![]() These signs are most easily appreciated when various areas of lung are compared to each other.Ĭlick on the video icon for further demonstration of egophony and whispered pectoriloquy examination. The inspiration to expiration (I:E) ratio is typically 3 to 1. During expiration, the sound intensity can diminish somewhat. These sounds are of low to moderate sound intensity (volume) with a low-pitch (200-600 Hz) with a rustling quality. Egophony is present when "e-e-e" spoken by the patient is heard through the stethoscope as "a-a-a." Egophony is generally found over consolidated lung where bronchophony is also present. Vesicular lung sounds are the most common auscultated sounds, usually heard over most of the chest wall. When voice sounds increase in intensity and take on a "bleating" quality, this is described as egophony. Is decreased when there is a decrease in lung density such as hyperinflation, or focally when the lung tissue is separated from the chest wall (for example in pneumothorax or pleural effusion).Is particularly notable if the patient whispers a message, and it is clearly audible through the stethoscope over the airless portion of lung ( whispered pectoriloquy).consolidation or atelectasis) and results in louder, clearer voice sounds ( bronchophony). ![]() Is increased over areas where the lung has become airless (e.g.The lung appears nearly identical to the liver in terms of density. Is an indistinct low-pitched mumble over normal lung. The diapgragmatic slip delineates the liver from the dense lower lobe consolidation.Is evaluated by having the patient say "ninety-nine" while listening with the stethoscope over various portions of the lungs.Ĭlick on the video icon for further demonstration of tactile fremitus examination techniques.Įvaluating speech through the stethoscope is termed vocal fremitus. Is increased in conditions that increase transmission of sound (such as consolidated lobar pneumonia).Is decreased or absent in conditions that impede transmission of sound (such as an obstructed bronchus, COPD, pleural fluid, or a very thick chest wall).Provides information about the density of underlying lung tissue and chest cavity.Is more prominent in the interscapular regions, less prominent at the lung bases. This video provides examples of the various types of lung sounds that may be heard during auscultation of the chest.You can access our step-by-step OSCE guid.Is evaluated by having the patient say "ninety-nine" or "one-two-three", and feeling the transmitted vibrations with the hands.Abnormal pulmonary findings can be further evaluated via palpation and auscultation of the patient's voice through the chest wall.įeeling the vibrations generated from the spoken voice is termed tactile fremitus.
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