Doctors ask you to say "99" during a physical exam, specifically when listening to your chest with a stethoscope, to check for tactile fremitus, a vibration felt through the chest wall, and assess lung sound clarity (bronchophony) to detect underlying lung issues like pneumonia or fluid, as the sound becomes clearer and louder in consolidated (solid) lung tissue. It's a historical practice, adapted from German medicine, but modern alternatives like "toy boat" are sometimes used because the "oy" sound better mimics the vowel in the German phrase "neun-und-neunzig".

Why do they say 99 in respiratory examination?

In bronchophony, the physician often asks the patient to say "ninety-nine" or "baseball" while listening over a lung field with a stethoscope. The spoken word sounds will be louder in areas where consolidation is present.

Why say ninety nine?

When our medical ancestors studied in Austria or Germany, they observed that physicians asked patients to say “neun und neunzig” to evoke fremitus over the thorax. When they came home they taught their patients to say “ninety-nine,” thus translating literally, but not phonetically, what they had heard.

What is the most concerning lung sound?

The most common abnormal (adventitious) lung sounds include:

• Rhonchi/rhonchus.
• Wheezing.
• Stridor.
• Crackles (rales).
• Pleural rub.

Is tactile fremitus good or bad?

A normal evaluation occurs when equal and moderate vibrations are noticed during speech. Fremitus is abnormal when it is increased or decreased. Because sound is transmitted more strongly through non–air-filled lung, increased fremitus suggests a loss or decrease in ventilation in the underlying lung.

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What does fluid overload sound like in the lungs?

Crackles are also known as alveolar rales and are the sounds heard in a lung field that has fluid in the small airways. Crackles create fine, short, high-pitched, intermittently crackling sounds. The cause of crackles can be from air passing through fluid, pus or mucus.

What lung sound does COPD have?

The Distinctive Characteristics of COPD Lung Sounds

Wheezes, for example, are high-pitched musical sounds that occur during exhalation when narrowed airways create turbulence. Crackles, on the other hand, are intermittent popping or rattling noises that indicate the presence of fluid or mucus in the airways.

Why do doctors say 99?

Bronchophony: While auscultating the lung fields, the patient is asked to repeat "99." Bronchophony is present if the "99" appears louder and more distinct over certain areas, suggesting underlying consolidation.

What do normal lungs sound like?

Thus in health, over most of the chest, the breath sounds are low-pitched and have a relatively quiet expiratory phase. The inspiratory component originates in the lobar and segmental airways, whereas the expiratory component arises from more central airways. They are soft, low pitched, and rustling in quality.

Can you have pneumonia with 99 oxygen?

Main Results. Among patients with a clinical suspicion of pneumonia in primary care and with a decision by the GP to perform a CXR, a temperature ≥ 37.8 °C and an oxygen saturation < 95% were both found to be predictors of pneumonia that was visible on a CXR.

How do you know if shortness of breath is heart or lungs?

Shortness of breath due to cardiovascular risk can appear gradually or over time. There are a few signs that will indicate if it is happening due to a heart condition: If there is swelling in your legs and you feel more breathless while lying down, it is a potential sign of heart failure.

What is a good score on a lung capacity test?

Your predicted total lung capacity (TLC) is based on your age, height, sex and ethnicity, so results will differ from person to person. Normal results typically range between 80% and 120% of the prediction.

What does stage 1 COPD feel like?

Stage 1 COPD feels like minimal or no symptoms, but you might notice a mild, nagging cough (sometimes with mucus, often called a "smoker's cough") and get slightly short of breath earlier than usual, especially with physical activity like climbing stairs, often mistaking it for being out of shape. Many people don't realize they have it because the symptoms are subtle and the body compensates well initially, but lung function is slightly reduced (80% or more of normal).
 

Can COPD be reversed if caught early?

Although any damage done to your lungs and airways cannot be reversed, giving up smoking can help prevent further damage. This may be all the treatment that's needed in the early stages of COPD, but it's never too late to stop – even people with more advanced COPD will benefit from quitting.

What age does COPD usually start?

It takes time to develop. Most people with COPD are smokers 40 years or older. Younger people can also get it, especially if a family member was diagnosed at younger than 40 years. You may be at risk even if you have never smoked.

What are the first signs of fluid in the lungs?

What are the symptoms of pulmonary edema?

• Trouble breathing, or shortness of breath.
• Feelings of anxiety related to breathing difficulties.
• Wheezing or noisy breathing.
• Quick, shallow breathing.
• Trouble breathing while lying down.
• Discomfort related to breathing.
• A feeling of suffocation.

What do pneumonia lungs sound like?

What lung sounds does pneumonia have? This depends on whether you have viral or bacterial pneumonia. Bacterial pneumonia tends to be more severe than viral pneumonia. People with bacterial pneumonia can have wheezing, rales, rhonchi, and pleural rub.

What are the first signs of walking pneumonia?

Walking pneumonia symptoms to look for:

• a fever of 101°F (38.5°C) or below.
• a cough that can last for weeks to months.
• fatigue (feeling very tired)
• headache, chills, sore throat, and other cold or flu-like symptoms.
• ear pain.
• chest pain or stomach pain.
• malaise (feeling of discomfort)
• vomiting.

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