诊断学总论-PPT课件.ppt

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1、PhysicalDiagnosisToday’smedicalstudentsTomorrow’scliniciansPhysicalDiagnosisWhatisthemeaningof“Clinician”?PhysicalDiagnosisWhatisthemainresponsibilityoftheclinician?MakingdiagnosisTreatadiseaseTreatapatientPhysicalDiagnosisAlinkagebetweenbasicmedicalknowledgeandclinical

2、medicine.Adisciplinetousebasicmedicaltheoryandskilltomakeadiagnosis.ObtaininformationFromanyandeverysourcepossible.Straintohearthevoiceofthepatientinthethinreedofhiscrying.Seemostacutelyoutofthecornerofyoureye.Tohearbestwithyourinnerear.ThecontentsofdiagnosisVerbalobser

3、vationorhistorytakingPhysicalobservationorexaminationLaboratoryobservationHistoryTakingObtainasmuchinformationasneededtodiagnoseandtreattheillness.Requirementsforthephysicians:Agenuine,profound,andabsorbinginterestinthepatient'swellbeingAdeep-seated,well-groundedselfcon

4、fidenceinabilitiesAthroughknowledgeofthediseasesAbilitytoseetheproblemfromthepatient'sviewpointHistoryTakingObtainingamedicalhistoryisan"art"Talkwith,rathertalktothepatient.Listenattentivelyandguideapatienteffectively.Asksearchingquestions.Interrogationoffamilyandfriend

5、sifnecessary.HistoryTakingKnowallaboutthediseaseSymptomsandsignsSymptoms:patient'scomplaints,orhisrecognitionofsomethingabnormal.Signs:findingselicitedbyphysicalexaminationPasthistoryFamilyhistorySystemsreviewPhysicalExaminationBeginswhengreetingthepatient.Sedulouslypra

6、cticingtheartofobservationmakeastudenttoaclinician.HowtoconductphysicalexaminationApplicationofthesensoryendorgantothepatient.Inarational,thorough,andaccuratefashion.Withefficiencyandminimaldiscomforttothepatient.5componentsofphysicalexamination:inspection,palpation,per

7、cussion,auscultationandsmelling.LaboratoryfindingsTodetectpathogenicorfunctioninginformation.Chemical,biologicalandphysiologicaltests.X-film,CT,MR.gastroscopy,angiographyandbronchoscopyetc.InterpretationoflaboratorydataLotsvariablesalterlaboratorytestsresults.Specificit

8、yandsensitivityofthetests.Overlappingbetweenthehealthyandthediseasedsubjects.TheIntellectualprocessofdiagnosi