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

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

Mechanism Blood velocity1 Blood vascosity Valve: narrowed or incompetent; organic or relative Abnormal connection Vibration of loose structure Diameter of vessel ^or

Definition: Palpitation may be defined as an awareness of the beating of the heart, an awareness most commonly brought about by change in the heart's rhythm or rate or by an augmentation of its contractility

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

Diarrhea Definition increase in the frequency of bowel movements increase in stool liquidity in some cases increase in daily stool weight

Definition Clinically apparent increase in the interstitial (间质) fluid volume Weight gain precedes overt edema Weight loss in edematous patients before “dry weight Massive edema is called Anasarca

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

In the present era of technological advances, particularly in the various imaging modalities, there is a growing conception among practicing physicians in cardiovascular medicine that bedside physical examination is unnecessary and does not provide useful information

Coughing is an essential defense mechanism that it prevents the airways from the foreign substance and clear the excretion of respiratory tract. Coughing is a reflex. permanent and frequent coughing indicates an abnormality