上海交通大学：《诊断学》课程PPT教学课件（英语版）Chapter 11 Examination of the Heart

米 Examination of the heart In the present era of technological advances, particularly in the various imaging modalities. there is a growing conception among practicing physicians in cardiovascular medicine that bedside physical examination is unnecessary and does not provide useful information

Examination of the Heart In the present era of technological advances, particularly in the various imaging modalities, there is a growing conception among practicing physicians in cardiovascular medicine that bedside physical examination is unnecessary and does not provide useful information

米 Examination of the heart It should be emphasized, however, that for proper application and interpretation of various new and old tests that are available for cardiovascular evaluation in a given patient. Bedside clinical examination should be performed and practiced in the same way following Similar sequences

Examination of the Heart It should be emphasized, however, that for proper application and interpretation of various new and old tests that are available for cardiovascular evaluation in a given patient. Bedside clinical examination should be performed and practiced in the same way following similar sequences

Examination of the heart Preparing the patient The heart examination should be made as easy as possible for the patient The ideal examining room is private warm enough to avoid chilling, and free from distracting noise and sources of interruption. Adequate(preferably fluorescent or natural) light is essential

Examination of the Heart Preparing the patient The heart examination should be made as easy as possible for the patient. The ideal examining room is private, warm enough to avoid chilling, and free from distracting noise and sources of interruption. Adequate (preferably fluorescent or natural) light is essential

米 Examination of the heart Landmarks and topographic anatomy Certain basic landmarks midsternal line midclavicular lines

Examination of the Heart Landmarks and topographic anatomy Certain basic landmarks midsternal line midclavicular lines

Certain basic landmarks anterior, middle, and posterior axillary lines suprasternal notch identification of various ribs and intercostal space

Certain basic landmarks anterior, middle, and posterior axillary lines suprasternal notch identification of various ribs and intercostal space

Specific areas for cardiac Pe sternoclavicular area aortic area pulmonary area

Specific areas for cardiac PE sternoclavicular area aortic area pulmonary area

Specific areas for cardiac PE anterior precordium apical area epigastric area ectopic area

Specific areas for cardiac PE anterior precordium apical area epigastric area ectopic area

米 Inspection Observe precordium Precordial bulge congenital heart disease(before puberty) pericardial effusion(adult life)

Inspection Observe precordium Precordial bulge congenital heart disease(before puberty) pericardical effusion (adult life)

米 Inspection Pulsation apical impulse The apical impulse is occurring early in systole. In adults the apical impulse normally is located in the left fifth intercostal space, either at or medial to the mvI and about 2-2.5 cm diameter. it serves the examiner as a marker for the onset of cardiac contraction

Inspection Pulsation apical impulse The apical impulse is occurring early in systole. In adults the apical impulse normally is located in the left fifth intercostal space, either at or medial to the mvl and about 2-2.5 cm diameter, it serves the examiner as a marker for the onset of cardiac contraction

Normal apical impulse It's location duration Intensity amplitude

Normal apical impulse: It’s location duration intensity amplitude