Clinical features of pneumonia are –
Correct Answer: Increased breath sounds
Description: Ans. is 'b' i.e., Increased breath sounds Physical examination findings of Common pulmonary conditions Pleural effusionPneumoniaEndobronchial tumorPneumothoraxTracheal positionChest wall movementFremitusPercussionBreath soundsCracklesWheezeShifted or midtineReduced or normalDecreasedDullDecreasedNoneNoneMidlineReduced or normalIncreasedDullIncreasedNoneNoneShifted or midi ineReduced or normalNormal or decreased Normal or DullNormal or DecreasedNonePossibleShifted or midlineReducedNoneHyperresonantDecreased/absentNoneNoneEgophonyBand above effusion (skodiac)PresentNoneNoneTracheal positionDeviated Away fromo Pneumo thoraxo EffusionDeviated towardso Collapseo ConsolidationTactile vocal fremituso Tactile vocal fremitus is vibration felt on the patients chest during low frequency vocalisation,o Commonly the patient is asked to repeat a phrase while the examiner feels for vibtations by placing a hand over the patient chest or back.o Tactile fremitus is normally more intense in the right second intercostal space as well as in the interscapular region as these:Tactile fremituso In creased-Consolidationo Decreased or absent-Pleural effusion or Pneumothorax o Reason for increased fremitus in a consolidated lung is the fact that the sound waves are transmitted with less decay in solid or fluid medium (consolidation) than in a gaseous medium (consolidation) than in a gaseous medium (aerated lung). Conversely the reason for decreased fremitus in a pleural effusion or pneumothorax (or any pathology separating the lung tissue itself from the body wall) is that this increased space diminishes or prevents entirely sound transmissiono Egophony is a change in timbre (EO to A) but not pitch or volume.o It is due to decrease in the amplitude and an increase in the frequency of the second formant produced by solid (including compressed lung) interposed between the resonator and the stethoscope head,o The sound of a spoken "E " change to "A " over an area of consolidation. The spoken "E " is beared as "A " when listening over the consolidation because the frequencies of the vibrations are altered by the consolidation. Egophony or "E" to ".A " changes may also occur in small band like area just above a pleural effusion because of compression of lung tissue that occurs just above the effusion.
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