Tactile fremitus
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Tactile fremitus is a method of detecting air, fluid or solid material. It can also detect a bronchial obstruction or solid material in the pleural space.
Differential Diagnosis
In alphabetical order. [1] [2]
- Increased sound throughout the chest
- Diffuse alveolitis
- Diffuse fibrosis
- Lobar pneumonia
- Streptococcus pneumoniae
- Decreased sound throughout the chest
-
- traumatic disruption of the thoracic duct
- Emphysema
- Foreign body aspiration
- Hemothorax
- chest trauma
- instrumentation
- Pleural thickening
- Ronchal fremitus
- Airway secretions
- Friction fremitus
Diagnosis
History and Symptoms
- Note: Symmetry of chest movement and sound.
Lungs
- Place hands firmly on patients chest
- Have them repeat "99" several times
- The purpose is to feel the vibration of the conducted sound
Laboratory Findings
- Labs include:
Chest X Ray
- Aids in exposing pneumonothorax, pneumonia, effusion, atelectasis
MRI and CT
- consider in the event of an abnormal X-ray
Treatment
- Attend to airway/breathing patterns
- Administer supplemental Oxygen
- Chest tube insertion for pneumothorax, hemothorax, chylothorax