技能考试相关（Skills related）.doc

技能考试相关（Skills related） 81. What is the normal value of the upper and lower hepatic diameters? Answer: 9 ~ 11cm. 82. What should I pay attention to when I touch the liver margin under right rib margin? Answer: liver margin and rib edge distance, liver surface texture, smoothness, whether there is no nodules, tenderness. 83. How should the spleen be enlarged? What lesions do you suggest? Answer: spleen margin is not more than rib, 2cm is mild, between rib 2cm to navel horizontal line is moderate, more than umbilical horizontal line or the right middle line is height, namely splenomegaly. In mild acute and chronic hepatitis, typhoid, miliary tuberculosis, infective endocarditis and sepsis; moderate in liver cirrhosis, malaria, sequelae of chronic lymphocytic leukemia, chronic hemolytic jaundice, lymphoma and SLE; high in chronic myelogenous leukemia, bone marrow fibrosis, lymphatic sarcoma, malignant histiocytosis. 84, Murphy sign positive, what does that suggest? Answer: cholecystitis. 85, Traube (Traube) disappear explain what the problem? Answer: Traube upper bound for the diaphragm and the inferior lung margin, the lower bound for the costal arch, left for spleen, right for the left hepatic margin, length 5 13cm, diameter 2.7-10cm, drum has significantly reduced if indicated severe splenomegaly, pleural effusion, left hepatic lobe increased. 86. What is movement dullness? What does it stand for? Answer: the change of voiced areas due to different postures is called movement dullness. Ascites. 87, the side rib ridge angle percussion pain, what to consider? What do you think of the bilateral rib angle percussion pain? Answer: nephritis, kidney stones, kidney tuberculosis and so on 88, what sounds disappear? Answer: 3-5 minutes to hear the gurgling sound. 89, how to distinguish between arterial and venous vascular murmurs? Answer: arterial murmur often in the ventral midline or abdomen side systolic and diastolic points; often in the umbilicus vein or upper abdomen, c