上海交通大学：《诊断学》课程PPT教学课件（英语版）Chapter 4 Auscultation of the Heart

Auscultation of the heart

Auscultation of the Heart

I Auscultatory Valve area 1. MV: apex, fifth left intercostal space. medial to the midclavicular line 2. PV: second left intercostal space 3. AV: second right intercostal space 4. AV2 left third intercostal space 5. TV: lower part of sternal 6. Other part

I. Auscultatory Valve Area • 1. MV: apex, fifth left intercostal space, medial to the midclavicular line • 2. PV: second left intercostal space • 3. AV: second right intercostal space • 4. AV2 : left third intercostal space • 5. TV: lower part of sternal • 6. Other part

I。 Auscultatory order Apex->PV→>AV→>AV,-T II. Content of auscultation ·1. Heart rate ·2. Heart rhythm 3. Heart sound 4 Heart murmurs

II. Auscultatory order • Apex→PV →AV →AV2 →TV III. Content of auscultation • 1. Heart rate • 2. Heart rhythm • 3. Heart sound • 4. Heart murmurs

1。HR Varies with age. sex. Physical activity and emotional status Normal adult 60-80/min Sinus tachycardia: >100/min Sinus bradycardia: <60/min

1. HR • Varies with age, sex. Physical activity and emotional status • Normal adult: 60-80/min • Sinus tachycardia: >100/min • Sinus bradycardia: 60/min

2. Heart rhythm 1)Sinus arrhythmia 2)Premature beat a sudden extrasystole of the heart in the basic of normal heart rhythm S1个;S2 Pulse absent Ectopic point at atrial, Av node, ventricle

2. Heart rhythm • 1) Sinus arrhythmia • 2) Premature beat: A sudden extrasystole of the heart in the basic of normal heart rhythm S1; S2 Pulse absent Ectopic point at atrial, AV node, ventricle

3)Atrial fibrillation Mechanism: a very high frequency impulse coming from the atrial ectopic point, in multl-reenti Three inconsistence: ventricular rhythm SI intensit Heart rate; pulse

• 3) Atrial fibrillation: Mechanism: a very high frequency impulse coming from the atrial ectopic point, in multi-reentry Three inconsistence: ventricular rhythm S1 intensity Heart rate; pulse

3. Heart sound: S1, s2, S3, S4 SI: S indicates the beginning of the ventricular constraction 1)Vibration of the closure ofA-v valve 2)Opening of the semilunar valve 3) Acceleration of the blood in arteries

3. Heart sound: S1 , S2 , S3 , S4 • S1 : S1 indicates the beginning of the ventricular constraction 1) Vibration of the closure of A-V valve 2) Opening of the semilunar valve 3) Acceleration of the blood in arteries

s,: Character of auscultation 1)Area: apex 2)Pitch 3)Lasting time 4)Together with apex impulse

• S1 : Character of auscultation 1) Area: apex 2) Pitch 3) Lasting time: 4) Together with apex impulse

S2: Vibration of the closure ofA, Pv during the beginning of ventricular diastole Indicates the beginning of ventricular diastole

• S2 : Vibration of the closure of AV, PV, during the beginning of ventricular diastole, Indicates the beginning of ventricular diastole