《诊断学》课程教学大纲(五年制英文班临床医学专业)教学文案.doc

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1、Good is good, but better carries it.精益求精，善益求善。诊断学课程教学大纲(五年制英文班临床医学专业)-OutlineofDiagnostics课程名称：Diagnostics授课专业：五年制英文班临床医学专业一、 学分与学时：理论课66学时，见习课68学时理论课教学内容及基本要求Introduction【Objectiveandemphasis目的要求】1TomasterthebasiccontentsofDiagnostics掌握诊断学的基本内容2Tounderstandthewaysoflearning理解诊断学学习方法【Instructioncont

2、ents教学内容】1DefinitionofDiagnostics诊断学的定义2TheimportanceoflearningDiagnostics学习诊断学的重要性3BasiccontentsofDiagnostics诊断学的基本内容4Thewaysoflearning学习方法【Thetimes教学时数】0.5hour，0.5小时【Teachingmethods教学方法】instruction,multiplemediapresenting,讲授,多媒体Historycollection(Inquisition)病史采集【Objectiveandemphasis目的要求】1Tomastert

3、hecontentsofinquistion掌握问诊的内容2Tounderstandtheinquisitionskill理解问诊技巧【Instructioncontents教学内容】generaldata,chiefcomplaint,historyofthepresentillness,pasthistory,reviewofsystems,personalhistory,Maritalhistory,Menstrualandreproductivehistoryfamilyhistory.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【Thetimes教学时数】1.5ho

4、ur，1.5小时【Teachingmethods教学方法】instruction,multiplemediapresenting,case-presenting讲授，多媒体，临床实习Historyrecord病史记录【Objectiveandemphasis目的要求】1.Tomasterhowtomakeahistoryrecord掌握怎样记录病史2.Tounderstandthebasicrequirementforthehistoryrecord理解病史记录的基本要求【Instructioncontents教学内容】（一）Outlineofcaserecord病史记录提纲1.Biograp

5、hicaldata一般资料2.chiefcomplaint主诉3.Historyofpresentillness(HPI)现病史4.Pasthistory(PH)既往史6.Personalhistory个人史7.Maritalhistory婚姻史8.Menstrualhistory(forfemalepatients)月经史9.Childbearing(reproductive)history生育史10.Familyhistory(FH)家族史11.Physicalexamination(PE)体格检查12.Laboratorytestsandinstrumentalexamination实验

6、室检查和仪器检查13.Primarydiagnosis初步诊断（二）Exampleofcaserecord病历示范【Thetimes教学时数】2hours，2小时【Teachingmethods教学方法】instruction,powerpointshowing,case-presenting讲授,多媒体，临床实习Commonsymptoms常见症状Fever发热【Objectiveandemphasis目的要求】1Tomasterthetypeoffeverandclinicalclassification掌握发热的类型和临床分类2Tounderstandthemechanismoffeve

7、randetiology理解发热的机制和病因【Instructioncontents教学内容】1Physiology生理机制2Mechanismoffever发热的机制3Etiology病因4Clinicalclassification:临床分类5Clinicalmanifestation临床症状6Typeoffever热型（1）Continuous(continued)fever稽留热（2）Remittentfever弛张热（3）Intermittent(periodic)fever周期性发热（4）Undulantfever波状热（5）Relapsing(recurrent)fever间歇热

8、（6）Irregularfever不规则发热7Symptomsandsignsoffever发热的症状和体征【Thetimes教学时数】2hour2小时【Teachingmethods教学方法】instruction,multiplemediapresenting,讲授,多媒体Abdominalpain腹痛【Objectiveandemphasis目的要求】1Tomasterthecontentsofabdominalpain掌握腹痛的内容2Tounderstandthesignificanceofabdominalpain了解腹痛的意义【Instructioncontents教学内容】1In

9、quisitiontechnique问诊技巧2Contentsofinquisitionforabdominalpain腹痛问诊的内容（1）Whereisthepainlocated?(Site)疼痛的部位?（2）Wheredoesthepainradiateto(referredpain),ordoesitoriginateelsewhereandmovetotheabdomen?疼痛放射到哪里?或疼痛原发于别的部位然后转移至腹部?（3）wharkindofpainisit?(Character)疼痛的性质?（4）Howseverisit?(Severity)疼痛的程度?（5）Whatoth

10、ersymptomsaccompanythepain?疼痛伴随哪些症状?（6）Whatfactorsbringitabout?什麽原因导致疼痛的发生?（7）Whatfactorscausereliefofpain?(AggravatingandRelievingfactors)什麽原因可减轻疼痛?（8）Inchronicabdominalpaininquireaboutthepatientsday.慢性腹痛的病人要问诊疼痛时间（9）Againinchronicpainitisusefultoinquireabouttheperiodicityofthepain.慢性腹痛的病人问诊疼痛的周期性3

11、ClinicalSignificance临床意义【Thetimes教学时数】2hours2小时【Teachingmethods教学方法】instruction,multiplemediapresenting，讲授，多媒体Cough,sputumproductionanddyspnea咳嗽,咳痰和呼吸困难【Objectiveandemphasis目的要求】1Tomasterthecausesandmechanismofsputumproductionanddyspnea掌握痰液产生和呼吸西困难的机制和原因2Tounderstandtheclinicalsignificanceofsputuman

12、ddyspnea理解痰液产生和呼吸西困难的临床表现【Instructioncontents教学内容】1Definitionofcoughanddyspnea咳嗽和呼吸困难的定义2Causesandmechanism病因和机制respiratorydisorders呼吸疾病pleuraldiseases胸膜疾病cardiovasculardisorders心血管疾病centralnervoussystemdisorders中枢神经系统疾病3Sputumproduction痰液产生Transudates漏出液Exudates渗出液Mucus黏液Dustsaspirated吸入灰尘Infracted

13、tissues坏死组织4Causesandsignificanceofdyspnea呼吸困难的病因和临床表现【Thetimes教学时数】2hours教学时数2小时【Teachingmethods教学方法】instruction,powerpointshowing,case-presenting讲授,幻灯片,病例分析CHAPTER1.Basicmethodsforphysicalexamination体检的基本方法【Objectiveandemphasis目的要求】1Tomasterthebasicmethodsofphysicalexamination掌握体格检查的基本方法2Tounderst

14、andthesignificanceofthesephysicalexamination理解体格检查的意义【Instructioncontents教学内容】1Inspection:thedefinitionofinspectionandgivesomeexamples视诊:视诊的定义并举例2Palpation:thedefinitionofpalpationandthekindsofpalpation,tomasterthemaneuverofpalpationandtheirsignificance.触诊:触诊的定义和分类,掌握触诊的方法和意义3Percussion:thedefinitio

15、nofpercussionandthekindsofpercussion,tomasterthemaneuverandthedifferentsoundsproducedbypercussion.叩诊：叩诊的定义和分类,掌握叩诊的方法和意义4Auscultation:thedefinitionandthesignificanceofauscultation.Knowhowtousestethoscope.听诊:听诊的定义意义.掌握怎样使用听诊器5Olfactoryexamination:knowsomespecialodorsthatcouldprovidevaluablecluesincli

16、nic.嗅诊：掌握一些在临床上提供有意义线索的特殊气味.【Thetimes教学时数】2hours2小时【Teachingmethods教学方法】instruction,powerpointshowing讲授,幻灯片CHAPTER2.Generalexamination一般检查【Objectiveandemphasis目的要求】1Tomasterthebasicmethodsandthecontentsofgeneralexamination掌握一般检查的基本方法和内容2Tomastermeasurementofthetemperature,bloodpressureandexamination

17、ofsequenceandmaneuveroflymphnodes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3Tounderstandthesignificanceofthephysicalexaminationandmasterthenormalandabnormalsignsandclinicalsignificance理解体格检查的意义,掌握正常和异常体征及临床意义【Instructioncontents教学内容】Vitalsigns:thenormalrangeandabnormalconditionsofTemperature,Bloodpressure,Pulse,Res

18、piration.Tomastermeasurementofthetemperature,bloodpressure.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：knowsomesex-relateddiseasesuchashemophilia,systemiclupuserythematous.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Developmentandhabitus:knowthejudgmentsaboutthenormaldevelopmentandthreetypesofhabitus.发育和姿势:掌握正常发育和

19、三种姿势Nutrition:howtojudgethestateofnutrition.营养:怎样判定营养状态Stateofconsciousness:thedefinitionoftheSomnolence,Confusion,Stupor,Coma.意识状态:嗜睡,昏睡,木僵和昏迷的定义Positionandposture:thethreetypesofpositionincludingactiveposition,passivepositionandcompulsiveposition.体位和体态:主动体位,被动体位,强迫体位Gait步态Facial(features)character

20、istics:knowtheabnormalsignandclinicalsignificanceaboutthefacial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featuresuchasAcutefacialfeature,Chronicfacialfeature,Hepaticface,Hyperthyroidismface,Moonface,Mitralface.Skin:tomasterthedefinitionofspiderangiomaanditsclinicalsignificance.皮肤:掌握蜘蛛痣的定

21、义和临床意义Edema:thedefinitionandkindsofedemaanditssignificance.水肿:水肿的定义和意义Subcutaneousnodulesandhair皮下结节和毛发Lymphaticnode:tomasterexaminationofsequenceandmaneuveroflymphnode.Significanceoflymphaticnodeifbepalpated.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【Thetimes教学时数】2hours2小时【Teachingmethods教学方法】instruction,powerpoi

22、ntshowing讲授,幻灯片CHAPTER3.Headandneck头颈【Objectiveandemphasis目的要求】1Tomasterthemethodsandthecontentsofheadandneckexamination掌握头颈检查的方法和内容2Tomasterthesignificanceofthephysicalexamination:especiallymeasurementofsequenceandmaneuverofcarotidartery,jugularvein,thyroidandtrachea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3

23、Tounderstandtheexaminationofsequenceandmaneuverofhead理解头部检查的顺序和方法【Instructioncontents教学内容】1Head:tomasterthecontentsofexaminationoftheheadandthemaneuverofthedetectionofthecranium,toknowcertaindeformitiesoftheskull,suchas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Squaredskull方型颅Deformingskull畸形颅Ox

24、ycephalia(towerskull,steepleskull)尖颅Macrocephalus头颅过大2Eyes：tomasterthenormalandabnormalsignsandtheirsignificanceinclinic眼：掌握正常和异常体征及其临床意义（1）Eyebrow:眉毛（2）Eyelids眼睑1）Disturbanceofclosureoftheeyelids:眼睑关闭异常2）Ectropion睑外翻3）Entropin睑内翻4）Eyelidedema眼睑水肿5）Eyelidptosis睑下垂（3）Conjunctiva：结膜（4）Eyeball:眼球l）Exop

25、hthalmos：眼球突出2）Enophthalmos：眼球内陷3）Eyeballmovements眼球运动（5）Sclera：yellowscleraoftenwasseeninjaundice巩膜:巩膜黄染常见于黄疸（6）Cornea：角膜（7）Irisandpupil：虹膜和瞳孔l）Pupillaryshape：瞳孔形状2）Pupillarydirectandconsensualresponsetolight:tomasterthecontentsofexamination,themaneuverandsignificance瞳孔光反射：掌握检查的内容,方法和意义3）Convergenc

26、eandaccommodation集合反射4）Functionalocularexaminations,includingvision(acuity),colorsensation:.眼功能检查，包括视力，色觉3Ears耳4Nose：tomastertheexaminationscontents,themaneuverandsignificanceofparanasalsinuses鼻：掌握检查内容,方法和意义5Mouth(Oralcavity)口腔1）Inspectthelips:toknowtheabnormalsignssuchasPallor,Redness,Cyanosisandpi

27、gmentation视诊口唇：异常的体征如苍白,紫绀和色素沉着2）Inspectoralmucousmembrane:toknowtheabnormalsignssuchasPallor,Redness,Cyanosisandpigmentation视诊口黏膜：掌握异常体征如苍白,红润,紫绀和色素沉着3）Examinetheteethandgingiva(gum):Methodforcountingtheteeth检查牙齿和牙龈:牙齿的计数方法4）Thetongue:舌5）Pharynxandlarynx:MethodforexaminingthePharynxandlarynx.Tomast

28、ertheDegreeoftheenlargedtonsil咽喉：咽喉的检查方法.掌握扁桃体肿大的程度6.Neck:tolearntheanatomyoftheneckandthecontentsofphysicalexaminations.颈部：掌握颈部的解剖和检查内容1）Cervicalvessels:tomasterthedefinitionandsignificanceofdistendedcervicalvein颈部血管：掌握颈静脉扩张的定义和意义2）Thyroidgland:tomasterthepalpationofthethyroidglandandthedegreeofthy

29、roidglandenlargement.Knowhowtodescribethethyroidglandwhenyoupalpateandauscultatethethyroidgland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:tomasterthecontentsofexamination,themaneuverandsignificance气管：掌握检查的内容,方法的意义【Thetimes教学时数】2hours2小时【Teachingmethods教学方法】instruction,powerpointshowing,case-presenti

30、ng.讲授，幻灯片，临床实习CHAPTER4.Abdominalexamination腹部检查【Objectiveandemphasis目的要求】1Tomasterthemarkersandthelinesofbodysurface,theareasandimportantvisceraunderlyingtheseregions.掌握体表线和体表标志，分区和这些区域的重要内脏器官2Tomasterinspection,palpation,percussion,auscultationofabdomen.Especiallypalpationofliverandspleen.掌握腹部的视,触,

31、叩听方法,特别是肝脾触诊3Tounderstandthesymptomsandsignsofcommonabdominaldiseases理解常见腹部疾病的症状和体征【Instructioncontents教学内容】1.themarkersandthelinesofbodysurface,theareasandinoportantvisceraunderlyingtheseregions.掌握体表线和体表标志,分区和这些区域的重要内脏器官2.examinationofabdomen腹部检查(1)Inspection:symmetry,abdominalpulsation,shape,scars

32、,sinuses,fistuas,engorgedvein,flankhaemorrhages,Visibleperistalsis.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:directtendernessandresistanceofmuscle,reboundtenderness,palpationofliver,spleen,gallbladder,kidney,atrtributesofmasse,fluidtrills,succusionsplash,tenderspotsofkidneyandureter.触诊:直接

33、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:Traubesspace,regionsofliver,spleen,bladderandkidney.叩诊:胃泡鼓音区，肝脾，膀胱和肾脏的区域(4)Ascultation:bowelsoundabdominalbruits,frictionrubs.听诊:肠鸣音和摩擦音3.Thesymptomandsingsofcommonabdominaldiseases:Pepticulcerdiseasesandthecomplications,hepaticcirrhosisand

34、portalhypertention,intestinalobstruction,acuteperitonitis,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【Thetimes教学时数】14hours(Instruction6hours,practice8hours)14小时【Teachingmethods教学方法】instruction,powerpointshowing,case-presenting.讲授,幻灯片,临床实习CHAPTER5.Physicalexaminationofthethorax胸部体检【Obj

35、ectiveandemphasis目的要求】1Tomasterthemethodsandthecontentsofthoraxexamination掌握胸部体检的方法和内容2Tomasterthemechanismandclinicalsignificanceoftactilefremitusandabnormalpercussion掌握触觉语颤的机制和临床意义3Tounderstandthephysicalexaminationandpositivesignsofsomecommonpulmonarydiseases了解常见肺部疾病体格检查和阳性体征【Instructioncontents教

36、学内容】1themarkersandthelinesofbodysurface,theareasandimoportantvisceraunderlyingtheseregions.掌握体表线和体表标志，分区和这些区域的重要内脏器官2examinationofthorax胸部检查（1）Inspectionofthelungandpleura肺和胸膜的视诊（2）Palpationofthelungandpleura肺和胸膜的触诊（3）Percussionofthelungandpleura肺和胸膜的叩诊（4）Auscultationofthelungandpleura肺和胸膜的听诊3Thesym

37、ptomandsingsofcommonrespiratorydiseases:pneumothorax,emphysema,Pleuraleffusion,pneumonia常见胸部疾病的症状和体征【Thetimes教学时数】14hours（Instruction6hours,practice8hours）14小时（讲授6小时,实习8小时）【Teachingmethods教学方法】instruction,powerpointshowing,case-presenting.讲授,幻灯片,临床实习CHAPTER6.Cardiovascularsystem心血管系统【Objectiveandemp

38、hasis目的要求】1Tomastertheexaminingsequenceandmethodsofheart，includinginspection,palpation,percussionandauscultation.掌握心脏的检查顺序和方法包括:视,触,叩,听方法2Tomastertheproducingmechanismofheartmurmursandtheirclinicalsignificance.Masteringthekeypointsofauscultationofheartmurmursanddifferentialdiagnosisofphysicalandpath

39、ologicalheartmurmurs.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3understandthesymptomsandsingsofcommonheartdiseases.理解常见心脏疾病的症状和体征【Instructioncontents教学内容】1Heart心脏Inspection视诊1）Observingprecordium观察心前区2）Thelocation,intensityandscopeofnormalapicalimpulseandclinicalvalueofitsdisplacement.正常心尖搏动的部位

40、,强度和范围,异常的临床意义3）Abnormalpulsationsintheotherareasandtheirclinicalvalues其他区域的异常搏动和临床意义Palpation触诊1）Thelocation,intensityandscopeofnormalapicalimpulseandclinicalvalueofitsdisplacement.正常心尖搏动的部位,强度和范围.异常的临床意义2）Theprecordialpulsationslocationanditsamplitude,durationandintensity.心前区搏动的部位,强度,持续时间和强度.3）The

41、producingmechanismofthrillsandlocation,intensityandqualityofthrills.震颤的产生机制和部位强度和性质4）Pericardialfrictionrub心包摩擦感Percussion叩诊1）Thepercussionmethodoftheheart.心脏的叩诊方法2）Theheartbordersandtheirconstituents.心界大小3）Normalrelativedullnessoftheheartandchangingcardiacdullness.心脏的相对浊音界和绝对浊音界Auscultation听诊Itincl

42、udesrate,rhythm,heartsound,murmurandpericardialfrictionsound.包括心率,心律,心音,杂音和心包摩擦音1）AuscultatoryValveAreas听诊瓣膜区2）Theproducingmechanismofheartsoundanddifferentialdiagnosisofnormalheartsounds（S1andS2）.心音产生的机制和正常心音的鉴别诊断3）Heartrateandheartrhythm.心率和节律4）Theproducingmechanismandcharacteristicsofheartmurmurs

43、(Location,timing,quality,radiation,andintensity).心脏杂音的产生机制和性质(部位,时期,性质,放射和强度)5）Theproducingmechanismanditsclinicalvaluesofpericardialfrictionrub.心包摩擦音的产生机制和临床意义2BloodVessels血压1）Thearterialpulseanditsrate,rhythm,intensityandtension.动脉脉搏和频率,节律,强度和张力2）Theproducingmechanismandcharacteristicsofwaveforms(

44、Waterhammerpulse,Pulsusalternans,Dicroticpulse,Paradoxicalpulse)波形的产生机制和性质(水冲脉,交替脉,重搏波,奇脉)3）Themeasurementofarterialpressureanditssignificance.血压测量的方法和意义4）Pistol-shotsoundandDuroziezssign.枪击音和Duroziezs征3Commonsymptomsandsignsofcardiovasculardiseases:mitralstenosis,mitralimcompetece,aorticincompetenc

45、e,aorticstenosis,pericardicaleffusion.心血管疾病的常见症状和体征:二尖瓣狭窄,二尖瓣关闭不全,主动脉瓣狭窄,主动脉瓣关闭不全【Thetimes教学时数】14hours.（Instruction6hours,practice8hours）14小时（讲授6小时,实习8小时）【Teachingmethods教学方法】instruction,powerpointshowing，case-presenting.讲授,幻灯片，临床实习CHAPTER7.Physiologicalandpathologicalreflex生理和病理反射【Objectiveandempha

46、sis目的要求】1Tomasterthemethodsofphysiologicalandpathologicalreflex掌握生理和病理反射的方法2Tounderstandthesignificanceofthephysicalexamination理解体格检查的意义【Instructioncontents教学内容】1Superficialreflex:浅反射（1）cornealreflex,角膜反射（2）plantarreflex,跖反射（3）abdominalreflex,腹壁反射（4）cremasteriereflex:提睾反射（5）Eanalreflex2Deepreflexes:

47、深反射（1）bicepsreflex,肱二头肌反射（2）tricepsreflex,肱三头肌反射（3）brachioradialisreflex,桡骨膜反射（4）anklejerk.跟腱反射（5）kneejerk.膝腱反射3Clonus:阵挛（1）Ankleclonus:踝阵挛（2）Patellarclonus:髌阵挛4Pathologicalreflex病理反射（1）Babinskissign:.巴氏征（2）Oppenheimssign:奥本海姆征（3）Hoffmannssign:.霍夫曼征5.Signsofmeningealirritation脑膜刺激征（1）Neckrigidity:颈项强直（2）Kernigssign:克氏征（3）Brudzinskissign:布氏征【Thetimes教学时数】1.5hour1.5小时【Teachingmethods