The reliability of findings obtained using these maneuvers are controversial, and they are not frequently used by physicians in daily practice. Usefulness of Vocal Fremitus and Vocal Resonance in Daily Clinical Practice Select sound frequencies are able to pass through consolidation and tend to distort the sound of the vowel "E" so that it is perceived by the examiner as "A" or "AAAH." Whispered pectoriloquy has the same significance as increased fremitus and adds no new information to those approaches.Įgophony or an "E to A" change: A qualitative change in the voice that resembles the bleating of a goat. Whispering pectoriloquy: While the examiner auscultates over the lung fields, the patient is asked to whisper "one, two, three." Whispered words are heard clearly in the presence of consolidation. īronchophony: A louder sound heard over an area of consolidation. The following changes in vocal resonance are seen. Vocal resonance is the auscultatory counterpart of vocal fremitus. On the other hand, inflammation and consolidation create a dense medium which increases the transmission of lower frequency sounds and vocal fremitus. Vocal fremitus also may be decreased in individuals with obesity. In case of pleural effusion and pneumothorax, air/fluid accumulates in the potential space between the chest wall and lung parenchyma, decreasing the transmission of lower frequency sound vibrations. Vocal fremitus is decreased in bronchial asthma, emphysema, or bronchial obstruction due to air trapping and decreased density of lung parenchyma. Vocal fremitus may be decreased in conditions affecting the lung parenchyma, pleura, or chest wall. Air is a poor conductor of low sound frequencies whereas a solid or dense medium increases the transmission of low sound frequencies. Normal lung parenchyma is a mixture of air-filled spaces and solid lung parenchyma. Transmission of spoken tones depends on the state of the underlying lung parenchyma in the pleural space. Sound vibrations produced in the larynx during phonation are transmitted to the bronchi and lungs and then communicated to the chest wall. Vocal (tactile) fremitus is palpation of the chest wall to detect changes in the intensity of vibrations created with certain spoken words in a constant tone and voice indicating underlying lung pathology. Palpation ascertains the signs suggested by inspecting and assessing the state of the pleura and lung parenchyma by studying the vocal fremitus. Chest inspection, palpation, and auscultation are key components of the physical examination of patients with respiratory disease.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |