Percussion and Fremitus Notes

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8 Terms

1
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Tympanic (percussion note)

Loud, high-pitched, drumlike. Normal over stomach/intestines. Abnormal in chest → pneumothorax.

2
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Hyperresonant (percussion note)

Very loud, lower-pitched, booming. Abnormal in adults. Seen in emphysema, asthma, pneumothorax (trapped air).

3
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Resonant (percussion note)

Moderate, low-pitched, hollow. Normal over healthy lungs.

4
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Dull (percussion note)

Soft, thudlike, muffled. Suggests fluid/solid replacing air → pneumonia, pleural effusion, tumor.

5
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Flat (percussion note)

Very soft, high-pitched, extremely dull. Normal over bone or muscle. Abnormal → large pleural effusion.

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Tactile Fremitus

Vibration felt on chest wall when patient speaks (“99”). ↑ with pneumonia (consolidation). ↓ with pleural effusion, pneumothorax, COPD.

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Rhonchal Fremitus

Vibrations felt from air moving through mucus in large airways. Seen in bronchitis or airway secretions (may clear with coughing).

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Pleural Friction Fremitus

Coarse, grating vibration on chest wall. Caused by inflamed pleural surfaces rubbing (pleuritis/pleurisy).