2. Diagnostic procedures in oral medicine پوسیجر های تشخیص در امراض غشای مخاطی .pdf

Diagnostic Procedures
‫ﺗﺸﺨﯿﺼﯿﻪ‬ ‫ﻫﺎی‬ ‫ﭘﺮوﺳﯿﺠﺮ‬
By: Dr Mohammad Nasir ( Sharify ) ‫ﺳﺘﻮﻣﺎﺗﻮﻟﻮژی‬ ‫ﻓﺎﮐﻮﻟﺘﻪ‬ ‫ﻫﻬﺸﺘﻢ‬ ‫ﺳﻤﺴﺘﺮ‬ ‫ﺑﺮای‬

‫ﺗﺸﺨﯿﺺ‬
‫ﯾﮏ‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﻣﻌﻠﻮﻣﺎت‬ ‫ﺗﺤﻠﯿﻞ‬ ‫و‬ ‫ﺗﺠﺰﯾﻪ‬ ، ‫آوری‬ ‫ﺟﻤﻊ‬ ‫ﭘﺮوﺳﻪ‬ :
. ‫ﻣﯿﺒﺎﺷﺪ‬ ‫ﻣﺮﯾﻀﯽ‬ ، ‫ﻧﻘﯿﺼﻪ‬ ، ‫ﺣﺎﻟﺖ‬
:‫ﺗﺸﺨﯿﺺ‬ ‫اﻧﻮاع‬
1. Clinical diagnosis : ‫ﮐﻠﯿﻨﯿﮑﯽ‬ ‫ﻣﻌﺎﯾﻨﺎت‬ ، ‫ﺗﺎرﯾﺨﭽﻪ‬ ‫از‬ ‫ﺣﺎﺻﻠﻪ‬ ‫ﺗﺸﺨﯿﺺ‬.
2. Pathological diagnosis:‫ﭘﺘﺎﻟﻮژﯾﮏ‬ ‫ﻣﻌﺎﯾﻨﺎت‬ ‫از‬ ‫ﺣﺎﺻﻠﻪ‬ ‫ﺗﺸﺨﯿﺺ‬.
3. Direct diagnosis: ‫ﭘﺘﻮﻟﻮژﯾﮏ‬ ‫ﻋﺎﻣﻞ‬ ‫ﯾﮏ‬ ‫ﻫﺎی‬ ‫وﯾﮋﮔﯽ‬ ‫از‬ ‫ﺣﺎﺻﻠﻪ‬ ‫ﺗﺸﺨﯿﺺ‬.
4. Provisional diagnosis: ‫ﻻزم‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﻫﺎی‬ ‫ﺑﺮﺳﯽ‬ ‫ﮐﻪ‬ ‫اﺑﺘﺪاﯾﯽ‬ ‫ﺗﺸﺨﯿﺺ‬
‫ﮔﺮدد‬ ‫ﺣﺎﺻﻞ‬ ‫دﻗﯿﻖ‬ ‫ﻧﺘﯿﺠﻪ‬ ‫ﺗﺎ‬ ‫ﻣﯿﺒﺎﺷﺪ‬.
5. Deductive diagnosis: ، ‫ﺗﺎرﯾﺨﭽﻪ‬ ‫ارزﯾﺎﺑﯽ‬ ‫از‬ ‫ﺑﻌﺪ‬ ‫ﺣﺎﺻﻠﻪ‬ ‫ﺗﺸﺨﯿﺺ‬
‫ﻻﺑﺮاﺗﻮاری‬ ‫و‬ ‫ﮐﻠﯿﻨﯿﮏ‬ ‫ﻣﻌﺎﯾﻨﺎت‬ .
6. Differential diagnosis: ‫ﻣﺸﺎﺑﻪ‬ ‫ﺣﺎﻟﺖ‬ ‫دو‬ ‫ﺗﻔﺮﯾﻖ‬ .
7. Provocative diagnosis: ‫ﻣﻨﺠﺮ‬ ‫ﺣﺎﻟﺖ‬ ‫ﯾﮏ‬ ‫ﺗﺤﺮﯾﮏ‬ ‫اﺛﺮ‬ ‫در‬ ‫ﮐﻪ‬ ‫ﺗﺸﺨﯿﺼﯽ‬
‫اﻧﺠﺎم‬ ‫را‬ ‫اﻟﺮژی‬ ‫ﺗﺴﺖ‬ ‫ﺷﺨﺺ‬ ‫ﯾﮏ‬ ‫ﻧﺰد‬ ‫در‬ ‫ﺷﻤﺎ‬ ‫ﻣﺜﻼ‬ ، .‫ﻣﯿﮕﺮدد‬ ‫ﺗﺸﺨﯿﺺ‬ ‫ﺑﻪ‬
‫ﻣﯿﮕﯿﺮد‬ ‫ﻗﺮار‬ ‫ﻧﺎک‬ ‫ﺧﻄﺮ‬ ‫ﺷﺪﯾﺪا‬ ‫ﻣﻮاد‬ ‫ﻣﻌﺮض‬ ‫در‬ ‫ﺷﺨﺺ‬ ‫و‬ ‫ﻣﯿﺪﻫﯿﺪ‬.
By: Dr Mohammad Nasir (Sharify )

Deﬁnition of Case History
‫ﻣﺮﯾﺾ‬ ‫ﺑﺎ‬ ‫ﮐﺮدن‬ ‫ﺑﺮﻗﺮار‬ ‫ارﺗﺒﺎط‬ ‫ﺟﻬﺖ‬ ‫ای‬ ‫ﺣﺮﻓﻪ‬ ‫و‬ ‫ﺷﺪه‬ ‫ﭘﻼن‬ ‫ﮔﻔﺘﮕﻮی‬
،‫ﻣﺮﯾﺾ‬ ‫ﻫﺎی‬ ‫ﮔﻔﺘﻪ‬ ‫از‬ ‫اﻃﻼﻋﺎت‬ ‫آوردن‬ ‫ﺑﺪﺳﺖ‬ ، ‫اﺿﻄﺮاب‬ ‫و‬ ‫ﺗﺮس‬ ‫ﮐﺎﻫﺶ‬
. ‫ﻣﯿﺒﺎﺷﺪ‬ ‫ﻣﺮﯾﺾ‬ ‫ﻧﺰد‬ ‫در‬ ‫ﺷﺪه‬ ‫اﯾﺠﺎد‬ ‫ﺣﺎﻟﺖ‬ ‫ﻣﺎﻫﯿﺖ‬

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‫ﺷﺨﺼﯽ‬ ‫ﻣﻌﻠﻮﻣﺎت‬
‫ﺗﺎرﯾﺨﭽﻪ‬ ‫ﺛﺒﺖ‬ ‫و‬ ‫ﮔﺮﻓﺘﻦ‬
‫ﮐﻠﯿﻨﯿﮑﯽ‬ ‫ﻣﻌﺎﯾﻨﺎت‬
‫ﺑﻪ‬ ‫ﻧﻈﺮ‬ ‫اﺑﺘﺪاﯾﻪ‬ ‫ﺗﺸﺨﯿﺺ‬ ‫اوردن‬ ‫ﺑﺪﺳﺖ‬
.‫ﮐﻠﯿﻨﯿﮑﯽ‬ ‫ﻣﺎﯾﻨﺎت‬ ‫و‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
. ‫ﻣﺘﻤﻤﻪ‬ ‫ﺿﺮوری‬ ‫ﻣﻌﺎﯾﻨﺎت‬ ‫اوردن‬ ‫ﺑﺪﺳﺖ‬
‫رﺳﯿﺪن‬ ‫ﺑﺮای‬ ‫ﻣﻌﻠﻮﻣﺎت‬ ‫ﺗﻤﺎم‬ ‫ﺑﺮﺳﯽ‬ ‫و‬ ‫ﺗﺤﻠﯿﻞ‬
.‫ﻗﻄﻌﯽ‬ ‫ﺗﺸﺨﯿﺺ‬ ‫ﺑﻪ‬
‫ﻧﺰد‬ ‫در‬ ‫ﺧﻄﺮات‬ ‫ﺑﺮﺳﯽ‬ ‫و‬ ‫ﺗﺪاوی‬ ‫ﭘﻼن‬ ‫ﺳﺎﺧﺖ‬
. ‫ﻣﺮﯾﻀﺎن‬
‫ﺷﺎﻣﻞ‬ ‫ﺗﺸﺨﯿﺼﯿﻪ‬ ‫ﻫﺎی‬ ‫ﭘﺮوﺳﯿﺠﺮ‬

‫اﺳﻢ‬
‫و‬ ‫ﺑﮑﻨﯿﺪ‬ ‫ﺧﻄﺎب‬ ‫اﻧﻬﺎ‬ ‫اﺳﻢ‬ ‫ﺑﺎ‬ ‫را‬ ‫اﻧﻬﺎ‬ ‫ﮐﻪ‬ ‫دارﻧﺪ‬ ‫ﻋﻼﻗﻪ‬ ‫ﻣﺮﯾﻀﺎن‬ ‫اﮐﺜﺮا‬ :
‫ﻧﯿﺎز‬ ‫ﻣﻮرد‬ ‫اﻃﻼﻋﺎت‬ ‫ﺗﻤﺎم‬ ‫ﮐﺎﻣﻞ‬ ‫راﺣﺘﯽ‬ ‫ﺑﺎ‬ ‫ﻣﺮﯾﺾ‬ ‫ﮐﻪ‬ ‫ﻣﯿﺸﻮد‬ ‫ﺑﺎﻋﺚ‬ ‫ﻫﻤﯿﻦ‬
‫ﺧﯿﻠﯽ‬ ‫ﻣﺮﯾﻀﺎن‬ ‫ﺑﺮای‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫رواﻧﯽ‬ ‫و‬ ‫روﺣﯽ‬ ‫ﻟﺤﺎظ‬ ‫از‬ ‫ﻣﮕﺮ‬ ‫ﮐﻨﺪ‬ ‫ﺑﯿﺎن‬ ‫را‬
.‫ﺷﻮد‬ ‫واﻗﻊ‬ ‫ﻣﻔﯿﺪ‬
‫آزاداﻧﻪ‬ ‫ﺻﺤﺒﺖ‬ ‫ﺑﻪ‬ ‫ﺗﺸﻮﯾﻖ‬ ‫را‬ ‫اﻧﻬﺎ‬ ، ‫اﻧﻬﺎ‬ ‫اﺳﻢ‬ ‫ﺑﯿﺎن‬ ‫اﻃﻔﺎل‬ ‫در‬ ‫ﺧﺼﻮﺻﺎ‬
.‫ﻣﯿﮑﻨﻨﺪ‬ ‫ﺑﯿﺎن‬ ‫ازاداﻧﻪ‬ ‫را‬ ‫اﻣﺪه‬ ‫ﭘﯿﺶ‬ ‫ﻣﺸﮑﻼت‬ ‫ﺗﻤﺎم‬ ‫و‬ ‫ﻣﯿﮑﻨﺪ‬
: ‫ﺷﺎﻣﻞ‬ ‫ﻣﺮﯾﻀﺎن‬ ‫اﺳﻢ‬ ‫ﻓﻬﻤﯿﺪن‬ ‫ﻣﺰاﯾﺎی‬ ‫ﺧﻼﺻﻪ‬ ‫ﻃﻮر‬ ‫ﺑﻪ‬
۱
. ‫ﻣﺮﯾﻀﺎن‬ ‫ﺑﺮای‬ ‫ﻣﺸﺨﺺ‬ ‫رﯾﮑﺎرد‬ ‫ﺛﺒﺖ‬ .
۲
‫ﻣﻮﺛﺮ‬ ‫ارﺗﺒﺎط‬ ‫ﺑﺮﻗﺮاری‬ .
۳
. ‫ﻣﯿﺒﺎﺷﺪ‬ ‫رواﻧﯽ‬ ‫و‬ ‫روﺣﯽ‬ ‫اﻫﻤﯿﺖ‬ .
Personal Information

: ‫ﺳﻦ‬
‫ﻣﺼﺎب‬ ‫را‬ ‫ﺧﺼﻮﺻﯽ‬ ‫ﺑﻪ‬ ‫ﺳﻨﯽ‬ ‫ﮔﺮوه‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﻌﻀﯽ‬
. ‫ﺳﺎزد‬
:‫ﺳﻮء‬ ‫دان‬ ‫ﺑﻪ‬ ‫ﺗﻮﻟﺪ‬ ‫اﻣﺮاض‬
Dental diseases
Related to jaw
• Agnathia
• Facial hemihypertrophy
• Macrognathia
• Cleft palate
• Facial hemiatrophy
Related to lip
• Commissural pits and ﬁstulas
• Double lip
• Cleft lip
• Hereditary intestinal polyposis syndrome
Related to gingiva
• Congenital epulis of the newborn
• Fibromatosis gingiva
Related to rest of oral mucosa
• Pigmented cellular nevus
• Cystic hygroma
• Fordyce granule
Related to tongue
• Microglossia
• Macroglossia
• Aglossia
• Ankyloglossia
• Cleft tongue
• Fissured tongue
• Median rhomboidal glossitis
• Lingual thyroid nodule
Related to salivary glands
• Aplasia
• Atresia absence or block of duct
• Developmental lingual salivary gland depression
Related to teeth
• Predeciduous dentition
Related to temperomandibular joint (TMJ)
• Aplasia or congenital hypoplasia of the mandibular
condyle
Others
• Teratoma
• Erythroblastosis fetalis
• Hemophilia

