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Respiratory Exam
 
 

Tactile Fremitus

 
 
 
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Overview

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.
  • How to Assess

  • Palpate the patient's posterior chest and ask them to say ‘ blue balloons'. Start at the top of the chest and move to the bottom, comparing both sides.

Increased Tactile Fremitus

Increased vocal sounds on palpation of the chest.
  • Significance

  • Occurs due to increased density within the lung parenchyma.
  • Causes of Increased Tactile Fremitus

  • Pneumonia
  • Atelectasis
  • Lung cancer

Decreased Tactile Fremitus

Reduced vocal sounds on palpation of the chest.
  • Significance

  • Occurs due to reduced density within the lung parenchyma.
  • Causes of Decreased Tactile Fremitus

  • Pneumothorax
  • Empysema
  • Haemothorax
  • Pleural effusion
  • Obesity

Overview

Tactile fremitus was first described by a German physician who called for the patient to say “neunundneunzig” (ninety-nine). “Blue Balloons” is an English phrase that closely resembles the sound and vibration emitted from the lungs when saying “neunundneunzig” (a low frequency ‘diphthong' phrase).
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