1.Objectives of this lecture; 2.Definition of a sentence; 3.Types of sentences; 4.Sentence patterns; 5.Short and long sentences; 6.Loose and periodic sentences; 7.Ways to establish links between sentences; 8.Common sentence problems

It is well known that advances in scientific medicine have occasionally threatened to displace the history and physical examination in the evaluation of the patient. However, we usually discover that technologic advances serve to make the physical examination more rational and provide new understanding or objective documentation of long- appreciated physical finding

Referred pain Because of this convergence and the fact that the spinal neurons are most often activated by inputs from the skin, activity evoked in spinal neurons by input from deep structures is mislocalized by the patient to a place that is roughly coextensive with the region of skin innervated by

Definition Cyanosis refers to bluish(带蓝色的 带青色的) color of the skin and mucous membranes resulting from an increased quantity of reduced hemoglobin(亚铁血 红蛋白;还原血红蛋白),orof hemoglobin derivatives, in the small blood vessels of those areas. It is usually most marked in the lips, nail beds(甲床),ears, and malar (颧骨的;颊的) eminences

The writing of clinical record A patient's health record plays many important roles: It provides a view of the patient's health history/status It serves as the legal document describing the healthcare services provided to the patient It provides a method for clinical communication and care

Five Ways of GI Bleeding Hematemesis: vomitting of blood of altered blood coffee grounds) indicates bleeding proximal to ligament of Treitz Melena: Tarry stool. Altered (black) blood per rectum(>60ml) Hematochezia: Bright red or maroon rectal bleeding implies bleeding beyond

Physical examination It is the process of examining the patient's body to determine the presence or absence of physical problems The goal of the physical examination is to obtain valid information concerning the health of the patient The examiner must be able to identify, analyze

I. Auscultatory Valve Area 1. MV: apex, fifth left intercostal space, medial to the midclavicular line 2. PV: second left intercostal space 3. AV: second right intercostal space 4. AV,: left third intercostal space 5. TV: lower part of sternal ·6. Other part

Dyspnea is defined as an awareness of difficulty in breathing It is therefore a symptom, usually described by the patient as \shortness of breath,\whether the sensation is due to actual difficulty in breathing or is essentially an awareness of hyperventilation. If the symptom becomes striking, it always companies with dilatation of nares, cyanosis, use of accessory muscles of respiration and abnormalities of respiratory rate, depth or rhythm

Definition: Dyspnea is defined as an awareness of difficulty in breathing It is therefore a symptom, usually described by the patient as \short of breath,\ whether the sensation is due to actual difficulty in breathing or is essentially an awareness of hyperventilation. If the symptom becomes striking, it always companies with dilatation of nares, cyanosis, use of accessory muscles of respiration and abnormalities of respiratory rate, depth or rhythm