abdominal diagnosis

8/12/2019 Abdominal Diagnosis

1/21


2/21


3/21


4/21

!"!#"$$

P

?-, M+,0 &'()*+,-. /+-0,)1+1

$J

89

(+N6


5/21

!"!#"$$

_

?-, M+,0 &'()*+,-. /+-0,)1+1

$J89

(+N6


6/21

!"!#"$$

J

?-, M+,0 &'()*+,-. /+-0,)1+1

$J89

(+N6+(,3OD ST834,-. 3L+(3,63 )A 1+(,3O1 -43 -]+683(D WA +8 +1 ,)8 B4313,8V 893

>+(,3O1 -43 ,)8 -]+683(^D

?-, M+,0 &'()*+,-. /+-0,)1+1

$J89(+N6


7/21

!"!#"$$

#

E 7-4*34 &'()*+,-. /+-0,)1+1

234'-. /+-0,)1+1 +1 '-13( ), 893

:9-,0 2-, K


8/21

!"!#"$$

e

5)+18


9/21

!"!#"$$

f

C).)4

[3T8


10/21


11/21

!"!#"$$

$$

1. Lax & Powerless

Fu Bu Ruan Ruo Wu Li

The abdominal wall iseither thin, weak and without

tonus or there may be excessivelayers of fatty tissue which areflaccid and atonic. There is a

marked decrease in abdominalpressure.

LAX

1. Lax & PowerlessFu Bu Ruan Ruo Wu Li

Even when the abdomen is lax itis not always powerless and whenthere IS strength in the depthsthen this is a sign of excess "Shi

Zheng#. If at the same timethere is constipation, the pulse is

deep and has strength and theabdomen has strength in the

depths, irrespective of the laxabdomen, this is an indication for

the use of a purgative

LAX


12/21


13/21

!"!#"$$

$E

3. Epigastric Obstruction HardnessXin Xia Pi Ying

Palpable resistance in theepigastric area generally

neither accompanies tensionof the abdominal muscles suchas the rectus abdominus, nor

tenderness. The patientsometimes feels pressure pain

however.

3. Epigastric Obstruction HardnessXin Xia Pi Ying

This means that when the

physician palpates, theycan feel tightness and

resistance which conformswith the patients

subjective complaint of afeeling of obstruction

under the ribs.


14/21

!"!#"$$

$P

4. Epigastric ObstructionXin Xia Pi

Subjective feeling ofobstruction in the pit of the

stomach "epigastrium#. Oftenaccompanied by heaviness and

distention.

4. Epigastric ObstructionXin Xia Pi

This is the samePatter! as

for #3 without the objectivefeelings of tightness.

It refers to complaints of astu%edfeeling in the pit of

the stomach when, uponexamination of the area, there is

neither resistance norobstruction nor pain with

pressure.


15/21

!"!#"$$

$_

5. Hypochondriac Painful FullnessXiong Xie Ku Man

Tenderness and the feeling offullness "Ku and Man #in thehypochondriac area can occur in thesubcutaneous structures outside theperitoneum, such as the muscles andfascia of the diaphragm, the greater

pectoral muscles, and the upperportions of the rectus abdominus

muscles. There have been reports onthe relationship of with

the morbid states of splenoma,pleurisy, chronic hepatitis and

hepatomegaly. It must be related to

those organs in the thorax or belowthe diaphragm, such as the liver,stomach, spleen and pancreas. It can

occur also when lymphocyte functionsaccelerate.

5. Hypochondriac Painful FullnessXiong Xie Ku Man

Abdomen #5 :

There is a feeling of fullness in thehypochondrium as well as distress andpain. This may occur on both sides at

the same time or on either sideseparately. It can be verified

objectively as pressure pain andresistance.

This Pattern is clearly anindication for the use of formulas

containing:Chai Hu.


16/21

!"!#"$$

$J

6. Hypochondriac Obstruction Hardness

Xie Xia Bi Ying

Morbid State:

Palpable resistance in thehypochondriac area very similar

to abdomen #3 EpigastricObstruction Hardness . One report says a

slight swelling of the left lobe ofthe liver found with ultrasound

examination.

7. Epigastric Splash

Xin Xia Bu Zhen Shui When the stomach wall is relaxed

and there is a certain amount of gastricjuices and air in the stomach, sloshingsounds come form inside the stomach. Thecause of the sound is thought to beconditions where the smooth muscles of thestomach are relaxed, as in the case of

gastroptosis. In these cases peristalsis of thestomach is decreased, and gastric juices andair cannot be excreted and accumulate in thestomach lumen.

These are signs of functional

deterioration of the vagus nerve, and theyusually accompany other signs of autonomicnervous system disorders.

The sounds could occur not only inthe stomach but also in the horizontal areaof the duodenum, and in the jejunum whenintestinal juices have accumulated.