Teratoma

Related to heart
• Atrial septal defect
• Patent ductus arteriosus
• Ventricular septal defect
• Pulmonary stenosis
• Aortic stenosis
• Tetralogy of Fallot
Related to respiratory system
• Bronchiolitis
• Cystic ﬁbrosis
Related to CNS
• Congenital myopathy
• Aqueduct stenosis
:‫ﺳﻮء‬ ‫دان‬ ‫ﺑﻪ‬ ‫ﺗﻮﻟﺪ‬ ‫اﻣﺮاض‬
Systemic diseases

: ‫ﻣﯿﺸﻮﻧﺪ‬ ‫ﻣﺼﺎب‬ ‫ﺧﻮاران‬ ‫ﺷﯿﺮ‬ ‫اﮐﺜﺮا‬ ‫ﮐﻪ‬ ‫اﻣﺮاﺿﯽ‬

‫ﺑﺰرﮔﺴﺎﻻن‬ ‫در‬ ‫اﮐﺜﺮا‬ ‫ﮐﻪ‬ ‫اﻣﺮاﺿﯽ‬
: ‫ﻣﯿﺸﻮﻧﺪ‬ ‫اﯾﺠﺎد‬ ‫ﺳﺎﻟﻬﺎ‬ ‫ﮐﻬﻦ‬ ‫و‬

: ‫ﺟﻨﺲ‬
: ‫ﻣﯿﺪﻫﻨﺪ‬ ‫رخ‬ ‫ﺧﺼﻮﺻﯽ‬ ‫ﺑﻪ‬ ‫ﺟﻨﺲ‬ ‫در‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﻌﻀﯽ‬
‫ﻣﻮﻧﺚ‬ ‫ﺟﻨﺲ‬ ‫ﻣﻌﻤﻮل‬ ‫ﮐﻨﻨﺪه‬ ‫ﻣﺼﺎب‬ ‫اﻣﺮاض‬ ‫ﻣﺬﮐﺮ‬ ‫ﺟﻨﺲ‬ ‫ﻣﻌﻤﻮل‬ ‫ﮐﻨﻨﺪه‬ ‫ﻣﺼﺎب‬ ‫اﻣﺮاض‬
‫زﯾﺒﺎﯾﯽ‬
‫ﻋﺎﻃﻔﯽ‬ ‫اﺣﺴﺎﺳﺎت‬
‫دواﯾﯽ‬ ‫ﻫﺎی‬ ‫ﺗﺪاﺧﻞ‬
. ‫دﻫﯽ‬ ‫ﺷﯿﺮ‬،‫ﺣﺎﻣﻠﮕﯽ‬ ،‫ﻣﺎﻫﻮار‬ ‫ﻋﺎدات‬ :
‫ه‬ ‫دوا‬ ‫دور‬
‫ا‬
. ‫دارﻧﺪ‬ ‫ﺿﺮورت‬ ‫ﮐﻤﺘﺮ‬ ‫دوز‬ ‫ﺑﺎ‬ ‫دوا‬ ، ‫ﮐﻤﺘﺮ‬ ‫وزن‬ ‫ﻧﺴﺒﺖ‬ :
‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ ‫دواﻫﺎی‬
‫ﻧﻪ‬ ، ‫ﻣﺮدان‬ ‫ﺟﻨﺴﯿﺪر‬ ‫ﻣﻘﺎرﺑﺖ‬ ‫ﻫﺎی‬ ‫ﻓﻌﺎﻟﯿﺖ‬ ‫در‬ ‫ﺗﺪاﺧﻞ‬ :
. ‫زﻧﺎن‬ ‫در‬
‫ﮐﯿﺘﺎﮐﻮﻧﺎزول‬
. ‫زﻧﺎن‬ ‫در‬ ‫ﻧﻪ‬، ‫ﻣﯿﺸﻮد‬ ‫ﻣﺮدان‬ ‫در‬ ‫ﺟﻨﺴﯽ‬ ‫ﻏﺮﯾﺰه‬ ‫ﮐﺎﻫﺶ‬ ‫ﺳﺒﺐ‬
‫ﯾﺎ‬ ‫ﻣﺮدان‬ ‫در‬ ‫ﭘﺴﺘﺎن‬ ‫ﺷﺪن‬ ‫ﺑﺰرگ‬
Gynecomastia
‫اﺛﺮ‬ ‫در‬
‫اﺳﺘﻔﺎده‬
ketoconazole, metronidazole, chlorpromazine
‫ﺳﺎﯾﺪ‬
. ‫اﻓﯿﮑﺖ‬
‫ﻣﻮﻧﺚ‬ ‫ﺟﻨﺲ‬ ‫ﻣﻌﻤﻮل‬ ‫ﮐﻨﻨﺪه‬ ‫ﻣﺼﺎب‬ ‫اﻣﺮاض‬

: ‫ادرس‬
: ‫دارﻧﺪ‬ ‫وﻗﻮﻋﺎت‬ ‫ﺧﺎﺻﯽ‬ ‫ﻣﻨﻄﻘﻪ‬ ‫و‬ ‫ﺧﺎص‬ ‫اﻗﻠﯿﻢ‬ ‫در‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﻌﻀﯽ‬
‫ﮐﺎﻓﯽ‬ ‫ﺷﮑﻞ‬ ‫ﺑﻪ‬ ‫ﻓﻠﻮرﯾﺪه‬ ‫اب‬ ‫ﮐﻪ‬ ‫ﻣﻨﺎﻗﯽ‬ ‫در‬ ‫ﺧﺼﻮﺻﺎ‬ ‫ﺑﯿﺸﺘﺮ‬ : ‫دﻧﺪاﻧﯽ‬ ‫ﻫﺎی‬ ‫ﮐﺮﯾﺲ‬
. ‫ﺑﯿﺸﺘﺮ‬ ‫ﺻﻨﻌﺘﯽ‬ ‫ﻫﺎی‬ ‫ﺷﻬﺮ‬ ‫در‬ ،‫ﻧﺒﺎﺷﺪ‬ ‫ﻣﻮﺟﻮد‬
‫ﺑﯿﺸﺘﺮ‬ ‫ﻣﺨﺎﻃﯽ‬ ‫ﻏﺸﺎی‬ ‫ﺳﺮﻃﺎن‬ ‫اﻣﺎ‬ ‫ﮐﻤﺘﺮ‬ ‫ﻟﺒﻬﺎ‬ ‫ﺳﺮﻃﺎن‬ ‫وﻗﻮﻋﺎت‬ ‫ﻫﻨﺪ‬ ‫در‬ : ‫ﺳﺮﻃﺎن‬
. ‫اﺳﺖ‬
. ‫ﻧﺸﯿﻦ‬ ‫ﻓﻘﯿﺮ‬ ‫ﻣﻨﺎﻃﻖ‬ ‫در‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﭘﺮﯾﻮدوﻧﺘﺎل‬ ‫اﻣﺮاض‬
‫وﻗﻮﻋﺎت‬ ‫ﺑﻨﮕﻼدﯾﺶ‬ ، ‫ﺑﻨﮕﺎل‬ ‫ﻏﺮب‬ ‫در‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﮐﻪ‬ ‫ﻣﺜﺎﻧﻪ‬ ‫اﻣﺮاض‬ :‫ﺟﻐﺮاﻓﯿﺎﯾﯽ‬ ‫ﻣﻨﻄﻘﻪ‬
.‫دارد‬ ‫وﻗﻮﻋﺎت‬ ‫ﻫﻨﺪ‬ ‫ﺟﻨﻮﺑﯽ‬ ‫و‬ ‫ﻏﺮب‬ ‫ﺷﻤﺎل‬ ‫در‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﭘﭙﺘﯿﮏ‬ ‫ﻗﺮﺣﺎت‬ ‫و‬ ،‫دارد‬
gall bladder disease (West Bengal and
Bangladesh), peptic ulcer (North Western and Southern parts
of India)

‫وﻇﯿﻔﻪ‬
:
. ‫اﺳﺖ‬ ‫ﻣﺘﻔﺎوت‬ ‫ﺷﺨﺺ‬ ‫اﻗﺘﺼﺎدی‬ ‫وﺿﻌﯿﺖ‬ ‫ﺑﻪ‬ ‫ﻣﻄﺎﺑﻖ‬ ‫ﺗﺪاوی‬ ‫اراﯾﻪ‬: ‫اﻗﺘﺼﺎدی‬ ‫وﺿﻌﯿﺖ‬
: ‫ﻣﯿﺎﯾﺪ‬ ‫ﺑﻮﺟﻮد‬ ‫ﺧﺎﺻﯽ‬ ‫ﺷﻐﻞ‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﻌﻀﯽ‬
‫اﺗﺮﯾﺸﻦ‬
Attrition
:
‫دﻧﺪاﻧﻬﺎ‬ ‫اﻧﺴﯿﺰال‬ ‫ﺳﻄﻮح‬ ‫اﺗﺮﯾﺸﻦ‬ ‫ﺳﺒﺐ‬ ‫ﮐﻪ‬ ‫ﻣﺨﺘﻠﻒ‬ ‫ﻫﺎی‬ ‫ﭘﯿﺸﻪ‬ ‫در‬ ‫ﭘﯿﻨﻬﺎ‬ ‫ﻋﺎدﺗﯽ‬ ‫ﮐﺮدن‬ ‫ﺑﺎز‬
. ‫ﻣﯿﺸﻮد‬
‫اﺑﺮﯾﮋن‬
Abrasion
:
‫اﯾﺠﺎد‬ ‫دﻧﺪاﻧﻬﺎ‬ ‫ﺑﯿﻦ‬ ‫در‬ ‫ﺳﻮزن‬ ‫ﯾﺎ‬ ‫ﻣﯿﺦ‬ ‫ﮔﺮﻓﺘﻦ‬ ‫ﺳﺒﺐ‬ ‫از‬ ‫ﺧﯿﺎﻃﻬﺎ‬ ‫و‬ ‫ﻧﺠﺎرﻫﺎ‬ ‫در‬ ‫ﺑﯿﺸﺘﺮ‬
. ‫ﻣﯿﺸﻮد‬
‫اﯾﺮوژن‬
Erosion
:
‫ﻧﺰد‬ ‫در‬ ‫ﺧﺼﻮﺻﺎ‬
sundblaster
. ‫ﺻﻨﺎﯾﻊ‬ ‫ﻫﺎی‬ ‫ﭘﺎﻟﺸﮕﺮ‬ ‫ﯾﺎ‬ ‫ﻫﺎ‬
‫ﻫﯿﭙﺘﺎﯾﺖ‬
B
:
. ‫ﻫﺴﺘﻨﺪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﺧﻮن‬ ‫ﺑﺎ‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﮐﻪ‬ ‫ﺻﺤﯽ‬ ‫ﮐﺎرﮐﻨﺎن‬ ‫در‬
‫وارﯾﺲ‬
Varicos Vein
:
.‫ﻣﯿﺸﻮد‬ ‫دﯾﺪه‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﺑﺲ‬ ‫دراﯾﻮران‬ ‫و‬ ‫ﻫﺎ‬ ‫ﺗﺮاﻓﯿﮏ‬ ‫در‬
: ‫ﻣﺜﺎﻧﻪ‬ ‫ﻧﯿﻮﭘﻼزم‬
.‫ﻣﯿﺸﻮد‬ ‫دﯾﺪه‬ ‫ﺳﺎزی‬ ‫رﻧﮓ‬ ‫ﮐﺎرﮔﺮان‬ ‫در‬ ‫اﮐﺜﺮا‬
Medialsemilunar cartilage injury: Injury to the medial
semilunar cartilage of the knee occurs in football players
and miners.
Stress disease: Certain occupational hazards are
associated with oﬃce work, e.g. repetitive strain injury
and migraine induced by stress of inappropriate lighting.
Cirrhosis of liver: Barmen who have ready access to
alcohol have high mortality for cirrhosis of liver and

Taking and Recording History
‫ﺗﺎرﯾﺨﭽﻪ‬ ‫ﺛﺒﺖ‬ ‫و‬ ‫ﮔﺮﻓﺘﻦ‬

Chief Complaint ‫ﻋﻤﺪه‬ ‫ﺷﮑﺎﯾﺖ‬
‫ﻋﻤﺪه‬ ‫ﺷﮑﺎﯾﺎت‬
‫ﺑﻪ‬ ‫ﮐﻪ‬ ‫ای‬
‫ﻣﻌﻤﻮل‬ ‫ﺷﮑﻞ‬
‫ﻣﺮﯾﻀﺎن‬
‫ﺣﮑﺎﯾﻪ‬
: ‫ﻣﯿﮑﻨﻨﺪ‬
‫دﻻﯾﻞ‬ ‫ﯾﺎ‬ ‫داﮐﺘﺮ‬ ‫ﺑﻪ‬ ‫ﻣﺮاﺟﻌﻪ‬ ‫دﻻﯾﻞ‬ ‫از‬ ‫ﻋﺒﺎرت‬ : ‫ﺗﻌﺮﯾﻒ‬
. ‫اﺳﺖ‬ ‫ﺗﺪاوی‬ ‫ﺑﺮای‬ ‫ﺟﺴﺘﺠﻮ‬

