(d) Watch for your thumbs to separate as the thorax expands.
(e) Feel for the range and symmetry of respiratory movement.
Figure 2-3. Anterior palpation.
d. Palpate the Chest for Tactile Fremitus (figure 2-4). Fremitus refers to the
palpable vibrations transmitted through the lungs to the chest wall when the patient
speaks. Have the patient say "ninety-nine" or "one-one-one" and you will feel
vibrations. Vibrations are more difficult to feel over bone. NOTE: Patients with a heavy
layer of fat may need to speak more loudly for you to feel the vibrations.
Figure 2-4. Sequence of tactile fremitus examination.