Diseases of the chest and the principles of physical diagnosis . dilatation and pulsation are demonstrable.^ 1 Pesci, G. : Laugmento di volume della brecchietta sinistra del cuore nel quadroradiologico. Radiologia med., I, 1914, 106. Wt^* ^<^^ QQ\JiUB^^ ...ViB SHY PERCUSSION OF THE HE 213 Increased dulness at the base is generally due to dilatation or aneur-ism of the aorta (Figs. 409, 412); it may in rare instances be due to apatulous ductus arteriosus. This lesion produces a quadrilateral area ofdulness to the left in the second (and first) interspace. Accurate outliningby percussion of t
Diseases of the chest and the principles of physical diagnosis . dilatation and pulsation are demonstrable.^ 1 Pesci, G. : Laugmento di volume della brecchietta sinistra del cuore nel quadroradiologico. Radiologia med., I, 1914, 106. Wt^* ^<^^ QQ\JiUB^^ ...ViB SHY PERCUSSION OF THE HE 213 Increased dulness at the base is generally due to dilatation or aneur-ism of the aorta (Figs. 409, 412); it may in rare instances be due to apatulous ductus arteriosus. This lesion produces a quadrilateral area ofdulness to the left in the second (and first) interspace. Accurate outliningby percussion of the normal aorta and pulmonary artery is difficult anderroneous results are frequent, owing to the overlying sternum. Method of Recording the Size of the Heart.—After outhning the heartby percussion and drawing hues upon the skin to correspond with thearea of dulness, the following dimensions should be measured and recorded. A Hne is drawn from the cardio-hepatic angle to the lowermost portionof the left border. A second line is drawn from the upper border of. Fig. 175.—Moritzs conjugates. cardiac dulness down the middle of the sternum to connect with the firstline. The extremes of these lines are connected and the following dimen-sions recorded in centimeters. Height (S. H.); Left obhque (L. S.); Right obhque (R. S.); Rightbase (R. H.); Left base (L. H.) (see Fig. 173). These dimensions undergo characteristic variations in different valvu-lar lesions, owing to a disproportionate increase in the size of differentchambers. Thus the left base is increased in left ventricular hypertrophyand in mitral insufficiency. The right base is increased in tricuspid lesionsand dilatation of the right auricle. The height is increased in aorticdisease, etc. (Fig. 172). Moritz has suggested a somewhat different method of recording thecardiac area which has found considerable favor, the dimensions thus ob-tained being known as Moritzs conjugates (Fig. 175).| 214 THE EXAMINATION OF CIRCULATORY
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