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Transmitted Sounds
Published in Noam Gavriely, David W. Cugell, Breath Sounds Methodology, 2019
As sounds travel through the thorax from wherever they may originate to the stethoscope or to the sound sensor, they are modified in various ways. They also require a finite period of time to travel from point to point. Clinicians have long relied on detection of changes in the acoustic properties of transmitted sound as a sign of lung disease (see Chapter 1). Sound generated by the vocal cords, as occurs when the patient utters a phrase repeatedly (“ninety-nine” is a favorite English language phrase because of its long duration), can be heard on the surface of the chest (vocal fremitus), and the accompanying vibratory motion of the chest wall can also be palpated (tactile fremitus). Whispered vocal sounds (“one, two, three” whispered repeatedly is the favorite in English) are also used to detect a change in sound transmission (whispered pectoriloquy), and is more sensitive than voice sound transmission for early detection of pulmonary consolidation. Still another long-used sound transmission measure is the “E to A” change (egophony). When the patient utters the letter “E,” it is normally heard on the chest surface as a muffled version of “E”, but, in the presence of consolidation, it resembles the spoken “A.” Although physicians currently devote little, if any, time assessing acoustic transmission through the thorax with a stethoscope, the application of modern signal-processing methods may well rekindle an interest in the diagnostic importance of sound transmission.
Identifying the gap in clinical skills: a pilot study investigating the use of clinical respiratory examination skills in practice
Published in Education for Primary Care, 2021
Sophia Kerzner, Randi Q. Mao, Janhavi Nikhil Patel, Shreyas Sreeraman, Jason Profetto
Auscultating for breath sounds was the only skill in the entire survey to be unanimously useful. (100%). Additionally, almost all respondents (98.7%) felt that auscultating for breath sounds should be taught. The three auscultation techniques for consolidation (aegophony, whispered pectoriloquy, and bronchophony), were rated as useful by less than 20% of respondents. Most respondents felt that the consolidation tests should not be taught to students.