palpation 中国医科大学触诊中国医科大学.pptVIP

right lateral decubitus position  bimanual palpation Splenometry 1line (A-B line) midclavicular line 2line (A-C line) the longest line 3 line (D-F line) * Palpation Palpation is the most important in examination of abdomen. The preparation of patient: with the patient in supine position, the head should be elevated on a pillow, patient’s arms relax at the two sides of the body, flex his thighs and knees, relax his abdominal muscles According to different parts and organs of examination, the patient can be in right lateral decubitus position such as the examination of spleen, or standing position such as the examination of kidney. The position of doctor the doctor stands at the right side of patient, warm hands, use your palmar aspect of fingers examine gently and lightly from superficial to deep, and from healthy part to lesion area. The sequence of palpation usually the sequence of palpation is contraclock direction:left lower left lumber left upper epigastric right upper right lumber right lower hypogastric umbilical.  the palpating methods 1、浅部触诊法 （light palpation）2、深部触诊法 （deep palpation）(1).深部滑行 （deep slipping palpation）(2).双手触诊法 （bimanual palpation）(3).深压触诊法 （deep press palpation）(4).冲击触诊法 （ballottement） Abdominal palpation  -light palpation Light palpation Deep palpation Deep palpation The contents of palpation 1.abdominal muscles tensity 2.tenderness and  rebound tenderness 3.abdominal organs4.abdominal masses 5.fluid thrill 6.succussion splash 1.abdominal muscle tensity (1). Increased tensity of generalized abdominal muscles Acute diffuse peritonitis caused by gastrointestinal perforation. In perforation, the muscle rigidity is very obvious, the abdominal wall is like board hard, so we call board-like abdomen Dough kneading sensation TB peritonitis carcinomatous peritonitis metastatic carcinoma of peritonium (2). Increased t