History of Present Illness ‫ﻓﻌﻠﯽ‬ ‫ﻣﺮﯾﺾ‬ ‫ﺗﺎﯾﺨﭽﻪ‬
‫ﻣﺮاﺟﻌﻪ‬ ‫دﮐﺘﺮ‬ ‫ﺑﻪ‬ ‫زﻣﺎﻧﯿﮑﻪ‬ ‫ﺗﺎ‬ ‫اﻋﺮاض‬ ‫وﻗﻮع‬ ‫اوﻟﯿﻦ‬ ‫زﻣﺎن‬ ‫از‬ ‫اﻃﻼﻋﺎت‬ ‫آوری‬ ‫ﺟﻤﻊ‬ ‫ﺷﺎﻣﻞ‬
: ‫ﺑﺎﺷﺪ‬ ‫ذﯾﻞ‬ ‫ﺳﻮاﻻت‬ ‫ﻣﺎﻧﻨﺪ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫ﮐﻪ‬ . ‫ﮐﺮده‬
۱
‫؟‬ ‫اﺳﺖ‬ ‫ﺷﺪه‬ ‫آﻏﺎز‬ ‫ﻣﺸﮑﻞ‬ ‫اﯾﻦ‬ ‫زﻣﺎﻧﯽ‬ ‫ﭼﻪ‬ .
۲
‫؟‬ ‫دارﯾﺪ‬ ‫ﺷﮑﺎﯾﺖ‬ ‫ﯾﺎ‬ ‫و‬ ‫ﻣﺸﮑﻞ‬ ‫ﮐﺪام‬ ‫ﺷﺪه‬ ‫اﺑﺠﺎد‬ ‫ﻣﺸﮑﻞ‬ ‫اﯾﻦ‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﺷﻤﺎ‬ ‫آﯾﺎ‬ .
۳
‫؟‬ ‫ﺷﻮد‬ ‫ﺑﻬﺘﺮ‬ ‫ﯾﺎ‬ ‫و‬ ‫ﺑﺪﺗﺮ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫ﺧﺎص‬ ‫زﻣﺎﻧﯽ‬ ‫در‬ ‫اﻋﺮاض‬ ‫آﯾﺎ‬ .
۴
‫؟‬ ‫ﮐﺮدﯾﺪ‬ ‫ﭼﻪ‬ ‫اﻋﺮاض‬ ‫رﻓﻊ‬ ‫ﺑﺨﺎﻃﺮ‬ ‫ﺷﻤﺎ‬ .
۵
‫؟‬ ‫اﯾﺪ‬ ‫ﮐﺮده‬ ‫ﻣﺸﻮره‬ ، ‫ﺷﺪه‬ ‫اﯾﺠﺎد‬ ‫ﻣﺸﮑﻞ‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫دﮔﺮ‬ ‫ﮐﺴﯽ‬ ‫ﺑﺎ‬ ‫ﺷﻤﺎ‬ ‫آﯾﺎ‬ .
۶
، ‫ﻣﺎه‬ ، ‫ﻫﻔﺘﻪ‬ ، ‫روز‬ ، ‫ﺳﺎﻋﺖ‬ ، ‫ﺗﺪرﯾﺞ‬ ‫ﺑﻪ‬ ، ‫ﻋﺎﻧﯽ‬ : ‫آﻏﺎز‬ ‫ﭼﮕﻮﻧﮕﯽ‬ .
۷
.‫ﻣﯿﮕﺮدد‬ ‫ﻋﻼﯾﻢ‬ ‫و‬ ‫اﻋﺮاض‬ ‫ﺗﺤﺮﯾﮏ‬ ‫ﺑﺎﻋﺚ‬ ‫ﭼﯿﺰی‬ ‫اﯾﺎ‬ : ‫آﻏﺎز‬ ‫ﻋﻠﺖ‬ .
۸
. ‫ﺷﺪه‬ ‫اﯾﺠﺎد‬ ‫ﺣﺎﻟﺖ‬ ‫زﻣﺎن‬ ‫ﻣﺪت‬ : ‫زﻣﺎن‬ .
۹
. ‫ﺷﺪت‬ ‫ﮐﺎﻫﺶ‬ ‫ﯾﺎ‬ ‫و‬ ‫ازدﯾﺎد‬ ، ‫ﻋﺎﻧﯽ‬ ، ‫ﮐﻨﻨﺪه‬ ‫ﻧﮑﺲ‬ ، ‫ﻣﻨﻘﻄﻊ‬ :‫اﻋﺮاض‬ ‫ﺷﺪت‬ ‫و‬ ‫دوام‬ .
۱۰
. ‫دوﺑﺎره‬ ‫ﻧﮑﺲ‬ ‫و‬ ‫رﺷﻒ‬ ‫و‬ ‫اﯾﺠﺎد‬.
۱۱
‫از‬ ‫ﻣﻌﻠﻮﻣﺎت‬ ‫ﮔﺮﻓﺘﻦ‬ ، ‫ﺣﺎل‬ ‫ﺑﻪ‬ ‫ﻣﺸﺎﺑﻪ‬ ‫ﺣﺎﻟﺖ‬ ‫ﺳﺎﺑﻘﻪ‬ ‫ﺗﺪاوی‬ ‫ﺻﻮرت‬ ‫در‬ : ‫ﺗﺪاوی‬ .
. ‫ﻣﺮﺑﻮﻃﻪ‬ ‫داﮐﺘﺮ‬ ‫اﺳﻢ‬ ‫ﺛﺒﺖ‬ ‫و‬ ‫ﺗﺪاوی‬ ‫ﻃﺮﯾﻘﻪ‬
۱۲
) ‫ﻣﻨﻔﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬ .
Negative history
‫ﻣﻮﺟﻮدﯾﺖ‬ ‫ﺻﻮرت‬ ‫در‬ : ‫ﻣﺜﺎل‬ ‫ﻃﻮر‬ ‫ﺑﻪ‬ :(
‫ان‬ ‫ﻃﺮﯾﻖ‬ ‫از‬ ‫ﻣﺎﯾﻊ‬ ‫ﺷﺪن‬ ‫ﺧﺎرج‬ ‫ﺗﺎرﯾﺨﭽﻪ‬ ‫ﻣﻮﺟﻮدﯾﺖ‬ ‫ﻋﺪم‬ ‫و‬ ‫ﮔﻮﻧﻪ‬ ‫ﯾﺎ‬ ‫ﮐﻮﻣﻪ‬ ‫در‬ ‫ﺳﯿﻨﻮز‬
‫اﺣﺘﻤﺎل‬ ، ‫ﺗﻌﺎم‬ ‫ﺻﺮف‬ ‫ﻫﻨﮕﺎم‬
Parotid Fistula
.‫(ﻣﯿﺴﺎزد‬ - ) ‫ﺑﺮﻃﺮف‬ ‫را‬

History of the patient in particular reference to pain
‫درد‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﻣﺮﯾﺾ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
yawning,
chewing,
drinking hot and
cold liquids
mild and
severe pain
burning, throbbing, , shooting, , vague , splitting, dull, aching,
lacinating, cutting, boring, constricting, gripping, , pounding,
heavy,
pressing, sharp, bright, , cramping, squeezing, or searing
localized or diffused,
radiating
or spreading and
enlarging or migrating
s
p
e
c
i
a
l
s
e
n
s
e
s
a
f
f
e
c
t
i
n
g
v
i
s
i
o
n
,
h
e
a
r
i
n
g
,
s
m
e
l
l
talking, brushing
of teeth, shaving,
washing the
face, turning the
head, lying down
i
n
t
e
r
m
i
t
t
e
n
t
o
r
c
o
n
t
i
n
u
o
u
s

: ‫ﺷﻮﻧﺪ‬ ‫ﭘﺮﺳﯿﺪه‬ ‫ﻣﺮﯾﻀﺎن‬ ‫از‬ ‫ﺑﺎﯾﺪ‬ ‫درد‬ ‫ﺑﺎ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﮐﻪ‬ ‫ﺳﻮاﻻﺗﯽ‬
۱
‫؟‬ ‫اﺳﺖ‬ ‫ﻧﺒﻀﺎﻧﯽ‬ ، ‫ﮔﻨﮓ‬ ، ‫آور‬ ‫زﺟﺮ‬ ، ‫ﺗﯿﺰ‬ ‫درد‬ ‫آﯾﺎ‬ .
۲
‫ﺧﺎﺻﯽ‬ ‫ﻓﻌﺎﻟﯿﺖ‬ ‫ﮐﺪام‬ ‫ﯾﺎ‬ ‫اﺳﺖ‬ ‫ﻣﻮﺟﻮد‬ ‫ﻣﺪاوم‬ ‫ﻃﻮر‬ ‫ﺑﻪ‬ ‫درد‬ ‫آﯾﺎ‬ .
‫؟‬ ‫ﻣﯿﮕﺮدد‬ ‫درد‬ ‫اﯾﺠﺎد‬ ‫ﺑﺎﻋﺚ‬
۳
‫؟‬ ‫ای‬ ‫وﻗﻔﻪ‬ ‫ﯾﺎ‬ ‫اﺳﺖ‬ ‫ﺛﺎﺑﺖ‬ ‫درد‬ ‫اﯾﺎ‬ .
۴
‫؟‬ ‫ﯾﮑﺒﺎره‬ ‫ﯾﺎ‬ ‫و‬ ‫ﻣﯿﺸﻮد‬ ‫اﯾﺠﺎد‬ ‫ﺗﺪرﺑﺠﯽ‬ ‫ﺻﻮرت‬ ‫ﺑﻪ‬ ‫درد‬ ‫آﯾﺎ‬ .
۵
‫؟‬ ‫ﻣﯿﺸﻮد‬ ‫ﮐﻤﺘﺮ‬ ‫ﯾﺎ‬ ‫ﺑﯿﺸﺘﺮ‬ ‫روز‬ ‫از‬ ‫اوﻗﺎت‬ ‫ﮐﺪام‬ ‫در‬ ‫درد‬ ‫اﯾﺎ‬ .
۶
‫؟‬ ‫ﻃﻮﻻﻧﯽ‬ ‫ﯾﺎ‬ ‫اﺳﺖ‬ ‫ﮐﻮﺗﺎه‬ ‫درد‬ ‫دوام‬ ‫زﻣﺎن‬ ‫ﻣﺪت‬ ‫آﯾﺎ‬ .

Swelling ‫ﭘﻨﺪﯾﺪﮔﯽ‬ ، ‫ورم‬
: ‫دوام‬ ‫ﻣﺪت‬ -
‫؟‬ ‫اﺳﺖ‬ ‫ﻣﻮﺟﻮد‬ ‫ﭘﻨﺪﯾﺪﮔﯽ‬ ‫ﮐﻪ‬ ‫ﻣﯿﺸﻮد‬ ‫روز‬ ‫ﭼﻨﺪ‬
‫ﺣﺎد‬
) ‫ﻫﻔﺘﻪ‬ ‫ﯾﺎ‬ ‫روز‬ ‫ﭼﻨﺪ‬ :
‫ﻣﺰﻣﻦ‬
) ‫ﺳﺎل‬ ‫ﯾﺎ‬ ‫ﻣﺎه‬ :
: ‫وﻗﻮع‬ ‫ﺷﯿﻮه‬ -
‫اﻧﺪازه‬ ‫ازدﯾﺎد‬
) ‫ﻏﺬا‬ ‫ﺟﻮﯾﺪن‬ ‫ﻫﻨﮕﺎم‬ ‫در‬
Salivary Gland Retention
.(
: ‫آﻫﺴﺘﻪ‬ ‫رﺷﺪ‬
، ‫ﻣﺰﻣﻦ‬ ‫ﻫﺎی‬ ‫اﻧﻔﮑﺸﻦ‬
Reactive Hyperplasia , Cyst
. ‫ﺳﻠﯿﻢ‬ ‫ﻫﺎی‬ ‫ﺗﻮﻣﻮر‬ ,
: ‫ﺳﺮﯾﻊ‬ ‫ﻧﺴﺒﯽ‬ ‫رﺷﺪ‬
. ‫ﺳﺮﻃﺎﻧﻬﺎ‬ ‫و‬ ‫ﺳﯿﺴﺘﻬﺎ‬ ، ‫ﻣﺰﻣﻦ‬ ‫ﻫﺎی‬ ‫اﻧﻔﮑﺸﻦ‬ ‫ﻣﺎه‬ ‫دو‬ ‫ﯾﺎ‬ ‫ﻫﻔﺘﻪ‬ ‫ﭼﻨﺪ‬
: ‫ﺳﺮﯾﻊ‬ ‫رﺷﺪ‬
، ‫آﺑﺴﻪ‬
Infected Cyst , Aneurysm, Hematoma , salivary Retention
.
: ‫ﺗﺐ‬ ‫ﺑﺎ‬ ‫ﻣﺘﺮاﻓﻖ‬ ‫ﮐﺘﻼت‬ -
‫ﻟﻤﻔﻮﻣﺎ‬ ، ‫اﻧﻔﮑﺸﻦ‬
: ‫اﻋﺮاض‬ -
. ‫ﺑﻠﻊ‬ ‫و‬ ‫ﺗﻨﻔﺲ‬ ‫در‬ ‫ﻣﺸﮑﻼت‬ ، ‫درد‬
-
: ‫ﭘﻨﺪﯾﺪﮔﯽ‬ ‫ﺑﺎ‬ ‫ﻣﺘﺮاﻓﻖ‬ ‫ﻣﺸﺨﺼﺎت‬
. ‫ﮔﯿﺮد‬ ‫ﺻﻮرت‬ ‫ﺗﻮﺟﻪ‬ ‫وزن‬ ‫ﮐﺎﻫﺶ‬ ، ‫ﺗﺐ‬ ‫ﻣﻮﺟﻮدﯾﺖ‬ ‫ﺻﻮرت‬ ‫در‬
: ‫ﺛﺎﻧﻮی‬ ‫ﺗﻐﯿﺮات‬-
. ‫ﺷﺪن‬ ‫ﻗﺮﺣﻮی‬ ، ‫ﺷﺪن‬ ‫ﻧﺮم‬
: ‫ﻓﻌﺎﻟﯿﺖ‬ ‫در‬ ‫اﺧﻼل‬ -
. ‫ﺣﺮﮐﺖ‬ ‫و‬ ‫ﻓﻌﺎﻟﯿﺖ‬ ‫رﻓﺘﻦ‬ ‫دﺳﺖ‬ ‫از‬
: ‫دوﺑﺎره‬ ‫ﻧﮑﺲ‬
.( ‫ﻫﺎ‬ ‫ﺳﯿﺴﺖ‬ ، ‫ﺳﺮﻃﺎﻧﯽ‬ ‫)ﺗﻐﯿﺮات‬ ‫دوﺑﺎره‬ ‫ﻧﮑﺲ‬ ‫و‬ ‫ﺑﺮداﺷﺘﻦ‬ ‫ﺻﻮرت‬ ‫در‬

