WordNet

relating to or designed for or using the singing voice; "vocal technique"; "the vocal repertoire"; "organized a vocal group to sing his compositions"
full of the sound of voices; "a playground vocal with the shouts and laughter of children"
having or using the power to produce speech or sound; "vocal organs"; "all vocal beings hymned their praise"

PrepTutorEJDIC

『声の』,音声の / 声に出す,口頭の / 《話》(意見などを)遠慮なくしゃべる,口やかましい / (ポピュラー歌手の)ボーカル

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/04/27 20:11:19」(JST)

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Fremitus is a vibration transmitted through the body.^[1] In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall (tactile fremitus) and/or heard by a stethoscope on the chest wall with certain spoken words (vocal fremitus), although there are several other types.

Respiratory

Pleural fremitus

Pleural fremitus is a palpable vibration of the wall of the thorax caused by friction between the parietal and visceral pleura of the lungs. See pleural friction rub for the auditory analog of this sign.

Rhonchal fremitus

Rhonchal fremitus, also known as bronchial fremitus, is a palpable vibration produced during breathing caused by partial airway obstruction. The obstruction can be due to mucus or other secretions in the airway, bronchial hyperreactivity, or tumors. See rhonchus (rhonchi) for the auditory analog of this sign.

Subjective fremitus

Subjective fremitus is a vibration felt by the patient on humming with the mouth closed.

Tactile fremitus

Tactile fremitus, known by many other names including pectoral fremitus, tactile vocal fremitus, or just vocal fremitus, is a vibration felt on the patient's chest during low frequency vocalization. Commonly, the patient is asked to repeat a phrase while the examiner feels for vibrations by placing a hand over the patient's chest or back. Phrases commonly used in English include, 'boy oh boy' and 'toy boat' (diphthong phrases), as well as 'blue balloons' and 'Scooby-Doo'. 'Ninety-nine' is classically included, however, this is a misinterpretation of the original German report, in which "Neun-und-neunzig" was the low-frequency diphthong of choice.

Tactile fremitus is normally more intense in the right second intercostal space, as well as in the interscapular region, as these areas are closest to the bronchial bifurcation. Tactile fremitus is pathologically increased over areas of consolidation and decreased or absent over areas of pleural effusion or pneumothorax (when there is air outside the lung in the chest cavity, preventing lung expansion).

The reason for increased fremitus in a consolidated lung is the fact that the sound waves are transmitted with less decay in a solid or fluid medium (the consolidation) than in a gaseous medium (aerated lung). Conversely, the reason for decreased fremitus in a pleural effusion or pneumothorax (or any pathology separating the lung tissue itself from the body wall) is that this increased space diminishes or prevents entirely sound transmission.

It has recently been suggested that the artifacts caused by eliciting tactile fremitus during breast ultrasonography can be used to differentiate between benign and malignant tumors.^[2] ^[3]

Tussive fremitus

Tussive fremitus is a vibration felt on the chest when the patient coughs.

Other

Hepatic fremitus

Hepatic fremitus is a vibration felt over the patient's liver. It is thought to be caused by a severely inflamed and necrotic liver rubbing up against the peritoneum. The name 'Monash sign' has been suggested for this clinical sign, after the Monash Medical Centre in Melbourne, Australia.^[4]

Hydatid fremitus

Hydatid fremitus is a vibratory sensation felt on palpating a hydatid cyst.

Pericardial fremitus

Pericardial fremitus is a vibration felt on the chest wall due to the friction of the surfaces of the pericardium over each other. See pericardial friction rub for the auditory analog of this sign.

Periodontal fremitus

Periodontal fremitus occurs in either of the alveolar bones when an individual sustains trauma from occlusion. It is a result of teeth exhibiting at least slight mobility rubbing against the adjacent walls of their sockets, the volume of which has been expanded ever so slightly by inflammatory responses, bone resorption or both. As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect fremitus.^[5]

