Clinical Manifestation
肺源性心脏病
(二)心功能不全
3. 利尿剂：选用缓和制剂，小剂量，短疗程，注意 不良反应； 4. 血管扩张剂：受体阻滞剂；钙拮抗剂；ACEI； 硝酸酯类药物；
5. 控制心律失常。
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A10123S
治疗：
二、缓解期的治疗
1. 增加机体抵抗力、防治呼吸道感染；
2. 治疗原发病；
3. 预防复发。
二、心脏改变
(一)右心
1. 代偿期：肺动脉高压，右心室后负荷增加，
代偿性肥厚；
2. 失代偿期：肺动脉高压、水钠潴留、心肌缺
氧等，心脏扩大和心力衰竭。
(二)左心
11 A10123S
临床表现(clinical manifestation)：
一、缓解期
(一)症状(symptom)
1. 基础疾病的症状：如咳嗽、咳痰和喘息等； 2. PaO2降低的表现：乏力、劳动力下降、气促、 心率增快、心悸、发绀(cyanosis)； 3. PaCO2升高的表现：不明显。
临床表现(clinical manifestation)：
三、并发症(complications)
3. 心律失常(arrhythmias)
各种类型均可见，以房性心律失常多见。
4. 休克(shock)
感染性；心源性；失血性。
19
A10123S
临床表现(clinical manifestation)：
三、并发症(complications)
5. 消化道出血(gastrointestinal hemorrhage)
粘膜糜烂；应激性溃疡；食道出血；DIC。
6. DIC(disseminated intravascular coagulation)
病理读片
inflammatory pseudotumor
Thankቤተ መጻሕፍቲ ባይዱ！
病理读片
Case One
ID 22372223 Male, 43 years old Clinical manifestation
chest distress、 anhelation for 2 months
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Maybe ……..
Pathologic findings
孤立性纤维瘤CT表现有一定特点。胸腔内实质性肿块，与胸 膜宽基底相连，肿块最大径在9cm以上，孤立性、边缘清楚 光整、浅分叶、密度均匀或伴有坏死;肿块向胸腔内突起，胸 壁相应部位肋骨未见异常改变;增强后一般中等度强化，肿瘤 内扭曲血管影及"假包膜征"等较具特征性。
鉴别诊断 肺癌多见于40岁以上，有吸烟史，影像学检查肿块可呈 分叶状，有毛刺，常有胸膜凹陷征，肺不张，阻塞性肺 炎。 肺肉瘤多在40岁以下，在肺实质内膨胀性生长，很少侵 犯或突破支气管黏膜，影像学表现为实性肿块，直径多 在5cm以上，肿块内可有钙化、空洞形成，多为局限性胸 膜侵犯。 肺良性肿瘤多发生于青壮年，常无明显症状，一般为单 发圆形或类圆形阴影，生长缓慢，密度均匀，不侵犯周 围组织，与胸膜无密切关系，增强后CT常无强化。
SFT是一种罕见的来源于间叶组织的梭形细
胞肿瘤。1931年Klemperer和Rabin首先报道 ，最初认为该肿瘤起源于胸膜间皮细胞，称 为局限性纤维性间皮瘤。但新近发现SFT可 累及腹膜、腮腺、肺、肝、肾及眼眶等身体 多处胸膜外组织。该肿瘤不具有间皮特征， 而具有向纤维母细胞分化的特征。80％的 SFT起源于胸膜，肺部SFT报道较少，其临 床表现无特异性，与肺癌的临床表现相似。
贫血总论
红细胞平均体积 MCV：mean corpuscular volume ； 红细胞平均血红蛋白浓度 MCHC：mean cell hemoglobin concentration
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大细胞性贫血 Macrocytic anemia
•巨幼细胞贫血（叶酸和VB12缺乏） Megaloblastic anemias ( folic acid and vitamin B12 deficiency) •酒精中毒 Alcoholism •药物 Drugs •肝病 Liver diseases •甲状腺机能减退症Hypothyroidism •脾脏切除术后Splenectomy
Classification according to etiology/pathogenesis
根据病因和发病机制的分类更能反映贫血的病理本质
The classification according to etiology/pathogenesis can represent the nature of anemia
4
正常值 Normal values of the hemogram:
RBC (×1012/L) Hb (g/L) 成年男性 (adult men） 4.0 ～ 5.5 120 ～ 160 成年女性 (adult women) 3.5 ～ 5.0 110 ～ 150 新生儿 (newborn) 6.0 ～ 7.0 170 ～ 200 孕 妇 (pregnant) ＞100 Hct (L/L） 0.40~0.50 0.37~0.48
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三、按骨髓增生程度分类 According to Bone marrow proliferative degree
骨髓Bone marrow 增生性贫血 Hyperplasia 增生不良性贫血 Hypoplasia 贫血anemia
脊髓疾病-中英对照
Overview
