369
2654147819011156112
Resistance1031596012894156211249304343405474537600
of1666596012878125
apex1826596012872141204274
beat.2136596012878140202241277
The2449596012895165227
resistance2711596012856118172211266304367436499561
(firmness)3307596012856102140187296364427481537584
of3926596012878125
the4086596012849118181
apex4302596012872141204273
beat4610596012878141203241
reflects4887596012856118165203266328366421
the5343596012847118180
density851839012870133202257296335406
of1290839012876123
the1448839012845114177
heart1660839012875137200245284
muscle19848390128110177232295334397
at2416839012868107
the2562839012843113175
moment27788390128109177288348419458
of3272839012876123
its343083901284382137
contraction.3602839012868137207246294355417456495564635670
In4309839012853122
normal4466839012876146193302362401
conditions,4903839012868138207278317355394464535589623
the8511080012839110172
apex10591080012863132195264
beat13581080012871133195234
is1628108001283993
non-resistant.17571080012870140210259305366421460514553616686724760
If2552108001284894
the26811080012840110173
muscle289010800128109177232295334395
is3319108001284095
perceived34501080012870132179241304342412474544
as40301080012863117
dense41821080012871133203257320
and45361080012863133204
elastic47751080012863101164217257295358
tissue,5168108001283978133188258320355
such8511321012855125188257
an11441321012887156
apex13351321012887156219288
beat16591321012895157219258
is19521321012863118
called21041321012887150189227290360
resistant,25001321012871133187226281319382451490526
observed30611321012894163218280327397460529
in36251321012864134
left37941321012863126172210
ventricular40401321012895158227265312351413482522584630
hypertrophy47051321012895166234297344383429499569638709
-54471321012879
arterial8511563012862109148211258296358396
hypertension,128315630128139210278341388427489559613652722792826
aortic214415630128131202249288326389
heart256815630128140202264310349
defects,295315630128138201248310371413468504
and349215630128131200271
mitral379815630128179215255302364402
insufficiency423615630128108178233302349396434497536598668731801
in507015630128109179
the528515630128108178239
compensation8511805012862133242310373443498561599637708778
stage.1664180501285593156225287323
Direction103120460128101140187249312351389459530
character15962046012874143206253314376415477524
of21552046012882128
apex23182046012874144207276
beat.26302046012881144206244280
The29472046012897167230
character32122046012874143206253314376415478525
of37722046012881128
the39352046012851120183
apex41532046012874143206275
beat44642046012881144206244
is47442046012850104
determined48842046012882144182245292401438508570639
by8512288012870141
the10252288012852123185
coincidence12452288012875146184255317356425488557620682
of19622288012882128
the21252288012852123186
pulsation23462288012882152191245307346385455525
of29072288012881129
the30712288012852121184
apex32892288012875145208278
of36032288012882129
the37672288012852121184
heart39862288012882145207254292
with432622880128102140179249
the46112288012850121184
pulsation48302288012882152191245308347385455525
of53912288012882129
the8512529012839110172
carotid10572529012873135182251290329399
artery.14922529012872118157220265335369
In18962529012857127
normal20592529012879150197306366405
conditions,25002529012874143214284322362400471540594630
the31652529012848119180
apex33802529012873143205275
beat36902529012880142205244
is39682529012850104
positive,41072529012879149204243282321390452487
coinciding46292529012873143181251314353422461531601
with527625290128101139178248
the8512771012839110172
pulsation10572771012893163202256319357396466535
of16282771012892139
the18022771012861131194
carotid20312771012883146192263301341410
artery.24772771012884130169232279349382
Negative289427710128124186256319358396467530
apex34582771012884154216286
beat37802771012891154217254
is40702771012860115
determined42212771012891154192255300411447518581650
during49062771012893162210247318388
the53292771012860130192
retraction8513012012847109148195258319358396467537
of142330120128101147
the16063012012869139202
intercostal18433012012870139179241287350420474514575614
space24933012012884155217279341
during286930120128101171218256327396
left33013012012869132179217
ventricular355330120128101163233272319357420490528591638
systole.42263012012884155209248318357419454
In47153012012878148
pathology,489830120128101163202272341381451520591624
negative8513254012870133202265304342412475
apex13613254012862131194264
beat16593254012870133195233
is1928325401283992
found20563254012845115186256325
in24173254012839108
adherent25613254012862131201264310372445484
(constrictive)30803254012847109178248303341388426489528566636699746
pericarditis.38613254012870131178217279341388457497535575629664
The10313495012886155218
symptom12843495012859130239306346416526
of18433495012876123
systolic20013495012862132185225294334372435
and24703495012868138208
diastolic27123495012876114177231270340379418481
tremor3226349501284592154262329377
(symptom36383495012852109179288356395466577
of42473495012876123
a44053495012870
cat's45093495012867129168193248
purr,47913495012875146193240275
i.e.5099349501284580143178
low53103495012845115216
vibrating8513737012870110179226289327366436505
murmur,140037370128109177224335402450485
resembles19203737012854117170233342410449512567
purring25223737012877147194241279349419
of29773737012876124
a31363737012870
cat).32403737012869131170221257
It3532373701285492
is36603737012845100
of37953737012878124
great39543737012879125187249288
value42773737012877140179248311
in46233737012846117
the47743737012847117180
diagnosis49893737012877115178247318388443481535
of8513979012870117
heart10033979012873135197243282
diseases.13213979012871110164227290343406459495
This18533979012885155194249
sign2137397901285796166235
depends24083979012872135204267336406460
