e. Follow this Procedure to Palpate Properly.
(1) Use the ball of the hand (the palm of the hand at the base of the fingers),
palpate and compare like areas of the lungs. To be more accurate, use only one hand
rather than both hands. Do not let your fingers touch the patient's chest.
(2) Have the patient repeat a sound that will make full and rich sounds such
as "ninety-nine" or "one-one-one." Symmetrically move your hand over the patient's
(3) You should feel vibrations of equal intensity on either side of the
Normally, you will feel fremitus on the upper chest, close to the bronchi.
Also, normally, you should feel little or no fremitus in the lower chest.
Compare like (symmetrical) areas of the lungs.
f. Diaphragm Level (figure 2-5). The level of the diaphragm can be estimated
roughly by noting where fremitus stops upon the downward palpation of the chest. It is
normal to find that the right side of the diaphragm is slightly higher than the left side.
Figure 2-5. Diaphragm level.