medical-90

哪家医院是美国最好的医院？它和一般医院的差距大吗？

医生：doctor

doctor

发音：英 ['dɒktə]  美 ['dɑktɚ]。

vt. 修理；篡改，伪造；为?治病；授以博士学位。

n. 医生；博士

vi. 就医；行医

同根词：

词根： doctor

adj.

doctoral 博士的；博士学位的；有博士学位的。

doctorial 博士的；学者的（等于doctorel）

n.

doctorate 博士学位；博士头衔。

doctoral 博士论文

扩展资料

例句：

1、She delivered exactly when the doctor predicted she would.。

她恰好在医生所说的预产期分娩了。

2、The doctor suggested I should have more outdoor exercise.。

医生建议我多做点户外活动。

3、The doctor enjoined a strict diet.。

医生嘱咐要严格规定饮食。

ProArt创艺国度Mini PC PA90怎么样，听说显示效果挺牛的？

美国最好的医院一般都是美国顶级大学的附属医院。如麻省总医院、丹娜法伯癌症研究院是哈佛大学医学院的附属医院，约翰霍普金斯医院是约翰霍普金斯大学医学院的附属医院等。

HS编码为95069190的商品需不需要出口许可证书

Mini PC ProArt PA90。

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关于体检的英文网站

52种商品出口需要许可证

发布时间:2003-1-17

为维护正常出口秩序，保证外贸出口健康发展，今年中国将继续对52种大宗及敏感商品实行出口许可证管理。其中包括原油、成品油、稀土、氧化锑、三氧化钨及蓝色氧化钨等化工产品。国家将对这52种商品分别实行出口配额许可证、出口配额招标、出口配额有偿使用、出口配额无偿招标和出口许可证管理。实行出口配额许可证管理的商品是：玉米、煤炭、焦炭、钨粉及其制品、锌矿砂、锌及锌基合金、锡矿砂、锡及锡基合金、石蜡等。实行出口配额招标的商品是：碳化硅、氟石块（粉）、滑石块（粉）、轻（重）烧镁等。实行出口许可证管理的商品是：重水、消耗臭氧层物质、监控化学品、易制毒化学品、铂金（以加工贸易方式出口）、电子计算机等。

毽子不需要出口许可证

95069190

一般的体育活动、体操或竞技用品。

应该正确

GS认证里有相关体育用品的认证。

但GS不是强制认证

CE里是强制认证

我没查到有关体育用品的认证

适用CE标志的指令

截止1997年12月，欧共体发布的实行CE标志的指令如下，现将适用产品、指令文号、发布日期、施行日期等分别列表：

Directive

Title

CE

Ref

Entry

into

force

名称

主要指令

开始日期和强制日期

Electromagnetic。

Compatibility

电磁兼容指令

89/336/EEC

1.1.1992

1.1.1996

Low

Voltage

Electrical

Products

低电压指令

73/23/EEC

modified

by

93/68/EEC

1.1.1995

1.1.1997

Toys

玩具指令

88/378/EEC

1.1.1990

Simple

Pressure-vessels。

简单压力容器指令

87/404/EEC

1.7.1992

Construction

Products

建筑产品

89/106/EEC

27.6.1991

Machines

机械指令

89/392/EEC

as

amended

1.1.1993

1.1.1995

Personal

Protective

Equipment

个人防护设备指令

90/686/EEC

as

amended

1.7.1995

Non-automatic

Weighing

Machines

非自动称量仪器指令

90/384/EEC

1.1.1993

Active

Implantable

Medical

Devices

可移植医疗器械指令

90/385/EEC

1.1.1993

1.1.1995

Medical

Devices-general。

普通医疗器械指令

93/42/EEC

1.1.1995

15.6.1998/4/3

Gas

Appliances

燃具炉具指令

90/396/EEC

1.1.1992

1.1.1996

Telecommunications。

Terminal

Equipment

电信终端设备指令

91/263/EEC

6.11.1992

Boilers

锅炉指令

92/42/EEC

1.1.1994

1.1.1998

Explosives

爆破器材指令

93/15/EEC

1.1.1995

1.1.2003

Satellite

Earth

Station

for

Telecommunications。

通讯卫星地面站指令

93/97/EEC

1.5.1995

1.5.1997

Lifts

升降设备

Proposal:

COM(92)35

COM(93)240Com

Pos.25/94

1.1.1998

1.1.2000

Equipment

for

Use

in

Explosive

Atmospheres

用于爆炸性气体设备指令

94/9/EC

1.3.1996

1.7.2003

Recreational

Craft

(Boats)

