Topic 24 - Physiological lung borders in dogs. Alterations of the lung borders and the percussion sounds. Percussion of the cardiac region, determination of the cardiac boundaries.

Question 1

What are the lung borders of dog?

Answer 1

1. At the line of the ventral border of tuber coxae and thoracic vertebrae 11
2. At the line of ischiadic tuber and the thoracic vertebrae 10
3. At the line of the point of the shoulder and thoracic vertebrae 8

Question 2

What are the lung borders of horse?

Answer 2

1. At the line of the ventral border of tuber coxae and thoracic vertebrae 16
2. At the line of ischiadic tuber and the thoracic vertebrae 14
3. At the line of the point of the shoulder and thoracic vertebrae 10

Question 3

What are the lung borders of ruminant?

Answer 3

1. At the line of the ventral border of tuber coxae and thoracic vertebrae 11
2. At the line of ischiadic tuber
3. At the line of the point of the shoulder and thoracic vertebrae 8

Question 4

Number of ribs in each animal:

Answer 4

Horse = 18
Ruminant = 13
Dog/cat = 13
Pigs = 14

Question 4

What are the lung borders of swine?

Answer 4

1. At the line of the ventral border of tuber coxae and thoracic vertebrae 11
2. At the line of ischiadic tuber and the thoracic vertebrae 9
3. At the line of the point of the shoulder and thoracic vertebrae 7

Question 4

Example of abnormal shift of the lung borders:

Answer 4

1. Displacement of the caudal border backwards and downwards
2. Decrease of the percussion area of the lungs
3. “Elevation” of the caudoventral border

Question 5

What can be the cause of a displacement of the caudal border backwards and downwards?

Answer 5

Alveolar and interstitial lung emphysema

Question 6

What can be the cause of a decrease of the percussion area of the lungs?

Answer 6

Abdominal distension, which can be due to:

*distention of stomach or intestine
*enlarged liver
*pregnancy
*ascites
*large intraabdominal tumor

Question 7

What can be the cause of an “elevation” of the caudoventral border?

Answer 7

Increase of the cardiac dullness

Question 8

Name examples of altered percussion sounds within the lung borders:

Answer 8

1. Relative, incomplete or absolute dullness
2. Tympanic sound
3. Hollow sound
4. Metallic sound
5. Cracked-pot sound

Question 9

Sound of relative or incomplete dullness of percussion sound:

Answer 9

Weak
High
Short
Non-musical sound

Question 10

Sound of absolute dullness:

Answer 10

Weaker and shorter

Question 11

What can cause relative, incomplete or absolute dullness?

Answer 11

1. Thickened thoracic wall (edema)
2. Decreased gas content of the lungs (pneumonia)
3. Pleuritis
4. Atelectatic abdominal organs
5. Atelectatic solid masses or masses filled with fluid within the thorax

Question 12

Sound of tympanic percussion sound:

Answer 12

Intensive and high resonance

Can be:
Sharp
Weak
High
Low

Question 13

What can cause tympanic sound?

Answer 13

1. atelectatic parenchyma around the normal lung cavern in the lung or open pneumothorax
2. Eventrated abdominal organs filled with gas
   -3. Ichorous pericarditis (fluid and gas in the pericardium)
3. Emphysema localised subcutaneously

Question 14

What is the sound of hollow precussion sound?

Answer 14

Low
More intensive
Shorter
More non-musical than tympanic

Question 15

In which cases can we hear hollow percussion sound?

Answer 15

in wasted animals with thin chest and severe lung emphysema

Question 16

In which cases can we hear the metallic percussions sound?

Answer 16

• pneumothorax
• large cavern within the lung
• prolapsed stomach or intestine in the thoracic cavity
• subcutaneous emphysema

Question 17

In which cases can we hear the cracked-pot percussion sound?

Answer 17

• Small subcutaneous emphysema
• Cavern filled with gas and located under the chest wall which communicates with a bronchus

Question 18

Percussion of the cardiac area, what is the primary goal?

Answer 18

To detect:
- Fluid accumulation
- Space occupying lesions
- PTX (Pneumothorax)

Question 19

What are the cardiac boundaries?

Answer 19

Hard to tell, since the heart is covered by the lungs, but we can detect cardiac dullness - Either absolute or relative

Question 20

Does dogs have absolute or relative cardiac dullness? What does it mean?

Answer 20

Absolute
= the heart is in contact with the thoracic wall

+ horse

Question 21

Does cats have absolute or relative cardiac dullness? What does it mean?

Answer 21

Relative
= Lung lobes are in the way

Question 22

In dogs, where can we locate absolute cardiac dullness

Answer 22

Right side: 4-5 ICS

Left side: 4-6 ICS

Question 23

In cats, where can we locate relative cardiac dullness

Answer 23

Usually difficult to detect

Question 24

Name some alterations of the area of cardiac dullness:

Answer 24

1. Enlargement of the cardiac dullness
2. Cardiac enlargement
3. Pericardial effusion
4. Cardiac dislocation
5. False enlargement
6. Fluid accumulation

Question 25

What is enlargement of the cardiac dullness?

Answer 25

Dullness in the lower part of the chest

Question 26

What is false enlargement?

Answer 26

other organs, space occupying lesions, such as: tumor, abscess, hernia

Question 27

How can we detect fluid accumulation in the heart?

Answer 27

1. Horizontal line of dullness
2. Diernhofer-triangle disappear

Almost impossible to detect in small animals!

Question 28

What is the horizontal line of dullness?

Answer 28

No sound can be heard under the line

Question 29

What is the Diernhofer-triangle?

Answer 29

Diernhofer triangle is normally filled with air, but in case of free fluid in the abdomen it will disappear.

Even in heart enlargement it remains.