诊断学课程教学大纲五年制英文班临床医学专业演示教学

1、学习 好资料Outline of Diagnostics课程名称： Diagnostics授课专业： 五年制英文班临床医学专业 学分与学时： 理论课 66 学时，见习课 68 学时一、 理论课教学内容及基本要求Introduction【 Objective and emphasis 目的要求】1 To master the basic contents of Diagnostics 掌握诊断学的基本内容2 To understand the ways of learning 理解诊断学学习方法【 Instruction contents 教学内容】1 Definition of Diagnos

2、tics 诊断学的定义2 The importance of learning Diagnostics 学习诊断学的重要性3 Basic contents of Diagnostics 诊断学的基本内容4 The ways of learning 学习方法【 The times 教学时数 】 0.5 hour ， 0.5 小时【 Teaching methods 教学方法 】 instruction, multiple media presenting, 讲授 ,多媒体History collection (Inquisition) 病史采集【 Objective and emphasis 目

3、的要求 】1 To master the contents of inquistion 掌握问诊的内容2 To understand the inquisition skill 理解问诊技巧【 Instruction contents 教学内容 】general data, chief complaint, history of the present illness,past history,review of systems, personal history,Marital history, Menstrual and reproductive history family histor

4、y.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【The times教学时数】1.5 hour, 1.5小时【 Teaching methods 教学方法 】instruction, multiple media presenting, case-presenting 讲授，多媒体，临床实习History record 病史记录【 Objective and emphasis 目的要求 】1. To master how to make a history record 掌握怎样记录病史2. To understand the basic requiremen

5、t for the history record 理解病史记录的基本要求【 Instruction contents 教学内容 】(一) Outline of case record 病史记录提纲1. Biographical data 一般资料2. chief complaint 主诉3. History of present illness (HPI) 现病史4. Past history (PH)既往史6. Personal history个人史7. Marital history 婚姻史8. Menstrual history ( for female patients) 月经史9.

6、Childbearing (reproductive) history 生育史10. Family history (FH) 家族史11. Physical examination (PE) 体格检查12. Laboratory tests and instrumental examination 实验室检查和仪器检查13. Primary diagnosis 初步诊断(二) Example of case record 病历示范【The times 教学时数 】 2 hours ，2 小时【 Teaching methods 教学方法 】 instruction, power point s

7、howing, case-presenting 讲授 ,多媒体，临床实习Common symptoms 常见症状Fever 发热【 Objective and emphasis 目的要求 】1 To master the type of fever and clinical classification 掌握发热的类型和临床分类2 To understand the mechanism of fever and etiology 理解发热的机制和病因【 Instruction contents 教学内容 】1 Physiology 生理机制2 Mechanism of fever 发热的机制3

8、 Etiology 病因4 Clinical classification: 临床分类5 Clinical manifestation 临床症状6 Type of fever 热型(1) Continuous(continued) fever 稽留热(2) Remittent fever 弛张热(3) Intermittent (periodic) fever 周期性发热(4) Undulant fever 波状热(5) Relapsing (recurrent)fever 间歇热(6) Irregular fever 不规则发热7 Symptoms and signs of fever 发热

9、的症状和体征【 The times 教学时数 】 2 hour 2 小时【 Teaching methods 教学方法 】 instruction, multiple media presenting, 讲授 ,多媒体Abdominal pain 腹痛【 Objective and emphasis 目的要求 】1 To master the contents of abdominal pain 掌握腹痛的内容2 To understand the significance of abdominal pain 了解腹痛的意义【 Instruction contents 教学内容 】1 Inqu

10、isition technique 问诊技巧2 Contents of inquisition for abdominal pain 腹痛问诊的内容(1) Where is the pain located? (Site) 疼痛的部位 ?(2) Where does the pain radiate to(referred pain), or does it originate elsewhere and move to the abdomen?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) whar kind of pain is it? (Character) 疼痛的性质 ?更

11、多精品文档学习 好资料（4）How sever is it? （Severity） 疼痛的程度 ?（5）What other symptoms accompany the pain? 疼痛伴随哪些症状 ?（6）What factors bring it about? 什麽原因导致疼痛的发生 ?（7）What factors cause relief of pain? （Aggravating and Relieving factors）什麽原因可减轻疼痛 ?（8）In chronic abdomi nal pain in quire about the patie nts慢性腹痛勺病人要问诊疼

