心臟體格檢查視診英文版

1、1Physical Examinationof Cardiovascular SystemFOR MBBS STUDENTSDepartment of DiagnosticsThe First Affiliated Hospital of Guangxi Medical University2345natomy67Part oneInspection 89deformitynApical impulse precordium10nInspect the obverse side.11Deformity12Deformity13Apical Impulse nApical impulse mai

2、nly results from the left ventricular contraction, when LV contracts, the apical knocks at the correspondent position of anterior chest wall, resulting in intercostal impulse outward movement.14Apical Impulse Normal apical impulsenPosition: left border of sternum, fifth intercostal space, inside the

3、 midclavicular line 0.51.0cmnRange: 22.5cm in diameter15Apical Impulse nApical impulse displacement16Apical Impulse Apical impulse displacement(1). extra-heart factors (2). cardiac enlargement (3). body posture17Apical Impulse DisplacementExtra-heart factors: Obesity, pregnancy, etc. cause elevation

4、 of diaphragm, apical impulse shifts to outward and upward, at left the 4th intercostal space outside midclavicular line. 18Apical Impulse DisplacementExtra-heart factors: Abdominal disease: abdominal tumor, a large number of ascites, etc. elevation of diaphragm, apical impulse shifts to outward and

5、 upward 19Apical Impulse DisplacementExtra-heart factors: Leptosome; severely pulmonary emphysema. Then apical impulse shifts to inward and downward, reaches at the 6th intercostal space.20Apical Impulse DisplacementExtra-heart factors: Single side pleural thickening, or adhesion, or atelectasis res

6、ult in mediastinum and heart shifting to the sick side, and the apical impulse shifts to the sick side , too. aortic arch LV to the sick side21NormalApical Impulse Displacementheart shifts to the healthy sidePleural effussion in the rightto the healthside22Apical Impulse DisplacementCardiac enlargem

7、entnRight ventricle enlargement. Apical impulse shifts to the left but not downward.nLeft ventricle enlargement. Apical impulse shifts to the left and downward at the same time.23Left Ventricle EnlargementNormal LV enlargement24Both Ventricles EnlargementBoth ventricles enlargementNormal25Apical Imp

8、ulse DisplacementBody posturenDorsal decubitus. Apical impulse moves a little upward, if left lateral decubitus the apical impulse shifts to the left 23cm. nRight lateral decubitus. The apical impulse shifts to the right 12.5cm.26Apical Impulse (1). (2). Pathological 2728Pathological Enhanced apical impulse : n left ventricular enlargementn hyperthyroidismn fever, anemiaPathologic