神经肌肉骨骼系统physical examination.pptxVIP

Physical examination（体格检查）;Introduction Physical examination step by step Observation Joint tests Muscle tests Neurological tests Special tests Functional ability Palpation Accessory movements Completion of the physical examination;Introduction;目的;Two assumptions （两个假设）： If symptoms are reproduced when a structure is stressed, the symptoms are thought to arise from that structure. 如果按压某结构使症状再发，则认为该症状来自于该结构 If an abnormality is detected in a structure, which theoretically could refer symptoms to the symptomatic area, then that structure is suspected to be a source of the symptoms. 如果某结构发现异常（体征），理论上在部位内查到此症状，则怀疑该结构就是此症状的来源;Summary of the physical examination ;PHYSICAL EXAMINATION STEP BY STEP ;Observation (视诊） ; Informal observation （非正式的视诊）;Formal observation;Ideal alignment ;The upper (or shoulder) crossed syndrome ;The lower (or pelvic) crossed syndrome ;The kyphosis-lordosis posture （驼背－脊柱前弯姿势）拉长和无力：颈屈肌、背部竖脊肌、腹外斜肌、腘绳肌缩短和增强：颈伸肌、屈髋肌、腰部竖脊肌;Layer syndrome;The flat back posture (平背姿势）;The sway back posture ;The handedness posture 利手姿势（ 右）;skin creases at various spinal levels （不同脊柱水平的皮肤皱褶）;肩胛骨活动延迟及下旋伴肱骨内旋：;;Sustained postures and habitual movements neck pain when sitting ;habitual movement pattern lumbar spine pain ;Observation of muscle form ;施加压力下肌肉反应;Observation of soft tissues 软组织;Observation of gait 步态;常见的异常步态;Observation of the patient‘s attitude and feelings （态度和情感）;Patients may feel apprehensive, fearful, embarrassed, restless, resentful, angry or depressed in relation to their condition and/or the clinician. They may, for example, have had several, possibly conflicting explanations of their problem. Unrealistic thoughts and beliefs affect the patients response to health problems and treatment 关系到病情和/或医生，病人可表现为理解、害怕、不安、不能休息、怨恨、愤怒或沮丧。他们可有数个可能是互相矛盾的有关其问题的解释。不确实际的想法和信心影响患者对健康问题和治疗的应对 ;Joint tests ;Joint integrity tests关节完整性检查;Active and passive physiological joint movement ;;The aims of joint movement examination关节运动检查的目的 ;主动和被动关节运动应注意：;Active physiolog