. Physical diagnosis . Root of the Ensiform Cartilage. The patientis a shoemaker of seventy, who has all his life pressed against his breast bone the shoe onwhich he worked. other hand, phthisis frequently exists in persons with normally shapedchests or with abnormally deep chests (Woods Hutchinson). (SeeFig. 186, page 289.) (c) The Barrel Chest. Nothing is less like a barrel than the barrel chest. Its moststriking characteristic is its greatly increased anteroposterior diameter,so that it approaches the form of the infants chest. The costal angleis very obtuse, the shoulders are high, and the
. Physical diagnosis . Root of the Ensiform Cartilage. The patientis a shoemaker of seventy, who has all his life pressed against his breast bone the shoe onwhich he worked. other hand, phthisis frequently exists in persons with normally shapedchests or with abnormally deep chests (Woods Hutchinson). (SeeFig. 186, page 289.) (c) The Barrel Chest. Nothing is less like a barrel than the barrel chest. Its moststriking characteristic is its greatly increased anteroposterior diameter,so that it approaches the form of the infants chest. The costal angleis very obtuse, the shoulders are high, and the neck is short. The INSPECTION 67 respiratory movements of the barrel chest will be spoken of later (seeFigs. 68 and 69). Nutrition of the Chest Walls. Emaciation is readily appreciated by inspection. The ribs areunusually prominent, the scapulae stand out, and the clavicles this may be seen independently of any change in the shape of thechest such as was described above under the title of Paralytic Fig. 65.—Pigeon Breast. Tuberculosis of the apices of the lungs may produce a marked fallingin of the tissues above and below the clavicle independent of anyemaciation of the chest itself. III. Deformities. The abnormalities just enumerated are symmetrical and affect thewhole thorax. Under the head of Deformities, I shall consider chieflysuch abnormalities as affect particular portions of the chest and notthe thorax as a whole. (a) Spinal Curvatures and Slight degrees of deformity are best seen by marking with a skin-pencil the position of the spinous processes (see Fig. 71). The more 1 See also page 58. The lesions are referred to here only in relation to their effectson heart and lungs. 68 PHYSICAL DIAGNOSIS marked cases of lateral curvature, which are usually accompanied by acertain amount of twisting, give rise to considerable displacement ofthe thoracic organs and render unreliable the usual bony landmarks,with reference to which we judge of the
Size: 1965px × 1271px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
