Diseases of the chest and the principles of physical diagnosis . t should be instructed to 22 THE EXAMINATION OF THE LUNGS assume a natural posture and not, on the one hand, to sit too rigidly, or,on the other, to assume a slouching position. The standing position maybe selected if the examiner prefers it, but it is not as convenient and if theexamination takes much time is tiring both for the patient and theexaminer. Inspection of the chest in patients who are confined to bed and acutelyill is never as satisfactory as in those who can sit or stand up. Further-more, only the anterior aspect of
Diseases of the chest and the principles of physical diagnosis . t should be instructed to 22 THE EXAMINATION OF THE LUNGS assume a natural posture and not, on the one hand, to sit too rigidly, or,on the other, to assume a slouching position. The standing position maybe selected if the examiner prefers it, but it is not as convenient and if theexamination takes much time is tiring both for the patient and theexaminer. Inspection of the chest in patients who are confined to bed and acutelyill is never as satisfactory as in those who can sit or stand up. Further-more, only the anterior aspect of the chest, as a rule, is available for themethod. Another difficulty is that in private houses the light frequentlycomes from one side onh, so that half of the chest is in a shadow whichseriously interferes with a good view. In very ill patients this methodof physical examination, in common with the other procedures, suffersfrom a lack of thoroughness which is often unavoidable. If the exami-nation of the patient in the recumbent attitude is unavoidable, care. Fig. 6.—The topography of the chest anteriorly. For purposes of description the chest isdivided into certain regions which are shown in this and in the following figure. should be taken to see that the body rests on an even plane; otherwisethe results maj be affected very materialh (see p. 202). To fix a standard of what constitutes a normal chest which shallserve as a criterion by which to estimate either the existence of or thedegree, of abnormal variations, is not possible. Individuals entirelyfree from thoracic disease present the greatest variations in the conforma-tion of their chests. The Conformation of the Normal Chest.—-Providing that the chestdoes not present some one of the recognized deformities, it is assumedto be normal if it is sjmmetrical, not onh generally but in its differentparts. The shoulders should be on the same level and the line from theneck to the point of the shoulder slightly convex. In m
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