Ulcer‫ﻗﺮﺣﻪ‬
: ‫وﻗﻮع‬ ‫ﺷﯿﻮه‬ -
. ‫دوام‬ ‫و‬ ‫ﺷﺮوع‬ ‫ﭼﮕﻮﻧﮕﯽ‬
‫درد‬
‫ﻗﺮﺣﺎت‬ ‫اﻣﺎ‬ ‫ﻫﺴﺘﻨﺪ‬ ‫دردﻧﺎک‬ ‫اﻧﻔﮑﺸﻨﻬﺎ‬ ‫ﺑﺎ‬ ‫ﺑﺎ‬ ‫ﻣﺘﺮاﻓﻖ‬ ‫ﻗﺮﺣﺎت‬ :
) ‫اﭘﯿﺘﻠﯿﻮﻣﯽ‬
BCC
. ‫ﻫﺴﺘﻨﺪ‬ ‫درد‬ ‫ﺑﺪون‬ (
: ‫اﻓﺮازات‬ -
.‫ﭼﺮک‬ ، ‫ﺳﯿﺮوم‬ ، ‫ﺧﻮن‬
: ‫ﻗﺮﺣﻪ‬ ‫ﺑﺎ‬ ‫ﻣﺘﺮاﻓﻖ‬ ‫اﻣﺮاض‬ -
TB
‫ﯾﺎ‬ ‫ﻧﻔﺮاﯾﺘﺲ‬ ,
Glomerulonephritis
,
. ‫ﺳﯿﻔﻠﯿﺲ‬ ، ‫ﺷﮑﺮ‬
BCC

Past Dental History
‫دﻧﺪاﻧﯽ‬ ‫ﻗﺒﻠﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
By : Dr Mohammad Nasir (Sharefy)
‫ﺷﯿﻮه‬ ، ‫روﺣﯿﻪ‬
، ‫داﮐﺘﺮ‬ ‫ﺑﺎ‬ ‫رﻓﺘﺎر‬، ‫ﺑﺮﺧﻮرد‬
، ‫رﺿﺎﯾﺖ‬ ، ‫ﺗﺪاوی‬ ‫ﻧﺘﯿﺠﻪ‬
‫ﻫﺎی‬ ‫ﺗﺪاوی‬ ‫اﺟﺮای‬
Restorative ,Endodo
ntic ,
Chemotherapy ,
Surgery
، ‫ﺣﺴﺎﺳﯿﺖ‬ ,
‫اﺧﺘﻼﺗﺎت‬ ‫رﺿﺎﯾﺖ‬

Past Medical History ‫ﻗﺒﻠﯽ‬ ‫ﻃﺒﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
:‫ﻗﺒﻠﯽ‬ ‫ﻃﺒﯽ‬ ‫ﺗﺎرﺧﭽﻪ‬ ‫ﮔﺮﻓﺘﻦ‬ ‫اﻫﺪاف‬
۱
.‫ﺳﯿﺴﺘﻤﯿﮏ‬ ‫اﻣﺮاض‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫دﻫﻦ‬ ‫ﺟﻮف‬ ‫اﻣﺮاض‬ ‫ﺗﺸﺨﯿﺺ‬ .
۲
. ‫ﻣﺮﯾﻀﺎن‬ ‫در‬ ‫ﺳﯿﺴﺘﻤﯿﮏ‬ ‫اﻣﺮاض‬ ‫ﺗﺸﺨﯿﺺ‬.
۳
‫ﺗﺪاوی‬ ‫ﭘﻼن‬ ‫ﮐﺮدن‬ ‫ﻣﺸﺨﺺ‬ .
۴
‫در‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﻣﺮﯾﻀﺎن‬ ‫از‬ ‫ﺑﻌﻀﯽ‬ ‫ﭼﻮن‬ ‫دﮔﺮ‬ ‫اﺧﺘﺼﺎﺻﯽ‬ ‫ﺑﺨﺶ‬ ‫از‬ ‫ﮔﯿﺮی‬ ‫ﻣﺸﻮره‬.
: ‫دارﻧﺪ‬ ‫ﻗﺮار‬ ‫ﺧﻄﺮ‬ ‫ﻣﻌﺮض‬
‫ﭼﺎق‬ ‫ﻣﺮﯾﻀﺎن‬
‫ﺑﻠﻨﺪ‬ ‫ﻓﺸﺎر‬ ‫ﺑﺎ‬ ‫ﻣﺮﯾﺎﺿﺎن‬
‫ﺳﯿﺴﺘﻤﯿﮏ‬ ‫ﺷﺪﯾﺪ‬ ‫ﻣﺸﮑﻼت‬ ‫دارای‬ ‫ﻣﺮﯾﻀﺎن‬
By : Dr Mohammad Nasir (Sharefy)

‫ﻣﺸﺎوره‬ ‫ﻧﺎﻣﻪ‬
_________ : ‫ﻣﺤﻞ‬
/ / : ‫ﺗﺎرﯾﺦ‬
۱۴۰۰
__________________ : ‫ﻣﺮﯾﺾ‬ ‫اﺳﻢ‬
__________________ : ‫ﮐﻨﻨﺪه‬ ‫ارﺟﺎع‬ ‫دﮐﺘﺮ‬ ‫اﺳﻢ‬
------------------------ : ‫ﺷﺪه‬ ‫راﺟﻊ‬ ‫داﮐﺘﺮ‬ ‫اﺳﻢ‬
‫دﻧﺪان‬ ‫زای‬ ‫اﺳﺘﺮس‬ ‫ﭘﺮوﺳﯿﺠﺮ‬ ‫ﺗﺤﺖ‬ ‫ﮐﻪ‬ ‫را‬ ____________ ‫ﺑﻨﺎم‬ ‫ﻣﺮﯾﻀﯽ‬ ‫اﯾﻨﺠﺎﻧﺐ‬
. ‫ام‬ ‫ﮐﺮده‬ ‫راﺟﻊ‬ ‫ﺷﻤﺎ‬ ‫ﺑﺮای‬ ‫را‬ ‫ﻣﯿﮕﯿﺮد‬ ‫ﻗﺮار‬
‫ﻃﺒﯽ‬ ‫ﺳﺎﺑﻘﻪ‬ ، ‫ﮐﻨﯿﻢ‬ ‫اﺳﺘﻔﺎده‬ ‫ﻣﻮﺿﻌﯽ‬ ‫ﺣﺴﯽ‬ ‫ﺑﯽ‬ ‫از‬ ‫ﺑﺎﯾﺪ‬ ‫ﭘﺮوﺳﯿﺠﺮ‬ ‫اﺟﺮای‬ ‫ﺑﺮای‬ ‫و‬
.‫ﺑﺮد‬ ‫ﻣﯽ‬ ‫رﻧﺞ‬ ________________ ‫از‬ ‫او‬ ‫ﮐﻪ‬ ‫دﻫﺪ‬ ‫ﻣﯽ‬ ‫ﻧﺸﺎن‬ ‫ﻣﺮﯾﺾ‬
‫ﻧﻈﺮ‬ ‫ﻣﻮرد‬ ‫ﻣﺮﯾﺾ‬ ‫آﯾﺎ‬ ‫ﮐﻪ‬ ‫ﻧﻤﺎﯾﯿﺪ‬ ‫ﺗﻮﺻﯿﻪ‬ ‫ﻣﺎ‬ ‫ﺑﺮای‬ ‫ﻣﺮﯾﺾ‬ ‫ﺣﺎﻟﺖ‬ ‫درﺑﺎره‬ ‫ﻧﻤﻮده‬ ‫ﻟﻄﻒ‬
‫اﻧﺴﺘﯿﺰی‬ ‫ﻧﻮع‬ ‫ﮐﺪام‬ ، ‫ﻧﻪ‬ ‫ﯾﺎ‬ ‫و‬ ‫ﺑﮕﯿﺮد‬ ‫ﻗﺮار‬ ‫دﻧﺪان‬ ‫زا‬ ‫اﺳﺘﺮس‬ ‫ﭘﺮوﺳﯿﺠﺮ‬ ‫ﺗﺤﺖ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬
‫ﻧﻤﻮده‬ ‫ﻟﻄﻒ‬ ، ‫ﺑﮕﯿﺮﯾﻢ‬ ‫ﺑﺎﯾﺪ‬ ‫دﺳﺖ‬ ‫روی‬ ‫را‬ ‫اﺣﺘﻤﺎﻣﺎت‬ ‫ﮐﺪام‬ ، ‫ﺑﮕﯿﺮﯾﻢ‬ ‫ﺑﮑﺎر‬ ‫را‬ ‫ﻣﻮﺿﯽ‬
. ‫ﻓﺮﻣﺎﯾﯿﺪ‬ ‫ﺗﻮﺻﯿﻪ‬
/ / :‫ﺗﺎرﯾﺦ‬ _______________: ‫ﻣﺮﯾﺾ‬ ‫اﻣﻀﺎی‬
۱۴۰۰
/ / : ‫_________________ﺗﺎرﯾﺦ‬ : ‫دﮐﺘﺮ‬ ‫اﻣﻀﺎی‬
۱۴۰۰
.‫ﺑﺮﮔﺮداﻧﯿﺪ‬ ___________________ ‫ﺑﻪ‬ ‫را‬ ‫ﻣﺸﺎوره‬ ‫ﻧﺎﻣﻪ‬ ‫اﯾﻦ‬ ً‫ﻟﻄﻔﺎ‬

‫ﭼﯿﺴﺖ؟‬ ‫درﻣﺎن‬ ‫ﺗﺤﺖ‬ ‫ﺷﺮاﯾﻂ‬ ، ‫اﺳﺖ‬ ‫ﭼﻨﯿﻦ‬ ‫اﮔﺮ‬ ‫ﻫﺴﺘﯿﺪ؟‬ ‫دﮐﺘﺮ‬ ‫ﻣﺮاﻗﺒﺖ‬ ‫ﺗﺤﺖ‬ ً‫اﺧﯿﺮا‬ ‫ﯾﺎ‬ ‫اﮐﻨﻮن‬ •
‫ﻃﯽ‬ ‫آﯾﺎ‬ •
2
‫اﯾﺪ؟‬ ‫ﺷﺪه‬ ‫ﺑﺴﺘﺮی‬ ‫ﺷﻔﺎﺧﺎﻧﻪ‬ ‫در‬ ‫ﮔﺬﺷﺘﻪ‬ ‫ﺳﺎل‬
‫ﮐﻨﯿﺪ؟‬ ‫ﻣﯽ‬ ‫ﻣﺼﺮف‬ ‫داﺋﻤﯽ‬ ‫ﻏﯿﺮ‬ ‫ﯾﺎ‬ ‫داﺋﻤﯽ‬ ‫ﺻﻮرت‬ ‫ﺑﻪ‬ ‫را‬ ‫ﻧﺴﺨﻪ‬ ‫ﺑﺪون‬ ‫ﯾﺎ‬ ‫ﺗﺠﻮﯾﺰی‬ ‫دواﻫﺎی‬ ‫ﺷﻤﺎ‬ ‫آﯾﺎ‬ •
‫ﭼﯿﺰی؟‬ ‫ﭼﻪ‬ ‫ﺑﻪ‬ ‫اﺳﺖ‬ ‫ﭼﻨﯿﻦ‬ ‫اﮔﺮ‬ ، ‫دارﯾﺪ‬ ‫ﺣﺴﺎﺳﯿﺖ‬ ‫آﯾﺎ‬ •
‫آﺳﭙﺮﯾﻦ‬ -
‫ﮔﻮﮔﺮد‬ ‫ﺣﺎوی‬ ‫داروﻫﺎی‬ -
‫دﯾﮕﺮ‬ ‫ﺑﯿﻮﺗﯿﮏ‬ ‫آﻧﺘﯽ‬ ‫ﻫﺮ‬ ‫ﯾﺎ‬ ‫ﺳﯿﻠﯿﻦ‬ ‫ﭘﻨﯽ‬ -
‫ﻣﺨﺪر‬ ‫ﻣﺎده‬ ‫ﻫﺮ‬ ‫ﯾﺎ‬ ‫ﮐﺪﺋﯿﻦ‬ -
‫دﻧﺪان‬ ‫ﻫﺎی‬ ‫ﮐﻨﻨﺪه‬ ‫ﺣﺲ‬ ‫ﺑﯽ‬ -
‫ﺧﺎﺻﯽ‬ ‫دوای‬ ‫ﻫﺮ‬ -
‫ﮐﻨﺪ؟‬ ‫ﻣﯽ‬ ‫ﻋﺼﺒﯽ‬ ‫را‬ ‫ﺷﻤﺎ‬ ‫دﻧﺪاﻧﭙﺰﺷﮑﯽ‬ ‫ﻫﺎی‬ ‫ﺗﺪاوی‬ ‫آﯾﺎ‬ •
: ‫ﻋﻤﻮﻣﯽ‬ ‫ﺳﻮاﻻت‬
‫اﺳﺘﺮاﺣﺖ‬ ‫ﺣﺎﻟﺖ‬ ‫در‬ ‫ﯾﺎ‬ ‫ﺧﻮردن‬ ‫ﻏﺬا‬ ‫ﻫﻨﮕﺎم‬ ، ‫ورزش‬ ‫ﻫﻨﮕﺎم‬ ‫ﺳﯿﻨﻪ‬ ‫ﻗﻔﺴﻪ‬ ‫ﻧﺎراﺣﺘﯽ‬ •
‫ﺳﯿﻨﻪ‬ ‫ﻗﻔﺴﻪ‬ ‫ﺳﺨﺘﯽ‬ •
‫ﻗﻠﺐ‬ ‫ﺗﭙﺶ‬ •
‫ﮐﺮدن‬ ‫ﺿﻌﻒ‬ •
• Ankle Edema
•
‫ﻧﻔﺲ‬ ‫ﺗﻨﮕﯽ‬
‫ﭘﺎﯾﯿﻦ‬ ‫ﯾﺎ‬ ‫ﺑﺎﻻ‬ ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ •
‫ﻗﻠﺐ‬ ‫ﺳﻮﻓﻞ‬ •
Heart Murmor
: ‫وﻋﺎﯾﯽ‬ ‫ﻗﻠﺒﯽ‬ ‫ﺳﻮاﻻت‬

