an obsolete sign:
1. rales and other adventitious sounds, changes in the respiratory murmurs, and increase in the whispered sound can be heard on auscultation over the acromial end of the clavicle some time before they become audible at the apex; heard primarily in pulmonary tuberculosis affecting the apical portion of the lung;
2. a dull-flat note, i.e., one between the normal dullness at the right apex and absolute flatness, heard on percussion in that region, indicating progress from incipient to advanced tuberculosis.