Vocal Resonance
July 1st, 2020
Overview
Vocal resonance is an assessment of the density of lung tissue, performed by auscultating the chest and asking the patient to speak. Increased vocal resonance suggests increased density, while reduced vocal resonance suggests an increase in the amount of air present.
How to Assess
Auscultate the patient's chest, starting at the top and moving to the bottom, as they perform the following:- Bronchophony - ask the patient to say ' blue balloons'.
- Egophony - ask the patient to say 'eeee'.
- Whispered pectoriloquy - ask the patient to whisper 'blue balloons'.
Increased Vocal Resonance
Increased resonance of vocal sounds on auscultation of the chest.
Significance
- Occurs due to increased density within the lung parenchyma.
Causes of Increased Vocal Resonance
- Pneumonia
- Atelectasis
- Lung cancer
Reduced Vocal Resonance
Reduced resonance of vocal sounds on auscultation of the chest.
Significance
- Occurs due to reduced density within the lung parenchyma.
Causes of Reduced Vocal Resonance
- Pneumothorax
- Emphysema
- Haemothorax
- Pleural effusion
- Obesity
Why Blue Balloons?
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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