Which options are expected assessment findings over the healthy adult lungs? (Select all that apply):

Normal pulmonary assessment reflects a patent airway and ventilated alveolar spaces within a symmetrical thoracic cage. Healthy lungs produce resonant vibrations during percussion because the air-filled parenchyma provides a specific acoustic density. Maintenance of pleural integrity ensures the lungs expand uniformly against the chest wall. No adventitious vibrations should be palpable or audible. A. Symmetrical chest expansion: This finding indicates equal bilateral lung inflation and intact neuromuscular function of the diaphragm and intercostal muscles. The nurse observes the thumbs moving apart equally during deep inspiration at the level of T9 or T10. Asymmetry would suggest pathology like pneumothorax or lobar pneumonia. B. Crepitus: This is a pathological finding characterized by a coarse, crackling sensation palpable over the skin surface. It occurs when air escapes from the lungs into the subcutaneous tissue, often following trauma or surgical procedures. It is never an expected finding in a healthy respiratory system. C. Increased tactile fremitus: Palpable vocal vibrations increase in intensity when lung tissue becomes consolidated, as seen in pneumonia. In healthy lungs, the air-filled parenchyma acts as a buffer, resulting in moderate, symmetrical fremitus. Increased intensity indicates that solid or fluid-filled tissue is conducting sound more efficiently than air. D. Adventitious sounds: These are abnormal noises, such as crackles, wheezes, or pleural friction rubs, superimposed over normal breath sounds. They indicate fluid, narrowing, or inflammation within the tracheobronchial tree. A healthy adult should exhibit only clear vesicular, bronchovesicular, and bronchial breath sounds in appropriate locations. E. Resonant percussion tones: Resonance is the expected low-pitched, clear, hollow sound elicited by percussing over healthy, air-filled lung tissue. It signifies that the underlying parenchyma is properly aerated and free of consolidation or excessive fluid. This is the standard percussion note for a normal pulmonary examination.