. Diseases of the heart and thoracic aorta. Fig. 158. Fig. 159. Fig. 158.—Pericardium distended into fifteen ounces of fluid. (After Sibson.)Fig. 159.—Case of pericarditis in w/iick the sac contained 3^ lbs. of fluid. Altered Position of the Heart and Apex effusion at first collects at the sides of the heart, atthe bottom of the pericardial sac, and around the great Physical Signs of Ac2iie Pericarditis. ;2i. Fig. ido. —OiUlme of percussion dulness hi a case of perica7-dial effusion.(After Sibson.) vessels. As it becomes more and more copious the sacbecomes, of course, more and more d
. Diseases of the heart and thoracic aorta. Fig. 158. Fig. 159. Fig. 158.—Pericardium distended into fifteen ounces of fluid. (After Sibson.)Fig. 159.—Case of pericarditis in w/iick the sac contained 3^ lbs. of fluid. Altered Position of the Heart and Apex effusion at first collects at the sides of the heart, atthe bottom of the pericardial sac, and around the great Physical Signs of Ac2iie Pericarditis. ;2i. Fig. ido. —OiUlme of percussion dulness hi a case of perica7-dial effusion.(After Sibson.) vessels. As it becomes more and more copious the sacbecomes, of course, more and more distended, and the heartis pushed upwards, the apex being tilted towards the consequence of this alteration in the position of the heart,the position of the cardiac impulse is altered, the lowerboundary of the impulse being situated in the fourth or eventhe third, instead of in the fifth interspace, as it is in apex beat not unfrequently corresponds to the leftnipple, and in some cases it may be situated slightly above,and to the outer side { to the left) of the nipple. Whenthe effusion is copious, the apex beat is usually impaired inforce or altogether effaced. In exceptional cases, owing tothe fact that the heart is enlarged, as the result of previousdisease, or tied down, as the result of previous pericarditicadhesions, the position of the heart and apex beat is notaltered. When the
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectheart, bookyear1884
