Sandra G. Adams, MD, MS demonstrates why tactile fremitus is increased or decreased in different clinical scenarios using cups and a straw. To get the most from this video, you will need 2 large plastic cups, 1 smaller plastic cup, and 1 straw. Pour water in the bottom fourth of one of the larger cups. Then follow along as Dr. Adams explains why tactile fremitus is increased in consolidation (pneumonia) and decreased or absent in a large pleural effusion and a large pneumothorax. Sandra G. Adams, MD, MS, is an Associate Professor of Medicine at the University of Texas Health Science Center at San Antonio and a Staff Physician at the South Texas Veterans Health Care System in San Antonio, TX.