12、痛时间（ 9） Again in chronic pain it is useful to inquire about the periodicity of the pain. 慢性腹痛的病人问诊 疼痛勺周期性3Clinical Significance 临床意义 【 The times 教学时数 】 2 hours 2 小时【 Teaching methods 教学方法 】 instruction, multiple media presenting ， 讲授，多媒体Cough ,sputum production and dyspnea 咳嗽 ,咳痰和呼吸困难【 Objective and

13、 emphasis 目勺要求 】1To master the causes and mechanism of sputum production and dyspnea 掌握痰液产生和呼吸西困难勺机制和原因2To understand the clinical significance of sputum and dyspnea 理解痰液产生和呼吸西困难勺临床表现【Instruction contents 教学内容 】1Definition of cough and dyspnea 咳嗽和呼吸困难勺定义2. Causes and mechanism病因和机制 respiratory disor

14、ders 呼吸疾病 pleural diseases 胸膜疾病 cardiovascular disorders 心血管疾病central nervous system disorders 中枢神经系统疾病3. Sputum production 痰液产生Tran sudates 漏出液Exudates渗出液Mucus 黏液Dusts aspirated 吸入灰尘Infracted tissues 坏死组织4. Causes and significance of dyspnea 呼吸困难勺病因和临床表现【 The times 教学时数 】 2 hours 教学时数 2 小时 【 Teachi

15、ng methods 教学方法 】 instruction, power point showing, case-presenting讲授,幻灯片 ,病例分析CHAPTER 1. Basic methods for physical examination 体检勺基本方法【 Objective and emphasis 目勺要求 】1. To master the basic methods of physical examination 掌握体格检查勺基本方法2. To understand the significance of these physical examination 理解体

16、格检查勺意义 【Instruction contents 教学内容 】1. Inspection: the definition of inspection and give some examples 视诊 : 视诊勺定义并举例2. Palpation: the definition of palpation and the kinds of palpation, to master the maneuver of palpation and their significance. 触诊 : 触诊勺定义和分类 ,掌握触诊勺方法和意义3. Percussion: the definition

17、of percussion and the kinds of percussion, to master the maneuver and the 更多精品文档different sounds produced by percussion. 叩诊：叩诊的定义和分类 ,掌握叩诊的方法和意义 4 Auscultation: the definition and the significance of auscultation. Know how to use stethoscope. 听诊 : 听诊的定义意义 .掌握怎样使用听诊器5 Olfactory examination: know some

18、 special odors that could provide valuable clues in clinic. 嗅诊：掌握一些在临床上提供有意义线索的特殊气味 .【 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 2. General examination一般检查【 Objective and emphasis 目的要求 】1 To master the basic methods and the contents of gen

19、eral examination 掌握一般检查的基本方法和内容2 To master measurement of the temperature, blood pressure and examination of sequence and maneuver of lymph nodes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3 To understand the significance of the physical examination and master the normal and abnormal signs and clinical significance理

20、解体格检查的意义 ,掌握正常和异常体征及临床意义【 Instruction contents 教学内容 】Vital signs: the normal range and abnormal conditions of Temperature, Blood pressure, Pulse, Respiration. To master measurement of the temperature, blood pressure.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： know some sex-related disease such as

21、hemophilia, systemic lupus erythematous. 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Development and habitus: know the judgments about the normal development and three types of habitus. 发育和姿势 :掌握正常发育和三种姿势Nutrition: how to judge the state of nutrition. 营养 :怎样判定营养状态State of consciousness: the definition of the

22、 Somnolence, Confusion, Stupor, Coma. 意识状态 :嗜睡 ,昏睡 ,木僵和昏迷的定义Position and posture: the three types of position including active position, passive position and compulsive position.体位和体态 :主动体位 ,被动体位 ,强迫体位Gait 步态Facial (features) characteristics: know the abnormal sign and clinical significance about th

23、e facial 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feature such as Acute facial feature, Chronic facial feature, Hepatic face,Hyperthyroidism face, Moonface, Mitral face.Skin: to master the definition of spider angioma and its clinical significance. 皮肤 :掌握蜘蛛痣的定义和临床意义Edema: the defi

24、nition and kinds of edema and its significance. 水肿 :水肿的定义和意义更多精品文档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 met

25、hods 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

26、 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,

27、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2Eyes： 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) Eyeb

28、row: 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

29、黄染常见于黄疸(6) Cornea :角膜( 7) Iris and pupil ：虹膜和瞳孔1) 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,方法和意义更多精品文档学习 好资料3) Convergence and accommodation 集合反射4) Functional ocular examinations, incl

30、uding vision (acuity), color sensation:. 眼功能检查，包括视力，色觉3 Ears 耳4Nose：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

