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同学们好
下面我们继续学习按诊的内容
按诊的运用相当广泛
涉及到各科疾病和全身各部分
尤其是腹部的按诊
对疾病的诊查非常重要
按诊 有五个学习内容
分别是按胸胁 按脘腹
按肌肤 按手足
和按腧穴等等
我们首先来学习按胸胁的主要内容
胸胁的范围 是指前胸和侧胸
前胸 包括缺盆(锁骨上窝)
至横膈以上的部位
侧胸 又称为胁肋部 或肋部
即胸部两侧
由腋下至十一 十二肋骨端的区域
也就是这个图上所看到这的部分
按胸胁的临床意义
主要是为了诊查局部皮肤 经络
骨骼的病变 以及心肺 肝胆
以及乳房的病变
胸部 正常的叩诊音 是清音
正常的肺下界
锁骨中线对应的是第六肋
腋中线对应的是第八肋
肩胛线对应的是第十肋
乳房按诊 要注意乳房肿块的数目
部位 大小 外形 硬度 压痛
活动度以及腋窝及锁骨下淋巴结的情况
下面 我们来看看虚里按诊
首先我们来看虚里的部位
虚里 是在左乳下第4到5肋间
也就是心尖搏动处
正常的虚里是 搏动不显 按之应手
搏动范围直径约为2-2.5cm
动而不紧 缓而不怠
动气聚而不散 节律清晰
虚里的一般临床意义
主要是为了推测宗气的强弱
疾病的虚实和预后的吉凶
诊虚里时 病人要仰卧位
医生站其右侧 用右手平抚虚里处
诊虚里时
主要是要诊虚里有无搏动
搏动的部位及范围
搏动的强度 节律 频率以及聚散等等
下面 我们看看胁部的按诊
诊胁部的部位
右侧胁肋 主要反映肝胆的病变
左侧胁肋 主要反映脾脏的病变
正常的两侧的胁肋部 包括肋缘下
没有脏器可以触及 也不会有压痛
诊胁肋时 病人仰卧或侧卧
医生站在腋下至肋弓部进行按诊 叩诊
同时还应从上腹部中线向两侧肋弓轻循
并按至肋弓
胁部按诊时 应该注意到
有无肿块及压痛
肿块的质地大小和形态等等
以上是胸胁按诊的主要内容
按胸胁 主要是为了诊查局部皮肤
经络 骨骼的病变
以及心肺 肝胆 以及乳房的病变
-Introductory remark
--QQ groups、WeChat public account
-Introduction
--【Discussion 1】Why do you want to take this course?
-Unit test for Introduction
-1.1 Yin-yang theory
-1.2 The theory of five elements
--1.2.1 The theory of five elements
--1.2.2 Application of the theory of five elements
-Frequently Asked Questions
-Unit test for week 1
-2.0 Outline
--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?
-2.1 Liver
--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with
-2.2 Heart
-2.3 Spleen
-2.4 Lung
--2.4 Lung
-2.5 Kidney
-2.6 Six fu organs
-Frequently Asked Questions
-Unit test for week 2
-3.1 Qi
--3.1 Qi
-3.2 Blood
-3.3 Body fluid
-3.4 The relationship of qi, blood and body fluid
--3.4 The relationship of qi, blood and body fluid
--【Discussion 4】A discussion about the theory of qi, blood and body fluid
-Frequently Asked Questions
-Unit test for week 3
-4.0 Outline
-4.1 Six exogenous factors
--4.1.2 Nature and pathogenicity of wind and cold
--4.1.3 Nature and pathogenicity of summer heat and damp
--4.1.4 Nature and pathogenicity of dryness and fire
-4.2 Etiology of visceral impairment
--4.2 Etiology of visceral impairment
-Frequently Asked Questions
-Unit test for week 4
-5.0 Outline of inquiry
--【Discussion 5】If you were a patient, how would you describe your condition to your doctor first?
-5.1 Inquiry of Chills and fever
--5.1.1 Chills and fever(Aversion to cold with fever)
--5.1.2 Chills and fever(Chills without fever)
--5.1.3 Chills and fever(Fever without chills)
--5.1.4 Chills and fever(Alternative chills and fever)
--【Discussion 6】How to understand "if you have clinical manifestations of cold, that is exterior syndr
-5.2 Inquiry of perspiration
-Frequently Asked Questions
-Unit test for week 5
-5.3 Inquiring of pain
--【Discussion 7】How to understand "stagnation leading to pain and innourish leading to pain"?
