《肺部体检》PPT课件.pptVIP

*;（1）掌握胸部常用的体表标志和人工划线，胸部的陷窝和分区； （2）掌握胸、肺部视诊、触诊检查方法，能获得较正确的结果；识别正常状态和异常体征； （3）熟悉肺部常见体征的临床意义。;胸部的体表标志;*;骨骼标志（Skeletal landmarks）;*;*;*;人工划线和自然陷窝;*;*;*;*; 表—里 上—下 前—后 视、触、叩、听顺序进行 ;视诊（inspection);胸壁皮肤——颜色、肿胀……;胸壁静脉——有无充盈或曲张;有无回缩或膨隆 吸气时肋间隙回缩提示呼吸道阻塞 肋间隙膨隆见于大量胸腔积液、张力性气胸、严重肺气肿患者用力呼气时 胸壁肿瘤、主动脉瘤、婴儿和儿童时期心脏明显肿大者，相应局部的肋间隙常膨出;胸廓形态;Barrel chest;胸廓形态;胸廓形态;*;*;*;*;*;呼吸方式——胸式、腹式 呼吸频率 呼吸深度 呼吸节律 吸气时相和呼气时相的时间变化 两侧呼吸运动的一致性;触诊（palpation）;胸廓扩张度（thoracic expansion);胸廓扩张度（thoracic expansion);语音震颤（vocal fremitus）-触觉震颤（tactile fremitus);语音震颤（vocal fremitus）-触觉震颤（tactile fremitus);语音震颤（vocal fremitus）-触觉震颤（tactile fremitus);语音震颤（vocal fremitus）-触觉震颤（tactile fremitus);胸膜摩擦感（pleural friction fremitus）;*;*;*;*;*;*;*;*;*;*;*;*;*;*;*;*;*;*;*;（1）胸骨角 (sternal angle)-Louis角的确定及意义？ （2）肩胛下角的确定及意义？ （3）锁骨中线的确定及意义？;*;*;病例书写格式;Large left Hemithorax can be seen in all of the following except:  1.Left pleural effusion 2.Left Pneumothorax 3.Kyphoscoliosis 4.Agenesis of right lung ;Smaller left Hemithorax can be seen in all of the following except:  1.Consolidation of left lower lobe 2.Atelectasis of left lung 3.Left Pleural fibrosis 4.Agenesis of left lung ;Which statement is correct in counting the Respiratory rate: 1.BP, Pulse and Respiratory rate should be taken first 2.Tell the patient that you are going to count his respiraory rate before counting 3.Count it aduring examination of Respiratory system steps 4.After patient is in a relaxed state count it without the patient being aware that you are counting his respiratory rate ;Bradypnea is seen in all of the following except:  1.Brain Tumor 2.Myxedema （粘液水肿） 3.Morphine overdose 4.Congestive heart failure ;Slow deep breathing is:  1.Kussmals breathing 2.Biots respiration 3.Cheyne stokes breathing 4.Sighs 5.Sleep apnea ;In Congestive Heart failure following can occur except:  1.Increased Respiratory rate 2.Cheyne stokes breathing 3.Platypnea 4.Orthopnea 5.Labored breathing ;Possible causes of unilateral diminuti