X-ray imaging related characteristics

low density

high density

medium density

The human eye can distinguish 16 gray levels

window width

window level

Currently there are only 1H protons

T1 weighted image

T2 weighted image

proton density weighted image

Permanent, normally conducting, superconducting magnets

Low field＜0.5T, midfield 0.5~1.5T, high field＞1.5T

MR cholangiopancreatography, MR urography, MR myelography, MR inner ear imaging

Diffusion imaging, perfusion imaging, diffusion tensor imaging, brain functional imaging

Reflects both the anatomy and the physiology and function of organs

Non-invasive visualization of physiological and pathological biochemical processes in vivo

Bones, calcified tissue, stones, air-containing lungs

Liver, spleen and pancreas parenchyma

Fat

liquid

Male 120~160g/L

Female 110~150g/L

Newborn 170~200g/L

Male (4.0~5.5)×10 to the twelfth power/L

Female (3.5~5.0)

Newborn (6.0~7.0)

Manual workers, cold climate and plateau residents may increase

Relatively reduced during pregnancy, physiological anemia

Adult (4~10)×10 to the ninth power/L

Children (5~12)

Newborn (15~20)

increase

reduce

Parasitic diseases

viral infectivity

Bacterial endocarditis, typhoid fever, active tuberculosis

(100~300)×10 to the ninth power/L

True or relative erythrocytosis, DIC consumption hypocoagulability phase, secondary fibrinolysis phase

endogenous

Prolonged: Seen in deficiencies of factors XII, XI, IX, VIII, X, and V

exogenous

Prolonged: Congenital deficiency of factors II, V, VII, and X

24h urine output

hematuria

specific gravity of urine

Urinary protein

proteinuria

urine sugar

different epithelial cells

tube type

Enteritis in children

bacillary dysentery

Upper gastrointestinal bleeding 50~70ml

cholera

bile duct obstruction

Normal pressure 0.78~1.76kPa

normal cerebrospinal fluid

Subarachnoid hemorrhage or intraventricular hemorrhage

Cerebrospinal fluid contains denatured hemoglobin, cerebroprotein or abnormally increased protein content

purulent meningitis

Meningitis caused by pseudomonas aeruginosa

meningeal melanoma

Glucose in cerebrospinal fluid comes from blood sugar 60%

Ideally, perform a lumbar puncture after fasting for 4 hours.

Most enzymes cannot pass the blood-brain barrier

Normally no red blood cells and only a few white blood cells

Alanine aminotransferase (ALT)

Aspartate alanine aminotransferase (AST)

Creatinine (Cr)

Creatine kinase isoenzyme CK-MB

Creatine kinase CK

Lipase

magnesium

phosphorus

calcium

Potassium

chlorine

sodium

Albumin/globulin (A/G) ratio

blood glucose

Glucose tolerance test normal

blood pH

Oxygen partial pressure PO2

Actual bicarbonate AB and standard bicarbonate SB

Alpha-fetoprotein AFP

carcinoembryonic antigen CEA

morphine

codeine

Fentanyl

Aspirin (acetylsalicylic acid)

Acetaminophen (paracetamol)

Phenytoin

diazepam

ethosuximide

carbamazepine

Imipramine

Fluoxetine

Mirtazapine

Benzodiazepines

barbiturates

Levodopa

The first choice for hypertension accompanied by heart failure, diabetes, or kidney disease

propranolol

analol

carvedilol

Acts on the medullary and cortical parts of the thick ascending branch of the medullary loop

proximal distal convoluted tubule

Distal convoluted tubule and collecting duct

Dehydration medicine

Hypertensive patients with angina pectoris

Hypertension, various types of angina pectoris and chronic cardiac insufficiency

Hypertension combined with cerebrovascular disease

Non-specific infection (purulent infection or general infection)

specific infection

Infection process

clinical manifestations

Superficial infection

deep infection

Staphylococcus aureus

Acute purulent infection of a hair follicle and its associated sebaceous gland

Many common in patients with diabetes

If it occurs in the dangerous triangle of the face, the infection can easily lead to suppurative cavernous sinusitis.

