9.心脏检查2-心 脏 医听 诊(5学时).pptVIP

复习上次课内容 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 注意事项 环境安静，听诊器体件与胸壁间不能隔有衣物 医生注意力要高度集中，认真仔细，规范有序 被检者多采取仰卧位或坐位。为了更好地听清和瓣别心音或杂音，有时需让被检者改变体位，作深吸气或深呼气，或作适当运动(在病情允许时) 选择合适的听诊器 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一、心脏瓣膜听诊区 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 心律 正常： 常见心律失常： 期前收缩（早搏） 提前出现的一次心跳，其后有代偿间歇 房颤：三个不均一 心律绝对不齐 第一心音强弱不一 脉搏短绌 窦性心律、节律规整 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 0.8s 0.1s 0.08s 0.3s 0.5s 心音—（一）发生机制及听诊特点 下一张 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 二尖瓣狭窄 完全性房室传导阻滞 心肌收缩力增强 二尖瓣关闭不全 主动脉瓣关闭不全 心肌收缩力减弱 房颤、室早 Ⅲ度房室阻滞 A2：高血压、主动脉粥样硬化 P2：二尖瓣狭窄、左心衰 A2：主动脉瓣狭窄/关闭不全 P2：肺动脉瓣狭窄/关闭不全 钟摆律（胎心律）—心肌严重受损 房室瓣位置 心室肌收缩力 瓣膜完整性与弹性 动脉内压力 半月瓣弹性好完整性 二尖瓣、三尖瓣关闭明显不同步（＞0.04s） 主、肺动脉瓣 关闭明显不同步 （ ＞0.035s） 深吸气末 右心排血延长：二狭 左心排血缩短：二不全 房间隔缺损 完全性左束支传导阻滞 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 不同类型S2分裂的特点： 生理性分裂：呼无吸有 持续性分裂：呼轻吸重 固定性分裂：呼吸一致 反常分裂： 呼重吸轻 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 额外心音 ej：喷射音 click：喀喇音 os：开瓣音 —在S1和S2之外，额外出现的病理性附加音。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 二尖瓣狭窄 缩窄性心包炎 Evaluation only. Created with Aspose.