Diseases of the chest and the principles of physical diagnosis . ct (Sahli) (Figs. 17, 26, 36, 83, 84). In order to detect spinal deformities the patient should be sitting,muscularly relaxed, and the examiner should note especiallj: the relativeheight of the shoulders and of the scapulae, the depth of the supra-clavicular fossae, and in women the height of the breasts. The^spineitself is, of course, also inspected both from a lateral and from an antero-posterior aspect. Small degrees of scoliosis may be emphasized by mark-ing the skin over the spinous processes of the vertebrae with a pencil.
Diseases of the chest and the principles of physical diagnosis . ct (Sahli) (Figs. 17, 26, 36, 83, 84). In order to detect spinal deformities the patient should be sitting,muscularly relaxed, and the examiner should note especiallj: the relativeheight of the shoulders and of the scapulae, the depth of the supra-clavicular fossae, and in women the height of the breasts. The^spineitself is, of course, also inspected both from a lateral and from an antero-posterior aspect. Small degrees of scoliosis may be emphasized by mark-ing the skin over the spinous processes of the vertebrae with a pencil. CHAPTER VII NORMAL VARIATIONS OF THE PULMONARY PERCUSSION SOUNDS INDIVIDUAL VARIATIONS There is no invariable normal standard. Actual values must bedetermined largely by the variation of the two sides of the chest, whilethe normal range must be learned by experience. Percussion soundswill vary with: (a) the soft parts overlying the lungs; (6) the flexibilityof the thorax; (c) the size and shape of the lungs, and their state oftension; (d) the region Fig. 85.—Showing normal areas of dulness and flatness caused by and outlining theanatomici position of the heart and the liver. The lower border of the heart cannot be out-lined since it overlies the liver and these organs have acoustically, in so far as percussion isconcerned, identical qualities. The heavy shading indicates the part of these organs whichare uncovered by lung tissue and therefore yield a fiat note. The arrows indicate the di-rection in which percussion should proceed. The light shading shows the areas over whichclear pulmonary resonance is replaced by slight dulness owing to the proximity of the under-lying liver and|heart. (See Figs. 86, 167.) REGIONAL VARIATIONS Anteriorly.—The clearest pulmonary resonance is encountered belowthe clavicles and at the angles of the scapulae. In women a diminutionof resonance and an elevation of pitch—owing to the mammcB—beginsbelow the second interspace. On the
Size: 1771px × 1410px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
