Diseases of the chest and the principles of physical diagnosis . eans of the fluoroscope orradiograph the contour of the arch on the affected side is seen to beabnormal. Becker gives the following description: The line is irregular,being fairly clear at some points and blurred in others. There is usuallya reversal of the normal respiratory movement. If bismuth is given,the upper line of the dome becomes very irregular from the new shadows; 638 DISEASES OF THE BRONCHI, LUNGS, PLEURA, AND DIAPHRAGM if the stomach is distended with CO2, the upper hne extends very highand lung shadows mav be seen
Diseases of the chest and the principles of physical diagnosis . eans of the fluoroscope orradiograph the contour of the arch on the affected side is seen to beabnormal. Becker gives the following description: The line is irregular,being fairly clear at some points and blurred in others. There is usuallya reversal of the normal respiratory movement. If bismuth is given,the upper line of the dome becomes very irregular from the new shadows; 638 DISEASES OF THE BRONCHI, LUNGS, PLEURA, AND DIAPHRAGM if the stomach is distended with CO2, the upper hne extends very highand lung shadows mav be seen through the distended stomach ( and 368). Diagnosis.—The condition is most apt to be confused with pneumo-thorax, especially in those cases in which there has been no obviouswound. From the latter evisceration may be distinguished by the ab-dominal flattening, restriction of motion of left chest, absence of bulgingof the intercostal spaces, absence of breath sounds and the presence ofgurgling sounds peculiar to the stomach and intestines. Examination. Fig. 368.—Same as Fig. 367. Showing bismuth in the stomach. with the X-rays will readily distinguish the two conditions. Eviscera-tion is also to be distinguished from eventration which is next to beconsidered. EVENTRATION OF THE DIAPHRAGM Eventration is a relatively rare condition. It is characterized by ageneral expansion of one-half of the diaphragm allowing the abdominalviscera to be displaced upward into the thoracic cavity. It differsfrom hernia and evisceration in that the contour of the affected dome isnot irregular. There is neither a bulging nor a locahzed opening (). Various names have been applied to the condition, the terms em-ployed being more or less descriptive of what is presumed to be theanatomical factor. Thus it has been referred to as insufficiency, relaxa-tion, dilatation, high position or elevation of the diaphragm. DISEASES OF THE DIAPHRAGM 639 Etiology.—There are two hypotheses as to t
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
