2021年临床医学概论复习资料.pdf

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1、临床医学概论复习资料1/37 临床医学概论复习资料（自制版）诊断学症状病人主观上感觉到的异常感觉或不适感觉称之为症状（Symptom）体征：经体格检查客观发现到的异常表现称为体征（sign）一、发热发热（fever）的概念：当机体在致热源作用下或各种原因引起体温调节中枢功能障碍，致使体温高出正常范围，即为发热正常体温：正常人体温为36.0-37.0（腋测法）左右。口测法 36.2-37.3 肛测法 36.5-37.5发热的临床过程及特点（三各阶段）1、体温上升期：分为骤升期和缓升期2、高热期3、体温下降期：分为骤降（crisis）和渐降（Lysis）病因1感染性发热(infective fev

2、er):各种病原菌引起发热2非感染性发热(noninfective fever):发热的分度：1、低热37.3-38 2、中等度热38.1-39 3、高热39.1-41 4、超高热41 以上热型与临床意义：1.稽留热：39-40 以上，持续数天或数周，24 小时体温波动不超过1 。2.弛张热(又称败血症热型)：39 以上，24 小时波动范围超过2 ，但在 37 以上3.间歇热：达高峰后持续数小时，又骤降至正常水平，无热期可持续1 天至数天。4.波状热：体温渐升达39 或以上，数日后又渐降至正常，持续数天后又逐渐升高。5.回归热：骤升至 39 以上，持续数天后又骤降至正常水平，高热期和无热期各持

3、续数天后规律性交替一次。6.不规则热：发热曲线无规律性。二、发绀定义：紫绀（cyanosis）是指血液中还原血红蛋白增多（超过50g/L），使皮肤、粘膜呈现青紫色的表现。分类可分为两大类：血液中还原血红蛋白增多；血液中存在异常血红蛋白衍化物1中心性紫绀：主要是心、肺疾病引起。发绀特点是全身性，除四肢与面颊外，也见于舌、口腔等粘膜及躯干皮肤，但皮肤温暖，即使加温保暖紫绀不消失。（1）肺性发绀：各种严重呼吸道疾病呼吸功能衰竭通气或换气功能障碍体循环还原血红蛋白增多而出现紫绀。（2）心性混合性发绀：静脉血未通过肺进行氧合作用，还原血红蛋白增多而出现紫绀。2周围性紫绀：周围循环血流障碍所致。紫绀特点：

4、肢体末端与下垂部位，如肢端、耳垂与鼻尖，这些部位皮温低，若按摩、加温、保暖，紫绀即可消失。精品w o r d 可编辑资料-第 1 页，共 37 页-临床医学概论复习资料2/37 3混合性紫绀：见于左、右心衰或全心衰。三、黄疸1定义：血清中胆红素升高，只是皮肤、粘膜、巩膜及其他组织发生黄染的现象。正常血清胆红素 8.5517.10umol/L(0.51.0mg/d1)。隐性黄疸：当血清胆红素浓度为17.134.2umol(12mg/d1)时，而肉眼看不出黄疸显性黄疸：血清胆红素浓度高于34.2umol/L(2mg/d1)时。分类：根据病因和发病机理1.溶血性黄疸：实验室检查 UCB增加、CB正常

5、2.肝细胞性黄疸：黄疸较重，浅黄至深黄色；实验室检查 UCB、CB均增加，伴肝功损害；3.梗阻性黄疸：黄疸重，色暗黄；实验室检查 CB增高，UCB正常四咳嗽与咳痰咳嗽：人体的一种保护性反射动作。咳痰（expectoration）：是通过咳嗽的动作将呼吸道内分泌物排出口腔外的病态现象。病因：1呼吸道疾病：2胸膜疾病：胸膜炎、肺结核、肺脓肿、肺癌、胸腔穿刺等，3心血管疾病：左心衰肺循环瘀血与肺水肿，引起夜间阵发性呼吸困难、端坐呼吸，咳嗽、咳痰是因肺泡和支气管粘膜淤血所致，一旦支气管粘膜下血管破裂即可引起咯血。4中枢神经因素：脑炎、脑膜炎可直接刺激延髓咳嗽中枢引起咳嗽。咳嗽的性质：1、咳嗽而无痰或痰

6、量甚少，称为干性咳嗽。常见于急性咽喉炎、支气管炎的初期，胸膜炎、轻症肺结核等。2、咳嗽伴有痰液时，称为湿性咳嗽。常见于肺炎、慢性支气管炎、支气管扩张、肺脓肿及空洞型肺结核等疾病等。痰的性状与痰量：痰的性质可分为粘液痰、浆液痰、脓性痰；黄绿色、铁锈色、粉红色、血性或混合痰。咳嗽伴随的症状：1.伴有发热：常表示呼吸道和肺部有感染存在，如胸膜炎、肺脓肿、支气管扩张并感染、肺结核、肺肿瘤等。2.伴有胸痛及呼吸困难：常见于胸膜炎、肺炎、肺脓肿、自发性气胸等。3.伴呼吸困难：常见于肺水肿、喉肿瘤、支气管哮喘、重症肺炎、肺结核大量胸腔积液、肺淤血、肺水肿、气管或支气管异物等。4.伴有哮喘：常见于支气管哮喘、

