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一手掩耳，以另一手指在其手背上摩擦时所听到的声音。<color=red>于呼吸两相均可听到，屏气时消失</color>。听诊位置：最常听到的部位是<color=red>前下侧胸壁</color>。","sound":"","obj":"","state":"XiongMoMoCaYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":43,"name1":"心脏听诊","name2":"心脏瓣膜听诊区","name3":"二尖瓣区（心尖区）","name4":"","txt":"位于<color=red>心尖搏动最强点</color>。","sound":"","obj":"","state":"ErJianBanQu","score_kh":"","score_sx":"0.5","type":"技能重点"},{"id":44,"name1":"心脏听诊","name2":"心脏瓣膜听诊区","name3":"肺动脉瓣区","name4":"","txt":"胸骨左缘第2肋间。","sound":"","obj":"","state":"FeiDongMaiBanQu","score_kh":"","score_sx":"0.5","type":"技能重点"},{"id":45,"name1":"心脏听诊","name2":"心脏瓣膜听诊区","name3":"主动脉瓣区","name4":"","txt":"胸骨右缘第2肋间。","sound":"","obj":"","state":"ZhuDongMaiBanQu","score_kh":"","score_sx":"0.5","type":"技能重点"},{"id":46,"name1":"心脏听诊","name2":"心脏瓣膜听诊区","name3":"主动脉瓣第二听诊区","name4":"","txt":"胸骨左缘第3肋间。","sound":"","obj":"","state":"ZhuDongMaiBanDiErTingZhenQu","score_kh":"","score_sx":"0.5","type":"技能重点"},{"id":47,"name1":"心脏听诊","name2":"心脏瓣膜听诊区","name3":"三尖瓣区","name4":"","txt":"胸骨左缘第4、5肋间。","sound":"","obj":"","state":"SanJianBanQu","score_kh":"","score_sx":"0.5","type":"技能重点"},{"id":48,"name1":"心脏听诊","name2":"心率","name3":"","name4":"","txt":"每分钟心搏次数。正常成人在安静、清醒的情况下心率范围为60-100次/分。","sound":"","obj":"","state":"XinLv","score_kh":"","score_sx":"2","type":"技能重点"},{"id":49,"name1":"心脏听诊","name2":"心音","name3":"第一心音","name4":"","txt":"产生机制：由于瓣膜关闭，瓣叶突然紧张产生振动而发出声音。在心室开始收缩时，<color=red>二尖瓣的关闭产生第一心音的第二成分；三尖瓣的关闭产生第一心音的第三成分</color>。听诊特点：音调低钝，强度较响，历时较长（持续约0.1s），<color=red>与心尖搏动同时出现</color>。听诊部位：在<color=red>心尖部最响</color>。","sound":"","obj":"","state":"DiYiXinYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":50,"name1":"心脏听诊","name2":"心音","name3":"第二心音","name4":"","txt":"产生机制：<color=red>半月瓣突然关闭</color>和<color=red>血流在主动脉与肺动脉内突然减速引起瓣膜振动所致</color>。听诊特点：音调较高而脆，强度较第一心音弱，历时较短（持续约0.08s），不与心尖搏动同时出现。听诊部位：在<color=red>心底部</color>最响。","sound":"","obj":"","state":"DiErXinYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":51,"name1":"心脏听诊","name2":"心音","name3":"第三心音","name4":"","txt":"产生机制：出现在心室舒张早期、快速充盈期之末，认为是由于<color=red>心室快速充盈的血流自心房冲击室壁，使心室壁、腱索和乳头肌突然紧张、振动所致</color>。听诊特点：音调轻而低，持续时间短（约0.04秒），仰卧位、呼气时较清楚。听诊部位：局限于<color=red>心尖部</color>或其内上方。","sound":"","obj":"","state":"DiSanXinYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":52,"name1":"心脏听诊","name2":"心音","name3":"第四心音","name4":"","txt":"产生机制：出现在心室舒张期，收缩期前。一般认为第四心音的产生<color=red>与心房收缩使房室瓣及其相关结构（瓣膜、瓣环、腱索、乳头肌）突然紧张、振动有关</color>。听诊特点：低调、沉浊而弱。属病理性。