CHAPTER VII. Tue CrrcuLatory SysTEM.
A. Inspection . I—The Precordia (1) Contour . a (a) Fullness . (b) Shrinking (2) Apex Beat . (3) Abnormal Pulsations (4) Systolic Retraction . II—The Blood-vessels . (1) Arteries . (2) Veins . (3) Capillaries . B. Palpation # é I—The Precordia (t) Apex Beat A ge (2) Abnormal Pulsations (3) Other Phenomena (a) Thrills . (b) Friction Rubs (c) Fluctuation
I[—The Pulse : (1) Digital Examination (a) Rate.
9 92g:
(d) Diastolic Shocks
(i) Bradycardia (ii) Tachycardia .
xv
116
= Ey x aay . 118 . 118
125
. 125 . 125
125
126
. 126 . 127
- 128
- 128
- 128
. 129
130 131
. 131
132
. 133 . 133 . 133 a ESS
- 135
- 135 . 136 . 136
137
. 138
- 139
xvi CONTENTS.
(b) Quality a (c) The Artery Wall (d) Rhythm . (e) Arterial Blood Pressure. (2) Instrumental Methods (a) The Cardiogram. . (b) The Arterial Sphyemios gram. . (c) The Venous Sphyemo- gram . . (d) Arrhythmia. ae (i) Sinus Irregula ties (ii) Extra- Systoles . (iii) Auricular Fibril- lation. . (iv) Ventricular Rhythm (v) Pulsus Alternans. (vi) Pulsus Bisferiens, C. Percussion I—The Normal Heart . II—Abnormal Cardiac Outlines. III—Extra-cardiac Dullness D. Auscultation . r I—The Normal Heart Sounds ‘ II—Modifications of the Heart Sounds (1) Accentuation é (2) Diminished Intensity 5 II—Arrhythmia . 58% (1) Embryocardia (2) Reduplication IV—Endocardial Murmurs . (x) Organic . : (a) Mitral Regurgitation (b) Mitral Stenosis .
- 139 . 142
143 144
144
145 147
. a8 IS
151 152
7256
. 154
155 155
5358 . 155 . 158 . 160
- 161 = 16x . 164
164
- 166 . 167 . 168
- 168 . 169 . 170 = 373 2373
CONTENTS. xvii
(c) Aortic Regurgitation . 176
(d) Aortic Stenosis . . . 178 (e) Tricuspid Regurgitation, 179 (f) Tricuspid Stenosis. . . 179 (g) Pulmonary ReEergis tion... 179 (h) Pulmonary Stenosis . . 180
(i) Combined Valve Lesions. 180 (j) Congenital Anomalies . 181
(2) Functional. . . 2... - . 183
V—Exocardial Sounds . . . . 184
(1) Pericardial Friction Rubs. . . . 184
(2) Churning .. . wes 185
(3) Arterial Murmurs . saw e noe TBS
(4) Venous Murmurs. . 2... . 185
E. Auscultatory Percussion... .-...- . 5 185
FE. Mensuration 2. 5 5) be Fed ee 186
G. The Temperature... . 2-1... .. . . 186
I—Palpation . . . foe : 186
II—Clinical ‘Thermometer co es 186
I1J—Temperature Chart... . . . . . . 187
H. The Blood. (See Appendix.) ....... . 188