腹部检查A教学课件.ppt

When the gallbladder is palpable the jaundice is unlikely to be due to stones. The gallbladder wall, in the presence of gallstones, would be fibrotic and non-distensible. 胆囊结石时胆囊壁常有纤维化不易扩大 胆囊肿大伴黄疸多与胆囊结石无关 Obstructive jaundice without a palpable gall-bladder does not necessarily imply that the jaundice is due to stones. A stone in the neck of the gall-bladder may cause a distended mucocele of the gall-bladder. 阻塞性黄疸不伴胆囊肿大不一定提示结石所致黄疸 胆囊颈结石可引起胆囊黏液充盈扩大 Pathological Findings异常征象 Gallbladder swelling accompanied with 胆囊肿大伴有 Tenderness: inflammation 触痛: 胆囊炎 Jaundice: biliary obstruction 黄疸: 胆管阻塞 Hardness: stone, carcinoma 实性感: 结石 癌肿 Murphy’s sign: inflammation 莫非氏征: 急性炎症 Palpation of the Pancreas胰腺触诊 Technique: sleeping palpation 检查方法: 滑行触诊 Normal: no palpable 正常: 不能触及 Enlarged: level zoster mass in epigastric or left hypochondrium 胰腺肿大: 上腹中部或左上腹 横行带状肿块 Disease of the Enlarged Pancreas肿大胰腺常见疾病 Tenderness and Abdominal muscle tone increase: acute pancreatitis 压痛及腹肌紧张: 急性胰腺炎 Blue skin in flanks: hemorrhage and necrosis of pancreas 腰部皮肤发蓝: 胰腺出血坏死 Rigidity and fixation: chronic pancreatitis 质硬固定: 慢性胰腺炎 Rigidity and node: pancreas carcinoma 质硬凸凹不平: 胰腺癌 smooth cystic and no tenderness: pancreatic pseudocyst 囊性 表面光滑 无压痛: 胰腺假性囊肿 Palpation of the Kidney肾脏触诊 Method: bimanual palpation 触诊方法: 双手触诊法 Special sign: smooth, circle body 特征: 光滑 钝圆形物 Normal: nonpalpable 正常: 触不到 Palpable kidney may suggest abnormal 触及肾脏提示异常 Meaning of Palpable Kidney触及肾脏的意义 Down-shifting of the kidney: nephroptosia, floating kidney 肾脏移位: 肾下垂 游走肾 Kidney enlargement: hydronephrosis, polycystic kidney, tumor 肾脏肿大: 肾盂积水 多囊肾 肾肿瘤 Renal Swellings肾脏肿大 Unilateral 单侧 Bilateral 双侧 Hydronephrosis 肾盂积水 Pyonephrosis 化脓性肾病 Cysts 肾囊肿 Abscess 肾脓肿 Tumor 肾肿瘤 Polycystic diseases 多囊肾 Hydronephroses 肾盂积水 Pressure Pain in the Point 压痛点 Vertebrocostal and c