A Manual of Physical Diagnosis

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Wood, 1878 - Diagnosis - 30 pages
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Page 22 - ... fourth, fifth, and sixth ribs on the left of the sternum. The heart rests upon the cordiform tendon of the diaphragm ; its base is on a line with the interval between the cartilages of the second and third ribs, and the impulse of its apex can be seen and felt between the fifth and sixth ribs, slightly to the left of the junction of the fifth rib with its cartilage and on a line with the junction of the xiphoid cartilage and the sternum, he true apex lies behind the sixth rib, covered in front...
Page 26 - The essential cause of these various reduplications seems to be a want of synchronism between the actions of the two sides of the heart. If the facility with which the two ventricles fill with blood be unequal, they will probably differ somewhat in their time of contraction ; certain conditions of the auriculo-ventricular valves...
Page 7 - Sometimes also a part of the left lobe of the liver. Part of the omentum and mesentery, the transverse part of the colon, transverse part of the duodenum, with some convolutions of the jejunum and ileum.
Page 26 - Pericardial are distinguished from endocardial murmurs by their quality (rubbing, grating, creaking), their superficial character, their limitation to a small area, their changeableness in position and intensity from hour to hour, their greater intensity when the patient leans forward or fills the lung, or, when the chest wall is pressed upon, their want of synchronism with the heart sounds. — DELAFIELD. Hydropericardium is excluded chiefly by the history. PROGNOSIS. — Based upon one hundred...
Page 24 - After the second sound is another interval of silence, the postdiastolic silence. If the period of an entire revolution of the heart...
Page 28 - ... or less clearly audible about and within the inferior angle of the left scapula, and in the left vertebral groove from the sixth to the ninth dorsal vertebra...
Page 11 - The inspiration is of tubular quality, of higher pitch, of marked intensity, and of considerable duration. The expiration is of tubular quality, of higher pitch, of greater intensity, and of longer duration than inspiration.
Page 11 - In the right infra-clavicular region both inspiration and expiration are often of higher pitch, and the expiration is longer than over the rest of the chest.
Page 6 - It is heard over the solid viscera, the liver, spleen, and kidneys, and over the thick muscles of the back. Its quality is flat, its pitch is high, its duration is short, its intensity is not great.
Page 14 - In the right infra-clavicular region the intensity of the voice is usually greater, the pitch higher, and the thrill more marked than in the corresponding region on the left side.

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