The main normal heart sounds are the S1 and the S2 heart sound. The S3 can be normal, at times, but may be pathologic. A S4 heart sound is almost always pathologic. Heart sounds can be described by their intensity, pitch, location, quality and timing in the cardiac cycle.
Nearly all Littmann stethoscopes feature at least one tunable diaphragm. (The exceptions: electronic, pediatric, and infant models.) Their tunable technology virtually eliminates the need to remove, turn over, and reposition the chestpiece just to hear different sounds.
Use palpation to estimate the systolic blood pressure. While palpating the radial pulse, inflate the cuff until the pulse disappears. Release the pressure until the pulse returns, and note the reading on the sphygmomanometer at this point. This is your palpated systolic blood pressure.Oct 24, 2018
To remove the Littmann tunable diaphragm, pinch the rim of the diaphragm with your thumb and index fingernails; pull and lift the diaphragm from the chestpiece. To assemble the nonchill bell sleeve, place one side of the sleeve on the edge of the chestpiece and stretch it over and around the chestpiece edge.
The most important parts to know are the diaphragm, which is larger, flatter side of the chest piece, and the bell, which has the smaller, concave piece with a hole in it. Switch between the two by twisting the chest piece 180 degrees. You’ll hear a click. Then tap each side to see which one…
The diaphragm is the circular end of the chestpiece. On two-sided chestpieces, the diaphragm is the larger of the two ends. Its larger size allows the user to listen to a bigger area of the patient’s body. The diaphragm is designed to pick up sounds with higher frequencies compared to the bell.
To remove, pull firmly on the eartip. With the diaphragm side up, grasp the rim with the thumbs and index fingers of both hands and roll the rim off the edge of the chestpiece. Remove the diaphragm from the rim and clean the parts in soapy water or wipe with alcohol.