Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . present. These variations are noted inFig. 30. PERCUSSION OUTLINE OF LUNG. Percussion gives valuable information concerningthe size and mobility of the lung, and no examina-tion is complete unless the percussion outline of theborders of the lung during inspiration and expira-tion is determined/ The only boundaries or bordersthat can be definitely mapped out by percussion are thesuperior or apex of the lung, the inferior or bases, andthat portion of the anterior that is not co
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . present. These variations are noted inFig. 30. PERCUSSION OUTLINE OF LUNG. Percussion gives valuable information concerningthe size and mobility of the lung, and no examina-tion is complete unless the percussion outline of theborders of the lung during inspiration and expira-tion is determined/ The only boundaries or bordersthat can be definitely mapped out by percussion are thesuperior or apex of the lung, the inferior or bases, andthat portion of the anterior that is not covered by thesternum and overlies the heart. Above the clavicle theapices of the lung rise from one to one and one-half PERIJUXSION. 99 inches. In exceptional cases they may reach as high astwo inches. The apex is free and unsupported by bone-,but below is bound down by the rigid first rib. Thoright apex rises somewhat higher than the left (one-halfinch), but this is not demonstrable by percussion. It isimpossible by percussion to map out with absoluteaccuracy the upper border. The most that can be deter- Fig. Relation of lungs, pleura, heart and liver to bony thorax. mined is the decree of resonance above the clavicle andthe changes that occur with inspiration and account of the difference in the thickness of the over-lying tissue the force of the percussion blow must that portion that lies above the clavicle and is boundtowards the median line by the inner side of the sterno-mastoid muscle and later ally by the inner border of the 100 TEE RESPIRATORY SYSTEM. trapezius, the percussion blow must be very light. Itwill be noted that the resonance diminishes from theclavicle upwards until about two fingers breadth abovethe clavicle the note becomes dull. Over the trapezius,from the inner side of the trapezius to the vertical linealong the spine and which corresponds to the posteriorportion of the apex of the lung, the percussion Wow must Fig. 32.
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