physical examination(体格检查)

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1、PhysicalexaminationDepartmentofEndocrinologyHainanmedicalcollegeWangXinjun（王新军）knewman@163.com18789826999PhysicalexaminationItistheprocessofexaminingthepatient’sbodytodeterminethepresenceorabsenceofphysicalproblems.Weuseeachofourfoursensestoelicitsignsofdisease:Inspection视诊（sightandsmell

2、）Palpation触诊（touch）Percussion叩诊（touchandhearing）Auscultation听诊（hearing）“teachtheeyetosee,thefingertofeel,andtheeartohear”Whatisthefifth?Smelling（嗅诊）InspectionInspectionisthesearchforphysicalsignsbyobservingthepatientwithyoureyesandsenseofsmell.FirststepinexaminingapatientorbodypartItincl

3、udesageneralsurveyofthepatient’smentalstatus（精神状况）posture（姿势）bodymovementgait（步态)breathodor（呼吸气味）skintypepatternofspeechstature（身材）stateofnutrition（营养状况)acromeglyHowtoinspectMakesuretheroomisinacomfortabletemperatureUsegoodlighting,preferablysunlightLookandobservebeforetouchingComparesym

4、metricalbodypartsMentalstatusandpersonalgroomingDoesthepatientlookwellorsick?Ishecomfortableinbed?Doesheappearindistress?Ishealertorishegroggy?Doeshelookacutelyorchronicallyill?poornutritionsunkeneyestemporalwastinglooseskinDoesthepatientappearclean?Isherhaircombed?Doesshebitehernails?Po

5、sture姿势ItmayrevealsignificantinformationCongestiveheartfailure:sitinachairtheentirenightThusthepositionsofthepatientatthetimeoftheexaminationmaysuggestcertaindiseasepossibilitiesPalpationPalpationisemployedoneverypartofthebodyaccessibletotheexaminingfingers.Thepalpationofabdomenisparticu

6、larlyimportantTheexaminertouchesandfeelsthepatient’sbodypartwithhishandstoexaminetexture（质地）Moistureskintemperaturecharacteristicsofmassestenderness（触痛）ofanorganorbodypartCharacteristicofmassessize（大小）shapeconsistency（密度）motilitysurfaceregularitypresenceorabsenceofexpansileortransmittedp

7、ulsation.MethodsofpalpationAlwaysbeginpalpationinanareaoftheabdomenthatisfarthestfromthelocationofpainTypesofpalpationLightpalpation（浅部触诊）Deeppalpation（深部触诊）Bimanualpalpation（双手触诊法）LightpalpationDeeppalpationUsedtodetermineorgansizeaswellasthepresenceofabdominalmassesThep