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83 Cards in this Set

  • Front
  • Back
What are the general things that are looked at by the clinician in an Inspection examination?
-Spirit
-Complexion
-form and bearing
What are the local things looked at by the clinician in an Inspection examination?
-head, neck,ears,eyes,nose and mouth
-skin
-vessels and nails
-excreta
And last but not least, what has very unique characteristics that a clinician looks at in an inspection examination?
the tongue
Why is the state of the spirit an important parameter for health?
Because the Shen is a reflection of a persons pre/post natal essence as well as reflecting the function of the zangfu and the condition of the Qi, Blood and body fluids.
How does one inspect a persons Shen?
Observe a patients eyes, facial expressions,complexion,mentality and reactivity.
What are the four spirit states?
-De Shen- spiritedness
-Shi Shen- spiritlessness
-Jia Shen - false spirit
-Luan Shen- mental derangement
Give the definition of De Shen.
State of sufficient essences, strong Qi, full of energy.
When would you see De Shen?
In a healthy body, mild illness or severe conditions with a favorable prognosis.
List some manifestations of De Shen.
conscious mental state,normal vitality,natural facial expressions,ruddy complexion,bright eyes, clear speech
Give the definition of Shi Shen.
State of exhaustion of life essence, deficient Qi, lack of energy
When would you see Shi Shen?
In severe conditions
What manifestations would be seen in Shi Shen?
weak body, listless,pale/dull complexion w/o luster, dull/stagnant eyes, weak or panting breath, low voice- in worse case emaciation,retarded response,unconsciousness or coma w/delirium
What is the definition of Jia Shen?
false manifestations in disagreement with the nature of the disease
When would you see Jia Shen?
In sever conditions. Signs of yin and yang about to separate. Patient's essence and qi are extremely declined-end stage of serious or chronic disease.Yang is floating.
What are the manifestations of Jia Shen?
Following signs of Shi Shen, suddenly the vitality becomes good, reddish cheeks, wanting to eat, talkative.
What is the definition of Luan Shen?
Shen is not stable.
When would you see Luan Shen?
In mental illness due to phlegm obstruction the Heart spirit or disturbance of the Heart by phlegm-fire.
Inspection of complexion looks at two aspects. What are they?
Color and luster.
What are the possible colors and what do they indicate?
red, white, blue, yellow and black.
They can indicate the location and nature of the disease.
What are the possible lusters? What do they indicate?
Bright and moist or dull and dry.
They tell the state of the related Zangfu.
Describe a persons normal, healthy complexion.
bright and moist with right color.
Right color is a persons normal governing color due to family/ethnicity, adjusted for seasonal variations.
Describe a morbid complexion.
dull and dry with wrong color.
What are the normal seasonal color changes in a persons complexion?
Spring- Blue
Summer- Red
Late Summer- Yellow
Autumn - White
Winter - Black
What are" Wrong" or Morbid colors?
Lusterless or too obvious color or just a single color.
What does the morbid color blue indicate?
LIVER- syndromes of cold/pain/blood stasis/convulsion(internal Liver wind).
What does the morbid color red indicate?
HEART-Heat syndromes.
whole face-excess exter.& interior heat
flushed cheeks-defic. heat due to Yin Defic.
occas. flush-pale after prolonged critical illness- false heat
What does the Morbid color yellow indicate?
SPLEEN - defic. or dampness syndromes.
-pale yellow, lusterless - SP&ST defic., QI & Blood defic.
-yellow & puffy - sp defic.
w/dampness
Yellow in whole body-JAUNDICE
Describe the different yellow presentations of Jaundice.
-bright yellow - Yang jaundice, D-H in LV/GB
-dim yellow- Yin jaundice cold-damp stagnating in LV/GB
Acute jaundice - sudden onset,whole body deep yellow w/fever & coma - D-H & pestilence steaming LV/GB
What does the morbid color white indicate?
LUNG- defic. or cold syndromes.
pale & puffy - Yang defic. H2O reten
thin body or emaciated- defic. of Qi/Blood
severe abdo cold-pain: interior excessive cold
sudden profuse cold sweat, cold limbs, indistinct pulse - sudden loss of yang qi
What does the morbid color black indicate?
KIDNEY - KD defic/cold/Blood stasis/fluid retension syndromes
-pale blackish - KD Yang defic.
-dry blackish - KD essence insuffic.
-puffy eye bags/dark circles - KD defic w/flooding H2O
-Squamous & dry skin - Blood stasis
What is meant by the term Form?
- the strength & weakness of a body
-the fatness & thinness of a body
- deformity of a body
What does a strong body indicate?
Good function of zangfu, sufficient Qi and Blood.
What does a weak body indicate?
Deficiency in zangfu or Qi and Blood
What does obesity indicate?
-Big appetite: strong excessive in QI & phlegm-damp
-Poor appetite & low energy: SP Qi defic. w/accum of phlegm-damp
What does a slender body indicate?
-Possible insufficiency of Yin & Blood & tendency to sustain defic. heat.
-Emaciation: exhaustion of essence seen in prolonged critical conditions
What is the cause of the of the deformities- chicken chest and tortoise back?
Pre or postnatal deficiency.
What are some possible causes of deformities in the four limbs?