听诊部位：<color=red>心尖部</color>及其内侧。","sound":"","obj":"","state":"DiSiXinYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":53,"name1":"心脏听诊","name2":"心音","name3":"第一心音增强","name4":"","txt":"听诊部位：心尖部","sound":"","obj":"","state":"DiYiXinYinZengQiang","score_kh":"","score_sx":"1","type":"技能重点"},{"id":54,"name1":"心脏听诊","name2":"心音","name3":"第一心音减弱","name4":"","txt":"听诊部位：心尖部","sound":"","obj":"","state":"DiYiXinYinJianRuo","score_kh":"","score_sx":"1","type":"技能重点"},{"id":55,"name1":"心脏听诊","name2":"心音","name3":"第一心音强弱不等","name4":"","txt":"听诊部位：心尖部","sound":"","obj":"","state":"DiYiXinYinQiangRuoBuDeng","score_kh":"","score_sx":"2","type":"技能重点"},{"id":56,"name1":"心脏听诊","name2":"心音","name3":"第二心音增强","name4":"","txt":"听诊部位：心底部","sound":"","obj":"","state":"DiErXinYinZengQiang","score_kh":"","score_sx":"1","type":"技能重点"},{"id":57,"name1":"心脏听诊","name2":"心音","name3":"第二心音减弱","name4":"","txt":"听诊部位：心底部","sound":"","obj":"","state":"DiErXinYinJianRuo","score_kh":"","score_sx":"1","type":"技能重点"},{"id":58,"name1":"心脏听诊","name2":"心音","name3":"第一心音分裂","name4":"","txt":"听诊部位：心尖部","sound":"","obj":"","state":"DiYiXinYinFenLie","score_kh":"","score_sx":"2","type":"技能重点"},{"id":59,"name1":"心脏听诊","name2":"心音","name3":"第二心音通常分裂","name4":"","txt":"听诊部位：肺动脉瓣区","sound":"","obj":"","state":"DiErXinYinTongChangFenLie","score_kh":"","score_sx":"2","type":"技能重点"},{"id":60,"name1":"心脏听诊","name2":"心音","name3":"第二心音固定分裂","name4":"","txt":"听诊部位：肺动脉瓣区","sound":"","obj":"","state":"DiErXinYinGuDingFenLie","score_kh":"","score_sx":"2","type":"技能重点"},{"id":61,"name1":"心脏听诊","name2":"心音","name3":"第二心音反常分裂","name4":"","txt":"听诊部位：肺动脉瓣区","sound":"","obj":"","state":"DiErXinYinFanChangFenLie","score_kh":"","score_sx":"2","type":"技能重点"},{"id":62,"name1":"心脏听诊","name2":"额外心音","name3":"舒张期额外心音","name4":"舒张早期奔马律","txt":"听诊部位：心尖部","sound":"","obj":"","state":"ShuZhangZaoQiBenMaLv","score_kh":"","score_sx":"2","type":"技能重点"},{"id":63,"name1":"心脏听诊","name2":"额外心音","name3":"舒张期额外心音","name4":"舒张晚期奔马律","txt":"听诊部位：心尖部","sound":"","obj":"","state":"ShuZhangWanQiBenMaLv","score_kh":"","score_sx":"2","type":"技能重点"},{"id":64,"name1":"心脏听诊","name2":"额外心音","name3":"舒张期额外心音","name4":"开瓣音","txt":"听诊部位：心尖部","sound":"","obj":"","state":"KaiBanYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":65,"name1":"心脏听诊","name2":"额外心音","name3":"收缩期额外心音","name4":"收缩中、晚期喀喇音","txt":"听诊部位：心尖部","sound":"","obj":"","state":"ShouSuoZhongWanQiKaLaYin","score_kh":"","score_sx":"2","type":"技能重点"},{"id":66,"name1":"心脏听诊","name2":"心脏杂音","name3":"收缩期杂音","name4":"二尖瓣区","txt":"听诊部位：心尖部","so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