no342014224腹部体检1.pptVIP

Abdominal Examination 于莲珍 南京医科大学第一附属医院 Abdominal Examination Range: superior: 横膈（diaphragma） inferior: 骨盆（pelvis） anterior: 腹壁（abdominal wall） posterior: 脊柱（spine) 腰肌(psoas muscle) Examination of abdomen: 视 Inspection 触 Palpation 叩 Percussion 听 Auscultation Abdominal Examination I - Inspection: Distention, skin lesions A - Auscultation: Bowel sounds P - Palpation: Tenderness, liver, spleen, masses P - Percussion: Tympany vs. dullness The marks of body surface： 剑突（xiphoid process） 肋弓下缘(costal margin)、 腹上角(epigastric angle)、 脐（umbilicus ）、 髂前上棘(anterior superior iliac spine)、 髂后上棘(posterior superior iliac spine) 腹直肌外缘(the+ lateral margin of rectus abdominis)、 腹中线(linea alba)、 腹股沟韧带（inguinal ligament）、 肋脊角 (costovertebral angle) The marks of body surface The regions of the abdomen：  四区分法(the four quadrants of the abdomen 九区分法(the nine quadrants of the abdomen) Abdominal quadrants and regions Abdominal examination Abdominal quadrants and regions Abdominal inspection Position：被检者仰卧位、充分暴露全腹； 光线充足柔和，从头、足侧射来； 医生站于右侧，一定顺序、自上而下。 Abdominal Contour Normal Abdominal Contour ：肋缘与耻骨联合构成基本平面，前腹壁与该平面相平或略低为腹部平坦。 肥胖及儿童较圆呈腹部饱满，老人及消瘦 者腹肌松弛呈低平状。 Abdominal Contour Abnormal Abdominal Contour Classified as: Abdominal distension Abdominal concauity Abdominal distension Definition：前腹壁明显高于基本平面。 physiological: obesity pregnancy pathological: ascites enormous tumor。 Classified as: Whole distension Local distension Abdominal distension Whole distension ：腹内容增多，见于 腹腔积液: 腹水(ascites)：frog belly 常见于：肝硬化门脉高压症（cirrhosis of liver and portal hypertension） 心力衰竭（heart failure） 缩窄性