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Learn how to conduct a thorough general survey of patients, understanding the relationships between diseases and general features, with examples included. Explore consciousness, facial features, positions, posture, gait, gender, age, vital signs, development, habitus, and nutritional status. Gain insights into sex-related illnesses, age-related diseases, body type classifications, and nutritional assessments. Discover abnormal developments, endocrine gland disorders, and factors influencing physical development.
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Chapter 4 Physical examination 第四章 身体评估
Aim • 1.We should know what to do during the general servey for your patient. • 2.You can explain the relationships between the disease and each element about the general servey for your patient. • 3.And give some example about it.
6.Consciousness 7.Facial Feature 面容与表情 8.Position体位 9.Posture/ Gait 姿势与步态 Gender Age Vital sign Development /Habitus 发育与体型 Nutritional status Preassessment Overview
6.Consciousness 7.Facial Feature 面容与表情 8.Position体位 9.Posture/ Gait 姿势与步态 Gender Age Vital sign Development /Habitus 发育与体型 Nutritional status Preassessment Overview
①sex-related illnesses • female • 99% breast cancer . • Ovarian cancer • Autoimmune diseases(SLE) • male • Prostate cancer • colour blindness • Hemophilia
AGE • Skin and mucous membrane elasticity and shineThe state of muscleAnd distribution of hair colorFace and neck skin wrinklesState of tooth
Age-related Disease-- Children diphtheria白喉 measles麻疹 Rickets佝偻病
Elderly Cancer Cardiovascular disease cerebrovascular disease Adolescent Tuberculosis 结核 rheumatic fever 风湿热 Age-related Disease-- :
①Interesting Facts Chest circumference=height/2 Sitting height=Leg Length Arm span=height
Genetic遗传Endocrine内分泌Nutrition Metabolism营养代谢Physical Exercise体育锻炼 Factors ②Factors? • Age • IQ Height 身高 • Age • Physicality Weight 体重 Sexual development
③Abnormal Development • 线性生长过速 • 身材矮小症 • 身体比例失调 • 身高下降
③Abnormal Development • Gigantism (巨人症)---growth hormone(GH)↑ • Acromegaly(肢端肥大症)---(GH)↑ • dwarfism (侏儒症)---growth hormone(GH) ↓ • Cretinism (呆小症)---thyroid hormone ↓ Give me your answers!
(二)habitus sternal angle skeleton骨骼 muscles肌肉 fat distribution Infrasternal angle Costal arch 肋弓
Habitus/Body Type Ectomorph Mesomorph Endomorph (瘦长型/无力型) (匀称型/正力型)(矮胖型/超力型)
5.Nutritional status • Height • Body weight • Sitting height • Head circumference • Chest Circumference • Upper arm circumference • Triceps Skinfold TSF
①Grade of Nutritional Status Normal Malnutrition Overweight
②BMI Calculator 中国 24 28
Grades/Type Normal Mild (Grade-Ⅰ) Moderate (Grade-Ⅱ) Severe (Grade-Ⅲ) Eating disorders --- cancer, liver disease, anorexia nervosa. Digestive disturbances --- stomach, intestines, pancreas disease. Increased energy consumption --- hyperthyroidism, diabetes, tuberculosis, cancer, etc ③Malnutrition
③Over Nutrition-Obesity • exogenous obesity - obesity caused by overeating • endogenous obesity- obesity resulting from dysfunction of the endocrine or metabolic system