Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Anaemia, pulmonic systolic. already been mentioned, and will be still further consid-ered under diseases of the aorta. When the stethoscope is lightly applied to the carotidand subclavian arteries the normal first and secondcardiac sounds may be faintly heard; the first soundweak and low pitched, the second sound louder, higherpitched and snapping, corresponding to its character 318 THE CIRCULATORY SYSTEM. at the aortic cartilage. Over the arteries that arefurther removed fro
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Anaemia, pulmonic systolic. already been mentioned, and will be still further consid-ered under diseases of the aorta. When the stethoscope is lightly applied to the carotidand subclavian arteries the normal first and secondcardiac sounds may be faintly heard; the first soundweak and low pitched, the second sound louder, higherpitched and snapping, corresponding to its character 318 THE CIRCULATORY SYSTEM. at the aortic cartilage. Over the arteries that arefurther removed from the heart, as the brachial, crural,femoral, etc., no sound is normally heard unless thepressure of the stethoscope is sufficiently hard to com-press the artery, when there is heard a systolic mur-mur (pressure murmur), whose intensity correspondsto the degree of narrowing, and which may have amusical quality. Fig. Pulmonic diastolic. Murmurs heard over the arteries may be produced(a) at the cardiac orifice or aorta, and conducted intothem, or (b) in the blood-vessels at the point whereheard. Systolic murmurs made in the arteries mav be due(a) to roughening of the inner coat; (b) to narrowing ofthe lumen, which may be caused by changes in the wall AUSCULTATION. 319 of the artery, as calcareous plates, or due to pressurefrom surrounding structures, as lymph nodes, etc.; (c)to dilatation of the vessel from fever, acute local in-flammation, chronic dilatation and vaso-motor condi-tions, causing paresis of the vessel itself at certainpoints; (d) to anaemia. Two or more of these causesmay be combined in any given case. The association oflocalized vaso-motor dilatation with anaemia is particu-larly common. Over the subclavian arteries a short, blowing, systolicmurmur (whiff) is normally heard when the chest isfully expanded. This murmur may become constantand harsher if the artery is contracted or a s
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