Re: [申覆] 醫學一 (24)

看板medstudent (醫學生)作者marvick (兔毛)時間14年前 (2011/08/02 18:15)推噓5(5推 0噓 6→)

留言11則, 5人參與討論串2/2 (看更多)

※ 引述《ri1966 (YM)》之銘言： : 24 下列關於胸腔穿刺（thoracentesis）敘述何者錯誤？ : (A)需避開肋骨下緣之肋間神經、血管（intercostal nerve, vessel） : (B)穿刺時需在吐氣（expiration）時進行 : (C)一般在第九肋間穿刺最適當 : (D)常在鎖骨中線（midclavicular line）位置進行穿刺 : 答案: D 建議答案:B 或 C 或 D : 佐證資料: : Manual of Intensive Care Medicine, 5th Edition : Editors: Irwin, Richard S.; Rippe, James M. : Copyright c (C)2010,2006,2000 Lippincott Williams & Wilkins : I - Procedures and Techniques > 10 - Thoracentesis > III. Procedure > : p.58 : A. Technique for Diagnostic (Needle Only or Catheter-Over-Needle) : Removal of Freely Flowing Fluid : step 4. With the patient sitting, arms at side, mark the inferior tip of the : scapula on the side to be tapped. This approximates the eighth intercostal : space, the lowest level that may be safely punctured unless previous : sonography determined that a lower interspace can safely be entered. : p.59 : B. Technique for Therapeutic Removal of Freely Flowing Fluid : Follow steps 1 to 8 as described previously. : 依據引文所述應以第八肋間進行穿刺較為恰當 : 第九肋間須確定確實安全無虞方使用 : 故建議答案C亦開放 Thoracentesis: A Step-by-Step Procedure Guide with Photos Authors: V. Dimov, M.D., Clinical Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; B. Altaqi, M.D., Assistant Clinical Professor of Medicine, University of Louisville, Kentucky 連結 http://note3.blogspot.com/2004/02/thoracentesis-procedure-guide.html 其中 Fig. 22 有說明 Hold needle steady and apply firm pressure while advancing it Aspirate as you advance needle 所以建議 B應該也可以選另外想問大家 referance就寫上面這樣OK嗎還是說必須要從最原始的textbook上找出來... -- ※ 發信站: 批踢踢實業坊(ptt.cc) ◆ From: 175.181.128.77