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6、前胸和肺[ANTERIOR CHEST AND LUNGS]
•视、触胸部
•双侧对称地叩诊肺尖
•叩诊前胸和侧胸
•双侧对称地听诊肺尖
•听诊前、侧胸部
•Inspect and palpate configuration and symmetry of chest
•Percuss supraclavicular fossae bilaterally and symmetrically
•Percuss anterior and lateral lung fields
•Auscultate supraclavicular fossae bilatcrally and symmetrically
•Auscultate anterior and lateral lung fields.
7、心脏[HEART]医学 全在.线提供www.med126.com
•嘱受检者仰卧，粗略估计颈静脉压
•观察心前区（取切线方向）
•用手掌、手指触诊心尖搏动
•用手掌触诊心前区
•叩诊心脏相对浊音界
•Screening test for elevated venous pressure.
•Observe precordium (view tangentially)
•Palpate apical area with palm and fingertips
•Palpate precordial area with palm
•Percuss relative dullness of the heart
（1）用膜型胸件听诊[Auscultate with diaphragm]
•肺动脉瓣区（胸骨左缘第2肋间隙）
•主动脉瓣区（胸骨右缘第2肋间隙）
•主动脉瓣第二听诊区（胸骨左缘第3、4肋间隙）
•二尖瓣区（心尖部）
•三尖瓣区（胸骨左缘第4、5肋间隙或胸骨体下端稍偏右）
•Pulmonary area (second left ICS)
•Aortic area (second right ICS)
•Second aortic area (third and fourth left ICS)
•Mitral area (Apical area)
•Tricuspid area (fourth, fifth left ICS, LSB and RSB)
（2）用钟型胸件听诊[Auscultate with bell]
•肺动脉瓣区
•主动脉瓣区
•主动脉瓣第二听诊区
•二尖瓣区
•三尖瓣区
•Pulmonary area
•Aortic area
•Second aortic area
•Mitral area (Apical area)
•Tricuspid area
8、腹部[ABDOMEN]
•正确暴露腹部
•头下置一小枕，嘱受检者屈膝、尽量放松腹肌、双上肢置于躯干两侧，平静呼吸
•视诊腹部
•听诊肠鸣音
•叩诊腹部
•叩诊肝浊音界
•触诊腹部时应注意受检者面部表情及退缩反应
•浅部触诊
•深部触诊
•单手法触诊肝脏
•双手法触诊肝脏
•在前正中线触诊肝脏
•双手法触诊脾脏
•右侧卧位触诊脾脏
•双手触诊法检查双侧肾脏
•检查腹部的触觉和痛觉
•Expose abdomen completely from just below breasts to just above pubis
•Place pillow under head, bend knees, arms at side, have patient breathe normally.
•Observe abdomen.
•Auscultate for bowel sounds, place stethoscope in area of umbilicus
•Percuss abdomen
•Percuss liver span
•Watch patient`s face and response as you palpate abdomen
•Palpate superficially
•Palpate deeply
•Palpate liver at midclavicular with monomanual method.
•Palpate liver at midclavicular line with bimanual method
•Palpate liver at midsternal line
•Palpate spleen with bimanual method
•Palpate spleen with patient rolled toward his right side.
•Palpate kidneys with bimanual method
•Test for pain of light touch on abdominal wall
9、下肢[LOWER LIMBS]
•充分暴露和视诊双下肢
•触诊双侧腹股沟浅表淋巴结（横组）
•触摸双侧腹股沟浅表淋巴结（纵组）
•触诊双侧股动脉
•触诊双侧足背动脉
•检查双下肢水肿
•检查下肢触觉或痛觉（至少2/3部位）
•Expose and inspect lower limbs
•Palpate transverse group of superficial groin lymph nodes
•Palpate longitudinal group of superficial groin lymph nodes
•Femoral artery (groin)
•Dorsalis pedis artery (top of foot)
•Check for pitting edema
•Test for sense of pain or light touch in at least 2 or 3 positions
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