233
2454147819011156112
During9935960128101171218257327397
the1425596012864133196
inspection,1656596012864134188258321383421460530600636
the2327596012864133196
localization,2558596012863133195257296335398460498537607677712
area,3305596012887133195257292
and3632596012887158227
height3895596012894156194265334374
of4304596012894141
the4481596012862132194
apex4710596012887157220289
beat5035596012893156218256
are5327596012887134196
determined.851839012870133172234281390426497560630666
Palpation15528390128114177214285347386424494564
further2151839012884154200239309371418
refines2604839012884146192231301363417
and30568390128100170239
additionally3331839012899169239277317355425495558596635705
determines40708390128107169208271318426463533596651
the4756839012876147208
strength,5000839012891129177239308379417487522
resistance,8511080012847109164202257296358428490553588
and14741080012862131201
character17111080012862131194241303364402465512
of22581080012870116
the24091080012839108171
apex26151080012863131194264
beat.29131080012871133196234269
Localization9931321012886155218281320358421483521559630700
of17281321012870116
apex18791321012863134196266
beat,21791321012870133195233269
changes24831321012862132195264334396450
in29681321012839109
pathology.31121321012870133171241310350419489560593
Leftward9931563012886148194233335397444514
displacement15411563012870109164233273335397459569629700739
of23141563012871118
the24671563012839108171
apex26731563012863131194263
beat29721563012870132194233
is3240156301283893
observed33671563012870141195257304373436505
in:39081563012839108147
10311815012865
left12111815012839102149186
ventricular14331815012883146215254300339402471510573619
dilatation20871815012883122160223262324362401471542
(aortic26641815012860121191238276315378
defects,30771815012883145191253316354409444
mitral356818150128109145185232294333
insufficiency,39371815012852123177246293340378441480542612675745778
hypertension,47501815012883154222285332371434503558596666736772
myocardial121120560128109178247309372418489528591630
infarction,18762056012838109156217264326364404473544578
cardiomyopathies);2489205601286212517124228135146052959866873177084087994199610431084
10312308012865
significant1211230801285594164233273320358421483552592
dilatation18372308012889129167230268330369408478548
of24202308012890137
the25912308012859129191
right28172308012866105175245284
ventricle,31362308012892155224262310349410449511546
causing37172308012882145214269307378448
the42002308012858128190
left44252308012858121168206
ventricle46662308012889151221261307346411449512
to52122308012859128
be53762308012889150
displaced12112549012870110164233273336397459529
to17762549012837108
the19202549012837107169
left;21252549012839101147186226
10312800012865
high12112800012870110179249
diaphragm14952800012871109172241311358420490600
level21272800012839102172235273
(meteorism,24362800012846156216255318388436474529638671
large31422800012839101148218281
abdominal34582800012863131202272381418489551590
cyst,40842800012862132185224260
ascites,43792800012862116178217256318373409
obesity);48212800012870141203257296335406451494
10313052012865
decreased12113052012870133195242304366420483552
volume179930520128179249288358467527
of236230520128181228
the262530520128149219281
left294130520128150211258297
lung327430520128148218288358
(atelectasis,366830520128157219257320358420483521583637676730766
pneumoconiosis,44693052012818024931138149155962269276380187192696410191054
pleurofibrosis,12113294012870110172241289358405443513561630684723777813
lung20593294012838108179248
resection);23433294012847107162225287325365434504551592
10313545012865
leftward12113545012839102149186288350397467
shift171335450128116186224271310
of205835450128132178
the227135450128101171234
mediastinum254035450128171231301341404457497535605675785
in335835450128101171
exudative356435450128124194264333396435474543606
pleuritis420535450128131170232303349388426466520
and475935450128125195265
tension505935450128100163232286325395464
pneumothorax12113787012870141203273383450490560630677740809
on20543787012870141
the22303787012838108171
