Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Oeep Seated Consolidation masked by V Empliysematous Lung Localized EmphysemaCompensatorytoConsolidation(Dulness) Dulness withTympanitic quality resonance. If the displacement of the air is completethen percussion of that portion of the lung will be sim- 96 TEE RESPIRATORY SYSTEM. ilar to that obtained over any solid, airless tissue, as thethigh or liver, and the sound will be designated as flat, It is necessary that a clear distinction be made be-tween dullness and flatness.
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Oeep Seated Consolidation masked by V Empliysematous Lung Localized EmphysemaCompensatorytoConsolidation(Dulness) Dulness withTympanitic quality resonance. If the displacement of the air is completethen percussion of that portion of the lung will be sim- 96 TEE RESPIRATORY SYSTEM. ilar to that obtained over any solid, airless tissue, as thethigh or liver, and the sound will be designated as flat, It is necessary that a clear distinction be made be-tween dullness and flatness. As long as any resonancecan be detected, the term dullness must be used withsome qualifying word denoting its degree. Flatnessmeans that the sound is absolutely devoid of any reso-nance. Fig. Absolute and relative heart and liver dullness and flatness. It is rare for pulmonary consolidation to give a per-fectly flat note, as there is usually enough air in thebronchi of the affected portion to give slight resonance. Liquid effusions and solid growths in the pleura]cavity are frequently large enough to give a perfectlyflat sound. The percussion note obtained when the lung has beenrendered more or less airless or solid depends upon the PERCUSSION. 97 seat of the consolidation. If the consolidated area isclose to the surface, immediately underneath the pleura,its influence upon the resonance would be marked andit can be best detected by light rather than by heavypercussion. If it is situated deeper in the lung andseparated from the pleura and bony thorax by a zoneof air-containing lung, then, in direct proportion to itsdepth, will it influence the resonance obtained and moreforcible percussion is needed. This can be best under-stood by referring to Figs. 28 and 29. (5) Influen
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