推荐心电图学教学PPT(彩图完整版).pptxVIP

心电图学教程Electrocardiogram teaching course一、心电图学基础Fundament of the ECG二、心电图的临床应用Clinical application of the ECG返回一、心电图学基础Fundament of the ECG（一）心血管传导系统cardiovascular intrinsic conduction system（二）正常心电图波形normal electrocardiographic complexes（三）心电图导联leads of the ECG 返回（一）心血管传导系统cardiovascular intrinsic conduction system返回心脏的传导系统由以下几部分组成窦房结 SA node结间束 internodal atrial pathways房室结 AV node希氏束 AV bundle右束支 right bundle branches左束支 left bundle branchesPurkinje 纤维网 Purkinje system 正常心电活动始于窦房结，并从此发出冲动，循此特殊传导系统的通道下传，先后兴奋心房和心室，使心脏收缩，执行泵血功能。这种先后有序的电兴奋的传播，将引起一系列的电位改变，形成心电图上相应的波形。单击上图单击上图单击上图由窦房结发出的冲动，通过心肌传导系统产生心肌自律细胞和收缩细胞除极化和复极化的连续过程，引起一系列的电位改变，用体表电极记录下来，就成为心电图。返回（二）正常心电图波形normal electrocardiographic complexes返回正常心电图波形normal electrocardiographic complexesP波表示心房除极化P waves signal depolarization of the atriaQRS 综合波表示心室的除极化QRS complexes signal depolarization of the ventricleT和U波由心室复极化形成T and U waves arise form ventricular repolarizationS-ANA-VN单击左图窦房结(S-AN)返回（三）心电图导联 leads of the ECG返回 临床心电图的信号主要是从体表采集的。如将探测电极安置于体表相隔一定距离的任意两点，原则上约可测出心电的电位变化，此两点即构成一个导联。两点的连线代表导联轴，具有方向性。 临床常用的心电图导联共12个。双极肢体导联 bipolar extremityⅠRALA－＋－＋ Ⅱ－＋ⅢLLⅠ＝LA－RA，Ⅱ＝LL－RA，Ⅲ＝LL－LA加压肢体导联 augmented extremity leads －－＋ －aVRaVL＋ ＋aVF包括aVR、aVL、aVF导联胸前导联（precordial leads）腋中线腋前线前正中线锁骨中线V1V2V3 V6V5V4包括V1、V2、V3、V4、V5、V6导联胸前导联（precordial leads）V1 胸骨右缘第4肋间fourth intercostal spac at the right sternal borderV2 胸骨左缘第4肋间fourth intercostal spac at the left sternal borderV3 V2与V4连线的中点equidistant between V2 and V4V4 左锁骨中线与第5肋间相交处 fifth intercostal space in the left midclavicular lineV5 左腋前线V4水平处 left anterior axillary line, in the same horizontal plane as V4V6 左腋中线V4水平处 left midaxillary line, in the same horizontal plane as V4返回二、心电图的临床应用Clinical application of the ECG（一）心电图的测量方法determination method of the ECG（二）正常心电图normal ECG（三）心房与心室肥大 atrial and ventricular hypertrophy返回（四）心律失常 cardiac arrhythmias（五）心肌缺血、损伤和心肌梗死 myocardial ischemia injury an myocardial infarction（六）电解质与心电图 electrolytes and the ECG（七）洋地黄与心电图digitalis an