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Reprinted from alumni of the user at 10:32 on December 13,
airmax, 2010 Reading (loading. ..) Comments (0) Category: Personal Diary
one Western operations -
1, please demonstrate palpation of supraclavicular lymph nodes? -
A: Check the supraclavicular lymph nodes, were seized were taken to sitting or lying position, head slightly flexion, with both hands to palpate, palpation of the right side of his left hand, right hand palpation on the left, from the shallow gradually touch After the deep to the clavicle. -
2, please sign demonstrates Murphy (Murphy) screening method, and pointed out that the positive clinical significance? -
A: The physicians who were Youlei hand flat on the lower part of belly hook the thumb under the pressure of the gallbladder in the right costal point, and then Zhu Huanzhe slow deep breath. In the process of breathing down the inflammation of the gallbladder encountered press hard on the thumb, can cause pain, this is the gallbladder tenderness, as a result of severe pain Erzhi inspiratory termination (not to inhale) and positive signs, said Murphy. -
3, check check sense fremitus? -
A: Check the hand around the ulnar will light up on both sides of the chest wall edge of the symmetric parts, and will urge that is checked repeatedly with the same intensity of hair Comparing both sides of the corresponding parts of the abnormal voice tremor, watch for increase or decrease. -
4, please check the demo light reflex? -
Answer: A, direct light reflex: the right hand holding torch, light the outside of the rapid shift from the pupil, while observing the immediate availability of reduced ipsilateral pupil, remove the light source, whether the pupil speedy recovery. Check on the left, and then check the right side the same way. B, indirect light reflex: the right hand held flashlight, separated his left eyes, light from the outside towards the pupil, while observing the subjects with or without contralateral pupil immediately reduced ,
31, accompanying course - Qzone log, with or without removal of the pupil light rapid recovery. Check on the left, and then check the right side the same way. -
5, please demonstrate the indirect percussion lungs? -
A: Indirect percussion - finger movements, methods, the proper order. -
① to the left of the middle finger of the first two panels refer to as the percussion, flat area close to tapping the surface of the right middle finger to wrist and finger joints left middle finger metacarpal joint activities, tapping the front of the second phalanx or first, between the second knuckle. -
② the correct order: First check the chest, starting from the supraclavicular fossa, one by one from top to bottom since the first intercostal space intercostal space for percussion, then check the side of the chest wall, told his arm raised by the examiner placed the head, downward from the axillary margin of percussion to the rib. Finally percussion back, Well that is checked bow slightly forward, hands folded holding the elbow, from top to bottom for percussion, percussion should be so, from top to bottom, inside and outside contrast knocking sound changes. -
6, please direct percussion demonstration of the lungs? -
A: Check by side with the middle finger or palm and finger together with its finger on the chest wall to inspection for percussion. -
7, please demonstrate pulmonary auscultation pulmonary auscultation and say the content? -
① auscultation method: Have client slightly open mouth, slightly deep breath, pay attention to every part of the auscultation respiratory cycle 1 to 2. ② auscultation order: usually start from the apex, top to bottom, from the outside in, from left to right, from the chest to the side of the chest and back (with the percussion parts, chest, side chest in each intercostal space, at least auscultation three parts, each of intercostal chest after at least 2 parts), symmetrical comparison site auscultation. ③ breath sounds: A. Bronchial breath sounds: normal in the throat, chest and back on the nest first and third 1,2 6,7 cervical spine near breath sounds can be heard this. As in other parts of the bronchial breath sounds heard, was an exception. B. Alveolar breath sounds: normal bronchial breath sounds in addition to audio and distribution of parts and bronchoalveolar lavage, the remaining lung are alveolar breath sounds. Alveolar breath sounds increased, decreased or disappeared, extended breath sounds , breath sounds are abnormal thickening. C. Bronchial alveolar breath sounds: such as bronchial breath sounds breath sounds breath sounds mixed with the alveolar breath sounds. 1,2 normal intercostal space on both sides of the sternum, shoulders, thoracic level between the Area and the apex before and after 3,4 Department of breath sounds can be heard this. As in other parts of the bronchial alveolar breath sounds heard was an exception. ④? Tone: is additional to breath sounds sound. Can be divided into dry? Tone and wet? Tone. Normal people can not hear? Tone. ⑤ resonant voice: Have client repeat with the general intensity of the sound made Normal to hear the soft, fuzzy sound. Check both sides of the chest in auscultation symmetrical comparison site, if found increased less compared to abnormal. ⑥ pleural friction rub: auscultation pleural friction rub is usually axillary line part of it is the lower part of the chest,