Staphylococcus aureus

Acute purulent infection of multiple adjacent hair follicles and their associated sebaceous or sweat glands

Purple-red infiltration area with unclear boundaries and a honeycomb shape after ulceration

Diabetics are prone to

Neck carbuncle "opposite mouth sore"

Lip abscesses should not be treated surgically

The amount of early ultraviolet intense erythema; Use weak erythema dose or sub-erythema dose to promote granulation growth Absorb infrared rays during repair period

reticulolymphangitis

tubular lymphangitis

Staphylococcus aureus

Staphylococcus aureus

If pus has accumulated under the nail bed, the nail must be pulled out

Hemolytic Streptococcus

No clear boundary with normal tissue

beta-hemolytic streptococci

Most commonly occurs on lower limbs and face

clear boundaries

staphylococcus

Early UV erythema amount

Metastatic right lower abdominal pain, gastrointestinal reactions such as nausea and vomiting, general fatigue, limb weakness and fever

Right lower quadrant tenderness, abdominal muscle tension, rebound tenderness

Appendicitis that has been on for several days and is complicated by inflammatory masses is temporarily treated conservatively

non-surgical treatment

Sluggish venous blood flow, venous wall damage, and blood hypercoagulability (an indispensable one)

Pulmonary embolism caused by detachment (cough, chest pain, difficulty breathing, severe shock)

Postoperative deep vein thrombosis

Ultrashort wave has no heat; Wax therapy: suitable for patients with acute peripheral lung disease

Mainly blood vessels of lower limbs

More common in male smokers aged 20 to 40 years old

More than 70% Gram-negative bacilli

Ascending infections are most common

acute cystitis

High fever, frequent urination, urgency, dysuria, urethra, perineum and suprapubic pain

Digital examination, do not perform prostate massage

Microscopic examination shows more than 10 white blood cells or pus cells per high-power lens

Prostatic fluid examination is the simplest and most effective

regular massage

First degree burns

II degree burns

Third degree burns

Palm 1%

Perineal 1%

Top 9%

9% on one limb

18% of one lower limb

Front of torso 18%

18% behind torso

Exudation of body fluids (shock phase)

acute infection stage

Wound repair period

functional recovery period

color

thickness

Elastic texture

area

Continuously apply capillary pressure 3.33kPa (25mmHg)

Wounds that heal within 10 days of burn injury

Wounds that heal in 11 to 20 days

Wounds more than 21 days old

More than 23 hours a day for 12 to 18 months

If the wound has more necrotic tissue or purulent secretions, use moderate or strong erythema of ultraviolet light.

Exposure of fresh granulation tissue reduced to threshold erythema volume

audio electrotherapy

wax treatment

Upper arm burns

dorsum of elbow

hand

Pain, swelling, bruising, dysfunction

Fainting, shock, fever, blood and metabolic changes, infection

The heel cannot touch the ground, the skin is flushed or has ecchymosis, the skin temperature is elevated, and there is local tenderness.

The pain is obvious at the beginning of activity, lessens after activity, and worsens after rest; Heel-raising and back-pedaling movements are limited, induration can be palpable on both sides of the Achilles tendon, and the gait is lame.

More common in bone and joint damage

Commonly seen in nerve paralysis

Snap or trigger finger

Pain at the radial styloid process in the ulnar deviation of the wrist when making a fist, positive Finkelstein test

Positive lateral pressure test

Deformity, abnormal movement, bone friction or bone friction feeling

Pain and tenderness, local swelling and ecchymosis, functional impairment

Shock, infection, damage to internal organs and important arteries, peripheral nerve damage, spinal cord damage

