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20. HEART NOISES. CLASSIFICATION. Intracardial noises. MECHANISM OF EDUCATION, PROPERTIES (7 PROPERTIES). DIAGNOSTIC VALUE

The gray noises are the sounds that are called. Instead of heart sounds (C), accompanied by sounds of C or arise without any connection with the tones of C. Classification: I. Inside the sulfur: a-organ is 1 valve, 2 non-valve; b-functions are 1-intermediate, 2-pure functions, 3-physical ones; II extra-e: a-perekardia-e, b-pleuropericardi-e, c-cardiopulmonary Mech m of internal noise Noise C is the mechanical oscillation of the structure caused by a turbulent blood flow as a result of: 1) narrower in the path of blood flow 2) expanded in the path of blood flow 3) roughness of the walls, which causes swirling flow 4) ^ speed. blood flow, ^ blood volume per unit time. 5) v blood viscosity, anemia. 6) wall seals (sclerosis). In normal conditions. the walls of the vessel, ventricles, atria extinguish turbulent blood flow, extinguish and water hammer. Properties of intracardiac noise I. Ratio of noise to the phase of the gray activity. Systole noise is heard in the systole phase between I and II tones in a short pause between them, after I tone. More precisely, one should determine the I tone, the phase of the systole, which coincide with the top push, the pulse wave. The reasons for the noise arising are S times but 2 large gr: 1) narrowing of the holes and arising obstacles fiziol. blood flow; 2) lack of tight closure by the valves of the valves of the holes and the resulting retrograde blood flow. II. The place where the noise was heard: - the mitral valve is heard at the apex, so the systolic noise at the apex is due to a lack of the mitral valve, and the diastole noise is due to the narrowing of the left venous opening; - at the basics. the sternum tricuspid valve is heard, so we come to the conclusion that systole noise, determined at this point, was explained by the lack of tricuspid valve, and diastole noise was caused by stenosis of the right atrioventricular. aperture; - in the II intercostal space between the right side of the sternum, the aortic valve was heard. The systolic murmur heard at this point, respectively, was a consequence of the narrowing of the mouth of the aorta. Diastole is the same noise heard at this point, due to the lack of aortic valves; - in the II intercostal space between. to the left I heard the pulmonary valve. Therefore, systole murmur at this point is a trace of narrowing of the mouth of the pulmonary artery. Diastole noise, by contrast, is a consequence of a lack of pulmonary valve artery. III. Location and direction of heart murmur: - systole; the noise of the mitral valve is carried out along the V intercostal space in the armpit with insufficient posterior leaflet.
If there is insufficient anterior leaflet, noise is made to Botkin's point; - systole; noise of insufficient tricuspid valve is not performed; - systolic murmur of stenosis of the aortic orifice is carried up the vessels, to the collarbone (by blood flow); - systolic murmur of narrowing of the pulmonary artery is not carried out ; -diastolic noise of stenosis of the left venous opening is not carried out; - diastolic noise of tricuspid stenosis is not carried out; - diastolic noise of lack of valve-in the aorta is carried out to the point of Botkin and further down along the left edge of the sternum; - diastolic noise of insufficiency- ty valves lego arterial artery runs down the left edge of the sternum. IV. Timbre of noise. Systolic noises are low, louder. Diastole noises are higher, more often soft, quiet. V. Change in noise over time. Systolic noise can be of the most various form which can be registered with. phonocardiograph. Subtlely, it is possible to distinguish noise occupying the entire systole, the beginning of noise with I tone. VI. The position of the body in which the noise is heard better. There is a general pattern, namely, that systolic murmurs are best heard in a clinostat. pos. pat-ta, and diastole-e - in the orthostat position. 1. Hearing C in the position of G-d on the left side helped. identify mitral diastolic murmur With this position. no orthostatic tachycardia. In addition, the left pin is located below the atrium, therefore, gravity forces the flow of blood and, consequently, the detection of noise diastolic. 2. After listening to the heart after mild exercise, it was possible to identify auscultatory symptoms more clearly as a result of accelerated blood flow. 3. Listen to C on a deep exhale and when the heart is less covered by the lungs on one side, the blood flow from the lungs to the heart and to the aorta increases. 4. After hearing C with the ass, breathing, breathing noises, it is very often difficult to auscult the heart. VII. Palpation perception. Low noise frequencies are perceived by palpation. With mitral stenosis, diastole trembling is palpated at the apex of the heart. On the top of C, systole trembling is rarely detected with mitral valve insufficiency. On the base of the heart, palpable systolic tremors on the aorta are more frequent with stenosis of its mouth, less often with stenosis of the pulmonary artery to the left of the sternum. Diastole tremor on the aorta
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20. HEART NOISES. CLASSIFICATION. Intracardial noises. MECHANISM OF EDUCATION, PROPERTIES (7 PROPERTIES). DIAGNOSTIC VALUE

  1. 16. INSPECTION AND PALPATION OF THE HEART AREA. RESEARCH OF THE TOP APPLICATION, EDUCATION MECHANISM, ITS PROPERTIES IN NORMAL AND PATHOLOGY. PUSH OF RIGHT VENTRICLE, EDUCATIONAL MECHANISM, DIAGNOSTIC VALUE.