ナイキ エアマックス 販売, pleural friction rub normal no. -
8, please demonstrate the upper bound of the percussion the liver? -
A: along the right midclavicular line, knocking down the lung area to the abdomen. As voiced by the voiceless when it is converted to the upper bound of the liver. -
9, please demonstrate mercury sphygmomanometer method of upper limb blood pressure? -
1, blood pressure (indirect measurement) -
(1) Check the blood pressure; key: first check whether the mercury column in the -
(2) set the right elbow; elbow placed in the heart of the same level. -
(3) blood pressure cuff lashing parts of air correct tightness appropriate; gas sleeve even close to the skin wrapped around the upper arm, the lower edge of the nest above the elbow about 2 ~ 3cm, brachial artery surface. -
(4) chest pieces placed at the brachial artery pulse (not tucked in under the air sleeve.) -
(5) to the gas Xiunei inflatable, inflatable side edge of auscultation, the brachial arterial pulse sound disappears, the mercury rises again after 20 ~ 30mmHg, slowly deflated, eyes observe the mercury, according to location of auscultation and mercury blood pressure reading. -
10, requested the presentation of thyroid palpation. -
A: ① palpation of the thyroid isthmus: Check who stand in front by the examiner, with the thumb (or stand on the back of subjects with index finger) touch up from the suprasternal notch, the trachea can be touched before the soft tissue, to determine a No thickening, this time to swallow your subjects, you can feel the soft tissue under the fingers sliding to determine whether the increases and mass. ② palpation of the lateral lobe of thyroid: a leaf-hand thumb pressure on the thyroid cartilage, the trachea into the opposite side, another Shoushi, middle finger in the opposite posterior border of sternocleidomastoid pushing forward of the lateral lobe of thyroid, thumb in the chest anterior papillary muscle palpation lock, subjects with the swallow, repeat the examination , the thyroid can be touched to be pushed. The other leaves with the same method to check the thyroid. Note that the first place check, the check should be cross-checked by the contralateral thumb, check the left side of the right thumb, left thumb check on the right. -
③ back palpation: The examinees take seats, check the inspectors who were standing in the back of one hand and said middle finger pressure on leaf thyroid cartilage, the trachea into the opposite side, the other hand thumb in the contralateral sternoclavicular posterior papillary muscle to push forward the thyroid, said middle finger palpation of the thyroid in the front. Coupled with the swallow, repeat examination. The other side using the same method to check the thyroid. -
11, please demonstrate palpation of superficial lymph nodes neck? -
(1) cervical lymph node examination -
inspection, told his head was slightly lower examiner, or tend to check the side, relax muscles, enabling palpation. Fingers close to the inspection area physicians, conducted by the shallow and deep sliding palpation, the general order: ears, ear , mastoid area, under the occipital area, posterior triangle, anterior triangle. -
(2) axillary lymph node examination -
Check the axillary
faced by inspectors, inspection should be checked by hand to the forearm a little outreach to the left of right axillary palpation that is checked, check the right side of his left armpit,
エアマックス ライト, check the armpit on both sides of the shallow and deep to axillary top. -
(3) Check the supraclavicular lymph nodes -
to inspection take seats or supine position, head slightly flexion, the examiner of patients with the left hand touch the right side of the left hand touch the patient, from shallow to gradually touch the deep after clavicle. -
(4) inguinal lymph node examination -
was seized by lying, check the right side of those who stand to be seized, the right hand four fingers close together to hit the groin pulp, from shallow and deep sliding palpation, first touch the bottom level of the inguinal ligament lymph nodes, and then touch a large inguinal saphenous vein at a vertical group of lymph nodes. Left groin contrast examination. -
(5) expressed when lymph node touch location, size, texture, volume, activity, with or without adhesions, tenderness, changes in local skin eight) -
12, your heart valve auscultation area shows the location and sequence of auscultation? -
A: (1) correctly pointed out that the heart valve auscultation area; (2) auscultation the correct order; from the mitral valve area to start the second aortic pulmonary auscultation District District District aortic tricuspid area, counterclockwise or called down 8 characters. (3) the expression of cardiac auscultation to main content. Heart rate and rhythm, normal heart sounds, heart sounds change, heart murmurs, pericardial friction rub and so on. -
