The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . Fig. 21.—Dotted lines indicate percussion area. PERCUSSION. Percussion of the heart is very easily and rapidly carried determine the deep or relative cardiac dullness the examinershould percuss with moderate force along lines converging towardthe center of the heart, beginning always well outside the normallimits. If the heart be normal, a marked increase in resistanceand rise of pitch will occur just within the nipple line on thel
The medical examination for life insurance and its associated clinical methods : with chapters on the insurance of substandard lives and accident insurance . Fig. 21.—Dotted lines indicate percussion area. PERCUSSION. Percussion of the heart is very easily and rapidly carried determine the deep or relative cardiac dullness the examinershould percuss with moderate force along lines converging towardthe center of the heart, beginning always well outside the normallimits. If the heart be normal, a marked increase in resistanceand rise of pitch will occur just within the nipple line on theleft, the third cartilage above, and the left sternal edge on the I III I \ \MI\ VI I- >.\ Ml Illl ( III 51 . ri^lu.* The lower border is so i losely in contact with the livit make its delimitation difficult. Very fine shades of duttmelicited by heavy percussion, had best he disregarded. Superficial Cardiac Area. To percuss the superficial cardiacarea it is better to commence at the center of known dullness andpercuss lightly in lines radiating from that center until tin- note. I- [G. jr.—11. •? ? ea, of relative dullness is obtained. Percussion over the manubriumsterni should nevi r be omitted. (See Fig. i |. Significance of Changes in Percussion Areas. -Ini rease inthe area of superficial dullness means usually one of three things:I ment of the heart. (b) Retraction of the lung. (c) Pericardial effusion. * Some clinicians make the right sternal margin or midsternal line;boundary of relative dullness. 226 THE MEDICAL EXAMINATION FOR LIFE INSURANCE. out murmurs. The examiner .should always have in mind the jact that seriousDilatation with- dilatation oj the heart may manifest itself in an increased area ofdullness though no murmur be present. Moreover, the shape ofthe area of relative heart dullness often assists a diagnosis. Areference to the three figures (Figs. 21, 22, and 23) will show theeffect of hypertrophy of the left ventricle, of the right ventricle,and of bot
Size: 1572px × 1590px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectdiagnosis, bookyear19
