Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . rigth lungthan over the left; that it is more marked over the rightapex than over the left. The reason for this difference in intensity is explainedby the anatomical arrangement of the primary bronchion the two sides and their relation to the trachea. Thebronchus going to the right lung is more nearly a con-:tinuation of the trachea, has a greater lumen, and leavesthe trachea at a less acute angle, so that the vibrationsthat are set up in the larynx reach the entire right lun
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . rigth lungthan over the left; that it is more marked over the rightapex than over the left. The reason for this difference in intensity is explainedby the anatomical arrangement of the primary bronchion the two sides and their relation to the trachea. Thebronchus going to the right lung is more nearly a con-:tinuation of the trachea, has a greater lumen, and leavesthe trachea at a less acute angle, so that the vibrationsthat are set up in the larynx reach the entire right lungwith greater force on account of the larger column of aircontained in the bronchi. PALPATION. 69 Vocal fremitus over the apices of the two lungs differ,being more intense on the right side. This physiological increase of vocal fremitus on theright side often misleads the observer, as its intensitymay suggest a pathological condition of the lung. The cause of this marked increase of vocal fremitusover the apex of the right lung is due to the fact thatthe bronchus supplying the upper lobe is given off from Fig. Diagram showing the relation of the trachea and bronchi to the anterior chest wall. the primary bronchus closer to the trachea, and thevibrations conveyed to the upper lobe of the right lungare correspondingly stronger. Whether or not an in-creased vocal fremitus over the right upper lobe is patho-logical can only be determined by considering othersigns in connection with it. The nearer the bronchi approach to the surface of thelung, and the larger their lumen, the more distinct will 70 THE RESPIRATORY SYSTEM. the vibrations be felt. For this reason the vibrations arestronger over the upper portion of the thorax, betweenthe scapula behind, especially on the right side, and atthe junction of the second intercostal spaces on the rightside and the third on the left, (Fig. 21.) The further the surface of the chest is removed fromthe larynx and trachea, the smaller the br
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