: ‫ﺗﻨﻔﺴﯽ‬ ‫ﺳﯿﺴﺘﻢ‬ ‫ﺳﻮاﻻت‬
‫ﻓﺸﺎر‬ ‫اﻧﺠﺎم‬ ‫ﻫﻨﮕﺎم‬ ‫در‬ ‫ﻧﻔﺲ‬ ‫ﺗﻨﮕﯽ‬ •
‫ﺧﻠﻂ‬ ‫ﺣﺪ‬ ‫از‬ ‫ﺑﯿﺶ‬ ‫ﺗﻮﻟﯿﺪ‬ ، ‫ﺳﺮﻓﻪ‬ ، ‫ﺧﺲ‬ ‫ﺧﺲ‬ •
‫ﺧﻮن‬ ‫ﮐﺮدن‬ ‫ﺳﺮﻓﻪ‬ •
.‫دﯾﮕﺮ‬ ‫ﻫﺎی‬ ‫دﯾﺪﮔﯽ‬ ‫آﺳﯿﺐ‬ ‫ﯾﺎ‬ ‫دﻧﺪان‬ ‫ﮐﺸﯿﺪن‬ ، ‫ﺑﺮﯾﺪن‬ ‫ﺣﯿﻦ‬ ‫در‬ ‫ﻣﺪت‬ ‫ﻃﻮﻻﻧﯽ‬ ‫ﺧﻮﻧﺮﯾﺰی‬ •
‫ﺷﻮﯾﺪ‬ ‫ﻣﯽ‬ ‫ﮐﺒﻮد‬ ‫راﺣﺘﯽ‬ ‫ﺑﻪ‬ ‫آﯾﺎ‬ •
‫اﯾﺪ‬ ‫داﺷﺘﻪ‬ ‫ﺧﻮن‬ ‫اﻧﺘﻘﺎل‬ ‫ﺑﻪ‬ ‫ﻧﯿﺎز‬ •
‫اﯾﺪ‬ ‫داﺷﺘﻪ‬ ‫ﻣﮑﺮر‬ ‫ﻫﺎی‬ ‫ﻋﻔﻮﻧﺖ‬ •
‫ﻫﺴﺘﯿﺪ‬ ‫ﺧﻮن‬ ‫ﻛﻢ‬ ‫ﻛﻪ‬ ‫اﻧﺪ‬ ‫ﮔﻔﺘﻪ‬ ‫ﺷﻤﺎ‬ ‫ﺑﻪ‬ ‫ﺣﺎل‬ ‫ﺑﻪ‬ ‫ﺗﺎ‬ •
: ‫ﺧﻮن‬ ‫ﻣﺸﮑﻼت‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫ﺳﻮاﻻت‬
‫ﻣﻐﺰی‬ ‫ﺿﺮﺑﻪ‬ ‫ﯾﺎ‬ ‫ﺳﺮ‬ ‫ﺑﻪ‬ ‫ﺿﺮﺑﻪ‬ •
/ ‫ﻓﺮاﻣﻮﺷﯽ‬ / ‫ﺗﺸﻨﺞ‬ •
‫ﻣﮑﺮر‬ ‫ﺳﺮدردﻫﺎی‬ •
‫اﯾﺪ‬ ‫ﮐﺮده‬ ‫ﺗﺠﺮﺑﻪ‬ ‫را‬ ‫ﭘﺎﻫﺎ‬ ‫ﯾﺎ‬ ‫ﻫﺎ‬ ‫دﺳﺖ‬ ، ‫ﺻﻮرت‬ ‫در‬ ‫ﮔﺰﮔﺰ‬ ‫ﯾﺎ‬ ‫ﺣﺴﯽ‬ ‫ﺑﯽ‬ ، ‫درد‬ ‫ﻫﺮﮔﻮﻧﻪ‬ •
‫اﯾﺪ‬ ‫ﺷﺪه‬ ‫ﻓﻠﺞ‬ •
: ‫ﻋﺼﺒﯽ‬ ‫ﺳﯿﺴﺘﻢ‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫ﺳﻮاﻻت‬

:‫اﻧﺪوﮐﺮاﯾﻦ‬ ‫و‬ ‫ﻣﯿﺘﺎﺑﻮﻟﯿﮏ‬ ‫ﺳﯿﺴﺘﻢ‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫ﺳﻮاﻻت‬
‫وزن‬ ‫اﻓﺰاﯾﺶ‬ ‫ﯾﺎ‬ ‫دادن‬ ‫دﺳﺖ‬ ‫از‬ ‫ﮔﻮﻧﻪ‬ ‫ﻫﺮ‬ •
‫ﻫﯿﭙﻮﺗﯿﺮوﺋﯿﺪﯾﺴﻢ‬ ‫ﯾﺎ‬ ‫ﻫﯿﭙﺮﺗﯿﺮوﺋﯿﺪﯾﺴﻢ‬ •
‫دﺳﺘﺎن‬ ‫ﺣﺪ‬ ‫از‬ ‫ﺑﯿﺶ‬ ‫ﮐﺮدن‬ ‫ﻋﺮق‬ •
‫ﺣﺪ‬ ‫از‬ ‫ﺑﯿﺶ‬ ‫ﺧﺴﺘﮕﯽ‬ •
۱
‫ﺑﻠﻌﯿﺪن‬ ‫در‬ ‫ﻣﺸﮑﻼت‬ .
۲
‫ﺣﺪ‬ ‫از‬ ‫ﺑﯿﺶ‬ ‫زدن‬ ‫ﻋﺎرق‬ ‫و‬ ‫ﻗﻠﺐ‬ ‫ﺳﻮزش‬ .
۳
‫اﺳﺘﻔﺮاغ‬ ‫و‬ ‫دﻟﺒﺪی‬ .
۴
‫ﺧﻮن‬ ‫اﺳﺘﻔﺮاغ‬ .
۵
‫ﺑﻄﻦ‬ ‫و‬ ‫ﺻﺪر‬ ‫ﻣﮑﺮر‬ ‫دردﻫﺎی‬ .
۶
‫ﻏﺎﯾﻄﻪ‬ ‫ﻣﻮاد‬ ‫اﻃﺮاح‬ ‫دﻓﻌﺎت‬ ‫ازدﯾﺎد‬ .
۷
‫اواﺧﺮ‬ ‫اﯾﻦ‬ ‫در‬ ‫اﺳﻬﺎل‬ ‫وﻗﻮﻋﺎت‬ .
۸
‫ﻏﺎﯾﻄﻪ‬ ‫ﻣﻮاد‬ ‫در‬ ‫ﺳﯿﺎه‬ ‫ﯾﺎ‬ ‫و‬ ‫روﺷﻦ‬ ‫ﺳﺮخ‬ ‫رﻧﮓ‬ ‫ﻣﺸﺎﻫﺪه‬ .
‫ﺻﻔﺮاوی‬ ، ‫ﮐﺒﺪی‬ ، ‫ﻫﻀﻤﯽ‬ ‫ﺳﯿﺴﺘﻢ‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫ﺳﻮاﻻت‬

‫ﺗﻨﺎﺳﻠﯽ‬ ‫ﺳﯿﺴﺘﻢ‬ ‫ﺑﻪ‬ ‫ﻣﺮﺗﺒﻂ‬ ‫ﺳﻮاﻻت‬
۱
‫ادرار‬ ‫دﻓﻌﺎت‬ ‫در‬ ‫ازدﯾﺎد‬ .
۲
‫ادرار‬ ‫ﻫﻨﮕﺎم‬ ‫در‬ ‫درد‬ ‫و‬ ‫ﻣﺸﮑﻼت‬ .
۳
‫آﻟﻮد‬ ‫ﺧﻮن‬ ‫ﭼﺮﮐﯿﻦ‬ ‫ادرار‬ .
۴
‫ادرار‬ ‫ای‬ ‫ﻗﻮه‬ ‫ﯾﺎ‬ ‫ﺳﺮخ‬ ‫رﻧﮓ‬ .
۵
‫ﻣﺎﻫﻮار‬ ‫ﻋﺎدت‬ ‫ﺳﺎﯾﮑﻞ‬ ‫در‬ ‫ﺗﻐﯿﺮات‬ .

: ‫ﺳﯿﺴﺘﻤﯿﮏ‬ ‫ﻣﺸﮑﻼت‬
‫اﻣﺮاض‬ ‫ﻣﻮﺟﻮدﯾﺖ‬ ‫و‬ ‫ﻣﻮﺟﻮدﯾﺖ‬ ‫ﻋﺪم‬ ‫ﺑﻪ‬ ‫ارﺗﺒﺎط‬ ‫در‬ ‫ﭘﺎﺳﺦ‬ ‫و‬ ‫ﭘﺮﺳﺶ‬
.‫ﻣﯿﮕﯿﺮد‬ ‫ﺻﻮرت‬ ‫ﺗﺪاوی‬ ‫ﭼﮕﻮﻧﮕﯽ‬ ، ‫ﺗﺪاوی‬ ‫ﮐﻮرس‬ ، ‫ﺳﯿﺴﺘﻤﯿﮏ‬
‫ﻣﺼﺎب‬ ‫ﻣﺮﯾﻀﺎن‬ ‫ﺗﺪاوی‬ ‫ﻫﻨﮕﺎم‬ ‫در‬ ‫در‬ ‫را‬ ‫ﺑﯿﺸﺘﺮ‬ ‫ﺗﻮﺟﻪ‬ ‫و‬ ‫دﻗﺖ‬ ‫ﮐﻪ‬ ‫اﻣﺮاﺿﯽ‬
: ‫ﻣﺎﻧﻨﺪ‬ ‫داﺷﺖ‬
Diabetes
Asthma
Bleeding disorders
Hypertension
Myocardial infarction
Hepatitis B
Diphtheria
Rheumatoid heart disease
Tuberculosis
Gonorrhea

: ‫ﺻﺪر‬ ‫درد‬
. ‫ﺑﺴﺎزد‬ ‫آﮔﺎه‬ ‫ﺷﺨﺺ‬ ‫وﻋﺎﯾﯽ‬ ‫ﻗﻠﺒﯽ‬ ‫ﺣﺎﻟﺖ‬ ‫از‬ ‫را‬ ‫ﻣﺎ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬
: ‫ﺣﺴﺎﺳﯿﺖ‬
‫ﺗﺪاوی‬ ‫ﭘﺮوﺳﻪ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫ﻏﺬا‬ ‫ﯾﺎ‬ ‫و‬ ‫دوا‬ ‫ﺑﻪ‬ ‫ﺣﺴﺎﺳﯿﺖ‬ ‫ﺻﻮرت‬ ‫در‬
، ‫ﺗﺐ‬ ، ‫اﮐﺰﯾﻤﺎ‬ ،‫ﺗﻨﮕﯽ‬ ‫ﻧﻔﺲ‬ ‫آﻣﺪن‬ ‫ﺑﻮﺟﻮد‬ ‫از‬ ، ‫ﮐﻨﺪ‬ ‫ﺗﻐﯿﺮ‬
urticaria ,
angioedema
.‫ﺷﻮد‬ ‫ﺳﻮال‬ ‫ﻫﺎ‬ ‫ﻏﺬا‬ ‫ﯾﺎ‬ ‫و‬ ‫دواﻫﺎ‬ ‫از‬ ‫ﺑﻌﻀﯽ‬ ‫اﺳﺘﻔﺎده‬ ‫ﺑﺎ‬
: ‫ﺷﻔﺎﺧﺎﻧﻪ‬ ‫در‬ ‫ﺷﺪن‬ ‫ﺑﺴﺘﺮی‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
‫وﺿﻌﯿﺖ‬ ، ‫ﺑﻬﺒﻮد‬ ، ‫ﻓﻌﻠﯽ‬ ‫ﺣﺎﻟﺖ‬ ، ‫ﻋﻠﺖ‬
.‫آﯾﺪ‬ ‫ﻋﻤﻞ‬ ‫ﺑﻪ‬ ‫ﭘﺮﺳﺶ‬ ‫ﺷﺨﺺ‬ ‫ﻓﻌﻠﯽ‬
: ‫ﺧﻮن‬ ‫ﺑﻪ‬ ‫ﻧﯿﺎز‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
: ‫دواﯾﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
‫ﻣﺪت‬ ‫ﮐﻮﺗﺎه‬ ‫ﺻﻮرت‬ ‫ﺑﻪ‬ ‫دوا‬ ‫اﺳﺘﻔﺎده‬ ‫ﻣﻮرد‬ ‫در‬ ‫ﻣﺮﯾﺾ‬ ‫از‬
.‫ﺷﻮد‬ ‫ﭘﺮﺳﺶ‬ ‫دوا‬ ‫ﻓﻌﻠﯽ‬ ‫اﺳﺘﻔﺎده‬ ‫و‬ ، ‫دوا‬ ‫ﻧﻮع‬ ، ‫ﻣﺪت‬ ‫ﻃﻮﻻﻧﯽ‬ ‫و‬

