291
2354147819011156112
1065606012865
Pulsation1205606012878148188242305342382452521
in1762606012842113
the1910606012842112175
2nd2120606012873144214
intercostal2369606012842112151214260322392447485548587
space2990606012859129192254315
at3340606012867105
the3480606012843113175
right369060601285190160230269
edge3995606012865135205268
of4298606012873120
the4454606012842111174
sternum466360601285898159206276346456
occurs5152606012874137199269316369
with8518490128101140179249
aortic1135849012894164211249288350
aneurysm,1520849012894164227296343413466576609
and2165849012892163233
in2434849012870140
the2610849012870139202
2nd28508490128101170240
intercostal3125849012870140179242288350420474513576615
space3775849012884155217279342
at4152849012893132
the4319849012870140203
left4557849012870132179217
edge4810849012893163232295
of51408490128100147
the5322849012870140202
sternum851109001285594157202273342452
occurs13361090012870132195265312367
with173810900128102139178248
dilation20201090012870109148211248288358427
of24831090012870117
the26351090012838108171
pulmonary28401090012870140179289357427490537607
trunk.3480109001283986156226297333
10651342012865
Pulsation12051342012878148188242305342382452521
in17621342012853122
the19201342012853122185
jugular21401342012853123193263302364411
fossa25861342012861130185239302
is29231342012853107
caused30661342012876138207262324394
by34961342012883153
the36831342012853124187
vibrations39051342012884122192239301339379448519573
of45141342012883130
the46791342012853123184
aortic48991342012876146193231271334
arch52681342012876122184253
with85115830128101140179249
increased11351583012853124186233295357411474543
systolic17131583012869139192232302341379442
ejection.21901583012876115177240279317388457493
The27181583012899169232
presence29851583012884130193247309379442504
of35241583012884131
pulsation36901583012884154193247310348387457528
in42531583012852123
the44111583012852123185
jugular46311583012853123193262302365410
fossa50761583012867137191246309
is54201583012852106
observed8511824012870141195258304373436505
in13921824012882151
cases157918240128105167222284338
of195318240128112158
aortic214618240128105176223262300363
aneurysm,254418240128105174237306353424477588620
aortic319918240128106177224262301364
insufficiency,35981824012881151205275322369408470509571641703774807
hypertension,444018240128113183252314361400463533587626696766802
and527718240128104175244
thyrotoxicosis.8512067012839110180225295335405474514576646700739793829
10652318012865
Epigastric12052318012886155195265327382420468505568
(suprasternal)18082318012884138208279325387442480543590659722761807
pulsation265023180128107178216270333372410480551
is32352318012877131
pulsation340223180128107179218272335374413482553
in39892318012877147
the41722318012875145208
epigastric441523180128100169208278340395433480519581
area.503123180128101148210271306
In53722318012886155
normal8512559012870141188297357396
conditions,12832559012865135205275314353392462531586622
epigastric19402559012865134173243306360398445484546
pulsation25212559012874143183237300337377447516
is3073255901284296
caused32052559012865126197252313384
by36242559012872143
the38002559012843113176
pulsation40112559012874143183237299337377446516
of45632559012873120
the47182559012841112174
abdominal49272559012865136205280390426497560599
aorta8512801012862133180218281
and11672801012876145215
is14172801012853107
more157428010128109177224286
common18952801012877147256365432503
in24342801012853123
young25932801012884152223292362
people29912801012884145216285325387
with342628010128102140179249
asthenic37112801012875130168239300371409472
constitutions,42182801012876145215269309347386456495534604674728764
having50172801012883145214254324393
a54462801012875
weak85130420128101163225296
abdominal11823042012867137207277386423493556595
wall181730420128101163202241
-20923042012853
this21803042012843114154208
is2423304201284498
false25563042012851114153207269
transmitted2860304201284491152222277386423462502564634
pulsation.35293042012875144183238301338377448517553
True41243042012886132202265
epigastric44243042012867136176245308361401448486549
pulsation50083042012873144182237299338377447517
is851328401283994
caused9813284012889150220274337406
by14233284012896167
the16233284012866137199
pulsation18583284012897167205259322361399469540
of24333284012896144
the26123284012865135197
left28443284012866128175214
ventricle30943284012896159228267314352415453516
in36453284012865135
cases38163284012888150205267322
of41733284012896144
its43523284012865104158
hypertrophy45463284012897168236299346383431501570640711
and52903284012889160229
dilation.8513525012870110148211249288358428463
Diagnostic134935250128141179242311381451505545583646
value:203035250128108171210280342380
congenital244635250128101170240311372443481521582621
and310235250128101172241
acquired337935250128101164233302342389450520
mitral393435250128148185224272334373
and434335250128101170241
tricuspid46183525012879126164226296351420459529
valve518235250128109171209279340
defects,8513767012870133180242304342396432