脊髓横贯性损害 Transverse lesions
腰膨大（ L1－S2 ）
Sense
loss of lower limbs and perineum Flaccid paralysis of lower limbs Urinary and fecal retention Autonomic dysfunction Root pain in groin
Acute myelitis
病因 Etiology ：
Infection
分类 Classification：
postinfectious
and vaccination Virus Parasite Bacteria Fungus Unclear
myelitis Postvaccinal myelitis Demyelinating myelitis Paraneoplastic myelitis
前角 Anterior horn: αand γmotor neuron 后角 Posterior horn: secondary sensory
neuron
侧角 Lateral horn:
C8－L2 交感神经低级中枢 Sympathetic nucleus S2－S4 脊髓副交感中枢 Parasympathetic nucleus
脊髓横贯性损害 Transverse lesions
高颈段（C1-4）
Spastic paralysis of all extremities
Sense loss below neck，root pain
Urinary and fecal retention，Absent
子宫肌瘤英语查房
五、Clinical Manifestation临床表现
1、Change of menorrhea 月经改变：
The amount of the increase, the period is prolonged, the cycle is short, the typical symptoms 经量增多、
八、TREATMENT治疗
Surgical approach手术方式
1、Myomectomy surgery肌瘤切除手术 Laparoscopy or laparotomy under direct vision, can also be removed through the vagina 腹腔镜或剖腹直视下进行， 也可经阴道切除。 2、Hysterectomy子宫切除手术 Apply to 适用于①Large fibroids, symptoms, drug treatment ineffective肌瘤较大，症状明显，药物治疗无效；②Not preserve fertility不保留生育功能；③Patients with suspected malignancy疑有恶变的患者。 50 years of age, patients with normal ovarian appearance, may retain ovary50岁以下，卵巢外观正常 的患者，可保留卵巢。
疗原则及手术适应症
性
4、To understand the secondary degeneration of uterine fibroids 了解 子宫肌瘤的继发变
一、Outline概述
1、The most common benign tumor of female genitalia from uterine smooth muscle女性生殖器最常见的良性肿瘤来源于子宫平
临床医学名词
临床医学名词
临床医学是一门涉及诊断、治疗和预防疾病的医学学科，以下是
一些常见的临床医学名词：
1. 临床表现（Clinical manifestation）：指疾病或病症在患者身上
表现出的症状和体征。
2. 诊断（Diagnosis）：通过病史、体检、实验室检查和影像学等
手段确定疾病的过程。
3. 治疗（Treatment）：针对疾病采取的各种干预措施，包括药物治疗、手术治疗、物理治疗等。
4. 预后（Prognosis）：对疾病的可能发展和结局进行预测。
5. 药物不良反应（Adverse drug reaction）：指药物在正常用法
用量下，出现的与治疗目的无关的有害反应。
6. 并发症（Complication）：指在原发疾病的基础上，发生的另
一种疾病或症状。
7. 慢性病（Chronic disease）：持续时间较长、进展缓慢的疾病，如糖尿病、高血压等。
8. 急性病（Acute disease）：发病急、病程短、症状明显的疾病，如感冒、急性阑尾炎等。
9. 预防（Prevention）：采取措施减少疾病的发生和传播。
10. 流行病学（Epidemiology）：研究疾病在人群中的分布、原因和控制的学科。
肺癌双语lung cancer讲解
Central lung cancer
Peripheral lung cancer
Cancer cavity
alveolar cell carcinoma（diffuse type）
alveolar cell carcinoma （nodular type）
• 肺癌在肺内支气管生长会产生肿块、阻塞支气管、引起阻 塞性肺炎、肺不张，进一步发展，可引起肺门、纵隔淋巴 结转移肿大，引起胸腔积液；形成癌空洞等病变。通过X 线胸片、透视，可以：
• 1、 发现块影或可疑肿块阴影，明确形态、部
6. ClinicБайду номын сангаасl manifestation
2. Symptoms caused by local tranfer
chest pain 侵犯胸膜、肋骨 胸痛
剧烈
dyspnea
呼吸困难
管腔内肿瘤
大气道狭窄、阻塞或隆
突被广泛侵犯
肿瘤或肿大淋巴结
压迫气管、大
