医学诊断学：肺部检查(2).ppt

physical examination肺部检查(2)Pulmonary Examination
pulmonary auscultation
肺部听诊
signs in pulmonary disease
肺部常见疾病体征
Auscultation of the Lung肺部听诊
breath sound 呼吸音
rales 啰音
vocal resonance 语音共振
pleural friction rub
胸膜摩擦音
Principles of Sound Transmission声音的传导
Distance
传导距离
Number of interfaces
界面的数量
The nature of the transmitting medium
传导介质的性质
The more dense the medium, the better the transmission
传导介质密度越高 传导性能越好
Breath Sounds呼吸音
Airflow tremor
Inspiratory phase: Ascending branch
Expiratory phase: Descending branch
Hearing duration: Length of the line
Loudness: Thickness of the line
Pitch: Angle
气流产生震动
吸气相:升支
呼气相:降支
声音时间:
线条长短
音响强弱:
线条粗细
音调高低:
夹角大小
Classify of Breath Sound呼吸音分类
Normal and abnormal
正常和异常呼吸音
Bronchial breath sounds
支气管呼吸音
Vesicular breath sounds
肺泡呼吸音
Bronchovesicular breath sounds
支气管肺泡呼吸音
Normal Bronchial Breath Sounds正常支气管呼吸音
They are harsher and of higher pitch than vesicular sounds.
It is an expiratory sound.
In expiration phase, it’s relatively louder, higher pitched and lasts longer.
Best heard at laryngeal, suprasternal fossa, C 6-7, and T 1-2.
气流经声门气道
产生震动
“哈”的声音
呼气时声门窄 声音响
吸气相长强高
呼气相更长更强更高
听诊部位
喉部 胸骨上窝
颈椎6, 7和胸椎1, 2
Normal Vesicular Breath Sounds正常肺泡呼吸音
Low pitched, fine, and heard well at the periphery of the lung.
It is an inspiratory sound.
In inspiration phase, it’s relatively louder, higher pitched and lasts longer
气流进出肺泡
产生振动
“夫”的声音
吸气时肺紧张 声音响
吸气相长 强 高
呼气相短 弱 低
听诊部位: 肺部区域
乳房 肩胛 腋窝下部
最清晰
Normal Bronchovesicular Breath Sounds 正常支气管肺泡呼吸音
A mixture of the two elements
The two phases are quite similar in intensity, duration, and pitch.
Best heard anteriorly over the upper end of the sternum and just beside it at the level of Louis’s angle, and posteriorly over the interscapular spaces at the level of the third and fourth t