Kurtz K J
Am J Med. 1984 Jun;76(6):1066-74. doi: 10.1016/0002-9343(84)90858-1.
Dynamic auscultation, defined as physiologic or pharmacologic maneuvers that alter cardiovascular sounds in predictable ways, is increasingly practiced in cardiac physical diagnosis. Dynamic maneuvers applicable to peripheral arterial sounds have also been described and deserve wider application since arterial occlusive disease is encountered frequently. These little-known maneuvers alter blood flow into and away from a critical stenosis, as well as flow through side branch arteries, thus allowing the examiner to accentuate and localize arterial bruits by modifying their intensity and duration. In this review, the pathophysiology of bruit production is applied to a description of specific bruit manipulations useful in the neck, chest, abdomen, and extremities. Application of these dynamic maneuvers during vascular auscultation should allow more discriminating use of subsequent expensive or invasive diagnostic procedures.
动态听诊，定义为以可预测方式改变心血管声音的生理或药理操作，在心脏物理诊断中越来越常用。适用于外周动脉声音的动态操作也已被描述，鉴于动脉闭塞性疾病常见，值得更广泛应用。这些鲜为人知的操作改变流入和流出严重狭窄处的血流，以及通过侧支动脉的血流，从而使检查者能够通过改变动脉杂音的强度和持续时间来突出和定位动脉杂音。在本综述中，杂音产生的病理生理学用于描述在颈部、胸部、腹部和四肢有用的特定杂音操作。在血管听诊期间应用这些动态操作应能更有区别地使用后续昂贵或侵入性诊断程序。
