[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory) › The pleuropulmonary syndromes: the comparison table to know [Clinical exam](https://durgical.com/en/clinical-exam/) · [Respiratory system](https://durgical.com/en/clinical-exam/#a-respiratory) # The pleuropulmonary syndromes: the comparison table to know - Topic Five syndromes and what each step of the chest exam finds in them: the most-asked table. Updated 2026-11-01 **See it in 3D:** [Pleura](https://durgical.com/en/anatomy/pleura/) · [Trachea](https://durgical.com/en/anatomy/trachea/) ## Key points - Fremitus is increased only in consolidation; it is reduced in effusion, pneumothorax, obstructive atelectasis and hyperinflation. - Dullness: consolidation, effusion (the flattest) and atelectasis. Hyperresonance: pneumothorax and hyperinflation. - Bronchial breathing, bronchophony and whispered pectoriloquy: consolidation. - Trachea toward the diseased side: atelectasis. Trachea away: massive effusion or tension pneumothorax. - Hyperinflation: bilateral, symmetric findings with prolonged expiration and wheezes. ## What it is The pleuropulmonary syndromes group chest findings by what lies beneath: solid lung, fluid or air in the pleura, collapsed lung, or obstructed airways with excess air. Comparing inspection, fremitus, percussion, breath sounds and voice sounds tells them apart at the bedside. Tracheal position is the final clue. ## Key facts - A consolidation with a blocked bronchus behaves like atelectasis: fremitus and breath sounds are reduced. - Above an effusion, compressed lung may give increased resonance, bronchial breathing and egophony. - In a small simple pneumothorax the trachea usually stays midline; a shift away signals tension. - Atelectasis may also raise the hemidiaphragm and narrow the intercostal spaces. ## Typical findings on the affected side in adults. Small or deep lesions may give a normal exam. | Syndrome | Inspection / expansion | Tactile fremitus | Percussion | Breath sounds | Voice / added sounds | | --- | --- | --- | --- | --- | --- | | [Consolidation](https://durgical.com/en/conditions/community-acquired-pneumonia/) | Expansion ↓ on that side; trachea midline | Increased | Dull | Bronchial | Bronchophony, egophony, pectoriloquy; crackles | | [Pleural effusion](https://durgical.com/en/conditions/pleural-effusion/) | Expansion ↓; trachea away if massive | Reduced or absent | Stony dull at the base | Reduced or absent | Voice ↓; egophony at the upper border | | [Pneumothorax](https://durgical.com/en/conditions/pneumothorax/) | Side moves little; trachea away if tension | Absent | Hyperresonant | Absent | Voice absent; no added sounds | | [Atelectasis (obstructive)](https://durgical.com/en/conditions/atelectasis/) | Retraction, expansion ↓; trachea toward the affected side | Reduced or absent | Dull | Absent | Voice absent | | [Bronchial obstruction / hyperinflation](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) | Barrel chest, expansion ↓ both sides; trachea midline | Reduced on both sides | Hyperresonant; low bases | Reduced, prolonged expiration | Wheezes, rhonchi | ## Memory aid Collapse pulls, fluid and tension push: that is how the trachea moves. ## Test yourself Think of the answer, then tap the question to see it. ## Which pleuropulmonary syndrome has increased tactile fremitus? Consolidation with an open bronchus, such as lobar pneumonia. ## How does percussion tell a pneumothorax from a pleural effusion? Pneumothorax is hyperresonant and effusion is dull; in both, fremitus and breath sounds are reduced or absent. ## Which way does the trachea shift in atelectasis and in a massive effusion? Toward the affected side in atelectasis (volume loss) and away from it in a massive effusion (mass effect). ## Which voice findings are typical of consolidation? Bronchophony, egophony and whispered pectoriloquy over a dull area with increased fremitus. ## What sets hyperinflation apart from the other syndromes in the table? It is bilateral and symmetric: barrel chest, hyperresonance with low bases, reduced breath sounds, prolonged expiration and wheezes. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/clinical-exam/the-pleuropulmonary-syndromes-the-comparison-table-to-know/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Pleura](https://durgical.com/en/anatomy/pleura/) - [Trachea](https://durgical.com/en/anatomy/trachea/) ## Related - [Consolidation syndrome](https://durgical.com/en/clinical-exam/consolidation-syndrome/) - [Pleural effusion syndrome](https://durgical.com/en/clinical-exam/pleural-effusion-syndrome/) - [Pneumothorax syndrome](https://durgical.com/en/clinical-exam/pneumothorax-syndrome/) - [Atelectasis syndrome](https://durgical.com/en/clinical-exam/atelectasis-syndrome/) - [Bronchial obstruction syndrome](https://durgical.com/en/clinical-exam/bronchial-obstruction-syndrome/) - [Pulmonary hyperinflation syndrome (emphysema)](https://durgical.com/en/clinical-exam/pulmonary-hyperinflation-syndrome/) ## Related conditions - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) - [Pleural effusion](https://durgical.com/en/conditions/pleural-effusion/) - [Pneumothorax](https://durgical.com/en/conditions/pneumothorax/) - [Atelectasis](https://durgical.com/en/conditions/atelectasis/) - [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) - [Asthma](https://durgical.com/en/conditions/asthma/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [Breath sounds: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/007535.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Pleural effusion: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000086.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Collapsed lung (pneumothorax)](https://medlineplus.gov/ency/article/000087.htm) (MedlinePlus, U.S. National Library of Medicine, 2024); [Atelectasis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000065.htm) (MedlinePlus, U.S. National Library of Medicine, 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/the-pleuropulmonary-syndromes-the-comparison-table-to-know/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/the-pleuropulmonary-syndromes-the-comparison-table-to-know/