Egophony

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Egophony (British English, aegophony) is an increased resonance of voice sounds [1] heard when auscultating the lungs, often caused by lung consolidation and fibrosis. It is due to enhanced transmission of high-frequency sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice.

American and British English spelling differences Comparison between US and UK English spelling

Many of the differences between American and British English date back to a time when spelling standards had not yet developed. For instance, some spellings seen as "American" today were once commonly used in Britain and some spellings seen as "British" were once commonly used in the United States. A "British standard" began to emerge following the 1755 publication of Samuel Johnson's A Dictionary of the English Language, and an "American standard" started following the work of Noah Webster and in particular his An American Dictionary of the English Language, first published in 1828.

Respiratory sounds specific sound generated by the movement of air through the respiratory system

Respiratory sounds refer to the specific sounds generated by the movement of air through the respiratory system. These may be easily audible or identified through auscultation of the respiratory system through the lung fields with a stethoscope as well as from the spectral chacteristics of lung sounds. These include normal breath sounds and adventitious or "added" sounds such as rales, wheezes, pleural friction rubs, stertor and stridor.

Auscultation listening to the internal sounds of the body, usually using a stethoscope

Auscultation is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems, as well as the gastrointestinal system.

Contents

Technique

While listening to the lungs with a stethoscope, the patient is asked to pronounce the modern English (more generally, post-Great Vowel Shift) long-E vowel sound.

The Great Vowel Shift was a series of changes in the pronunciation of the English language that took place primarily between 1350 and the 1600s and 1700s, beginning in southern England and today having influenced effectively all dialects of English. Through this vowel shift, all Middle English long vowels changed their pronunciation. Some consonant sounds changed as well, particularly those that became silent; the term Great Vowel Shift is sometimes used to include these consonant changes.

Interpretation

Stethoscopic auscultation of a clear lung field during this articulation will detect a sound matching that received through normal hearing; that is, the sound articulated by the patient will be clearly transmitted through the lung field and heard unchanged by the clinician. When the lung field is consolidated (filled with liquid or other solid mass such as tumor or fungus ball), the patient's spoken English long E will sound like a "pure-voweled" long E or a modern English long A without the latter's usual offglide. This effect occurs because the solid mass in the lung field will disproportionately dampen the articulated sound's acoustic overtones higher in the harmonic series, transmuting the English long E, in which higher overtones predominate strongly, to a sound (the English long A) in which higher overtones predominate only slightly, i.e., to a markedly lesser degree than in the former sound. This finding is referred to in clinical contexts as the "E to A transition." If associated with fever, shortness of breath, and cough, this E to A transition indicates pneumonia.

Somewhat related, bronchophony, a form of pectoriloquy, is a conventional respiratory examination whereby the clinician auscultates the chest while asking the patient to repeat the word "ninety-nine". Better phrases in English include "toy boat”, "Scooby Doo", and “blue balloons". [2] In the UK, regional variation with clinicians from Edinburgh to Glasgow use the phrase "one-one-one" due to its more rounded sound.

Bronchophony abnormal transmission of sounds from bronchi

Bronchophony is the abnormal transmission of sounds from the lungs or bronchi. Bronchophony is a type of pectoriloquy.

Pectoriloquy is the increased resonance of the voice through the lung structures, so that it is clearly comprehensible using a stethoscope on the chest. It usually indicates consolidation of the underlying lung parenchyma.

Similar terms are bronchophony and whispered pectoriloquy. The mechanism is the same; that is, fluid or consolidation causes the sound of the voice to be transmitted loudly to the periphery of the lungs where it is usually not heard.

Whispered pectoriloquy refers to an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields on a patient's torso.

Causes

Pleural effusion accumulation of excess fluid in the pleural cavity

A pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. This excess fluid can impair breathing by limiting the expansion of the lungs. Various kinds of pleural effusion, depending on the nature of the fluid and what caused its entry into the pleural space, are hydrothorax, hemothorax (blood), urinothorax (urine), chylothorax (chyle), or pyothorax (pus). A pneumothorax is the accumulation of air in the pleural space, and is commonly called a "collapsed lung".

Pneumonia Infection of the lungs

Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.

Pulmonary consolidation radiologic sign

A pulmonary consolidation is a region of lung tissue that has filled with liquid instead of air. The condition is marked by induration of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood. Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation.

Etymology

Egophony comes from the Greek word for "goat," (αἴξ aix, aig-) in reference to the bleating quality of the sound. [3]

See also

Related Research Articles

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Idiopathic pulmonary fibrosis chronic, irreversible and ultimately fatal disease characterized by a progressive decline in lung function

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Since the invention of the stethoscope by René-Théophile-Hyacinthe Laennec France in 1816, physicians have been utilizing lung sounds to diagnose various chest conditions. Today auscultation provides physicians with extensive information on the examination of the patient. The skills of the examiner however, vary, as seen in a clinical study that was conducted on the diagnosis of pneumonia in 2004.

Rheumatoid lung disease is a disease of the lung associated with RA, rheumatoid arthritis. Rheumatoid lung disease is characterized by pleural effusion, pulmonary fibrosis, lung nodules and pulmonary hypertension. Common symptoms associated with the disease include shortness of breath, cough, chest pain and fever. It is estimated that about one quarter of people with rheumatoid arthritis develop this disease, which are more likely to develop among elderly men with a history of smoking.

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References

  1. ↑ " egophony " at Dorland's Medical Dictionary
  2. ↑ Salvatore Mangione (2000). Physical diagnosis secrets. Philadelphia: Hanley & Belfus. p. 330. ISBN   1-56053-164-9.
  3. ↑ Sapira JD (1995). "About egophony". Chest. 108 (3): 865–7. doi:10.1378/chest.108.3.865. PMID   7656646.
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