Page 2 of 2: Diagnostic test for patients presenting with chest pain

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P.E.: tension pnemothorax

hyperresonant or tympanic over the pleural air

trachea shifted towards opposite side if much air

decreased to absent over the pleural air

no adventitious sounds

decreased to absent tactile fremitis and transmitted vocie sounds

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They will ask you to perform tactile fremitus and what that means !

Tactile Fremitus

Ask the patient to say "ninety-nine" several times in a normal voice. ++
Palpate using the ball of your hand.
You should feel the vibrations transmitted through the airways to the lung.
Increased tactile fremitus suggests consolidation of the underlying lung tissue

In tension pnemothorax, there is "DECREASED" tactile fremitus

Say 99, 99, ninety-nine !!!

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Additional physical examination for a tension pnemothorax patients

remember they will expect you to know the basic of physical examination.

Please review the basic physical examination of the lung !!!!!!!!!!!

Tactile Fremitus
Ask the patient to say "ninety-nine" several times in a normal voice. ++
Palpate using the ball of your hand.
You should feel the vibrations transmitted through the airways to the lung.
Increased tactile fremitus suggests consolidation of the underlying lung tissues. [8]
Bronchophony
Ask the patient to say "ninety-nine" several times in a normal voice. ++
Auscultate several symmetrical areas over each lung.
The sounds you hear should be muffled and indistinct. Louder, clearer sounds are called bronchophony.
Whispered Pectoriloquy
Ask the patient to whisper "ninety-nine" several times. ++
Auscultate several symmetrical areas over each lung.
You should hear only faint sounds or nothing at all. If you hear the sounds clearly this is referred to as whispered pectoriloquy. [9]
Egophony
Ask the patient to say "ee" continuously. ++
Auscultate several symmetrical areas over each lung.
You should hear a muffled "ee" sound. If you hear an "ay" sound this is referred to as "E -> A" or egophony.

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MGS · Credits: 586 My Scrapbook

4 tensin PTX u should not waite 4 CXR but
Senario indicate to spontaneous PTX which if lower than 10 percent you do not need Chest Tube .Tall Young Men W/O truma always wants you to manage a spontaneous PTX

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