Pressure ulcers, joint stiffness, ischemic muscle contracture, ischemic osteonecrosis, deep vein thrombosis of the lower limbs, accumulation pneumonia, myositis ossificans, traumatic arthritis

granulation repair period

primitive callus stage

mature bone plate stage

shaping period

X-ray fracture line blurred

After the external fixation is released, the upper limb can be lifted forward up to 1kg for 1 minute; The lower limbs can walk continuously on level ground for 3 minutes without crutches, no less than 30 steps

The fracture site does not deform for two consecutive weeks

Rotation and separation of the fracture site must be completely corrected

Children's lower limb fracture shortens within 2cm

Adult lower limb fractures should be shortened and displaced by no more than 1cm, and the angle to the side should be perpendicular to the direction of joint movement and must be completely reduced.

Double fractures of the forearm require good alignment and alignment

A transverse fracture of a long bone corresponds to at least 1/3

Metaphyseal fractures are laterally displaced and aligned by at least 3/4

Functional position of shoulder joint

Functional position of elbow joint

ankle joint

knee joint

If the injury is not reduced within 3 weeks, surgical reduction is required.

Anterior dislocation 95%

Square shoulder deformity, Dugas positive (the elbow joint cannot be close to the chest wall, and the palm of the hand cannot touch the opposite shoulder when close)

Rotator cuff injuries are common complications

After reduction, the upper arm is fixed in a neutral position with slight extension and rotation for 3 weeks. After removal, shoulder joint movement is started.

When the elbow is straight, the olecranon is higher than the medial and lateral condyles, and it is fixed for 3 weeks.

Lower limbs exhibit flexion, adduction, internal rotation, and shortening deformities

The buttocks touch the bulging femoral head

After reduction, use skin traction to keep the affected limb straight and abducted for 3 weeks.

Sensory impairment on the radial side of the dorsum of the hand and the proximal 3 and a half fingers on the radial side; Loss of thumb and finger extension function, wrist droop

Claw hands, Froment's sign, interosseous and adductor muscle paralysis; Sensory disorder on the dorsal side of the little finger

Dysfunction of thumb to palm and thumb and index finger when pinching objects, ape hand; Palmar sensory impairment

If the trauma lasts for more than 12 hours or the repair technique is difficult, only debridement and wound closure will be performed; Tendon and nerve injuries can be repaired in the second phase after the primary wound has healed.

Surgical suturing using "Z" morphology

Immobilization for 2 weeks after vascular anastomosis; immobilization for 3 to 4 weeks after tendon suture; immobilization for 4 to 6 weeks after nerve repair; 3 weeks for joint dislocation; 4 to 6 weeks for fracture

The sutures are removed 10 to 14 days after the operation, and the pedicle is removed 3 to 4 weeks after the pedicle flap transplantation.

Scaphoid fractures are fixed for 4 to 8 weeks

Flexor tendon repair

Extensor tendon repair

Flexor tendon release surgery

Jebson Hand Function Test, Minnesota Manipulative Registration Test MRMT, Purdue Pegboard Test

Most commonly, plain X-ray films may show straightening of the cervical spine curvature, but no narrowing of the intervertebral space.

Most commonly occur at C5~6 and C6~7

Cervical spine compression test and spinal nerve root traction test were positive

pyramidal tract sign

Weakening of muscle strength in both lower limbs

Positive Hoffmann reflex

Migraine, deafness and tinnitus

Morning stiffness, symmetrical pain, joint swelling, swan-neck deformity

Morning joint stiffness for at least 1 hour, duration of disease 6 weeks; Have had swelling in 3 or more joints for 6 weeks; Swelling of the wrist, metacarpophalangeal joints, and proximal interphalangeal joints for 6 weeks; Symmetrical joint swelling for 6 weeks; There are subcutaneous nodules; Changes in X-rays; Rheumatoid factor positive

Posture training and corrective gymnastics below 10°

Add lateral electrical stimulation at 10~20°

Wear orthotics at 20~40°

40~45° surgical correction and then wearing orthotics

Dual energy X-ray absorption

single photon absorption

Ultrasonic measurement

Quantitative CT

Cerebral thrombosis, cerebral embolism, lacunar infarction

Pathological staging

Trilateral sign, dominant hemisphere is affected, often resulting in aphasia

Hours after infarction, T1 hypointensity and T2 hyperintensity

Lumbar puncture examination is only performed when CT examination is not possible and it is difficult to distinguish between cerebral infarction and cerebral hemorrhage clinically.

