诊断学疾病部分英文讲解.ppt

诊断学疾病部分英文讲解Mitral stenosisCausesRHD-rheumatic heart diseasesenile retrogradecongenital heart diseaseMitral stenosisSymptomsdyspnea coughhemoptysis dysphagia HoarsenessSignsinspection mitral complexapex impulse may be displaced to the leftpalpationdiastolic thrillpercussionnormal heart borderspear shape heartAuscultationdiastolic murmurs:apical area,mild and late diastolic,crescendo,rumbling,more clearly when lying on ones left sideS1 opening snap mar be auscultatoryaccentuation of pulmonary second sound(P2),splittingGraham Steels murmur(PV diastolic)systolic mumur(TV area)atrial fibrillation(late stage)Mitral insufficiencyacute:infection ischemiachronic:RHD-rheumatic heart disease mitral prolapse coronary heart disease senile retrograde Mitral insufficiencySymptomspalpitationfatiguecoughdyspnea on exertionSignsinspection apex impulse displaced to left downwardpalpationheaving apex impulse,systolic thrill(severe)percussionthe border of dullness enlarged to left downward,both sides enlarged at late stage Auscultationmurmurs:apical area,pansystolic period,harsh,blowing,3/6 grade transmitted to left oxter and left infrascapular angleS1 P2,splittingAortic stenosisCausesRHD-rheumatic heart diseasecongenital heart disease senile retrogradeSymptomsdyspnea,angina pectoris,syncopeSignsinspection apex impulse increased and displaced to left downwardpalpationapex beat is elevated and forcefulsystolic thrill(AV1)pulse tarduspercussionnormal heart borders or the border of dullness enlarged to left downwardAuscultation murmurs:AV1 area,systolic period,harsh,ejection sound,3/6 grade transmitted to neckS2 (AV),reversed splittingS4Aortic insufficiencySymptomspalpitationfatiguedizzinesspulsating sense(head)angina pectoris dyspnea Signsinspection apex impulse displaced to left downwardpalpationheaving apex impulse and displaced to left downwardpercussionthe border of dullness enlarged to left downward,boot shape Auscultationmurmurs:aortic valvular area,diastolic period,decrescendo sighing heard clearly sitting erect and forward transmitted to left inferior sternum and apical area Austin Flint murmurPeripheral vascular signshead noddingcapillary pulsationwater hammer pulsepistol shot soumdDuroziezs MUEMUEvisible pulsation of carotid arteriesPericardial effusionCausesinfectivenon-infectiveSymptomspalpitation,dyspnea,cough,abdominal distention,edema,fever,shockSignsinspection apex impulse diminutionpalpationapex beat is palpated uneasilypercussionenlargement of the cardiac dullness bilaterally,changed with posture Auscultationpericardial friction,rapid HR,pericardial knocking sound,heart sound decreasedLarge PEjugular venous enlargementhepatomeglyhepatojugular reflux positiveEwart sign:(Subscapularis area )vocal fremitus dullness brochovesicular breath soundparadoxical pulseHeart failureSymptomsleft side heart failure:fatigue,progressive exertional dyspnea-nocturnal paroxysmal dyspnea-orthopnoeacough,foam sputum hemoptysis Symptomsright side heart failure:abdominal distentionoliguriaanorexia nausea and vomitingSigns(LHF)inspection Tachypnea,cyanosis,to sit up straight.Pink foam sputum,palpationpulsus alternanspercussionauscultationgallop rhythm,HR,P2 ,fine crackles,bronchial asthmaSigns(RHF)inspection:jugular venous enlargement peripheral cyanosis,edemapalpation:hepatomegly hepatojugular reflux positive edema percussion:pleural and ascitic fluidauscultation:systolic murmur(TV),gallop rhythmsymptoms and signs of primary heart disease 谢谢观赏！2020/11/524