Tactile Fremitus
Increased Decreased
Pneumonia Unilateral
Pneumothorax Pleural effusion Bronchial obstruction
Atelectasis (incomplete expansion of lungue tissue)
Bilateral
Chronic obstructive heart disease Chest wall thickening
Points to note on auscultation of the chest.
•Vesicular breath sounds
•Bronchial breath sounds
•Vocal fremitus and resonance
–bronchophony
–whispering pectoriloquy
–aegophony
Added sounds
–pleural rub
–wheezes
–crackles
Causes of crackles
•Left ventricular failure
•Fibrosing alveolitis
•Extrinsic allergic alveolitis
•Pneumonia
•Bronchiectasis
•Chronic bronchitis
•Asbestosis