emphysema,13183767012893202270341411464527637697732
and20863767012893163233
other235537670128100139209271318
respiratory27083767012878139194263303349411450520567636
diseases337737670128101141196259321375437492
leading39033767012870133194264303373443
to43823767012868138
right45553767012878116186256296
ventricular488537670128101164233271319358419490528591636
insufficiency.8514009012839110164233281327366428467530599662732765
True16514009012896143213276
epigastric19624009012872142181251313367406453491554
pulsation25504009012881150189244307345384454523
can31094009012872134203
also33474009012873111166236
be36184009012879142
caused37944009012873135204259321391
by42204009012880151
the44044009012850119182
pulsation46214009012880149189243306344383453523
of51794009012880127
the53414009012848119180
liver851425001283978148211258
with114642500128101140178249
tricuspid1430425001284187127189258312384423492
valve19584250012872134173243305
insufficiency.22984250012841112166236283330368430469531601663733767
Physiological31034250012878148220272312383422492562601663726764
(false)3902425001284996158196251314360
epigastric42974250012864134173242305360398445483546
pulsation48784250012872142181235298336375445515
is5428425001284195
localized8514491012839110172234273311374436505
in13924491012868138
the15664491012868138201
middle180244910128139175246317356419
third22564491012867138176223293
of258444910128100147
the27664491012868138200
epigastrium30014491012892162201270332387426473512581691
and37254491012892162232
slightly39934491012884124162232302341380451
to44774491012869140
the46524491012869138201
left48884491012868130177215
of51394491012899147
the53214491012868138200
midline.85147330128109146216256295366428463
It13494733012883121
is15064733012874129
better167047330128107169208246309356
seen20604733012891154215285
in23804733012875145
a25614733012898
horizontal269447330128105176222261324393463502564603
position333347330128105175230268308346416487
and38544733012899168239
after41284733012899145183246293
physical445547330128107176247300339402464502
exertion,49934733012899168231278315354425494529
decreases8514975012870133195242304366420483537
on14234975012898167
inhalation16264975012866135205268306369408446516586
with225049750128128167205275
a25604975012890
distended26854975012897137191229292361432494564
abdomen.32834975012890160231300410470540576
True389449750128112158229292
epigastric42214975012889159199269331386425472510572
pulsation48284975012898168206261324362400471540
is54044975012865119
localized8515216012839110172234273311374436505
directly13925216012886126173234297335374445
below18705216012888150189259361
the22655216012857127189
xiphoid24895216012887127196266336375445
process,29695216012887134204266327382437472
slightly34765216012871110149219289328366437
to39465216012857127
the41095216012855126189
right43325216012864103173243282
of46495216012887134
the48185216012856126188
midline,505952160128109146216256295365428462
and8515457012862133202
intensifies10895457012839108147210279333373420458521574
on16995457012870139
inhalation.18745457012839108178239278341379418488558593
Palpation10655704012686155195273342389428498577
of16755704012670118
the18285704012646124187
Heart204957040126110172241303349
Area.243457040126101163225295331
Objectives103159410128101171210272335374412483545599
of16645941012870117
the18165941012839109172
examination20235941012862131194302338409472511550620690
(criteria):27515941012847109155194232295342380442490528
9936192012865
the12056192012839110172
properties14116192012870117187257320366405443506559
of20076192012870117
the21596192012839109172
apex23666192012862131194263
beat:26646192012870133195233273
localization,29726192012838108170232271310373435473511582652686
area,36936192012862109171233269
height,39976192012870132171241311350386
strength,4418619201285492139202271340380450485
resistance,49386192012846109163202257295358427490552586
synchrony8516434012855125194256327374443514584
with146864340128102140179250
carotid17546434012862123170240278317387
pulsation/direction217664340128701401792332963343734435135526226607077708328709099791049
(positive32606434012847117187242280320358429491
or37866434012870117
negative);39376434012870133202264303342412474521559
9936685012865
the12056685012839110172
presence14116685012895142205258321391453515
of19616685012896143
pathologic21386685012896159197266336375445515554617
pulsations:27896685012896166204259321360398469539593632
cardiac34566685012888150196266306367430
beat,39216685012895158220258293
aortic42506685012888157204242281343
and46286685012888157227
pulmonary48916685012895165204313381452514561631
pulsations,8516926012870141179233296335374443514568603
epigastric14906926012861132170240302357395443481543
pulsation;20676926012870141179233296335374443514552
9937178012865
the12057178012839110172
presence14117178012870117180233296365428491
of19367178012870118
systolic20897178012854124178217287326365427
and25527178012862131201
diastolic27877178012870110173226265335374413475
tremor.3297717801283986148258325373408