13, the heart of your demonstrated the relative dullness of percussion? -
A: The knock out of the normal heart dullness, and the heart can be measured out in the thorax surface dullness. Percussion techniques with the former, since the left side outside the apex beat percussion at the beginning of 2-3cm, from outside to inside news, and cloud changes made by the clear mark and measure the vertical distance between the center line with the sternum, and then one by one up the percussion until the second rib intercostal between its mark dashed into the connection. On the right as above, will be dashed into the heart of dullness marked connection. -
normal heart relative dullness: -
the right boundary (cm) intercostal left border (cm) -
2-3 Ⅱ 2-3 -
2-3 Ⅲ 3.5-4.5-
3-4 Ⅳ 5-6 -
; Ⅴ 7-9 -
(Note: The left subclavian central line from the sternal midline to 8-10cm) -
14, please demonstrate abdominal fluid wave flutter (a sense of volatility) way to check? -
A: The fluid wave tremor: patient supine, legs buckling, relax the abdominal wall, the examiner to a palm face side of the abdominal wall affixed to the patient, the other four fingers close together and a little hand flexion, finger tapping with contralateral abdominal wall or finger impact abdominal wall. To prevent vibration transmitted to the contralateral abdominal wall itself, allowing the other hand pressure on the ulnar margin of the belly of the umbilical cord. -
15, please demonstrate right lower abdominal pain, tenderness and rebound tenderness patient examination? -
A: Check the hand those who are checked by abdominal palpation tenderness, the finger can place it a moment, feeling the tenderness stabilized, then quickly raised his hands and left abdominal wall, abdominal pain, feeling of the inspected suddenly increased. -
16, please make the heart palpation of the demo? -
A ⑴ examiner who checked the right palm placed on the heart before the area began to palpation. And then gradually to the ulnar hypothenar palm of your hand or index finger, middle finger, ring finger close together, with its pulp to palpation . Palpation press palm strength appropriate. -
(2) in the apex beat area (a single index finger pulp can be used) to confirm the apex beat and pulse can express the location where the body surface; (3) palpation of the tremor, pericardial friction sensitivity; tremor : A small palm or palm ulnar flat thenar all parts of the heart anterior to the palpable sense of shock with or without fine. Pericardial friction sensitivity: the use of such tactics in mind palpation anterior margin of the 4th intercostal space left sternal palpation. Palpation of the conditions of satisfaction (forward position, systolic, breathing end of hold your breath. -
17, requested the presentation of the inspection and auscultation abdominal reflex bowel sounds? -
A: The abdominal reflex in check: that is checked supine, legs slightly buckling, so that the abdominal wall relaxation, but with a blunt bamboo sticks along the costal margin, respectively, the umbilical level and parallel to the direction on the groin, abdominal wall from outside to inside scratching skin. Normal reaction is localized abdominal muscle contraction. -
auscultation bowel sounds: -
① stethoscope chest pieces should be placed in the abdominal wall and comprehensive auscultation districts. -
② order: left to right, bottom to top. -
③ normal bowel sounds: 4-5 times per minute. -
④ hyperthyroidism bowel sounds: more than 10 times per minute and the gurgling sound bright, high-pitched. -
⑤ standard bowel sounds disappear :3-5 minutes can not hear bowel sounds. -
18, please demonstrate abdominal examination of shifting dullness. -
A: intra-abdominal free ascites> 1000ml: Let sit to inspection, since the Department began belly to belly on both sides of percussion, there dullness, the board refers to the hand without leaving the abdominal wall, so that the inspected right side, the board refers to the The highest point in the abdomen, then percussion, drum sound was, when the percussion side of the fuselage, the knocking sound and as voiced, and then left lying so that is checked, the same method of tapping, which appeared due to the different position voiced District, said the phenomenon of change shifting dullness. -
19. Please demonstrate ankle clonus, corneal reflex examination? -
A: The ankle clonus: instruct patient supine, slightly hip and knee flexion, the patient physician leg in one hand, the front paws in one hand patients, forced hyperextension of the ankle upward, positive place for the gastrocnemius and soleus muscle rhythm contraction. Corneal reflex: Well that is checked within the top or side of eyes checking the index finger were put up and avoid the look cotton swabs, cotton swabs from the cornea with a fine touch at the outer edge of the cornea. Were seized when the visible side of the normal eyelid closure quickly, as a direct corneal reflex, and also appeared opposite reaction of eyelid closure, corneal reflex called indirect. -
20, do the Babinski sign (Babinski sign), and Hoffman sign (Hoffmann sign) check? -
