病史书写朱伟ppt课件.ppt

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1、体格检查(二）Inspection：腹纹：abdominalstriae外形：contour膨胀：distension平坦的：flat腹胀不对称：asymmetricaldistension蛙腹：frogbelly腹部普遍膨隆（凹陷）：generalprominenoe(retraction)oftheabdomen五、腹部AbdomenInspection：腹围增大：increasedabdominalgirth肠型：intestinalpattern(orcontour)阶梯样蠕动波：peristalticwaveinladderpattern脐膨出：p

2、rojectionoftheumbilicus膨隆的：protuberant舟状腹：scaphoidabdomen妊娠纹：striaegravidarumstriaeofpregnancy静脉曲张：varicoseveins;dilatedtortuousveins；varicoaty可见胃蠕动：visiblegastricperistalsisInspection：1.Inspectionrevealsvisibleperistalticwavespassingfromlefttorightacrosstheupperabdomen.2.Findi

3、ngsoninspectionareadistendedabdomencoveredbytense,shinyskin.3.lntheupperabdomen,dilatedtortuousveinsareseeninwhichthebloodflowsupwards,Palpation：板样强直:board-likerigidity肝脾肿大：hepatosplenomegaly肝肿大：hepatomegaly；enlargementoftheliver腹壁松弛：laxabdominalwall墨菲(氏)征：Murphy‘ssign肌卫：musclegu

4、arding反跳痛：reboundtenderness强直：rigidity脾肿大：splenomegaly;enlargementofthespleen压痛：tendernessPalpation：1.Reboundtendernessandboard-likerigidityoftheabdominalmusculaturearepresentinallabdomen2.Thepatienthasapalpableloopofthickenedbowelintheleftlowerquadrant3.Afirmtumormass,about3c

5、mindiameter,isfelt4centimetersbelowthecostalmarginattheexternalmarginoftherightrectusmusclePercussion：浊音：dullness移动性浊音:shiftingdullness鼓音：tyrnpaniticresonance；1.Percussionoftheabdomendemonstratestympanythroughout2.Thereisnoshiftingdullness3.Onpercussionthereisdullnessintheflank

6、sandtympaniticinthemiddleAuscultation：浊音：dullness肠鸣：Borborygmi击水声：splashes肠鸣音：bowelsoundsperistalticsounds气过水声：gurgling；borborygmusofbubblingquality振水声：succusionsound；clapotage；clapotement外展：abduction指端肥大：acromegaly内收：adduction关节强硬:ankylosis髁关节强硬：ankylopodia前屈：anteflexion撕脱：avulsi

7、on胼胝：callus杵状指：clubbing；clubbedfinger骨性强直：bonyankylosis六、Extremityandspine褥疮：decubitus；bedsore脊柱畸形：deformityofspine背侧屈曲：dorsiflexion伸直：extension屈曲：flexion前屈：forwardbending膝内翻：genuvarum;bowleg膝外翻：knock-knee;genuvalgus脊柱后凸（驼背）：kyphosis；rachiocyphosis侧弯：lateralbending；脊柱前凸：lordosis跛行

8、：limping；limp脊柱前侧突：lordosc