[教育]循環(huán)系統(tǒng)障礙common_symptoms_and_signs_of_circulation_system

1、Common symptoms and signs of circulation system,Common symptoms of heart disease,Chest Pain,Dyspnea,Palpitation,Edema,Syncope,Cyanosis,Common symptoms of heart disease——chest pain,AP AMI Acute pericarditis

2、 Cardiac neurosis,Cause:,cardiogenic：,other,1, location,Common symptoms of heart disease——chest pain,keypoints of inquiry,2, nature and degree,3, duration,4, incentive,5, reliever,6, radiation,7, accompanied symptoms,

3、Cardiac factors: cardiac dysfunction, pericardial tamponade, etc.,Common symptoms of heart disease——dyspnea,Cause,Non-cardiac factors: disease of respiratory system, disease of blood system, etc.,Others:,1, acute or

4、chronic2, relationship with position and movement 3, accompanied symptoms,Common symptoms of heart disease——dyspnea,keypoints of inquiry,heartthrob enhancearrhythmiatachycardiabradycardiaarrhythmiacardiac neurosis

5、,Common symptoms of heart disease——Palpitation,Common cause:,1, precipitating factor2, accompanied symptoms3, primary disease,Common symptoms of heart disease——Palpitation,keypoints of inquiry,CardiogenicCardiac out

6、put blockArrhythmia,Common symptoms of heart disease——syncope,Other,Cause,1, Attack position2, Precipitating factor3, Symptoms before the attack4, Accompanied symptoms,Common symptoms of heart disease——syncope,keypoi

7、nts of inquiry,Cardiogenic factors: cardiac dysfunctionpulmonary embolism, etc,Common symptoms of heart disease——cough,Cause,Non-cardiogenic factors: respiratory system diseasecentral cough,CauseSystemic edemacard

8、iacnephrogenichepaticOther reasons,Common symptoms of heart disease——edema,Local edemaLocal inflammationVenous reflux obstruction, etc,1,Past history2,Starting position3,Accompanied symptoms,Common symptoms of hea

9、rt disease——edema,Keypoints of inquiry,Cause:Central cyanosis:cardiovascularpulmonary,Common symptoms of heart disease——cyanosis,Peripheral cyanosis: Relative increase of peripheral oxygen consumptionArterial ischem

10、ia,Mixed cyanosis: Cardiac dysfunctionAbnormal hemoglobin derivant,1,Onset age2,Heart and lung disease history3,Accompanied symptoms,Keypoints of inquiry,Common symptoms of heart disease——cyanosis,,Ventricular enlarg

11、ement signsHeart rate and rhythm changeHeart sound changeHeart murmurOther important signs,Heart sign,,Left ventricular enlargement,Apex pulse:,Left ventricular enlargement,lower-left shift,greater than 2 cm,lifting

12、type impulse,lower-left enlargement,Apex pulse range:,The apex :,Cardiac dullness border:,Right ventricular enlargement,Apex pulse:,Right ventricular enlargement,left-shift,Precordium :,lifting type impulse,Subxyphoid a

13、pex pulse:,common in pulmonary emphysema with right ventricular enlargement,Protrusion of precordium:,onset during childhood,Cardiac dullness border:,left enlargement,pear-shaped heart,boot-shaped heart,mitral (valve) s

14、tenosis,aortic insufficiency,hydropericardium,upright positin,lying position,Heart rate and rhythm change,Fast and regular: sinus tachycardia, paroxysmal tachycardia,Slow and regular: sinus bradycardia, conduction block

15、of level III with escape rhythm,Arrhythmia: sinus arrhythmia, premature beat, conduction block above II, atrial fibrillation,,,S1,S2,,,,,,,,,,left edge of sternum and apex region,bottom,,normal,S1 enhance,S1 recede,S1 d

16、ivision,apex,apex,bottom,factors that affect S1,Integrity of atrioventricular valveActivity of atrioventricular valveVentricular systolic rate(dp/dt),Mitral stenosisTachycardiaHigh CO,factors that enhance S1,Mitral v

17、alve insufficiencyAtrioventricular block level IMyocardial damage,factors that weaken S1,factors that affect S2,Aortic and pulmonary artery pressureIntegrity and elasticity of semilunar valve,P2 enhancement in:Pulmon

18、ary hypertensionPulmonary circulation congestion,factors that enhance S2,A2 enhancement in:HypertensionAortic atherosclerosis,P2 weakened in pulmonary valve lesionsA2 weakened in aortic lesions,factors that weaken S2

19、,,,,,,,,,,,,,,,,,expiration,inspiration,general Splitting,fixed splitting,reversed splitting,1,2,1,A2P2,1,A2P2,1,A2P2,,1,P2A2,1,2,Extral sound,gallop rhythm opening snapabnormal heart sounds after prosthetic valve repl

