【医院科室学习-物理诊断学】--__3-Physical Examination.pptVIP

* * Physical Examination基本检查方法 北京医院呼吸与危重症医学科学习 * * What is physical examination? It is a fundamental examining method, it is proceeded by the sense organs such as eyes, ears, nose and hands or simple tools –stethoscope and plexor. * * The basic methods of physical examination inspection 视诊 palpation 触诊 percussion 叩诊 auscultation 听诊 olfactory examination 嗅诊 * * Inspection * * Inspection Includes a general view of the patient’s 1.mental status 意识状态 2.development 发育 3.nutrition 营养 4. posture 体位 5.body movement 姿势 6.gait 步态 7.facial expression 表情 8.complexion 面容 * * 无力型（瘦长型） 超力型（矮胖型） 正力型（匀称型） * * pallor exophthalmus Cyanosis (lips) moon face spider angioma barrel chest Gastric type Abdomenal respiratory movement anemia Hyperthyroidism mitral face cushing syndrome liver cirrhosis pulmonary emphysema pylorus obstruction Normal，men，children Inspection * * palpation * * Palpation Mainly used in abdominal examination mass:  1. location 部位 2. size 大小 3. contour 边缘 4. consistency 质地/边界 5. mobility 活动度 6. tenderness 压痛 7. pulsation 波动感 * * Palpation * * The methods of palpation Light palpation 浅部触诊法 Deep Palpation 深部触诊法 deep slipping palpation 深部滑行触诊 bimanual palpation 双手触诊法 deep press palpation 深压触诊法 ballottement 冲击触诊法 The methods of palpation light palpation 浅部触诊法 abdominal muscle tensity  abdominal tenderness * * * * Deep Palpation Deep Palpation deep slipping palpation ---deep mass bimanual palpation --- liver, spleen, kidney 3. deep press palpation ---tenderness point * * bimanual palpation liver and spleen * * Deep press palpation tenderness point Cholecystic point : Murphy’s sign Acute cholecystitis tenderness point * *  Cholecystic point : Murphy’s sign Appendix point: McBurney point