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您 you
在上一讲中，我们观察了心尖的心腔视图 in a previous lecture we looked at the apical for chamber view of the heart
好吧，现在我们要看五室视图，这并不多 okay now we're gonna look at the five chamber view and this is not much
可以，但是有一个不同，我们有一些不同的结构 different okay but there's a different there's some of different structures we
可以看到，我们将在这里查看，因此在此视图中，我们希望患者 can see and we'll look at those here so in this view again we want the patient
在左侧卧位位置，我们希望将换能器与 in the left lateral decubitus position we want to put the transducer similar to
可以看到房顶的顶端，所以在最大冲动或顶端附近 the apical for chamber view okay so near the point of maximum impulse or apical
冲动就在这里，这是我们要引导心脏的顶点 impulse which is right here at the apex of the heart we want to direct the
换能器到三点钟，所以三点钟就在这里，记住这一点 transducer to three o'clock so right here at three o'clock remember this
想像一个时钟，这将是六个，将是九个，将是十二个 would imagine a clock this would be six this would be nine this would be twelve
好吧，三点钟，我们在这个区域有换能器，注意 okay so a three o'clock here we have the transducer in this region notice the
它朝那个方向定位的标记就可以了，所以标记指向这三个 markers it oriented in that direction okay so the markers towards the three
顶脉冲时的换能器，我们要做的就是 o'clock transducers at the apical impulse and what we do is from that
顶端四腔室视图您要做的就是将换能器向 apical four chamber view all you want to do is tilt the transducer towards the
病人的左髋好吧这是病人的左侧这是右 patient's left hip okay this is the left side of the patient this is the right
因此，将其朝患者的左臀部放下 side so bring it down towards the patient's left hip which would be down
在这里，如您所见，这种箭头指向该方向 here so as you can see this arrow kind of pointing down into that direction the
患者的左髋关节，直到您看到一个顶瓣或阁楼瓣开始出现 patient's left hip and until you can see that a or attic valve starting to appear
好的，我们将看看在此视图中看到的内容，以便我们可以保持深度 okay and we'll look at what we see in this view so the depth we can keep
介于14到18厘米之间，类似于HIPPA热量小组的审查， between 14 and 18 centimeter similar to the HIPPA calor team review and
显然，这可以根据患者而改变，所以我们在此视图中看到了什么 obviously that can change based on the patient so what do we see in this view
好吧，我们在这里有三种不同的描绘我们有那幅卡通 okay so we have our three different depictions here we have that cartoon
在左侧的图片中，我们在中间和 depiction on the left side we have the unlabeled image in the middle and on the
好的，我们已经标记了图像，所以可以使用三种不同的视图 right we have the labeled image okay so three different views that will
希望能帮助您了解这里发生的情况，因此请注意，我们希望将 hopefully help you see what's going on here so notice that we wanted to bring
主动脉瓣就位，在这里 the aortic valve into place okay in the aortic valve is here sitting in the
中心好，所以这里是主动脉，实际上这是这里的主动脉，然后 center okay so here's the aorta actually this is the aorta here and then you have
阀门，您几乎可以看到这个左心室流出道 the valve and you're pretty much seeing this left ventricular outflow tract okay
LV OT，所以是他们订购的左心室流出道 the LV OT so that's the left ventricular outflow tract they ordered valve in
在那里看到主动脉根，我们从哪里得到 there seeing the aortic root and where we get that
五腔第五腔本质上是主动脉 five chamber the fifth chamber is essentially the aorta okay that valve
流出道的根部，然后他们命令是第五腔 the root in the outflow tract so then they order is that fifth chamber you can
还可以看到左心房，也可以看到左心室的右心房， also see the left atrium you can see the right atrium the left ventricle and
右心室好吧，所以如果我们给这些标签贴上标签，请注意 right ventricle okay so if we were to label these notice that the left
心室是最接近换能器的行程请记住换能器 ventricle is the one closest trip to the transducer remember the transducers
在这里，这是蓝色，这是标记 right here this here in blue this is the marker
这里有标记，传感器顶部是黄色的，所以我们 there's the marker and yellow the transducers here at the top so we're
看到左心室还可以，它也在这里 seeing the left ventricle okay notice it's here as well you have the right
你的心室右心房，你的左心房好，然后 ventricle you have the right atrium you have the left atrium okay and then in
在中心，您在主动脉瓣中有一个Horta，所以这三个瓣膜 the center you have that a Horta in the aortic valve so the three valves that
您可以在此视图中看到心房之间的心室，因此它们 you can see in this view are the ones between the atria the ventricles so they
