File:Medical diagnosis for the student and practitioner (1922) (14598030168).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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s upper pole. The stomach is palpated under direct observation to determine the mobil-ity and patency of the pylorus. The duodenum is also palpated and the degree to which this stimulationincreases gastric peristalsis is noted. Following the examination the patientis observed fluoroscopically at intervals as these two bismuth meals progressthrough the intestinal canal. Roentgenograms may be made from time totime, as a permanent record of any pathological condition noted, or, possibly,to reveal something overlooked on the screen. Appearance of the Normal Stomach.—The normal stomach varies ratherwidely with the sex and habit of the individual. The most common type is EXAMINATION OF THE STOM H n the perpendicular, hook-shaped 0f£a*f, with equidistant borders, the lower pole -hreaching a point about 2) £ inches below the pylorus. ! Bh*ped ,y- Another type is the semihorizontal, steerhoru-shaped stomach which lies high Stttrtem*1/;/ the abdomen with the pylorus at its lowest extremity.
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Fig. 434.—Congenital atresia of the esophagus. Note distention of stomach andintestine with air. This was explained at autopsy by a union of the distal end of theesophagus and the main bronchus. (Dr. Frank S. Bissell.) This is the type usually observed in the male of stout habitus. It israrely seen in the female. Various types, depending upon the muscu- 836 MEDICAL DIAGNOSIS Normal reten-tion periods. Significanceof delay. lar tone of the stomach, as well as the length of its mesentery are describedas: (i) Hypertonic. (2) Orthotonic. (3) Hypotonic. (4) Atonic. Motility.—An unobstructed stomach will, with rare exceptions, clear itselfof bismuth meal No. 1, within six hours after ingestion. The time of completeevacuation varies from two to six hours, depending upon muscular tone, and thedegree of acidity of the gastric contents. A delay of more than six hours dis-

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