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<div id="agcaoyi" class="mark clearfix"> <div id="8eiiaoe" class="fl"> <span id="csk8moi" class="time">2022-04-26 15:49</span> <a href="http://thedailypurge.net" title="醫(yī)學教育網" class="a1">醫(yī)學教育網</a> </div> <a href="javascript:void(0)" onclick="window.external.AddFavorite(location.href,document.title);" target="_self" class="collection ico fr"></a>  <div id="qsiaquc" class="fen fr">|</div> <div id="8gu0owg" class="font_size fr ico"><a href="javascript:void(0);" target="_self" class="big lan ico">大</a><a href="javascript:void(0);" target="_self" class="small ico">小</a></div> </div> </div> </div>  <div style="width: 800px;text-align: left;margin: 0 auto;margin-bottom: 20px;"> <div style="width:800px; height:90px;"> <a href="http://thedailypurge.net/yishizigekaoshi/baoming/li2412107427.shtml" target="_blank"> <img title="報名預約" src="http://thedailypurge.net/upload/resources/image/2024/12/12/826342.png" width="800" height="90" style="border:0px;"></a> </div> </div> <div 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style="color: rgb(0, 0, 255);">報考測評>></span></a> </td> </tr> </tbody> </table> <p></p> </span> </div>  <div id="g0kmaig" class="news_con"> <div id="eqywaow" class="jxbox clearfix"> <p style="text-align: left;">2022年臨床執(zhí)業(yè)醫(yī)師實踐技能考試時間：2022年6月13日-26日。實踐技能第二站體格檢查是考試難點之一，為了幫助廣大醫(yī)考生學習，醫(yī)學教育網老師專門總結了“腸鳴音，震水音，肺部聽診，集合反射——臨床醫(yī)師技能體格檢查?？肌?，預祝大家都能取得優(yōu)異成績：</p><p style="text-align: left;"><strong>查看匯總</strong>：<a href="/linchuangyishi/jinengfudaopeixun/su2204158905.shtml" articlerela="5029926" target="_blank">全國臨床執(zhí)業(yè)醫(yī)師實踐技能第二站體格檢查歷年模考題匯總</a></p><section data-role="title" data-tools="135編輯器" data-id="110063" style="white-space: normal;"><section style="margin: 10px auto; text-align: center;"><section style="color: rgb(255, 255, 255); display: flex; justify-content: flex-start; align-items: flex-end;"><section style="background: rgb(224, 14, 13); border-radius: 0px 13px 0px 0px; padding: 8px 15px; transform: rotate(0deg);"><strong data-brushtype="text">體格檢查</strong></section><section data-brushtype="text" style="padding: 3px 8px; background: rgb(255, 207, 71); border-radius: 0px 15px 0px 0px; letter-spacing: 1.5px;">模擬試題</section></section><section style="background: rgb(242, 242, 242); padding: 0px 17px 25px 0px;"><section style="box-sizing: border-box; width: 0px; height: 1px; margin-bottom: 15px; border-top: 10px solid rgb(224, 14, 13); border-right: 10px solid transparent; overflow: hidden;"></section><p style="text-align: left;">題號：腸鳴音，震水音，肺部聽診，集合反射</p><p style="text-align: left;"><strong>1.腸鳴音</strong></p><p style="text-align: left;">洗手。被檢查者雙腿屈膝，解開上衣，將聽診器置于右下腹，聽診1分鐘。</p><p style="text-align: left;">報告考官被檢查者腸鳴音為4（或5，正常為4～5）次/分，屬于正常，操作完畢。</p><p style="text-align: left;"><strong>2.震水音</strong></p><p style="text-align: left;">檢查時被檢查者仰臥，醫(yī)生以耳湊近上腹部，同時以沖擊觸診法震動上腹部，可聽到氣、液撞擊的聲音，為振水音。也可用聽診器進行聽診。正常人見于餐后或飲多量液體時。如果清晨空腹或者餐后6～8小時仍有此音提示幽門梗阻或胃擴張。</p><p style="text-align: left;"><strong>3.肺部聽診</strong></p><p style="text-align: left;">1.肺部聽診的一般原則</p><p style="text-align: left;">肺部的聽診應注意：是由肺尖開始，從上到下，左右對比，逐一肋間聽診，每一肋間聽2～3個呼吸頻率。分別聽診前胸部、側胸部以及背部，其中前胸部聽診應注意避開心臟，背部的聽診應避開肩胛骨。</p><p style="text-align: left;">2.胸膜摩擦音</p><p style="text-align: left;">胸膜摩擦音是胸膜產生炎癥、纖維素滲出變得粗燥時，臟壁兩層胸膜隨胸廓呼吸運動所產生的摩擦音。通常與呼吸兩相均可聽到，一般在吸氣末或呼氣初較為明顯，屏氣時消失。</p><p style="text-align: left;">聽診胸膜摩擦音時，將聽診器體鍵應放置在前下側胸壁，因為在呼吸時該區(qū)域呼吸的動度最大，產生的摩擦音最強，故更容易聞及。</p><p style="text-align: left;">3.語音共振</p><p style="text-align: left;">語音共振的原理與語音震顫相同。聽診時囑被檢者發(fā)長音“yi”，然后用聽診器體鍵由肺尖開始，從上到下，左右對比進行聽診。正常情況下語音共振在氣管和大支氣管聽到的聲音最強，肺底則較弱。</p><p style="text-align: left;">報告考官：被檢查未聞及異常呼吸音、未聞及干濕啰音等，屬于正常。</p><p style="text-align: left;"><strong>4.集合反射</strong></p><p style="text-align: left;">囑被檢查者注視1m以外的目標（通常為檢查者的食指尖），然后逐漸將目標移至距被檢查者眼球約10cm處，這時觀察雙眼瞳孔變化情況。由看遠逐漸變?yōu)榭唇?，即由不調節(jié)狀態(tài)到調節(jié)狀態(tài)時，正常反應是雙側瞳孔逐漸縮?。ㄕ{節(jié)反射）、雙眼球向內聚合（聚合反射）。</p><p style="text-align: left;"><strong style="color: rgb(51, 51, 51); text-indent: 32px;"><span style="color: rgb(192, 0, 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