Diseases of the chest and the principles of physical diagnosis . ough, and afterward breathe crepitant rales of early tuberculosis may thus be elicited (latentrales). They are also more apt to be heard before or during the periodof the morning cough, when such is present. Owing to the faintness oftheir sound, rales are only rarely heard at a distance from the seat oftheir origin, although it is said that they are occasionally conducted alongthe ribs and may even be heard in the opposite lung. Certain tinkling, gurgling and splashing sounds may be heard overthe chest, especially near
Diseases of the chest and the principles of physical diagnosis . ough, and afterward breathe crepitant rales of early tuberculosis may thus be elicited (latentrales). They are also more apt to be heard before or during the periodof the morning cough, when such is present. Owing to the faintness oftheir sound, rales are only rarely heard at a distance from the seat oftheir origin, although it is said that they are occasionally conducted alongthe ribs and may even be heard in the opposite lung. Certain tinkling, gurgling and splashing sounds may be heard overthe chest, especially near the spinal column, as the result of liquid passingdown the esophagus when the patient swallows. These sounds are oftenmarked and delayed in the presence of a diverticulum. 128 THE EXAMINATION OF THE LUNGS Expansion—. V. frem-itus O- + , Breatlisounds,O, metallic |tinkle +,succusionsplash +,bell tym-pany + ,[nterspacesfull. Ex-panison — ,Phrenicwave O. O-V. reso-[nance O-Movabledulness +-t-. Breathsounds O,Metallictinkle -|- J. Fig. 1D6.—Hyuho-pneumothorax. The right pleural cavity is represented as partlyfilled with fluid, partly with air. The rupture of the lung has occurred below the presentfluid level, so that the fistulous tract opens into the effusion and bubbles are given off duringrespiration. The right lung is collapsed. The left lung is functionating compensatorilydespite its compression. Siiccussion splash may be elicited because both air and liquid arepresent in a large cavity. Metallic tinkle is due to bubbles from the fistulous tract passingup through the effusion, not to drops of liquid falling upon the surface of the effusion. ADVENTITIOUS BREATH SOUNDS 129 Expansion—. Vocalfremitus+ . Vocalresonance+ . Percus-sion: highpitchedtympany,Breathsounds :,broncho-vesicular Expansion—. Inter-spaces O-Vocal reso-nance O- ,percussion |dulness + + +.Breathsounds O-Phrenicshadow O-
Size: 1377px × 1815px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
