恶心呕吐讲诉.pptxVIP

恶心呕吐讲诉;Nausea and Vomiting As the symptoms;Goals;Definition of Nausea and Vomiting;Nausea and Vomiting;1、恶心：咽部及上腹部不适，胃张力和蠕动减弱，幽门和贲门开放。 2、干呕：胃窦部和腹壁肌肉收缩，腹压增加，食管及咽部开放。 3、呕吐：胃和/或小肠内容物经食管和口腔排除体外。;迷走兴奋表现;呕吐区别于反食;Mechanisms of emesis;CTZ Emetic Center (Vomiting center);CTZ Emetic Center (Vomiting center);Emetic Center;Neurotransmitters in CTZ Emetic Center;第14页/共89页;第15页/共89页;Emetic Center;第17页/共89页;nausea and vomiting;Reflective vomiting （反射性呕吐）;咽部刺激;;肝、胆、胰腺;其他;Intra-cranial infection Cerebrovascular disorders Craniocerebral injury Epilepsy Metabolic disorders Drugs;颅内感染（脑炎、脑膜炎）;脑血管疾病、颅脑损伤;癫痫;全身疾病;Drug;Neurologic Psychogenic causes;Characteristics of Nausea and Vomiting;;呕吐与进食的关系 （ Timing with meals）;呕吐特点;The accompanying symptoms;问诊要点;History/Background;CAUSES OF NAUSEA/VOMITING;PHYSICAL EXAM;LABORATORY;Break;泸沽湖黄昏;泸沽湖黄昏;泸沽湖?摩梭女;玉龙雪山?雪月;46;Constipation;Background;Constipation Is a Constellation of Symptoms;Sandler RS, et al. Dig Dis Sci. 1987;32:841-845.;Reduced Stool Frequency Is Not the Most Commonly Reported Symptom in Constipation;Prevalence in the General Population;Epidemiology;Constipation Affects All Age Groups;Profile of a Typical Chronic Constipation Patient in My Practice;Constipation Can Have a Negative Impact on Quality of Life;Constipation Significantly Impacts Healthcare Utilization;Complications related with constipation;Definition: Causes of Chronic Constipation;Presentation Objectives;What is Constipation?;Rome II Defines Functional Constipation Based on Multiple Symptoms;Normal metabolism;Defecation Process;;2. Anal intra- and extra-sphincter Relaxation;2. Abdominal effects;What Causes Constipation?;What Causes Constipation?;What Causes Constipation?;What Causes Constipation?;Classification of etiologies;psycho-related;Tediously long Colon; Organic constipation (certain diseases or conditions cause constipation);Rectal and Anal disorders;intestinal obstruction;Benign or malignancy tumor;Outside tumor or mass;Systemic diseases or conditions;;Acco