ppt课件-assessmentofthe abdomen( gastrointestinal system)（assessmentofthe腹部(胃肠系统)）.pptVIP

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2017-01-25 发布于四川
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ppt课件-assessmentofthe abdomen( gastrointestinal system)（assessmentofthe腹部(胃肠系统)）.ppt

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* * Health Assessment Across the Lifespan Structure and Function Subjective Data—Health History Questions Objective Data—The Physical Exam Abnormal Findings Slide 21-* Surface landmarks Borders of abdominal cavity Abdominal muscles Internal anatomy (viscera) Solid viscera Liver Pancreas Spleen Adrenal glands Kidneys Ovaries Uterus Slide 21-* Internal anatomy (viscera) (cont.) Hollow viscera Stomach Gallbladder Small intestine Colon Bladder Slide 21-* Slide 21-* ? Pat Thomas, 2006. Slide 21-* ? Pat Thomas, 2006. Abdominal wall divided into four quadrants Right upper (RUQ) Left upper (LUQ) Right lower (RLQ) Left lower (LLQ) Slide 21-* Slide 21-* Appetite Dysphagia Food intolerance Abdominal pain Nausea/vomiting Bowel habits Abdominal history Medications Nutritional assessment Slide 21-* Preparation Lighting and draping Measures to enhance abdominal wall relaxation Equipment needed Stethoscope Small centimeter ruler Skin-marking pen Alcohol swab Slide 21-* Inspect the abdomen Contour Symmetry Umbilicus Skin Pulsation or movement Hair distribution Demeanor Slide 21-* Slide 21-* Auscultate the abdomen Bowel sounds Vascular sounds (bruits) Percuss the abdomen General tympany Liver span Usual technique Scratch test Splenic dullness Costovertebral angletenderness Special procedures Fluid wave Shifting dullness Slide 21-* Palpate the liver Measures to enhance muscle relaxation Light palpation Deep palpation Bimanual palpation Normally palpable structures Liver Usual technique Hooking technique Spleen Kidneys Aorta Slide 21-* Rebound tenderness (Blumberg’s sign) Inspiratory arrest (Murphy’s sign) Iliopsoas muscle test Obturator test Slide 21-* Slide 21-* Slide 21-* Slide 21-* Obesity Air or gas Ascites Ovarian cyst Pregnancy Feces Tumor Slide 21-* Umbilical hernia Epigastric hernia Incisional hernia Diastasis recti Slide 21-* Hypoactive bowel sounds Hyperactive bowel sounds Slide 21-* Enlarged liver Enlarged nodular liver Enlarged gallbladder Enlarged spleen Enlarged kidne