A. GENERAL EXAMINATION/VITAL SIGNS
（一般检查）
1. Introduce yourlf to patient, usually last name and title and have a little conversation to relax the patient and to judge mental state.
只是一个普通人
2. Wash hands before starting examination
Preferably, this should be done in view of the patient.
3. Patient is ated in a chair
4. Palpate radial (wrist) Puls for at least 30 conds and record
五好文明家庭The examiner places the pad of his index, middle and ring fingers over the radial artery. If properly done, the examiner should be able to feel the artery pulsating under the examiner’s fingertips. The radial pul may be measured for 30 conds, then the pul perminute can be found by multiplying by two. Attention should also be paid to the rhythm. 敬佩的近义词是什么
The examiner should not u his thumb to palpate any pul.
5. Palpate both radial (wrist) puls simultaneously for symmetry for at least 30 conds
6. Measure respiratory rate for 30 conds and record
The examiner unobtrusively measures patient’s respiratory rate. This may be accomplished by the examiner leaving his hands on the patient’s wrists for another 30 conds after measuring the radial puls so the patient does not realize that the examiner is watching him breathe. The depth and rhythm should also be noticed. The respiratory rate can also be measured during the back exam.
鸡和什么属相相冲7. Measure blood pressure on right arm
Blood pressure may be measured with the patient in a sitting or lying position. In each position, the artery in which the blood pressure is to be measured should be at the level of the heart (at the level of the fourth intercostal space in the sitting position; at the level o
f the middle axillary line in the lying position). The patient’s arm should be resting on a smooth table or supported by the examiner, and slightly flexed at the elbow.
8. Place cuff in correct location 2-3 cm above the atecubital crea
The examiner cures the blood pressure cuff snugly over the upper, arm so that one finger can be admitted under the cuff. The cuff should be positioned 2～3 cm above the antecubital crea or elbow joint. Put the middle of the cuff over the brachial artery.
360背景9. Palpate brachial artery
The examiner can locate the brachial artery which lies slightly medial to the tendon of the biceps muscle in the antecubital fossa. The mercury column on the manometer dial should be properly calibrated with the pointer at “0” before the cuff is inflated (i. e. , all the air should be presd out of the cuff before it is inflated).
The stethoscope is placed firmly over the brachial artery. The examiners inflates the cuff slowly but steadily. Until the brachial artery pul disappears. Then he continues to inflate
cuff 2.6～4.0kPa (20～30 mmHg higher, generally to about 21.3kPa (160mmHg)).
10. Measure blood pressure over brachial artery twice and record the lower reading
Deflate the cuff slowly at the rate of about 0.26kPa (2mmHg) Per cond. The number where the examiner hears the first pul sound is the systolic pressure. The pul sound will waken and then disappear. The number where the pul sound disappears is the diastolic pressure. If the difference between weakening of the sound and its disappearance is 2.6kPa (20mmHg) or greater, the examiner should record the two numbers. The cuff must be completely emptied with the pointer at “0” before it is reinflated. The same procedure may be followed for a cond measurement of B. P. in the same or opposite arm. The lower pressure is recorded as the patient’s blood pressure. After finishing the measurement, the examiner deflates and rolls up the cuff, leans the manometer over a little so the mercury column disappears, clos the mercury column switch, puts the balloon in order, and clos the manometer.语文阅读方法
B. HEAD AND NECK
自我描述怎么写
（头颈部）
Skull
11. Palpate and obrve scalp (parting hair, and obrving hair density, color, lustre and distribution)
The examiner palpates the entire skull using both hands and simultaneously examines symmetrical areas. The examiner parts the hair to obrve the scalp, noting any scaliness, deformities, lumps, tenderness, lesions or scars. The examiner also obrves the density, color, lustre and distribution of the hair.
Eyes
12. Visual screening:（omitted）
通俗唱法教学13.Obrve cornea, sclera, conjunctiva and lacrimal puncta by gently moving lower eyelids down.
Cornea Examination-With oblique lighting inspect the cornea for opacities, foreign bodies etc. Inspect lower palpebral, fornical, bulbar conjunctiva and sclera. Ask the patient to look up as you depress lower eyelid with your thumb exposing lower palpebral, fornical, bulbar conjunctiva and sclera. Inspect the conjunctiva and sclera for color, and note the vascular pattern against the white scleral background.
