Diseases of the chest and the principles of physical diagnosis . line drawn from the middle of that just described, to the third costo-sternal articula-tion. {After Doyen, Bouchon and Doyen.) Fig. 70.—Left lung. The interlobar fissure may be located by drawing a line from thefourth dorsal vertebra to the sixth costo-sternal articulation. These relations are not ab-solutely fixed, but are subject to individual variations. {After Doyen, Bouchon and Doyen.) The vertebral spines correspond to the level of the rib below. Thefirst rib begins and is in direct articulation with, the seventh cervicalve
Diseases of the chest and the principles of physical diagnosis . line drawn from the middle of that just described, to the third costo-sternal articula-tion. {After Doyen, Bouchon and Doyen.) Fig. 70.—Left lung. The interlobar fissure may be located by drawing a line from thefourth dorsal vertebra to the sixth costo-sternal articulation. These relations are not ab-solutely fixed, but are subject to individual variations. {After Doyen, Bouchon and Doyen.) The vertebral spines correspond to the level of the rib below. Thefirst rib begins and is in direct articulation with, the seventh cervicalvertebra. The second rib articulates with the second and third verte-brae, the third rib with the third and fourth vertebrae, etc., but theeleventh and twelfth ribs articulate directly with their respective verte-brae. The scapulce overlie the second to the seventh or the third tothe eighth ribs. The hilus of the lung lies opposite to the spines of thefourth, fifth and sixth, and the bodies of the fifth, sixth and seventh,vertebrae. ANATOMIC CONSIDERATIONS 79. Fig. 71.—Vertical section of the body, showing the shape of the lower lobes, the upperlobes having been removed. Note the higher position of the right phrenic dome, whichcauses the lower border of pulmonary resonance to be slightly higher on the right side. Onthe left the stomach imparts a tympanitic quality to the lower portion of the lung. Iffilled with food it diminishes pulmonary resonance and may simulate consolidation or asmall pleural effusion. CHAPTER VIMETHODS AND RESULTS OF PERCUSSION The Immediate or Direct Method.^—The hand or the finger tips arestruck directly against the object in which we desire to set up was the method of Auenbrugger, who, however, covered the fingerswith a soft glove to diminish the finger element of the sound, especiallythe overtones. The direct method is still occasionally employed todetermine the resonance of the upper lobes of the lung (by using theclavicle as the
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