Rheumatoid arthritis, TB, Gout, tumors
What is meant by a persons bearing?
A persons posture and gait - the way a person stands and moves
Describe a person with a Yang bearing and what it indicates.
Patient is active, likes to lie supine and extend and stretch. Indicates exterior, heat and excessive syndrome.
Describe a person with a Yin bearing and what it indicates.
Patient is inactive, likes to lie curled up, closed. Indicates interior, cold and deficient syndrome.
How would insufficient Yin and/or Blood to nourish tendons and channels manifest?
Tremors in finger, toes, lips and eyelids.
How would flaccid syndrome or wind-stroke manifest?
Weakness or paralysis of body parts.
A detailed inspection is done of the head, ,ears, ,nose and ?
neck,eyes,mouth
Thinning, weakened, gray-white or original color getting lighter indicates what?
Deficiency of kidney essence and/or Qi and Blood.
What does alopecia indicate?
Blood deficiency with attack by wind.
What does a large loss of hair in a short period of time indicate?
Severe disease or toxins, medicines (chemo) etc.
What does a big head with small face and low intelligence indicate?
Kidney essence deficiency with fluid retension.
What does a small head with a round top and low intelligence indicate?
Kidney essence deficiency.
What does a square head in a child indicate?
Rickets.
If a child's fontanel closes after the child is two years old, what is indicated?
Delayed development due to prenatal deficiency or postnatal malnutrition.
If a child's fontanel is sunken, what does it indicate?
Deficiency, possibly dehydration.
If a child's fontanel protrudes, what does it indicate?
Excess such as high body temperature or cranial pressure.
Involuntary shaking of the head indicates what?
Liver wind.
A goiter is a visible enlargement of the lymph nodes in the neck. True or False
False. Goiter is the visible enlargement of the thyroid gland.
If a person gains weight easily and has low energy it may indicate Hypothyroidism. what would the TCM diagnosis be?
Spleen deficiency with stagnation of phlegm and QI
If a person has weight loss, feels hot and sweaty, has palpitations and is restless it may indicate Hyperthyroidism. What would the TCM diagnosis be?
Qi and Yin deficiency.
Enlarged lymph node may indicate what?
viral or bacterial infection, TB or a tumor.
Scrofula is TB affecting the lymph nodes which may have no symptoms. What would the TCM diagnosis be?
Lung and Kidney Yin deficiency,
An enlarged lymph node that has no pain on palpation and is hard and fixed may indicate what?
A malignant tumor- secondary cancer site
A painful enlarged lymph node may indicate what?
A nearby infection - Wind-Heat
A stiff neck is rigid and a wry neck is ....?
Tilted
What is indicated by the following lip colors: Pale
Bright Red
Deep/Purplish red
Pale-Defic. Qi and Blood
Bright Red- Defic. heat
Deep/Purplish Red- excessive heat
What is the manifestation of stagnated heat in the Spleen and Stomach?
Cold sores.
What is the manifestation of damp-heat or Yin defic. in Spleen and Stomach?
Canker sores.
What is a possible manifestation of Stomach heat?
red and swollen gums with pain or bleeding.
Chronic mildly swollen gums with pain or bleeding indicate what?
Deficient heat.
Five Zangs have their corresponding part in the eye, what are these called?
The five wheels.
Name the five wheels.
canthus -Blood wheel- Heart
sclera- Qi wheel- Lung
cornea- wind wheel- Liver
pupil- water wheel- Kidney
eyelids- muscle wheel- Spleen
Redness in the whole eye indicates what?
Liver wind-heat.
Redness in the other parts of the eye indicate what?
Heat in the corresponding Zang.
Yellow sclera indicates what?
Jaundice due to dampness.
What is indicated by the following eye forms:sunken, swollen,protruding.
sunken-insufficient fluid
swollen-edema
protruding-hyperthyroidism
Eyeballs turning upwards indicates what?
Liver wind
Pupils size and reaction to light can indicate what?
tumor or concussion.
Kidneys open to the ears.
Name the colors of the ear and what they indicate.
Pale white-cold syndrome
Blue-black- pain
Thin & dry- defic. of KD essence
Dry & blackish-deple. of KD essenc.
Yellow or white dischar.- D-H stagnating in LV/GB
Lungs open to the nose.
The nose is closely linked to what two meridians?
Spleen and Stomach
A red, swollen nose with pimples indicates what?
Stagnated heat in Lung and Stomach.
Conditions of edema,dryness and squamous/scaly skin indicate what?
edema- overflow of water or accum. of dampness.
Dryness- insuff. of body fluids or Blood.
squam/scaly- defic and stasis of Blood
Macula are raised, discolored spots on the skin. True or False?
False. they are not elevated above the level of the skin.
What causes Yang macula?
Exogenous warm-heat entering Ying-Blood and propelling Blood to overflow causing bright or purple red spots with fever,dysphoria and rapid pulse.
What causes Yin macula?
Deficient Qi failing to control bloow and causing it to overflow its vessels. Light or dull purple spots with pale complexion and tongue,weak pulse.
Papula are small or large solid elevation of the skin that does not contain pus. True or false?
True
Give three example of papula.
Measles- wind-heat
Rubella- wind-heat
Uticaria- ext. wind/Blood defic. or internal D-H