. Roentgen interpretation; a manual for students and practitioners . be transmitted through it. Bands of adhesions to thepleura or the chest wall may elevate small stringy or triangularareas. Changes in Mobility.—Slight limitation of motion may be observedwhen the patient is breathing quietly, which disappears completelywith deep respiration. Bilateral limitation of motion may be due9 130 THE CHEST to emphysema, ptosis, ascites, peritonitis, pleuritis at the base ofboth lungs, or fibrosis from an old inflammatory process. Whenunilateral, we must look above the diaphragm for tuberculosis ordise
. Roentgen interpretation; a manual for students and practitioners . be transmitted through it. Bands of adhesions to thepleura or the chest wall may elevate small stringy or triangularareas. Changes in Mobility.—Slight limitation of motion may be observedwhen the patient is breathing quietly, which disappears completelywith deep respiration. Bilateral limitation of motion may be due9 130 THE CHEST to emphysema, ptosis, ascites, peritonitis, pleuritis at the base ofboth lungs, or fibrosis from an old inflammatory process. Whenunilateral, we must look above the diaphragm for tuberculosis ordisease of the pleura on that side or below it for an inflaimiiatoryprocess such as a diseased appendix or gall-bladder, subdiaphrag-matic or liver abscess. Paradoxical excursion of the diaphragm isseen in paralysis of the phrenic nerve and diaphragmatic afiected side rises during inspiration and falls during Fig. 106.—An abscess of the liver which contained gas as well as taken with the patient in the upright position-. The plate Changes in Position.—It is low in ptosis and emph^^sema. It ishigh in adiposity, ascites and subphrenic abscess, eventration andhernia of the diaphragm. Eventration and hernia are both morecommon on the left side. In eventration, although considerablyelevated, its contour is preserved and movement is normal in direc-tion though limited. In hernia its outline is obscured and its move-ment paradoxical. In both cases the barium meal will demonstratethe position of the abdominal viscera. Pleural Effusions.—Pleural effusions obliterate the costodiaphrag-matic angle if small or the entire diaphragmatic shadow if they are LUNG FIELDS 131 extensive. It is worth noting that in rare cases fluid may beobtained from a chest that is roentgenologically negative. Subdiaphragmatic Abscess.—Subdiaphragmatic abscess causesmarked upward displacement of the shadow of
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