诊断学教案首页.docVIP

教 案 首 页 第 4 次课， 授课时间 2007年 4月10 日， 教案时间2007年 4 月 1 日 课程名称 诊断学 年级 2004级 （七年制） 专业、层次 临床医疗 授课方式 大班课 学时 1.5 教员 郑青 专业技术职务 副教授 电话 授课题目（章、节） 腹痛 基本教材 参考书目 1、 陈文彬，王友赤主编，诊断学，第五版，北京：人民卫生出版社. 2、 欧阳钦、吕卓人主编，临床诊断学，第一版，北京：人民卫生出版社. 3、 王鸿利主编，实验诊断学，第一版，北京：人民卫生出版社. 教学目的与要求 掌握腹痛的常见病因和分类 掌握腹痛的发生机制 掌握腹痛的临床表现及伴随症状 掌握临床上腹痛的问诊要点 大体内容与时间安排，教学方法 内容：1、复习疼痛的生理学基础要点：定义、发生机制、传导途径。 2、腹痛的常见病因。（1）急性腹痛…… （2）慢性腹痛…… 3、腹痛的发生机制：内脏性腹痛、躯体性腹痛和牵涉痛的概念和特点 4、腹痛的临床表现。 5、腹痛的伴随症状和问诊要点(起病情况、性质、部位、程度、时间、伴随症状)。 教学时数：1.5学时 教学方法：多媒体幻灯 教学重点、难点： 腹痛的发生机制和病因 腹痛的临床表现及伴随症状 学员学习方法 大课授课 教 案 续 页 基 本 内 容 辅助手段 时间分配 Pain Definition Pain is universally understood as a signal of disease, and is one of the common symptoms for which the physician is consulted. It is an unpleasant sensation localized to a part of the body. It is often described in terms of a penetrating or tissue-destructive process (e.g., stabbing, burning, twisting, tearing, squeezing) and/or of a bodily or emotional reaction (e.g., terrifying, nauseating, sickening). Furthermore, any pain of moderate or higher intensity is accompanied by anxiety and urge to escape or terminate the feeling. These properties illustrate the duality of pain: It is both sensation and emotion. Proper evaluation of pain depends largely upon knowledge of the various qualities of pain, the significance of referred pain. Pathophysiology During injury of tissue, some irritating substances are liberated that stimulate nerve endings. Bradykinins, serotonin, acetylchonie, 5-hydroxytypamine, histamine, prostaglandins, and other similar polypeptides or acid metabolites cause pain by irritating the nerve endings, from which the sensation is sent through posterior root of spinal cord, mostly cross to other side, through spinothalamic tract, (lateral) medulla pons, and internal capsule, spread diffusely into parietal and frontal lobe. The pain sensation is in segmental distribution, as anterior part of head is through trigeminal, the thorax is through first to