心脏查体英语.ppt

Examination of the Heart Examination of the Heart In the present era of technological advances, particularly in the various imaging modalities, there is a growing conception among practicing physicians in cardiovascular medicine that bedside physical examination is unnecessary and does not provide useful information. It should be emphasized, however, that for proper application and interpretation of various new and old tests that are available for cardiovascular evaluation in a given patient. Bedside clinical examination should be performed and practiced in the same way following similar sequences. Preparing the patient The heart examination should be made as easy as possible for the patient, who usually expects it to be a relatively distasteful experience. If the physician is considerate and gentle, the patient should feel when it is all over, that most of his or her fears on that score were unfounded. The ideal examining room is private, warm enough to avoid chilling, and free from distracting noise and sources of interruption. Adequate (preferably fluorescent or natural) light is essential. The examining table may be placed with its head against the wall, but both sides (particularly the right) and the foot should be accessible to the examiner. And the results should be recorded carefully. Examination of the Heart Landmarks and topographic anatomy Certain basic landmarks midsternal line midclavicular lines Certain basic landmarks anterior, middle, and posterior axillary lines suprasternal notch identification of various ribs and intercostal space Specific areas for cardiac PE sternoclavicular area aortic area pulmonary area Specific areas for cardiac PE anterior precordium apical area epigastric area ectopic area Inspection Inspection of the precordium should begin at the foot of the bed. The sub