HESI (Health and Environmental Sciences Institute) Health Assessment Practice Test

Where is tactile fremitus typically felt most intensely?

1. Over the lower lobes

2. Between the scapulae

3. At the fifth intercostal space

4. At the third intercostal space

The correct answer is: Between the scapulae

Tactile fremitus is assessed during a physical examination to evaluate the presence and intensity of vibrations transmitted through the lung tissue when a patient speaks. It is most intensely felt between the scapulae because this area is close to large bronchial structures. The larger and more proximal airways, such as the bronchi, are more effective at transmitting sound and vibrations compared to the smaller airways found in the lower lobes. The anatomy in this region allows for better conduction of sound waves from the larynx down to the thoracic wall, making this site ideal for detecting alterations in sound transmission, which can indicate conditions like pneumonia or other lung pathologies. By contrast, other areas such as the lower lobes, fifth intercostal space, and third intercostal space may not transmit these vibrations as clearly due to differences in lung tissue density or air movement within the chest cavity.