. A practical treatise on medical diagnosis for students and physicians . i^m ^ FIG. 2.—Posterior Aspect. /^ sJ^Ao <r^&t Pleurisy with Effusion (right-sided).. :■ / -T&-. (v^ M/j^ FIG. 2.—Posterior Aspee -A;; Pleurisy with Effusion (left-sided) ACUTE PLEURISY. 911 level will change with the position of the patient if the fluid is free. Ifthe upper level is at the third interspace when the patient is sitting up,it will fall to the fourth or lower when he is lying down. This changeof level can not be appreciated when the eifusion is very large. More-over, above the line of dulness the percuss
. A practical treatise on medical diagnosis for students and physicians . i^m ^ FIG. 2.—Posterior Aspect. /^ sJ^Ao <r^&t Pleurisy with Effusion (right-sided).. :■ / -T&-. (v^ M/j^ FIG. 2.—Posterior Aspee -A;; Pleurisy with Effusion (left-sided) ACUTE PLEURISY. 911 level will change with the position of the patient if the fluid is free. Ifthe upper level is at the third interspace when the patient is sitting up,it will fall to the fourth or lower when he is lying down. This changeof level can not be appreciated when the eifusion is very large. More-over, above the line of dulness the percussion-note is hyper-resonant ortympanitic—Skodas resonance. Toward the spine on the affected sidethere may be partial resonance and bronchial breathing, because here thelung is compressed against the vertebra?. In large effusions the tympaniticresonance in the second interspace does not change when the mouth isI opened—that is, Williams tracheal tone can often be elicited. Theupper limit of dulness in large pleural effusions is higher at the spine andslopes downward, and is lowest in front. This parabolic line is onlyobtained when the patient is
Size: 2345px × 1065px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidpracticaltre, bookyear1904
