程医学英语课件2.docVIP

一．杂音描述 相关词汇 Auscultation Stethoscope, bell of the stethoscope Suprasternal notch Manubrium sterni Sternal angle Infrasternal angle = under the Xiphoid process [zi] Rib Free ribs Intercostal space Scapula Spinous process 脊突 Costae 肋 Costal spinal angle 肋脊角 Anterior midline 前正中线 Sternal line Parasternal line Midclavicular line anterior axillary line midaxillary line posterior axillary line scapular line posterior midline axillary tossa 腋窝 suprasternal tossa infraclavicular tossa suprascapular region infrascapular region interscapular region heart sound splitting extra cardiac sound qaudruple rhythm 四音律 gallop rhythm protodiastolic gallop 舒张早期奔马律 late diastolic gallop opening snap (MS) pericardial knock 缩窄性心包炎 tumor plop early systolic click /(ejection sound )大动脉根部和半月瓣震动，意义小 mid and late systolic click （mitral prolapse） murmurs crescendo murmur decrescendo murmur crescendo- decrescendo murmur continuous murmur plateau murmur Austin Flint （MS secondary to severe AR） Graham steel （PR secondary to PA enlargement） pericardial friction sound holosystolic, pansystolic high-frequency， high-pitched rediate to a slight delay after… rumbling murmur be best heard at …. in the left lateral decubitus（卧位） position dorsal decubitus仰卧位 in the supine position 仰卧位 ventral decubitus伏卧位 描述要点 1. the timing in the cardiac circle; 2. where on the chest they were heard; 3. their characteristics; 4. their intensity; 5. their duration 挑战实例 风湿性心脏病二尖瓣狭窄听诊特点： 心尖S1亢进，局限于心尖区的，舒张中晚期，低调，隆隆样，递增型杂音，平卧位或左侧卧位易闻及，常伴震颤。 示例范文 Systolic murmurs are very common and do not always imply cardiac disease. They are usually rated on a scale of 1 to 6, which grade 1 is barely audible, grade 4 is associated with palpable vibrations (thrill), grade 5 can be heard with the edge of the stethoscope, and grade 6 can be heard without a stethoscope. Most murmurs fall in the 1-3 range, and murmurs in the 4 -6 range are almost always due to pathologic conditions; severe disease can exist with grades 1-3