Where would you position a stethoscope to auscultate different lung areas: between the thoracic spinous process and the lower portion of the medial border of the scapula (scapula), at the right mid-axillary line over ribs 11-12, at the right mid-clavicular line between ribs 4-5, above the medial end of the clavicle (clavicle), and on the anterior chest at the right mid-clavicular line above the 4th costocartilage?

From the Guidelines

To correctly position a stethoscope for lung auscultation, you would place it in specific locations to listen to different areas of the lung, including between the thoracic spinous process and the lower portion of the medial border of the right scapula for the right posterior lower lobe, as guided by anatomical landmarks 1. When listening to the lungs, it's crucial to position the stethoscope correctly to ensure accurate assessment of different lung segments.

• Between the thoracic spinous process and the lower portion of the medial border of the right scapula is the correct position to listen to the right posterior lower lobe.
• The right mid-axillary line over ribs 11-12 is used to auscultate the right lateral lower lobe.
• The right mid-clavicular line between ribs 4-5 is the location for listening to the right middle lobe, with the midclavicular line defined as an imaginary vertical line on the chest originating from the midpoint of a clavicle 1.
• Above the medial end of the right clavicle is where you would place the stethoscope to listen to the right upper lobe apex.
• The anterior chest on the right mid-clavicular line, above the level of the 4th costocartilage, is the position for listening to the right upper lobe anterior segment. Proper positioning is essential because lung sounds vary by location, and certain pathologies may be detected only in specific areas of the lung fields, highlighting the importance of accurate stethoscope placement during respiratory examination.

From the Research

Positioning of Stethoscope to Listen to Different Areas of the Lung

• Between the thoracic spinous process and the lower portion of the medial border of the of the right scapula: This position corresponds to the area where the stethoscope would be placed to listen to the upper lobes of the lung, specifically the posterior segments 2.
• Right mid-axillary line over ribs 11-12: This position is used to listen to the lower lobes of the lung, specifically the lateral segments 3.
• Right mid-clavicular line between ribs 4-5: This position corresponds to the area where the stethoscope would be placed to listen to the upper lobes of the lung, specifically the anterior segments 4.
• Above medial end of right clavicle: This position is used to listen to the apex of the lung, which is the uppermost part of the lung 5.
• Anterior chest on the right mid-clavicular line, above the level of the 4th costocartilage: This position corresponds to the area where the stethoscope would be placed to listen to the upper lobes of the lung, specifically the anterior segments 6.

Areas of the Lung and Corresponding Stethoscope Positions

• Upper lobes: Between the thoracic spinous process and the lower portion of the medial border of the of the right scapula, Right mid-clavicular line between ribs 4-5, Anterior chest on the right mid-clavicular line, above the level of the 4th costocartilage 2, 4, 6
• Lower lobes: Right mid-axillary line over ribs 11-12 3
• Apex of the lung: Above medial end of right clavicle 5