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Sakamoto Auscultation Simulator 2 M164-1 User Manual Download Page 38

 

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12-2

 

Changes in Cardiac Sound 

We will auscultate the heart using the Auscultation Simulator. Only a single cardiac sound or cardiac 
murmur will be produced from the 4 auscultation points. However, as is the case when auscultating 
on an actual patient, the I sound and II sound spread mutually, and at the cardiac apex a I > II , at the 
cardiac base a I < II relationship is reproduced. 
We have attached a simple electrocardiogram and explanation for each of the following 20 cases. 
Please listen to them every day repeatedly even if it is only for a short time. We hope it is useful in 
improving your auscultation skills. 

 

(1)    Normal (II sound no break-ups) 

 

 

(2)    Normal (II sound break-ups) 

 

 

(3)    Abnormal (II sound break-ups) 

 

 

Each of the auscultation points of the heart is shown as 
A    Right cardiac base (around aorta) 
P    Left cardiac base (around pulmonary artery) 
T    Left sternal edge/third intercostal space (around   

tricuspid valve) 

M    Cardiac apex 
First, compare the volume of the I sound and the II 
sound at each point. 

Next, apply a stethoscope to P. The II sound will 
break up three times and twice it will be a single 
sound. The interval of the break-up is 0.03 seconds, 
which shows normal respiratory disruption. 

Again at P, this time the II sound break-up can be 
heard at a much longer interval (0.08 seconds). This 
is a typical characteristic of complete right heart 
block, etc. 

Summary of Contents for Auscultation Simulator 2 M164-1

Page 1: ...d questions 74 10 Troubleshooting 75 11 Specifications 76 12 Appendix Auscultation Points and Changes in Cardiac Sound 77 13 ３ You can view this product s introductory page on our company s website by using either the following URL or the QR code at right Sakamoto Model Corporation s Introductory page for the SAKAMOTO Auscultation Simulator 2 http www sakamoto model co jp product nursing m164 QR c...

Page 2: ... 54 7 2 Auscultation of Breathing Sound 55 7 3 Auscultation of Heart Sound 58 7 4 Volume Adjustment and External Output 61 7 5 Playing Sounds Independently from the Tablet 63 7 6 Saving and Loading Memory Files 65 7 7 Setting the Language 71 8 Cleaning and storage 72 9 Frequently asked questions 74 10 Troubleshooting 75 11 Specifications 76 12 Appendix Auscultation Points and Changes in Cardiac So...

Page 3: ...e of this product first refer to 9 Frequently asked questions P 74 If you are still not sure about the correct operation please contact Sakamoto Model Cautions and other symbols This manual uses the following symbols to indicate cautions on handling and other information which may be useful to know during use This indicates a caution that applies when using the product If the instructions listed a...

Page 4: ... 44 External speaker Chest cover Stethoscope Double head type 2 Product contents Body Router Tablet External speaker charging cable Tablet charging cable Baby powder ...

Page 5: ...the body with items such as ballpoint pens If you write on the body using a ballpoint pen or similar object the surface of the body will become smeared with ink which cannot be removed Do not touch against printed items If the body is placed on top of or wrapped in printed items such as newspapers and books the body may become imprinted with ink which cannot be removed Tablet Do not use the tablet...

Page 6: ...ric shocks or fire occurring In addition do not connect or disconnect the cable with wet hands If you notice any problems when using the product stop using it If problems occur with the product during use stop using it turn off the power and disconnect the power cable from the electrical outlet Then contact Sakamoto Model If you continue using the product accidents may result Do not store in place...

Page 7: ...nd Heart sounds are generated from the left and right cardiac base the left edge of the sternum and the cardiac apex Use the accessory stethoscope to carry out auscultation The heart sounds can be selected from 20 types and the volume can also be adjusted In addition the heart rate can be changed within the range of 30 140 times per minute in increments of 10 3 External output of sounds Breathing ...

