File:Diseases of the chest and the principles of physical diagnosis (1920) (14593224569).jpg

Identifier: diseasesofchestp1920norr (find matches)
Title: Diseases of the chest and the principles of physical diagnosis
Year: 1920 (1920s)
Authors: Norris, George William, 1875-1965 Landis, Henry R. M. (Henry Robert Murray), 1872-1937, joint author Krumbhaar, E. B. (Edward Bell), 1882-1966
Subjects: Chest Diagnosis Thoracic Diseases Diagnosis
Publisher: Philadelphia, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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slightlytympanitic note results, due to relaxation of pulmonary tension and toabdominal tympany. The note over empyemas is more apt to be dullor flat, but, for the same reasons, this is not invariable. In serous orpurulent effusions as a general rule, therefore, we do not find as flat anote as in adults, under the same conditions. In ausculting over a pleural effusion (serum or pus) the breath soundsoften persist and in some cases the diagnosis can be definitely establishedonly by the exploring needle. In the case of large effusions, especially ifpurulent and causing marked compression of lungs, we may find bronchialor cavernous breathing, with whispered pectoriloquy, from the clavicledown as far as the third or even the fourth rib. An erroneous diagnosisof cavity is sometimes made. Cavities in children are rare. The second pulmonic sound is actually and relatively louder than thesecond aortic—this difference persisting throughout childhood. Organic 144 THE EXAMINATION OF THE LUNGS
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Fig. 117.—Sagittal section of the hwdx i.i :i //. <//// <.<//( child vicwitl fiwiii the right, theplane of the section being 0.25 cm. to the left of the mid-sterual line. M.V., mitral valve;L.A., left auricle; L.A.A., left auricular appendage; L.V.P., orifices of the left pulmonaryveins; R.P.A., right pulmonary artery; L.B., left bronchus; L.S.A., left subclavian artery;I.A., innominate artery; L.C.A., left common carotid artery; L.I.V., left innominate vein;A.A., aortic arch; A.L., aortic leaflets; T.L.,tricuspid leaflets; R.V., right ventricle; D, dia-phragm: L. liver. PHYSICAL FINDINGS IN INFANTS AND YOUNG CHILDREN 145

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