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Respiratory Exam
 
 

Vocal Resonance

 
 
 
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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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