Page 8: ...he flow of training using the Auscultation Simulator 2 Example of training for checking breathing sound The breathing sound and breathing rate for the Auscultation Simulator 2 are set using the tablet The trainee checks the breathing sound of the Auscultation Simulator 2 ...

Page 9: ...est cover so that the points can be easily located when the chest cover is placed onto the body Use the chest cover if necessary when carrying out training Place the chest cover onto the body as shown in the diagram below 5 Part names Overall connection diagram Hook the rubber band onto the cable of the body Stethoscope Body Chest cover Power switch Tablet Body power cable Bluetooth communication ...

Page 10: ...tablet for other applications If the tablet is used for other applications problems may occur when using it to operate this product In addition do not install security software to the tablet or use it to connect to any Wi Fi devices other than to this product The Wi Fi connection between the tablet and the body is enabled at the time of purchase The Wi Fi connection will not be enabled while the r...

Page 11: ...t enabled Check the wireless password which is written on the label on the base of the router The Bluetooth connection between the tablet and the external speaker is enabled at the time of purchase ON The content of the characters on the label may vary from the above diagram depending on the specifications of the router Router Label on base Wireless password ...

Page 12: ...Tablet Operations P 54 The screen displays may differ slightly depending on the specifications of the tablet and the OS その際 接続先 本製品のタブレット の機器 OS 種別は Android アンドロイド となりますので 該当する手順にしたがってください 2 Enter the wireless password which was checked in step into the password text box The part varies for each product 3 Tap CONNECT 1 Tap the connection name TP Link_ ...

Page 13: ... 53 Return to the home screen and tap ちょうしん くん ...

Page 14: ... using the tablet 1 Tap This is the most basic operation Gently tap the tablet screen with your finger at the place where you would like to carry out an operation 2 Slide Touch the tip of your finger against a control on the tablet screen and then slide your finger while still pressing down This is used at times such as when adjusting the volume 7 4 Volume adjustment and external output P 61 etc 3...

Page 15: ...lighted at this time This is because the setting is linked to the body operation Be sure to carry out the next step even if the rate which you would like to set is already selected the button is highlighted at this time This is because the setting is linked to the body operation The tablet screen displays are taken from when the product was in development They may differ slightly from actual displ...

Page 16: ...ry depending on which breathing sound was selected in step The selection will be 30 60 times per minute when Tachypnea Consonating rales or Tachypnea shallow respiration is set and it will be 10 40 times per minute for all other settings Either step or step can be carried out first However note that the available selections for the rate will vary depending on which breathing sound has been selecte...

Page 17: ...rhonchi 1 Continuous rales dry rales High pitch rhonchi 1 wheeze Bronchiolar stenosis brochial asthma 6 High pitch rhonchi 2 Continuous rales dry rales High pitch rhonchi 2 wheeze Bronchiolar stenosis brochial asthma 7 Tachypnea Consonating rales Tachypnea Consonating rales Nervous dyspnea 8 Intensified bronchovesicular sounds Intensified bronchovesicular sounds Resting dyspnea 9 high pitch rhonch...

Page 18: ...xt step even if the heart sound which you would like to set is already selected the button is highlighted at this time This is because the setting is linked to the body operation Tap the heart sound Be sure to carry out the next step even if the rate which you would like to set is already selected the button is highlighted at this time This is because the setting is linked to the body operation ...

Page 19: ... per minute in increments of 10 The heart sound will come from the left and right cardiac base the left edge of the sternum and the cardiac apex Use the accessory stethoscope for training Either step or step can be carried out first A commercially available stethoscope can also be used Tap the rate ...

Page 20: ...osis 2 Normal split second sound 12 Mitral insufficiency 3 Abnormal split second sound 13 Aortic stenosis 4 Increased apical second sound in hypertension 14 Aortic insufficiency 5 Apical fourth sound 15 Subaortic stenosis 6 Innocent murmur 16 Atrial septal defect 7 Aortic ejection sound 17 Ventricular septal defect 8 Mid systolic clicks 18 Pulmonary stenosis 9 Mitral escape clicks murmur 19 Acute ...

