Callan R J, McGuirk S M, Step D L
Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison.
Vet Clin North Am Food Anim Pract. 1992 Jul;8(2):257-70. doi: 10.1016/s0749-0720(15)30743-x.
Assessment of the cardiovascular and lymphatic systems first requires a complete signalment, history, and general physical examination. Further assessment of the cardiovascular system begins with evaluation of the cardiac borders through palpation and thoracic percussion. Complete cardiac auscultation requires careful evaluation of several parameters. The location, intensity, and character of normal heart sounds are first determined. This is followed by assessment of heart rate and rhythm. Finally, special attention should be placed on identifying abnormal heart sounds and describing them based on their location, intensity, duration, sound quality, and radiation. Assessment of the arterial, venous, and capillary systems provides additional information on the status of the cardiovascular system. Assessment of the lymphatic system primarily involves evaluation of external and palpable internal lymph nodes. Commonly palpable external lymph nodes include the intermandibular, parotid, retropharyngeal, superficial cervical, subiliac, mammary, and scrotal lymph nodes. Palpable internal abdominal lymph nodes include the iliofemoral lymph nodes and the iliosacral lymph center. Other lymph nodes that may be palpable include the renal, ruminal, and mesenteric lymph nodes. Lymph nodes should be evaluated for size, consistency, and tenderness.
对心血管系统和淋巴系统的评估首先需要完整的病史、症状及全身体格检查。对心血管系统的进一步评估始于通过触诊和胸部叩诊对心脏边界的评估。完整的心音听诊需要仔细评估几个参数。首先要确定正常心音的位置、强度和特征。随后评估心率和心律。最后，应特别注意识别异常心音，并根据其位置、强度、持续时间、音质和传导情况进行描述。对动脉、静脉和毛细血管系统的评估可提供有关心血管系统状况的更多信息。对淋巴系统的评估主要涉及对外侧及可触及的内侧淋巴结的评估。常见的可触及外侧淋巴结包括颌下、腮腺、咽后、颈浅、髂下、乳腺及阴囊淋巴结。可触及的腹部内侧淋巴结包括髂股淋巴结和髂骶淋巴中心。其他可能可触及的淋巴结包括肾、瘤胃及肠系膜淋巴结。应对淋巴结的大小、质地和压痛情况进行评估。
