Anterior view
Listen above and below the clavicles, then move down the chest while comparing matching sides.
Picture guide
Anterior and posterior lung-field views
Compare the same height on the right and left before moving down. Most lower-lobe tissue is best heard posteriorly and laterally.
Posterior view
Ask the patient to cross the arms if able so the scapulae move laterally and expose more lung tissue.
Technique
Seven steps for a clean lung assessment
1
Position and expose
Sit the patient upright when possible. Listen on skin, not through clothing, while preserving dignity and warmth.
2
Reduce noise
Pause conversation, move tubing and clothing away from the diaphragm, and limit ambient noise when possible.
3
Use the diaphragm
Warm the stethoscope and place the diaphragm firmly against the skin without pressing painfully.
4
Coach slow breaths
Ask the patient to breathe slightly deeper than normal through an open mouth. Watch for dizziness and allow breaks.
5
Listen one full cycle
Hear one complete inspiration and expiration at each location before moving.
6
Compare side to side
Move in a ladder pattern between matching right and left locations so asymmetry is easier to notice.
7
Describe and reassess
Document location, phase, quality, intensity, symmetry, and changes after coughing, repositioning, or treatment.
Where are you listening?
Interactive location guide
Anterior chest
Start above the clavicles, then compare matching upper and lower fields side to side. Avoid listening directly over bone when possible.
Arrange the steps
Build the assessment sequence
Move all seven steps into the lower row in the order you would use them.
Available steps
Your sequence
Common errors
What can make the assessment misleading?
Listening through clothingFabric movement can imitate crackles or hide quieter sounds.
Listening over boneThe scapula and ribs transmit sound differently and reduce access to lung tissue.
Moving too quicklyOne short moment may miss an inspiratory crackle or expiratory wheeze.
Not comparing sidesAsymmetric or unilateral findings can be missed without a consistent ladder pattern.
Calling every noise a wheezeUpper-airway noise, clothing, mucus, and transmitted sounds can be misleading.
Skipping reassessmentThe change after treatment can be more useful than the first sound alone.
Apply the skill
Practice with your existing simulator
Rotate the patient, choose different left and right findings, and tap lung-field or neck locations.