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Adventitious breath sounds causes11/21/2023 ![]() Decreased fremitus may be due to fluid (effusions) or air (pneumothorax) between the lung and chest wall (the extra interface causes some sounds to be reflected rather than transmitted), or increased air (lower density) in the lungs (COPD).If you feel asymmetry, it may be abnormally decreased on one side or increased on the other. You may find one hand works better than the other, and you will need to switch from side to side at the same level. ![]() ![]() Have the patient say “toy boat” or “ninety-nine” over and over as you feel for asymmetry. Find what part of your hand is most sensitive to vibrations – often it is the portion of your hand that is most ticklish when you lightly stroke one palm with the other hand’s fingertips – and place this on the patient’s thorax.
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