J腹部检查B.pptxVIP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...