Eve Eve Alves和主动脉瓣好吧，让我们看一下这些元音 Eve Eve Alves as well as the aortic valve okay so let's look at those vowels
很快就在这里，所以我们之间有二尖瓣，所以这里是左边 right here quickly so we have the mitral valve between so here's the left
心室和左心房，然后我们在这里有二尖瓣 ventricle and the left atrium and then we have the mitral valve here okay and
然后我们有正确的心房和正确的心室，然后在这里 then we have the right atrium and the right ventricle and then here we have
我们的三尖瓣好吧，所以请注意三尖瓣和二尖瓣 our tricuspid valve okay so notice that tricuspid valve the mitral valve and
然后，当左心室熄灭时，主动脉瓣正好位于两者之间 then the aortic valve sitting right in between as the left ventricle goes out
到主动脉好吗是它们之间的主动脉瓣 to the aorta okay is the aortic valves between them
如此有希望地再次使第五室主动脉根部 so hopefully that makes sense so again that fifth chambers the aortic root
您几乎看到了，所以这类似于心室视图的顶端 you're pretty much seeing so this is similar to the apical for chamber view
但是我们得到了左心室流出道 but we get the additional visualization of the left ventricular outflow tract a
或鸭瓣和主动脉根好吧，所以回到顶端四腔 or duck valve and the aortic root okay so go back to the apical four chamber
您可以看一下，然后看看有什么区别可以 you would take a look at that and you'll see what what the difference is okay now
注意左心室，右心室左心房和右心房 note that the left ventricle the right ventricle left atrium and right atrium
在这个视图中被缩短了，所以这四个房间被缩短了，所以我 are foreshortened in this view okay so those four chambers are foreshorten so I
现在想指出的是，我们要评估的是 want to point that out now what we want to assess here is we can look at and
为什么是二尖瓣和三尖瓣，我们可以看一下运动 why's the mitral valve and tricuspid valve and we could look at the motion
如果主动脉瓣有反流的迹象 and if there's any evidence of regurgitation at the aortic valve okay
所以就在中心，我们可以看到，这样一件事要注意 so right there in the center we can see that okay so one thing to note all right
因此，在结束本文之前，让我们回顾一下我们讨论的内容，以便再次 so let's review what we discussed before we end here so again patients in the
我们想做的是将左侧卧位放在传感器上 left lateral decubitus position what we want to do is put the transducer at the
顶冲将标记指向三点钟，类似于顶四 apical impulse direct the marker towards three o'clock similar to the apical four
腔室视图，从顶四腔室视图来看，您想要做的是 chamber view and from the apical four chamber view what you want to do is no
将换能器尾巴向患者的左髋倾斜，直到主动脉 tilt the transducer tail towards the patient's left hip until the aortic
阀门再次出现，深度可以类似14 18厘米，您可以 valve appears again the depth can be similar 14 18 centimeters and you can
根据需要进行调整评估-记住五个房间 adjust as needed assessing - remember the five chamber
第五分庭命令他们是奥尔塔，好吧，我们可以看到左边 that fifth chambers that a order they are a Horta okay and we can see the left
心室流出道是一个或一组的顺序阀，这是不同的 ventricular outflow tract a order valve in a or a group and that's what differs
从顶端的腔室视图记住，四个腔室是 from the apical for chamber view remember that the four chambers are
在此视图中可以简化，我们可以在此处评估三个不同的阀 foreshortened in this view and we can assess three different valves here the
二尖瓣三尖瓣，我们可以寻找任何运动以及是否有证据 mitral tricuspid and we can look for any the motion and if there's any evidence
主动脉瓣关闭不全的问题，所以希望这是有意义的 of aortic regurgitation at the aortic valve okay so hopefully that makes sense
好了，这是本讲座的结尾，我希望你学到了一些东西 well that's the end of this lecture I hope you learned something
现在只是为了让您记住我们提供的课程材料 now just to keep you in mind of our course material that we have available
再说一次，如果您访问我们的网站WWE kg MD好的，那么这是我们的网站以及 so again if you go to our website WWE kg MD okay so this is our website and what
您会注意到，如果您在这里参加心电图课程，那么您会发现一些东西 you'll notice is that if you go to the EKG course here okay you'll find stuff
这是分开的，所以请注意，我们有许多主题练习材料 that's separate so notice that we have a number of topics practice material
讲课为您做贡献的方法，这是这里的课程 lectures a way for you to contribute and this is the course here over here so
您会注意到我们有300多个视频左右，而YouTube上的视频更多 you'll notice we have over 300 videos or so and that's more on YouTube there's
另外100多个，大约200个可与 another hundred more than 100 about 200 videos that are available with the
当然，这些都是本课程中的独立视频 course so those are separate videos in this course is really designed to take