Medical History
‫ﻃﺒﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
Dr Mohammad Nasir (Sharefy)
Oral Meducine

‫ﻋﻤﻮﻣﯽ‬ ‫ﻫﺎی‬ ‫ﭘﺎﺳﺦ‬ ‫و‬ ‫ﭘﺮﺳﺶ‬
۱
‫اﯾﺪ‬ ‫ﺑﻮده‬ ‫اﮔﺮ‬ ‫و‬ ‫؟‬ ‫اﯾﺪ‬ ‫ﺑﻮده‬ ‫داﮐﺘﺮ‬ ‫ﮐﺪام‬ ‫ﻧﺰد‬ ‫در‬ ‫ﺗﺪاوی‬ ‫ﺗﺤﺖ‬ ‫اﺧﯿﺮا‬ ‫آﯾﺎ‬ .
‫؟‬ ‫ﺑﻮده‬ ‫ﻣﺸﮑﻞ‬ ‫ﭼﻪ‬ ‫ﺑﺎﻋﺚ‬ ‫از‬
۲
‫؟‬ ‫اﯾﺪ‬ ‫ﺷﺪه‬ ‫ﺑﺴﺘﺮ‬ ‫ﺷﻔﺎﺧﺎﻧﻪ‬ ‫ﮐﺪام‬ ‫در‬ ، ‫ﮔﺬﺷﺘﻪ‬ ‫ﺳﺎل‬ ‫دو‬ ‫ﺟﺮﯾﺎن‬ ‫در‬ ‫آﯾﺎ‬ .
۳
‫؟‬ ‫دارﯾﺪ‬ ‫ﺣﺴﺎﺳﯿﺖ‬ ‫ﭼﯿﺰی‬ ‫ﮐﺪام‬ ‫ﺑﻪ‬ ‫آﯾﺎ‬ .
‫؟‬ ‫ﻣﯿﺴﺎزد‬ ‫ﻋﺼﺒﯽ‬ ‫را‬ ‫ﺷﻤﺎ‬ ‫دﻧﺪان‬ ‫ﻫﺎی‬ ‫ﺗﺪاوی‬ ‫آﯾﺎ‬

: ‫ﺷﺨﺼﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
: ‫اﻋﺘﯿﺎد‬ ‫و‬ ‫ﻋﺎدات‬
‫در‬ . ‫ﻣﯿﺒﺎﺷﻨﺪ‬ ‫اﻣﺮاض‬ ‫ﺳﺎز‬ ‫زﻣﯿﻨﻪ‬ ‫و‬ ‫ﻣﻬﻢ‬ ‫ﻋﺎدات‬ ‫ﺟﻤﻠﻪ‬ ‫از‬ ‫اﻟﮑﻮل‬ ، ‫ﺳﮕﺮت‬ ، ‫ﺗﻨﺒﺎﮐﻮ‬
.‫ﺷﻮد‬ ‫ﭘﺮﺳﯿﺪه‬ ‫روز‬ ‫در‬ ‫دﻓﻌﺎت‬ ‫و‬ ‫ﻣﺪت‬ ‫ﻃﻮل‬ ‫ﻣﻮرد‬
: ‫ﮐﺮدن‬ ‫ﺑﺮس‬ ‫ﺗﮑﻨﯿﮏ‬ ‫و‬ ‫دﻫﻦ‬ ‫ﺟﻮف‬ ‫اﻟﺼﺤﻪ‬ ‫ﺣﻔﻆ‬
: ‫اور‬ ‫ﻓﺸﺎر‬ ‫ﻋﺎدات‬
‫ﻗﺪاﻣﯽ‬ ‫دﻧﺪاﻧﻬﺎی‬ ‫ﭘﺮوﮐﻠﯿﻨﯿﺸﻦ‬ ‫ﺑﺎﻋﺚ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫ﻟﺒﻬﺎ‬ ، ‫ﺷﺴﺖ‬ ‫اﻧﮕﺸﺖ‬ ‫ﭼﻮﺷﯿﺪن‬
.‫ﺷﻮﻧﺪ‬ ‫ﻣﮕﺰﯾﻼ‬
: ‫دﻫﻨﯽ‬ ‫ﺗﻨﻔﺲ‬
‫ﺑﺎﻋﺚ‬ ‫ﻣﯿﺘﻮاﻧﺪ‬
Anterior Marginal Gingivitis
‫ﻫﺎی‬ ‫دﻧﺪان‬ ‫ﻋﻨﻖ‬ ‫ﮐﺮﯾﺲ‬ ‫و‬
. ‫ﺷﻮﻧﺪ‬ ‫ﻗﺪاﻣﯽ‬
: ‫ﻫﺎ‬ ‫دﻧﺪان‬ ‫ﺳﺎﯾﺪن‬ ‫ﻋﺎدت‬
‫ﮐﻪ‬
Attrition
.‫ﻣﯿﺸﻮد‬ ‫دﻧﺪاﻧﻬﺎ‬ ‫در‬
Tongue Thrusting
‫ﻣﺸﺮوﺑﺎت‬ ‫ﻧﻮﺷﯿﺪن‬ ‫ﻋﺎدات‬
‫اﻟﮑﻮﻟﯽ‬ ‫ﻏﯿﺮ‬ ‫و‬ ‫اﻟﮑﻮﻟﯽ‬
: ‫ﻏﺬاﯾﯽ‬ ‫ﻋﺎدات‬
۱
: ‫ﻧﺮم‬ ‫ﻏﺬاﯾﯽ‬ ‫رژﯾﻢ‬ .
. ‫ﻣﯿﺸﻮﻧﺪ‬ ‫دﻧﺪان‬ ‫ﺳﻄﺢ‬ ‫ﺑﻪ‬ ‫ﻣﻮاد‬ ‫ﭼﺸﭙﯿﺪن‬ ‫ﺑﺎﻋﺚ‬ ‫ﺑﯿﺸﺘﺮ‬
۲
: ‫ﺳﺨﺖ‬ ‫ﻏﺬاﯾﯽ‬ ‫رژﯾﻢ‬ .
‫ﺑﺎﻋﺚ‬ ‫ﺑﯿﺸﺘﺮ‬
Attrition
.‫ﻣﯿﺸﻮد‬ ‫دﻧﺪان‬ ‫ﺳﻄﺢ‬ ‫در‬
۳
.
‫ﮐﺎرﺑﻮﻫﺎﯾﺪرﯾﯿﺖ‬ ‫ﺣﺎوی‬ ‫ﻏﺬاﯾﯽ‬ ‫رژﯾﻢ‬
.‫ﻓﺎﺳﻔﺎت‬ ‫و‬

: ‫ﺧﻮاب‬ ‫ﻋﺎدات‬
) ‫ﺑﯿﺨﻮاﺑﯽ‬
Insomnia
‫ﺗﺎﯾﺮوﺗﻮﮐﺴﮑﻮز‬ ‫در‬ ‫اﮐﺜﺮا‬ ‫ﮐﻪ‬ (
.‫ﻣﯿﺸﻮد‬ ‫ﻣﺸﺎﻫﺪه‬ ‫اﺑﺘﺪاﯾﯽ‬
: ‫اﺟﺘﻤﺎﻋﯽ‬ ‫ﺣﺎﻟﺖ‬
۱
‫ﻣﺘﻮﺳﻂ‬ ‫و‬ ‫ﺑﺎﻻ‬ .
:
Caries , Aryeriosclerosis, Heart disease,
Acute appendicitis
.‫ﻣﯿﺸﻮد‬ ‫ﻣﺸﺎﻫﺪه‬ ‫اﮐﺜﺮا‬ ‫اﻧﻬﺎ‬ ‫در‬
۲
‫ﭘﺎﯾﻦ‬ .
:
Periodontitis , TB Anemia
‫ﺗﻐﺬی‬ ‫ﺳﻮء‬ ‫اﺛﺮ‬ ‫در‬
.‫اﻓﺮاد‬ ‫از‬ ‫ﮔﺮوه‬ ‫اﯾﻦ‬ ‫در‬ ‫ﺑﺪﻫﻨﺪ‬ ‫رخ‬ ‫ﻣﯿﺘﻮاﻧﻨﺪ‬
.‫دﻫﯽ‬ ‫ﺷﯿﺮ‬ ‫و‬ ‫ﺣﺎﻣﻠﮕﯽ‬
. ‫ﻣﻘﺎرﺑﺘﯽ‬ ‫و‬ ‫زﻧﺎﺷﻮی‬ ‫رواﺑﻂ‬
‫ﻣﺤﯿﻂ‬
. ‫ﺣﯿﻮاﻧﺎت‬ ‫و‬ ‫زﻧﺪﮔﯽ‬ ‫ﻣﺎﺣﻮل‬ ‫و‬
‫ﺳﻔﺮ‬
‫ﺑﯿﺮون‬ ‫ﺑﻪ‬
‫ﻣﻌﺎﻓﯿﺖ‬ ‫ﮐﺴﺐ‬ ‫و‬ ‫واﮐﺴﯿﻨﺎﺳﻮن‬

Family History
‫ﻓﺎﻣﯿﻠﯽ‬ ‫ﺗﺎرﯾﺨﭽﻪ‬
hemophilia, diabetes mellitus,
hypertension and heart diseases.
‫ﺑﻪ‬ ‫ﻓﺎﻣﯿﻞ‬ ‫در‬ ‫ﻣﯿﺘﻮاﻧﺪ‬ ‫ﮐﻪ‬ ‫ارﺛﯽ‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﺴﯿﺎر‬ ‫ﺗﺸﺨﯿﺺ‬ ‫در‬
: ‫ﻣﺎﻧﻨﺪ‬. ‫ﻣﯿﮑﻨﺪ‬ ‫ﮐﻤﮏ‬ ‫ﺑﭙﯿﻮﻧﺪد‬ ‫وﻗﻮع‬

Clinical Examinations
‫ﮐﻠﯿﻨﯿﮑﯽ‬ ‫ﻫﺎی‬ ‫ﺑﺮﺳﯽ‬
Dr Mohammad Nasir (Sharefy)
Oral Medicine

: ‫ﮐﻠﯿﻨﯿﮑﯽ‬ ‫ﻣﻌﺎﯾﻨﺎت‬ ‫ﻣﺮاﺣﻞ‬
۱
) ‫ﺗﻔﺘﯿﺶ‬ .
Inspections
‫ﻏﯿﺮ‬ ‫ﺷﮑﻞ‬ ‫ﺑﻪ‬ ‫ﺿﺎﯾﻌﺎت‬ ‫دﯾﺪن‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ : (
. ‫ﻣﯿﺸﻮد‬ ‫اﺳﺘﻔﺎده‬ ‫ﻣﺴﺘﻘﯿﻢ‬
۲
) ‫ﮐﺮدن‬ ‫ﺟﺲ‬ .
Palpation
‫ﺛﺒﺎت‬ ‫و‬ ‫ﻗﻮام‬ ‫ﻓﻬﻤﯿﺪن‬ ‫و‬ ‫ﺑﺮﺳﯽ‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ :(
. ‫ﻣﯿﮑﻨﺪ‬ ‫ﮐﻤﮏ‬ ‫ﻫﺎ‬ ‫ﺳﺎﺧﺘﻤﺎن‬
۳
) ‫اﺻﻐﺎ‬.
Auscultation
‫ﺣﺮﮐﺎت‬ ‫ﻣﻄﺎﻟﻌﻪ‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ :(
TMJ
‫ارزﯾﺎﺑﯽ‬ ‫و‬
‫ورﯾﺪی‬ ‫ﺳﺎﺧﺘﻤﺎﻧﯽ‬ ‫ﻧﻘﺎﯾﺺ‬
Venous Malformation
.‫ﻣﯿﮑﻨﺪ‬ ‫ﮐﻤﮏ‬
۴
)‫ﻗﺮع‬ .
Percussion
‫ﻣﺮﯾﺾ‬ ‫آﯾﺎ‬ ‫اﯾﻨﮑﻪ‬ ‫ﺑﺮﺳﯽ‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ :(
Periapical
infection
.‫ﻣﯿﺸﻮد‬ ‫اﺳﺘﻔﺎده‬ ، ‫ﻧﻪ‬ ‫ﯾﺎ‬ ‫دارﻧﺪ‬
۵
‫ﭘﺮوب‬.
Probing
‫ﺳﺎزی‬ ‫ﻣﺸﺨﺺ‬ ‫و‬ ‫ﮔﯿﺮی‬ ‫اﻧﺪازه‬ ، ‫ﻧﺸﺎﻧﯽ‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ :
.‫ﻣﯿﮕﺮدد‬ ‫اﺳﺘﻔﺎده‬ ‫ﻫﺎ‬ ‫ﭘﺘﺎﻟﻮژی‬ ‫و‬ ‫ﻫﺎ‬ ‫ﮐﺮﯾﺲ‬

Bilateral palpation: This
is done to differentiate
between
symmetrical structures
on both side of face
Bidigital palpation: In this, two
ﬁngers are used to manipulate the
tissue. It is used for thinner
structure

Bimanual palpation: It is done by palms of both hands.
In this, one hand is used to support the structure hand
and another is used to manipulate the structure. This
type of palpation is used in ﬂoor of mouth

