J腹部检查B教学课件.ppt

physical examination腹部检查 (2)Abdominal Examination palpate mass 腹部包块触诊 percussion and auscultation 腹部叩诊和听诊 signs of common diseases 腹部常见疾病征象 Abdominal Masses腹部包块 Physical mass In abdominal wall In abdominal cavity Pathological mass swelling of organ Inflammatory masses Tumor 生理包块 腹壁包块 腹腔包块 病理包块 脏器肿大 炎性包块 肿瘤 Physical Masses生理性包块 Abdominal wall: venter musculi or tendinous intersections of musculus rectus abdominis 腹壁: 腹直肌肌腹及腱划 Abdominal cavity: lumbar centrum, sacral promontory, abdominal aorta, inferior pole of right kidney, transverse colon, sigmoid colon, cecum 腹腔: 腰椎体 骶骨岬 腹主动脉 右肾下极 横结肠 乙状结肠 盲肠 Pathological Masses病理性包块 Shifting or swelling of parenchymatous organ 实质性脏器肿大 Distension of hollow viscus 扩大的空腔脏器 Inflammatory masses (abscess or adhesion) 炎性包块(脓肿或粘连) Tumor or cyst 肿瘤与囊肿 Lymphadenectasis 淋巴结肿大 Characteristics of Palpation 触诊要点 Location: relation to organs Size: diameter in long, wide and thick Contour: shape, margin and surface Texture: soft, firm and hard Tenderness: inflammation, liver swelling Pulsation: dilative and conductive Movability: shift by respiration or hand 部位: 所在部位与该处脏器多相关连 大小: 纵长 横宽 深厚 可用实物比喻 轮廓: 形状 边缘 表面 质地: 柔软 中等硬度 质硬 压痛: 炎症 肝肿大 搏动: 膨胀性和传导性 移动度: 随呼吸移动 用手推动 Fluid Thrill液波震颤 Technique: move flank wall by hand 检查方法: 用手推动一侧腹壁 Positive: the other hand feels liquid wave 阳性征象: 对侧手掌感到液体波动 Meaning: large volume of ascites, usually 3000ml 临床意义: 大量腹水在3~4升以上 Percussion of Abdomen 腹部叩诊 organs in the abdomen 脏器叩诊 fluid in the abdomen 腹水叩诊 Organs Percussion脏器叩诊 Percussion notes: indirect percussion 叩诊音: 间接叩诊 Tympany: hollow viscus as Traube’s area, intestine 鼓音: 空腔脏器 胃泡鼓音区 肠腔 Dullness or flatness: parenchyma viscus as liver or spleen, enlarged bladder or uterus 叩音或实音: 肝脏和脾脏实质脏器 增大的膀胱或子宫 Knock pain: indirect knock impress inflammation 叩击痛: 间接叩击 提示炎症 Organs: liver, gallbladder, kidney 脏器: 肝脏 胆囊 肾脏 Abnormal A