COMMON PULMONARY DISORDERS AND PHYSICAL ASSESSMENT FINDINGS USUALLY PRESENT Thus if pectoriloquy is present, it indicates consolidation of some portion of the lung field. Consolidation of the lung tissue causes filling of the air spaces of the alveoli and voice transmission through that part of the lung will be unusually clear and louder than normal. If consolidation is present in a section of the lung field, the whispered voice will sound unusually clear and loud, instead of muffled and distant. Normally the whispered voice will be distant and very muffled through the stethoscope. You will ask the patient to whisper a number or short phrase and repeat it such as counting, “1, 2, 3” “1, 2, 3”, etc. This is another term to determine the presence of consolidation of the lungs. This indicates consolidation, or that there is fluid in the lungs. If the sound changes to “ay” sound, while the patient is saying “ee” then egophony is present. Normally, it will sound muffled, but it will remain with the long sound of “ee” when you listen over most of the lung field. Ask the patient to repeatedly say the sound “ee” while you listen with the stethoscope. This is a term that indicates that there is consolidation of the lung or possible collapse of the lung. This occurs because sound transmission through consolidated tissues will be greater and clearer because dense tissue transmits sound better than normal “fluffy” lung tissue. If it sounds clear through the stethoscope, there is probably consolidation of the lung and Bronchophony is present. When you listen through normal lung tissue, sounds are normally muffled. Normally the sound of “ninety-nine” will sound very faint and muffled. Ask the patient to say the words: “ninety-nine” while you listen through the stethoscope. Consolidation refers to increased density of the lung tissue, due to it being filled with fluid and/or blood or mucus. This term represents a test to perform on the patient which may indicate that there is consolidation of the lung. Perhaps ask him to breath faster that may enhance the quality of the sounds you are hearing. If you are unsure of what you are hearing through the stethoscope, or if breath sounds are diminished, ask him/her to breathe deeper and/or open the mouth wider. ASSESSMENT OF THE LUNGS AND THORAX CONTINUED ADDITIONAL BREATH SOUNDS
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