Published Oct 5, 2013
rosemary_petals
30 Posts
Is it possible to hear a murmur while listening for blood flow when you are checking blood pressure in the brachial artery?? I am trying to understand if what I hear is just the turbulent flow if blood or if it's a murmur. It heard often but not the whole time on my clinical patient.
Esme12, ASN, BSN, RN
20,908 Posts
It is technically possible, depending on the murmur, to hear certain murmurs without a stethoscope at all.....if they are loud enough. They can be auscultated in the carotids and by the clavicle.....an aortic murmur can be heard on the back. This is much more common in children. Approach to Cardiac Murmurs | Learn Pediatrics
So yes it's possible. Although not all turbulent blood flow is caused by a murmur and your patient my not have that loud of a murmur
Whether or not that is what you are hearing? It is difficult to tell you yes..... I would ask your instructor to listen to the patients B/P and tell you what you are hearing.
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
The old joke about cardiac murmurs is that the I/VI is the one that only the professor of cardiology can hear, and the VI/VI can be heard with the stethoscope diaphragm above the skin, not touching the chest. This last is actually true.
Sound is carried by fluids really well-- this is why whales can communicate over many, many miles and some think they can pick up the sound of heavy surf, thus identifying land masses, from hundreds of miles. It's also why you hear aortic murmurs in the anatomical place downstream of the AV (the aortic arch), and mitral murmurs at the apex of the heart (check your anatomy diagram to envision this better).
I doubt very much that you would be hearing a cardiac murmur at the brachial artery, but you might be hearing turbulence from an arterial lesion a bit further north, such as an aneurysm or stenosis at the subclavian artery.
My dad's murmur was very loud....rheumatic fever.....you really could hear it into his carotids. He had many carotid ultrasounds because of this. Children's murmurs can also be easily auscultated due to the small surface area of their little bodies.