-5.4 Inquiring of head, body, thorax and abdomen
--5.4 Inquiring of head, body, thorax and abdomen
-5.5 Inquiring of ears and eyes
--5.5 Inquiring of ears and eyes
-5.6 Inquiring of sleep
-5.7 Inquiring of food and drink, appetite and taste
--5.7 Inquiring of food and drink, appetite and taste
-5.8 Inquiring of defecation and urination
--5.8.1 Inquiring of defecation
--5.8.2 Inquiring of urination
-5.9 Inquiring of infantile and women's disease
--5.9 Inquiring of infantile and women's disease
-Unit test for week 6
-6.0 Outline of Observation
--【Discussion 8】Please use the whole body inspection (including the expression, complexion and figure)
-6.1.1 Observation of vitality
--6.1.1 Observation of vitality
-6.1.2 Observation of the color
--6.1.2.1 The content, principles of inspection of the color
--6.1.2.2 Indication of diseases by five colors
--【Discussion 9】How do you understand the normal complexion of a normal people?
-6.1.3 Observation of the appearance
--6.1.3 Observation of the appearance
-6.1.4 Observation of figure and posture
--6.1.4 Observation of figure and posture
-Unit test for week 7
-6.2.1 Observation of head and face
--6.2.1 Observation of head and face
-6.2.2 Observation of five sensory organs
--6.2.2.1Observation of five sensory organs(observation of eyes,ears,nose)
--6.2.2.2Observation of five sensory organs(observation of lips,teeth and gums,throat)
-6.2.3 Observation of body
-6.2.4 Observation of limbs
-6.2.5 Observation of two lower orifices
--6.2.5 Observation of two lower orifices
-6.2.6 Observation of skin
-6.3 Observation of excreta
-6.4 Observation of infantile fingerprints
--6.4 Observation of infantile fingerprints
-Frequently Asked Questions
-Unit test for week 8
-7.1 Outline of tongue inspection
--7.1.1 The morphology and structure of the tongue
--7.1.2 The principle of tongue examination
--7.1.3 The method and precaution of tongue examination
--7.1.4 The content of tongue examination, normal tongue
-7.2 Inspection of tongue structure
--7.2.1 Observe the color of tongue
--7.2.2 Observe the shape of tongue
--7.2.3 Observe the states of tongue
--7.2.4 Observation of sublingual vein
-7.3 Observation of tongue coating
--7.3.1 Observation of coating texture
--7.3.2 Observe the color of coating
-7.4 Clinical significance of tongue diagnosis
--7.4 Clinical significance of tongue diagnosis
--【Discussion 10】Why to observe the tongue can be used to diagnose disease?
-Unit test for week 9
-8.1 The principle of pulse examination
--8.1 The principle of pulse examination
-8.2 The regions and methods of pulse examination
--8.2 The regions and methods of pulse examination
-8.3 The elements of pulse examination and the normal pulse
--8.3 The elements of pulse examination and the normal pulse
-8.4 Characteristics and significance of pulse
--8.4.1 Superficial pulse, deep pulse, slow pulse, rapid pulse
--8.4.2 Surging pulse, thin pulse, long pulse, short pulse
--8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven
--8.4.4 Taut pulse, tense pulse,soggy pulse, moderate pulse
--8.4.5 Knotted, slow-regular-intermittent, irregularly abrupt
-8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞
--8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞
--【Discussion 11】Why is complex pulse more common than single-factor pulse?
-8.6 Women’s pulse, children’s pulse
--8.6 Women’s pulse, children’s pulse
-8.7 The clinical significance of pulse diagnosis
--8.7 The clinical significance of pulse diagnosis
-Unit test for week 10
-9.1 Listening
-9.2.1 Abnormal sound
-9.2.2 Abnormal language
-9.2.3 Respiratory abnormality
--9.2.3 Respiratory abnormality
-9.2.4 Cough
--【Discussion 12】How to observe the patient's cough sound and sputum changes to determine whether the
-9.2.5 Abnormal sounds of the stomach and intestines
--9.2.5 Abnormal sounds of the stomach and intestines
-9.3 Smelling
--【Discussion 13】How to diagnose by smelling?
-Unit test for week 11
-10.1 The method, meaning and precautions of palpation
--10.1 The method, meaning and precautions of palpation
-10.2 Contents of palpation
--10.2.1 Palpating chest and hypochondrium
--10.2.2 Palpating stomach and abdomen
--10.2.4 Palpating hands and feet, palpating acupoints
--【Discussion 14】How to determine whether external or internal injuries?
-Unit test for week 12
-Conclusion
-Final Exam
--Final Exam