Auscultation: more heart sounds

'Tis the season: more heart sounds.

My latest favorite, since I find the HeartSounds software that came with our book to be pretty irritating to navigate, and non-productive in that you have to hold down the mouse button for as long as you want to hear a sound, is the American College of Cardiology's Heart Songs. Though the CD costs $50-100 (which I'm going to ask the library if they'll purchase), they have a few sample MP3s, each of which are 7-9 minutes long, with lots of explanation, lengthy sound segments, and most importantly, repetition. The quiz that's available on that page is high quality, and though it delays feedback until the end and you can't go back to listen to the ones you missed, the quizzes increase in complexity and thus fit my favorite criteria for learning tools in that they are scaffolded.

Other favorite tutorials/quizzes remain the Cardiology Site and Blaufuss's Heart Sounds Tutorial and Quiz.

We can also finally settle the debate over the 3M tunable bell/diaphragms:

Bell Mode (low-frequency)
For low-frequency sounds, light contact is used on the chestpiece. The diaphragm membrane is contained by a flexible surround that actually suspends it, allowing the membrane to resonate low-frequency sounds.

Diaphragm Mode (high-frequency)
For high-frequency sounds, firm contact pressure is used on the chestpiece. By pressing on the chestpiece, the diaphragm membrane moves inward until it reaches an internal ring. The ring simply restricts the diaphragm membrane's movement. It blocks, or attenuates, low-frequency sound and allows you to hear the higher frequency sounds.


I've been wrong along! Good to know. I still <3 my Littman Cardiology III.

Auscultation tutorials

We're coming up on auscultation quizzes in Physical/Clinical Diagnosis, so I've been sorting through tutorials online. I need lots of repetition for tasks that involve memory-based auditory discrimination, so the more the better.

• Blaufuss -- some very nice tutorials with clinical scenarios, visual depictions and testing. I looked at "Heart Sounds Quiz" in particular.
  
• Cardiology site has a very extensive site of heart sounds, including many pathological.
  
• a basic set of lung sounds from RALES
  
• basic set of heart and lung sounds from 3M
  
• nice set of lung sounds from UC Davis, the one from which I made an iFlash deck of flashcards
  
• and lastly, if you own Bates Guide to Physical Examination, there are updated versions of HeartSounds available, most importantly one that runs kindof-natively in OS X. (I was really impressed that I was able to get the author's email from the readme on the CD, email him, and get a response with the updated app info directly from him within a day. Thanks, Dr Pitts!)
  

All in all, the winner is Blaufuss: Heart Sounds Tutorial.

Oh, and an amazing database of ophthalmology images.