消化肾脏泌尿腹部理学检查.pptVIP

Iliopsoas muscle test - in appendicitis - experience lower quadrant pain - patient attempts to flex hip while examiner applies pressure to lower thigh Obturator muscle test - in appendicitis or pelvic abscess - experience pain in the hypogastric area - patient flexes right leg at hip and knee, examiner rotates the leg laterally and medially Rovsing’s sign If palpation of the lower left quadrant of a persons abdomen results in more pain in the right lower quadrant, the patient is said to have a positive Rovsings sign and may have appendicitis Physical examination - Penis Inspection 1. The skin 2. The prepuce or foreskin 3. The glans- ulcer, scar, nodule  or sign of inflammation 4. The urethral meatus- size,  location, discharge Palpation- tenderness or induration, size and contour ! Use gloves ! Remember to replace the  retracted foreskin Physical Examination- Scrotum and its contents Inspection 1. Skin - nodules, inflammation, ulcers 2. Scrotal contour – swelling, lumps or veins Palpation 1. Testes: size, shape, consistency, tenderness, nodules 2. Epididymis 3. Spermatic cord and vas deferens: nodules or swelling Transillumination Physical Examination - Hernia Inspection bulges in inguinal and femoral areas Palpation Indirect, direct, femoral hernia, reducible, incarcerated, strangulated Physical Examination – rectal examination Inspection bulging, hairy skin or discoloration or scar in sacral area lumps, ulcers, inflammation, warts, fissures, rashes or excoriation in perianal areas. Palpation Perianal sensation, bulbocavernous reflex The tonicity of the rectal sphincter Prostate- size, shape, consistency, nodules, induration, asymmetry, tenderness Seminal vesicles Peritoneal cavity- rectal shelf , tenderness Patient Standing And Bent Over The Examining Table Knee-chest position Prostate ex