Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . 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.
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . 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. Percussion outline of the lung (posterior). be fairly forcible, and the resonance gradually dimin-ishes until it is lost at a point which corresponds to thelevel of the spine of the first dorsal vertebra. The uppei*limit of resonance varies in health. After forcible ex-piration it is found lower and the amount of resonanceabove the clavicle is diminished. If a deep inspirationbe taken and the breath held, and the muscles holding PERCUSSION. 101 the bony thorax are allowed to relax, there will be anextension of resonance upwards due to inflation of theapex. The actual carrying upwards of the line of theapex is not as noticeable as the fact that that portionabove the clavicle becomes more resonant. If per-cussion is made over the anterior portion of theapex at the end of forced inspiration and while thepatient by the contraction of the accessory muscles ofinspiration is holding the thorax in an elevated position,very little information can be obtained—in fact, thearea of percussion du
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