课件：心脏体格检查视诊英文版.pptVIP

* Apical Impulse Displacement Extra-heart factors: Obesity, pregnancy, etc. cause elevation of diaphragm, apical impulse shifts to outward and upward, at left the 4th intercostal space outside midclavicular line. * Apical Impulse Displacement Extra-heart factors: Abdominal disease: abdominal tumor, a large number of ascites, etc. elevation of diaphragm, apical impulse shifts to outward and upward THANK YOU SUCCESS * * 可编辑 * Apical Impulse Displacement Extra-heart factors: Leptosome; severely pulmonary emphysema. Then apical impulse shifts to inward and downward, reaches at the 6th intercostal space. * Apical Impulse Displacement Extra-heart factors: Single side pleural thickening, or adhesion, or atelectasis result in mediastinum and heart shifting to the sick side, and the apical impulse shifts to the sick side , too. aortic arch LV to the sick side * Normal Apical Impulse Displacement heart shifts to the healthy side Pleural effussion in the right to the health side * Apical Impulse Displacement Cardiac enlargement Right ventricle enlargement. Apical impulse shifts to the left but not downward. Left ventricle enlargement. Apical impulse shifts to the left and downward at the same time. * Left Ventricle Enlargement Normal LV enlargement * Both Ventricles Enlargement Both ventricles enlargement Normal * Apical Impulse Displacement Body posture Dorsal decubitus. Apical impulse moves a little upward, if left lateral decubitus the apical impulse shifts to the left 2~3cm. Right lateral decubitus. The apical impulse shifts to the right 1~2.5cm. * Apical Impulse （ inspection） Changes of intensity and area of apical impulse (1). Physical conditions (2). Pathological conditions * Physical conditions Thickness of the chest wall Emotion excited Strong physical activity Changes of Intensity and Area of  Apical Impulse * Changes of intensity and area