on29043979012872142
the30813979012841111174
same32893979012856119228288
causes36123979012865127197252315370
that40173979012841111174217
are42703979012864111173
responsible44783979012848110165234305375429468538577639
for51523979012849119166
the53533979012841111173
murmur85142200128109177224335402450
arising13364220012890137176231271340410
in17824220012867137
stenosed19544220012883122183254323378441510
valve25004220012897160199268331
orifices.28664220012898145183230269331393446482
In33834220012875145
order35644220012897144213276323
to39224220012866137
determine40944220012898160198261308416453523586
the47154220012867138201
thrill,49514220012866137183222261300336
the53224220012865136198
palpating8514461012870133172242304342381451521
hand14084461012893156226296
should17394461012879149219289328398
be21724461012895157
placed23644461012895133196259320390
flat27904461012871109172210
on30354461012894165
the32354461012863133196
points34654461012895165204274312367
where386844610128126194257304366
the42694461012863133195
heart44984461012895158220267305
is48394461012862117
normally49924461012894164210320380419458529
auscultated.8514702012862133188249320358397459498560630666
Tremor155247020128110156218327395442
palpated20294702012895158197266329367430499
over25634702012894164226273
the28714702012862131194
heart31004702012894156217264303
apex34394702012885155217286
during37614702012894163211248319389
diastolic41854702012894132195249288358397436498
contraction47194702012886155224264315377438477516586656
is54114702012861115
characteristic8514945012862133195242305366405468513552606646684747
of163349450128106152
mitral182049450128145182221268331370
stenosis,22264945012890128191260331385423478514
and27754945012897168237
tremor30484945012877123185294361409
felt34924945012882145184223
over375149450128105176239284
the40714945012874144207
aorta43134945012898167214253315
during466349450128106175223262331401
systole50994945012891161214253324362425
indicate8515186012839110179219281343381444
stenosed1330518601285492155224295349412481
aortic18465186012863133179218256319
orifice.22005186012870117155202240303365401
Percussion10315432012686148210272350405459499568647
of17115432012670118
the18645432012646125187
Heart.208554320126110172241304351386
Relative10315669012894156195258296335405468
dullness15325669012870141180218289351405459
borders20265669012871141188257320367420
of24825669012870117
the26345669012838108170
heart28395669012871133196241280
in31555669012837108
normal32975669012870141187297357396
condition.37295669012862132202272311350389458529564
Right10315911012894133203273311
border13785911012882152199268331377
of17915911012881128
relative19545911012859120159222259298368430
dullness24195911012881152190230299362415470
of29245911012882129
the30875911012850120183
heart33055911012883145207253292
–36335911012881
located37505911012851120183245283346415
along42015911012873111182252321
the45585911012850120183
right4776591101285896167236275
edge50865911012874143214277
of53975911012881128
the8516152012839110172
sternum1057615201285694157204273343453
in15436152012839110
the16896152012839108171
4th18956152012870109179
intercostal21086152012840111149212259320390444484545584
space27286152012855124187249311
or30746152012871118
may322761520128109170241
protrude35026152012870117188227274343413476
0.5-140136152012870105175228297
cm43456152012863171
to45506152012840110
the46966152012840109172
right4903615201284786155226264
of52036152012870117
the53556152012839109170
right851639301284786156226265
edge11516393012862133202265
of14496393012871118
the16026393012839108171
sternum.1808639301285393156201270341451483
Formed23266393012878148195306366436
by27976393012871141
the29716393012839110173
right3179639301284684155224264
atrium.34786393012861100147185255365397
Upper103166350128101171242304351
border14166635012872141188257320367
of18186635012871117
relative19706635012848110148211248288358420
dullness24256635012871140179218289350405459
of29206635012870116
the30726635012839108171
heart32786635012870133195241280
–35936635012872
located37016635012838109171233272334404
at41406635012863101
the42766635012840109172
level44826635012840102172234273
of47906635012870117
the49426635012839109173
3rd51506635012871117187
rib5372663501284785154
along8516877012862101172242311
a11986877012881
line1314687701285796166229
115786877012888
cm17016877012881191
to19246877012858129
the20876877012858129190
left23136877012857120166205
of25536877012888135
the27236877012857128189
left29476877012858120167206
edge31896877012879148219281
of35056877012889136
the36756877012858128190
sternum,39006877012873112175221291360470503
formed44386877012866137184293353423
by48976877012889160
the50906877012858128191
left53166877012857120166204
auricle8517118012862133180218281320381
and12677118012863133202
the15057118012839108171
cone17117118012862131201263
of20087118012870118
the21617118012839108171
pulmonary23657118012871141180289357428491537608
artery.30067118012862109148210257328361
Left10317360012886148194233
border13007360012875144192262324370
of17067360012874122
relative18637360012851113151214253291361423
dullness23217360012874145183223293355409464
of28207360012874121
the29767360012843114176
heart31877360012874137200246284
–35077360012878
located36207360012844113176238276339409
1-1.540657360012873122192227296
cm43967360012867176
to46057360012844115
the47567360012843114176
left49677360012843106153191
of51937360012875122
the53507360012843113175
midsternal85176010128109146216272311374420490552591
line1478760101283777146209
in17227601012838109
the18667601012838107170
5th20707601012870109179
intercostal22847601012840109147210257319388446484547585
space.29057601012854123186248310345
Formed32847601012878149196305365435
by37557601012870140
the39297601012839109172
left41367601012839101148187
ventricle.43587601012870132201240287325388426489524