. La diagnosi medica per lo studente e professionista. collasso, pleurisy, ecc. Pericardio: pericardite. Pressione predominante i sintomi. 776 per la diagnosi medica in parete toracica: localizzate, dolore sordo. Tronchi nervosi: i dolori nervosi, paroxysmaland intermittente, spesso grave e intrattabile. Arteria polmonare: systolicpulmonary mormorio, dilatata di cuore destro. Fibre sympa: orcontracted dilatata pupilla, sudorazione unilaterale o pallore. Plesso cardiaco: anginalattacks. Per la vena cava superiore: edema della estremità superiore, cianosi. Thoracicduct: marasmus. Vago: dispepsia nausea, vomito, dispnea. Phrenic:singhiozzo,

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. Medical diagnosis for the student and practitioner. collapse, pleurisy, etc. Pericardium: pericarditis. Predominant pressure symptoms. 776 MEDICAL DIAGNOSIS Chest wall: localized, dull pain. Nerve trunks: neuralgic pains, paroxysmaland intermittent, often severe and intractable. Pulmonary artery: systolicpulmonary murmur, dilated right heart. Sympathetic fibers: dilated orcontracted pupil, unilateral sweating or pallor. Cardiac plexus: anginalattacks. Superior vena cava: edema of upper extremity, cyanosis. Thoracicduct: marasmus. Vagus: dyspepsia, nausea, vomiting, dyspnea. Phrenic:hiccough, unilateral diaphragm spasm or paralysis. Recurrent laryngeal:hoarseness, aphonia, spasm or paralysis left cord, paroxysmal dyspnea. Itmust notbe forgotten that any or all of these symptoms may be caused bymediastinal growths other than aneurysms and that the incidence of suchsymptoms is variable and irregular. PHYSICAL SIGNS.—Inspection.—This must be both direct and tan-gential and one seeks primarily to discover any local bulging or pulsation.. Fig. 419.—Aneurysm of the ascending portion of the arch. The aneurysm representedby the percussion outline shown ruptured into esophagus in the authors presence, as thepatient suddenly sat up, because of abrupt anginal obligatory orthopnea. The region of the manubrium, and the back between the left scapula and thespine should be examined with special care. The Primary Signs are: (a) Abnormal pulsation usually in the localitymentioned, yet variable in position, degree and extent, and if typical, heavingand expansile, (b) Rarely, a visible tumor yielding expansile pulsation andcovered by tissues which may be normal, tense, shiny, and congested or evennecrotic (c) A positive radiogram. Secondary Signs.—(a) The peripheral signs of an associated aortic regur-gitation may be present, (b) The apex-beat is low and may indicate leftventricular enlargement, a condition commonly but not invariably associatedwith thoracic aneurysm, {c) Sig

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• bookcentury1900
• bookdecade1920
• booksubjectdiagnos
• bookyear1922