‫ﻋﻤﻮﻣﯽ‬ ‫ﻫﺎی‬ ‫ﺑﺮﺳﯽ‬
‫ﻧﺒﺾ‬
Pulse
‫در‬ ‫ﻧﻮاﻗﺺ‬ ، ‫ﻣﺮﯾﻀﯽ‬ ‫ﺷﺪت‬ ‫ﺑﺮﺳﯽ‬ ‫ﻣﻨﻈﻮر‬ ‫ﺑﻪ‬ ‫ﮐﺮدن‬ ‫ﭼﮏ‬ :
، ‫وﻋﺎﯾﯽ‬ ‫ﻗﻠﺒﯽ‬ ‫ﺳﯿﺴﺘﻢ‬
Hypertension , Hypotension , Shock
,
.‫ﺗﺎﯾﺮوﺗﻮﮐﺴﯿﮑﻮزﯾﺲ‬ ‫و‬ ‫ﺗﺐ‬
‫اﻧﻮاع‬
Pulse
:
۱
) ‫رادﯾﺎل‬ ‫ﭘﺎﻟﺲ‬ .
Radial Pulse
.(
۲
) ‫ﺑﺮاﺧﯿﺎل‬ ‫ﭘﺎﻟﺲ‬ .
Brachial Pulse
.(
۳
) ‫ﮐﺮوﺗﯿﺪ‬ ‫ﭘﺎﻟﺲ‬.
Carotide pulse
.(

radial pulse (located on
ventral
aspect of wrist)
branchial pulse (located
medial to biceps
tendon in the antecubital
fossa)
carotid pulse (medial
to sternocleidomastoid
muscle, inferior and medial to the
angle of mandible)

: ‫ﻧﺒﺾ‬ ‫ارزﯾﺎﺑﯽ‬ ‫ﺗﮑﻨﯿﮏ‬
: ‫ﺑﮑﻨﯿﻢ‬ ‫ﺑﺮﺳﯽ‬ ‫ﻣﯿﺨﻮاﻫﯿﻢ‬ ‫را‬ ‫رادﯾﺎل‬ ‫ﻧﺒﺾ‬ ‫ﻣﺘﺎل‬ ‫ﮔﻮﻧﻪ‬ ‫ﺑﻪ‬
‫ﻣﯿﺪﯾﺎل‬ ‫ﻃﺮف‬ ‫ﺑﻪ‬ ‫دﺳﺖ‬ ‫ﺑﻨﺪ‬ ‫ﻧﺰدﯾﮑﯽ‬ ‫در‬ ‫ﻣﺘﺮ‬ ‫ﺳﺎﻧﺘﯽ‬ ‫ﭼﻨﺪ‬ ‫را‬ ‫رادﯾﺎل‬ ‫ﺷﺮﯾﺎن‬
Radius
‫اﻧﮕﺸﺖ‬ ‫و‬ ‫اﺷﺎره‬ ‫اﻧﮕﺸﺖ‬ ‫ﻧﻮک‬ ‫ﺑﺎ‬ ‫اﻧﺮا‬ ‫دﯾﻮاره‬ ‫و‬ ‫ﮐﺮده‬ ‫ﺟﺴﺘﻮ‬
،‫ﮐﻨﯿﺪ‬ ‫ﺟﺲ‬ ‫ﻣﯿﺎﻧﯽ‬
‫ﺑﻪ‬ ‫ﺷﺼﺖ‬ ‫اﻧﮕﺸﺖ‬ ‫اﺳﺘﻔﺎده‬ ‫از‬ ، ‫اﻧﺪ‬ ‫ﺣﺴﺎس‬ ‫اﻧﮕﺸﺘﺎن‬ ‫ﻧﻮک‬ ‫ﺑﺎﺷﯿﺪ‬ ‫ﻣﺘﻮﺟﻪ‬
(‫ﮐﻨﻨﺪه‬ ‫ﺑﺮﺳﯽ‬ ‫ﺷﺨﺺ‬ ‫ﺧﻮد‬ ‫رادﯾﺎل‬ ‫ﻧﺒﺾ‬ ) ‫ﻏﻠﻂ‬ ‫ﺗﻔﺼﯿﺮ‬ ‫از‬ ‫ﺗﺮس‬ ‫ﻣﻨﻈﻮر‬
‫ﻣﺤﻮ‬ ) ‫ﮐﻨﯿﺪ‬ ‫اﺟﺘﻨﺎب‬ ‫از‬ ‫ﻧﺎﺣﯿﻪ‬ ‫ﺑﺎﻻی‬ ‫زﯾﺎد‬ ‫اوردن‬ ‫ﻓﺸﺎر‬ ‫از‬ ، ‫ﮐﻨﯿﺪ‬ ‫ﺟﻠﻮﮔﯿﺮی‬
.(‫ﻧﺒﺾ‬ ‫ﮐﺮدن‬

: ‫ﻧﺒﺾ‬ ‫ارزﯾﺎﺑﯽ‬ ‫در‬ ‫اﻫﻤﯿﺖ‬ ‫ﺑﺎ‬ ‫ﻧﮑﺎت‬
1. Rate : Fast or Slow (normal: 60_ 100 beat /min)
2. Rhythem : Regular or Irregular (Ventricular ectopic --
Arterial ﬁbrillation).
3. Volume (Pulse Pressure Normal 40 -60 mmHg :
High or Low
(wide pulse pressure: Aorteic and Mitral Regurgitation ,High
outpute state: Pregnancy , Anemia Left ventricular Failure,
obstraction of Left ventricleMitral Stenosis , aortic stenosis)
: ‫ﻧﺒﺾ‬ ‫ﻫﺎی‬ ‫وﯾﮋﮔﯽ‬
Water hammer pulse : Aortic regurgitation.
Paradoxus pulse : Pericardial effusion.
‫ﻣﻮج‬ ‫در‬ ‫آﻫﺴﺘﻪ‬ ‫ﺑﯿﺖ‬ ‫دو‬ ‫ﺷﮑﻞ‬ ‫ﺑﻪ‬ ‫ﮐﺮوﺗﯿﺪ‬ ‫ﺷﺮﯾﺎن‬ ‫ﻧﺒﺾ‬،‫ﺣﺎﻻت‬ ‫اﯾﻦ‬ ‫در‬
.‫ﻣﯿﺸﻮد‬ ‫اﺣﺴﺎس‬ ‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬
Pulsusbisfringus : in Aortic Stenosis .
‫ﻣﻮج‬ ‫در‬ ‫ﺳﺮﯾﻊ‬ ‫ﺑﯿﺖ‬ ‫دو‬ ‫ﺷﮑﻞ‬ ‫ﺑﻪ‬ ‫ﮐﺮوﺗﯿﺪ‬ ‫ﺷﺮﯾﺎن‬ ‫ﻧﺒﺾ‬،‫ﺣﺎﻻت‬ ‫اﯾﻦ‬ ‫در‬
.‫ﻣﯿﺸﻮد‬ ‫اﺣﺴﺎس‬ ‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬

Delay of the left temporal pulse compared with right
pulse is found in coarctation of aorta.
‫در‬ ‫راﺳﺖ‬ ‫ﻧﺒﺾ‬ ‫ﺑﺎ‬ ‫ﻣﻘﺎﯾﺴﻪ‬ ‫در‬ ‫ﭼﭗ‬ ‫ﻧﺒﺾ‬ ‫ﺗﺎﺧﯿﺮ‬
Coarectation Aorta
.‫ﺷﻮد‬ ‫ﻣﯽ‬ ‫ﯾﺎﻓﺖ‬

‫ﺧﻮن‬ ‫ﻓﺸﺎر‬
: ‫ﻧﺎرﻣﻞ‬ ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬
‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬
120
-
140
mm Hg
‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬ ‫و‬
80
-
90
km Hg
., ‫ﻣﯿﺒﺎﺷﺪ‬
Stroke Volum
‫را‬ ‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬ ‫ﻓﺸﺎر‬ ، ‫ﺷﺮﯾﺎﻧﯽ‬ ‫رﮔﻬﺎی‬ ‫ﺷﺨﯽ‬ ‫و‬ ‫ﻗﻠﺐ‬
‫ﻣﺤﯿﻄﯽ‬ ‫رﮔﻬﺎی‬ ‫ﻣﻘﺎوﻣﺖ‬ ‫و‬ ‫ﻣﯿﮑﻨﺪ‬ ‫ﮐﻨﺘﺮول‬
Pripheral resistans
‫را‬ ‫دﯾﺎﺳﺘﻮﻟﯿﮏ‬ ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬
.‫ﻣﯿﮑﻨﺪ‬ ‫ﮐﻨﺘﺮول‬
: ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ ‫در‬ ‫ﺗﻐﯿﺮات‬
) ‫ﻣﺜﺎﺗﻪ‬ ‫ﻣﺸﮑﻼت‬ ، ‫ﺗﻨﺒﺎﮐﻮ‬ ، ‫اﻟﮑﻮل‬ ، ‫ﻏﺬا‬ ، ‫ورزش‬ ، ‫اﺣﺴﺎس‬
Bladder Distension
.‫درد‬ ، ‫ﺗﺐ‬ ,(
: ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ ‫دﯾﺪن‬ ‫ﺑﺎ‬ ‫ﺷﻮﻧﺪه‬ ‫ﺗﺸﺨﯿﺺ‬ ‫ﺣﺎﻻت‬
Hypertension
Hypotension
Aortic incompetence
: ‫ﻧﺎﻣﺘﻮازن‬ ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬
‫ﻣﺎﻧﻨﺪ‬ ‫اﻣﺮاﺿﯽ‬ ‫ﻣﻮﺟﻮدﯾﺖ‬ ‫در‬ ‫اﮐﺜﺮا‬ ، ‫ﺑﺎزو‬ ‫دو‬ ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ ‫در‬ ‫ﺗﻨﺎﻗﺾ‬
Supravalvular Aortic Stenosis
Preductal Coarectation of Aorta
Unilateral Occlusive disease of Aorta

: ‫ﺧﻮن‬ ‫ﻓﺸﺎر‬ ‫ﺳﺎزی‬ ‫ﻣﺸﺨﺺ‬ ‫ﭘﺮوﺳﯿﺠﺮ‬
: ‫وﺳﺎﯾﻞ‬
Stethoscope
Sphygmomanometer
: ‫ﻣﺮاﺣﻞ‬
1
‫ﺳﻮﯾﻪ‬ ‫ﺑﻪ‬ ‫ﮐﺎﻓﯽ‬ ‫ﻃﻮر‬ ‫ﺑﻪ‬ ‫ﺳﺎﻋﺪ‬ ‫ﮐﻪ‬ ‫دﻫﯿﺪ‬ ‫ﻗﺮار‬ ‫ﻗﺴﻤﯽ‬ ‫ﻣﯿﺰ‬ ‫ﺑﺎﻻی‬ ‫را‬ ‫او‬ ‫راﺳﺖ‬ ‫دﺳﺖ‬ ‫و‬ ‫ﻧﺸﺎﻧﺪه‬ ‫را‬ ‫ﻣﺮﯾﺾ‬ .
.‫ﺷﻮد‬ ‫ﺣﻤﺎﯾﺖ‬ ‫ﻗﻠﺐ‬ ‫ﺳﻮﯾﻪ‬ ‫ﺑﻪ‬ ‫ﺗﻘﺮﯾﺒﺎ‬ ‫ارﻧﺞ‬
2
‫ﮐﺎف‬ .
Cuff
‫ﺑﺎﻻی‬ ‫را‬
Brachial Artery
‫ﺳﯿﺮ‬ ‫ﮐﻪ‬
Lateral
‫ﺑﻪ‬
Medial
‫ﻓﺎﺻﻠﻪ‬ ‫ﺑﻪ‬ ، ‫دارد‬ ‫ﺑﺎزو‬ ‫در‬
1
-
2
‫و‬ ‫ارﻧﺞ‬ ‫از‬ ‫دورﺗﺮ‬ ‫اﻧﭻ‬
Anticubital Fossa
. ‫دﻫﯿﺪ‬ ‫ﻗﺮار‬
3
‫ﻣﻘﺪار‬ ‫ﺑﻪ‬ ‫را‬ ‫ﮐﺎف‬ ‫ﭘﻤﭙﺎژ‬ .
20
-
30
mm Hg
‫ان‬ ‫از‬ ‫ﺑﯿﺸﺘﺮ‬ ‫زﻣﺎﻧﯿﮑﻪ‬ ‫ﺗﺎ‬
Radial pulse
‫ﻟﻤﺲ‬ ‫ﻗﺎﺑﻞ‬
) ‫ﻣﯿﺒﺎﺷﺪ‬ ‫ﺿﺮوری‬ ‫ﻫﺎﯾﭙﺮﺗﯿﻨﺸﻦ‬ ‫دﭼﺎر‬ ‫ﻣﺮﯾﻀﺎن‬ ‫در‬ ‫ﺧﺼﻮﺻﺎ‬ ‫ﮐﺎر‬ ‫اﯾﻦ‬ ،‫دﻫﯿﺪ‬ ‫اداﻣﻪ‬ ‫ﻧﺒﺎﺷﺪ‬
Silent gap
.(
‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬ ‫ﻓﺸﺎر‬ ‫ارزﯾﺎﺑﯽ‬
‫روی‬ ‫را‬ ‫ﺳﺘﺎﺗﺴﮑﻮپ‬ :
‫دﻫﯿﺪ‬ ‫ﻗﺮار‬ ‫آرﻧﺞ‬ ‫ﺧﻮردﮔﯽ‬ ‫ﭼﯿﻦ‬ ‫دﺳﺘﺎل‬ ‫ﻗﺴﻤﺖ‬ ‫در‬ ‫ﺷﺮﯾﺎن‬
‫ﻓﺸﺎر‬ ‫ﺑﻪ‬ ‫و‬
3mm Hg
‫ﻫﻮای‬
cuff
‫ﮐﻪ‬ ‫را‬ ‫ﺻﺪاﯾﯽ‬ ‫اوﻟﯿﻦ‬ ،‫ﺳﺎزﯾﺪ‬ ‫ﺧﺎرج‬ ‫آﻫﺴﺘﻪ‬ ‫را‬
. ‫ﮐﻨﯿﺪ‬ ‫ﺛﺒﺖ‬ ‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬ ‫ﻓﺸﺎر‬ ‫ﻣﻨﺤﯿﺚ‬ ‫را‬ ‫ﻣﯿﺸﻨﻮﯾﺪ‬
‫دﯾﺎﺳﺘﻮﻟﯿﮏ‬ ‫ﻓﺸﺎر‬ ‫ارزﯾﺎﺑﯽ‬
‫ﻓﺸﺎر‬ ‫ﮐﺎﻫﺶ‬ ‫ﺑﺎ‬ :
cuff
‫ﺻﺪا‬ ‫اﺧﺮﯾﻦ‬
. ‫ﻧﻤﺎﯾﯿﺪ‬ ‫ﺛﺒﺖ‬ ‫ﺳﯿﺴﺘﻮﻟﯿﮏ‬ ‫ﻓﺸﺎر‬ ‫ﻣﻨﺤﯿﺚ‬ ‫را‬
: ‫ﻏﻠﻂ‬ ‫ﺗﻔﺼﯿﺮ‬ ‫ﻋﻮاﻣﻞ‬
۱
. ‫اﺷﺘﺒﺎه‬ ‫ﺗﮑﻨﯿﮏ‬ .
۲
‫ﮐﺎف‬ ‫ﺳﺴﺖ‬ ‫ﺑﺴﺘﻦ‬ .
۳
. ‫ﺑﺎزو‬ ‫ﺑﻪ‬ ‫ان‬ ‫دادن‬ ‫ﻗﺮار‬ ‫از‬ ‫ﻗﺒﻞ‬ ‫ﮐﺎف‬ ‫ﺗﺨﻠﯿﻪ‬ ‫ﻋﺪم‬ .
۴
.‫ﺑﺎزو‬ ‫ﺑﻪ‬ ‫ﻧﺴﺒﺖ‬ ‫ﮐﺎف‬ ‫ﺑﻮدن‬ ‫ﮐﻮﭼﮏ‬ .
۵
‫ﺗﺮس‬ ‫و‬ ‫اﺿﻄﺮاب‬ .

