Fremitus
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Fremitus is a vibration transmitted through the body.[1] In common medical usage, it usually refers to 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 fremitus), although there are several other types.
Types
Vocal fremitus
When a person speaks, the vocal cords create vibrations (vocal fremitus) in the
Pleural fremitus
Pleural fremitus is a palpable vibration of the wall of the thorax caused by friction between the parietal and visceral pleura of the lungs.[3] See pleural friction rub for the auditory analog of this sign.
Dental fremitus
Fremitus appears when teeth move. This can be assessed by feeling and looking at teeth when the mouth is opened and closed.[4]
Periodontal fremitus
Periodontal fremitus occurs in either of the
Rhonchal fremitus
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,
Tactile fremitus
Tactile fremitus, known by many other names including pectoral fremitus, tactile vocal fremitus, or just vocal fremitus, is a vibration felt on the patient's chest during low frequency vocalization.[6]: 409 Commonly, the patient is asked to repeat a phrase while the examiner feels for vibrations by placing a hand over the patient's chest or back. Phrases commonly used in English include, 'boy oh boy' and 'toy boat' (diphthong phrases), as well as 'blue balloons' and 'Scooby-Doo'. 'Ninety-nine' is classically included, however, this is a misinterpretation of the original German report, in which "neunundneunzig" was the low-frequency diphthong of choice.[7]
Tactile fremitus is normally more intense in the right second intercostal space, as well as in the interscapular region, as these areas are closest to the bronchial trifurcation (right side) or bifurcation (left side). Tactile fremitus is pathologically increased over areas of consolidation and decreased or absent over areas of pleural effusion or pneumothorax (when there is air outside the lung in the chest cavity, preventing lung expansion).[citation needed]
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). Conversely, the reason for decreased fremitus in a pleural effusion or pneumothorax (or any pathology separating the lung tissue itself from the body wall) is that this increased space diminishes or prevents entirely sound transmission.
It has been suggested that the artifacts caused by eliciting tactile fremitus during breast
Tussive fremitus
Tussive fremitus is a vibration felt on the chest when the patient coughs.[6]: 411
Pericardial fremitus
Pericardial fremitus is a vibration felt on the chest wall due to the friction of the surfaces of the pericardium over each other. See pericardial friction rub for the auditory analog of this sign.[9]
Hydatid fremitus
Hydatid fremitus is a vibratory sensation felt on palpating a
References
- ^ "fremitus" at Dorland's Medical Dictionary
- ^ ISBN 9780323393850.
- ISBN 9780702049521.
- ISBN 9783662466230.
- ISBN 9789350253670.
- ^ ISBN 9780170354844. Retrieved 13 April 2018.
- PMID 4514297.
- S2CID 25945830.
- ^ Francis, Johnson (24 November 2017). "Pericardial fremitus - palpable pericardial rub - due to friction". Cardiophile MD.
- .