Western Diagnosis----Physical examination diagnosis/Notes/5...examination----- Cardiovascular System...
Transcript of Western Diagnosis----Physical examination diagnosis/Notes/5...examination----- Cardiovascular System...
Western Diagnosis----Physical examination
----- Cardiovascular System
Western Diagnosis ------ Physical examination-- Heart
HEART EXAMINATIONInspection and Palpation
1. The Apex-beat5th intercostal space, 0.5-1 cm in the
middle side of midclavicular line, scope diameter 2.0-2.5cm
2. Alteration in the Width and Strength of the Apex-beat
3. The Neighborhood of the Heart in general
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATIONPercussion
1. Normal Percussion Figure of the Heart .Right boundary (cm) Intercostal space Left boundary (cm)
2-3 II 2-3
2-3 III 3.5-4.5
3-4 IV 5-6
V 7-9
It is about 8-10 cm from midline to Left midclavicular line
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATION
Percussion
2. Enlargement of the Area of Heart-dullness (Hypertrophy and dilatation of the left ventricle, Fluid in the pericardium)
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATION
Percussion
3. Diminution or Loss of Heart-dullness (emphysema of the lungs 肺气肿, pneumo-pericardium 心包积气)
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATION
Percussion4. Displacement (dislocation) of the Heart-
dullness (chest flattened or pressed in, Emphysema
of the lungs, pleurisy胸膜炎, Shrinking of the lungs)
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATION
Auscultation1. Method
1. Aortic valve : 2nd intercostal space, right of sternum.
2. Pulmonic valve : 2nd intercostal space, left of sternum
3. Tricuspid valve :left sternal border4. Mitral valve : Apex
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATIONAuscultation
2. Normal ConditionThe first and second heart-sounds1st sound : Closure of the mitral and the
tricuspid valves and ventricular contraction.
2d sound : Closure of aortic and pulmonary valve.
Western Diagnosis ------ Physical examination -- Heart
HEART EXAMINATION
Auscultation3. Abnormal Condition
• Abnormalities of the First Heart Sound• Abnormalities of the Second Heart
Sound• Systolic Clicks• Diastolic Opening Snaps• Murmurs