Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . easurement in centimetresCircumference = natural, emphysematous, = Anteroposterior = (Dr. Gee.) from the rounded thorax. The normal anteroposteriorcurvature of the spine is increased. Bilateral or uniform enlargement is most frequentlycaused by pulmonary emphysema (large lung) : it occursalso during attacks of asthma (temporary emphysema),bilateral pleurisy with effusion, hydro-thorax and cancer(rare). 48 THE RESPIRATORY SYSTEM. (2)
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . easurement in centimetresCircumference = natural, emphysematous, = Anteroposterior = (Dr. Gee.) from the rounded thorax. The normal anteroposteriorcurvature of the spine is increased. Bilateral or uniform enlargement is most frequentlycaused by pulmonary emphysema (large lung) : it occursalso during attacks of asthma (temporary emphysema),bilateral pleurisy with effusion, hydro-thorax and cancer(rare). 48 THE RESPIRATORY SYSTEM. (2) The Paralytic, Alar, or Pterygoid Chest.—In thistype there is an abnormal flattening of the sternumand ribs, so that the anteroposterior diameter of thechest is diminished and there is a slight increase in thelateral diameter. (Fig. 15.) The depression of the ribs and of the sternum carriesthe sternal end of the clavicle downwards, lengtheningthe neck and causing the chin to project farther forwardthan normal over the anterior plane of the thorax, givinga characteristic appearance to the individual. Fig. 15. R f. /5 c The flat or phthisical chest, short anteroposterior, long traverse diameter. (Gee.) The angle of the plane of the clavicle with the scapula*and sternum alters the depressions above the clavicles,increasing their depth, the intercostal spaces are deep-ened. The shoulder blades are depressed and stand outfrom the ribs, giving the winged appearance (alar, orpterygoid). The movements on quiet breathing may be nearlynormal in frequency and extent, but on exertion orforced breathing expansion is less than normal, andthe movements become more rapid. This type may be simulated in marked emaciation bydiminution in the soft parts which normally give the INSPECTION. 49 rounded contour to the upper portion of the chest. Lackof muscular development, or changes in the muscles ofrespiration, such as occur from long recumbence in bed,cause slight depressions of the bony thorax,
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