Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . itedto the base. Fluoroscopic examinations have shown thatwhen there is a slight infiltration of the apex there is acorresponding loss of motion of the diaphragm on theaffected side. On the right side the relation of the lungto the liver renders mapping out of the lower border ofpulmonary resonance easy. On the left side, on accountof the relation of the lung to the resonant abdominalorgans, the lower level can only be determined over thatportion of the axillary line where th
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . itedto the base. Fluoroscopic examinations have shown thatwhen there is a slight infiltration of the apex there is acorresponding loss of motion of the diaphragm on theaffected side. On the right side the relation of the lungto the liver renders mapping out of the lower border ofpulmonary resonance easy. On the left side, on accountof the relation of the lung to the resonant abdominalorgans, the lower level can only be determined over thatportion of the axillary line where the lung is in relationto the spleen. (Figs. 31 and 32.) AUSCULTATORY PERCUSSION (Stethoscopic Percussion) In this method the chest piece of the stethoscope isplaced upon the chest over the organ that is under exam- PERCUSSION. 103 ination; mediate and immediate percussion is madefrom a distance toward the point where the stethoscoperests, and the variations in the sound are noted. \\ henthe percussion is made directly oyer the organ amarked increase in the intensity of the vibrations isboth heard and felt. Fig. Within certain limitations it is a valuable method ofexamination, allowing of a differentiation between comditions giving the same sound, as between the flatness olthe heart and liver where the two organs are contiguous;between right-side pleurisy with effusion, pulmonaryconsolidation and liver flatness. 104 TBE RESPIRATORY SYSTEM. In order to be of use, the chest piece of the stetho-scope should be small and rest wholly over the organ*under examination. A special part to replace the ordi-nary chest piece should be used so as to allow of itsbeing placed between the ribs, thus avoiding the vibra-tions readily conveyed by the bony thorax. The per-cussion should be light and, as the value is comparative,the points percussed should be equally distant from thetip of the stethoscope. Another method which I have found very sensitiveand which avoids the vibrations of the bon
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