支气管
病变广泛
肺泡癌
肿瘤侵犯胸膜、心包膜 胸腔积液、心
原发性支气管肺癌
Primary Bronchogenic Carcinoma
1.Definition
原发性支气管肺癌
简称肺癌（Lung Cancer） 指 起 源 于 支 气 管 粘 膜 (tunica mucosa bronchiorum)或腺体(glands)的癌症。
2.Morbidity and mortality
5. Cllinical classification
按生长部位分为
中央型肺癌(central lung cancer)
Modern Disease(现代病)
No.5
• WiFi-dependence disease(WiFi依赖症)
Clinical manifestation: Looking for WiFi in every public place."Please tell me the WiFi password!" is becoming a pet phrase(口头禅).WiFi has become a measuring criteria for rastaurants, if a place doesn't have WiFi, they will feel very uncomfortable. Prescription: Avoid to focus your mind on your mobile phone, enrich your life as more as possible.
No.2
• Obsessive-compulsive disorder(强迫症)
Clinical manifestation(临床表现)： Before going out,some people always check pockets and bags,and always mumble Mobile phone, keys ,wallet ,bus card... Mobile phone ,keys, wallet, bus card... Mobile phone, keys ,wallet ,bus card... Mobile phone ,keys, wallet ,bus card... Prescription(病方): Relieve the tension and the fear ,ignore symptoms is the best attitude,take it easy.
新生儿疾病-新生儿呼吸窘迫综合征英文
Distress Syndrome
NRDS
新生儿呼吸窘迫综合征
Definition Etiology Pathogenesis Clinical manifestation Assistant examination Diagnosis Differential diagnosis Therapy Prevention
pulmonary alveoli
Etiology
Preterm birth
pH of body fluid, body temperature, volume of pulmonary blood flow and hormone can influence PS secretion.
Asphyxia, hypothermia, placenta previa, placental abruption and hypotension of mother, which can influence blood flow of fetus.
Therapy
General treatment：
incubation monitoring of T, R, HR, BP, blood gas liquid and nutrition Supply Rectification of acidosis shut off arterial ductus antibiotics
work at inspiration↑difficulty at alveolus opening
tidal volume↓
CO2 retention respiratory acidosis Alveolar permeability↑
川崎病的临床表现
(2)球结合膜充血 Conjestion of Ocular Conjunctivae
（3）唇及口腔改变 Changes of Lips and Oral
Dry and Cracked Lips
Strawberry Tongue
(4)手足症状 Symptom of Limbs
Indurative Edema
Desquamation at Fingertips
(5)皮肤改变 Changes of Derma
Annular Erythema
（6）颈淋巴结肿大 Cervical lymphadenopathy
The others：
间质性肺炎
Interstitial pneumonia
无菌性脑膜炎
aseptic meningitis
关节炎和关节痛
symptoms of arthritis
黄疸
jaundice
Examination
1.血液检查 Blood Test 白细胞增高 以中性粒细胞为主 血小板早期正常 第2-3周增多 血沉增快 C反应蛋白升高
波
Summary
Questions
1、川崎病的主要临床表现？ 2、川崎病的临床表现和病理分期的关系？
川崎病的临床表现
Clinical Manifestations of Kawasaki Disease
Etiology and pathogenesis
Etiology and pathogenesis
阿尔茨海默症英语介绍
.
