Thorax & Lungs Flashcards
Technique for tactile fremitus
use ulnar surface of the hand and ask patient to say “99” as the entire posterior thorax is covered
What is fremitus?
normal lung transmits a palpable vibratory sensation to the chest wall
When is fremitus increased?
over areas of consolidation, as in pneumonia (when the normally air-filled parenchyma becomes fluid-filled)
When is fremitus decreased or absent?
when the transmission of vibrations is impeded by a thick chest wall, an obstructed bronchus, COPD, or pleural changes (effusion or air)
Technique for bronchophony
aks patient to repeat “99” each time the lung fields are auscultated
What is the normal finding for bronchophony?
normally the lung sounds transmitted through the chest wall are muffled & indistinct
What is bronchophony?
is when the spoken words are louder or more clear; this would be the case over consolidation (as in pneumonia)
Technique for egophony
ask the patient to reap the vowel “E” each time the lung fields are auscultated
What is the normal finding for egophony?
normally the spoken “E” is heard as “E”
When is egophony present and what does it sound like?
- present when “E” sounds like “A”
- seen in lobar consolidation from pneumonia
Technique for whispered pectoriloquy
ask the patient to whisper “1 2 3” while the lung fields are auscultated
What is the normal finding for whispered pectoriloquy?
normally the whispered words are heard faintly & indistinctly, if at all
When is whispered pectoriloquy present and what does it sound like?
- present when whispered words are louder & clearer
- represent consolidation, as in pneumonia
What is stridor?
- audible high-pitched wheeze
- sign of upper airway obstruction in the larynx or trachea
What does nasal flaring represent?
increased effort of breathing
