part pack.