呼吸系统-重点整理

地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltsshouldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediameterofboltbearinggoodhingeholes,dressedwithagoodtwocouplingboltsbeforeyoucanmovetherotor,boring-reamingholeinturn.Couplingboltsmustbetightcouplingissymmetricaldiameter,inboring,reaming,twoboltsout.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Duetothecouplingboltsinaccordancewithhingeholescorrespondingtothediameterofthescrewholesonebyoneafterprocessing,processingbackboltinstallationlocationcannotbechanged,soaccordingtoboltaftertheactualweightdifferenceofnutandlockwashertomatch.Generalrequirementsforcouplingtwosymmetricaldiameterbolt,nutandlockwasher'stotalweightdifferenceshouldnotbegreaterthan10gandknocksstampedmark.(SeeFigure18)Thecouplingboltsapplylubricant,andthengentlywithcopperhome,nottoolooseortootight.BoltAssemblyisfinished,symmetricaltighteningallboltsto30%,50%,70%,100%force,andcheckthecouplingflutterandbeforeconnectingthecirclegraduallychangesitsvalueshouldbelessthan0.02mm.Tighteningtorqueofthecouplingboltsshallcomplywiththetechnicalrequirementsmanufacturersdrawings,withadynamometricwrenchorlogtensiontools.Threewheelrotorswingtestcouplingconnectionsshouldbechecked:takingleave,呼吸系统【症状总结】1、咳嗽：发作性干咳→咳嗽变异型哮喘•长年咳嗽，冬季加重→慢性支气管炎2、咳痰：铁锈色痰→肺炎链球菌感染（大叶性肺炎）•大量黄脓痰→肺脓肿或支扩•砖红棕色胶冻样痰→肺炎克雷伯菌感染•粉红色泡沫痰→肺水肿•脓痰有恶臭→厌氧菌感染:吸入性肺脓肿3、咯血：痰中经常带血是肺结核、支扩、肺癌的常见症状4、呼吸困难：•反复发作性呼气性呼吸困难→支气管哮喘•夜间阵发性呼吸困难→急性左心衰•慢性进行性气促→慢阻肺•急性气促伴胸痛→气胸、胸腔积液、肺炎•吸气性喘鸣音→喉头水肿、肿瘤、异物引起上气道阻塞•一、慢性支气管炎及阻塞性肺气肿、慢性阻塞性肺疾病【注意】呼吸系统疾病要掌握一个轴心：慢性支气管炎→慢性阻塞性肺疾病→肺动脉高压→慢性肺源性心脏病。地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltsshouldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediameterofboltbearinggoodhingeholes,dressedwithagoodtwocouplingboltsbeforeyoucanmovetherotor,boring-reamingholeinturn.Couplingboltsmustbetightcouplingissymmetricaldiameter,inboring,reaming,twoboltsout.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Duetothecouplingboltsinaccordancewithhingeholescorrespondingtothediameterofthescrewholesonebyoneafterprocessing,processingbackboltinstallationlocationcannotbechanged,soaccordingtoboltaftertheactualweightdifferenceofnutandlockwashertomatch.Generalrequirementsforcouplingtwosymmetricaldiameterbolt,nutandlockwasher'stotalweightdifferenceshouldnotbegreaterthan10gandknocksstampedmark.(SeeFigure18)Thecouplingboltsapplylubricant,andthengentlywithcopperhome,nottoolooseortootight.BoltAssemblyisfinished,symmetricaltighteningallboltsto30%,50%,70%,100%force,andcheckthecouplingflutterandbeforeconnectingthecirclegraduallychangesitsvalueshouldbelessthan0.02mm.Tighteningtorqueofthecouplingboltsshallcomplywiththetechnicalrequirementsmanufacturersdrawings,withadynamometricwrenchorlogtensiontools.Threewheelrotorswingtestcouplingconnectionsshouldbechecked:takingleave,（一）、慢性支气管炎1、病因：尚未完全明确【注意】引起慢性支气管肺炎最常见的病因→吸烟2、症状特点：1、咳嗽：慢性、长期、反复2、咳痰：以白色粘痰为主，可有脓痰【注意】咳嗽、咳痰反复发作时间一定要记住：每年发作至少3个月，持续2年以上。3、诊断首选检查→肺功能检查4、诊断标准：1）典型症状加上一定时间（≥3月/年ⅹ2年）可以考虑诊断2）病程不足但有明确的肺部影像学表现或肺功能表现也可诊断5、分型：1）单纯型：咳嗽、咳痰2）喘息型：伴有喘息（实质上为慢支加哮喘），喘息型支气管炎要掌握。6、治疗：注意一点→慢支炎急性发作首选治疗是：控制感染（二）阻塞性肺气肿【注意】肺气肿判断指标：1、桶状胸2、叩诊过清音、肝浊音界下降3、X线：肺透明度增加4、RV/TLC＞40%（RV为残气量，TLC为肺总量）如果在慢性支气管炎题干中，出现以上任何一条，均提示慢支炎地形平坦开阔，地层由第四系全新冲积层，第四系上更新统冲层组成，局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25～50m，岩性主要为黏土、粉质黏土、粉土、粉砂、细砂；第四系上更新统冲积层厚度大于50m，岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为：粉土、黏土、粉质黏土，局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcretestrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltsshouldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediametero