《诊断学》课程教学大纲（五年制英文班临床医学专业）

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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 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 【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing 讲授,幻灯片

CHAPTER 3. Head and neck 头颈

【Objective and emphasis 目的要求】

1．To master the methods and the contents of head and neck examination掌握头颈检查的方法和内容 2．To master the significance of the physical examination: especially measurement 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

3．To understand the examination of sequence and maneuver of head理解头部检查的顺序和方法 【Instruction contents 教学内容】

1．Head: to master the contents of examination of the head and the maneuver of the detection of the cranium, to know 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

2．Eyes：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 （1）Eyebrow:眉毛 （2）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 （3）Conjunctiva：结膜 （4）Eyeball:眼球

l）Exophthalmos：眼球突出 2）Enophthalmos：眼球内陷 3）Eyeball movements眼球运动

（5）Sclera：yellow sclera often was seen in jaundice巩膜:巩膜黄染常见于黄疸 （6）Cornea：角膜

（7）Iris and pupil：虹膜和瞳孔

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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 sensation:. 眼功能检查，包括视力，色觉 3．Ears耳

4．Nose：to master the examination’s contents, the maneuver and significance of paranasal sinuses 鼻：掌握检查内容,方法和意义 5．Mouth (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 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 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 palpation 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 【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】 instruction, power point showing, case-presenting.

讲授，幻灯片，临床实习

CHAPTER 4. Abdominal examination 腹部检查

【Objective and emphasis 目的要求】

1．To 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

2．To master inspection, palpation, percussion, auscultation 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

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3．To understand the symptoms and signs of common abdominal diseases 理解常见腹部疾病的症状和体征 【Instruction contents 教学内容】

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,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, palpation 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: Traube’s 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: 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 【The times教学时数】14 hours (Instruction 6 hours, practice 8 hours) 14小时

【Teaching methods教学方法】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

【Objective and emphasis 目的要求】

1．To master the methods and the contents of thorax examination 掌握胸部体检的方法和内容 2．To master the mechanism and clinical significance of tactile fremitus and abnormal percussion 掌握触觉语颤的机制和临床意义

3．To 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

【Instruction contents 教学内容】

1．the 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 2．examination of thorax胸部检查

（1）Inspection of the lung and pleura肺和胸膜的视诊 （2）Palpation of the lung and pleura肺和胸膜的触诊 （3）Percussion of the lung and pleura肺和胸膜的叩诊 （4）Auscultation of the lung and pleura肺和胸膜的听诊

3．The symptom and sings of common respiratory diseases: pneumothorax,emphysema,Pleural effusion, pneumonia

常见胸部疾病的症状和体征

【The times教学时数】 14hours（Instruction 6 hours, practice 8 hours）

14小时（讲授6小时,实习8小时）

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【Teaching methods教学方法】 instruction, power point showing,case-presenting. 讲授,幻灯片,临床实习

CHAPTER 6. Cardiovascular system 心血管系统

【Objective and emphasis 目的要求】

1．To 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

2．To master the 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

3．understand the symptoms and sings of common heart diseases . 理解常见心脏疾病的症状和体征 【Instruction contents 教学内容】

1．Heart 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）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

2）The precordial pulsation’s 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 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 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（S1 and S2）. 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 murmurs (Location, timing, quality, radiation, and intensity).

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