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1、呼吸困難:oeffortisthegreatestintheinspiratoryphaseoobstructioninthetracheaormajorbronchi(tumorjoreignbody,severelaryngitis喉炎)cthreedepressionssign三凹征(interspaces,suprasternalfossaandsupraclavicularfossas)oaudiblestridor(localized)Expiratorydyspnea呼氣性呼吸困難:effortisthegre
2、atestintheexpiratoryphaseobstructioninthebronchioles細(xì)支氣管andsmallerbronchi(asthma哮喘,bronchitis氣管炎,andobstructiveemphysema阻塞性肺氣腫)expirationisprolongedandoftenaccompaniedbydiffusedwheezing喘鳴bulgingoftheinterspaces?PALPATIONPalpationistheprocessoftouchingthepatientinan
3、efforttoevaluatecervicalandaxillarylymphnodestrachea"sposition(positionofthemediastinum縱隔)thoracicexpansiontendernessanychestabnormalitiesthatarenotevident⑹vocalfremitus語音震顫Vocalfremitus?thevibration振動(dòng)causedbyphonation發(fā)音andtransmittedthroughthechestiscalledvocalfem
4、itusNormalvariationsoffremitusIntensity強(qiáng)度ofthevoicePitch音調(diào)ofthevoicevaryingrelationsofthebronchitothechestwallvaryingthicknessofthethoracicWallDecreasedtactile觸覺vocalfremitusexccssairinthelung(emphysema肺氣腫)obstructionofmajorbronchus(obstructiveatelectasis阻塞性肺不張)fib
5、rousthickeningofthepleurapleuraleffusionorpneumothoraxsubcutaneousemphysema皮下氣腫IncreasedtactilevocalfremitusConsolidationoflung肺實(shí)變Pneumonia肺炎Pulmonaryinfarction肺梗死Bigcavityclosedtochestwall?PERCUSSIONPercussionreferstothetappingonasurfacetodeterminetheunderlyingstr
6、ucture.LPercussionmethodsMediate間接percussion(indirectpercussion)Immediate直接percussion(directpercussion)PercussionsoundsThecharacterofpercussionnotesaredependentupontheair-tissueratiotheyhaveResonance清音Hyperresonance過清音Tympany鼓音Dullness濁音firmlytotheskin2.Normalbr
7、eathsoundsInthenormallung,thesoundsheardonauscultationarethesoundsofairrushingthroughthetubelikestructuresofthetracheobronchialtree.Sincetherateofflowchanges未根除腐敗,但社會(huì)反腐敗的強(qiáng)人壓力,畢競(jìng)還是使腐敗現(xiàn)象受到了一?定程度的遏制。而在其他-些第三惟界國家,比如墨西琲,人民對(duì)腐敗則"寬容"得多,他們認(rèn)為,權(quán)勢(shì)者可以貪污受賄,只耍不拿得太多就行。最近,韓國金泳三總統(tǒng)的次
8、子被捕,除了證明腐敗的廣泛存在外,至少也反應(yīng)出人民的壓力和政府反腐敗的決心。同時(shí),韓國歷屆政府盡管都采取了各種措施,有些在一定時(shí)期內(nèi)有很有成效,但始終未能根治腐敗問題,也證明了反腐敗是一個(gè)反期的過程,不可能一勞永逸。這對(duì)于我們的反腐敗斗爭(zhēng)來講,也是一個(gè)有益的啟示。因此,我們從韓國發(fā)展模式得