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1、聽診器（stethoscope）的發(fā)明者—雷奈克1816年雷奈克去探視一位年輕的女心臟病人。由于肥胖，叩診或觸診困難，而附耳于其胸口做診斷又不被風(fēng)俗允許，他想起音學(xué)原理，聲音透過某些固體的傳遞可以達(dá)到放大的效果。隨即用紙卷成圓筒，結(jié)果聽到心臟跳動(dòng)的聲音，比他以前任何一次直接附耳于患者胸口來得更清晰。就在一瞬間，一個(gè)卷起的紙筒使臨床醫(yī)學(xué)向前邁進(jìn)了一大步。雷奈克最后定名為“聽診器”。聽診器的構(gòu)造及使用方法體件軟管及耳件彈簧部鐘型膜型國內(nèi)外常用的聽診器教學(xué)用聽診器電子聽診器一次性聽診器聽診器的使用方法：鐘形體件：用于聽取低調(diào)聲音膜形體件：適用于聽取高音調(diào)聲音
2、鐘形體件必須輕輕置于皮膚上，若壓得太緊，皮膚猶如隔膜，使低調(diào)聲音濾掉，反之，膜型體件需要緊貼胸壁皮膚。絕不能隔著衣服聽診。聽診方法1直接聽診法（directauscultation）2間接聽診法（indirectauscultation）聽診注意事項(xiàng)：1環(huán)境安靜，避免干擾。2聽診器體件貼于皮膚，切忌隔衣聽診。3正確使用聽診器：鐘型體件膜型體件4囑病人采取適當(dāng)體位。5聽診肺部或心音時(shí)，要注意摒除心音或呼吸音的干擾，必要時(shí)可囑病人控制呼吸配合聽診。心臟聽診（一）auscultationoftheheart心臟聽診（auscultationofthehear
3、t）心臟聽診的目的：Thepurposeofauscultationoftheheartistofindthenormalandabnormalsoundsoftheheart.Itplaysaveryimportantroleinthediagnosisofheartdisease.Itisaveryinterestingthingtomastertheauscultation,butitisdifficult.心臟聽診（auscultationoftheheart）聽診與體位等：Forathoroughexamination,auscultatio
4、nmustbedonewiththepatientinasitting,lying,andleftlateralrecumbentposition,andchangethepositionofpatientinordertodetectsomeabnormalsoundsandmurmurs.Whilethepatientrollontohisleftside,themurmurattheapexwillbehearmoreclearly.Exerciseisvaluableforincreasingtheintensityoffaintmurmurs
5、.Inauscultation,sometimesletthepatientholdingthebreathattheendofexpiration,themurmurwillbeheareasier.相關(guān)醫(yī)學(xué)基礎(chǔ)心臟瓣膜聽診區(qū)聽診順序聽診內(nèi)容心臟聽診須知心瓣膜的解剖位置與聽診部位心臟瓣膜聽診區(qū)AuscultatoryValveAreas4個(gè)瓣膜5個(gè)區(qū)心尖部（二尖瓣區(qū)）mitralvalvearea:Itisattheapex,inthefifthleftintercostalspace,medialtothemidclavicularline.主動(dòng)脈
6、瓣區(qū)aorticvalvearea:TherearetwoauscultatoryareaofAV,oneislocatedinthesecondrightintercostalspace,justlateraltothesternum.Theotherisatthethirdorfouthintercostalspace,lefttothesternumborder.WecallitthesecondauscultatoryareaofAV（主動(dòng)脈瓣第二聽診區(qū)）.肺動(dòng)脈瓣區(qū)pulmonaryvalvearea:inthesecondleftinter
7、costalspacejustlateraltothesternum.三尖瓣區(qū)tricuspidvalvearea:atthelowerpartofthesternumnearthexiphoid..聽診順序Thephysicianshouldadoptasystematicwayoflistening:startattheapex,thenmovetothePVarea,AVarea,secondAVarea,TVarea.Beside,accordingtheclinicalfeature,theotherpartofpericardium,nec
8、k,axilla,andbackmaybeexamined.胸部表面標(biāo)志及瓣膜聽診區(qū)藍(lán)線—心臟