A: The Babinski sign: Patients with a bamboo stick along the lateral border of foot, from back to front to the little toe heel and turned to the inside of the mother positive toe dorsiflexion for the foot, fanning out over the toe . Hoffman symptoms: physicians left holding the wrist of patients above the right hand to the middle finger and index finger holding the patient, put up a little, so that the wrist is slightly off thrust, and then quickly play the thumb finger nails scraping patients , the middle finger flexion muscle caused by the remaining four fingers pulling a slight palmar flexion response was positive. -
21, please demonstrate Babinski sign (Babinski sign), Auburn Ham sign (Oppenheim sign) of the check? -
A: The Babinski sign: Patients with a bamboo stick along the lateral border of foot, from back to front to the little toe heel and turned to the inside of the mother positive toe dorsiflexion for the foot, fanning out over the toe . Auburn Ham sign: the examiner with the thumb and index finger along the anterior tibia was seized by force by the pressure on the decline, the positive performance with the Babinski sign. -
22, please demonstrate palpation of the spleen? -
A: ① Check the front of those who left around the abdomen, waist, left hand placed in the first 7 to 10 ribs,
ナイキ エアクラシックBW,
06.6.23 - Qzone log, try to hold up the spleen from back to front, right palm flat on the upper abdomen, and the costal arch is roughly vertical direction, with the breath, bend your fingers under the pressure of the abdominal wall strength, until it touches the edge of the spleen. ② When the supine position than spleen palpation, the examiner will urge is to take the right lateral position, right leg straight, left leg buckling, this time with both hands by palpation. ③ Clinically, splenomegaly often be divided into light, medium and high level: deep breathing, spleen margin of not more than ribs 2cm, mild swelling; to more than 2cm above the umbilical level, moderate swelling; than horizontal or former umbilical was a high degree of swelling in the midline, that splenomegaly. Splenomegaly who can describe the above. -
23, how the neck resistance, Brandt sign checks? -
A: Check the operation of cervical resistance: supine, neck relaxed, straight leg, the examiner who was seized in the hands of the occipital drag, passive neck flexion movements to do. Such as resistance to strengthen, that is, stiff neck; -
Check the operating levy
Brandt: was seized by supine, legs straight, the examiner who single-handedly drag the occipital was seized, the other hand on their chest, when the head of passive flexion, the double hip and knee Buckling was also positive. -
24, please demonstrate palpation of the kidney problem? -
A: supine palpation of the right kidney, the Zhu Huanzhe legs buckling, and take a deep breath. Physicians were on the right stand to lift up his left hand pushed up from its Youyao. Square in the right upper quadrant right palm , fingers, roughly parallel to the direction and slightly lateral right costal margin. Folder in Touch with both hands in patients with renal inhale. Touch the left kidney, the left hand over the patient and try to jack up the front left waist, right palm placed in patients with left upper abdominal transverse, according to the former French hands touch the kidney, normal renal generally difficult to reach. -
25, please demonstrate one hand palpation palpation of the liver operation? -
A: single-handed palpation: the examiner will be the right hand four fingers close together, metacarpophalangeal joints straight, roughly parallel with the costal margin on the inspected the right of the right upper abdomen or umbilical is estimated below the lower edge of the liver. When that is checked with the breath, deep finger pressure to the abdomen, once again inhale, move your finger down on a welcome touch of the liver edge. This is repeated in the fingers can not leave the edge of the abdominal wall and gradually slide to the liver until the liver edge or rib edge touched up. -
-
Second, the Chinese operation -
1, please demonstrate that cut into the needle do? -
Answer: ⑴ thumb or index finger with the left hand side next to cut left-lose points; ⑵ right hand needle, close to the surface of the left hand nails piercing the needle quickly acupoints; ⑶ This method is suitable for short needle into the needle. -
2, please flash demo cupping method commonly used? -
Answer: ⑴ the site of exposure should be cupping; ⑵ ready for the corresponding items; tweezers, alcohol, cotton balls, matches, glass jars, etc.; ⑶ clamp the grip of alcohol cotton ball one, lit the fire, so that fireball in the tank 1 to 3 laps around after the fire exit, quickly cupping can buckle in the appropriate parts of; ⑷ cupping according to different requirements to determine the specific time. -
4, how to press the virtual in? -
Answer: pulse (beat should not, re-financing may only) is in the card, empty pulse (the inability to move, according to the emptiness) of deficiency. -
