第二章一般检查(熊维宁).ppt

第二章 一般检查Chapter2 General Examination;General Examination Head Neck Chest Abdomen;General Examination;Contents of General Examination;Section 1 General status examination;1 Gender;（1）Temperature;;（2） Respiration;（3） Pulse;(4) Blood Pressure;4 Development and Habitus;; Endocrine influence Hyperpituitarism→Gigantism Hypopituitarism → Pituitary dwarfism ; Endocrine influence Hyperthyroidism→ beyond the general physical development Hypothyroidism → Cretinism;1 Asthenic type Tall and thin, slender neck, narrow shoulders, flat chest, epigastric angle 90° 2 Normal type Each part and structure is proper. 3 Orthosthenic type fat and short Neck, red face, broad shoulders, big chest, epigastric angle 90°;5 State of nutrition;(1) Classification of nutrition state;;(2) Common abnormal states of nutrition;2. Overnutrition 营养过度 Obesity 肥胖 is defined as over 120% of standard weight（or BMI27 in male or 25 in female) It’s caused by the excessive intake which exceeds the consumption. The excess is transformed into fat accumulated in the body. In addition, endocrine, heredity, life style, exercise and mental state may have influence to it.;Classifying obesity based on etiology Exogenous Obesity Fat distributed in equilibration Usually with genetic predisposition Commonly not indicating special diseases Endogenous Obesity Usually caused by some endocrine diseases, such as adrenocortical hyperfunction syndrome (Cushing’s syndrome).;Cachexia;Endogenous obesity;6 Consciousness 意识;Examination method of consciousness Inquisition is commonly used to learn about the patient’s thought, response, emotion, orientation (judgment of time, place and person) and calculation ability. Pain test and reflex test are also used in serious cases. ;7 Tone and Voice 语调和语态;8 Facial features and expression面容与表情;Abnormal facial features ;6 hyperthyroidism face and exophthalmos ;;Before treatment After treatment A hypothyroidism patient;8 mitral