Файл:The diagnosis and treatment of diseases of women (1907) (14597694349).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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tumor of the wall or of the omentum ordinarily gives dullness in light percus-sion and resonance in deep percussion. Endeavor to get definitely in mind exactly the reason for the dullness or reson-ance found in a particular case, and then its diagnostic significance will be clear. PERCUSSION AND AUSCULTATION 29 AUSCULTATION. FETAL HEART SOUNDS, VASCULAR MURMUR. Auscultation, either by tlie ear direct (a sheet intervening) or by the stethoscope,should always be employed when there could be any confusion with advanced preg=nancy, as in a case of large ovarian tumor or large fibroid. The fetal heart soundsare the only sounds pathognomonic of pregnancy. The placental murmur may besimulated by the large vessels of a tumor. The absence of fetal heart sounds doesnot exclude pregnancy, for even in cases of norma( pregnancy they cannot alwaysbe heard. Auscultation should be employed also in obscure cases of pain in theabdomen, particularly if accompanied by pulsation. The pain may be due to an
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Fig. 38. Ordinary Percussion, which is usuallyrather superficial. Fig. .39. Deep Percussion. Notice iiow tlie leftindex finger is pressed into the abdomen, so as tothin out the wall and get closer to deep structures. aneurism of the abdominal aorta, which occasionally runs its course unrecognizeduntil rupture and sudden death. In auscultation for aneurismal murmur with astethoscope, be careful that the abdominal wall is not pressed firmly against theaorta with the stethoscope, for such pressure will cause a murmur in a normal vessel. Excessive gurgling in the intestines may be heard in most intestinal diseases ac-companied with tympanites. It is heard particularly in the region of the iliocecalvalve or about a partial obstruction or over a loop of bowel in peristaltic move-ment. Gurgling over a large mass indicates that one or more intestinal coils are be-tween it and the abdominal wall. This intestine may be in front because the massis retroperitoneal or because an intestinal coil is

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