Page 21: ...mitting location can be adjusted separately Adjusting all volume settings at once Switching sound output to tablet or external speaker Tap Volume on the tablet screen Set and adjust using the Volume screen Adjusting the volume Slide or tap the controls to adjust the volume Tap to turn the heart sound on or off Adjusting the breathing sound and heart sound all at once Tap to turn the breathing soun...

Page 22: ... be possible If the power for the external speaker is turned on while sound has been set to be output from the tablet the sound output will switch to the external speaker instead of the tablet Use the volume adjustment function for the tablet or external speaker to adjust the volume of the sound coming out from the tablet or the external speaker The breathing sounds and heart sounds can be played ...

Page 23: ...unds from the tablet independently without turning on the power for the body The sounds can also be output from the external speaker Turn on the power switch of the tablet At the Auscultation Simulator 2 startup screen hold down the Start button The operating screen will appear ON Hold down Tablet ...

Page 24: ...dy If the external speaker is turned on the sounds will be output from the external speaker The breathing sounds and heart sounds can be played from the tablet and the external speaker but these sounds cannot be output from both simultaneously Furthermore sounds from multiple locations on the body cannot be output simultaneously ...

Page 25: ...aved together as a single memory file Up to five memory files can be saved and the titles of each memory file can also be changed Saving memory files Tap My Settings on the tablet screen Tap Save Tap the setting title for the saving destination Tap the setting title The initial setting titles are Setting 1 to Setting 5 ...

Page 26: ...he text box in the input screen The keyboard will appear Enter the new setting title and then tap OK The setting title will be changed The setting title can also be changed afterwards Tap to return to the previous screen without saving the setting title ...

Page 27: ...gs will then be saved Loading memory files Tap My Settings on the tablet screen Tap Load Up to five different groups of settings can be saved In addition the settings cannot be saved onto external media such as a USB drive ...

Page 28: ...tle for the loading source Tap OK The settings will then be loaded Changing the setting titles To change a setting title after settings have been saved carry out the following steps Tap My Settings Save Tap the setting title ...

Page 29: ... 69 Tap the setting title which you would like to change Tap Edit Title Tap the text box in the input screen The keyboard will appear Tap the setting title ...

Page 30: ... setting title and then tap OK The setting title will be changed Tap Tap to return to the previous screen without saving the setting title If you tap OK the setting will be overwritten so tap here instead Do not tap OK ...

Page 31: ...7 Setting the Language The language for tablet screen operations can be switched between Japanese English Chinese Traditional and Korean Tap Language Tap the language which you would like to set Tap language ...

Page 32: ...r When not using the product or when cleaning or storing it away turn off the power switches of the tablet and the external speaker Disconnecting the router It is not necessary to disconnect the router from the body after using the product but take care not to subject the router to shocks or bend the cable with excessive force when transporting the body If disconnecting the router pull out the cab...

Page 33: ...the body using a ballpoint pen or similar object the surface of the body will become smeared with ink which cannot be removed Do not get the product wet or immerse it into water The body is not designed to be waterproof so do not place it into water or get it wet otherwise it will become damaged Coat the body with baby powder to protect it and to stop it from becoming sticky If not using the produ...

Page 34: ...cultation of Breathing Sound P 55 2 Where on the body can the breathing sound be listened to Over the whole of the chest Furthermore there are three speakers one is built into each of the airway left lung and right lung 7 2 Auscultation of Breathing Sound P 55 3 Can the back of the body be used for auscultation No it cannot Auscultation can only be carried out at the chest area 7 2 Auscultation of...

