Diagnostics 122 Flashcards
Body resistance is also known as
Vital qi
Pathogenic factors are also known as
Evil qi
Manifestation
Refers to the external display of an internal pathogenic development
Manifestation includes both
Signs and symptoms
Symptom
Refers to the subjective abnormal sensations felt by the patient. Ex: pain, distension, numbness, etc
Sign
Refers to objective abnormal display which, upon examination, indicates a disease. Ex: pale face, skin rashes, rapid pulse
Pattern (3 aspects)
Refers to the highly pathogenic condensation of a certain stage of disease; implies a group of manifestations at a certain pathogenic stage; provides the perspective for treatment
Disease
Result of the interaction of pathogenic factors and body resistance finally causing the breakdown of the balance of yin and yang
Diagnosis
Refers to the judgment from a physician as to the state of the constitution, as well as the name of the disease and its pattern types
Four diagnostic methods
Inspection, olfaction and auscultation, interrogation, and palpation and pulse examination
Inspection includes observing the patient’s
Vitality (Shen), complexion (se), physical appearance (xing), and movements and abnormalities in local areas of the body, including various excretory products such as sweat, sputum, saliva, urine, and stools
Auscultation includes
Listening to the sound of their voice and pitch of their voice, coughing, breathing, vomiting, hiccoughing, borborygmus, and groaning and speech patterns of the patient
Olfaction refers to
Smelling of abnormal odors emitted for either the patient of their residence
Interrogation refers to
Asking questions about how the disorder arose, its development and treatment process, what the patient feels now, the patient’s and family’s medical histories, individual cravings such as dietary indulgences and smoking, and the living/working conditions of the patient.
What is the aim of interrogation?
To find out the cause of the disorder and identify the pattern type by systemically uncovering the whole process of generation and development of the problem, as well as the symptoms of the patient
What is palpation?
Diagnostic method of palpating or pressing a certain area of the body with the practitioner’s hands to find moisture and temperature changes on the skin, the shapes and characteristics of lumps, tenderness, the degree and characteristic of pain, soreness, distension, and other sensations
Frequency and rhythm of the respiration and heartbeat and the patient’s reaction to palpating are included in which diagnostic method?
Palpation
Way are the eight different qualities of a pulse?
Location, frequency, length, width, strength, fluidity, tension, and equilibrium
What is the purpose of pattern identification?
to classify and analyze the clinical manifestations based on the four diagnostic methods and trace the causes of disease
Three Primary categories of pattern identification:
External Pathogenic factors, Internal Pathogenic factors, Pathogenic factors that are neither internal not external
Six environmental phenomena:
wind, cold, summer heat, dampness, dryness and fire, and epidemic pathogens
Seven Emotions:
grief, joy, anger, anxiety/melancholy, and fear/fright
Examples of pathogenic factors that are neither internal nor external:
improper food intake, fatigue, traumatic injury, sexual indulgence, and insect and animal bites
Secondary Pathogens:
blood stasis, damp, phlegm, phlegm fluids, and water qi
How are secondary or “special” pathogenic factors produced?
produced in the course of disease due to the dysfunction of the internal organs, and they result in additional diseases
pattern identification is the result of…
a comprehensive analysis of etiology, pathogensis, and signs and symptoms of a disease in certain stages
What is the main diagnostic principle and method of TCM?
pattern identification
What supplies vitality to the internal organs?
essence and qi
What is vitality?
an external expression of the function of the organs, essence, and qi
Vitality is clinically divided into three types:
presence of vitality, absence of vitality, and false vitality
Presence of Vitality refers to….
the general state of the essence and qi of the internal organs that is preserved without serious impairment, even while the patient is suffering from a disorder
Absence of vitality means…
that the essence and qi of the internal organs have been impaired during the course of an illness
False vitality usually appears in what type of patient?
a patient whose condition is severe, or who is even dying
False Vitality manifests as…
a sudden short-lived improvement in spirit, complexion, voice, and food intake, which worsens very soon
What does false vitality indicate?
the essence and qi of the internal organs are declining, leading to separation of yin and yang
What is the difference between presence of vitality and absence of vitality when analyzing the eyes?
Presence of vitality: eyes sparkle
Absence of Vitality: eyes are dull looking
What is the difference between presence of vitality and absence of vitality when analyzing the spirit?
Presence of vitality: Vigorous
Absence of Vitality: Listless
What is the difference between presence of vitality and absence of vitality when analyzing the facial expression?
Presence of Vitality: Natural
Absence of vitality: Indifferent
What is the difference between presence of vitality and absence of vitality when analyzing the complexion?
Presence of vitality: bright, moist
Absence of Vitality: Dim, dry
What is the difference between presence of vitality and absence of vitality when analyzing the mind?
Presence of Vitality: Clear
Absence of Vitality: Confused
What is the difference between presence of vitality and absence of vitality when analyzing the speech?
Presence of Vitality: correct in normal voice
Absence of Vitality: Incoherent in low or high voice
What is the difference between presence of vitality and absence of vitality when analyzing the action?
Presence of vitality: coordinated
Absence of Vitality: Disharmonious
What is the difference between presence of vitality and absence of vitality when analyzing the reaction?
Presence of Vitality: quick
Absence of Vitality: dull
What is the difference between presence of vitality and absence of vitality when analyzing the muscle?
Presence of Vitality: good muscle tone
Absence of Vitality: weak and flaccid
What is the difference between presence of vitality and absence of vitality when analyzing the severity?
Presence of Vitality: mild case
Absence of vitality: severe case
What is the difference between presence of vitality and absence of vitality when analyzing the prognosis?
Presence of Vitality: good
Absence of Vitality: poor
