CLINICAL NOTE – If you never hear absolute dullness, lungs are - TopicsExpress

CLINICAL NOTE – If you never hear absolute dullness, lungs are enlarged, and there is no point that the heart projects to surface w/o lung in front of it. Area w/ Heart + lung = sound is relatively dull (compared to resonant sound) now can estimate size of heart Points where relative dullness begins = Surface projection of heart borders SVC = 3rd R rib, next to sternum R limit of coronary groove = 6th IC space, 2-3 cm R of sternum Apex of Heart = 5th IC space, 9 cm left = also called location of Apex beat Apex beat = pulse resulting from apex of heart being forced against ant thoracic wall when L ventricle contracts L limit of coronary groove = left 3rd rib, 3 cm left Area w/ just heart = sound is totally dull Technically, where heart not covered by lung/pleura Where heart has direct contact w/ ant thoracic wall (except for pericardium) *Kind of like Space of Traube for stomach usually you start hearing this b/w 4th & 6th rib, parasternally *on L side* Location of resonant sound – location of absolute dullness = size of lung

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