Those years when I hung up and upgraded in the hospital

Chapter 180 High-end physical examination (please subscribe)

"Teacher, what is this?" Although Fang Yun didn't know where he was taken, he also knew that this might be a place where he, the attending physician, would not normally come.

"It doesn't matter. Don't worry. This is usually the examination room for the associate high school examination. However, we think your current ability is almost up to standard. The results of the examination here will be more accurate."

"I see that it has been many years since you have been to the intermediate level. In the examination room here, there are generally few people coming to take examinations, so you have nothing to do." One of them, bald, looked at Fang Yun with a smile and said.

Associate college entrance examination room.

It's no wonder that I have never seen it before.

There are three models inside, and I don’t know what the specific assessment content is.

However, the old man had no idea of ​​​​explaining, and just said: "For these models, you have done a physical examination based on your understanding, and then input the results of the physical examination into the three machines over there in the form of text. page, and we will manually evaluate the score in the end.”

"There will be no waste of time, and the assessment will be faster."

"The storage table next to you has all the tools you need for a physical examination." The bald old man pointed at Fang Yun.

Fang Yun hurriedly leaned over, complaining in his heart, can you save some time? Wasting other people's time is making money and killing people.

However, it seems that there is a small part of you that wants to plot against me, so that’s okay.

Fang Yun is not a pure idiot, how could he not see that if he comes to the Hubei Medical Association, he may meet someone to support him.

Speaking of these old men and women, just by looking at their temperament, you can tell that they were formerly rich. It is estimated that just one of them may be the leader of a certain sub-specialty in Hubei Province, or at least the chairman of the branch group of the Medical Association. Or the team leader’s.

Fang Yun is very serious and meticulous.

Physical examination generally focuses on visual touch, percussion and listening.

However, in orthopedics, it is visual touch volume and some specialist physical examinations, and the order will be different.

This is the basis, but obviously, it is impossible to achieve the content of your own assessment with only these foundations.

Fang Yun feels that the three diagnostic operating points of percussion, palpation, and auscultation are greater than visual examination, but visual examination cannot be ignored.

On the surface, these three models appear to be the neck, chest, and abdomen.

If there are no limbs, then the order of physical examination and touch volume of the orthopedic specialist can be ignored.

The key contents of the inspection are inspection, percussion, palpation and auscultation.

If you want to start specifically, you still have to listen step by step according to the order.

Inspection.

The neck is symmetrical, and there are no deviations, scars, pigmentation, etc., and no skin bulges, etc., so there should be no pits that are most easily visible during inspection.

Then comes palpation.

Fang Yun rubbed his hands, disinfected them with alcohol, and then began to explore the fingertips of his right hand.

The content of palpation mainly depends on whether the skin and subcutaneous tissue are soft to the touch of normal skin. If not, there may be nodules, and even turbulent tremors in the narrowed parts of the blood vessels can be touched.

As soon as Fang Yun put his hand up, he discovered that the neck, which looked very normal, actually had blood vessels flowing, and the temperature was equal to normal body temperature.

At this moment, Fang Yun quickly stopped.

As long as you can feel the blood vessels, the heart rate must be one of the things you want to palpate. Fang Yun cannot forget this detail.

Counting the time silently in his mouth, he was calculating the heart rate data in his mind.

"1...2...3...4..."

Fifteen seconds later, Fang Yun frowned.

30 beats, the heart rate is about 120+ per minute, the heart rate is irregular, it seems that there is irregularity... but which category it belongs to, and whether it is considered a typical atrioventricular block.

It's hard to say. It cannot be confirmed through physical examination. It can only be suspected through subtle touch. To diagnose arrhythmia, it is best to use electrocardiogram or cardiogram. The diagnosis is confirmed by physical examination. It is all nonsense, but it can be suspected.

This is Fang Yun's first physical examination sequence. In fact, the physical examination has not officially started yet. The physical examination of the neck starts with the lymph node examination.

The model just has the lower edge of the auricle, and Fang Yun starts from here.

Fortunately, this patient's cervical lymph node area is not swollen, so he should not be a tumor patient.

Immediately afterwards, Fang Yun began to palpate his thyroid gland again. Since he was lying down, it was naturally difficult to use the sitting method for physical examination.

When palpating the thyroid gland again, Fang Yun laughed.

He may have understood what this physical examination meant.

Or maybe it was a mistake that caused Fang Yun to touch the patient's heart rate in advance. Therefore, this patient should be a hyperthyroid patient, because his thyroid gland had diffuse enlargement, which was very obvious through palpation.

But the problem is that its neck is not obvious, so you need to carefully figure it out...

Then came the auscultation session.

When Fang Yun placed the stethoscope on the bilateral carotid arteries and subclavian arteries to listen to the murmur, he discovered a second abnormal point. Good guy, the pulse rates of the bilateral supraclavicular arteries are not consistent yet——

However, inconsistent pulse rates may not necessarily be focal, but they need to be reflected...

Similar pits appeared more than once during the assessment process.

During the subsequent assessment process, Fang Yun fumbled around and found some messy pitfalls during the abdominal and chest examinations.

The most typical one is that there is a piece of bone under the skin of the patient's abdomen, which is obviously orthotopic ossification.

After touching this bone, Fang Yun found a heterotopic ossified bone in the deltoid muscle at the back of the neck.

There are really many hidden pitfalls in the details of this physical examination.

It took Fang Yun more than 20 minutes to finally complete the physical examination of the three models. He then copied the contents of his physical examination to three different pages on the computer, typed them, and reviewed them carefully. After another four or five minutes, no flaws were found.

Then click submit.

The submission process took another 10 minutes or so before I got a reply.

There is no accuracy rate, but a score.

Three 80 points.

Fang Yun was puzzled after reading this. Generally speaking, for the assessment of basic medical skills, twenty points are added to each level. Even if it is level 4, it should be 60 points, not [-] points?
Can?
All of a sudden, the three old men were all laughing so hard.

He quickly stepped forward and said, "Dr. Fang, it's not bad. He was able to get such high evaluations from the elderly people in the internal medicine department. Not bad, not bad, not bad."

"It's getting late now. How about we go to the work cafeteria to have something to eat before taking the assessment?" It seemed that it was already lunch time.

Fang Yun wanted to say, what the hell, my girlfriend is still waiting for me outside.

But now, the future is the most important thing, so Fang Yun agreed first.

But he still said: "Teacher, I have something to do in the afternoon and need to go to my girlfriend's house, so can we take the assessment in advance at noon?"

If it weren't for these old men who had to make such a show, I would have almost finished all the assessments.

"Oh, want to see my father-in-law? Okay, it doesn't matter, it won't take long."

"Let's go, let's eat first."

(End of this chapter)