. Physical diagnosis . time. If the layer oflamellated clot in the sac is very thick, the thrill is less apt to be felt. - ft j 3^ * Fig. 173.—Position When Looking for Slight Aneurysmal Pulsation. Diastolic Shock. • ? More important in diagnosis is a diastolic shock or tap which isappreciated by laying the palm of the hand lightly over the affectedarea. This diastolic shock is due to the recoil of the blood in thedilated aorta, and is one of the important and characteristic signs inaneurism. As the wall of the sac becomes weaker, the intensity ofthis shock diminishes. This diastolic shock may
. Physical diagnosis . time. If the layer oflamellated clot in the sac is very thick, the thrill is less apt to be felt. - ft j 3^ * Fig. 173.—Position When Looking for Slight Aneurysmal Pulsation. Diastolic Shock. • ? More important in diagnosis is a diastolic shock or tap which isappreciated by laying the palm of the hand lightly over the affectedarea. This diastolic shock is due to the recoil of the blood in thedilated aorta, and is one of the important and characteristic signs inaneurism. As the wall of the sac becomes weaker, the intensity ofthis shock diminishes. This diastolic shock may be appreciated overthe trachea also, and is thought by some to have even more signifi-cance when felt in this situation. Of special importance in aneurism of the transverse arch is the signknown as the tracheal tug. The arch of the aorta runs over the left THORACIC ANEURISM 265 primary bronchus in such a way that when the aorta is dilated, thebronchus is pressed upon with each expansile pulsation of the Fig. 174.—Aneurismal Tumor (.4). The arrow B points to a gummatous swellingnear the ensiform cartilage. The radiographic appearances of this case are shown below(Fig. 177).
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectdiagnos, bookyear1912
