(7)淋巴結(jié)[Lymph nodes]
•觸診耳前淋巴結(jié):雙側(cè)耳前區(qū)
•觸診耳后淋巴結(jié):雙側(cè)耳后區(qū)
•觸診枕后淋巴結(jié):枕外隆凸下方
•觸診下頜下淋巴結(jié):屈曲手指于下頜骨內(nèi)側(cè)觸診
•觸診頦下淋巴結(jié):屈曲手指于頦下中線處觸診
•觸診頸前淋巴結(jié)淺組:位于乳突下,胸鎖乳肌前緣淺表處
•觸診頸后淋巴結(jié):位于胸鎖乳突肌后緣淺表處
•觸診鎖骨上淋巴結(jié):屈曲手指在鎖骨與胸鎖乳突肌之間的交角處觸診
•Palpate preauricular nodes (front of ears)
•Palpate post-auricular nodes (back of ears)
•Palpate occipital nodes (base of skull)
•Palpate submaxillary nodes (by bending finger under patient`s jaw)
•Palpate submental nodes (by bending finger under patient`s chin)
• Palpate anterior cervical nodes (superficial group under mastoid and the front of sternomastoid muscle)
•Palpate posterior cervical nodes (behind sternomastoid muscle)
•Palpate supraclavicular nodes (by bending finger above patient`s collarbone)
(8)甲狀腺[Thyroid gland]
•用雙指觸摸甲狀軟骨,檢查其移動(dòng)度及有無(wú)疼痛
•用雙手從患者前面或后面在正確部位觸診甲狀腺
•觸摸甲狀腺狹部、配合吞咽動(dòng)作
•觸摸甲狀腺側(cè)葉、配合吞咽動(dòng)作
•Palpate and/or move thyroid cartilage with two fingers checking for malformation and movability
•Palpate thyroid in correct anatomical location in front of or behind the patient with both hands
•Palpate isthmus of thyroid with and without swallowing
•Palpate thyroid gland(lobes) with and without swallowing
(9)頸動(dòng)脈、氣管[Carotid Artery and Trachea]
•觸診頸動(dòng)脈
•檢查氣管位置
•Gently palpate carotid artery(bilaterally)
•Palpate the position of trachea
(10)頸椎運(yùn)動(dòng)[Movement of Cervical Spine]
•屈曲
•后伸
•側(cè)彎(耳—肩運(yùn)動(dòng))
•旋轉(zhuǎn)(頦—肩運(yùn)動(dòng))
•囑受檢者對(duì)抗阻力作頭部旋轉(zhuǎn)或聳肩以檢查第Ⅺ對(duì)顱神經(jīng)功能
•Flexion (actively, if possible; if abnormal, do passively)
•Extension (actively, if possible; if abnormal, do passively)
•Lateral bending [ear-to-shoulder]; (actively, if possible; if abnormal, do passively)
•Rotation (chin-to-shoulder), (actively, if possible; if abnormal, do passively)
•Test rotation of patient`s head against resistance or check resistance of shrugged shoulders (cr n XI)
3、上肢[UPPER LIMBS]
•正確暴露上肢
•Expose upper limbs
(1)手[Hands]
•觀察手掌、手背,觸診雙手各關(guān)節(jié)
•檢查雙手及指甲,有無(wú)紫紺和杵狀指
•伸展手指
•彎曲近指間和遠(yuǎn)指間關(guān)節(jié)呈爪狀
•握拳醫(yī)學(xué) 全在.線提供
•拇指對(duì)掌運(yùn)動(dòng)
•檢查遠(yuǎn)端肌力
•Inspect dorsa and palms and palpate all joints of hand
•Check fingernails for clubbing or cyanosis
•Ask patient to extend fingers
•Ask patient to make a claw
•Ask patient to make a fist
•Check patient`s ability to perform thumb opposition
•Check for distal muscle strength
(2)腕[Wrist]
•觸診雙手腕有無(wú)腫塊、水腫、畸形和壓痛
•背伸
•掌曲
•Observe and palpate wrist (for lumps, swelling, deformities, and tenderness)
•Extension of wrist (bend backward)
•Flexion of wrist (bend forward)
(3)肘[Elbow]
•觸診鷹嘴和肱骨髁狀突
•觸診滑車上淋巴結(jié)
•屈肘
•檢查上臂肌力
•伸肘
•旋前和旋后
•Palpate olecranon process and epicondyles
•Palpate epitrochlear lymph nodes
•Flexion
•Check for upper arm muscle strength
•Extension
•Pronation and supination (with elbows locked at patient`s side)