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1、诊断学课程教学大纲载于网络 Outline of Diagnostics 课程名称：Diagnostics 授课专业：五年制英文班临床医学专业 学分与学时：理论课66学时，见习课68学时 一、 理论课教学内容及基本要求 Introduction 1To master the basic contents of Diagnostics 掌握诊断学的基本内容 2To understand the ways of learning 理解诊断学学习方法 1Definition of Diagnostics诊断学的定义 2The importance of learning Diagnostics学习诊
2、断学的重要性 3Basic contents of Diagnostics诊断学的基本内容 4The ways of learning学习方法 0.5 hour ，0.5小时 instruction, multiple media presenting, 讲授,多媒体 History collection (Inquisition) 病史采集 1To master the contents of inquistion掌握问诊的内容 2To understand the inquisition skill理解问诊技巧 general data, chief complaint, history
3、of the present illness, past history,review of systems, personal history, Marital history, Menstrual and reproductive history family history. 一般项目 主诉 现病史 既往史 系统回顾 个人史 婚姻史 月经和生育史 家族史 1.5 hour，1.5小时 instruction, multiple media presenting, case-presenting 讲授，多媒体，临床实习 History record 病史记录 1. To master ho
4、w to make a history record掌握怎样记录病史 2. To understand the basic requirement for the history record理解病史记录的基本要求 Outline of case record 病史记录提纲 1. Biographical data 一般资料 2. chief complaint 主诉 3. History of present illness (HPI) 现病史 4. Past history (PH) 既往史 6. Personal history 个人史 医护英语博客 email：sibara 载于网络
5、7. Marital history 婚姻史 8. Menstrual history ( for female patients) 月经史 9. Childbearing (reproductive) history 生育史 10. Family history (FH) 家族史 11. Physical examination (PE) 体格检查 12. Laboratory tests and instrumental examination 实验室检查和仪器检查 13. Primary diagnosis 初步诊断 Example of case record 病历示范 2 hours
6、 ，2小时 instruction, power point showing, case-presenting 讲授,多媒体，临床实习 Common symptoms 常见症状 Fever发热 1To master the type of fever and clinical classification掌握发热的类型和临床分类 2To understand the mechanism of fever and etiology理解发热的机制和病因 1Physiology 生理机制 2Mechanism of fever发热的机制 3Etiology 病因 4Clinical classifi
7、cation:临床分类 5Clinical manifestation临床症状 6Type of fever热型 Continuous(continued) fever 稽留热 Remittent fever弛张热 Intermittent (periodic) fever周期性发热 Undulant fever波状热 Relapsing (recurrent)fever间歇热 Irregular fever不规则发热 7Symptoms and signs of fever发热的症状和体征 2 hour 2小时 instruction, multiple media presenting,
8、讲授,多媒体 Abdominal pain腹痛 1To master the contents of abdominal pain掌握腹痛的内容 2To understand the significance of abdominal pain了解腹痛的意义 1Inquisition technique问诊技巧 2Contents of inquisition for abdominal pain腹痛问诊的内容 Where is the pain located? (Site)疼痛的部位? Where does the pain radiate to(referred pain), or do
9、es it originate elsewhere and move to the abdomen?疼痛放射到哪里?或疼痛原发于别的部位然后转移至腹部? 医护英语博客 email：sibara 载于网络 whar kind of pain is it? (Character)疼痛的性质? How sever is it? (Severity)疼痛的程度? What other symptoms accompany the pain?疼痛伴随哪些症状? What factors bring it about? 什麽原因导致疼痛的发生? What factors cause relief of p
10、ain? (Aggravating and Relieving factors) 什麽原因可减轻疼痛? In chronic abdominal pain inquire about the patients day. 慢性腹痛的病人要问诊疼痛时间 Again in chronic pain it is useful to inquire about the periodicity of the pain. 慢性腹痛的病人问诊疼痛的周期性 3Clinical Significance临床意义 2 hours 2小时 instruction, multiple media presenting，
11、 讲授，多媒体 Cough ,sputum production and dyspnea咳嗽,咳痰和呼吸困难 1To master the causes and mechanism of sputum production and dyspnea 掌握痰液产生和呼吸西困难的机制和原因 2To understand the clinical significance of sputum and dyspnea 理解痰液产生和呼吸西困难的临床表现 1Definition of cough and dyspnea咳嗽和呼吸困难的定义 2Causes and mechanism病因和机制 respir
