一般检查general examination一， 性别sex 男Male 女Female 二， 年龄 age三， 生命体征 ：vital age体温body temperature a,口测法oral measurementb,肛测法archos measurement c,腋测法axil measurement呼吸respirations脉搏pulse血压 blood pressure 四，发育development 体型（Habitus）：无力型（asthenic type）、超力型（sthenic type）、正力型（orthosthenic type）五，营养state of nutrition: 良好well、中等moderatelty。肥胖（Obesity）、消瘦slake六，意识consciousness: 嗜睡drowsiness、意识模糊clouding of consciousness 昏睡hyponody、昏迷coma（浅，中，深度），谵妄acute confusional state七，语调tone 语态voice八，面容facial features 急性病容face of acute ill，慢性病容chronic disease face，贫血面容anemic face，甲亢面容hyperthyreosis feature，粘液性水肿面容myxedema face, 二尖瓣面容mitral facies，满月脸面容moon face，肢端肥大症面容acromegaly facies，伤寒面容typhoid face，病危面容,Hippocrates face表情expression 正常normal，淡漠indifference烦躁不安dysphoria，痛苦suffering 忧郁gloom九，体位position a,自主体位active position b,被动体位passive position 极度意识衰竭和丧失culmination consciousness failure and loss c,强迫体位compulsive position强迫坐位（端坐呼吸）compulsive sitting position (orthopnea)十，姿势posture十一，步态 gaita a,蹒跚步态 waddling gait b,醉酒步态drinken man gait c,共济失调步态 ataxic gait d,慌张步态 festinating gait e,跨閱步态 steppage gait f,剪刀步态 scissor gait g,间歇性跛行 intermittent gait十二，皮肤skin1， 颜色skin color a,苍白 pallor 贫血anaemia b,发红 redness 发热fever c,发绀 cyanosis缺氧hypoxia d,黄染 stained yellow 肝病liver disease e,色素沉着 pigmentation肝病liver disease f,色素脱失 coloring material loss 白化症 albinismus2，湿度moisture 干燥dry 脱水dewat 湿润moist 休克shock 3，弹性elasticity4，皮疹skin eruption a 斑疹 maculate b 玫瑰疹roseola c 丘疹papules ; d 斑丘疹maculopapulate , e 荨麻疹urticaria5，脱屑scales 6赘生物vegetation 7，皮下出血subcutaneous hemorrhage a 瘀点petechia b瘀斑ecchymosis c 紫癜purpura d血肿hematome8，蜘蛛痣 spider angioma 肝掌liver palms 9，水肿edema 10，皮下结节subcutaneous nodules 11，瘢痕scar 12，毛发hair 13，淋巴lymph 体检（胸腹部）Physical examination(chest and belly)1、肋骨和软组织ribs and soft tissure胸骨上切迹suprasternal notch浮肋free ribs胸壁chest wall扁平（桶状、佝偻、漏头、鸡）胸flat (barrel,rachitic, funnel, pigeon) chest皮下气肿subcutaneous emphysema捻发音Crepitus软组织损伤soft tissue injury肋骨畸形abnormality of the ribs(rib deformity, costal anomaly)肋软骨畸形costochondral deformity肋软骨增生costal cartilage hyperplasia肋下切口subcostal incision肋间隙宽（窄）wide (narrow) intercostal space2、乳房breast3、肺lung呼吸缓慢（急促）bradypnea (tachypnea)呼吸浅慢（深快）hypopnea (hyperpnea)呼吸不规则irregular respiration点头呼吸nodding breathing端坐呼吸orthopnea三凹征retraction sign of three fossae叹息样呼吸sighing respiration浅快shallow and rapid呼（吸）气性呼吸困难expiratory (inspiratory) dyspnea呼吸道烧伤（塌陷）burn (collapse) of respiratory tract(airway)呼吸道阻塞respiratory tract obstruction呼吸均匀（呼吸加深或加快）eupnea(exaggerated or acclerated respiratory)呼吸停止apnea呼吸费力respiration is labored语音（触觉）震颤vocal (tactile) fremitus语颤相等（减弱、增强）vocal fremitus is equal(diminished, accentuated)间接（直接）叩诊mediate (immediate) percussion 浊（实、鼓、清、过清、金属）音dullness (flatness, tympany, vesicular resonance, hyperresonance, bell)移动范围range of movement 呼吸音消失（减弱，增强）absence (diminution, exaggeration) of breath sound呼吸音粗（清）sound of breath(SOB) is rough (clear)支气管（支气管肺泡，肺泡）音bronchophony (bronchovesicular sound, vesicular sound)管状呼吸音tubular breath sound捻发音crepitant rales爆裂音crackles干（湿）罗音dry (moist) rales细（中等、粗）罗音fine (medium, coarse) rales呼（吸）气未罗音end-inspiratory (expiratory) rales胸膜摩擦音pleural friction rub呼（吸）气延长prolonged inspiratory (expiratory)高（低）调鼾音sibilant (sonorous) rhonchi (sonorous rales)哨笛音sibilant rales哮鸣音wheezing小（中、大）水泡音small(middle, big) bubbles支气管语音bronchophony耳语音whispered羊鸣音egophony高（低）音调high (low)-pitched两肺部（右背部）over both lung fields (right back)两（左）肺底over the both (left) lower lung整个肺野the whole lung field左（右）上（下）肺the left (right) upper (lower) lung肺尖（底）apex (base) of lung4、心脏Heart心房atrium cordis 心室cardiac ventricle 室间隔interventricular septum 房间隔atrial septum 主动脉瓣aortic valve 肺动脉瓣pulmonary valve 二尖瓣atrioventricular valve,left 三尖瓣atrioventricular valve,right;用手掌（指尖）触诊心尖搏动palpate apical area with palm numbness (fingertips)心前区隆起（凹陷）precordial bulge (retraction)搏动弥漫（局限）diffuse (local) pulsation负性搏动inward inpulse心尖搏动apex beat (apical impulse)剑突下搏动xiphoideusal pulsaton抬举性心尖搏动heaving apex impulse心尖搏动最强点point of maximal impulse (PMI)锁骨中线mid-calvicular line (MCL)肋间intercostal space (ICS)收缩（舒张）期震颤systolic (diastolic) thrill心浊音界the border of cardiac dullnes心绝对（相对）浊音界扩大（缩小）enlarged (diminished) absolute (relative) cardiac dullness叩诊心脏大小正常heart size is normal on (to) percussion心脏向左（右）扩大cardiac dilation (enlargement) to the left (right)第1（2、3、4）心音S1(S2,S3,S4)第1心音增强（减弱，听不清）first heart sound is exaggerate (decreased, muffled)生（病）理性杂音（分裂）physiologic (pathological) murmur (splitting)生理性（固定、反常、逆）分裂physiologic (fixed, par