Tactile fremitus is a palpable vibration felt over the chest wall that is produced by the transmission of sound waves from the trachea and larger bronchi to the chest wall. It is a valuable clinical sign that can be used to assess the patency of the airways and to detect the presence of consolidation or fluid in the lungs.
Tactile fremitus is best elicited by placing the ulnar aspect of the hand firmly against the chest wall and asking the patient to say “ninety-nine” or “one-one-one.” The vibrations produced by the patient’s voice will be transmitted to the examiner’s hand, and the examiner will feel a palpable thrill. The intensity of the tactile fremitus will vary depending on the underlying lung tissue. It will be increased over areas of consolidation or fluid, and it will be decreased or absent over areas of emphysema or atelectasis.
