Perceptible vibration felt through the chest wall when the patient speaks

Use of accessory muscles for respiration

Movement of the thoracic diaphragm during breathing

DSSSB -28 August 2019 (Shift-2)

Medical & Surgical Nursing

Easy

What is fremitus?

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

Fremitus is defined as the vibration that can be felt on the chest wall when the patient speaks.
These vibrations are created by the vocal cords and transmitted through the airways and lung tissue to the chest surface.
The standard technique to elicit these vibrations for assessment is to have the patient repeat a resonant phrase like "ninety-nine.".
Assessing fremitus helps in evaluating the density of the underlying lung tissue and pleural space.

Option A: A widened costal angle is a change in the anatomical shape of the chest, not a palpable vibration. It reflects chronic hyperinflation of the lungs.
Option B: The use of accessory muscles is a sign of increased work of breathing and respiratory distress, not a vibration felt during speech.
Option D: This describes diaphragmatic excursion, which is the movement of the diaphragm during breathing, assessed by percussion, not palpation of speech-induced vibrations.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Respiratory System Assessment as background academic context rather than a clinical decision trigger.
Assessing tactile fremitus is a fundamental nursing skill that provides valuable clues about underlying pulmonary conditions without requiring any equipment.
An increase in fremitus might be one of the earliest signs of pneumonia, prompting a nurse to recommend further diagnostic tests like a chest X-ray.
A decrease or absence of fremitus can signal serious conditions like a pneumothorax (collapsed lung) or a large pleural effusion, which are medical emergencies requiring immediate intervention.

How to Approach the Question

First, read the question and identify the core term: "fremitus."
This is a direct recall question asking for a definition. Your task is to find the option that accurately defines this term.
Evaluate each option against your knowledge of respiratory assessment.
Option A (costal angle) relates to chest shape. Option B (accessory muscles) relates to the work of breathing. Option D (diaphragm movement) relates to excursion.
Recognize that "fremitus" comes from a Latin word meaning "to murmur or roar," which links it to sound and vibration.
Select the option that describes a palpable vibration associated with speech, which is the correct definition of tactile fremitus.

Concept Tested & Keywords

QGs4QDlVmKJUU_jYpp9KOM

E6 Nursing Fundamentals Potter Perry 12e Part 3 pp. 93-95, 95-97

E6 Medicine Macleod Clinical Examination 15e p. 105-107

Practise the full DSSSB -28 August 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.