Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Pulmonic systolic anaemic murmur. artery (most commonly). In anaemic murmurs thepoint of maximum intensity and area of diffusion ismore variable than in those dependent on stenosis atorifice. (Figs. 73 and 74.) Pulmonic Diastolic Murmurs.—This murmur isvery rare. The point of maximum intensity is over thepulmonic valve area. The area of diffusion is along the AUSCULTATION. 31 left edge of the sternum. It may occur (a) from con-genital malformation or ulcerative endocarditis;
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Pulmonic systolic anaemic murmur. artery (most commonly). In anaemic murmurs thepoint of maximum intensity and area of diffusion ismore variable than in those dependent on stenosis atorifice. (Figs. 73 and 74.) Pulmonic Diastolic Murmurs.—This murmur isvery rare. The point of maximum intensity is over thepulmonic valve area. The area of diffusion is along the AUSCULTATION. 31 left edge of the sternum. It may occur (a) from con-genital malformation or ulcerative endocarditis; (b)from relative insufficiency caused by dilatation of thepulmonary artery or orifice. (Fig. 75.) Exocardial Murmurs. A. Arterial Murmurs.—Thepresence over the aorta of the normal cardiac sounds, andof murmurs made at the aortic orifice and in aorta, has Fig. Anaemia, pulmonic systolic. already been mentioned, and will be still further consid-ered under diseases of the aorta. When the stethoscope is lightly applied to the carotidand subclavian arteries the normal first and secondcardiac sounds may be faintly heard; the first soundweak and low pitched, the second sound louder, higherpitched and snapping, corresponding to its character 318 THE CIRCULATORY SYSTEM. at the aortic cartilage. Over the arteries that arefurther removed from the heart, as the brachial, crural,femoral, etc., no sound is normally heard unless thepressure of the stethoscope is sufficiently hard to com-press the artery, when there is heard a systolic mur-mur (pressure murmur), whose intensity correspondsto the degree of narrowing, and which may have amusical quality. Fig. 75.
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