Bowel SoundsBowel sounds are created when food, bowel gas and feces move through the intestines. Most bowel sounds are normal. On occasion abnormal bowel sounds are heard, indicating the presence of abdominal pathology. Evaluation of bowel activity can be performed by listening to the abdomen with a stethoscope.
Arterial SoundsWhen listening to the abdomen with a stethoscope harsh sounds can, at times, be heard. These sounds are called bruits after the French term for noise. The bruits are caused by conversion of the arterial laminar flow to turbulent flow by the presence of atherosclerotic lesions in the blood vessels. When examining the abdomen the area over the aorta, both renal arteries, both iliac arteries and both femoral arteries should be examined carefully for bruits.
Examining the AbdomenThe routine procedure for auscultation of the abdomen is to start at the upper left quadrant and proceed to the upper right, lower right and finally the lower left. Bowel sounds and arterial sounds are high frequency; so use the diaphragm. The same routine should be used for both bowel and arterial sounds.
Each lesson in this course includes text describing the heart or lung abnormality and a simulated torso indicating the stethoscope chestpiece location. An audio recording of the sound is provided. Phonocardiograms or waveforms are included with each lesson. These waveforms can be a highly useful aid in learning to recognize heart murmurs. In addition, short videos clips illustrate the heart's motion for each abnormality. These animations indicate the origin of each murmur. Blood flow is also animated. For lung sounds, the source (location) of the sound can be revealed.
After completing a lesson, use the lesson table of contents to navigate to another lesson.
When all lessons have been completed, we recommend using the auscultation practice exercises or quiz. In order to gain a certificate of achievement, please complete the course lessons and practice drill during one session. Most users complete the course in 30-45 minutes.
Course ContributorsAuthored by Dr. Jonathan Keroes, MD, David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Registered users can earn a certificate of achievement for this module by reading all content and then earning a passing score on this module's quiz.
Completed modules and related scores can be viewed on the dashboard.
Heart Sounds and Murmurs Across the Lifespan (with CD)
by Dr Barbara Ann Erickson
ISBN-10: 0323020453; ISBN-13: 978-0323020459
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
Heart Sounds Made Easy with CD-ROM: (with CD-ROM) 2nd Edition
Anthony P. Salmon
- NCBI Review of Heart Sounds and Murmurs: A Practical Guide
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds And Murmurs
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Ventricular Function Curves in the Exercising Dog
JONATHAN KEROES , ROGER R. ECKER , and ELLIOT RAPAPORT
Circulation Research, Vol. 25, No. 5
Electrocardiographic changes associated with ritodrine-induced maternal tachycardia and hypokalemia
American Journal of Obstetrics Gynecology, VOLUME 154, ISSUE 4, P921-923, APRIL 01, 1986
Susan K Hendricks, MD, Jonathan Keroes, MD, Michael Katz, MD
A Multimedia Guide to Heart Sounds and Murmurs
January 2007 JAMA The Journal of the American Medical Association 297(2):217-218
DOI:10.1001/jama.297.2.217. M. Saleem Seyal, MD, Reviewer