娱乐用船只指令

94/25/EC

16.6.1996

16.6.1998

Non-simple

Pressure

Vessels

非简单压力容器

Proposal:COM(93)319。

1.7.1996

1.1.1999

养老保险缴费基数是什么意思

Physical examination or clinical examination is the process by which a health care provider investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.。

Although providers have varying approaches as to the sequence of body parts, a systematic examination generally starts at the head and finishes at the extremities. After the main organ systems have been investigated by inspection, palpation, percussion and auscultation, specific tests may follow (such as a neurological investigation, orthopedic examination) or specific tests when a particular disease is suspected (e.g. eliciting Trousseau's sign in hypocalcemia).。

With the clues obtained during the history and physical examination the healthcare provider can now formulate a differential diagnosis, a list of potential causes of the symptoms. Specific diagnostic tests (or occasionally empirical therapy) generally confirm the cause, or shed light on other, previously overlooked, causes.。

Whilst the format of examination as listed below is largely as taught and expected of students, a specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight and speech. Likewise an Orthopaedic surgeon will examine the affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist. Non-specialists generally examine the genitals only upon request of the patient.。

A complete physical examination includes evaluation of general patient appearance and specific organ systems. It is recorded in the medical record in a standard layout which facilitates others later reading the notes. In practice the vital signs of temperature examination, pulse and blood pressure are usually measured first.。

[edit] Vital Signs。

[edit] Temperature。

Temperature recording gives an indication of core body temperature which is normally tightly controlled (thermoregulation) as it affects the rate of chemical reactions.。

The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever (temp > 38.5°C or sustained temp > 38°C). Other causes of elevated temperature include hyperthermia. Temperature depression (hypothermia) also needs to be evaluated. It is also noteworthy to review the trend of the patient's temperature. A patient with a fever of 38°C does not necessarily indicate an ominous sign if his previous temperature has been higher.。

[edit] Blood pressure。

Main article: blood pressure#Measurement。

The blood pressure is recorded as two readings, a high systolic pressure which is the maximal contraction of the heart and the lower diastolic or resting pressure. Usually the blood pressure is taken in the right arm unless there is some damage to the arm. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with an aneroid or electronic sphygmomanometer. The classic measurement device is a mercury sphygmomanometer, using a column of mercury measured off in millimeters. In the United States and UK, the common form is millimeters of mercury, whilst elsewhere SI units of pressure are used. There is no natural 'normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. The guideline acceptable reading also takes into account other co-factors for disease. Elevated blood pressure hypertension therefore is variously defined when the systolic number is persistently over 140-160 mmHg. Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities. These pressures are called segmental blood pressures and are used to evaluate blockage or arterial occlusion in a limb (see Ankle brachial pressure index).。

[edit] Pulse

Main article: Pulse。

The pulse is the physical expansion of the artery Its rate is usually measured either at the wrist or the ankle and is recorded as beats per minute. The pulse commonly is taken is the radial artery at the wrist. Sometimes the pulse cannot be taken at the wrist and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries. The pulse rate can also be measured by listening directly to the heartbeat using a stethoscope. The pulse varies with age. A newborn or infant can have a heart rate of about 130-150 beats per minute. A toddler's heart will beat about 100-120 times per minute, an older child's heartbeat is around 90-110 beats per minute, adolescents around 80-100 beats per minute, and adults pulse rate is anywhere between 50 and 80 beats per minute.。

[edit] Respiratory rate。

Varies with age, but the normal reference range is 16-20 breaths/minute.。

[edit] Basic biometrics。

[edit] Height

Height is the anthropometric longitudinal growth of an individual. A statiometer is the device used to measure height although often a height stick is more frequently used for vertical measurement of adults or children older than 2. The patient is asked to stand barefoot. Height declines during the day because of compression of the intervertebral discs. Children under age 2 are measured lying horizontally.。

[edit] Weight

Weight is the anthropometric mass of an individual. A scale is used to measure weight.。

Body mass index, or BMI, is used to calculate the relationship between healthy height and weight and obesity or being overweight or underweight.。

Medical professionals generally prefer to use the SI unit of kilograms, and many medical facilities have ready-reckoner conversion charts available for professionals to use, when patients describe their weight in non-SI units. (In the US, pounds and ounces are common, while in the UK stones and pounds are frequently used; in most other countries the metric system predominates.)。