    heart disease. These include: cardiac hump, visible pulsation in various departments, expansion of skin veins in the heart. You should pay attention to the features of the skeleton of the chest. The heart hump is a protrusion of the chest in the region of the heart, associated with a significant increase in its size. Significantly increased apical impulse can be determined visually, moreover
  2. Lecture. Heart murmurs, 2010
    Heart murmur. The physical basis for the occurrence of heart murmur. Characteristic of heart murmur. Noise analysis scheme.
  3. 17 BOUNDARIES OF RELATIVE AND ABSOLUTE HEART OBSTACLES. TECHNIQUE OF DEFINITION. DIAGNOSTIC VALUE. HEART DIMENSIONS. LENGTH, HEART RADIATOR, WIDTH OF VASCULAR BEAM IN NORMAL AND PATHOLOGY. DIAGNOSTIC VALUE.
    The boundaries of the relative dullness of the heart. Right border. First, they find the level of standing of the diaphragm on the right in order to determine the general position of the heart in the chest. On the mid-clavicular line, deep percussion determines the blunting of percussion sound, corresponding to the height of the dome of the diaphragm. Make a mark on the edge of the finger-pessimeter, facing a clear sound. Count the rib. Further quiet
  4. Organic noise
    Organic noise is divided into: • - noise regurgitation; • - noises of exile; • - noises in congenital or acquired pathological anastomoses. The noise of regurgitation is the noise of an unnatural blood flow caused by valve insufficiency. They can be: 1) systolic, associated with insufficiency of the atrioventricular valve, left or right,
  5. MENTAL EDUCATIONS AND PROPERTIES OF PERSONALITY OF A MILITARY SERVANT
    As follows from the content of the above educational material, mental processes, above all, provide a reflection in the consciousness of a person surrounding his reality, as well as the formation of its subjective image. Their completeness and quality entirely depend on the indicators of the psyche (characteristics of the considered psychic phenomena) of a particular person and are largely determined by their characteristics
  6. Physical properties of water (temperature, transparency, color, taste, smell) and the effect of these properties on human health.
    These include smell, taste, color and transparency, that is, those properties that can be determined by the human senses. Turbid, dyed in any color or having an unpleasant smell and taste, water is defective in sanitary-hygienic terms, even if it is harmless to the human body. Deterioration of the properties of water adversely affects the drinking water regime, reflexively
  7. Functional noise
    Functional noises include heart murmurs arising from: - changes in heart function (with adrenergic dysregulation - thyrotoxicosis, neurocirculatory dystonia), - rheological properties of blood (anemia). Features: 1. Noise in such cases is associated with accelerated blood flow through an unchanged heart. 2. Such people do not have
  8. Physiological noise
    With the perfect adaptation of the heart and blood vessels of most healthy people to the function of blood circulation, during their work significant turbulent blood flows do not arise and, therefore, heart murmurs do not occur. In childhood, some (1-10%) during the growth process may experience temporary imbalances and most often there is a relative narrowness of the pulmonary artery. In this period
  9. Hygienic importance of soil composition and properties
    The soil consists of solid particles and free spaces between them, filled with air or water. Soil particles with a diameter of more than 3 mm include stones and gravel, from 1 to 3 mm - coarse sand and less than 1 mm - fine sand, clay, dust, silt. From a hygienic point of view, it is important to know the basic properties of the soil in order to be able to conclude whether this or that soil will be healthy or unhealthy. These include
  10. 21. INSPECTION AND PALPATION OF PERIPHERAL VESSELS. RESEARCH OF THE ARTERIAL PULSE. PULSE PROPERTIES (7 BASIC PROPERTIES).
