A manual of the physical diagnosis of thoracic diseases / by E. Darwin Hudson.

  • Erasmus Darwin Hudson, Jr.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the physical diagnosis of thoracic diseases / by E. Darwin Hudson. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    Aneurism of the ascending and transverse aorta, also involves the right recurrent laryngeal nerve, .inducing laryngeal spasm, irrita- bility, and aphonia. Aneurism of the ascending portion may obstruct the right pul- monary bronchi or bronchus to the upper lobe of the right lung. Aneurism of the transverse portion compresses the trachea, cutting off air to the lung, and irritating both recurrent laryngeals. Orthop- noea, laryngeal spasm, shallow chest expansion, supra-sternal and epigastric sinking, and anorexia are often marked. Aneurism of the descending arch disturbs only the left recurrent laryngeal and the apex of the left lung, its investing pleura and Fig. 84.—Area of dulness of aneurism (Piorry). bronchi; discomfort is then on the left side of the sternum and of the left sca23ula and interscaj)ular rea:ions. Physical Signs.—Inspection.—In its early stage aneurism may show nothing. Later, vibration and bulging are observed in the second intercostal space to the right of the sternum, or, if of trans- verse portion, pulsation may a]3pear in the suprasternal notch and extend up the cervical vessels. In aneurism of the descending por- tion, the bulging is to the left of the sternum, at the second carti- lage. Later, the sternum, ribs, and cartilages may bulge over the aneurism or be eroded, and the spheroidal pulsating tumor is seen to the right or left of the sternum. Yascular swelling and cyanosis of the head, neck, arms, and thorax
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