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Whispered Pectoriloquy
Whispered pectoriloquy refers to an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields on a patient's torso. Usually spoken sounds of a whispered volume by the patient would not be heard by the clinician auscultating a lung field with a stethoscope. However, in areas of the lung where there is lung consolidation, these whispered spoken sounds by the patient (such as saying 'ninety-nine') will be clearly heard through the stethoscope. This increase in sound exists because sound travels faster and thus with lower loss of intensity through liquid or solid ("fluid mass" or "solid mass," respectively, in the lung) versus gaseous (air in the lung) media. Whispered pectoriloquy is a clinical test typically performed during a medical physical examination to evaluate for the presence of lung consolidation, causes of which include cancer (solid mass) and pneumonia (fluid mass). Related tests The whispered pectoriloquy test is similar to bronc ...
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Auscultation
Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems (heart and breath sounds), as well as the alimentary canal. The term was introduced by René Laennec. The act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. (Auscultation and palpation go together in physical examination and are alike in that both have ancient roots, both require skill, and both are still important today.) Laënnec's contributions were refining the procedure, linking sounds with specific pathological changes in the chest, and inventing a suitable instrument (the stethoscope) to mediate between the patient's body and the clinician's ear. Auscultation is a skill that requires substantial clinical experience, a fine stethoscope and good listening s ...
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Stethoscope
The stethoscope is a medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, and one or two tubes connected to two earpieces. A stethoscope can be used to listen to the sounds made by the heart, lungs or intestines, as well as blood flow in arteries and veins. In combination with a manual sphygmomanometer, it is commonly used when measuring blood pressure. Less commonly, "mechanic's stethoscopes", equipped with rod shaped chestpieces, are used to listen to internal sounds made by machines (for example, sounds and vibrations emitted by worn ball bearings), such as diagnosing a malfunctioning automobile engine by listening to the sounds of its internal parts. Stethoscopes can also be used to check scientific vacuum chambers for leaks and for various other small-scale acoustic monitoring tasks. A stethoscope that intensifies auscultatory sounds is called a phonen ...
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Lung Consolidation
A pulmonary consolidation is a region of normally compressible lung tissue that has filled with liquid instead of air. The condition is marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation. Signs Signs that consolidation may have occurred include: *Expansion of the thorax on inspiration is reduced on the affected side *Vocal fremitus is increased on the affected side *Percussion is dull in the affected area *Breath sounds are bronchial *Possible medium, late, or pan-inspiratory crackles *Vocal resonance is ...
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Bronchophony
Bronchophony is the abnormal transmission of sounds from the lungs or bronchi. Bronchophony is a type of pectoriloquy. It is a general medical sign detected by auscultation. Technique The patient is requested to repeat a word several times while the provider auscultates symmetrical areas of each lung. The numbers "ninety-nine" or "sixty-six" are traditionally mentioned. The choice of "ninety-nine" is the result of a literal translation. The test was originally described by a German physician who used the phrase "neun und neunzig" (pronounced nɔʏnʊntˈnɔʏntsɪç, which he found would cause maximum vibration of the chest. The translation, "ninety-nine", has fewer vowels and is less effective in evoking the phenomenon. Better phrases in English include "toy boat”, "Scooby Doo", and “blue balloons".Whispered pectoriloquy Interpretation Normally, the sound of the patient's voice becomes less distinct as the auscultation moves peripherally; bronchophony is the phenomenon of ...
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Egophony
Egophony (British English, aegophony) is an increased resonance of voice sounds heard when auscultating the lungs, often caused by lung consolidation and fibrosis. It is due to enhanced transmission of high-frequency sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice. Technique While listening to the lungs with a stethoscope, the patient is asked to pronounce the modern English (more generally, post-Great Vowel Shift) long-E vowel sound. Interpretation Stethoscopic auscultation of a clear lung field during this articulation will detect a sound matching that received through normal hearing; that is, the sound articulated by the patient will be clearly transmitted through the lung field and heard unchanged by the clinician. When the lung field is consolidated (filled with liquid or other solid mass such as tumor or fungus ball), the patient's spoken English lo ...
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Vocal Fremitus
Fremitus is a vibration transmitted through the body. In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall (''tactile fremitus'') and/or heard by a stethoscope on the chest wall with certain spoken words (''vocal fremitus''), although there are several other types. Types Vocal fremitus When a person speaks, the vocal cords create vibrations (''vocal fremitus'') in the tracheobronchial tree and through the lungs and chest wall, where they can be felt (''tactile fremitus''). This is usually assessed with the healthcare provider placing the flat of their palms on the chest wall and then asking a patient to repeat a phrase containing low-frequency vowels such as "blue balloons" or "toys for tots" (the original diphthong used was the German word neunundneunzig but the translation to the English 'ninety-nine' was a higher-frequency diphthong and thus not as effective in eliciting fremitus). An increase in ta ...
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Tactile Fremitus
Fremitus is a vibration transmitted through the body. In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall (''tactile fremitus'') and/or heard by a stethoscope on the chest wall with certain spoken words (''vocal fremitus''), although there are several other types. Types Vocal fremitus When a person speaks, the vocal cords create vibrations (''vocal fremitus'') in the tracheobronchial tree and through the lungs and chest wall, where they can be felt (''tactile fremitus''). This is usually assessed with the healthcare provider placing the flat of their palms on the chest wall and then asking a patient to repeat a phrase containing low-frequency vowels such as "blue balloons" or "toys for tots" (the original diphthong used was the German word neunundneunzig but the translation to the English 'ninety-nine' was a higher-frequency diphthong and thus not as effective in eliciting fremitus). An increase in ta ...
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Symptoms And Signs: Respiratory System
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indications ...
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