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

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

Importance of Inquiry Gaining clinical information and collecting case history based on systemic inquiry Base of clinical practice *60~80% diagnosis could be induced from interview between patient and physician New form: consultation by phone, in internet

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

Definition Peptic Ulcer Disease is defined as an ulcer occurring in a region that touches gastric aci d(胃酸) and pepsin(胃蛋白酶) and usually refers to gastric ulcer(胃溃疡) or duodenal ulcer (十二指肠溃疡)

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

Woman complained of tightness in abdomen associated with belching wind which did not relieve feeling. Symptoms usually began between 5 and 6 p.m. lasing several hours. Relieved by White mixture. (D=Doctor, P=Patient)

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

IMPORTANTCE! Despite recent advances in neuroscience and the continuing development of sensitive diagnostic procedures, the essential skill required for the diagnosis remains the clinical neurologic examination Most neurologic diagnosis can be made on the basis of the history alone

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