File:Medical diagnosis for the student and practitioner (1922) (14597776070).jpg

Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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c aortic murmurs. In this last lesion one also findsthe lower end of the sternum a point of aortic transmission. The Suprasternal Notch.—The use of this area may enable one to hearweak heart sounds not audible over the selective areas mentioned above. INSPECTION FACIES.—No internal ailment presents more external signs to the ob-server than does established heart disease in many instances. In some formsthe external signs are relatively prompt in appearance and apparent at aglance. In others they are obscure and relatively late or never appear. The most strikingly objective lesion, over periods embracing many years,28 Murmurs maybe absent. Anatomic position unimportant. Arbitrary auscultation areas. Often strikinglyobjective. 434 MEDICAL DIAGNOSIS Jerkingvessels. is aortic regurgitation, usually associated with pallor and meagerness offace, yet seldom with marked actual anemia. In such cases the jerky throbof the carotid, temporal, or any other superficial artery, may at once strike
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Capillary pulse. Fig. 161.—Drop heart with evidence of slight dilation. Note borders, equidistantfrom median line. Calcined focus in upper left lung field. A mitral systolic murmurwas present in this case. (Dr. Frank S. Bissell.) the eye, and even the head nods rhythmically in some cases or the foot jerksin time with the heart beat if the knees are crossed. In rare instances the eye may catch the rhythmic blushing and paling ofthe capillary pulse if some skin area becomes congested or even in the lipsor nails. One may find jerking vessels and a capillary pulse in thyroid cases, THE EXAMINATION OF THE HEART 435 lacking aortic regurgitation, but possessing overacting hearts and extremevasomotor relaxation, and the condition of this gland should always benoted, together with the presence or absence of the peculiar stare, actualexophthalmos, or tremor, which may indicate a frank hyperthyroidism. In rare instances the tracheal tug of aortic aneurysm may exist in somarked a degree as to c

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