Hyperresonant sounds may also be heard when
percussing lungs hyperinflated with air
, such as may occur in patients with COPD, or patients having an acute asthmatic attack. An area of hyperresonance on one side of the chest may indicate a pneumothorax. Tympanic sounds are hollow, high, drumlike sounds.
What does Hyperresonance mean in lungs?
Medical Definition of hyperresonance
:
an exaggerated chest resonance heard in various abnormal pulmonary conditions
.
What does Hyperresonance sound like?
Hyperresonant (pneumothorax) said to sound
similar to percussion of puffed up cheeks
. Normal resonance/ Resonant the sound produced by percussing a normal chest. Impaired resonance (mass, consolidation) lower than normal percussion sounds.
What causes increased vocal resonance?
Evaluating for vocal fremitus, in the hands of an experienced examiner, can quickly rule in or out clinical issues of concern. Causes of increased vocal fremitus:
pneumonia, lung abscess
. Causes of decreased vocal fremitus: pleural effusion, pneumothorax, emphysema.
What causes absent tactile fremitus?
As a result, areas of increased lung tissue density are better conductors of sound, and generally present a more noticeable fremitus than normal air-filled lung tissue. Conversely,
an excessive amount of air within the lungs may cause impaired sound transmission
, leading to a decreased or absent tactile fremitus.
What is Hyperresonance in COPD?
Chest hyperresonance
The chest percussion should be done routinely in COPD patients to determine the type of percussion sounds. The percussion sound is hyperresonant,
if the sound is more hollow than normal
.
How can you tell the difference between a pneumothorax and a Hemothorax?
A hemothorax will have a similar presentation as a pneumothorax, with symptoms such as dyspnea, hypoxia, decreased breath sounds, and chest pain. A key clinical finding that separates these two is that
a pneumothorax will have hyper-resonance to percussion
, but a hemothorax will have a hypo-resonance to percussion.
What is cardiac dullness?
Absolute cardiac dullness is
the projection of the anterior surface of the heart
, which is not covered by the lungs onto the chest. Absolute cardiac dullness is formed by the right ventricle.
What causes dull lung sounds?
Absent or decreased sounds can mean: Air or fluid in or around the lungs (such as pneumonia, heart failure, and pleural effusion)
Increased thickness of the chest wall
.
Over-inflation of a part of the lungs
(emphysema can cause this)
What is Fremitus?
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. …
What is the normal vocal resonance?
Normally when listening to the patient’s voice through the stethoscope placed on the chest wall,
the sound is muffled, indistinct and words unintelligible
. This is referred to as vocal resonance.
How do you test for vocal resonance?
Assess vocal resonance
Assessing vocal resonance involves
auscultating over different areas of the chest wall
whilst the patient repeats a word or number consistently. The presence of increased tissue density or fluid affects the volume at which the patient’s speech is transmitted to the diaphragm of the stethoscope.
What does high vocal resonance mean?
Vocal resonance is an assessment of the density of lung tissue, performed by auscultating the chest and asking the patient to speak. Increased vocal resonance suggests
increased density
, while reduced vocal resonance suggests an increase in the amount of air present.
How does tactile fremitus feel?
To assess for tactile fremitus, ask
the patient to say “99” or “blue moon”
. While the patient is speaking, palpate the chest from one side to the other. Tactile fremitus is normally found over the mainstem bronchi near the clavicles in the front or between the scapulae in the back.
How do you test for tactile fremitus?
During palpation the examiner can evaluate tactile fremitus:
the examiner will place both of his hands on the patient’s back, medial to the shoulder blades, and ask the patient to say “ninety-nine
.” An increase in the tactile fremitus points towards an increased intraparenchymal density and a decreased fremitus hints …
Is fremitus normal?
A
normal evaluation occurs
when equal and moderate vibrations are noticed during speech. Fremitus is abnormal when it is increased or decreased. Because sound is transmitted more strongly through non–air-filled lung, increased fremitus suggests a loss or decrease in ventilation in the underlying lung.
