诊断学-心脏检查.pptVIP

Arterial Pulse Abnormalities脉搏异常 Infrequent pulse 迟脉 Alternating pulse 交替脉 Water-hammer pulse 水冲脉 Dicrotic pulse 重搏脉 Pulsus paradoxus 奇脉 Alternating Pulse交替脉 characterized by alternation of a pulsation of small amplitude with the pulsation of large amplitude while the rhythm is normal. 脉搏强弱交替出现 Seen in left ventricular failure (more significant if pulse slow) 提示左心功能不全 Water-hammer Pulse水冲脉 Owning a greater amplitude than the normal pulse, a rapid rise to a narrow summit, and a sudden descent. 脉搏起伏大时间短 Seen in pulse pressure increase , such as aortic regurgitation, anemia, hyperthyroidism, patent ductus arteriosus. 提示脉压增大，如主动脉瓣关闭不全 贫血 甲 亢 动脉导管未闭 Pulsus Paradoxus奇脉 Characterized by an exaggerated decrease (10 mmHg) in the amplitude of pulsation during inspiration and increased amplitude during expiration. 吸气时脉搏明显减弱 Seen in premature cardiac contraction, tracheobronchial obstruction, bronchial asthma, emphysema, pericardial effusion, constrictive pericarditis. 提示心脏受压如肺过度充气 心包积液 缩窄性心包炎 Bruits and Hums异常声音及征象 Hyperthyroidism: a soft, pulsatile, whooshing, blowing sound in the thyroid gland area 甲状腺机能亢进: 甲状腺区血管柔和吹风样杂音 Polyarteritis: large artery systolic murmur 多发性大动脉炎: 大动脉血管收缩期杂音 Renal artery stenosis: systolic murmur in upper abdomen and back 肾动脉狭窄: 上腹及腰背部收缩期杂音 Aortic insufficiency: pistol shot sound, Duroziez double murmur, capillary pulsation. 脉压增大: 枪击音 杜氏双重杂音 毛细血管搏动征(甲床红白交替) Peripheral Vascular Sign周围血管征 Vascular sign: 征象 Water-hammer Pulse 水冲脉 Carotid artery impulse 颈动脉搏动 Nodding spasm 点头运动 Capillary pulsation 毛细血管搏动征 Pistol shot sound 枪击音 Duroziez double murmur 杜氏双重杂音 Clinical meaning: Seen in pulse pressure increase aortic insufficiency, hypertension, hyperthyroidism 提示: 脉压增大 主动脉瓣关闭不全 高血压 甲状腺机能亢进 Heart Disease心脏疾病 mitral stenosis 二尖瓣狭窄 aortic insufficiency 主动脉瓣关闭不全 Mitral Stenosis二尖瓣狭窄 L.A enlargement?Pulmonary artery