12、atory disorders呼吸疾病 pleural diseases胸膜疾病 cardiovascular disorders心血管疾病 central nervous system disorders中枢神经系统疾病 3Sputum production痰液产生 Transudates漏出液 Exudates渗出液 Mucus黏液 Dusts aspirated吸入灰尘 Infracted tissues坏死组织 4Causes and significance of dyspnea呼吸困难的病因和临床表现 2 hours教学时数 2小时 instruction, power point
13、 showing, case-presenting 讲授,幻灯片,病例分析 CHAPTER 1. Basic methods for physical examination 体检的基本方法 1To master the basic methods of physical examination掌握体格检查的基本方法 2To understand the significance of these physical examination理解体格检查的意义 1Inspection: the definition of inspection and give some examples视诊: 视
14、诊的定义并举例 2Palpation: the definition of palpation and the kinds of palpation, to master the maneuver of palpation 医护英语博客 email：sibara 载于网络 and their significance.触诊: 触诊的定义和分类,掌握触诊的方法和意义 3Percussion: the definition of percussion and the kinds of percussion, to master the maneuver and the different soun
15、ds produced by percussion. 叩诊：叩诊的定义和分类,掌握叩诊的方法和意义 4Auscultation: the definition and the significance of auscultation. Know how to use stethoscope. 听诊: 听诊的定义意义.掌握怎样使用听诊器 5Olfactory examination: know some special odors that could provide valuable clues in clinic. 嗅诊：掌握一些在临床上提供有意义线索的特殊气味. 2 hours 2小时 i
16、nstruction, power point showing讲授,幻灯片 CHAPTER 2. General examination 一般检查 1To master the basic methods and the contents of general examination 掌握一般检查的基本方法和内容 2To master measurement of the temperature, blood pressure and examination of sequence and maneuver of lymph nodes 掌握体温测量,血压测量的方法和淋巴结检查的顺序和方法 3
17、To understand the significance of the physical examination and master the normal and abnormal signs and clinical significance 理解体格检查的意义,掌握正常和异常体征及临床意义 Vital signs: the normal range and abnormal conditions of Temperature, Blood pressure, Pulse, Respiration. To master measurement of the temperature, b
18、lood pressure. 生命体征：正常范围,体温血压,脉搏,呼吸的异常情况.掌握体温血压的测量方法 Sex：know some sex-related disease such as hemophilia, systemic lupus erythematous. 性别：知道哪些性别相关性疾病,如血友病,系统猩红斑狼疮 Age年龄 Development and habitus: know the judgments about the normal development and three types of habitus.发育和姿势:掌握正常发育和三种姿势 Nutrition: h
19、ow to judge the state of nutrition.营养:怎样判定营养状态 State of consciousness: the definition of the Somnolence, Confusion, Stupor, Coma. 意识状态:嗜睡,昏睡,木僵和昏迷的定义 Position and posture: the three types of position including active position, passive position and compulsive position. 体位和体态:主动体位,被动体位,强迫体位 Gait步态 Fac
20、ial (features) characteristics: know the abnormal sign and clinical significance about the facial 面容特征:掌握异常面容的体征和临床意义如急性面容,慢性面容,肝病面容,甲状腺功能减低面容,满月脸,二尖瓣面容 feature such as Acute facial feature, Chronic facial feature, Hepatic face, Hyperthyroidism face, Moon face, Mitral face. Skin: to master the defin
21、ition of spider angioma and its clinical significance. 医护英语博客 email：sibara 载于网络 皮肤:掌握蜘蛛痣的定义和临床意义 Edema: the definition and kinds of edema and its significance. 水肿:水肿的定义和意义 Subcutaneous nodules and hair 皮下结节和毛发 Lymphatic node: to master examination of sequence and maneuver of lymph node. Significance
22、 of lymphatic node if be palpated. 淋巴结:掌握淋巴结检查顺序和方法,可触到的淋巴结的意义 2 hours 2小时 instruction, power point showing 讲授,幻灯片 CHAPTER 3. Head and neck 头颈 1To master the methods and the contents of head and neck examination掌握头颈检查的方法和内容 2To master the significance of the physical examination: especially measurem
23、ent of sequence and maneuver of carotid artery, jugular vein, thyroid and trachea掌握体格检查的意义:颈动脉,颈静脉甲状腺和气管检查的顺序和方法 3To understand the examination of sequence and maneuver of head理解头部检查的顺序和方法 1Head: to master the contents of examination of the head and the maneuver of the detection of the cranium, to k