12
3 Pathogeny＆Treatment
.
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Pathogenesis hypothesis of AD
.
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Pathogeny
vs
Abnormal amyloid beta cell deposition in neurons
Abnormal phosphorylation of tau protein
.
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Degradation of memory and cognition
➢ "the effects of Alzheimer's disease on the right parietal lobe of the brain are particularly severe, which directly affects the ability of the brain to visualize and develop the ability to draw pictures of the brain."said Dr. Bruce Miller, a neurologist.
Ⅰ期
Ⅱ期
Ⅲ期
death
1-3 years 2-10 years 8-12 years
More women than men 7:5~4:6
Disease for up to 10-20 years
.
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Degradation of memory and cognition
William Utermo.hlen的自画像
Nerve cells die in areas of the brain that are vital to memory and other mental abilities.
住院病历中英文对照
随着中外交流的加强，专业英语对医院也是越来越重要！花了点时间整理了下“住院病历的英汉对照”的格式，发上来和大家分享，希望对能用到的人有所帮助！POMR (Problem-Oriented Medical Records)表格式住院病历Biographical data:一般项目：Name Age Sex Marital status Nativity Race姓名年龄性别婚否籍贯民族Occupation Date of admission Informant History职业入院日期病史叙述者病史Chief complaint主诉History of present illness现病史Past history既往史：Previous health status: well ordinary bad Infectious diseases平素健康状况：良好一般较差传染病史Immunizations Allergies: N Y clinical manifestation预防接种史过敏史无有临床表现allergen: Trauma: Surgery:过敏原外伤史手术史Review of systems:(Tick if positive, cross out if negative. If postive, you should write down your disease history and brief course of diagnose and therapy)系统回顾：(有打√无打×阳性病史应在下面空间内填写发病时间及扼要诊疗经过) Respiratory system:呼吸系统Sore throat chronic cough sputum hemoptysis wheezing咽痛慢性咳嗽咳痰咯血哮喘dyspnea chest pain呼吸困难胸痛cadiovascular system:循环系统Palpitation dyspnea on exertion hemoptysis syncope心悸活动后气促咯血晕厥edema of lower limbs precordial pain hypertention下肢水肿心前区疼痛高血压Digestive system:消化系统Anorexia sour regurgitation belching nausea vomitting食欲减退反酸嗳气恶心呕吐abdominal distention abdominal pain constipation diarrhea腹胀腹痛便秘腹泻hematemesis melena hematochezia jaundice呕血黑便便血黄疸Urinary system:泌尿系统Lumbago frequent micturition urgent micturition urodynia腰痛尿频尿急尿痛dysuria hematuria nocturia polyuria oliguria facial edema排尿困难血尿夜尿多尿少尿面部水肿Hematopoietic system造血系统Fatigue dizziness blurred vision gingival bleedig乏力头昏牙龈出血subcutaneous hemorrhage ostealgia epistaxis皮下出血骨痛鼻衄Metabolic and endocrine system:代谢及内分泌系统Excessive appetite anorexia sweats cold intolerance食欲亢进食欲减退多汗畏寒polydipsia tremor hands change of character obvious obesity 多饮双手震颤性格改变显著肥胖emaciation hirsutism hair losing pigmentation消瘦多毛毛发脱落色素沉着chang of sexual function amenorrhea性功能改变闭经Musculoskeletal system肌肉骨骼系统Floating arthralgia arthraliga swelling of joints游走性关节痛关节痛关节红肿deformiteies of jionts myalgia atrophy of muscle关节变形肌肉痛肌肉萎缩Nervous system神经系统Dizziness headache vertigo syncope