Diseases of the chest and the principles of physical diagnosis . gins at the periphery and gradually spreads inwardtoward the hilus and although dulness occurs quite early, bronchialbreathing and bronchophony do not appear until the entire fan-shapedarea of lung tissue lying between the pleura and the large bronchi hasbecome consohdated (see Fig. 97). Bronchial breathing is never heard over normal lu7ig tissue. It maj beimitated by a harshly whispered Ha or by a guttural Ch. 120 THE EXAMINATION OF THE LUNGS Cavernous Breathing.—This type of breathing may be heard overcavities and open pneumoth
Diseases of the chest and the principles of physical diagnosis . gins at the periphery and gradually spreads inwardtoward the hilus and although dulness occurs quite early, bronchialbreathing and bronchophony do not appear until the entire fan-shapedarea of lung tissue lying between the pleura and the large bronchi hasbecome consohdated (see Fig. 97). Bronchial breathing is never heard over normal lu7ig tissue. It maj beimitated by a harshly whispered Ha or by a guttural Ch. 120 THE EXAMINATION OF THE LUNGS Cavernous Breathing.—This type of breathing may be heard overcavities and open pneumothoraces. It is low in pitch, and has a hollowreverberating quality. Frequently the expiration is even lower-pitchedthan the inspiration, the relations of bronchial breathing being thusreversed. As pointed out by Flint, it is more apt to be confused withnormal vesicular breathing, than with the bronchial type, and is to be , a c : Soil C^— ^ C ^ C 0-5 C3_ C3 rt 2 i!. «-£-o M i S c „ o o j: j; c. o £ S 5 o S o .»>.? w+iS>2icfi;^ iJ ^ £ 7 S. c3 a >- H 3 |Sa2T3 I t4 a a —• a-33-3-2 g 0* M > t^ n £? S* r 3 s C-S £ -o - o-^c-Ct^-^ see^§<°S-2 3 - - - <u i:s S-e a^ o 3 g c fc-e g, M X - * W I o 03 I- II T3v3 r? i ? j; fy differentiated from the former only by the absence of the vesicularquality in the inspiratory sound (Flint). The expiration is always pro-longed and puffing (Loomis). Phonetic equivalent = whispered authors deny the existence of cavernous breathing altogether,classing it as a variety of bronchial breathing—low-pitched breathing may be imitated by breathing into the hollowed NORMAL AND ABNORMAL BREATH SOUNDS 121 hands It is heard normally over the occiput, especially if the mouth beclosed (see Fig. 96). Like bronchial breathing, cavernous breathing has its origin in theupper respiratory tract. In the former, however, we are dealing notmerely with ordinary bronchi but also with excavati
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