On occasion, the systolic murmur can be transmitted and auscultated over the liver. Less typically, diastolic murmur may also be heard as a result of pulmonary insufficiency.
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The anterior fields can also be auscultated from the front. Abnormal breathing sounds heard during a lung exam can indicate the presence of a lung condition; wheezing for example is commonly associated with asthma and COPD.
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Heart rate is also noted. When listening to lungs, breath sounds such as wheezes, crepitations and crackles are identified. The gastrointestinal system is auscultated to note the presence of bowel sounds. Electronic stethoscopes can be recording devices, and can provide noise reduction and signal enhancement.
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IPPA is a physical examination with four key steps: inspection, palpation, percussion, and auscultation. Although the steps are consistent across organ systems, the order may vary. Notably, for the abdominal exam, auscultation is performed before palpation, because the act of palpation could change what was auscultated.
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One of the most serious complications is pancarditis, or inflammation of all three heart tissues. A fibrinous pericarditis can develop with a classic friction rub that can be auscultated. This will give increasing pain upon reclining. Further endocarditis can develop with aseptic vegetations along the valve closure lines, in particular the mitral valve.
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A chest X-ray might depict pleural effusion, pulmonary infiltration, or pericardial effusion. During medical doctor examination, a pericardial friction rub can be auscultated indicating pericarditis. Auscultation of the lungs can show crackles indicating pulmonary infiltration, and there can be retrosternal/pleuritic chest pain worse on inspiration (breathing in). Patient can also depict sweating (diaphoresis) and agitation or anxiety.
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Knowledge of the surface anatomy of the thorax (chest) is particularly important because it is one of the areas most frequently subjected to physical examination, like auscultation and percussion.Drake (2009) Ch.3 Thorax - Thorax surface anatomy, pp. 224-6 and Fig. 3.96 A In cardiology, Erb's point refers to the third intercostal space on the left sternal border where S2 heart sound is best auscultated.
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Only 5% of large intestinal impactions at referral hospital involve the cecum. Primary cecal impactions usually consist of dry feed material, with the horse slowly developing clinical signs over several days. Secondary cecal impactions may occur post- surgery, orthopedic or otherwise, and the cecum does not function properly. Horses usually show clinical signs 3–5 days post general anesthesia, including decreased appetite, decreased manure production, and gas in the cecum which can be auscultated.
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