Disability rate 50%

The most common cause is hypertension combined with arteriosclerosis

The most common bleeding site in hypertensive cerebral hemorrhage

CT first choice

Common causes: miliary aneurysm

Sudden, unusually severe, generalized headache

CT first choice

hypertension

Those with neurological deficit lasting less than 24 hours

Internal carotid artery TIA

Vertebrobasilar TIA

One of the most common causes of death is lung infection

Headache, vomiting, and optic disc edema

C5~7, T4~7, T10~L2

The earliest histological change is punctate hemorrhage in the central gray matter

6 hours after injury is the best time for treatment

cervical spinal cord injury

Spinal shock, motor and sensory dysfunction, defecation disorders, spasticity

central bundle

cut in half

Toe-in

rear toe

conus medullaris

ponytail

Spinal cord concussion

Therapeutic walking T6~T12

Family walking L1~L3

Community walking L4~S1

Basically able to take care of oneself

C7 and below are completely able to take care of themselves

C4 is completely unable to take care of itself

In the early stage of nerve regeneration, percussion damages the distal end of the nerve, and an abnormal sensation of numbness and pain may occur.

Ⅰ degree

Ⅱ degree

III degree

IV degree

Degree V

Most common

First symptoms

Reached peak in 2 weeks

It feels like a glove-sock-like distribution

The most reliable laboratory diagnostic method

Optic neuritis, acute myelitis

Spinal cord MRI abnormal lesions >3 vertebral segments; Brain MRI does not meet MS diagnostic criteria; Serum NOM-IgG positive

most common

Worst prognosis

resting tremor

slow movement

Muscle stiffness

Abnormal posture and gait

The drug of choice for early stage and mild disease

The most effective way to control PD

Basic daily movement movements

Actions around you

Apply action

Communication skills

Job ability

Role in family and unit

own body control ability

Social skills

Loss of consciousness, convulsions all over the body

The whole process takes 5~10 minutes

Grading

stable angina

unstable angina

Clinical treatment

acute myocardial infarctionAMI

old myocardial infarction

Clinical treatment

A

B

C

D

E

Phase I

Phase II

Phase III

Smoking, hyperlipidemia, diabetes, age >60, male or postmenopausal female, family history of premature cardiovascular disease (first-degree relatives onset age <50)

Level 1 mild

Level 2 Moderate

Level 3 severe

isolated systolic hypertension

low risk

moderate risk

Highly dangerous

Extremely high risk

Control blood pressure to at least <140/90

People with diabetes or chronic kidney disease should drop to below 130/80

Patients with stroke or elderly systolic hypertension generally have systolic blood pressure between 140 and 150 and diastolic blood pressure <90 but not less than 65.

beta blockers

calcium channel blockers

angiotensin-converting enzyme inhibitor

Most common

Coughing up pink frothy sputum during acute attack

Left ventricular ejection fraction LVEF ≤ 40% is systolic heart failure

Jugular venous distension, pitting edema of lower limbs, hepatomegaly

Level I

Level II

Level III

Level IV

<150m severe cardiac insufficiency

150~425m moderate cardiac insufficiency

426~550m Mild cardiac insufficiency

important reason

During an acute attack, wet and dry rales are heard on the back or at the base of both lungs, which decrease or disappear after coughing.

control infection

Antitussive and expectorant

Relieve asthma

Barrel-shaped chest, hypervoiceless lungs upon percussion

There are no changes in lung X-rays in the early stage, but later, increased and disordered lung markings, enlarged lung fields, and increased transparency can be seen.

