物诊3常见症状腹泻黄疸意识障碍.ppt

腹泻(Diarrhea)定义Definition分类Classify急性腹泻的病因Etiologyofacutediarrhea慢性腹泻的病因（1）Etiologyofchronicdiarrhea(1)慢性腹泻的病因（2）发病机制
Mechanism1分泌性腹泻1Secretorydiarrhea2渗出性腹泻3渗透性腹泻3Osmoticdiarrhea4动力性腹泻4Dynamicdiarrhea5吸收不良性腹泻5Malabsorptiondiarrhea临床表现Clinicalmanifestation临床表现临床表现伴随症状Accompaniedsymptom伴随症状问诊要点2021222324252627282930313233343536373839404142434445464748495051525354555657意识障碍Disturbanceofconsciousness定义Definition病因Etiology病因Etiology发生机制Consciousnessreferstoasetofneuralprocessesthatallowanindividualtoperceive,comprehend,andactontheinternalandexternalenvironments.Itconsistsoftwocomponents:awarenessandarousal.
Awarenessreferstothehigher-levelintegrationofmultiplesensoryinputsthatpermitmeaningfulunderstandingselfandenvironment,residinginthecerebralcortex.
Arousalreferstoan“on-offswitch”forthecorticalawarenesssystembyascendingreticularactivatingsystem(ARAS),residinginthebrainstem.
Anyinjuriesinvolvingbothbilateraldiffusecerebralcortexand/orbrainstemcancausedisturbanceofconsciousness.临床表现Clinicalmanifestation临床表现Clinicalmanifestation4昏迷coma：严重的意识障碍，意识持续的中断或完全丧失It’stheseriousdisturbancesofconsciousness,consciousnessretainsinterruptedorevenlosescompletely.
(1)轻度昏迷mildcoma：无自主活动，对声光刺激无反应，对疼痛刺激有痛苦表情或肢体退缩等防御性反应；生理反射可存在。It’snospontaneousactivity,noresponsetothesound-opticstimulation,havingthedefensiveresponses(painfulexpressionorwithdrawallimbs)totheachestimulation,thephysiologicalreflectionmayexist.
(2)中度昏迷moderatecoma：对周围事物及各种刺激均无反应，对于剧烈刺激或可出现防御性反射，各种生理反射减弱或迟钝，眼球无转动。Ithasnoresponsetothesurroundingsandallkindsofstimulation,ormaypresentthedefensivereflexregardingthefiercestimulation,eachphysiologicalreflectionisweakenorslow,theeyeballdoesnothavetherotation.
(3)深度昏迷deepcoma：全身肌肉松弛，刺激无反应，深浅反射均消失Thewholebodymuscleisrelaxation,noresponsetoanystimulation,norshallowreflectionanddeepreflection.谵妄delirium:意识模糊,定向力丧失,感觉错乱,躁动不安,言语杂乱aspeicaldisturbanceofconsciousnesswithincreasedexcitability.Forthepatient,awarenessisfuzzy,theorientationabilityloses,feelingisconfused,moveisrestless,spokenwordsi