. Medical diagnosis for the student and practitioner. Fig. 123.—Selective points formanifestation of physical signs inpulmonary tuberculosis. THE EXAMINATION OF THE LUNGS AND PLEURA 307 Hon and expiration arc Hgk-pitched; between them is a distinct break. Expira-tion is greatly prolonged, its intensity being equal to or even greater than that ofinspiration and its pitch usually higher. Pathologic—Such breathing indicates consolidation, cavitation or com-pression of lung tissue in close relation to a patent bronchus. Thus it is heard in pneumonia and established or advanced phthisicalinfiltrati
. Medical diagnosis for the student and practitioner. Fig. 123.—Selective points formanifestation of physical signs inpulmonary tuberculosis. THE EXAMINATION OF THE LUNGS AND PLEURA 307 Hon and expiration arc Hgk-pitched; between them is a distinct break. Expira-tion is greatly prolonged, its intensity being equal to or even greater than that ofinspiration and its pitch usually higher. Pathologic—Such breathing indicates consolidation, cavitation or com-pression of lung tissue in close relation to a patent bronchus. Thus it is heard in pneumonia and established or advanced phthisicalinfiltration, over lung compressed by mediastinal or other tumors or by. Fig. 124.—Malignant growth (left) and pulmonary abscess (right). The larger mass onthe left side involves a bronchus, and would yield signs of consolidation. The anteriorsuperficial mass would present only dulness, diminished voice and breath sounds, withdefective lung movement on the affected side. Such abscesses as are here shown presentfew recognizable physical signs and are often overlooked. Malignant growths of the typeshown are usually marked by hemorrhagic effusion. massive pleural or pericardial effusion, but still maintaining communicationwith a patent bronchus. Because of such compression probably, the locally intensified voice andbreath sounds and especially the whispered voice are fairly well conductedfrom the condensed lung in some cases of effusion. In such instances the flat,toneless percussion note and usually (though paradoxically) a markedlyimpaired or wholly absent palpatory voice fremitus over the area of flatnesssuggests the correct diagnosis. The breathing is,
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
