Piper(風笛手)評估胸部片子好不好

Piper(風笛手)評估胸部片子好不好

P   patient information

I   inspiration

P   penetration

E   exposed area

R   rotation

P 身分臨床追舊片

I 吸氣足夠六十分(前肋骨第六根，後肋骨第十根)(悟記：考試六十分)

  後肋骨角度比前肋骨較橫較好數，至少要看到9 根才代表吸氣足夠
前肋骨 ，角度較斜，至少看到 6根才能算是好片子

P 下胸椎隱約可見

E 片子夠大不遺漏

R spinous process在中間

胸部X光判讀整理

首先，檢查X光片拍得好不好

1. 兩側Clavicle的medial ends距midline是否等距→ 若不等距，可能有Rotation
2. Diaphragm位置是否到10'th~11'th肋間→ 若沒有，病人可能沒吸飽氣
3. Thoracic vertebrae應該要隱約可見→ 表示X ray有適當的穿透度

受傷時這麼說

受傷時這麼說

I sprained my knee.

(替代置換：burned，cut，fractured，bruised，scraped擦傷，broke，skinned刮傷)

I sprained my ankle.

I broke a tooth.

I cut my finger.

I burnt my hand on the oven.

I fell while riding my bicycle.

EKG Axis: 看I、II 、III導聯

Axis: 看I、II 、III導聯

正常I、II 、III均向上

I向上*、III向下→ 生理性左偏

lead II向下→ 病理性左偏→Left Anterior HemiBlock

I向下、III向上*→ 右偏→Left posterior HemiBlock

There is pathologic LAD (LAHB) (Left Anterior HemiBlock) if net QRS is more negative than positive in lead II. )→LAHB (Left Anterior HemiBlock)

判斷一個心電圖的電軸是不是偏移只需看它的I、III導聯，如果I、III導聯的主波方向不同，即有一個向上，另一個向下，那麼這個心電圖的電軸就是偏的。那麼到底向哪個方向偏呢？我們分析時可以把1導聯的電圖放左手邊，3導聯的電圖放右手邊，哪邊的主波向上它的電軸就往這個方向偏！(There is pathologic LAD (LAHB) (Left Anterior HemiBlock) if net QRS is more negative than positive in lead II. ) 

Nature is speaking

Nature Is Speaking – Julia Roberts is Mother Nature

Some call me nature. Others call me mother nature.

I’ve been here for over 4.5 billion years 22,500 times longer than you.

I don’t really need people. But people need me. Yes, your future depends on me.

When I thrive, you thrive. When I falter, you falter. Or, worse.

But I’ve been here for eons. I’ve fed species greater than you. And I’ve starved species greater than you.

My oceans, my soil, my flowing streams, my forests they all can take you, or leave you.

How you choose to live each day whether you regard or disregard me, doesn’t really matter to me.

One way or the other, your actions will determine your fate. Not mine.

I am nature. I will go on. I’m prepared to evolve. Are you?

手太陽小腸經穴位歌訣

手太陽小腸經

手太陽小腸經 手太陽穴一十九 少澤 前谷 後谿 藪 腕谷 陽谷 養老 繩 支正 小海 外輔肘 肩貞 臑俞 接 天宗 髎外 秉風 曲垣 首 肩外俞 連 肩中俞 天窗 乃與 天容 偶 銳骨之端上 顴髎 聽宮 耳前珠上走