J腹部检查BVIP免费

physicalexamination腹部检查(2)AbdominalExaminationpalpatemass腹部包块触诊percussionandauscultation腹部叩诊和听诊signsofcommondiseases腹部常见疾病征象1第一页，共五十二页。AbdominalMasses腹部包块PhysicalmassInabdominalwallInabdominalcavityPathologicalmassswellingoforganInflammatorymasses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2第二页，共五十二页。PhysicalMasses生理性包块Abdominalwall:ventermusculiortendinousintersectionsofmusculusrectusabdominis腹壁:腹直肌肌腹及腱划Abdominalcavity:lumbarcentrum,sacralpromontory,abdominalaorta,inferiorpoleofrightkidney,transversecolon,sigmoidcolon,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3第三页，共五十二页。PathologicalMasses病理性包块Shiftingorswellingofparenchymatousorgan实质性脏器肿大Distensionofhollowviscus扩大的空腔脏器Inflammatorymasses(abscessoradhesion)炎性包块(脓肿或粘连)Tumororcyst肿瘤与囊肿Lymphadenectasis淋巴结肿大4第四页，共五十二页。CharacteristicsofPalpation触诊要点Location:relationtoorgansSize:diameterinlong,wideandthickContour:shape,marginandsurfaceTexture:soft,firmandhardTenderness:inflammation,liverswellingPulsation:dilativeandconductiveMovability:shiftbyrespirationorhand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:形状边缘外表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5第五页，共五十二页。FluidThrill液波震颤Technique:moveflankwallbyhand检查方法:用手推动一侧腹壁Positive:theotherhandfeelsliquidwave阳性征象:对侧手掌感到液体波动Meaning:largevolumeofascites,usually>3000ml临床意义:大量腹水在3~4升以上6第六页，共五十二页。PercussionofAbdomen腹部叩诊organsintheabdomen脏器叩诊fluidintheabdomen腹水叩诊7第七页，共五十二页。OrgansPercussion脏器叩诊Percussionnotes:indirectpercussion叩诊音:间接叩诊Tympany:hollowviscusasTraube’sarea,intestine鼓音:空腔脏器胃泡鼓音区肠腔Dullnessorflatness:parenchymaviscusasliverorspleen,enlargedbladderoruterus叩音或实音:肝脏和脾脏实质脏器增大的膀胱或子宫Knockpain:indirectknockimpressinflammation叩击痛:间接叩击提示炎症Organs:liver,gallbladder,kidney脏器:肝脏胆囊肾脏8第八页，共五十二页。AbnormalAreaofTympany鼓音范围异常Enlargedarea:intestinalobstruction,perforationofgastrointerstinaltract范围增大:胃肠高度胀气胃肠穿孔Reducedarea:swellingofparenchymatousorgan,tumor,ascites范围缩小:肝脾等脏器极度肿大腹腔肿瘤大量腹水9第九页，共五十二页。Traube’sArea胃泡鼓音界Location:lefthypochondrium位置:左季肋部Upperborder:leftlung,diaphragm上界:左肺下缘膈Lowerborder:Rib下界:肋弓Rightborder:liver右界:肝脏Leftborder:spleen左界:脾脏10第十页，共五十二页。Traube’sAreaAbnormal胃泡鼓音范围异常Pathology:contentvariationofstomachandcompressionofneighbororgan机制:胃内含气量变化邻近器官扩大压迫Enlarged:gastricdilatation,pylorusobstruction扩大:见于胃扩张幽门梗阻Reduced:swellingsofliverorspleen,leftpleuraleffusion,pericardialeffusion缩小:见于肝脾肿大左侧胸腔积液心包积液11第十一页，共五十二页。DullnessAreaofLiver肝脏浊音界Method:percussionalongthelinesofrightmidclavicular,midaxillaryandscapularline方法:沿右锁骨中线右腋中线右肩胛线叩诊Superiorborder:relativedullnessmarginbetweenliverandlung,it’sfromresonancetodullness,correspondtotopofliver.,肝上界:由肺区向下叩出肝与肺清音变浊音的相对浊音界相当于被肺遮盖的肝顶部Inferiorborder:fromabdo...