上海第二医科大学仁济医院临床医学院.doc

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1、JL海交通大学医学院仁济医院临床医学院理论课教案第1次课教学方式大课学时专业医学班级07年4月21口题目Cough,sputumproduction,&hemoptysis;Chestpain（胸部疾病的症状）本要课求目的•Understandthemechanismsofsymptoms（cough,sputumproduction,&hemoptysis）andtheunderlyingcommonrespiratorydiseases（理解胸部疾病常见症状的机制及其反映的可能潜在疾病）•Makefamiliarwiththecharactersofthesymptoms（熟悉

2、各症状的特征）•Grasptheimportantaspectofthesesymptomsinaimtodiagnosetheunderlyingdisease（掌握症状血皇本要点）•Grasptheprincipleofdifferentiatehemoptysisfromhematomesis（掌握咯血与呕血的鉴别）•Makefamiliarwiththecommoncausesofchestpain;thedifferentmanifestationshelpingforcorrectdiagnosis（熟悉胸痛的各种常见疾病及其各自特征与区别）本点课、的难重点1.them

3、echanismofcoughreflux:distributionofafferentsignalreceptors.（咳嗽反射的机制，传入性信号感受器的分布）2.procedureofcoughconductedbyaseriasofactivities.（咳嗽过程的一系列活动）3.differentcharactersofsputumindicatedifferentunderlyingdisease（不同性状痰液可能提示的各种潜在疾病）4.hemoptysisbeingdifferentiatedfromothertypeofbleedingoutofmouth.（鉴别咯血

4、与其他经过口腔排岀的出血）5.differenciatingmanifestationsofchestpain/discomfortforcorrectdiagnosisoftheunderlyingdiseases（鉴别胸痛/胸部不适的特点以正确作出诊断）本材课及使参用考教书诊断学.■■…高等医药院校教材内科疾病诊断与鉴别诊断problemsinpulmonarymedicinefortheprimaryphysician.ByRoberth.Poe,M.D.Lea&Febiger.Philadelphia,1982.Chest2006;129supplement木用电次教化课具

5、器应及材电脑CAI技术Coghisthemostcommonofrespiratorysymptoms,occuningwithawidevarietyofdiseasesthataffecttherespiratorytract.3min.Itisaprotectivereflux,itspresentusuallyimpliesanunderlyingabnormalityofrespiratorysystemorothersystemssuchascardiovascular.3min.Therefluxarc:imtatingsignals;afferentnerve,co

6、ughcenter;efferentinformationtotheeffectposition:glottis,muscles;Aseriesofactivitiesproducinghighairflowtobringoutmaterialsfromairwayorevaporatestheirritation6min.Affectingfactorsanyfactorthatinterruptthestepswilldecreasethecleaningeffectsofacough,anesthesiaandsuppressivedrugs,failedclosureoft

7、heglottis3minCommoncauses:inflammatoryrespiratorydiseases;neoplasms;Mechanicalandchemicalirritations;cardiovascularabnormalities;pleuralandchestwalldiseases・Generaldiseasesaffectingtherespiratorysystem.;andlessseeninemotionalreasons.10m