腹部触诊教案.doc

第 一 临 床 学 院 诊断学理论授课教案 诊断学教研室 邱振宇 诊断学理论授课教案首页 课程名称 诊断学（Diagnosis） 章节（课题） Chapter 8 Abdomen Palpation of abdomen, Ascites 授课对象 临床医学专业 英文班2007年级19-21 班 授课时间 年 月 日 授课学时 2 hour 授课地点 第一教学楼第7教室 教学目的及要求 1. Prehension: Basal methods of palpation; the palpation of liver and spleen; the contents of abdominal palpation. 2. Familiarity: Differential diagnosis of ascites. 3. Comprehend: Pathogenesis of ascites. 教学重点与难点 Focal point：The palpation of liver and spleen. Difficulty：Pathogenesis of ascites. 教学方法 Method of enlightenment and clinical cases analysis 教具 multimedia、picture 板 书 提 纲 Chapter 7 Abdomen Palpation of abdomen The principle of palpation a)To relax the patient b)To palpate four quadrants superficially from LLQ counterclockwise c)To palpate four quadrants Basal methods of palpation light palpation deep palpation: single-handed palpation reinforced palpation bimanual palpation ballottement The contents of palpation abdominal tenseness direct tenderness and rebound tenderness palpation of viscera – liver, spleen, gallbladder abdominal masses fluid wave thrill succussion splash Ascites Definition of Ascites Pathogenesis of ascites Diagnosis History Physical examination Three physical signs of portal hypertension are common Differential diagnosis Acute Hepatic Vein Thrombosis Chronic Hepatic Vein Occlusion Obstruction of the Portal System Portal Hypertension 教 学 步 骤 Introduce 3min Palpation of abdomen 47min The principle of palpation 10min a)To relax the patient b)To palpate four quadrants superficially from LLQ counterclockwise c)To palpate four quadrants deeply Basal methods of palpation 10min light palpation deep palpation: single-handed palpation：mass、organ reinforced palpation: tenderness, rebound bimanual palpation：liver, spleen, kidney, mass ballottement: ascites The contents of palpation 27min abdo