Clinical Significance
Vocal fremitus is a vibration transmitted through the body. It refers to the assessment of the lungs by either the vibration intensity felt on the chest wall (tactile fremitus) and/or heard by a stethoscope on the chest wall with certain spoken words (vocal resonance).
Is it normal to have tactile fremitus?
A normal evaluation occurs when equal and moderate vibrations are noticed during speech. Fremitus is abnormal when it is increased or decreased. Because sound is transmitted more strongly through non–air-filled lung, increased fremitus suggests a loss or decrease in ventilation in the underlying lung.
When assessing for tactile fremitus the nurse should?
To assess for tactile fremitus, ask the patient to say “99” or “blue moon”. While the patient is speaking, palpate the chest from one side to the other. Tactile fremitus is normally found over the mainstem bronchi near the clavicles in the front or between the scapulae in the back.
Why is vocal resonance increased in pneumonia?
In pneumonia all the frequencies, both high and low, are transmitted well. In pleural effusion, low frequencies (100-300 Hz) are attenuated while higher ones (>400 Hz) are augmented. This explains why in pneumonia abnormal vocal resonance (>300 Hz) as well as increased tactile vocal fremitus (100-200 Hz) is present.
What causes increased vocal resonance?
Abnormal vocal resonance
Increased volume over an area suggests increased tissue density (e.g. consolidation, tumour, lobar collapse). Decreased volume over an area suggests the presence of fluid or air outside of the lung (e.g. pleural effusion, pneumothorax).
Is atelectasis serious?
Large-scale atelectasis may be life threatening, especially in someone who has another lung disease or illness. In a baby or small child, lung collapse due to a mucus obstruction or other causes can be life threatening.
What causes tracheal deviation during tension pneumothorax?
Pneumothorax is the most frequently reported cause of tracheal deviation from pressure buildup. This condition happens when excess air builds up in your chest cavity and can’t escape.
Why is fremitus increased in pneumonia?
The reason for increased fremitus in a consolidated lung is the fact that the sound waves are transmitted with less decay in a solid or fluid medium (the consolidation) than in a gaseous medium (aerated lung).
Why does consolidation increase breath?
ADDITIONAL BREATH SOUNDS
Consolidation refers to increased density of the lung tissue, due to it being filled with fluid and/or blood or mucus. Ask the patient to say the words: “ninety-nine” while you listen through the stethoscope. Normally the sound of “ninety-nine” will sound very faint and muffled.
What does barrel chest indicate?
Barrel chest is a visible symptom of COPD, emphysema, osteoarthritis, and CF. The lungs fill with air and are unable to fully breathe out. This gives the chest a pronounced barrel shape. The treatment of barrel chest focuses on managing symptoms of the underlying condition and limiting the extent of lung damage.
Why is tactile fremitus increased in consolidation?
Increased intensity of tactile fremitus generally occurs as a result of increased density within the lung tissue. This commonly occurs as a result of lung consolidation, which refers to the replacement of the air within healthy lung tissue with another substance; either inflammatory exudate, blood, pus, or cells.
