Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
Percussion over the region of the heart yields a dull flat sound. The
sound is dullest opposite the right ventricle, F; whilst above and to
either side of this point, where the heart is overlapped by the anterior
shelving edges of both lungs, the sound is modified in consequence of
the lung's resonant qualities. The heart-sounds, as heard through the
stethoscope, in valvular disease, will, of course, be more distinctly
ascertained at the locality of F, the right ventricle, which is
immediately substernal. While the body lies supine, the heart recedes
from the forepart of the chest; and the lungs during inspiration
expanding around the heart will render its sounds less distinct. In the
erect posture, the heart inclines forwards and approaches the anterior
wall of the thorax. When the heart is hypertrophied, the lungs do not
overlap it to the same extent as when it is of its ordinary size. In the
latter state, the elastic cushion of the lung muffles the heart's
impulse. In the former state, the lung is pushed aside by the overgrown
heart, the strong muscular walls of which strike forcibly against the
ribs and sternum.
The thorax is separated from the abdomen by the moveable diaphragm. The
heart, F E, lies upon the diaphragm, L L*. The liver, M, lies
immediately beneath the right side of this muscular septum, L*, while
the bulging cardiac end of the stomach, O, is in close contact with it
on the left side, L. As these three organs are attached to the
diaphragm--the heart by its pericardium, the stomach by the tube of the
oesophagus, and the liver by its suspensory ligaments--it must happen
that the diaphragm while descending and ascending in the motions of
inspiration and expiration will communicate the same alternate motions
to the organs which are connected with it.
Public-domain text, read in full here on John Shaqi.
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