醫學三：80題 ( 包括內科,家庭醫學科等科目及其相關臨床實例與醫學倫理 )題庫下載題庫

(A)(B)

Many peripheral signs of aortic regurgitation have been identified and named after the physician that first described it; they are listed below. The sensitivity of these findings are low. While intellectually and historically interesting, they are not always clinically useful.

• Corrigan’s pulse: A rapid and forceful distension of the arterial pulse with a quick collapse
• De Musset’s sign: Bobbing of the head with each heartbeat (like a bird walking)
• Muller’s sign: Visible pulsations of the uvula
• Quincke’s sign: Capillary pulsations seen on light compression of the nail bed
• Traube’s sign: Systolic and diastolic sounds heard over the femoral artery (“pistol shots”)
• Duroziez’s sign: Gradual pressure over the femoral artery leads to a systolic and diastolic bruit
• Hill’s sign: Popliteal systolic blood pressure exceeding brachial systolic blood pressure by ≥ 60 mmHg (most sensitive sign for aortic regurgitation)
• Shelly’s sign: Pulsation of the cervix
• Rosenbach’s sign: Hepatic pulsations
• Becker’s sign: Visible pulsation of the retinal arterioles
• Gerhardt’s sign (aka Sailer’s sign): Pulsation of the spleen in the presence of splenomegaly
• Mayne’s sign: A decrease in diastolic blood pressure of 15 mmHg when the arm is held above the head (very non-specific)
• Landolfi’s sign: Systolic contraction and diastolic dilation of the pupil

(C)

The murmur of aortic regurgitation is best heard with the diaphragm of the stethoscope. Low-intensity, high-pitched aortic regurgitation murmurs may not be heard unless firm pressure is applied with the diaphragm of the stethoscope over the left sternal border or over the right second interspace, while the patient sits and leans forward with the breath held in full expiration

(D)

Austin Flint Murmur: Mid diastolic, low pitch rumble murmur heard best at the apex with the patient leaning forward and breathing out. 

Mechanism: Occurs in aortic regurgitation as a result of the vibration of the anterior leaflet of the mitral valve due to the regurgitant jets from the left atrium and aorta. The striking of these regurgitant jets often cause the premature closure of the mitral leaflets, commonly mistaken for mitral stenosis.