Tactile Fremitus: What Is It, How Is It Assessed, Uses, and More | Osmosis Tactile fremitus is assessed by asking an individual to repeat a certain phrase while the examiner places the palms or the bony edge of their hands on the individual’s chest wall to feel for sound vibrations Low-frequency vibrations, such as those created by two adjacent vowel sounds (e g “coin”, “sound”, or “boat”), are transmitted more effectively down the tracheobronchial
Atelectasis: What Is It, Causes, Diagnosis, and More | Osmosis In the physical exam, a clinician may notice chest wall expansion, decreased or absent breath sounds, decreased vibration while speaking (i e , tactile fremitus), a dull sound when tapping fingers on the area of atelectasis, and sometimes, crackling sounds while breathing (i e , basilar rales)
Physical assessment - Thorax and lungs: Nursing - Osmosis Assessment of the thorax and lungs should be completed as part of a comprehensive assessment, like during a routine physical exam, or as part of a focused exam if a client is experiencing respiratory issues like shortness of breath, cough, or chest discomfort Examination of the thorax and lungs gives the nurse information about the movement of air and gas exchange Let’s review the process
Assessment of Thorax and Lungs - Osmosis Decreased or lack of fremitus can mean there’s excess air in the pleural space, like with a pneumothorax; whereas increased fremitus may occur due to fluid in the lungs You’ll also check for crepitus by palpating with the palmar surface of your hands over the anterior and posterior chest
Atelectasis: Nursing: Video Causes | Osmosis During auscultation, there are reduced or absent breath sounds on the affected side Also, crackles can sometimes be heard, which is the sound of collapsed alveoli popping open with inspiration On percussion, there’s dullness over the affected area, and on palpation, there might be decreased fremitus
Pleural effusion, pneumothorax, hemothorax and atelectasis . . . - Osmosis On chest palpation, chest expansion is uneven due to decreased chest wall movement of the affected side and tactile fremitus is decreased Tactile fremitus can be felt when the hand is placed on the chest wall When a person says “99” the chest wall vibrates
Hemothorax: Video Meaning | Osmosis So, there could be absent unilateral breath sounds, dullness to percussion, and decreased tactile fremitus on the affected side Once you’ve obtained both history and physical examination, you should order labs, including a CBC and INR, as well as a chest x-ray If the labs and chest x-ray are normal, you should consider an alternative diagnosis
USMLE® Step 2 Question of the Day: Hemothorax - Osmosis Findings that may suggest a substantial hemothorax include diminished absent breath sounds, dullness to percussion, hypotension, tachycardia, and decreased tactile fremitus The first step in the management of patients with hemothorax is an ABCDE assessment in order to determine if the patient is stable or unstable