31、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 exam

32、ining 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

33、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

34、 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 vis

35、cera 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

36、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

37、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

38、脏和输尿管压痛 点八、(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 cirrh

39、osis 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

40、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 ex

41、amination 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 ple

42、ura 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3The 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( Instruct

43、ion 6 hours, practice 8 hours )14小时(讲授 6小时,实习 8 小时)【 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, p

44、ercussion and auscultation.掌握心脏的检查顺序和方法包括 : 视,触,叩 ,听方法2To 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

45、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)

46、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 inte

47、nsity.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

48、 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

49、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).心脏杂音的产生机制和性质 (部位 ,时期 ,性质,放射和强度 )5) The producing mechanism and its clinical values of pericardial friction rub. 心包摩擦音的产

50、生机制和临床意义更多精品文档学习 好资料2 Blood Vessels 血压1）The arterial pulse and its rate, rhythm, intensity and tension. 动脉脉搏和频率 ,节律 ,强度和张力2）The producing mechanism and characteristics of wave forms （Water hammer pulse, Pulsus alternans, Dicrotic pulse, Paradoxical pulse）波形的产生机制和性质 （水冲脉 ,交替脉 ,重搏波 ,奇脉 ）3）The measurem

51、ent of arterial pressure and its significance. 血压测量的方法和意义4）Pistol-shot sound and Duroziez's sign. 枪击音和 Duroziez's 征3 Common symptoms and signs of cardiovascular diseases: mitral stenosis,mitral imcompetece,aortic incompetence,aortic stenosis,pericardical effusion.心血管疾病的常见症状和体征:二尖瓣狭窄 , 二尖瓣关闭不

52、全 ,主动脉瓣狭窄 , 主动脉瓣关闭不全【 The times 教学时数 】14 hours.（ Instruction 6 hours, practice 8 hours ）14 小时（讲授 6 小时,实习 8 小时）【Teach ing methods 教学方法 】in struct ion, power point show ing , case-prese ntin g.讲授，幻灯片，临床实习CHAPTER 7. Physiological and pathological reflex 生理和病理反射【 Objective and emphasis 目的要求 】1To master

53、the methods of physiological and pathological reflex 掌握生理和病理反射的方法2To understand the significance of the physical examination 理解体格检查的意义【 Instruction contents 教学内容 】1Superficial reflex: 浅反射（1）corneal reflex, 角膜反射（2）plantar reflex, 跖反射（3）abdominal reflex, 腹壁反射（4）cremasterie reflex: 提睾反射（5）Eanal reflex2

54、Deep reflexes: 深反射（1）biceps reflex, 肱二头肌反射（2）triceps reflex, 肱三头肌反射（3）brachioradialis reflex, 桡骨膜反射（4）ankle jerk. 跟腱反射（5）knee jerk. 膝腱反射3Clonus: 阵挛（1）Ankle clonus: 踝阵挛（2）Patellar clonus: 髌阵挛4Pathological reflex 病理反射（1）Babinski's sign:. 巴氏征（2）Oppenheim's sign: 奥本海姆征（3）Hoffmann' s sign:霍夫曼

55、征5. Signs of meningeal irritation 脑膜刺激征（ 1） Neck rigidity: 颈项强直（ 2） Kernig's sign: 克氏征更多精品文档（3）Brudzinski's sign: 布氏征The times 教学时数 】 1.5 hour 1.5 小时Teaching methods 教学方法 】 instruction, power point showing ， case-presenting. 讲授 ,幻灯片，实习Laboratory Examination 实验室检查CHAPTER 1. Stool Routine Test

56、 大便常规Objective and emphasis 目的要求 】1 To master the methods of stool routine test 掌握大便常规的方法2 To master the significance of the changes of stool property and the occult blood test 掌握大便性状改变的意义和隐血实验的意义3 To understand the significance of microscopic examination 理解显微镜检查的意义Instruction contents 教学内容 】1 Gener

57、al property of stool 大便的一般性状（1）watery stool: 水样便（2）mucus stool: 黏液便（3）pyohemochezia stool: 脓血便（4）hematochezia stool: 血便（5）melena or tarry stool: 黑便或柏油样便2 Microscopic examination 显微镜检查（1）Cells: 细胞（2）WBC 白细胞（3）RBC 红细胞（4）macrophage:normal 巨噬细胞（5）tumor cell 肿瘤细胞（6）Food residue:食物残渣（ 7） Ovum of parasite 寄生虫卵3.Occoul blood test 隐血实验The times 教学时数 】 0.5 hour 0.5 小时Teaching methods 教学方法 】Instruction, power point s