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Diagnosis, Immunity
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ngertips Such tapping helps the clinician (clin-ISH-un) working in a clinic to evaluate the size, borders, and consistency of underlying viscera (internal organs) Percussion can also help reveal the relative amount of uid accumulated within a body cavity Often following percussion is auscultation (aws-kul-TAY-shun) a process of (-ion) listening (auscult) (The combined sequence is often called percussion and auscultation, abbreviated as P & A) For many centuries, auscultation was performed by simply placing an ear tightly against a body surface, such as the back or chest This permitted the hearing of internal body sounds, like the beating of the heart and movement of air into and out of the lungs
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Laennec invents the stethoscope
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One of the most vital improvements in the quality of auscultation (internal body listening) came with the inventive mind of a Frenchman named Rene Laennec (LAY-uh-nek), who lived in Europe from 1781 to 1826 Dr Laennec was walking home one day, and he noticed two young boys playing One boy was holding a thick stick up to his ear, while the other was scratching a long pin over the other end This simple trick gave Laennec a brilliant insight Why not try that with my patients he must have said to himself As a result, Laennec set to work and invented the rst stethoscope (Figure 54) Laennec originally developed it as an instrument used to examine (scope) the sounds of the chest (steth) Basically, it was a hollow wooden cylinder over which Laennec pressed one of his ears The resulting ampli cation (am-plih- h-KAY-shun) or enlargement (boosting) of chest sounds made auscultation of the thorax much more accurate and ef cient Today, of course, the basic stethoscope design consists of Y-shaped rubber tubing connecting two earpieces to a single bell that is held against the body
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Ultrasound goes far beyond
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Traditional auscultation using a stethoscope, of course, depends upon the existence of audible (AW-dih-bl) sound waves those that are capable (-ible) of being heard (aud) Around 1957, a whole new science called ultrasonics (ultrah-SAHN-iks) was developed This name translates to mean pertaining to (-ic) vibrations that are far beyond (ultra-) the range of audible sound (son) Ultrasound (UL-trah-sound) technology for medicine was developed largely by a British physician named Ian Donald During World War II, ultrasonics was rst used to bounce sound waves of very high frequency off the hulls of enemy submarines Later, it detected cracks, aws, and bubbles in the metal of machine parts But Ian Donald altered this technology to create medical ultrasonography
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Cells and Body Defense
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Fig 54 Laennec invents the stethoscope for auscultation (A) Laennec using a hollow
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wooden cylinder as his primitive stethoscope for auscultation of the chest (B) A modern stethoscope with Y-shaped tubing
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Diagnosis, Immunity
(ul-trah-son-AHG-rah-fee) This new eld involves the process of recording (-graphy) extremely high-frequency sound waves re ected off internal body structures Sound waves of very high frequency can easily and harmlessly pass through human esh They are re ected or bounced off tissues with different degrees of density These re ected high-frequency waves then make a visible tracing on an electronic screen The visible tracing is called a sonogram (SOH-noh-gram) or sound record Because the high-frequency rays are harmless, they are especially helpful in creating ultrasound pictures (sonograms) of the human fetus (FEE-tus) A fetus is technically the unborn offspring (fet) during the later stages of pregnancy This technique enables physicians to diagnose many prenatal (pree-NAY-tal) problems those that occur before (pre-) birth (nat)
X-rays come out from the unknown
A third major diagnostic technology is radiography (ray-dee-AHG-rahfee) the process of recording (-graphy) x- rays (radi) The interesting story behind x-rays involves a German physicist (FIZZ-ih-sist) named W K Roentgen (RENT-gun) In 1895, Roentgen was experimenting with a new device called a vacuum tube This is a sealed glass tube that encloses a vacuum (space completely empty of air) The tube contains a cathode (KAY-thohd) or lament that gives off electrons (negatively charged particles) when heated Roentgen was surprised to nd that something very different (in addition to a stream of electrons) was coming out of his heated vacuum tube There were also mysterious, invisible rays of unknown origin, which he called x-rays These rays were able to pass right through softer, less dense body tissues, such as the skin and muscle tissue of his wife s hand (See Figure 55, A) However, the rays bounced off the harder, denser body tissues, such as bone and cartilage (KARtih-lahj) The result was the very rst radiogram (RAY-dee-oh-gram) x-ray (radi) record (gram) of the human body [Thinking probe: Please observe that the radiogram of the hand of Roentgen s wife has the bones clearly standing out as a black image upon a white background of the softer skin and muscle tissue Now, think about the modern radiograms you have seen of people s bones Do the x-rayed bones show up black, as they did in Roentgen s day ] Because of his pioneering work, W K Roentgen can be given credit as the Father of Radiology, which is the study of (-ology) rays (radi) Therefore, he was also the rst radiologist, because he was one who studied (-ologist) these mysterious rays Soon after Roentgen s discovery, early uoroscopes (FLOOR-oh-skohps) were developed These are technically instruments that examine (-scopes) the interior of the body by casting x-ray shadows ( uor) of them In 1896,
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