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《常见心脏病症状和体征.ppt》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、心脏查体复习视诊心前区外形心尖搏动正常心尖搏动异常心尖搏动（移位、弥散、反向）心前区异常搏动触诊心尖搏动正常异常（抬举性，移位）心前区搏动震颤与临床意义心包摩擦感心脏查体复习叩诊手法顺序正常心浊音界心浊音界改变及对应的临床意义听诊5个听诊区位置听诊顺序6个听诊内容心脏听诊复习正常心率范围心律不齐类型心音构成,心动周期划分,强度变化,心音分裂及其临床意义额外心音及其临床意义舒张期:奔马律,开瓣音,心包扣击音,肿瘤扑落音收缩期:A&P喷射音,喀喇音杂音及其临床意义5要素概念5听诊区两期中杂音的临床意义常见心脏病症状体征MitralstenosisMitralregurgitationAo
2、rticstenosisAorticregurgitationPericardialeffusionHeartfailure收缩期心脏瓣膜舒张期心脏瓣膜二尖瓣狭窄HistoryDyspneaaccompanywithcough&wheezingHemoptysisSystemicembolismPEMitralfaciesApex:TrillofMSLargedRVS1,P2>A2,spiltS2,OS,lowpitchedrumblingDMofMS，GrahamSteell二尖瓣关闭不全HistoryNosymptomsforyearsWhenLVfailuredyspneawe
3、akness，fatiguePEApexpulsemovetoleftApex:Liftingpulse&TrillofMSLeftBorder:toLeftandlowerS1,high-pitchedblowingSM,radiationtoaxilla主动脉瓣狭窄HistoryAngina(5y)Syncope(3y)Heartfailure(2y)SuddendeathPE(-)/ApexpulsemovetoleftApex:LiftingpulseA2area:TrillofMSLeftBorder:toLeftandlowerA2,P2>A2,reversespiltS
4、2A1area:SM主动脉瓣关闭不全HistoryDizzinessPalpitationHeartfailurePEcarotisA.pulseApex:leftandlower/liftingpulseWaterhammerpulseLeftBorder:toleftandlowerA2area:decrescendoDMAustinFlint,Pistolshotsound心包积液History症状取决于积液的速度和量CoughordyspneaDysphagiaPaininchestweekandfeverPEApexpulse:Apexpulse:DoubleBorder:
5、enlargedEwartsignLittleeffusion:Pericardialfrictionsound.Largeeffusion:HRS1S2,Pericardialknock左心衰竭HistoryExertionaldyspneaOrthopneaParoxysmalnocturnaldyspneaCoughWeakPECyanosis,polypnea,sweatPulsealternansDoubleBorder:enlargedPulmonaryrales,P2Galloprhythm右心衰竭HistoryAnorectic,VomitusAbdominaldis
6、tensionUropeniaPEEdemaHepatojugularrefluxCongestivehepatomegalyRVenlargedHydrothorax,AscitesGalloprhythm课程回顾心脏查体视诊,触诊,叩诊,听诊(6项)血管检查脉搏,血压,血管杂音,周围血管征常见心脏病症状体征心脏瓣膜病,心包积液,心衰THANKYOU
