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262 MILLER AND QUJMBY: DETERMINING CHEST CONDITION. [New Yokk .1. JOURN and stud) their movements; (lien by means of an intensifying Zestoretic 20 screen and instantaneous exposure we are able to make a plate which gives a correct though slightly hazy record of their Buy Zestoretic Online varying posi- tions; but our most valuable skiagraphs are those made Purchase Zestoretic without the screen and requiring an exposure of one fifth to one and one half second. These represent in accurate detail slight differences in the density Zestoretic 20 25 Mg of the parts under consideration and are the result of the most careful manipulation of the apparatus and patient after considerable preliminary study of each case. In order to represent quite ac- curately a third dimension, and enable Purchase Zestoretic Online us to see the superimposed shadows in perspective, two sepa- rate plates are exposed, in immediate succes-ion and under exactly the same conditions, except that the tube is moved horizontally two and one half Order Zestoretic inches Cheap Zestoretic to correspond with the average pupillary dis- tance. These plates when placed in a special ap- paratus give the effect familiar to all in the parlor stereoscope and enable the observer to determine the relationship of the larger shadows. Finer de- tail is obtained in doubtful conditions by sectional radiographs of small areas made under specially arranged conditions and at various angles. The principal points to be noticed in a radiologi- cal che^t examination are these : 1. Heart— (a) Position. (I.) Size. (c) Outline. (d) Movements. 2. Lungs — (a) Zestoretic 20 12.5 Mg Quality of Zestoretic Generic structure throughout. ( li ) Arborization. ( c) Outline of surface and excursion of diaphragm. (d) Adventitious tissue, exudates, and cavities. ( e ) I'oreign matter. (f) Condition and contents of pleural sac. 3. Mediastinum. Position, size, and outline of — (a) Trachea. (b) Esophagus. (c) Aorta and vessels, fd) Lymphatics. (e") Neoplasms. ( I ) Foreign bodies. 4. Osteocartilaginous structures — (a) Size, position, and relation. (b) Calcification, Zestoretic Online rarefaction, or sclerosis. The normal lung should present a very faint shadow, slightly denser toward the hilum and base. Beginning at the hilum Buy Cheap Zestoretic the main branches of the bronchi and pulmonary vessels may be plainly seen on account of the large amount of fibrous tissue in the former and the blood in the latter. It should be possible in many cases to distinguish between them at this point, as the bronchi manifest their hollow structure by dense borders and light centres, while the reverse is true of the bloodvessels. In their finer ramification, however, they are consid- ered collectively and constitute the pulmonary arborization, and in their Order Zestoretic Online continuation toward the periphery present a more veiled appearance, as of interlacing net work. It should also be understood that on account of various shadows being superim- posed, it is not possible to give full value to each part on one radiogram, but a separate set of condi- Buy Zestoretic tions must be arranged for each phase which Lisinopril 20 we desire to record, since the angle from which the rays are directed, as well as the position of the pa- tient Zestoretic Price and relation of plate to patient, will vary the appearance of the parts under observation. The cases in which radiology is especially valua- ble in making a diagnosis of pulmonary tuberculo- sis, before the disease may be determined by physi- cal signs, may be classed as follows: Generic Zestoretic Group A. in which there are areas of infiltration. Group B. in Zestoretic Strengths which scattering glands are infected. Under group A three areas are generally consid- ered by diagnosticians, the apex or subclavicular fossa, subscapular area or root, and the base. ( )f these our examinations would lead us to believe that the subscapular area is more commonly the first area affected than has been generally noted. And in this area also the physical signs are more ob- scured by the chest wall. We have also noticed that in some cases an ex- tensive process on one side may be continued for some months with Zestoretic Cost fibrosis, which has escaped notice till a more acute process on the opposite side calls attention to Zestoretic Tablets the case, and at such times the more serious lesion gives no distinguishable signs.

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