问题 问答题 简答题

请演示语音震颤的检查方法。

答案

参考答案:

(1)考生站位、告知被检查者体位和姿势正确(1分)考生站于被检查者前面或后面(卧位时站于被检者右侧),请被检查者取坐位或仰(俯)卧位,充分暴露前胸或胸背部。

(2)检查手法正确,动作规范(1.5分)考生双手掌平放于被检者胸壁两侧的对称部位(0.5分),嘱被检者发低音调"yi",由上而下、左右反复比较(1分)。

1.语音震颤的产生机制及影响因素有哪些?正常人分布有何特点?答:语音震颤是发音时声波沿气道传到胸壁引起共鸣的振动,医师用手放在胸壁所感觉的震颤。影响因素主要与发音的强弱、胸壁的厚薄及传导气道是否通畅有关。正常人前胸上部比下部强,后胸下部比上部强,右上胸比左上胸强。

2.语音震颤减弱或消失和增强分别常见于哪些情况?答:语音震颤减弱或消失主要见于肺泡内含气量过多,如肺气肿;支气管阻塞,如阻塞性肺不张;大量胸腔积液或气胸;胸膜高度增厚粘连;胸壁皮下气肿。语音震颤增强常见于肺泡内有炎症浸润,如大叶性肺炎、大片肺梗死等;接近胸膜的肺内有巨大空腔,如空洞型肺结核、肺脓肿等。

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     One day I was mailing a package in the office when I saw a woman approach the postal clerk. "I
found this lying on the floor by my box, " she said, "and I'd like to hand it in."
     The postal clerk laughed and said, "I've  _1_   had anyone hand in money before, but I'll put it in an
envelope. Please write your name and telephone number on the front. If no one   2  the money, we'll call
you."
      The lady explained, "I've lost money before and it was never turned in. I remember how I    3  . I
don't want to make someone else feel that way." The postal clerk responded with her own   4   of having
dropped some money while shopping and not knowing it    5   she was preparing to pay for her purchases.
     I admit that I'd slowed down on my preparations as I was busy listening to their    6  . The lady who
handed in the money left the post office. At almost the same time a very young woman    7  . She
approached the postal clerk and asked, "Has anyone turned in any money recently?"
     She told the clerk the   8  ,  and the clerk laughed again. "As a matter of fact, yes!" she responded. "It
was turned in just several    9    ago."
     Then a young man ran in and said, "It's not on the ground!"
     She turned to him and said, "Someone turned the money in!"
     The look of    10   on both of these young people's faces is a memory I'll have for a long time. The
young lady told how she thought the money was   11    in her coat pocket when she walked in to check
her mailbox. Only when she arrived home did she     12    that it was no longer there.
     Yes, I finally finished preparing the package to be mailed, but I was the one who had a very special
surprise in the post office.
( )1. A. often      
( )2. A. claims    
( )3. A. behaved    
( )4. A. way        
( )5. A. until      
( )6. A. debate    
( )7. A. drove in  
( )8. A. event      
( )9. A. minutes    
( )10. A. surprise  
( )11. A. generally
( )12. A. believe  
B. always    
B. requires  
B. felt      
B. intention
B. when      
B. quarrel  
B. rushed in
B. time      
B. hours    
B. relief    
B. merely    
B. doubt    
C. never    
C. accepts  
C. reacted  
C. memory  
C. after    
C. lecture  
C. cut in  
C. story    
C. days    
C. pression
C. dly      
C. realize  
D. occasionally    
D. seeks            
D. imagined        
D. risk            
D. though          
D. conversation    
D. broke in        
D. amount          
D. weeks            
D. excitement      
D. securely        
D. prove            
                   
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