WATER / GAS


17/21

!"!#"$$

$#

8. Chest and Abdomen Pulsations

Xin Ji/ Xin Xia Ji/ Qi Xia Ji / /

These are pulsations of the aortaabdominalis. This is divided into the left andright common ileac arteries at the level of theumbilicus. Xin Ji is the pulsation of theaorta abdominalis itself. Xin Xia Ji could be the pulsation of the furcation of theaorta abdominalis, above the umbilicus. Qi XiaJi could be the pulsation of a furcationbelow the umbilicus. In a healthy condition,the artery is situated on the floor of theabdomen and is impossible to palpate withlight touch. But in the case of a patient withDeficiency Kyo Sho! where the

abdominal wall is thin and lax, it can be felt.Also, in a patient with Excesswho has sympathetic nervous system strain, thepulsation of the abdominal aorta will becomestrong and refers to the abdominal wall whereit can be felt at the surface.

Abdomen #8 :

1. Pulsations of the cardiac area "Xin Ji #when anarea in the epigastric region "under the heart#is excited&the apical pulse

2. Epigastric pulsations "Xin Xia Ji #when thearea around Ren.9 "Shui Fen#is excited.

3. Lower umbilicus pulsations "Qi Xia Ji #alsoknown as themovement between the Kidneys. Theyare all obvious pulsations of the abdominal arterieswhich are observable and easily palpable.

They can be identified by looking or by palpation with alight touch of the hand.

Generally, when you find such pulsations in these places,it means that the heart is accelerating and the patientwill soon be deficientso that diaphoretics, emetics andpurgatives are forbidden "ie: anything draining the lowerportion of the body#


18/21

!"!#"$$

$e

9. Inside EmergencyLi Ji

Fig.1

Due to the cold, digestivefunctions have deteriorated and gas andintestinal fluids are occluded or flow in theintestines causing them to expand. These

vermiculations are sporadic and they donot excrete the contents of the intestines.Fig. 2

As neither pain on palpation nordeep pain are found generally, this strain isnot related to muscle contraction such asin the reflection of an organsmovement. Rather Li Ji is a resultof overly strained rectus abdominus

compensating for low abdominal pressure.

Fig.1

Fig.2

Abdomen #9:

ThisLi Ji is detected when on the inside of theabdominal wall the skin below the surface can be seen as aspasm or felt as a contraction &Fig.1.

If the abdominus rectus muscle goes into spasm this canbe included inside thisPresentatio!'Fig.2.

The termLi Ji includes both spasms of the rectusabdominus and any sti%ness, spasm, jerk orjumpthatyou may illicit upon pressure.

ThisLi Ji is only seen in Deficient "Xu Zheng#patients.


19/21

!"!#"$$

$f

10. Lower Abdomen Tight ContractionShao Fu Ju Ji

Very similar findings to the

abdomen #9 Inside EmergencyLi Ji .

In this case the location ofthe spasms or contractions are

along the rectus abdominismuscles of the lower abdomen.

As previously stated, Li Jiis a result of overly strained

rectus abdominus compensatingfor low abdominal pressure.

Abdomen #10:

The site of thesmall abdomen "Shao Fu #is the lower abdomen. Here, thecontractions of the rectus abdominus are inthe area between the navel and the pubicbone and that is where you will see thespasms. Such a case is often referred to as:lower burner deficiency. It may also becalledKidney Deficiency

This is commonly called theBa WeiDi Huang Wa!Presentation


20/21

!"!#"$$

!g

11. Lower Abdomen FlaccidShao Fu Bu Ren

Fig. 1 'ThisPattern is composed bydropped tension of the linea alba in the lowerabdomen and relatively exacerbated tension of therectus abdominus muscles, backed bydeterioration of abdominal pressure.

Fig. 2 'The structure of Median Plane Core belowthe umbilicus is plica umbilicalis mediana, which isfelt on the median plane. On the other hand thestructure above the umbilicus is ligamentus tereshepatis, the debris of the umbilical artery and the

vein. Usually it cannot be palpated from thesurface of the body due to adipose tissue, but

when adipose tissue reduces its size and tension ofthe linea alba is dropped, causing a drop inabdominal pressure, it may be palpated.

Fig.1

Fig.2

12. Lower Abdomen (Resistant) FullnessShao Fu Man / Shao Fu Ying Man

The kind of resistance and

obstruction felt by both patientand practitioner is similar to that

in Otsuka abdomen #2Abdominal Fullness. Here

however the location isspecifically in the lower abdomen.In both thesePatterns, the lower

abdomen is said to be inflated butin theLower Abdomen Fu#andHard"Fig.2#it is also hard and

resistant.

Fig.1

Fig.2


21/21

!"!#"$$

!$

13. Lower Abdomen Tightly KnottedShao Fu Ji Jie

Oketsu PointThere is hyperalgesia due to referred

pain and the strain of the abdominal wall. Thetypes of pain are strong internal organ pain andreferred pain related to the internal organperceptive reflex. The area by the left ileac fossain a woman is known to be equivalent to thehypersensitive zone referred to the left ovary anduterine duct; the area in the right ileac fossa isoften associated with the ileocecal valve,appendix and ascending colon.Terasawa Okestu point "Tendernessaround the umbilicus This area is crowded

with micro'circulation vessels such as smallintestine, mesentary and caul. This suggests theexistence of a morbid state of blood occlusiondue to deterioration of micr'circulation such ashemostasis or hyperemia. Even though, as caulhas a limited number of pain receptors, paincould be from the small intestine or mesentarydue to a morbid state of blood occlusion.

abdominal diagnosis

Documents