What is an expected chest finding in a patient with emphysema?

In patients with emphysema, the destruction of the alveolar walls leads to larger air spaces and reduces the surface area available for gas exchange. This air trapping results in hyperinflation of the lungs, which can create decreased airflow during auscultation. Consequently, decreased breath sounds are commonly noted upon examination. In cases of hyperinflation, the lung volumes increase, and as a result, the normal acoustic transmission of breath sounds diminishes, leading to this expected finding.

Cyanosis of lips and fingers, while it may occur in advanced emphysema due to hypoxemia, is not an expected or primary finding. A normal respiratory rate is also not characteristic since patients with emphysema often present with increased respiratory effort and rate due to airway obstruction. Increased tactile fremitus would indicate conditions associated with lung consolidation (like pneumonia), which is not relevant in emphysema where air-filled spaces are prominent. Thus, decreased breath sounds are an expected and characteristic finding in patients with emphysema.