degeneration of memory 头昏头痛眩晕晕厥记忆力减退visual disturbance insomnia disturbance of consciousness视力障碍失眠意识障碍tremor spasm paralysis paresthesia颤动抽搐瘫痪感觉异常Personal history:个人史Birthplace Occupation sexual history smoking N Y出生地职业冶游史吸烟无有about years average pieces per day ceased for years约年平均支/日戒烟年alcohol intake N occasional frequent about years嗜酒无偶有经常约为年average ml per day others平均 ml/日其他Marital history:婚姻史：Marrying age companion’s state of health结婚年龄配偶健康状况Menorrhea and Childbearing:月经及生育史Menarche age cycle lasting for days date of last period初潮每次持续时间末次月经时间(age of menopause)绝经年龄Amount of flow: little normal large menstrual pain: N Y经量少正常多痛经无有cycle: regular irregular pregnancy times natural labor经期规则不规则妊娠次顺产times abortions times premature delivery times胎流产胎早产胎stillbirths times difficult labor and its condition死产胎难产及病情Familly history (pay attention to the congenital diseases andcommunicable diseases and communicable dieases related to the paitent家族史（注意与患者现病有关的遗传病和传染性疾病）Father: still alive illness died cause of deaths mother:父：健在患病已故死因母 still alive illness died cause of death siblings: others:健在患病已故死因兄弟姐妹子女其他Physical examination体格检查Vital signs生命体征:Temperature体温pulse脉搏 /min次/分respiration呼吸 /min次/分B.P血压 mmHgGeneral Appearance一般状况:Development发育:ortho-sthenic type正常asthenic type不良sthenic type超常nutrition营养:well良好fairly中等poor不良cachexia恶病质Facial features面容:normal无病容acute急性chronic慢性病容others其他Expression表情:natural自知painful痛苦anxious忧虑dreadful恐惧indifferent淡漠Position: active semi-recumbent others体位：自主半卧位其他Gait: normal abnormal步态正常不正常Conciousness: aware somnolence confusion stupor coma神志清楚嗜睡模糊昏睡昏迷delirium coppperatio; well badly谵妄配合检查合作不合作Mucocutaneous color: normal red pale cyaosis stainted皮肤粘膜色泽无病容潮红苍白紫绀yellow pigmentation lesions:N Y (type and distribution)黄染色素沉着皮疹无有（类型及分布）Subcutaneous hemorrhange: N Y(type and distribution)皮下出血无有（类型及分布）Hair: normal reduced edema: N Y(position and degree)头发分布正常减退水肿无有（部位及程度）Hepatic palm: N Y spider angionma:N Y（position numbers ） others:肝掌无有蜘蛛痣无有(部位数目) 其他Lymphnodes:淋巴结Superficial lymph nodes: non-swelling swelling(position and characteristics)全身淋巴结肿大无肿大肿大（部位及特征）Head : cranium : size : normal large small deformity:头部头颅大小正常大小畸形N Y(coxycephaly squared skull deforming skull)无有（尖颅方颅变形颅）Others: tenderness mass sunk (position)其他异常：压痛包块凹陷（部位）Eyes eyelid: normal edema ptosis trichiasis conjunctive :眼睑正常水肿下垂倒睫结膜normal hyperemia edema hemrrhage正常充血水肿出血eye ball: normal proptosis depression tremor眼球正常突出凹陷震颤motion dysfunction(left right)运动障碍Sclera :normal yellow cornea : normal abnormal ( left right )巩膜无黄染有黄染角膜正常异常（左右）Pupils: equal roundness same size unequal left cm瞳孔等圆等大不等左 cmreaction to light: normal delay (left right) disappear (left right) 对光反射正常迟钝（左右）消失（左右）Others:其他Ears: auricle :normal deformity fistula others (left right )耳耳廓正常畸形瘘管其他（左右）excretions of external auditory canal: N Y (left right