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Palpation of the lungs
Last reviewed: 23.04.2024
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The results of the examination are supported by palpation, which is recommended to be combined with examination. First of all, the degree of asymmetry of chest involvement in the act of breathing is clarified: the palms applied to the chest wall make the lagging of the corresponding half more noticeable with deep breathing.
Especially important is the palpation of the asymmetry of conduction of voice tremor (fremitus pectoralis) - the vibration that occurs when the sound "P" (for example, in the words "thirty-three, thirty-four"), most clearly felt in the upper part of the chest, closer to the trachea and large The bronchi, where this vibration is formed.
Distinguish voice tremor enhancement that usually occurs during compression of the lung tissue (pneumonitis, pulmonary infarction, pulmonary atelectasis ), when the conditions of uniformity and better vibration of the periphery. The opposite situation is the heterogeneity of the vibration environment, which leads to a weakening of the vocal jitter detected in the presence of fluid or gas in the pleural cavity (hydrothorax, pneumothorax ), with pulmonary emphysema.
Carrying out palpation, the doctor gets an idea of the resistance of the chest, the increase of which is observed when compaction of lung tissue, hydrothorax, sometimes feels rubbing the pleura in their inflammation ( dry pleurisy ); In addition, he specifies the features of the cervical, axillary, ulnar lymph nodes (for example, their increase in lung tumors, tuberculosis), assesses the skin condition (turgor, moisture), subcutaneous tissue, muscles, determines pain points (for example, in intercostal spaces), that it is important to understand the patient's complaints of pain, as well as a peculiar crunch when the air breaks into the subcutaneous fatty tissue ( subcutaneous emphysema ).
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