《儿科护理学》课程教学资源（PPT课件）青紫与杂音 Cyanosis and Heart Murmurs

Problem based learning (Session I) Cyanosis

Problem based learning (Session I) Cyanosis

Cyanosis-Hints Central cyanosis:implies decreased arterial oxygen saturation Peripheral cyanosis:caused by a decreased rate of peripheral blood flow

Cyanosis-Hints ◼ Central cyanosis: implies decreased arterial oxygen saturation ◼ Peripheral cyanosis: caused by a decreased rate of peripheral blood flow

Differential diagnosis Cardiovascular disease -Congenital heart disease -Eisenmenger syndrome -Pulmonary arteriovenous fistulae -Systemic arteriovenous fistulae -Primary pulmonary hypertension

Differential diagnosis ◼ Cardiovascular disease -Congenital heart disease -Eisenmenger syndrome -Pulmonary arteriovenous fistulae -Systemic arteriovenous fistulae -Primary pulmonary hypertension

Differential diagnosis -Congestive heart failure/low output state Respiratory diseases -Nasal obstruction -Foreign body aspiration -Tracheal compression -Bronchiolitis -Reactive airway disease

Differential diagnosis -Congestive heart failure/ low output state ◼ Respiratory diseases -Nasal obstruction -Foreign body aspiration -Tracheal compression -Bronchiolitis -Reactive airway disease

Differential diagnosis -RDS -Meconium aspiration -Pneumonia -Plural effusion -Diaphragmatic hernia -Lung hypoplasia

Differential diagnosis -RDS -Meconium aspiration -Pneumonia -Plural effusion -Diaphragmatic hernia -Lung hypoplasia

Differential diagnosis Metabolic disease -Hypoglycemia ■Neurologic diseases -Seizures -Edema -Hemorrhage

Differential diagnosis ◼ Metabolic disease -Hypoglycemia ◼ Neurologic diseases -Seizures -Edema -Hemorrhage

Differential diagnosis Miscellaneous -Crying -Sepsis -Breath holding -Drug:respiratory depressants

Differential diagnosis ◼ Miscellaneous -Crying -Sepsis -Breath holding -Drug: respiratory depressants

Differential diagnosis Discussion Cardiovascular -Neonates with cyanosis by CHD 1.Poor mixing of the systemic and pulmonary circulations ransposition Nomal Heart RV Foramen Ovale

Differential diagnosis Discussion ◼ Cardiovascular -Neonates with cyanosis by CHD 1. Poor mixing of the systemic and pulmonary circulations

Differential diagnosis Discussion Decreased pulmonary blood flow and normal peripheral perfusion Pulmonary Atresia with Intact Ventricular Septum Tetralogy of Fallot R

Differential diagnosis Discussion ◼ Decreased pulmonary blood flow and normal peripheral perfusion

Differential diagnosis Discussion Increased pulmonary venous pressure leading to pulmonary edema and poor gas exchange View of abnormal connection of Oxygenated pulmonary blood from veins behind the right the heart lung Pulmonary Veins Oxygenated RA blood from RV the left lung TAPVD

Differential diagnosis Discussion ◼ Increased pulmonary venous pressure leading to pulmonary edema and poor gas exchange