心脏评价.PPT

心脏检查CARDIOVASCUIAR EXAMINATION 课堂目标learning oblectives 说出正常心尖搏动的位置和范围 To state the range and site of apical impulse 阐述震颤的概念、产生机制及临床意义 To elaborate the concept, mechanism and clinical significance of thrill 描述正常心脏相对浊音界的范围 To describe the border of relative dullness 说出心脏瓣膜听诊区的概念及位置 To state the concept and site of auscultatory cardiac valve areas 比较S1、S2心音的产生机制、特点与临床意义 To compare the difference between S1 and S2 about their mechanism, character and clinical significance 陈述杂音的概念与分级 To state the concept and grade of heart murmurs 概 述introduction 运用视、触、叩、听等检查方法初步判定有无心脏疾病，判断心脏病的病因、性质、部位及程度．在临床上具有重要的意义。 To use inspection, palpation, percussion and auscultation to determine whether heart diseases exist and what the causes may be, the site and the characters if heart diseases exist .So CARDIOVASCUIAR EXAMINATION has great significance . 检查的注意事项matters needing attention in the examination 一般采取仰卧位或坐位； dorsal position or sitting position is often used; 环境应安静； 光线充足，最好是来源于左侧， The environment should be quiet and bright; it will be better if light source comes from left side; 室温不低于20℃； Temperature should be higher than 20 ℃ 心脏视诊lnspection of the heart (一)心前区隆起与凹陷 eminence or introcession in precordial region (二)心尖搏动 apical impulse (三)心前区异常搏动 Abnormal precordial pulsation 心脏触诊Palpation of the heart 检查者常用右手，以全手掌、手掌尺侧(小鱼际)或示指、中指和无名指并拢以指腹触诊。 The whole palm, antithenar eminence or fingertipsof Right hand is often used when Palpation. 检查震颤常用手掌尺侧，检查心尖搏动常用2-4指指腹。 antithenar eminence is often used for thrill Palpation, while fingertips are often used for apical impulse Palpation Palpation of the heart (一)心尖搏动 apical impulse (二)震颤:概念;产生机制 Thrill: concept; mechanism (三)心包摩擦感:概念;产生机制;特点 sense of pericardial friction :concept; mechanism; character 心脏叩诊Percussion of the heart 心脏叩诊用以确定心界，判定心脏大小、形状及在胸腔位置的一种方法。 Percussion of the heart is used to find the border of the heart; 相对浊音界反映心脏的实际大小,具有重要的临床意义. border of relative dullness present the true size o