Tactile fremitus

Tactile fremitus

A detailed medical illustration showing the procedure of checking tactile fremitus. A healthcare professional places both hands symmetrically on a patient's chest while the patient is speaking. The lungs, pleural cavity, and chest wall are outlined to demonstrate the tactile fremitus assessment process, with no additional annotations or arrows.

Tactile fremitus refers to the palpable vibrations on the chest wall that are produced by the vocal cords when a person speaks. These vibrations are transmitted through the lungs and chest wall and can be felt by placing the hands or fingers on the patient’s chest. It is part of the physical examination used to assess the condition of the lungs and pleural spaces.

Examination Procedure:

  1. Ask the patient to say a word with low-frequency vibrations, such as “ninety-nine” or “blue balloon.”
  2. Place the palms or ulnar aspect of your hands over the chest in symmetrical areas, moving from top to bottom and comparing both sides.
  3. Feel for the intensity of the vibrations.

Clinical Significance:

  • Increased tactile fremitus: Indicates a consolidation of the lung tissue, as seen in conditions like pneumonia. Consolidation improves sound conduction.
  • Decreased or absent tactile fremitus: Suggests conditions that obstruct the transmission of sound vibrations, such as pleural effusion, pneumothorax, or thickened pleura.

Table: Interpreting tactile fremitus parameters with possible causes

Tactile Fremitus Finding

Interpretation

Common Causes

Increased Tactile Fremitus

Enhanced transmission of vibrations through consolidated lung tissue.

– Pneumonia (lung consolidation)
– Pulmonary edema

Decreased or Absent Tactile Fremitus

Decreased transmission of vibrations due to air, fluid, or thickened tissue.

– Pleural effusion
– Pneumothorax (air in pleural space)
– Atelectasis (lung collapse)
– Obstructive bronchial conditions

Asymmetrical Tactile Fremitus

Uneven distribution of vibration transmission across lungs.

– Unilateral consolidation (pneumonia)
– Large pleural effusion or pneumothorax on one side
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