Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Displacement of heart and mediastinum to the right by effusion into left pleural sac. Broken line shows level of fluid and position of heart after removal of 76 ounces. X-Ray tracing. the healthy side of a chest when there is pleural effusionon the other side. The superior angle of the triangleis situated on the spine, at about the level of the upperlimit of the effusion; its base is fomied by a line fromone and a half to three inches in length, running alongthe lower border
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . Displacement of heart and mediastinum to the right by effusion into left pleural sac. Broken line shows level of fluid and position of heart after removal of 76 ounces. X-Ray tracing. the healthy side of a chest when there is pleural effusionon the other side. The superior angle of the triangleis situated on the spine, at about the level of the upperlimit of the effusion; its base is fomied by a line fromone and a half to three inches in length, running alongthe lower border of the natural pulmonary resonance, 230 TEE RESPIRATORY SYSTEM. and its internal side is formed by the middle line of theback. Within this area the deficiency of resonance isgreater the nearer one gets to the base and the innerside of the triangle. Kesonance returns when the fluidon the opposite side is removed by aspiration, or is ab-sorbed naturally, and it is lost again when the fluidreaccumulates. All these symptoms are more marked Fig. Dotted line showing position of heart, according to amount of effusion. when the pleural effusion is on the right side than whenit is on the left. They are caused by any kind ofeffusion, whether serous or purulent, and in lie absenceof effusion they are not caused by tumor or by any vari-ety of pneumonia, or by plastic inflammation of thepleura. The importance of Greeces sign is that it fur-nishes an additional means of diagnosis between these DISEASES OF RESPIRATORY TRACT. 231 diseases on the one hand and pleural effusion on the other. 3. Pleurisy- with Adhesion.—Fibrous thickening ofthe pleura with adhesions causes the percussion note tobe impaired over the lower portion of the lung, and isusually associated with retraction of the bony thorax. Auscultation. 1. Dry Pleurisy.—The respiratory Fig. 39.
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