Diseases of the chest and the principles of physical diagnosis . Fig. 5U. Fig. 51. Figs. 50 and 51.—The dots indicate the areas of the chest over which vocal fremitus andvocal resonance are normally most intense. The solid lines indicate the lower margins ofthe areas over which these phenomena are obtainable (lower pulmonary border). Thedotted lines indicate the lower margin during forced inspiration, the lungs having expandeddownward, filling the complemental space. Downward movement of the percussion reso-nance from the solid to the dotted lines during inspiration also indicates pulmonaryexp
Diseases of the chest and the principles of physical diagnosis . Fig. 5U. Fig. 51. Figs. 50 and 51.—The dots indicate the areas of the chest over which vocal fremitus andvocal resonance are normally most intense. The solid lines indicate the lower margins ofthe areas over which these phenomena are obtainable (lower pulmonary border). Thedotted lines indicate the lower margin during forced inspiration, the lungs having expandeddownward, filling the complemental space. Downward movement of the percussion reso-nance from the solid to the dotted lines during inspiration also indicates Fig. 52.—Advanced bilateral pulmonary tuberculosis. Both upper lobes containcavities of variable, but for the most part small, size, surrounded by completely infiltratedlung tissue. The lower lobes of the lung are relatively uninvolved. Fremitus was muchincreased over the upper lobes and was associated with bronchophony and percussion dul-ness, having, especially in the left axilla (large cavity) a tympanitic quality. Clear-cutmetallic rales were heard, as well as whispered pectoriloquy. The lower lobesyielded animpaired note with diffuse crackling rales. Expansion over the upper chest was almostabsent. 52 THE EXAMINATION OF THE LUNGS from suiTouiuliiig consolidated lung, in other words, failure to localizethe fremitus directly over the cavity. Fremitus is Normally Feeble.— (a) As the result of overlying fat ormammary glands (vibratory reflection). (6) In women and children because the chest, the resonator, is not inas favorable a relation with vocal cords as in men and because th
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