5, please bird pecking moxibustion moxa demonstrate the operation? -
Answer: ⑴ moxibustion according to disease site selection; ⑵ will be lit moxa, moxibustion aligned position; ⑶ peck like birds, like a click event moxibustion; ⑷ moxibustion to the skin flushing for the degree. -
6, requested the presentation method is holding the needle? -
Answer: ⑴ held with the left thumb and forefinger pinch the disinfection of drinking dry cotton ball, grip the lower end of the needle body, will be fixed at the barbed tip of the skin surface of acupoints; ⑵ right hand twist move the needle handle, the needle piercing the acupoints rapidly; ⑶ this law applies to a long needle into the needle. -
7, please demonstrate the operation Exists diagnosis? -
Answer: ⑴ patient sitting or supine position to take the arm flat, near the same level and the heart, straight wrists, palms up, and pad surface veins in the wrist pillow; ⑵ patients with the left hand by right hand, left hand with right hand on the patient; ⑶ first post in the palm with the middle finger high bone at the medial vein set off, and then take the index finger-inch clock, the ring finger to take foot clock; ⑷ three fingers should take a bow, fingers flush to pulp by touch vein; ⑸ points light, medium and heavy Qiemo three forces. -
8, please demonstrate the operation of mild moxibustion moxa? -
Answer: ⑴ lit one end of the moxa, moxibustion aligned position, about 2cm ~ 3cm away from the skin around the BBQ; ⑵ locally so that patients without a burning sense of warm feeling, usually every 5 minutes at about 7 moxibustion minutes to flush the skin for the degree; ⑶ for fainting, decreased perception of local and pediatric patients, doctors may be food, middle finger, placed either side of moxibustion to patient perception of the degree of local heating, moxibustion at any time adjust the distance, to prevent burns. -
9, the tongue coating by inspection include? What yellow greasy fur the main card? -
answer: the tongue coating by inspection, including fur fur color and quality of both; the main heat Accumulation yellow greasy fur, phlegm retention of heat, food and other permits heat to rot. -
10, how to look sublingual veins? -
Answer: Normal: Context does not thick, and no branches and blood spots. If there is a lot of bruising or purple tongue small blisters, mostly sparse liver failure, blood stasis. If the collaterals purple varicose and thick phlegm heat resistance or Hanning Zhang stasis. -
11, how to look tongue? -
Answer: ⑴ patient by sitting or supine position; ⑵ lit, must lingual bright and easy to observe; ⑶ Shenshe posture: a natural Shenshe in extraoral tongue relax, the tongue flat, slightly to the tip of the tongue as far as mouth; ⑷ looking tongue position order: first tongue, the tongue side of the base of the tongue; ⑸ the tongue-shaped, Laonen, fat, big, thin, cracks, indentation, prick. -
12, the tongue of the form of quality by inspection include? How much fat scalloped tongue master card? -
Answer: ⑴ tongue shape quality by inspection includes ups and downs, Laonen, fat, thin, prick, crack, etc. characteristics; ⑵ much fat scalloped tongue master Qi Sheng Yang wetlands and other evidence. -
13, please demonstrate the operation of rubbing method? -
Answer: ⑴ with the middle finger or thumb finger, palm or palm thenar attached to certain parts of the root; ⑵ forearm to the wrist with a gentle easing of the swing; ⑶ coherent action and can persist for some time. -
14, to press the foot? What are its contents? -
⑴ by foot: ① taken sitting or supine position the patient, the doctor of the opposite or right side of the home patients; ② fully exposed to the patient's foot; ③ touch the hot and cold, check the actual situation and the table good times or bad cold and heat; ④ compare diagnostic methods: heart and hand,
airmax 通販, foot and hand, foot and back, palms and forehead, etc.; ⑤ edema and emphysema, or by whether the children finger: finger, middle finger. -
⑵ contents: ① the main proved cold and heat. Hand, foot and both general Yang yin is cold, is cold; hand, foot and mostly all hot or yang deficiency,
Switch User replies,
nike air max ltd, is hot. ② identify the injury disease or exogenous. Back of hand, foot warmer, for exogenous heat; dysphoria than the heat, the heat internal injuries. ③, respectively, in the heat or the surface heat: the amount of heat even in the palm of the hand on the hot, hot for the table; palms on the amount of heat even in the heat, as in the heat. ④ pediatric issues, the main seizures in children of cold fingers. One Hot main exogenous cold finger. Alone in the cold finger, to be made of hemp as smallpox. -
15, by the skin of the main content? -
Answer: cold and heat proved the body muscles form (yang ups. If in addition is very hot, long time anti-light by hot, hot in the table; if the hot counter is very long, thermal evaporation from the inside out, as the heat in there), moistening and swelling (according to the depression, not that from the swelling, according to the depression, that is from a show of hands as emphysema). -
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