24、now certain deformities of the skull, such as 头部：掌握头部检查的内容和颅部检查的方法,知道头颅畸形,例如 Microcephalus头颅过小 Squared skull方型颅 Deforming skull畸形颅 Oxycephalia (tower skull, steeple skull)尖颅 Macrocephalus头颅过大 2Eyes：to master the normal and abnormal signs and their significance in clinic 眼：掌握正常和异常体征及其临床意义 Eyebrow:眉毛
25、Eyelids眼睑 1）Disturbance of closure of the eyelids:眼睑关闭异常 2）Ectropion 睑外翻 3）Entropin睑内翻 4）Eyelid edema 眼睑水肿 5）Eyelid ptosis睑下垂 Conjunctiva：结膜 Eyeball:眼球 l）Exophthalmos：眼球突出 2）Enophthalmos：眼球内陷 3）Eyeball movements眼球运动 Sclera：yellow sclera often was seen in jaundice巩膜:巩膜黄染常见于黄疸 Cornea：角膜 Iris and pupil
26、：虹膜和瞳孔 医护英语博客 email：sibara 载于网络 l）Pupillary shape：瞳孔形状 2）Pupillary direct and consensual response to light: to master the contents of examination, the maneuver and significance 瞳孔光反射：掌握检查的内容,方法和意义 3）Convergence and accommodation集合反射 4）Functional ocular examinations, including vision (acuity), color
27、sensation:. 眼功能检查，包括视力，色觉 3Ears耳 4Nose：to master the examinations contents, the maneuver and significance of paranasal sinuses 鼻：掌握检查内容,方法和意义 5Mouth (Oral cavity)口腔 1）Inspect the lips: to know the abnormal signs such as Pallor, Redness, Cyanosis and pigmentation 视诊口唇：异常的体征如苍白,紫绀和色素沉着 2）Inspect oral
28、mucous membrane: to know the abnormal signs such as Pallor, Redness, Cyanosis and pigmentation 视诊口黏膜：掌握异常体征如苍白,红润,紫绀和色素沉着 3）Examine the teeth and gingiva (gum): Method for counting the teeth 检查牙齿和牙龈:牙齿的计数方法 4）The tongue: 舌 5）Pharynx and larynx: Method for examining the Pharynx and larynx. To master
29、the Degree of the enlarged tonsil 咽喉：咽喉的检查方法.掌握扁桃体肿大的程度 6. Neck: to learn the anatomy of the neck and the contents of physical examinations. 颈部：掌握颈部的解剖和检查内容 1）Cervical vessels: to master the definition and significance of distended cervical vein 颈部血管：掌握颈静脉扩张的定义和意义 2）Thyroid gland: to master the palp
30、ation of the thyroid gland and the degree of thyroid gland enlargement. Know how to describe the thyroid gland when you palpate and auscultate the thyroid gland 甲状腺：掌握甲状腺的触诊方法和肿大程度.掌握甲状腺触诊和听诊的描述 3）Trachea: to master the contents of examination, the maneuver and significance 气管：掌握检查的内容,方法的意义 2 hours
31、2小时 instruction, power point showing, case-presenting. 讲授，幻灯片，临床实习 CHAPTER 4. Abdominal examination 腹部检查 1To master the markers and the lines of body surface, the areas and important viscera underlying these regions. 掌握体表线和体表标志，分区和这些区域的重要内脏器官 2To master inspection, palpation, percussion, auscultatio
32、n of abdomen. Especially palpation of liver and spleen. 掌握腹部的视,触,叩听方法,特别是肝脾触诊 医护英语博客 email：sibara 载于网络 3To understand the symptoms and signs of common abdominal diseases 理解常见腹部疾病的症状和体征 1. the markers and the lines of body surface, the areas and inoportant viscera underlying these regions. 掌握体表线和体表标志
33、,分区和这些区域的重要内脏器官 2.examination of abdomen腹部检查 (1)Inspection: symmetry, abdominal pulsation, shape, scars, sinuses, fistuas, engorged vein, flank haemorrhages, Visible peristalsis. 视诊:对称性,腹部搏动,形状,瘢痕,窦道,瘘管,扩张的静脉,胁腹出血，胃肠蠕动波 (2)Palpation: direct tenderness and resistance of muscle, rebound tenderness, pa
34、lpation of liver, spleen, gallbladder, kidney, atrtributes of masse, fluid trills, succusion splash, tender spots of kidney and ureter. 触诊:直接压痛和腹壁紧张度,反跳痛,肝脏,脾脏,胆囊,肾脏,包块,液波震颤，振水音,肾脏和输尿管压痛点 (3)Percussion: Traubes space, regions of liver, spleen, bladder and kidney. 叩诊:胃泡鼓音区，肝脾，膀胱和肾脏的区域 (4)Ascultation:
35、 bowel sound abdominal bruits, friction rubs.听诊:肠鸣音和摩擦音 3. The symptom and sings of common abdominal diseases: Peptic ulcer diseases and the complications, hepatic cirrhosis and portal hypertention, intestinal obstruction, acute peritonitis, appendicitis.常见腹部疾病的症状和体征:消化性溃疡和并发症,肝硬化和门脉高压,肠梗阻,急性腹膜炎,阑尾炎
36、 14 hours (Instruction 6 hours, practice 8 hours) 14小时 instruction, power point showing ,case-presenting. 讲授,幻灯片,临床实习 CHAPTER 5. Physical examination of the thorax 胸部体检 1To master the methods and the contents of thorax examination 掌握胸部体检的方法和内容 2To master the mechanism and clinical significance of ta
37、ctile fremitus and abnormal percussion 掌握触觉语颤的机制和临床意义 3To understand the physical examination and positive signs of some common pulmonary diseases 了解常见肺部疾病体格检查和阳性体征 1the markers and the lines of body surface, the areas and imoportant viscera underlying these regions. 掌握体表线和体表标志，分区和这些区域的重要内脏器官 2exami
38、nation of thorax胸部检查 Inspection of the lung and pleura肺和胸膜的视诊 Palpation of the lung and pleura肺和胸膜的触诊 Percussion of the lung and pleura肺和胸膜的叩诊 Auscultation of the lung and pleura肺和胸膜的听诊 3The symptom and sings of common respiratory diseases: pneumothorax,emphysema,Pleural effusion, pneumonia 常见胸部疾病的症
39、状和体征 14hours 14小时 医护英语博客 email：sibara 载于网络 instruction, power point showing,case-presenting. 讲授,幻灯片,临床实习 CHAPTER 6. Cardiovascular system 心血管系统 1To master the examining sequence and methods of heart，including inspection, palpation, percussion and auscultation. 掌握心脏的检查顺序和方法包括: 视,触,叩,听方法 2To master th
40、e producing mechanism of heart murmurs and their clinical significance. Mastering the key points of auscultation of heart murmurs and differential diagnosis of physical and pathological heart murmurs. 掌握心脏杂音的产生机制和他们的临床意义.掌握杂音听诊的关键点和生理性杂音和病理性杂音的鉴别诊断 3understand the symptoms and sings of common heart
41、diseases . 理解常见心脏疾病的症状和体征 1Heart 心脏 Inspection 视诊 1）Observing precordium 观察心前区 2）The location, intensity and scope of normal apical impulse and clinical value of its displacement. 正常心尖搏动的部位,强度和范围,异常的临床意义 3）Abnormal pulsations in the other areas and their clinical values其他区域的异常搏动和临床意义 Palpation触诊 1）T
42、he location, intensity and scope of normal apical impulse and clinical value of its displacement. 正常心尖搏动的部位,强度和范围. 异常的临床意义 2）The precordial pulsations location and its amplitude, duration and intensity. 心前区搏动的部位,强度,持续时间和强度. 3）The producing mechanism of thrills and location, intensity and quality of
43、thrills. 震颤的产生机制和部位强度和性质 4）Pericardial friction rub 心包摩擦感 Percussion 叩诊 1）The percussion method of the heart. 心脏的叩诊方法 2）The heart borders and their constituents. 心界大小 3）Normal relative dullness of the heart and changing cardiac dullness.心脏的相对浊音界和绝对浊音界 Auscultation 听诊 It includes rate, rhythm, heart
44、sound, murmur and pericardial friction sound. 包括心率,心律,心音,杂音和心包摩擦音 1）Auscultatory Valve Areas 听诊瓣膜区 2）The producing mechanism of heart sound and differential diagnosis of normal heart sounds. 心音产生的机制和正常心音的鉴别诊断 3）Heart rate and heart rhythm. 心率和节律 4）The producing mechanism and characteristics of heart
45、 murmurs (Location, timing, quality, radiation, and intensity). 医护英语博客 email：sibara 载于网络 心脏杂音的产生机制和性质(部位,时期,性质,放射和强度) 5）The producing mechanism and its clinical values of pericardial friction rub. 心包摩擦音的产生机制和临床意义 2Blood Vessels 血压 1）The arterial pulse and its rate, rhythm, intensity and tension. 动脉脉
46、搏和频率,节律,强度和张力 2）The producing mechanism and characteristics of wave forms (Water hammer pulse, Pulsus alternans, Dicrotic pulse, Paradoxical pulse) 波形的产生机制和性质(水冲脉,交替脉,重搏波,奇脉) 3）The measurement of arterial pressure and its significance. 血压测量的方法和意义 4）Pistol-shot sound and Duroziezs sign. 枪击音和Duroziezs征 3Com
