Clinical tuberculosis . ion of the apices while the patients head is erect and tension removedfrom the sternocleidomastoideus and other neck muscles. B, wrong position, percussingsame when the head is turned and bent over toward the opposite side, thus putting thesternocleidomastoideus and other muscles on tension, thereby raising the pitch of thepercussion note and increasing the resistance to the percussion finger. PERCUSSION 41J same conditions as possible. The arms should be in the sameposition. All muscles should he relaxed. The hc<id should bein the median position. A very common erro
Clinical tuberculosis . ion of the apices while the patients head is erect and tension removedfrom the sternocleidomastoideus and other neck muscles. B, wrong position, percussingsame when the head is turned and bent over toward the opposite side, thus putting thesternocleidomastoideus and other muscles on tension, thereby raising the pitch of thepercussion note and increasing the resistance to the percussion finger. PERCUSSION 41J same conditions as possible. The arms should be in the sameposition. All muscles should he relaxed. The hc<id should bein the median position. A very common error is to percuss onesupraclavicular notch with the head erect and face forward andthe other with the face turned to one or the other side; or tryingto compare findings derived while the head is turned to oneside, as shown in Fig. 88, A and B. Turning the face to the op-posite side throws the muscles of the neck on a stretch whichresults in a higher pitched note and greater resistance to the M. scalenusposterior M. trapez. M. sternociei(io-niastoideus M. scalenus medius M. scalenus anterior Fig. 89.—Important muscles which affect percussion of apices anteriorly, shownschematically. (Gerhartz.) finger, thus giving wrong information. The important muscleswhich affect apical percussion anteriorly are shown schematicallyin Pig. 89. The percussion note differs in different chests. Each must beconsidered by itself, consequently there is no note or tone thatcan be interpreted to mean a definite pathological condition. In-creased or decreased resistance to the finger, however, alwaysmeans relatively greater or lesser density of tissue. 420 DIAGNOSIS OF EARLY PULMONARY TUBERCULOSIS Percussion Changes in Early Clinical Tuberculosis.—The per-cussion liudings in early tuberculosis vary greatly in different in-dividuals, and are modified by the nature of the infiltration itself;l)y the condition of the lung tissue and surrounding structures; bythe elasticity of the bony thorax; by the amo
Size: 1507px × 1659px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherstlou, bookyear1922
