Fremitus is a vibration transmitted through the body. In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall and/or heard by a stethoscope on the chest wall with certain spoken words, although there are several other types.
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).
In individuals with healthy lung tissue, tactile fremitus can be felt symmetrically along both sides of the chest. Normally, tactile fremitus is more pronounced near the clavicles and in between the shoulder blades, with a decreasing intensity towards the base of the lungs.
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.
Rhonchal fremitus, also known as bronchial fremitus, is a palpable vibration produced during breathing caused by partial airway obstruction. The obstruction can be due to mucus or other secretions in the airway, bronchial hyperreactivity, or tumors.
Tactile fremitus is an assessment of the low-frequency vibration of a patient's chest, which is used as an indirect measure of the amount of air and density of tissue present within the lungs.
When our medical ancestors studied in Austria or Germany, they observed that physicians asked patients to say “neun und neunzig” to evoke fremitus over the thorax. When they came home they taught their patients to say “ninety-nine,” thus translating literally, but not phonetically, what they had heard.
Evaluate Vital Signs
The normal range of a respiratory rate for an adult is 12-20 breaths per minute at rest, and the normal range for oxygen saturation of the blood is 94–98% (SpO₂) Bradypnea is less than 12 breaths per minute, and tachypnea is greater than 20 breaths per minute.
Documentation of a basic, normal respiratory exam should look something along the lines of the following: The chest wall is symmetric, without deformity, and is atraumatic in appearance. No tenderness is appreciated upon palpation of the chest wall. The patient does not exhibit signs of respiratory distress.
Tactile fremitus is normally found over the mainstem bronchi near the clavicles in the front or between the scapulae in the back. As you move your hands downward and outward, fremitus should decrease. Decreased fremitus in areas where fremitus is normally expected indicates obstruction, pnemothorax, or emphysema.
Vibrations (Fremitus) A fremitus is usually caused by occlusal trauma, or when two occlusive teeth are smashing together harder than they should be. Your dentist can touch the side of your mouth and feel these vibrations.
During palpation the examiner can evaluate tactile fremitus: the examiner will place both of his hands on the patient's back, medial to the shoulder blades, and ask the patient to say "ninety-nine." An increase in the tactile fremitus points towards an increased intraparenchymal density and a decreased fremitus hints ...
Normal breath sounds are heard over the chest wall or trachea. Basically, breath sounds contains background noises, on which adventitious sounds are sometimes superimposed. Breath sounds are classified into normal tracheal sound, normal lung sound or vesicular breath sounds, and bronchial breath sound.
Absent or decreased sounds can mean: Air or fluid in or around the lungs (such as pneumonia, heart failure, and pleural effusion) Increased thickness of the chest wall. Over-inflation of a part of the lungs (emphysema can cause this) Reduced airflow to part of the lungs.
Palpation is used both as a screening technique and as a means to confirm a specific diagnosis. Light palpation over the entire thorax posteriorly, laterally, and anteriorly will aid in the identification of cutaneous and subcutaneous nodules and the site of previously unsuspected tenderness.
Which of the following would be best for a nurse to use when assessing for fremitus in a client? The palmar base or ulnar surface of the hand is best for assessing tactile fremitus because the area is especially sensitive to vibratory sensation.
Palpation is the tactile examination of the chest from which can be elicited tenderness, asymmetry, diaphragmatic excursion, crepitus, and vocal fremitus.
In emphysema, the inner walls of the lungs' air sacs (alveoli) are damaged, causing them to eventually rupture. This creates one larger air space instead of many small ones and reduces the surface area available for gas exchange. Emphysema is a lung condition that causes shortness of breath.