The last step on auscultation is to listen at the apex. In this case, we shall listen with both the diaphragm and the bell, so we can appreciate both the high frequency sounds with the diaphragm and the lower frequency sounds with the bell. Let's listen and, again, use the carotid for timing of systole. Everyone listen together. [Cut-away] And now, I shall turn to the bell of the stethoscope and we'll listen again. [Cut-away]