Which is correct about pneumonia
a) Bronchophonia
b) Decreased vocal fremitus
c) Shifting of trachea
d) Amphoric breathing
Correct Answer - A
Ans. is ‘a’ i.e., Bronchophonia
Physical examination findings of Common pulmonary
conditions
Pleural effusion Pneumonia Endobronchial
tumor Pneumothorax
Tracheal
position
Shifted or
midline Midline Shifted or
midline Shifted or midline
Chest wall Reduced or
normal
Reduced or
normal
Reduced or
normal Reduced
Fremitus Decreased Increased Normal or
decreased None
PercussionDull Dull Normal or Dull Hyperresonant
Breath
sounds Decreased Increased Normal or
Decreased Decreased/absent
Crackles None None None None
Wheeze None None Possible None
Egophony Band above
effusion(skodiac)Present None None
Tracheal
position
Deviated
Away from
Pneumo
thorax
Effusion
Deviated
towards
Collapse
Consolidation
Tactile vocal fremitus
Tactile vocal fremitus is vibration felt on the patients chest during low
frequency vocalisation.
Commonly the patient is asked to repeat a phrase while the
examiner feels for vibtations by placing a hand over the patient chest
or back.
Tactile fremitus is normally more intense in the right second
intercostal space as well as in the interscapular region as these :
Tactile fremitus
Increased → Consolidation
Decreased or absent → Pleural effusion or Pneumothorax
Reason for increased fremitus in a consolidated lung is the fact that
the sound waves are transmitted with less decay in solid or fluid
medium (consolidation) than in a gaseous medium (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
Egophony is a change in timbre (E0 to A) but not pitch or volume.
It is due to decrease in the amplitude and an increase in the
frequency of the second formant produced by solid (including
compressed lung) interposed between the resonator and the
stethoscope head.
The sound of a spoken “E” change to “A” over an area of
consolidation. The spoken “E” is heared as “A” when listening over
the consolidation because the frequencies of the vibrations are
altered by the consolidation. Egophony or “E” to “A” changes may
also occur in small band like area just above a pleural effusion
because of compression of lung tissue that occurs just above the
effusion.