基本检查方法课件

1. deep slipping palpation 深部滑行触诊
2. bimanual palpation 双手触诊法
3. deep press palpation 深压触诊法
4. ballottement
冲击触诊法
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The methods of palpation
• light palpation 浅部触诊法 abdominal muscle tensity abdominal tenderness
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Inspection
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Inspection
Includes a general view of the patient’s
1.mental status 意识状态 2.development 发育
3.nutrition 营养
4. posture 体位
5.body movement 姿势 6.gait 步态
7.facial expression 表情 plexion 面容
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无力型（瘦长型） 正力型（匀称型） 超力型（矮胖型）
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Inspection
1. pallor 2. exophthalmus 3. Cyanosis (lips) 4. moon face 5. spider angioma 6. barrel chest 7. Gastric type 8. Abdomenal
liver enlargement, splenomegaly with massive ascites
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Notice:
1. Patient in supine position 仰卧位 2. Ask patient flex his thighs and knees 放松、屈膝 3. Tell patient relax his abdomenal muscles 腹部放
2. size 大小 4. consistency 质地/边界 6. tenderness 压痛
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Palpation
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The methods of palpation
• Light palpation 浅部触诊法
• Deep Palpation 深部触诊法
respiratory movement
1. anemia 2. Hyperthyroidism 3. mitral face 4. cushing syndrome 5. liver cirrhosis 6. pulmonary emphysema 7. pylorus obstruction 8. Normal，men，
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Deep Palpation
• Deep Palpation
1. deep slipping palpation ---deep mass 2. bimanual palpation --- liver, spleen,
kidney 3. deep press palpation ---tenderness point
松
4. Doctor stands at the right side of patient 站右侧
5. Warm hand, use your palmar aspect of finger, examining gently and lightly, from superficial to deep.手脑并用
children
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palpation
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Palpation
• Mainly used in abdominal examination mass:
1. location 部位 3. contour 边缘 5. mobility 活动度 7. pulsation 波动感
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Percussion
1. lungs ---margin 界 2. heart ---size and shape 大小、形状 3. liver ---upper margin 上界 4. Ascites 腹水 ---shifting dullness 移动
浊音
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Percussion methods
• There are two methods that may be used for percussion
Physical Examination 基本检查方法
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What is physical examination?
• It is a fundamental examining method, it is proceeded by the sense organs such as eyes, ears, nose and hands or simple tools – stethoscope and plexor.
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The basic methods of physical examination
1. inspection 视诊 2. palpation 触诊 3. percussion 叩诊 4. auscultation 听诊 5. olfactory examination 嗅诊
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bimanual palpation liver and spleen
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Deep press palpation tenderness point
Cholecystic point : Murphy’s sign Acute cholecystitis
tenderness point
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Deep Palpation
• Cholecystic point : Murphy’s sign • Appendix point: McBurney point
acute appendicitis • Rebound tenderness：acute peritonitis • Ballottement：冲击