Tactile fremitus
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Tactile fremitus is a method of detecting air, fluid or solid material. It can also detect a bronchial obstruction or solid material in the pleural space.
Differential Diagnosis
In alphabetical order. [1] [2]
- Increased sound throughout the chest
- Diffuse alveolitis
- Diffuse fibrosis
- Lobar pneumonia
- Steptococcus pneumoniae
- Decreased sound throughout the chest
- Asthma
- Atelectasis
- Bronchitis
- Chylothorax
- traumatic disruption of the thoracic duct
- Emphysema
- Foreign body aspiration
- Hemothorax
- chest trauma
- instrumentation
- Pleural effusion
- CHF
- Cancer
- Pulmonary embolus
- Pneumonia
- Connective tissue disease
- Pancreatitis
- Renal Disease
- Liver Disease
- Pleural thickening
- Ronchal fremitus
- Airway secretions
- Friction fremitus
- pleural friction rub
Diagnosis
History and Symptoms
- Note: Symmetry of chest movement and sound.
Lungs
- Place hands firmly on patients chest
- Have them repeat "99" several times
- The purpose is to feel the vibration of the conducted sound
Laboratory Findings
- Labs include:
- CBC
- pulse oximetry
- electrolytes
- BUN / creatinine
- calcium
- glucose
- Blood/sputum culture
- Arterial blood gas
- pulmonary function tests
Chest X Ray
- Aids in exposing pneumonothorax, pneumonia, effusion, atelectasis
MRI and CT
- consider in the event of an abnormal X-ray
Treatment
- Attend to airway/breathing patterns
- Administer supplemental Oxygen
- Chest tube insertion for pneumothorax, hemothorax, chylothorax
References
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