Page 35: ...Check that the Wi Fi connection for the tablet is enabled 6 Preparation P 50 3 The characteristics set using the tablet are different from the actual characteristics and rate determined from auscultation The setting values on the tablet screen may not have been applied to the body such as immediately after the body is turned on Enter the setting value once more at the tablet screen If the values a...

Page 36: ...consumption 15 W Wi Fi connection distance Distance between tablet and router should be 5 m or less this may vary due to obstacles or signal status Continuous operating time 5 hours or less recommended Body Dimensions W 54 cm D 28 cm H 48 cm Dimensions are approximate Weight 5 5 kg 11 Specifications ...

Page 37: ...is located on the left edge of the sternum in the second intercostal space The sound coming from the pulmonary artery can be clearly heard but the sound of the mitral valve and aortic insufficiency can also be heard from this area Cardiac apex The cardiac apex is located in the fifth intercostal space of the middle collarbone The sound coming from the mitral valve and the left ventricle can be cle...

Page 38: ...ul in improving your auscultation skills 1 Normal II sound no break ups 2 Normal II sound break ups 3 Abnormal II sound break ups Each of the auscultation points of the heart is shown as A Right cardiac base around aorta P Left cardiac base around pulmonary artery T Left sternal edge third intercostal space around tricuspid valve M Cardiac apex First compare the volume of the I sound and the II so...

Page 39: ...0mmHg It can occasionally be heard normally but can be distinguished because the IV sound is not heard At M the relationship between the I sound and II sound is normal but the IV sound can be heard This is because the extension of the ventricular muscles has dropped due to anemic disorder etc It can be heard in 50 of people over 60 years old At P during early mid systole a soft ejection murmur can...

Page 40: ...passing through the aortic valve and when the blood flow is fast At M it is sometimes heard during mid systole This is due to a minor gap that develops mid systole in the cuspis anterior and posterior to the mitral valve Occasionally two or more clicking sounds can be heard At M during mid late systole a regurgitant murmur can be heard This murmur occurs because the closure of the mitral valve dev...

Page 41: ...om ventricular septal defect At M a distinct acceleration of the I sound followed by the II sound and then an opening snap OS rambling noise during middiastole and a murmur during early systole can be heard The patient s auscultation position should be lying on the left and a bell type stethoscope should be used At M a regurgitant murmur can be heard during all systolic periods This is due to mitr...

Page 42: ... At A an ejection murmur can be heard This is a relative murmur due to increased blood volume This murmur occurs because at T blood that was initially sent to the aorta regurgitates to the left ventric1e during diastole This murmur during systole and diastole is generally called to and fro murmur At T an ejection murmur can be heard during early mid systole This is because the muscular enlargement...

Page 43: ... large rough murmur accompanied by trilling can be heard during all systolic periods This is commonly seen among congenital heart disorders but the smaller the pathway from the left ventricle to the right ventricle is the larger the murmur heard Levine 3 6 4 6 At P an ejection murmur can be heard during late systole It is sometimes combined with congenital heart disorders such as Tetralogy of Fall...

Page 44: ...ocardial infarction The patient suffers from acute congestive heart failure The III sound is not so obvious At P an ejection murmur during systole and a regurgitant murmur during diastole can be heard As in the case of aortic insufficiency the murmur occurs because blood regurgitates from the pulmonary valve into the right ventricle At T a rumbling murmur can be heard during mid diastole ...

Page 45: ...f the manufacturers 606 0865 京都市左京区下鴨東高木町 34 Tel 075 701 1135 Fax 075 722 5638 URL http sakamoto model co jp E Mail info sakamoto model com 製品の仕様及び外観は 改良のため予告なく変更 することがあります 34 Higashitakagicho Shimogamo Sakyo ku KYOTO606 0865 JAPAN Tel 81 75 701 1135 Fax 81 75 722 5638 URL http sakamoto model co jp E Mail trade sakamoto model com Product specifications and appearance are subject to change for impr...

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