GOLDEN RULE : REMOVE THE SCAPULA , ask the patient to cross his\her hands and put them on his\her contralateral shoulder , you can take a look at the fingers for clubbing/cyanosis and get a clue about the diagnosis in the OSCE , especially if you are in a shot-case exam and where asked to examine the chest posteriorly only.
Tactile fremitus is a palpable vibration of the chest wall resulting from speech. Tactile fremitus may be performed in two ways. The first way is to place the ulnar surface of your hands against the patient's chest wall and ask them to repeat the phrase “ninety-nine”. The second way is to place the palmar surface of the fingers against the chest wall. And again, have the patient repeat the phrase “ninety-nine”. The test should be repeated from the front. Again, going from top to bottom. Again, have your patients say “ninety-nine”. Tactile fremitus is increased by conditions that cause the lung to become more solid, such as consolidation, fluid, or a mass. Tactile fremitus is decreased by conditions that decrease the transmission of sound waves, such as increased fat and air-fluid level in the chest wall or overexpansion of the lungs from emphysema.
Not entirely true, it IS a vocal diphthong (/ai/), but it is a central, rather than back, vowel onset, so the frequency isn't as low. It's a little less efficient.
LOLsaudi TF is increased with fluid accumulation in the lung itself, such as with pneumonia; it is decreased with pleural effusion, or fluid within the pleural space but not within the lung itself.
What you said about pleural effusion is WRONG. Tactile Fremitus decreases in Pleural Effusion. So fluids decrease Tactile fremitus and increases in Solids like Pneumonia
Doesn't have to do with solids or liquids (pneumonia is not solid). Has to do with whether the pathology is INSIDE the lung, or OUTSIDE the lung. Pneumonia is fluid inside the lung, so the fluids will increase tactile fremitus. A pleural effusion is just outside the lung, so the fluid there will insulate and cause decreased tactile fremitus.
