Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . est. This type of chest has also been called thePhthisical. In many cases of pulmonary tuberculosisthe flattening of the thorax is more apparent than real,being due to the marked emaciation and loss of muscle-tissue. Actual measurements in cases of pulmonarytuberculosis often show that both diameter are below 50 THE RESPIRATORY SYSTEM. the normal, but the antero-posterior not more so thanthe transverse. The diminution in the size of the bonythorax gives the chest a flattened
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . est. This type of chest has also been called thePhthisical. In many cases of pulmonary tuberculosisthe flattening of the thorax is more apparent than real,being due to the marked emaciation and loss of muscle-tissue. Actual measurements in cases of pulmonarytuberculosis often show that both diameter are below 50 THE RESPIRATORY SYSTEM. the normal, but the antero-posterior not more so thanthe transverse. The diminution in the size of the bonythorax gives the chest a flattened look on account of theprominence of the shoulders, clavicle and scapula. Athorax flattened at the upper portion is of especialimport, as it occurs most frequently in connection withtubercular infiltrations of the apices of the lungs. Suchflattening at the top may be present with good or evenrelatively increased antero-posterior diameter below. The pathological conditions which tend to produce theflat type of chest are thickening of the intercostal pleura,which interferes with the elevation of the ribs and Fig. Rachitic chest. Circumference = line indicates the shape of chest in an infantabout the same age. (Gee.) widening of the intercostal spaces during inspiration;thickening of the pulmonary pleura preventing the nor-mal expansion of the lungs; changes in the lung whichdiminish its elasticity, as tubercular induration, fibro-sis, etc., and the closure of the bronchi, which preventsthe entrance of air into the lung. (3) The Rachitic Types.—In the simplest form thereis a flattening laterally of the chest, especially in thelower segment; while in the upper portion the sternumis carried forward and the ribs are more or less straight-ened, so that the antero-posterior diameter of the chest H p OP» wo
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