[edit] Pain

Because of the importance of pain to the overall wellness of the patient, subjective measurement is considered to be a vital sign. Clinically pain is measured using a FACES scale which is a series of faces from '0' (no pain at all showing a normal happy face) to '5' (the worst pain ever experienced by the patient). There is also an analog scale from '0' to maximum '10'. It is important to allow patients to make their own choices on a pain scale. Physicians and health care workers frequently understate patient pain.[citation needed]。

[edit] Structure of the written examination record。

[edit] General appearance。

Obvious apparent features as the patient enters the consulting room and in the course of taking the history (e.g. mobility problem or deafness)。

JACCOL, a mnemonic for jaundice, suggestion of anaemia (pale colour of skin or conjunctiva), cyanosis (blue coloration of lips or extremities), clubbing of fingernails, edema of ankles, lymph nodes of neck, armpits, groins. 。

[edit] Organ systems。

Cardiovascular system 。

Blood pressure, pulse rate and rhythm. 。

Jugular venous pressure (JVP), peripheral oedema and evidence for pulmonary oedema. 。

Precordial exam (cardiac exam) 。

Lungs

4 parts: examination, auscultation, palpation, percussion 。

Examination involves observing the respiratory rate which should be in a ratio of 1:2 inspiration:expiration. An acidotic patient will have more rapid breathing to compensate known as Kussmaul breathing. Another type of breathing is Cheyne-Stokes respiration, which is alternating breathing in high frequency and low frequency from brain stem injury. Also observe for retractions seen in asthmatics. Observe for barrel-chest (increased AP diameter) seen in COPD. Observe for shifted trachea or one sided chest expansion, which can hint pneumothorax. 。

Lung auscultation is listening to the lungs bilaterally at the anterior chest and posterior chest. Wheezing is described as a musical sound on expiration or inspiration. It is the result of narrowed airways. Rhonchi are bubbly sounds similar to blowing bubbles through a straw into a sundae. They are heard on expiration and inspiration. It is the result of viscous fluid in the airays. Crackles or rales are similar to rhonchi except they are only heard during inspiration. It is the result of alveoli popping open from increased air pressure. 。

For palpation, place both palms or medial aspects of hands on the posterior lung field. Ask the patient to count 1-10. The point of this part is to feel for vibrations and compare between the right/left lung field. If the pt has a consolidation (maybe caused by pneumonia), the vibration will be louder at that part of the lung. This is because sound travels faster through denser material than air. 。

On percussion, you are testing mainly for pleural effusion or pneumothorax. The sound will be more tympanic if there is a pneumothorax because air will stretch the pleural membranes like a drum. If there is fluid between the pleural membranes, the percussion will be dampened and sound muffled. 。

There is always difficulty differentiating between pneumonia and pleural effusion based on just auscultation since both will have crackles or rhonchi. That is why such exams like palpation will help differentiate between the two. If there is pneumonia, palpation should reveal increased vibration and percussion should be decreased. If there is pleural effusion, palpation should reveal decreased vibration and percussion should also be decreased. 。

Breasts

Abdomen

Abdominal examination notes in particular any tenderness, bloating, organ enlargement, or aortic aneurysm. 。

No abdominal examination is complete without a Rectal examination 。

Genitalia

Musculoskeletal system 。

Nervous system, including mental status 。

Head and neck (HEENT) 。

Skin

Check of the hair to see if the hair growth is receding (baldness) or there is loss of hair (alopecia). 。

Check of the skin will tell if there are marks such as hemangioma or strawberry marks or changes to the skin. Dark spots on the skin, nevi are also places where cancerous changes can appear because the face, head and neck are most usually sun exposed. Specific skin conditions (e.g. pyoderma gangrenosum, erythema nodosum, acanthosis nigricans) may be associated with specific diseases (ulcerative colitis, sarcoidosis and polycystic ovary syndrome, respectively). 。

At Wikiversity, you can learn about: 。

Physical examination。

[edit] See also。

Eye examination 。

Heart sounds

Human weight

Knee examination 。

Medical record 。

Medical test

Intimate examination 。

[edit] External links。

Connecticut Tutorials Physical Examination Video 。

UCSD school of medicine - guide to writing HPI and performing complete physical exam. Excellent for medical students 。

The Journal of Clinical Examination - A useful online source for evidence-based guidance on physical examination 。

JAMA Rational Clinical Exam - A collection of papers reviewing the evidence base for physical examination。

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