Generalexamination技术总结.ppt

General examination General examination is actually the first step of physical examination Inspection is the major method during general examination, combining with palpation, auscultation, and smelling The examiner should observe the following aspects of the patients: general appearance state of nutrition body habitus（体型） symmetry（对称性） posture 姿势） speech General appearance Sex Age Vital sign（生命征） Development/habitus（发育/体型） Nutritional status（营养状态） Consciousness（意识状况） Speech（tone/voice 语调/语态） Facial feature/expression（面容/表情） Position/posture（体位/姿势） Gait（步态） Sex In female: estrogen and male hormone In male: male hormone Sex is involved in some specific disease female: SLE thyroid chlorosis 萎黄病 male: haemophilia 血友病 Sex Impacts of diseases on sex characters Female patients will be masculinized in long term use of corticosteriod（皮质类固醇） or adrenocortical tumor（肾上腺皮质肿瘤） Male cirrhotic patient will develop gynecomastia（男性乳房发育） mainly because male hormone secretion was suppressed The impacts of normal sex chromosome on the sex and sex characters: biasexual abnormality klinefelter syndrome turner syndrome Age Age is tightly related to some diseases Infant and children: rickets（佝偻病） measles（麻疹） diphtheria（白喉） Children and adolescence: tuberculoses（结核）, rheumatopyra（风湿热） Elder: carcinoma and sclerosis Vital sign Vital signs are physical signs that indicate an individual is alive body temperature breath rate pulse blood pressure heart rate These signs can be measured/monitored to assess level of physical functioning of an individual Normal ranges of measurements of vital signs may change with age, sex, weight, exercise tolerance and condition Body temperature Oral（口腔） Rectal（肛门） Axillary（腋下） Body temperature Oral Place the thermometer under the tongue and close the mouth using the lips hold the thermometer tightly The patient must breath through the nose Leave the thermometer in the mouth for 5 min Reliable method Not suitable: infants