7、心源性哮喘、气管内异物、痉挛性支气管炎。5.伴有紫绀常见于重病的心肺疾患，如自发性气胸、肺原性心脏病伴有心功能不全时。6.伴有杵状指多见于支气管扩张症、慢性肺脓肿、支气管肺癌等。7.伴咯血见于肺结核、支气管扩张症、支气管肺癌、二尖瓣狭窄。五咯血1.定义：咯血喉部以下的呼吸器官出血，经咳嗽从口腔排出。病因：精品w o r d 可编辑资料-第 2 页，共 37 页-文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 Z

8、C5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7

9、ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7

10、 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X

11、7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9

12、X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B

13、9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1

14、B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10临床医学概论复习资料3/37 1支气管疾病；2肺部疾病；3心血管疾病；4血液病5流行性出血热；颜色和性状：1、鲜红色肺结核、支扩、肺脓肿、出血性疾病2、铁锈色血痰大叶性肺炎、肺吸虫病、肺泡出血3、砖红色胶冻样血痰肺炎杆菌肺炎4、暗红色二尖瓣狭窄肺淤血5、粉红色泡沫样血痰左心衰肺淤血伴随症状：1 发热；2 胸

15、痛；3 呛咳4 脓痰5 黄疸6 皮肤黏膜出血；呕血(hematemesis)是指消化道出血经口腔呕出；六呼吸困难定义：（dyspnoea）患者感觉到空气不足、呼吸费力，客观表现呼吸运动费力，重者张口呼吸、抬肩、鼻翼扇动，甚至出现发绀，呼吸辅助肌也参加活动，并伴有呼吸频率、深度与节律的异常。病因：1 肺源性呼吸困难；2 心血管系统疾病；3 中毒性呼吸困难；4 神经精神性呼吸困难；临床表现：1 吸气性呼吸困难；2 呼气性呼吸困难；3 混合性呼吸困难；4 由循环系统疾病所引起，主要见于左心或右心功能不全。七胸痛定义：主要由胸部疾病引起，少数由其他部位病变所致。病因1胸壁疾病：1、各种炎症：皮炎、蜂窝

16、织炎、带状疱疹、肋间神经炎、肌炎；2、骨折：2。肋骨骨折、肋软骨炎；3、肿瘤：急性白血病、多发性骨髓瘤等。2呼吸系统疾病：胸膜炎、胸膜肿瘤、自发性气胸、急性气管-支气管炎、肺炎、肺癌等。3心血管疾病：1、心脏：2、血管：主动脉瘤、主动脉窦瘤破裂；3、其他；肺动脉高压、心脏神经官能症等。4纵隔疾病：纵隔炎、纵隔肿瘤、纵隔脓肿、食管癌等。临床表现：（一）胸痛部位：1、胸壁疾病：疼痛局限、压痛明显；2、食管和纵隔病变：胸骨后疼痛，精品w o r d 可编辑资料-第 3 页，共 37 页-文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J1

17、0K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J

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19、J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P

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21、P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z

22、6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2

23、Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10临床医学概论复习资料4/37 吞咽时加重；3、心脏病变：心绞痛伴放射性；4、胸膜和肺部病变：患侧腋中线与腋前线附近。（二）胸痛性质：1、刀割样或灼痛-带状疱疹；2、烧灼痛-食管炎；3、绞

24、窄性痛伴重压窒息感-心绞痛；4、剧烈胸痛伴恐惧、频死感-心肌梗塞；5、尖锐刺痛或撕裂痛-干性胸膜炎；6、胸部闷痛-肺癌；7、剧烈刺痛或绞痛伴呼吸困难或紫绀-肺梗塞。（三）持续时间：阵发性痛-平滑肌痉挛或血管狭窄缺血（心绞痛）；持续性痛-炎症、肿瘤、梗塞（心梗）。影响疼痛因素：诱因、加重或缓解因素。如劳累、体力活动、精神紧张可诱发心绞痛发作，休息、含服硝酸甘油或硝酸异山梨酯，可使心绞痛缓解，而心肌梗塞疼痛则无效。胸膜炎和心包炎的胸痛则因深呼吸或咳嗽而加剧。八心悸定义（palpitation）：是一种自觉心跳或心慌感。伴心前区不适病因：1心脏搏动增强；2心律失常；3心脏神经官能症；临床表现：九水肿

