《体格检查-胸部》PPT课件

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1、PhysicalExaminationoftheChestDepartmentofmedicineLiuYuanChapter3LungsandPleura1.InspectionRespiratoryrateanddepthNormalBradypneaTachypneaFastandDeepBreathingRespiratoryRhythmTidalBreathingCheyne-StokesBiotsBreathingSighing　Breathing2.PalpationThoracicExpansionVocalFremitusPneumo

2、niaPleuralEffusionPneumothoraxPleuralFrictionFremitus3.Percussion正常胸部叩诊音UpperLungMarginsNormal4～6cmLowerLungMarginsTheExtentofDiaphragmaticExcursionAbnormalPercussionSound4.Auscultation三种正常呼吸音NormalBreathSoundsBronchialBreathSound机理特点部位喉部、胸骨上窝、背部第6、7颈椎、第1-2胸椎VesicularBreathSoundB

3、ronchovesicularBreathSound机理特点部位胸骨两侧第1、2肋间、肩胛间区第3、4胸椎水平、右肺尖AbnormalVesicularBreathSound肺泡呼吸音减弱或消失的常见原因（1）影响肺泡呼吸音传导（2）胸廓或肺的扩张受限（3）通气动力不足（4）通气阻力增大1、肺组织实变2、肺内大空洞3、压迫性肺不张AbnormalBronchialBreathSoundAbnormalBronchovesicularBreathSound1、肺实变区域较小与正常含气肺组织混杂2、肺实变部位较深且被正常肺组织所覆盖RalesorAd

4、dedSounds湿性罗音Moistralesorbubblesound干性罗音DryralesorrhonchiMoistrales机理分类CoarseralesMediumralesFineralesCrepitus特点：1、常连续多个出现2、吸气相明显3、部位较恒定性质不易变DryRalesorRhonchi机理分类2、1、DiffusedrhonchiLocalizedrhonchiSibilantrhonchiSonorousrhonchi特点：1、音调较高2、呼气相明显3、性质、部位易变语音共振VocalRe

5、sonance胸膜摩擦音PleuralFrictionRub机理易听诊部位鉴别诊断屏气试验闭口掩鼻试验OutlineforPhysicalExaminationoftheChestInspection1.Chestcontour,symmetry2.Breathingrate,rhythm,movementPalpation1.Trachealposition2.thoracicexpansion3.vocalfremitus4.pleuralfrictionfremitusOutlineforPhysicalExaminationofthe

6、ChestPercussion1.resonance,hyperresonance,dullness,tympany,stonydullness2.lungmarginsOutlineforPhysicalExaminationoftheChestAuscultation1.breathsounds2.addedsoundsorralesmoistrales,dryrales3.vocalresonance4.pleuralfrictionrubs