Transmitted Voice
Sounds
If you hear adventitious sounds on
auscultation, assess how these sounds change as the patient
speaks. Voice assessment can provide important clues about
respiratory abnormalities. Normal lungs are filled with air, and
air does not transmit sound readily. Normally, transmitted voice
sounds are difficult to hear spoken words are muffled and
indistinct and whispered words are usually not heard at all.
However, when substances such as fluid or solid
masses replace air in the lungs, sounds are transmitted more
clearly. The sounds that can be assessed are:
- Whispered pectoriloquy: Ask the patient to whisper a sequence of words such as
one-two-three, and listen with a stethoscope.
Normally, only faint sounds are heard. However, over
areas of tissue abnormality, the whispered sounds will be
clear and distinct.
- Bronchophony:Ask the
patient to say "99" in a normal voice. Listen
to the chest with a stethoscope. The expected finding is
that the words will be indistinct. Bronchophony is
present if sounds can be heard clearly.
- Egophony: While listening
to the chest with a stethoscope, ask the patient to say
the vowel e. Over normal lung tissues, the
same e (as in "beet") will be
heard. If the lung tissue is consolidated, the
e sound will change to a nasal a
(as in "say"). Click here to visit the Egophony/Aegophony YouTube video presented by Dr. Prodigious.
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