25、定义（edema）：过多的液体在人体组织间隙或体腔内积聚，使组织肿胀。病因：1、毛细血管内静水压升高；2、血浆胶体渗透压降低；3、钠与水的潴留；4、毛细血管通透性的增高；5、淋巴回流障碍；全身性水肿（anasarca）1、心源性水肿（cardiac edema）2、肾源性水肿（renal edema）3、肝源性水肿（hepatic edema）4、营养不良性水肿(nutritional edema)5、5、其他水肿(other edema)：粘液性水肿，如甲亢；6、特发性水肿，如体位性水肿；7、药物性水肿，如糖皮质激素；局部性水肿：局部静脉、淋巴回流受阻，如肢体血栓、橡皮肿、炎症等十恶心与呕吐

26、定义：恶心(nausea)为上腹部不适感，可伴头晕、流涎、面色苍白、肢体冷、出汗等自主功能失调表现。常为呕吐的前驱症状，但也可单独出现。精品w o r d 可编辑资料-第 4 页，共 37 页-文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7

27、ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7

28、 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X

29、7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9

30、X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B

31、9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1

32、B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V

33、1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10临床医学概论复习资料5/37 呕吐(vomiting)是指胃内容物或一部分小肠内容物，通过食物逆流出口腔。病因：1、中枢性呕吐；2、精神性呕吐；3、周围性呕吐（1）胃源性呕吐（2）腹部疾病引起的反射性呕吐（3）周围感觉器官疾病引起反射性呕吐；十一呕血与便血定义：呕血(hematemesis)是指消化道出血经口腔呕出；病因：1食道疾病；2胃及十二肠疾病；3肝、胆、胰腺疾病；4血液系疾病；如再生障碍性贫血、急性白血症等。5其它如重症肺性脑病、重症尿毒症及某些传染病如流行性出血热

34、、钩端螺旋体病等。便血（hematochezia）是指消化道出血，血液由肛门排除。便血可呈鲜红、暗红或黑色，少量出血，须经隐血试验确定者，称为隐血。病因：1上消化道疾病上消化道疾病引起出血后，均可有便血。2下消化疾病（1）小肠疾病小肠肿瘤、小肠血管瘤、Meckel 憩室（2）结肠疾病慢性非特异性结肠炎、结肠癌、结肠息肉（3）直肠疾病直肠损伤、非特异性直肠炎、直肠癌（4）肛门疾病痔、肛裂、肛瘘3其它疾病（1）急性传染病与寄生虫病如急性细菌性痢疾、阿米巴痢疾、流行性出血热、钩虫病等。（2）血液病同呕血抽搐全身或局部成群骨骼肌非自主抽动或强烈收缩。问诊定义：问诊（inquiry）是医师通过对患者或相

35、关人员的系统询问获取病史资料，通过综合分析而作出的临床判断的一种诊法。内容：1、一般项目；2、主诉；3、现病史；4、既往病史；5、系统回顾；6、个人史；精品w o r d 可编辑资料-第 5 页，共 37 页-文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H

36、2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10

37、H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY1

38、0H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY

39、10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 H

40、Y10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1

41、HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1

42、 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10临床医学概论复习资料6/37 7、婚姻史；8、月经史；9、生育史；10、家族史；一般项目：1.姓名2.性别3.年龄4.籍贯5.出生地6.民族7.婚姻8.通讯地址9.电话号码10.工作单位11.职业12.入院日期13.记录日期14.病史陈述者15.可靠程度主诉就诊的最主要的痛苦或最明显的症状或（和）体征,也就是本次就诊最主要的原因及持续的时间。现病史：定义：它记录患者从起病后的全过程，即发生发展、演变和诊治经过。内容包括：1.起病情况与患病时间2.主要症状的特

43、点3.病因与诱因4.病情的发展与演变5.伴随症状在主要症状的基础上又出现一系列的其他症状。伴随症状常常是鉴别诊断的依据。6.诊治经过7.病程中的一般情况问诊的重要性：1、问诊是病史采集的主要手段,是每个医生必须掌握的基本功2、获得诊断线索的基本方法,避免漏诊和误诊3、提供体检和其它检查的依据4、了解病情发展的全过程5、问诊是医患沟通的良好手段,是建立良好的医患关系最重要时机.问诊的方法：（一）问诊开始时1.先作自我介绍，说明职责2.消除患者紧张情绪3.保护患者隐私4.使用恰当的语言和体表语言：（二）尽量让患者自己讲述病情，必要时灵活地把语题转向。从主诉开始，逐渐深入有目的、有层次、有顺序的进行

44、询问。（三）追溯首发症状开始的确切时间，直到目前的演变过程。（四）在问诊的两个项目之间使用过渡语言精品w o r d 可编辑资料-第 6 页，共 37 页-文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO

45、2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:C

46、O2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:

47、CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码

48、:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编

49、码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档

50、编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文档编码:CO2Z6P5J10K1 HY10H2V1B9X7 ZC5K5I6T7K10文