MANUAL PHYSIOLOGY PRACTICAL - Repository:The Medical ...

FM/UOJ
Place the most sensitive portion of our hand on the chest and ask the patient to say
‘ninety nine’ or a similar word which has a nasal sound and feel the “vocal fremitus”.
Vocal fremitus is the vibration of the sound transmitted through the lungs and the chest
wall.
What changes in the respiratory system increase or decrease the vocal fremitus?
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Percussion:
The middle finger of the left hand is placed firmly on the part to be percussed. The
back of the middle phalanx is then struck with the tip of the middle finger of the right
hand; the force for strike should be obtained only from the movement of the wrist and
inter phalanigal joints. The quality of the sound depends on the nature of the structure
percussed. Solid structures produce dull sound and structure containing air produce
resonant sound. Listen and identify the normal resonance.
How does percussion help in surface marking? What conditions lead to change in the
resonance?
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Auscultation:
Auscultation is listening to the sounds produced in the chest with a stethoscope. Three
observations can be made. character of breath sounds, vocal resonance, and abnormal
sounds.
There are two types of breath sounds vesicular breath sounds (sounds produced by
movement of air in and out of normal alveoli); and bronchial breath sounds (sounds
produced by passage of air through trachea and large bronchi). Listen to the vesicular
breath sound over different part of chest and observe the nature of the sounds and the
differences between inspiration and expiration. Listen to the bronchial breath sound over
the trachea and observe the same characteristics.
When could you hear bronchial breath sounds over the chest?
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Vocal resonance is produced in the same way as vocal fremitus. The only difference
is auscultation instead of palpation.
Respiration
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