心血管检查7培训课件.ppt

Pericardial Friction Rubs心包摩擦音 Pathogenesis: Irritated visceral and parietal pericardial surfaces grate against each other 意义: 心包膜表面粗糙 Best heard site: LSB,3rd, 4th ICS 部位: 胸骨左缘第3, 4肋间 Characteristics: occur at the same time with heartbeats and have no relation with respiration 特点: 与心跳相一致 与呼吸无关 Clinical significance: pericarditis 提示: 心包炎 Vascular Examination血管检查 pulse examination 脉搏检查 blood vessel examination 血管杂音 Peripheral Arteries Blood Vessels周围动脉血管 carotid artery 颈动脉 brachial artery 肱动脉 radial artery 桡动脉 femoral artery 股动脉 popliteal artery 腘动脉 posterial tibial artery 胫后动脉 dorsalis pedis artery 足背动脉 Characteristics of Palpation触诊特点 Pulse rate 脉率（是否与心率一致） Pulse rhythm 脉律（节律是否整齐） Contour (wave form) 强度（增强→洪脉 减弱→细脉） Amplitude (strength) 紧张度（血管张力与弹性） Symmetry 对称性 Obstructions to blood flow 方法: 手指指腹 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 aortic regurgitation, patent ductus arteriosus. 提示主动脉瓣关闭不全 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 art