feature)外耳道分泌物无有（左右性质）Tenderness of mastoid : N Y audation dysfunction: N Y (left right)乳突压痛无有听力粗试障碍无有（左右）Nose: shape : normal: abnormal ( ) other abnormalities:N Y鼻外形正常异常（）其他异常无有Nosalala flap obsruction excretions nasal sinus tenderness:鼻翼扇动鼻塞分泌物鼻旁窦压痛N Y (position )无有（部位）Mouth lips :red syanosis pale herpes fissure mucosa :normal口唇红润发绀苍白疱疹皲裂粘膜正常abnormal ( pale petechia)异常（苍白出血点）Opening of parotid gland duct: normal abnormal (swelling腮腺导管开口正常异常（肿胀suppurative excretions)脓性分泌物）Tongue:normal abnormal (coverings tremor leaning to left or right)舌正常异常（舌苔伸舌震颤向左、向右偏斜）Gums: normal swelling pus overflow hemorrhage pigments牙龈正常肿胀溢脓出血色素沉着lead line tooth:regular edentulous carious teeth铅线牙列齐缺牙—|—龋齿—|—Tonsils: pharynx: voice: normal hoarse扁桃体咽声音正常嘶哑Neck:resistence:N Y carotid artery pulsation: normal increased颈部抵抗感无有颈动脉搏动正常增强decreased (left right) jugular vein:normal distention减弱（左右）颈静脉正常充盈high distention trachea:middle deviation to (left right)怒张气管正中偏移（向左向右）Hepatojugular reflux:(-) (+) thyroid: normal swelling degree肝颈静脉回流征：（-）（+）甲状腺正常肿大度Symmetry 对称Dominance in one side: spreading nodular:soft hard others :N Y 侧为主弥漫性结节性质软质硬其他无有(tenderness tremor bruits)（压痛震颤血管杂音）Chest topography:normal barrel chest pigeon chest funnel chest胸部胸廓正常桶状胸鸡胸漏斗胸flat chest bulging or retraction (left right )扁平胸膨隆或凹陷（左右）bulging in the precordial region tenderness of sternum心前区膨隆胸骨压痛Breast: normal symmetrical abnormal : left right(gynecomastia乳房正常对称异常左右（男乳女化mass tenderness excretions of nipples)包块压痛乳头分泌物）Lung肺Inspection : movement of respiration : normal abnormal : left视诊呼吸运动正常异常左right( increased decreased)右（增强减弱）Intercostal space :normal wide narrow(position)肋间隙正常增宽变窄（部位）Palpation : vocal fremitus:normal abnormal :left right (increased触诊：语颤正常异常左右（增强decreased ) pluernal friction rubs: N Y（position）减弱胸膜摩擦感：无有（部位）Subcutaneous crepitus: N Y(posotion) percussion: resonance皮下捻发感无有（部位）叩诊正常清音abnormal dullness flatness hyperresonance tympany异常叩诊音浊音实音过清音鼓音Lower borders:scapular line: right intercostal space, left肺下界肩胛线右肋间左intercostal space Range of mobility: right cm , left cm肋间移动度右 cm，左 cmDusculation: breath regular irregular听诊呼吸规整不规整Breath sound: normal abnormal( feature, position )呼吸音正常异常（性质，部位描写）Rale: N Y ：ronchi: sonorous sibilant啰音：无有：干性鼾音哨笛音Moist rales: coarse medium fine rales crepitus湿性大中小水泡音捻发音Vocal conduction: normal abnormal: reduced increased(position)语音传导正常异常减弱增强（部位）Plueral friction rubs: N Y (position)胸膜摩擦音无有（部位）Heart 心Inspection:bulging in precordial region : N Y apex impulse:视诊心前区隆起无有心尖搏动normal unseen increased diffusing position: normal正常未见增强弥散心尖搏动位置正常deviation ( the distance from midclavicular line cm)移动（距左锁骨中线内外厘米）Other precordial pulsations: N Y (position)其他部位搏动无有（部位）Palpation:apex impulse:normal increased thrust unclear触诊心尖搏动正常增强抬举感触不清thrills :N Y (position period) percardial friction rubs:N Y震颤无有（部位时期）心包摩擦感无有Percussion:relative