心血管体格检查PPT.pptx

Department of Cardiology, Renmin Hospital of Wuhan University;心血管系统体格检查;How to diagnosis?;Examination of the heart includes: Inspection: protrusion of precordium, apical impulse Palpation: point of maximum impulse, and sensation of pericardiac frication and thrill Percussion: estimate the heart size Auscultation: heart rate, cardiac rhythm, cardiac sound, extra cardiac sound, cardiac murmur, pericardial friction sound;Learning Objectives;Location of heart in th the chest;Landmarks and topographic anatomy;Landmarks and topographic anatomy;The patient lies on the back or stand, the doctor stands at the right of the patient Quiet environment, fitting light, comfortable room temperature Stethophone is comfortable The doctor is absorbed in and meticulous;Inspection;Inspection;Thoracic abnormalities;Apical impulse Normal apical impulse Location: in?the?left?fifth?intercostal?space,? 0.5~1.0cm?medial?to?the?left?mid-clavicular?line? Range：2.0~2.5cm in diameter Influential factor: Body habitus, Position, Age, Pregnancy ;;Inspection Apical impulse ;Inspection Apical impulse ;Inspection Apical impulse ;Inspection Apical impulse ;Inspection Apical impulse ;Inspection Apical impulse ;Inspection Apical impulse ;Inspection;Inspection;Abnormal precordial impulse;单选题;正常成人心尖搏动范围以直径计算为 A. 1.0~1.5cm B. 1.5~2.0cm C. 2.0~2.5cm D. 2.5~3.0cm E. 以上都不是;心尖搏动的论述，错误的是 A. 搏动范围以直径计算为1.0~1.5cm B. 可位于第五肋间左锁骨中线内0.5cm C. 可位于第四肋间 D. 可位于第六肋间 E. 体位、体型对心尖搏动位置有影响;心尖搏动移位的论述,错误的是 A. 肥胖体型者，心尖搏动可上移至第四肋间 B. 瘦长体型者，心尖搏动可下移至第六肋间 C. 左心室增大时心尖搏动向左下移位 D. 右心室增大时心尖搏动向右移位 E. 一侧胸膜粘连、增厚、心尖搏动向患侧 移位;Palpation;Palpation;Method;Palpation;Palpation;Palpation;Palpation;Palpation;震颤的论述，错误的是 A. 在心尖区触及收缩期震颤可见于二狭 B. 临床上凡触及震颤均可认为心脏有器质性病变 C. 触诊有震颤的部位多数可听到杂音 D. 在胸骨右缘第2肋间触及收缩期震颤可见于主狭 E. 在胸??左缘第2肋间触及收缩期震颤可见于肺动脉瓣狭窄;单选题;配伍题型;Percussion;Percussion;Percussion;Percussion;Percussion