20、acement,gallop rhythm,mid-diastolic galloppresystolic gallopquadruple rhythm,opening snap,Meaning: mitral stenosisMechanism,abnormal heart sounds after prosthetic valve replacement,speedy blood flow,stenosis of valve

21、 opening or blood vessel,relative stenosis caused by ventricular enlargement or large blood vessels dilation,valvular insufficiency,relative valvular insufficiency,shunt of large blood vessels or chambers of heart,intra

22、cardiac floaters,Heart murmurs mechanism,1.Blood flow speedy2. Valvular lesions3. Large blood vessels or cardiac enlargement4. Shunt5. Intracardiac floaters,listenning content of cardiac murmur,locationtimeconduct

23、ion of murmurtones of murmurloudness of murmurrelationship between murmur and breathing, position, movement or some drugs,Cardiac auscultation region,Systolic murmurs strength classification,Level 1: weak noise, a v

24、ery short time, unheard during the first few seconds,Level 2: weak noise, more easily heard,Level 3: noise of medium intensity,Level 4: a loud noise, often accompanied by tremor,Systolic murmurs strength classification,L

25、evel 5: very loud, shocking , unheard after taking stethoscope away from chest wall , all accompanied by tremor,Level 6: extremely loud, heard even with stethoscope a certaindistance away from chest wall , with stron

26、g tremor,cardiac murmur,mitral insufficiency,ventricular septal defect VSD,Aortic stenosis,pulmonary valve stenosis,aortic insufficiency,mitral (valve) stenosis,patent ductus arteriosus PDA,conduction of murmur tones o

27、f murmur relationship between murmur and breathing, position, movement,differentiation between physiological and pathological murmur,,Pericardial rub,other important sighs,Tremor,Peripheral vascular signs,The clinical

28、significance of various cardiac tremor,Peripheral vascular sign,Water hammer pulseCapillary pulsationShooting sound,abnormal pulse,Water hammer pulse:,pulse rises rapidly, and suddenly falls, indicating pulse pressure

29、 increase，common in aortic incompetence.,Pulse deficit：,pulse rate slower than ventricular rate, indicating atrial fibrillation.,abnormal pulse,Paradoxical pulse:,Pulse weaken obviously or disappear during inspiration.S

30、uggesting pericardial effusion or constrictive pericarditis (cp).,Pulsus alternans：,Rhythm is normal , strong and weak pulse appear alternately , serious myocardial damage performance.,Mitral stenosis,auscultation: S1

31、enhancement in apex, and late diastole rumbling murmur, most clear in left decubitus, P2 hyperfunction or division, valve openning tone,percussion: pear-shaped heart,palpation: diastolic fine tremor in apex area,Inspecti

32、on: mitral valve face, apex impulse left- shift,Mitral insufficiency,auscultation: Apex rough blowing pansystolic murmurs, range is wide, conduct to left axillary or left shoulder angle, conduction, S1 abate, P2 hyperfu

33、nction,percussion: left enlargement of cardiac dullness border,palpation: lifting type impulse of the apex,Inspection: apex impulse lower-left shift,Aortic stenosis AS,auscultation: A2 weaken or disappear, rough syst

34、olic murmur can be heard in aortic valve area, conducting to neck,Inspection: apex impulse lower-left shift,palpation: lifting type impulse of the apex,systolic tremor in aortic valve area,percussion: lower-left enla

35、rgement of cardiac dullness border,Aortic insufficiency,Auscultation: Apex S1 abate, A2 weaken or disappear, sighing diastolic murmur can be heard in the second aortic auscultation area , conducting to the apex region

36、,Inspection: apex impulse lower-left shift, range dispersed,Palpation: apex impulse lower-left shift, lifting type impulse of the apex,Percussion: lower-left enlargement of cardiac dullness border, boot-shaped heart,

37、Peripheral vascular signs: capillary pulsation sign, water shock pulse, artery shooting tone,Ventricular septal defect VSD,Inspection: apex impulse normal or slight left shift,Palpation: systolic tremor can be heard i

38、n sternal left edge 3rd and 4th intercostal space,Percussion: cardiac dullness border normal or slight enlargement, slight cardiac waist bulging,Auscultation: rough systolic murmur in sternal left edge 3rd and 4th inter

39、costal space, P2 hyperfunction,middle diastolic murmur can be heard during large shunt,Patent ductus arteriosus,Inspection: apex impulse normal or slight left shift,Palpation: systolic tremor can be heard in sternal

40、left edge 2nd intercostal space , it can be continuous,Percussion: cardiac dullness border normal or slight left enlargement, slight cardiac waist bulging,Auscultation: continuous machine murmur in sternum left edge 2n

41、d intercostal place , P2 hyperfunction and division,Heart murmurs description should include：,locationperiodintensitynatureconductioninfluence of respiration、position and exercise,A,B,C,D,E,F,G,Signs of heart diseas