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Pectoriloquy, also called whispered pectoriloquy, refers to sound heard through a stethoscope when a doctor listens to a patient’s lungs. The physician typically asks the patient to repeat a word or numbers in a whispered voice while the doctor places the stethoscope on several areas of the patient’s back. If the doctor can clearly hear the whispers, the patient might suffer from pneumonia or another condition that causes fluid to collect in the lungs. Pectoriloquy is just one of several audible sounds a doctor might hear during a pulmonary physical exam.
Normal lung function produces a muted sound that is hard to understand when a patient speaks or whispers while a doctor listens to the lungs. When pectoriloquy occurs, the whisper becomes clearly audible through the stethoscope. Typically, it means fluid in the lungs, which might be caused by pneumonia, pleurisy, or emphysema.
Other tests performed to measure lung function include listening for bronchophony. The doctor usually asks the patient to repeat the numbers one, two, and three while he or she listens for noise in the chest cavity. Normally, the doctor hears muffled or subdued sounds when the patient speaks. With bronchophony symptoms, the noise is louder where fluid has accumulated.
A similar test is called egophony. The doctor instructs the patient to make a continuous “E” sound while the physician listens via the stethoscope. If the doctor hears noise resembling a long “A,” it also might indicate excessive fluid in or around the lungs.
Abnormal lung sounds might also appear as crackles, wheezes, or rhonchi. Crackles represent high-pitched tones heard intermittently. They are described as having a popping noise or tone similar to the sparking of wood over a hot fire. Wheezes might appear as high-pitched or low-pitched noise where the airway is obstructed. A deep, gurgling noise when a patient breathes in and out might indicate rhonchi, which might go away when the patient coughs.
One other test uses vibrations to indicate the presence of fluid inside or outside the lungs. In a process called tactile fremitus, the patient repeats a series of numbers or certain words while the doctor places his or her hand on the chest. If the doctor feels excessive reverberation, it might indicate fluid in the airway leading to the lungs. If the vibration is faint, the doctor might check for fluid outside the lung, which might indicate chronic obstructive pulmonary disease.
These tests represent a comprehensive pulmonary examination when a doctor suspects abnormal lung function. Most physicians rely on chest X-rays to diagnose pneumonia and other disorders linked to fluid in the lungs. An X-ray gives the doctor more information about the extent of fluid accumulation and exactly where it occurs.