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第一节:Abdominal landmarks Area 一、 Abdominal landmarks 二、Abdominal Area four quadrants system Nine regions system Normal √abdominal flatness(腹部平坦) √ abdominal fullness(腹部饱满) √ abdominal lowness(腹部低平 Overall abdominal bulge can be caused by several pathological factors besides overly obesity or physiological pregnancy. In obesity and fat, the umbilicus is usually deeply inverted.  Peritoneal fluid If there is a large amount of free fluid within the abdomen, i, e. ascites, abdominal wall can be lax in supine position, fluid can deposit at both lateral sides, the contour just like a frog belly. Apical belly尖腹 Apical belly is caused by peritonitis or infiltration of cancers, and hence abdominal muscle is tense, usu. with the apical shape. Peritoneal air 腹腔积气 Peritoneal air is caused by a large amount of air accumulating in the cavity of stomach. √ If you ask the patient to move or change the position, the shape of abdomen remains globular. √ This is commonly found in intestinal obstruction or enteroparalysis(肠麻痹). Pneumoperitoneum气腹√ Pneumoperitoneum is caused by air accumulating in the abdominal cavity. √ It is commonly found in perforation of gastrointestinal diseases or artificial pneumoperitoneum meant to treat. Huge abdominal enclosed mass 腹内巨大包块   Huge abdominal enclosed mass is usually found in full-term pregnancy, huge ovarian cyst(卵巢囊肿), teratoma, etc. Local abdominal bulge局部膨隆 Local abdominal bulge is usually caused by enlarged viscera, tumor, inflammatory enclosed mass, gastrointestinal flatulence(肠胃胀气), hernia, etc. Abdominal concavity/ retraction 腹部凹陷 Overall abdominal concavity/retraction 全腹凹陷  Overall abdominal retraction is usually found in patients severely emaciated or seriously dehydrated. Scaphoid abdomen舟状腹√Scaphoid abdomen is so called because the contour of abdomen is shaped like a boat, with the anterior abdomen almost approximating to spinal column . √ This sign is commonly seen