[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":66},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-115-1-基礎醫學-014","nurse-115-1-basic-medicine-014",115,1,14,"以聽診器聽取病人心跳時，下列那一個瓣膜關閉時產生第一心音？",{"A":15,"B":16,"C":17,"D":18},"肺動脈瓣膜","下腔靜脈瓣膜","主動脈瓣膜","二尖瓣膜","D",null,[],"本題考點在於心音與瓣膜關閉時序的對應。依心動週期,第一心音來自心室收縮開始時心房心室瓣關閉所產生的振動,即二尖瓣與三尖瓣,故選 D。A 肺動脈瓣與 C 主動脈瓣同屬半月瓣,在心室舒張開始時關閉而形成第二心音,其中主動脈瓣關閉聲是第二心音的主要成分。B 下腔靜脈的瓣膜為胚胎循環的殘留構造,既不位於心房與心室之間,也不承受足以產生可聽診心音的壓力差。掌握第一心音對應收縮期開始、第二心音對應舒張期開始,即可推回瓣膜。","聽診位置口訣「主肺二三」由上而下:主動脈瓣區在右第二肋間、肺動脈瓣區在左第二肋間、三尖瓣區在胸骨左緣第四至五肋間、二尖瓣區在左第五肋間鎖骨中線,後者也是心尖搏動處,故第一心音在心尖最清楚、第二心音在心底最清楚。心音的本質不是瓣膜互撞聲,而是瓣膜關閉瞬間血流突然減速造成的血液與心壁振動。時序連結:第一心音之後是收縮期,第二心音之後是舒張期,所以收縮期雜音落在兩音之間(如主動脈瓣狹窄、二尖瓣閉鎖不全),舒張期雜音落在第二心音之後(如二尖瓣狹窄)。延伸概念:第二心音生理性分裂與吸氣的關係、S3 與 S4 的意義、等容收縮期壓力變化。",[25,28,30,32,34],{"term":26,"count":27},"第一心音",4,{"term":29,"count":11},"心房心室瓣(二尖瓣、三尖瓣)",{"term":31,"count":11},"半月瓣與第二心音",{"term":33,"count":11},"心動週期時序",{"term":35,"count":11},"聽診位置",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-1-basic-medicine-015","下列何者是供應下肢養分的最主要血管？",15,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-106-1-basic-medicine-011","大腸的那一構造，是由縱走的平滑肌束構成？",11,106,{"webId":47,"stem":48,"number":49,"year":45,"session":50},"nurse-106-2-basic-medicine-025","於雌性生殖細胞中，何者具單套 23 條成對之染色體？",25,2,{"webId":52,"stem":53,"number":54,"year":55,"session":50},"nurse-107-2-basic-medicine-063","在治療過敏性氣喘（allergic asthma）的藥物中，生物製劑之抗體藥物 omalizumab 其主要作用為何？",63,107,{"webId":57,"stem":58,"number":59,"year":60,"session":11},"nurse-109-1-basic-medicine-027","那一段腎小管對水的滲透性最低？",27,109,{"webId":62,"stem":63,"number":64,"year":65,"session":11},"nurse-110-1-basic-medicine-061","關於 corticosteroid 的臨床用途，下列何者錯誤？",61,110,"2026-08-06",1787299087590]