诊断学——循环系统检体-辽宁医学院附属第一医院.pptVIP

The Physical Examination of blood vessels 1st Affiliated Hospital  Liaoning Medical College He Xin 一、pulse 1、pulse rate 2、pulse rhythm 3、tensions and state of arterial wall 4、intensity 5、pulse wave 1、pulse rate Atrial fibrillation and frequent premature beat stroke volume peripheral artery no pulse pulse rate less than HR(pulse deficit) 2、pulse rhythm ---pulse deficit ---bigeminal pulse,trigeminal pulse ---dropped pulse 3、tensions and state of arterial wall ---Artery tension depending on blood pressure (mainly SBP) ---Judge state of artery wall 4、intensity ---Bownding pulse seen:high fever, hyperthyroidism, AI ---Microsphygmia seen:HF,AS and shock 5、pulse wave ---normal pulse wave composed of upstroke（knocking wave） peak （tide wave）and downstro （dicrotic wave） ---water hammer pulse seen:AI,hyperthyroidism,PDA, severe anemia ---pulse tardus seen:AS ---dicrotic pulse seen:HCM ---pulsus alternans seen:HBP,AMI,AI ---paradoxical pulse seen:cardiac tamponade,constrictive pericarditis ---Pulseless seen:serious shock, arteritis 二、blood pressure 1、method of measurement ---direct measurement method ---indirect measurement method 2、Standard of blood pressure definition of Bp level and classification(older than 18 years old) classification SBP(mmHg) DBP(mmHg) Ideal BP ?120 ?80 Normal BP ?130 ?85 High limit of BP 130-139 85-89 Grade 1（mild） 140-159 90-99 subgroup： boundline hypertension 140-149 90-94 Grade 2（moderate） 160-179 100-109 Grade 3（severe） ≥ 180 ≥110 Simple systolic hypertension ?140 ?90 subgroup： boundline systolic hyp