right.2436378701284584155225263299
Rightward8514029012894133203273311413475522592
displacement14774029012870109164233273335397459569630700740
of22514029012870117
the24034029012838108171
apex26094029012863131194263
beat29084029012870131194233
is3176402901283893
observed33044029012870140195257304373436505
in:38444029012839109148
10314280012865
low12114280012839110211
diaphragm14574280012870108171240310357419488598
level20884280012839101171235274
(emaciation,23974280012845108217277339378441480520589660695
visceroptosis);31264280012870109163226288335404474513583637677731778819
10314531012865
decreased12114531012870133195242304366420483552
volume179945310128168238277347456516
of235245310128169216
the260345310128137208271
right290845310128145185254324363
lung330745310128137207277348
(atelectasis,369045310128145207246308347410471510573626665720755
pneumoconiosis,44804531012816823930137148154961168275279186091595410081043
pleurofibrosis,12114773012870110172241289358405443514561630685724778814
lung20604773012838108178248
resection);23444773012846107162225287325364434504551591
10315024012865
rightward1211502401284786156226265366428475545
shift179250240128105176215262300
of212750240128123170
the23325024012891161224
mediastinum259150240128161221292331394449487526596666775
in34005024012892162
exudative359750240128115185255325388426465535598
pleuritis423050240128122161224293340378417456511
and477550240128115185256
tension50665024012892154224278316386456
pneumothorax12115267012870141203273383450490560630677740809
on20545267012870141
the22305267012838108171
left.24365267012838100147185221
Area103155080128101148210272
of13385508012871118
apex14915508012862131194263
beat.17895508012870133195233269
In10315749012847117
normal11845749012880151197306366405
conditions,16255749012874144215284323362401471541595630
the22895749012851121183
apex25075749012874143206275
beat28175749012881144206244
area30975749012873120183244
is33765749012851105
1-235155749012882132202
cm².37525749012874183223258
If40455749012858105
the41855749012850121184
area44035749012874120183244
is46825749012850105
more483457490128109177224286
than51555749012850121183252
254435749012880
cm²,8515991012862173212248
it1134599101283877
is1247599101283994
called13765991012863124163201264333
diffuse;17455991012870108155202271326388427
if2207599101283986
less23285991012838101154209
than25735991012837110173242
128495991012870
cm²,29555991012862171211246
it3236599101283879
is3350599101283993
limited.3479599101283977186223262325395431
Diffuse103162330128101140187234304358421
apex14876233012862131194263
beat17856233012871133194233
is2054623301283792
caused21826233012862123193249310381
by:25976233012870141178
10316483012865
hypertrophy12116483012870141209272319358405474545614685
and192964830128128198269
dilation223364830128135174212275314353422493
of276164830128135182
the297864830128104173236
left324964830128104166213251
ventricle353664830128134197266305353390453491554
(aortic412564830128112175244291329368430
defects,459064830128136198243306368407461497
mitral512264830128174211250298360399
insufficiency,12116726012839110164233281327366428467530599662732765
hypertension,20116726012870141209272319358420490545583653723759
myocarditis,280467260128110179247310372421491531569609663698
dilated35376726012870109147210249311381
cardiomyopathy);39536726012863124170241279349459528596667729768839910954995
10316977012865
tumor12116977012839110220287335
of15816977012870117
the17336977012839108171
posterior19386977012870141195233296343381451498
mediastinum;247169770128109169239279342396435473544614723762
10317229012865
shrinkage12117229012855125172210280351412483545
of17907229012870118
the19437229012839108171
anterior21497229012863132171233280318389436
edges26207229012862131201263317
of29727229012871117
the31247229012838109172
lungs.33317229012838107178247302337
Decreased103174700128101163225272335397452514584
apex16507470012863132194263
beat19497470012870132194233
area22187470012860107170232
(limited)2485747001284786124234270310373443490
is3010747001283893
observed31377470012870140195257304373436505
in:36787470012839108147