Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . g to the valvewhence the sound proceeds—aortic area, pulmonaryarea, tricuspid area and mitral area. The areas do notcorrespond to the anatomical situation of the valves(Fig. 11), but to points on the surface of the chest, towhich the vibrations made at the valves are conductedwith the greatest intensity. (Fig. 59.) The Mitral Area.—The valvular element of the firstsound, heard at the fifth intercostal space, is that pro-duced by the mitral valve. The location of the mitralare
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . g to the valvewhence the sound proceeds—aortic area, pulmonaryarea, tricuspid area and mitral area. The areas do notcorrespond to the anatomical situation of the valves(Fig. 11), but to points on the surface of the chest, towhich the vibrations made at the valves are conductedwith the greatest intensity. (Fig. 59.) The Mitral Area.—The valvular element of the firstsound, heard at the fifth intercostal space, is that pro-duced by the mitral valve. The location of the mitralarea does not correspond with the anatomical site ofthis valve, which is situated behind the left half of the AUSCULTATION. 291 sternum, opposite the insertion of the fourth left costalarticulation. The conduction of the vibrations made atthe mitral valve to the apex is through the tense chorda?tendinea? and papillary muscle and the ventricle wall. The Tricuspid Area.—The sound made at the tri-cuspid valve is heard over the lower end of the of the sound from seat of production to the Fig. From above downwards, showing the anatomical positions of thepulmonic, aortic, mitral and tricuspid valves. The arrow-heads showtheir respective sites of audibility. Shaded portion shows part of leftheart projecting beyond the right heart. lower end of the sternum is due to conveyance by thechorda? tendinese and papillary muscle on the right sideto that portion of the right ventricular Avail which is inclose contact with the lower left edge of the Aortic Area is in the second right intercostal 292 TEE CIRCULATORY SYSTEM. space, close to the sternum, and the second right carti-lage has been called the aortic cartilage. The aorticvalve is situated lower than this area, being behind theleft half of the sternum to the left of the> right thirdinterspace. The vibrations made at the aortic orifice areconveyed to the aortic area through the tense walls of thea
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