cardiac outline: normal shrink extant (right left )叩诊相对浊音界正常缩小扩大（右左）Ausculation: heart rate bpm/min rhythm(regular irregular听诊心率次/分心律（齐不齐）absolutly irrgelar) heart sound:S1normal increased decreased绝对不齐心音 S1 正常增强减弱split S2 normal increased decreased split分裂 S2 正常增强减弱分裂S3 N Y S4 N Y A2 P2S3 无有 S4 无有 A2 P2Extra heart sound N gallop (diastolic presystotic summalion额外心音无奔马律（舒张期收缩前期重叠gallop) opening snap others murmurs: N Y (degree conduction)开瓣音其他杂音无有（图示并描述传导）Pericardial friction rubs N Y心包摩擦音无有Peripheral vessals: normal pistal shot of big arteries周围血管无异常血管征大血管枪击音Duroziez’s sign water hammer pulse capillary pulsa tion二重杂音水冲脉毛细血管搏动pulse deficit paradoxical pulse pulsus alternans other脉搏短绌奇脉交替脉其他Abdoman腹部Inspection: shape normal distention frog abdomen( size cm)视诊外形正常膨隆蛙腹（腹围厘米）scaphoid apical abdomen gastral pattern intestinal pattern舟腹尖腹胃型肠型peristalsis abdominal respiration:existance disappear umbilicus:蠕动波腹式呼吸存在消失脐normal protruding excretions others: N Y(venous distention of正常凸出分泌物其他异常无有（腹壁静脉曲张abdoman purple striae surgical scars hernia)条纹手术疤痕疝）Palpation: soft muscle tension position tenderness N Y触诊柔软腹肌紧张部位压痛无有rebound tenderness N Y fluidthtill N Y succussions plash N Y 反跳痛无有液波震颤无有振水音无有Mass N Y(position size) discription of feature liver:can’t be 腹部包块无有（部位大小）特征描述肝未触及touched can be touched :subcostal cm under xipfoid process可触及肋下厘米剑突下discription of feature gallbladder: can’t be touched can be touched特征描述胆囊未触及可触及size cm tenderness N Y Murphy’s sign spleen: can’t be 大小厘米压痛无有 Murphy征脾未触及touched can be touched distance from costal margin cm可触及肋下厘米Kideny:can’t be touched can be touched size consistency肾未触及可触及大小硬度tenderness mobility tenderness of ureters: N Y (position)压痛移动度输尿管压痛点无有（部位）percussion: borders of liver dull(existance shrink obliteration )叩诊肝浊音界（存在缩小消失）Upper borders of liver on right midclavicular line intercostal space 肝上界位于右锁骨中线肋间shifting dullness N Y tenderness in renal region N Y (right left )移动性浊音无有肾区叩痛无有（右左）ausculation : borhorygmus normal increased decreased听诊肠鸣音正常增强减弱disappear gurgling N Y vessal bruits N Y (position)消失气过水声无有血管杂音无有（部位）Genitalia :not examined normal abnormal Rectum and Anus :生殖器未查正常异常肛门直肠not examined normal abnormal未查正常异常Spine and Extremities脊柱四肢Spine : normal deformities (lateral anterior posterior protruding)脊柱正常畸形（侧前后凸）Spinous process : tenderness pain while percussed ( position )棘突压痛叩痛（部位）Mobility : normal restricted extremeties: normal abnormal移动度正常受限四肢正常异常deformity swelling of joints joints stiffness畸形关节红肿关节强直tenderness of muscles atrophy of muscles肌肉压痛肌肉萎缩Venous distention of lower limbs (position and feature ) acropachy下肢静脉曲张（部位及特征）杵状指Nervus System神经系统Abdominal wall reflex ( normal ) muscle tone ( normal )腹壁反射（正常）肌张力（正常）Myodynamia ( degree ) paralysis of limbs N Y (left right肌力（级）肢体瘫痪无有（左右upper lower) biceps reflex left (normal) right (normal)上下）肱二头肌反射左（正常）右（正常） knee