Dtsch Med Wochenschr 2015; 140(14): 1078-1082
DOI: 10.1055/s-0041-102883
Fachwissen
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Die Lungenauskultation – Erkenntnisse und Irrtümer

Lung auscultation – an overview
Urs Bürgi
1   Klinik für Pneumologie, UniversitätsSpital Zürich
,
Lars Christian Huber
1   Klinik für Pneumologie, UniversitätsSpital Zürich
› Author Affiliations
Further Information

Publication History

Publication Date:
16 July 2015 (online)

Zusammenfassung

Die Lungenauskultation ist der wichtigste Teil der pulmonalen Untersuchung. Neben der Anamnese ist sie das Kernstück des diagnostischen Prozesses bei der pneumologischen Erstbeurteilung. In Notfallsituationen können dadurch effizient, reproduzierbar und kostengünstig Differenzialdiagnosen erhoben werden. Das Erkennen des normalen Atemgeräuschs oder von pathologischen Veränderungen und Nebengeräuschen erfordert entsprechende Übung. Eine wichtige Voraussetzung dazu ist die korrekte Durchführung und die Verwendung der international definierten Nomenklatur.

Abstract

The auscultation of the lungs is – among anamnesis – the most important part in the assessment of patients presenting with pulmonary symptoms. The lung auscultation is reproducible, cost efficient and very helpful to distinguish between differential diagnoses, in particular in emergency situations. Detection and description of lung sounds requires experience and should be performed by strict adherence to the internationally accepted terminology.

 
  • Literatur

  • 1 Bohadana A, Izbicki G, Kraman SS. Fundamentals of Lung Auscultation. N Engl J Med 2014; 370: 744-751
  • 2 Kraman SS. Determination of the site of production of respiratory sounds by subtraction phonopneumography. Am Rev Respir Dis 1980; 122: 303-309
  • 3 Gavriely N, Shee TR, Cugell DW et al. Flutter in flow-limited collapsible tubes: a mechanism for generation of wheezes. J Appl Physiol 1989; 66: 2251-2261
  • 4 Loudon R, Murphy RL. Lung sounds. Am Rev Respir Dis 1984; 130: 663-673
  • 5 Heuer AJ, Scanlan CL. Wilkins’ Clinical Assessment in Respiratory Care. 7th. Edition Mosby Elsevier; 2013. 978-0323100298
  • 6 Vyshedskiy A. Mechanism of Inspiratory and Expiratory Crackles. Chest 2009; 135: 156-164
  • 7 Forgacs P. The functional basis of pulmonary sounds. Chest 1978; 73: 399-405
  • 8 Speich R. The key to diagnosis in respiratory medicine. Pneumologe 2012; 9: 63-80
  • 9 Baughman RP, Loudon RG. Stridor: differentiation from asthma or upper airway noise. Am Rev Respir Dis 1989; 139: 1407-1409
  • 10 Earis JE, Marsh K, Pearson MG et al. The inspiratory „squawk“ in extrinsic allergic alveolitis and other pulmonary fibroses. Thorax 1982; 37: 923-926
  • 11 Paciej R, Vyshedskiy A, Bana D et al. Squawks in pneumonia. Thorax 2004; 59: 177-178
  • 12 Shim CS, Williams MH. Relationship of wheezing to the severity of obstruction in asthma. Arch Intern Med 1983; 143: 890-892
  • 13 Meslier N, Charbonneau G, Racineux J-L. Wheezes. Eur Resp J 1995; 8: 1942-1948
  • 14 Baughman RP, Loudon RG. Quantitation of wheezing in acute asthma. Chest 1984; 86: 718-722
  • 15 Epler GR, Carrington CB, Gaensler EA. Crackles (rales) in the interstitial pulmonary diseases. Chest 1978; 73: 333-339
  • 16 Shirai F, Kudoh S, Shibuya A et al. Crackles in asbestos workers: auscultation and lung sound analysis. Br J Dis Chest 1981; 75: 386-396
  • 17 Forgacs P. Lung sounds. Br J Dis Chest 1969; 63: 1-12
  • 18 Mikami R, Murao M, Cugell DW et al. International Symposium on Lung Sounds. Synopsis of proceedings. Chest 1987; 92: 342-345
  • 19 Tawhai MH, Lin C-L. Airway gas flow. Compr Physiol 2011; 1: 1135-1157
  • 20 Spiteri MA, Cook DG, Clarke SW. Reliability of eliciting physical signs in examination of the chest. Lancet 1988; 1: 873-875
  • 21 Thacker RE, Kraman SS. The prevalence of auscultatory crackles in subjects without lung disease. Chest 1982; 135: 156-164
  • 22 Gilbert VE. Detection of pneumonia by auscultation of the lungs in the lateral decubitus positions. Am Rev Respir Dis 1989; 140: 1012-1016
  • 23 Cottin V, Cordier J-F. Velcro crackles: the key for early diagnosis of idiopathic pulmonary fibrosis?. Eur Respir J 2012; 40: 519-521