01呼吸系统总论PPT.ppt

Diagnosis and Evaluation ofRespiratory Disease;1. Medical History ;-Less often: abnormal laboratory finding －positive result on the tuberculin test －abnormality seen on screening chest radiograph. -Sometimes: presence of an extrapulmonary lesion, such as sarcoidosis involving the skin or the eye.;Recent studies have shown : Majority of diagnoses and most management decisions can be made on the basis of the history, physical examinations and simple blood and urine laboratory tests. ;;CHIEF COMPLAINT AND PRESENT ILLNESS;;Major Pulmonary Symptoms;COUGH ;Diagnostic Features. ;1. chronic cough (cough that persists for more than 8 weeks) ---Murray and Nadels Textbook of Respiratory Medicine. 4th 2005: 839 2. the medical history is important to determine whether : cough is acute (ie, 3 weeks), subacute(ie, 3 to 8 weeks), chronic (ie, 8 weeks). - An Empiric Integrative Approach to the Management of Cough. ACCP Evidence-Based Clinical Practice Guidelines. CHEST 2006; 129:222S–231S;Some causes of chronic cough (1);Some causes of chronic cough (2);Expectoration of Sputum;Diagnostic Features of Sputum;DYSPNEA ;Some causes of dyspnea(1) ;Some causes of dyspnea(2);American Thoracic Society Dyspnea Scale ;CHEST PAIN ;Some causes of chest pain(1) ;Some causes of chest pain(2);Some causes of chest pain(3);Some causes of chest pain(4);HEMOPTYSlS ;Some causes of hemoptysis（1）;Some causes of hemoptysis（2）;Some causes of hemoptysis（3）; 2. Physical Examinations;;;Clinical Disorders Commonly Associated with Digital clubbing;;Classification of common lung sounds ;Classic Physical Findings in Some common Pulmonary Disordrs;3. Diagnostic Procedures ;2. Bronchoscope;Endobronchial biopsy and bronchoalveolar lavage ;Transbronchoscopic Needle Aspiration (TBNA);Medicacl thoracoscopy is for evaluating pleural effusions and other pleural pathologic processes by visual exploration and directed biopsy. ;4. Radiographic techniques: CT and MRI;;5.