您从初学者到高级口译人员，好吧，所以完全分开了 you from a beginner to advanced interpreter okay so completely separate
从您免费获得的网络上可以，这些都是课程材料 from what you're getting online for free okay these are course material that
附带它，所以请注意您有一本书 comes with it so notice that you have a book
好的，然后您也可以使用袖珍指南，以便选择 okay and then you also have the pocket guide available so you can choose which
它们在口袋里的指南格式不同 format they are the same thing both these book in the pocket guide different
格式我真的很喜欢这个小格式，因为您可以将其保持白色 formats I really like this small one because you can keep it in your white
如果您在诊所或口袋里，这件外套真的很适合 coat if you're in the clinic or in your pocket and it's really available on the
现在就去看书吧，您还会获得视频，所以请注意这些视频还可以， go now with the book you also get videos so notice these are the videos okay and
这些是该书中每页的视频，因此超过30小时 these are a video for every single page in that book so it's over 30 hours of
视频中有很多练习材料，我会继续上传 video there's number of practice material that I continue to upload there
好吧，我们很快就会有练习题，所以都可以使用 okay we'll have practice questions coming soon so all of that's available
同样，这与您已经可以的所有免费材料分开，所以 again this is separate from all the free material that you get already okay so
这是高产量的东西这就是我们用来教技术人员的东西 this is more high-yield stuff this is what we used to teach our technicians
在这里和我们的学生在Mayo诊所，现在已经在许多人中使用 here and our students here at Mayo Clinic and it's used now among many
如此使用过的机构现在检查一下它也包括我们的卡尺 institutions so used check that out now what it also includes our calipers so
是的，您可以在本课程中找到卡尺，好吧，我不认识其他人 yes you get calipers with this course okay I don't know anyone else that
提供，但您确实可以使用卡尺，我认为它们非常有帮助，他们可以 offers that but you do get calipers I think they're very helpful and they can
如果您知道如何正确使用它们，可以帮助您识别不同的 you know if you know how to use them correctly can help to identify different
持续的心律不齐，然后您也得到了我们的帮助 arrhythmias that are going on okay and then you also get our pocket
心电图参考好，这是我们在开发过程中总结的 EKG reference ok this was something we've put together as we were developing
当然适合同伴，这真是太好了 course for the fellows and this is really nice it has every coat as you saw
前面列出的内容是我可以帮助的非常小的袖珍指南 earlier laid out they're very small pocket guide available I had help with
我的同事博士梅诺（Mayo）的心电图实验室负责人Peter Noseworthy my colleague dr. Peter Noseworthy who's the head of the EKG lab here at Mayo
诊所并对其进行编辑，因此这是我们使用的东西，我们发现 Clinic and editing it so this is something that we use and we found very
有用，所以去心电图课程，您会看到一些讲课的例子，为什么我们 helpful so go to the EKG course you'll see examples of lectures ok why we
开发这个还可以，很多是因为我自己努力学习公斤 developed this ok a lot of it came about from myself struggling with learning kgs
父亲是介入心脏病专家，你知道 having a father that was an interventional cardiologist and you know
仍然在挣扎，所以我的挣扎是我不想让你有的挣扎 still struggling so my struggle is a struggle that I don't want you to have
在学习它们的过程中，您可以阅读所有介绍性内容 in learning them ok you can read all those introductory
但说实话，它们还不够好，您会发现自己使用了其他 but honestly they are not enough okay and you find yourself using other
资源是学习过程的一部分 resources which is part of the learning process
我想为您加快该过程，并降低其效率。 I wanted to expedite that process for you and make it less inefficient in
我通过心电图学习所经历的几乎是什么，所以再次从 pretty much what I struggled with going and learning through EKGs so again from
通过本课程的初学者到高级，您将获得有关卡尺的书 beginner to advanced level with this course you get the book the calipers the
编码参考视频访问正常，现在我们提供25％的优惠25％的优惠 coding reference video access okay and now we're offering 25% off 25% off put
该代码在结帐时输入，您将获得25％的折扣，即使是 that code in on checkout and you'll have yourself 25% off that will even it's
几乎涵盖了我们用来打印材料的成本，因此我们不会 pretty much covers the cost of what we use to print the material so we don't
真正发挥作用，更多的是可以帮助我们的学习者成长并真正能够 really make much of it it's more to help our learners grow and really be able to
有助于患者护理，这就是我们这样做的原因，我们喜欢这样做，所以谢谢 contribute to patient care that's why we do this and we love doing it so thank
如果您有任何疑问，请多多支持。 you so much for your support if you have any questions just leave them below and
我们很高兴回答他们，祝您有美好的一天 we're happy to answer them alright have a great day
您 you