【文章內(nèi)容簡(jiǎn)介】
* acute distress 重度 窘迫 * nasal flaring or pursed lip縮唇 breathing * audible signs (stridor or wheezing) * cyanosis發(fā)紺 * using accessory輔助 muscles Inspiratory dyspnea吸氣性呼吸困難 : ? effort is the greatest in the inspiratory phase ? obstruction in the trachea or major bronchi (tumor, foreign body, severe laryngitis喉炎 ) ? three depressions sign三凹征 (interspaces, suprasternal fossa and supraclavicular fossas) ? audible stridor (localized) Abnormal types of respiration Abnormal types of respiration Expiratory dyspnea呼氣性呼吸困難 : * effort is the greatest in the expiratory phase * obstruction in the bronchioles 細(xì)支氣管 and smaller bronchi (asthma哮喘 , bronchitis氣管炎 , and obstructive emphysema阻塞性肺氣腫 ) * expiration is prolonged and often acpanied by diffused wheezing喘鳴 * bulging of the interspaces PP AA LL PP AA TT II OO NNP alp ation is the p r oc e ss of touchi n g thep atie n t in an e ff or t t o e valu ate⑴ c e rvic a l and a x il lar y l y mph nodes⑵ tra c he a ’s posit ion (posi ti on of the media st inum 縱隔 )⑶ thora c ic e x pa nsi on⑷ tende rne ss⑸ a n y c he st a bnorm a li ti e s t ha t ar e not e vident⑹ voc a l fr e mi tus 語(yǔ)音震顫 V oc al f r e m itus the vibr a tion 振動(dòng)c a use d b y phon a tion 發(fā)音 a nd tra nsmit te d thro ug h the c he stis ca lled voc a l f e mit usN orm al v ar iat ions of f r e m it us( 1) I nte nsit y 強(qiáng)度 of the vo ic e( 2) Pit c h 音調(diào) of the vo ic e( 3) va r y in g r e la tions of the br on c hi to the c he st w a ll( 4) va r y in g thic kn e ss o f the tho r a c ic w a llD e c r e ase d ta c t ile 觸覺(jué) voc al f r e m itus( 1) e x c e ss a ir in the lung ( e mph y s e ma 肺氣腫 )( 2) obstr uc tion of ma jor br onc hus ( obstr uc tive a te le c ta sis 阻塞性肺不張 )( 3) f ibr ous thic ke ning o f the ple ur a( 4) ple ur a l e f f usion or pne umothor a x( 5) subc uta ne ous e mph y se ma 皮下氣腫In c r e ase d t ac t il e voc al f r e m itusC onsoli da ti on of lung 肺實(shí)變P ne umonia 肺炎P ulm ona r y infa r c ti on 肺梗死B ig c a vit y c losed to c h e st wa llPP EE RR CC UU SS SS II OO NNP e r c ussi on r e f e r s t o t he t app in g on asurf ac e t o det e r m in e t he un der lyin gst r uct ur e .1. Pe r c ussi on m e t hod s⑴ Me dia te 間接 pe r c ussion ( indir e c t pe r c ussion)⑵ I mme dia t e 直接 pe r c ussion ( dir e c t pe r c ussion)2. P e r c ussion soun dsT he c ha