Archives of internal medicine . aracter 5. Groedel, F. M.: Deutsch. Arch, f. klin. Med., 1908, xciii, 79. 144 THE ARCHIVES OF INTERNAL MEDICINE of the one or the other. It may be noted from the examples given howclosely the heart of nephritis approaches that of aortic regurgitation inmany cases (see ^ig^^res 3, 10 and 11). It was felt that a numerical expression of the shape of ihe heartsilhouette would be of assistance in the study of such combined lesionsand of cardiac changes which were not secondary to valvular disease. Forthis purpose, there are only four available fixed landmarks on the
Archives of internal medicine . aracter 5. Groedel, F. M.: Deutsch. Arch, f. klin. Med., 1908, xciii, 79. 144 THE ARCHIVES OF INTERNAL MEDICINE of the one or the other. It may be noted from the examples given howclosely the heart of nephritis approaches that of aortic regurgitation inmany cases (see ^ig^^res 3, 10 and 11). It was felt that a numerical expression of the shape of ihe heartsilhouette would be of assistance in the study of such combined lesionsand of cardiac changes which were not secondary to valvular disease. Forthis purpose, there are only four available fixed landmarks on the cir-cumference of the heart shadow (Fig. 1), namely, the right auriculo-venous junction (a), the auriculohepatic angle (c), the upper extremityof the left ventricular border (&), and the apex of the heart (d). Withgood illumination these landmarks may be fixed in the majority ofcases, especially in the erect position, which is the position chosen in ourwork. In this position the diaphragm rests at a lower level and the apex. Fig. 6.—Mitral regurgitation, typical round heart. Case 96. cm.; cm.; long diameter ; area 121; index .834. of the heart can be more easily followed through the liver shadow. Forcomparable results it is of course necessary to use a uniform technic. Of these landmarks, a and b represent definite anatomical points andwill vary in position as the auricles vary in distention and size. Innormal cases, b usualty represents the junction of the conus arteriosusand the ventricle, but in enlarged hearts the left auricle frequentlypresents, and it then represents the junction of its shadow with that ofthe ventricle. Point c varies with a number of conditions, such as thedegree of dilatation of the right auricle, changes in the obliquity of thecardiac axis, lengthening of the arch of the aorta, elevation of the dia-phragm from abdominal distention or its depression in emphysema,splanchnoptosis, and so forth. The apex (d) is the most important of
Size: 1564px × 1598px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidarchi, booksubjectmedicine
