体格检查4呼吸系统－异常课件.ppt

Sept.2, 2011 呼吸系统体格检查 Pneumothorax Sept.2, 2011 呼吸系统体格检查 Symptoms Sudden chest pain Dyspnea Forced sitting position Dry cough Tension pneumothorax Progressive dyspnea Tachycardia Cyanosis Respiratory failure Sept.2, 2011 呼吸系统体格检查 Inspection Tachypnea Limited movement of affected side Costal interspaces of affected side are wider Palpation Trachea shifts to opposite side Decreased vocal fremitus Signs(1) Sept.2, 2011 呼吸系统体格检查 Percussion Tympany Auscultation Decreased or disappeared vesicular breath sound Decreased vocal fremitus Signs (2) Sept.2, 2011 呼吸系统体格检查 Pulmonary atelectasis Sept.2, 2011 呼吸系统体格检查 Signs (1) Inspection Tachypnea Limited movement of affected side Costal interspaces of affected side are narrow Palpation Trachea shifts to sick side Decreased or disappear vocal fremitus Sept.2, 2011 呼吸系统体格检查 Percussion Dullness or flatness Auscultation Decreased or disappeared vesicular breath sound Decreased or disappear vocal fremitus Signs (2) Sept.2, 2011 呼吸系统体格检查 肺与胸膜常见病变的体征表 Sept.2, 2011 呼吸系统体格检查 肺与胸膜常见病变的体征表 Sept.2, 2011 呼吸系统体格检查 * Sept.2, 2011 呼吸系统体格检查 Abnormal bronchial breath sound (tubular breath sound) Bronchial breath sound appears in supposed vesicular breath sound area Consolidation: lobar pneumonia (consolidation stage) Large cavity: TB, lung abscess Compressed atelectasis: hydrothorax, pneumothorax Sept.2, 2011 呼吸系统体格检查 Abnormal bronchovesicular breath sound Bronchovesicular breath sound appears in supposed vesicular breath sound area The lesion is relatively smaller or mixed with normal lung tissue Sept.2, 2011 呼吸系统体格检查 2、 Rales Moist rales ( Bubble sound, Crackles ) Dry rales (Rhonchi, wheezes) Sept.2, 2011 呼吸系统体格检查 Moist rales Mechanism During inspiration, air flow passes thin secretion in the airway to rupture the bubbles, or to open the collapse of bronchioli due to adhesion by secretion. Sept.2, 2011 呼吸系统体格检查 Characteristics of moist rales (MR) Adventitious sound Intermittent Appeared in phase of inspiration or e