课件：J腹部检查B.ppt

* Ascites Sign腹水征 Inspection: frog shape of abdomen in dorsal position, hypogastrium region distension with hilum hernia in stand. 视诊: 仰卧位蛙状腹 直立位下腹膨隆脐突出 Palpation: fluid thrill (ascites large than 3000 ml) 触诊: 液波震颤 (腹水量3000ml) Percussion: shifting dullness (ascites large than 1000 ml), puddle sign (small amounts of fluid) 叩诊: 移动性浊音 (腹水量1000ml) 水坑征 (少量腹水) Auscultation: umbilicus scratch sound in elbow-knee posture (ascites 120ml) 听诊: 脐部搔弹音 (腹水量120ml) * Acute Perforated Gastric or Duodenal Ulcer急性胃十二指肠穿孔 Suddenly epigastric pain, forced supine position and twin lower limbs flection 突发上腹痛 强迫仰卧位 双下肢屈曲 Acute peritonitis signs, tenderness and rebound pain in epigastrium or round umbilicus quarter 急性腹膜炎征象 压痛反跳痛位于上腹部和脐周 Hepatic dullness region decrease or disappear 肝浊音区缩小消失 shifting dullness in abdomen 腹部移动性浊音 * Physical Examination Point 急性胃肠穿孔检体要点 Gas in abdominal cavity: dullness area of liver disappear 腹腔气体: 肝浊音区缩小消失 Liquid in abdomen: shifting dullness 腹腔液体: 腹部移动性浊音 Inflammation in abdomen: acute peritonitis sign, serious in epigastric and umbilical region. 腹部炎症反应: 急性弥漫性腹膜炎征象 压痛反跳痛位于上腹部和脐周 forepart: acute ache face, compulsive supine position, lower limbs flection 早期: 急性痛苦面容 冷汗 强迫仰卧位 双下肢屈曲 anaphase: high fever, pulse frequency 后期: 高热 失水 精神萎靡 面色灰白 眼球凹陷 脉搏频数 * Acute Peritonitis Signs急性腹膜炎征象 Inspection: general depression in abdomen, decreased or disappeared abdominal respiration 视诊: 腹部凹陷 腹部呼吸运动减弱消失 Palpation: tenderness, rebound tenderness, rigid abdominal wall 触诊: 压痛和反跳痛 腹壁呈板状硬 Percussion: shifting dullness 叩诊: 可有移动性浊音 Auscultation: decreased or absence of bowel sounds 听诊: 肠鸣音减弱消失 * Intestinal Obstruction肠梗阻 Symptom: abdominal pain, vomiting, no defecate and anus exhaust 症状: 腹痛 呕吐 无排便和肛门排气 Inspection: full distension, intestine form and peristaltic wave 视诊: 腹部膨隆 肠型 可见肠蠕动波 Palpation: rigid abdom