National Board of Chiropractic Examiners (NBCE) Practice Test

Increased tactile fremitus is most characteristic of which condition?

1. Pneumothorax

2. Pulmonary edema

3. Chronic bronchitis

4. Lung cancer

The correct answer is: Pulmonary edema

Increased tactile fremitus is most characteristic of pulmonary edema. This phenomenon occurs due to the excess fluid in the lungs, which leads to a solidification of lung tissue and enhances the transmission of vibrations. When a clinician palpates the chest while a patient is speaking, the vibrations produced by the vocal cords travel more effectively through this denser, fluid-filled lung tissue, resulting in increased tactile fremitus. In the context of other conditions, such as pneumothorax, there is typically a decrease in fremitus because the presence of air in the pleural space interferes with the transmission of sound vibrations through the lung. Similarly, chronic bronchitis can lead to an overall decrease in fremitus due to mucus production and airway obstruction, which does not contribute positively to the transmission of vibrations. Lung cancer may also lead to decreased fremitus if there is significant obstruction or presence of a pleural effusion. Thus, pulmonary edema stands out as the condition where increased tactile fremitus is notably present due to changes in lung density from fluid accumulation.