    Inspection of arteries: In young people, at rest, a pulsation can be observed: 1. Carotid artery on the neck. 2. Truncus brachiocephalicus in the jugular fossa. 3. Connect the arter in the subhole. 4. Abdominal aorta. In older people, an additional definition of pulsating arteries: 5. Shoulder 6. Elbow 7. Superficial temporal temporal pulsation; art can be detected in healthy people, which means physical and / or emotional stress. when ^
  11. CELL DIVISION - MECHANISM OF CONTINUITY OF HEREDITARY PROPERTIES
    New cells result from the division of existing cells. When dividing a unicellular organism from the old (maternal) organism, two new ones arise. A multicellular organism develops from a single cell: its numerous offspring arise through repeated cell division. This process continues throughout life: as it grows and develops, as well as regeneration,
  12. Noises (tinnitus)
    Causes Various diseases, senile changes in the hearing aid, ear injuries, pathology from the cardiovascular system, prolonged use of certain medications, such as antibiotics. Also, the cause of tinnitus may be the accumulation of earwax, because a person does not hear external sounds and internal noise in the ears becomes louder. Symptoms Constant noise (hum, hiss, whistle, ringing) in
  13. 22. RESEARCH OF PERIPHERAL VESSELS. PROPERTIES OF THE ARTERIAL PULSE UNDER PATHOLOGY (CHANGE OF RHYTHM, FREQUENCY, FILLING, VOLTAGE, WAVE FORM, PROPERTIES OF THE VASCULAR WALL OF THE VESSEL).
    On palpation of the common carotid, humeral, ulnar, temporal, femoral, popliteal, and rear art stops, the tasks are narrowed down to an approximate assessment of the pulsatory movements by voltage and filling. The carotid artery is palpated on the left and right in a delicate way, removing the sternoclavicular-nipple muscle outwards at the level of the thyroid cartilage, palpating the facts of the common carotid artery on the left and right.
  14. 12. ADVERSE RESPIRATORY NOISES.
    low and high rales. The noise of friction of the pleura. Dry wheezing occurs if the bronchi contain a viscous thick secret. Drops of secretion are held against the wall of the bronchus, forming jumpers, films or wall plugs. When air passes through the bronchi, these formations oscillate and, like strings, produce sounds that we perceive as wheezing. In the process of inhaling and exhaling, the films and jumpers burst, again
  15. 13. ADVERSE RESPIRATORY NOISES
    wet rales are sonorous, inaudible, small-, medium-, large-bubbly. Crepitus. Wet rales are formed in the bronchi and cavities in the presence of liquid contents in them: exudate (inflammatory fluid), transudate (edematous fluid), blood. When a stream of air passes through a bronchus filled with liquid contents, sounds arise that resemble the sound of bursting bubbles on a boiling surface
  16. 19. HEART TONES (CHARACTERISTIC OF I, II TONS, PLACE OF LISTENING). RULES OF AUSCULTATION. PROJECTION OF HEART VALVES ON THE BREAST CELL. HEART VALVE LISTENING POINTS. PHYSIOLOGICAL CHANGE OF HEART TONES. DIAGNOSTIC VALUE
    The projection of heart valves on the anterior chest wall: 1) a bicuspid valve (mitral) is projected to the left at the sternum at the level of cartilage of the 4th rib; 2) the tricuspid valve is projected onto the middle of the line connecting the III costal cartilage on the left and the V costal cartilage on the right; 3) aortic valves are projected onto the middle of the sternum at level III of the costal cartilage; 4) pulmonary valve valves are projected onto III
  17. The history of the development of sanitary protection of the soil. Indicators characterizing the basic properties of the soil, their hygienic value
    In the history of hygiene, the most ancient preventive measures to protect human health were measures aimed at the sanitary protection of the soil. At that time, people walked barefoot, slept on the ground or in earthen shelters, breathed soil air, drank ground water, and finally ate products grown on the soil. The problem of the effect of soil on human health has interested mankind with
  18. 15. DISTRIBUTION OF PATIENTS WITH DISEASES OF THE CARDIOVASCULAR SYSTEM. COMPLAINTS (8 BASIC), THEIR DETAILS, MECHANISM. DIAGNOSTIC VALUE.
    One of the frequent complaints of people suffering from heart disease is shortness of breath, i.e. painful feeling of lack of air. The occurrence of shortness of breath is a sign of the development of circulatory failure, and its severity can be used to judge the degree of insufficiency. Therefore, when questioning the patient, it is necessary to find out under what circumstances it appears. So, in the initial stages of cardiac
  19. ELECTROPHYSIOLOGICAL MECHANISMS OF ARRHYTHMES AND HEART BLOCKADE (CLASSIFICATION AND CHARACTERISTIC)
    Cardiac arrhythmias in a broad sense include changes in the normal frequency, regularity and source of excitation of the heart, as well as disorders of the impulse, impaired communication and (or) the sequence between the activation of the atria and ventricles. The reasons for the numerous tachy and bradyarrhythmias that are still not well understood can be combined in the most general form into 3 classes: I. Shifts
  20. Violation of the repolarization of the ventricles of the heart: mechanisms of occurrence, detection methods and clinical significance
    The urgency of the problem of risk stratification in patients with cardiovascular diseases, and, first of all, with coronary heart disease, is due to the fact that today this nosological group continues to be the leading cause of death in most developed countries. An important factor for the prognosis is the electrical instability of the myocardium, which reflects the vulnerability of the myocardium to the development of life-threatening arrhythmias.
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