Expiratory volume in the first second as a percentage of forced vital capacity (FEV1/FVC): a sensitive indicator for evaluating airflow limitation

Expiratory volume in first second as a percentage of predicted (FEV1% predicted): a good indicator of COPD severity

FEV1/FVC＜70 and FEV1＜80

FEV1/FVC＜70 and FEV1＞80

FEV1＜70, maximum ventilation volume＜80, residual volume＞40

Secretion once in the morning and once in the afternoon

Excessive phlegm 3 to 4 times a day

Drain one site for 5 to 10 minutes at a time. If there are multiple drainage sites, the total time will not exceed 30 to 45 minutes.

Mild

Moderate

Severe

Ketoacidosis and hyperglycemic hyperosmolar state

FPG≥126mg/dl（7mmol/L）

OGTT test 2-hour blood glucose ≥200mg/dl (11.1mmol/L)

Random blood sugar ≥200mg/dl (11.1mmol/L)

FPG＞300mg/dl（16.7mmol/L）

diabetic ketoacidosis

proliferative retinopathy

Kidney disease (Cr>1.768)

nonatrophic gastritis

atrophic gastritis

superficial gastritis

gastric ulcer

duodenal ulcer

diagnosis

Barium meal X-ray

1~5cm mild, 6~10cm moderate, 11cm severe

oliguric phase

polyuria period

Gold standard: pathological diagnosis of renal tissue biopsy

Escherichia coli is the most common

Ascending infection is the main route

diagnosis

Autism Behavior Checklist ABC

Childhood Autism Rating Scale CARS

Klinefelter's Autism Behavior Scale (CABS)

Applied behavior analysis therapy ABA

structured teaching

interpersonal training method

Sensory Integration Checklist

Raven test

Achenbach Child Behavior Scale

Gestational age <32 or >42 weeks, birth weight <2000g or >4000g

spastic quadriplegia

spastic diplegia

spastic hemiplegia

Not casually sporty

ataxic type

Horner syndrome

Common

Inner hand muscle paralysis, claw-like deformity, and Horner syndrome may occur

Pelvic girdle muscle weakness, low muscle tone, slow walking, and easy falling are the first symptoms; Gradual development of duck steps, Gowers sign, and winged scapulae

Poor appetite, poor sleep, easily frightened, crying at night

Square skull, chicken breast shape, X-ray shows that the long bone calcification zone disappears, and the metaphysis is brush-shaped.

UVA

PUVA therapy

triple therapy

Tympanic effusion and hearing loss

middle ear mucosa

throbbing tinnitus

Forehead and affected side

Top of head, temporal or occipital area

Headache in the forehead and temporal region, mild in the morning and severe in the afternoon

medial canthus or root of nose

Forehead pain is cyclical and regular headache

Headache radiates to the top of the head and occiput, and can be reflected to the neck and behind the eyeballs

Beta-hemolytic Streptococcus, Staphylococcus aureus, Pneumococcus pneumoniae

I degree

II degree

III degree

Squamous blepharitis

ulcerative blepharitis

Canthus blepharitis

Uhthoff's sign

Visual field examination shows typical central scotoma or concentric narrowing

2~4mm

10~30mm

Number up to ten, 1~2mm

Sexually transmitted diseases caused by Neisseria gonorrhoeae and Chlamydia trachomatis

Increased discharge, itching and burning sensation in vulva

Salpingitis is the most common

Expansive growth, clear boundary, not easy to relapse after surgical resection, and does not metastasize

Infiltrative or expansive growth, the central area may be necrotic, and the boundary may be unclear. It may recur or metastasize after surgical resection.

cancer

sarcoma

blastoma

Myeloma, leukemia, Hodgkin's disease, melanoma

Undifferentiated cancer cells account for 0~25

25~50

50~75

75~100

Tumor disappears for at least 4 weeks

Tumor shrinks by more than 50% for at least 4 weeks

Tumor shrinks by less than 50% or increases by less than 50%

Increased by more than 25%