LABORATORY MANUAL OF PHYSIOLOGY. 



(b) Bronchial Breathing. With a stethoscope listen to the 

 breathing over the trachea and over the second costal cartilage on 

 the right side. The latter position is at the bifurcation of the right 

 bronchus. The sounds heard here are due to the passage of air 

 through a tube and in part over the mouth of a tube. This is a 

 fair example of normal bronchial breathing. Compare with ve- 

 sicular breathing. Should bronchial breathing be heard where you 

 listened for vesicular breathing ? What change in the lung might 

 give rise to bronchial breathing ? 



(c) Listen over the right lung during forced respiration. How 

 do the respiratory sounds differ from those of quiet respiration ? 



(d) Now go over the chest systematically, first one side and then 

 the other, comparing the two. Start at the supraclavicular space 

 of one side, then listen in the same region on the other side, and so 

 on over all of the anterior, lateral, and posterior aspects of the 

 thorax. Note any differences in the sounds in the different regions 

 of the chest either in intensity, or duration, or character. Explain. 



3. Palpation. Vocal Fremitus. Place the same hand suc- 

 cessively over the various regions of the chest both in front and 

 behind, alternating sides, so as to compare one region with its fel- 

 low of the opposite side. While the hand is applied to the chest 

 wall let the subject say " twenty-one " or some other number. The 

 vibrations of the chest wall during phonation are distinctly felt by 

 the hand. There are pathologic variations of this, either in an ac- 

 centuation of the fremitus on one side as compared with the other, 

 or in a diminution of the fremitus. 



Listen again over the various regions of the chest while the sub- 

 ject counts "one, two, three." The sound will be transmitted to 

 the ear, but more as a murmur, and not as distinctly enunciated 

 syllables. In certain pathologic conditions the spoken or whis- 

 pered word is very distinctly heard, as if it were spoken directly 

 into the end of the stethoscope. What physical changes in the 

 lung might cause this condition ? 



4. Percussion. Laying the middle finger of the left hand be- 

 tween the ribs, in the intercostal spaces, and using the bent mid- 



