【8A文】Physical-examination(体格检查).ppt

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1、PhysicalexaminationDepartmentofEndocrinologyHainanmedicalcollegeWangXinjun（王新军）knewman@163.com18789826999PhysicalexaminationItistheprocessofexaminingthepatient’sbodytodeterminethepresenceorabsenceofphysicalproblems.Weuseeachofourfoursensestoelicitsignsofdis

2、ease:Inspection视诊（sightandsmell）Palpation触诊（touch）Percussion叩诊（touchandhearing）Auscultation听诊（hearing）“teachtheeyetosee,thefingertofeel,andtheeartohear”Whatisthefifth?Smelling（嗅诊）InspectionInspectionisthesearchforphysicalsignsbyobservingthepatientwithyourey

3、esandsenseofsmell.FirststepinexaminingapatientorbodypartItincludesageneralsurveyofthepatient’smentalstatus（精神状况）posture（姿势）bodymovementgait（步态)breathodor（呼吸气味）skintypepatternofspeechstature（身材）stateofnutrition（营养状况)acromeglyHowtoinspectMakesuretheroomisinac

4、omfortabletemperatureUsegoodlighting,preferablysunlightLookandobservebeforetouchingComparesymmetricalbodypartsMentalstatusandpersonalgroomingDoesthepatientlookwellorsick?Ishecomfortableinbed?Doesheappearindistress?Ishealertorishegroggy?Doeshelookacutelyorch

5、ronicallyill?poornutritionsunkeneyestemporalwastinglooseskinDoesthepatientappearclean?Isherhaircombed?Doesshebitehernails?Posture姿势ItmayrevealsignificantinformationCongestiveheartfailure:sitinachairtheentirenightThusthepositionsofthepatientatthetimeoftheexa

6、minationmaysuggestcertaindiseasepossibilitiesPalpationPalpationisemployedoneverypartofthebodyaccessibletotheexaminingfingers.ThepalpationofabdomenisparticularlyimportantTheexaminertouchesandfeelsthepatient’sbodypartwithhishandstoexaminetexture（质地）Moisturesk

7、intemperaturecharacteristicsofmassestenderness（触痛）ofanorganorbodypartCharacteristicofmassessize（大小）shapeconsistency（密度）motilitysurfaceregularitypresenceorabsenceofexpansileortransmittedpulsation.MethodsofpalpationAlwaysbeginpalpationinanareaoftheabdomenthat

8、isfarthestfromthelocationofpainTypesofpalpationLightpalpation（浅部触诊）Deeppalpation（深部触诊）Bimanualpalpation（双手触诊法）LightpalpationDeeppalpationUsedtodetermineorgansizeaswellasthepresenceofabdominalmassesThep