References

^ "fremitus" at Dorland's Medical Dictionary
^ Sohn C, Baudendistel A (1995). "Differential diagnosis of mammary tumors with vocal fremitus in sonography: preliminary report". Ultrasound Obstet Gynecol 6 (3): 205–7. doi:10.1046/j.1469-0705.1995.06030205.x. PMID 8521071.
^ Yildirim D, Gurses B, Ekci B, Kaur A (2011). "Power Doppler Vocal Fremitus Breast Sonography: Differential Diagnosis with a New Classification Scheme—Power Doppler Vocal Fremitus Examination of Breast Lesions". Scientific Research 2 (2): 243–252. doi:10.4236/jct.2011.22031.
^ Nagappan R, Parkin G, Tsui A, Sievert W (2001). "Hepatic fremitus: 'Monash sign'". Intern Med J 31 (9): 567–8. doi:10.1046/j.1445-5994.2001.00145.x. PMID 11767877.
^ Trauma from Occlusion Handout, Dr. Michael Deasy, Department of Periodontics, NJDS 2007. page 12

^ fremitus at Dorland's Medical Dictionary -- broken link

UpToDate Contents

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1. 成人における嗄声 hoarseness in adults
2. 小児における自然気胸 spontaneous pneumothorax in children
3. 頸動脈内膜剥離術および頸動脈ステント留置術の麻酔 anesthesia for carotid endarterectomy and carotid stenting
4. 声帯ひだ奇異性運動 paradoxical vocal fold motion
5. Techniques and devices for airway management for anesthesia: Supraglottic devices (including laryngeal mask airways)

English Journal

How to find an isoechoic lesion with breast US.

Kim MJ, Kim JY, Yoon JH, Youk JH, Moon HJ, Son EJ, Kwak JY, Kim EK.SourceDepartment of Radiology, Research Institute of Radiological Science, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, South Korea.
Radiographics : a review publication of the Radiological Society of North America, Inc.Radiographics.2011 May-Jun;31(3):663-76. doi: 10.1148/rg.313105038.
Breast ultrasonography (US) is recognized as a useful diagnostic tool for palpable or nonpalpable breast masses, but isoechoic lesions surrounded by fat can be a challenge for radiologists and can result in false-negative interpretations and a delayed diagnosis of breast cancer. Identifying isoechoi
PMID 21571650

Does this patient have a pleural effusion?

Wong CL, Holroyd-Leduc J, Straus SE.SourceDivision of Geriatrics, University of Toronto, and St Michael's Hospital, Toronto, Ontario, Canada.
JAMA : the journal of the American Medical Association.JAMA.2009 Jan 21;301(3):309-17. doi: 10.1001/jama.2008.937.
CONTEXT: Pleural effusion is a common finding among patients presenting with respiratory symptoms. The value of the bedside examination to detect pleural effusion is unclear.OBJECTIVE: To systematically review the evidence regarding the accuracy of the physical examination in assessing the probabili
PMID 19155458

Japanese Journal

喉頭痙攣の1症例

永澤昌,浜井行夫,大野木信,佐伯菊子,平川勝洋,鈴木衛
耳鼻咽喉科臨床　補冊 1994(Supplement72), 169-173, 1994
… Fiberscopic laryngoscopy showed adduction of the vocal cords followed by severe inspiratory dyspnea. … Local fremitus and wheeze were heard over the anterior neck. …
NAID 130004683773

肺・胸郭系における音の伝達特性―実験的胸水による変化

米丸亮,阿部直,小林弘祐,川城丈夫,横山哲朗
日本胸部疾患学会雑誌 29(7), 829-835, 1991
肺・胸郭系において胸水貯留の音の伝達特性に及ぼす影響を検討した. 実験的胸水として生理的食塩水を雑種成犬の胸腔内へ注入し, 気管切開口から胸壁までの音の伝達特性を100～1,000Hzの周波数範囲で測定した. 実験的胸水の貯留部では100～200Hzの範囲で周波数が低いほど音の透過損失が増大した. 一側の胸腔あたり5, 10, 15ml/kgの実験的胸水による100Hz純音の透過損失は, コントロ …
NAID 130003450211

胃粘膜内に，形質細胞の単クローン性浸潤をみた原発性マクログロブリン血症

恵美宜彦,川島康平,大野竜三,平林紀男,矢野邦夫,竹山英夫,坂行雄,佐竹立成
臨床血液 24(8), 1080-1085, 1983
… Physical examination revealed moderate epigastric tenderness, decreased vocal fremitus and flat percussion note on the left side with decreased breath sounds. …
NAID 130004498589

Related Pictures

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