医学翻译课堂-- 标准化病人体检项目之上肢等

1、医学翻译课堂- 标准化病人体检项目之上肢等泛瑞翻译1、上肢UPPER LIMBS·正确暴露上肢·Expose upperlimbs（1）手Hands·观察手掌、手背，触诊双手各关节·检查双手及指甲，有无紫绀和杵状指·伸展手指·弯曲近指间和远指间关节呈爪状·握拳·拇指对掌运动·检查远端肌力·Inspect dorsa andpalms and palpate all joints of hand·Check fingernailsfor clubbing or cyanosis·

2、;Ask patient toextend fingers·Ask patient tomake a claw·Ask patient tomake a fist·Check patientsability to perform thumb opposition·Check for distalmuscle strength（2）腕Wrist·触诊双手腕有无肿块、水肿、畸形和压痛·背伸·掌曲 ·Observe andpalpate wrist (for lumps, swelling, deformities, a

3、nd tenderness)·Extension ofwrist (bend backward)·Flexion of wrist(bend forward)（3）肘Elbow·触诊鹰嘴和肱骨髁状突·触诊滑车上淋巴结·屈肘·检查上臂肌力·伸肘·旋前和旋后·Palpate olecranonprocess and epicondyles·Palpateepitrochlear lymph nodes·Flexion·Check for upperarm muscle stren

4、gth·Extension·Pronation andsupination (with elbows locked at patients side)（4）肩Shoulder·触诊双肩·功能检查（三个过筛试验：一手越过头顶触摸对側耳朵；双臂上举，双手置于后枕；一手从背后触及对侧肩胛下角）·检查上肢近端肌力·检查触觉或痛觉（至少2/3部位）·贝勒氏（Barres）上肢轻瘫试验（闭眼）·Palpate bothshoulders·Functional examination (3 screening mane

5、uvers: hand over head toopposite ear, hands behind head, touch lower border of opposite scapula)·Check forproximal muscle strength·Test sense of pain or touch:at least 2 of 3 positions (upper arm,forearm, & hand) on each upper extremity bilaterally and symmetrically·Barres upperli

6、mb test (test for drift of outstretched arms with eyes closed)（5）腱反射Deep Tendon Reflexes(The reflexes should be checkedbilaterally and both sides com-pared.)·肱二头肌反射·肱三头肌反射·桡骨骨膜反射·Biceps reflex·Triceps reflex·Brachioradialisreflex（6）共济运动Coordination·快速轮替动作·指鼻试验

7、（睁眼）·指鼻试验（闭眼）·Rapid alternatingmovement·Finger to nosetest (with open eyes)·Finger to nosetest (with closed eyes)2、背部BACK·正确暴露背部·逐个触诊脊柱棘突，检查有无畸形、压痛·逐个叩击脊椎棘突（或用间接叩击法）检查有无叩痛·检查肾区压痛和叩击痛·检查胸廓活动度和对称性·嘱受检者稍前倾，双上肢交叉，双手分别置于对侧肩部·叩诊后胸部·双侧对称地叩诊后胸部

8、3;叩诊肺下界移动范围·嘱受检者轻微张口作深呼吸·听诊后胸部·双侧对称地听诊后胸部·听觉语音（耳语音）·Expose the backcorrectly·Palpate spinousprocesses one by one (check for scoliosis and tenderness)·Test forpercussion pain of spinal column one by one (or by indirect method)·Test CVA forkidney tenderness by p

9、ressure and indirect fist percussion·Palpate thoracicexpansion and symmetry·Have patientcross arms in front and touch opposite shoulder·Percuss posteriorlung fields·Percuss posteriorlung fields comparatively and symmetrically·Measurediaphragmatic excursion·Instruct the

10、patientto breathe a little deeply with mouth open slightly·Auscultateposterior lung fields·Auscultatecomparatively and symmetrically·Vocal audibleresonance3、乳房（女性）BREASTS(FEMALE)·充分暴露双侧乳房·坐位（或站立位）观察乳房·前倾位观察乳房·双臂高举过头观察乳房·用手指掌面以适当压力触诊右乳房·按内上、外上、尾部、内下、外下顺序触诊

11、右乳房，至少4/5部位·触诊右乳晕及乳头，注意乳头溢液·用手指掌面以适当压力触诊左乳房·按内上、外上、尾部、内下、外下顺序触诊左乳房，至少4/5部位·触诊左乳晕及乳头，注意乳头溢液·教检者作乳房自我检查·检查受检者右腋窝·触诊右腋窝5群淋巴结·检查受检者左腋窝·触诊左腋窝5群淋巴结·Expose bothbreasts completely·Inspect bothbreasts symmetrically in sitting position·Inspect bothbr

12、easts symmetrically with patient leaning forward·Inspect bothbreasts symmetrically with arms raised above head·Inspect bothbreasts symmetrically with hands on hips and squeeze·Palpate patients right breast with pads of fingers of right hand,applying gentle pressure·Palpate right

13、breast in the 5 following areas;superinternal,superlateral, tail, inferinternal, inferlateral (at least 4 of 5 parts of thebreast should be palpated)·Palpate nipples,areola, attempt to express discharge from nipple·Palpate patients left breast with pad of fingers and palm, applyinggentle p

14、ressure.·Palpate left breast in the folloing areas:superinternal, superlateral,tail, inferinternal, inferlateral.·Palpate nipples,areola, attempt to express discharge from nipple.·Teach patientbreast self-examination.AxillaryExaminaton·Inspect thepatients right axilla.·Palpa

15、te chains oflymph nodes on right:top , medial, anterior, posterior, lateral·Inspects patientsleft axilla·Palpate chains oflymph nodes on left: tcp, medial, anterior, posterior, lateral.4、前胸和肺ANTERIOR CHESTAND LUNGS·视、触胸部·双侧对称地叩诊肺尖·叩诊前胸和侧胸·双侧对称地听诊肺尖·听诊前、侧胸部·Inspect andpalpate configuration and symmet