jerk left (normal) right( normal) achilles jerk left膝健反射左（正常）右（正常）跟腱反射左(normal) right ( normal )正常右（正常）Hoffmann’s di gn left (+)(-) right(+)(-)Hoffmann征左（+）(-) 右（+）（-）Babinski’s sign left(+)（-） right(+)(-)Babinski 左（+）（-）右（+）（-）Kernig’s sign left(+)（-）right(+)(-) othersKernig征左（+）（-）右（+）（-）其他Laboratory findings实验室及器械检查结果（The important laboratory examination .X-ray . ECG and other result areincluded） (重要的化验、X线、心电图及其他有关化验) Nunber of X-rayX线片号Abstract病历摘要Diagnosis(impressions)入院诊断Recorder病史记录者Examiner并使审阅者Date of record 记录日期 . ..。
钾的异常 英文
Reasons:
Inadequate
intake Excessive losses Extracellular potassium has moved into body cells
Clinical manifestation: Myasthenia gravis Patients with anorexia, nausea, vomiting, abdominal distension, intestinal peristalsis disappeared intestinal paralysis Heart block, the abnormal rhythm Electrocardiogram: T wave decrease, flattening or inversion, ST segment depression, prolongation of the QT interval, U wave Metabolic alkalosis and Paradoxical acidic urine （代谢性碱中毒,反常性酸性尿）
Diagnosis:
Diagnosis: potassium than 5.5mmol/L Aided diagnosis：ECG
TreLeabharlann tment1.Immediately stop all drugs containing potassium or solution 2.Reduction of serum potassium concentration Urges the potassium ion to intracellular: infusion of sodium bicarbonate solution Cation exchange resin（阳离子交换树脂） Dialysis therapy（透析疗法） 3.Against arrhythmia：Intravenous glucose acid calcium solution
外科感染病人的护理
(2)深部淋巴管炎:患肢肿胀、疼痛
78
3.急性淋巴结炎
acute lymphadenitis
轻：区域淋巴结肿大 重：疼痛、触痛剧烈
明显的全身症状
79
(三)处理原则
principle of management
1.处理原发病灶
2.局部:休息、抬高患肢，药物外敷 50%硫酸镁湿热敷局部
3.全身应用有效抗生素 丹毒:全身症状消失后,仍继续使用３-５天以防止丹 毒复发
67
护理-nursing
3. 疼痛管理 4. 防治窒息(suffocate)：观察有无呼吸费力、呼
吸困难、发绀、窒息，一旦发现，及时做好 气管切开的准备。
68
四、急性淋巴管炎和淋巴结炎
（acute lymphangitis，acute lymphadenitis )
69
（一）病因与病理
etiology & pathology
65
(3)颌下蜂窝织炎
*积极治疗无效者，尽 早切开减压，防止喉头水 肿和气管压迫
66
护理-nursing
1. 控制感染,维持正常体温
(1)定时监测体温 (2)加强创面护理
2．作好脓肿切开引流术后的护理 -保持引流通畅，定时换药； -厌氧菌感染：3%过氧化氢、0.2%甲硝唑冲洗， 持续湿敷。 -后期创面可用理疗仪照射局部
Aureus Staphylococcus
30
临床表现
(clinical manifestation)
局部：红、肿、热、痛、功能障碍
31
Furuncle
32
疖病：多处发
生疖肿，见于 DM患者与小儿
33
手部疖病
慢性心力衰竭Chronic-Heart-Failure-(双语)
Laboratory investigation
1.利钠肽 BNP,NT-proBNP BNP levels vary directly with severity Dyspnea due to COPD, BNP levels < 100, HF > 1,000 BNP <100 yield negative predictive value of 89-96% BNP >480, 40% death rate or readmission within 6 mo Increased in elderly, women, cirrhosis, renal failure,
肝肿大liver large，congestive liver
心脏体征
9
全心衰竭Biventricular heart failure
右心衰竭继发于左心衰竭形成全心衰竭，当右心 衰竭出现后,左心衰竭肺淤血症状反而减轻，主要 表现为心排血量减少的相关症状和体征。
have clinical manifestation of left and right heart failure
④急性肺水肿acute pulmonary edema
5
Clinical manifestation (left heart failure )
咳嗽、咳痰、咯血Cough, expectoration, hemoptysis
乏力、疲倦、头昏、心慌 Weakness, fatigue on exertion, dizziness, flustered
Chronic Heart Failure
People's Hospital
1
Definition of Heart Failure