Auscultation
Protocols
Auscultation:
1. Bowel sound: Normal or sluggish or absent (if paralytic ileus). 2-3 sound /minute normal .
Site:
- Place the stethoscope just to the Right of the umbilicus & kept there sound is here .Before said bowel absent we must see four quadrant & see at 3 min before declare bowel sound absent .
Abnormal Bowel sound:
- a. Absent bowel sound: peritonitis, paralytic ileus,
- b. Increase bowel sound :
- intestinal obstruction,
- carcinoid syndrome
- Diarrhea.
- Food allergy.
- GI bleeding.
- Infectious enteritis.
- Ulcerative colitis.
2. Over liver (hepatic bruit or rub).
3. Renal bruit (2 cm above the umbilicus and lateral to midline).
4. Bruit of aortic aneurysm (if any).
5. Splenic rub (rarely found).
6. Venous hum (heard between xiphisternum and umbilicus). It is a continuous, low pitch soft murmur. Presence of venous hum indicates portal hypertension (rare finding). It is due to large volume of blood flowing in umbilical or paraumbilical vein in falciparum ligament due to porto-systemic shunt.