Temperature ‫ﺣﺮارت‬ ‫درﺟﻪ‬
: ‫ﻧﺎرﻣﻞ‬
°
36
° -
37.5
° ‫دﻫﻦ‬ ‫ﺟﻮف‬ - ‫ﺳﺎﻧﺘﯿﮕﺮاد‬ ‫درﺟﻪ‬
37
.
: ‫ﻧﺎرﻣﻞ‬ ‫ﺗﻨﺎﻗﺺ‬
‫ﮐﺎﻫﺶ‬
2
-
4
‫اﻃﻔﺎل‬ ,‫ﭼﺎﺷﺖ‬ ‫از‬ ‫ﺑﻌﺪ‬ ‫ﻃﺮف‬ ‫از‬ ‫ازدﯾﺎد‬ ‫و‬ ‫ﺻﺒﺢ‬
: ‫ارزﯾﺎﺑﯽ‬ ‫ﺑﺮای‬ ‫ﺑﺪن‬ ‫ﻣﻮﻗﻌﯿﺖ‬
° ) ‫دﻫﻦ‬ ‫ﺟﻮف‬
1
- (‫ﺑﻐﻞ‬ ‫زﯾﺮ‬ ‫از‬ ‫ﺑﯿﺸﺘﺮ‬
Axilla
.
: ‫ﺳﻨﺠﺶ‬ ‫وﺳﯿﻠﻪ‬
Mercury Thermometer
‫ﻣﺪت‬ ‫ﺑﻪ‬ ‫را‬
1
‫در‬ ‫دﻗﯿﻘﻪ‬
, ‫دﻫﯿﺪ‬ ‫ﻗﺮار‬ ‫ﻣﻮﻗﻌﯿﺖ‬
Degital thermometer
.

Conversion Of Fahrenheit To Celsius
‫ﺳﺎﻧﺘﯿﮕﺮاد‬ ‫ﺑﻪ‬ ‫ﻓﺮاﻧﻬﺎﯾﺖ‬ ‫ﺗﺒﺪﯾﻞ‬
Fahrenheit into Celsius
subtract 32 and multiply by 5/9
97.9°F (36.6°C) to
99°F (37.2 °C).

: ‫دواﻣﺪار‬ ‫_ﺗﺐ‬
‫ﺑﺎﻗﯽ‬ ‫روز‬ ‫ﻃﻮل‬ ‫در‬ ‫ﻃﺒﯿﻌﯽ‬ ‫ﺣﺪ‬ ‫از‬ ‫ﺑﺎﻻﺗﺮ‬ ‫دﻣﺎی‬ ‫ﮐﻪ‬ ‫ﺗﺒﯽ‬ ‫ﺑﻪ‬
‫از‬ ‫ﺑﯿﺶ‬ ‫ﺑﻪ‬ ‫و‬ ‫ﻣﺎﻧﺪ‬ ‫ﻣﯽ‬
1
‫در‬ ‫درﺟﻪ‬
24
: ‫ﻣﺜﺎل‬ ،‫ﮐﻨﺪ‬ ‫ﻧﻤﯽ‬ ‫ﻧﻮﺳﺎن‬ ‫ﺳﺎﻋﺖ‬
Lobar pneumonia, Typhoid and Infective endocarditis.
) ‫ﺑﺎزﮔﺸﺘﯽ‬ ‫ﯾﺎ‬ ‫راﺟﻌﻪ‬ ‫_ﺗﺐ‬
Remittent Fever
: (
‫ﻃﻮل‬ ‫در‬ ‫ﺣﺮارت‬ ‫درﺟﻪ‬
‫از‬ ‫ﺑﯿﺶ‬ ‫ﺑﻪ‬ ‫و‬ ‫اﺳﺖ‬ ‫ﻃﺒﯿﻌﯽ‬ ‫ﺣﺪ‬ ‫از‬ ‫ﺑﺎﻻﺗﺮ‬ ‫روز‬
1
‫ﻃﻮل‬ ‫در‬ ‫درﺟﻪ‬
24
‫ﺳﺎﻋﺖ‬
.‫ﺗﯿﻔﻮﺋﯿﺪ‬ ‫ﺗﺐ‬ :‫ﻣﺜﺎل‬ ‫ﻋﻨﻮان‬ ‫ﺑﻪ‬ ، ‫دارد‬ ‫ﻧﻮﺳﺎن‬
) ‫ﻣﺘﻨﺎوب‬ ‫ﯾﺎ‬ ‫ای‬ ‫وﻗﻔﻪ‬ ‫ﺗﺐ‬
Intermittent Fever
(
‫در‬ ‫ﺑﺪن‬ ‫ﺣﺮارت‬ ‫درﺟﻪ‬ :
‫ﺣﺎﻟﺖ‬ ‫ﺑﻪ‬ ‫ﺑﺮﮔﺸﺖ‬ ‫روز‬ ‫ﺳﺎﻋﺎت‬ ‫ﻣﺘﺒﺎﻗﯽ‬ ‫در‬ ‫و‬ ‫اﺳﺖ‬ ‫ﺑﻠﻨﺪ‬ ‫روز‬ ‫از‬ ‫ﺳﺎﻋﺎﺗﯽ‬
. ‫ﻣﯿﮑﻨﺪ‬ ‫ﻧﻮرﻣﺎل‬
) ‫روزه‬ ‫ﻫﺮ‬ ‫ﺗﺐ‬ ‫ﺑﻨﺎم‬ ‫ﺑﭙﯿﻮﻧﺪد‬ ‫وﻗﻮع‬ ‫ﺑﻪ‬ ‫روزاﻧﻪ‬ ‫اﮔﺮ‬
Quotidian
.‫ﻣﯿﺸﻮد‬ ‫ﯾﺎد‬ (
‫ﻣﯿﺎن)ﻫﺮ‬ ‫در‬ ‫روز‬ ‫ﯾﮏ‬ ‫اﮔﺮ‬
24
) ‫ﺑﻨﺎم‬ ‫ﺷﻮد‬ ‫واﻗﻊ‬ ( ‫ﺳﺎﻋﺖ‬
Tertian
‫ﺑﺎد‬ (
.‫ﻣﻼرﯾﺎ‬ ‫ﺗﺐ‬ ‫ﻣﺜﺎل‬ .‫ﻣﯿﺸﻮد‬
‫ﻫﺮ‬ ‫اﮔﺮ‬
3
‫ﺑﻨﺎم‬ ‫ﺷﻮد‬ ‫واﻗﻊ‬ ‫ﺑﻌﺪ‬ ‫روز‬
Quatrian
: ‫ﻣﺜﺎل‬ ،‫ﻣﯿﺸﻮد‬ ‫ﯾﺎد‬
malaria, kala azar, pyemia and septicemia

Bacteremia is the simple presence of
bacteria in the blood while Septicemia is
the presence and multiplication of
bacteria in the blood. Septicemia is also
known as blood poisoning.

_
) ‫ﺳﭙﺘﯿﮏ‬ ‫ﺗﺐ‬
Septic Fever
: (
‫ﻧﺎرﻣﻞ‬ ‫ﺣﺪ‬ ‫از‬ ‫ﺑﯿﺸﺘﺮﺗﺮ‬ ‫ﺗﺐ‬ ‫اﻓﺰاﯾﺶ‬
° ‫از‬ ‫)ﺑﻠﻨﺘﺮ‬
5
: ‫ﻣﺜﻼ‬، ( ‫درﺟﻪ‬
Septicemia
.
) ‫ﭘﺎﯾﯿﻦ‬ ‫ﮔﺮﯾﺪ‬ ‫ﺑﺎ‬ ‫_ﺗﺐ‬
Low grade fever
: (
‫در‬ ‫ﺣﺮارت‬ ‫درﺟﻪ‬ ‫اﻓﺰاﯾﺶ‬
‫از‬ ‫ﻣﮕﺮ‬ ، ‫ﭼﺎﺷﺖ‬ ‫از‬ ‫ﺑﻌﺪ‬ ‫ﺧﺼﻮﺻﺎ‬ ‫ﻧﺎرﻣﻞ‬ ‫ﺣﺪ‬ ‫از‬ ‫روز‬ ‫ﻃﻮل‬
37.8
‫درﺟﻪ‬
. ‫ﺗﻮﺑﺮﮐﻠﻮز‬ ‫در‬ : ‫ﻣﺜﻼ‬ .‫ﻧﻤﯿﮑﻨﺪ‬ ‫اﻓﺰاﯾﺶ‬ ‫ﮔﺮﯾﺪ‬ ‫ﺳﺎﻧﺘﯽ‬
) ‫ﺷﺪﯾﺪ‬ ‫ﺗﺐ‬ ‫ﭘﺎﯾﺮﯾﮑﺴﯿﺎ‬ ‫_ﻫﺎﯾﭙﺮ‬
Hyperpyrexia
: (
Tetanus, malaria, septicemia, heat stroke, encephalitis,
and hemorrhage

Harmful effects:
hypercatabolism—N2 nitrogen( increased circulating catabolic hormones (eg, cortisol,
catecholamines) and inﬂammatory cytokines (eg, tumor necrosis factors, interleukin-1beta)
wastage and weight loss, ﬂuid and electrolyte imbalance due to
sweating, convulsions, brain damage, circulatory overload
and arrhythmias, Seizure, Coma, death
: ‫ﺗﺐ‬ ‫ﻣﻔﯿﺪ‬ ‫ﺗﺎﺛﯿﺮات‬
‫ﻧﺘﯿﺠﻪ‬ ‫در‬ ‫ﮐﻪ‬ ‫ﻣﯿﺸﻮد‬ ‫داﺧﻠﯽ‬ ‫ﻫﺎی‬ ‫ﭘﺎﯾﺮوﺟﯿﻦ‬ ‫ﺳﺎزی‬ ‫ازاد‬ ‫ﺑﺎﻋﺚ‬ ‫اﻣﺮاض‬ ‫از‬ ‫ﺑﻌﻀﯽ‬ ‫در‬
‫ﺣﺠﺮات‬ ‫ﺷﺪن‬ ‫ﻓﻌﺎل‬ ‫ﺳﺒﺐ‬
T cell
.‫ﻣﯿﺪﻫﺪ‬ ‫اﻓﺰاﯾﺶ‬ ‫را‬ ‫ﻣﯿﺰﺑﺎن‬ ‫دﻓﺎﻋﯽ‬ ‫ﻣﯿﮑﺎﻧﯿﺰم‬ ‫و‬ ‫ﺷﺪه‬

Hypothermia:
Hypothermia may be caused by endocrine
disorders like :
hypothyroidism
Hypopituitarism hypoglycemia( Insuﬃcient ACTH hormone secretion
results in cortisol deﬁciency; therefore, hypopituitarism may cause hypoglycemic events in diabetic
patients on medical treatment including insulin therapy.
Toxicity (Alcohol intoxication)
Barbiturate poisoning
Ketoacidosis
Exposure to cold
Autonomic dysfunction.

Respiration
Anesthesia and in early postoperative days
One complete cycle of inspiration and expiration is
counted as one. Normal rate—14–18 cycles/minute
Tachypnea (fast breathing): It occurs in fever, shock,
hypoxia, cerebral disturbances, metabolic acidosis,
tetany, and hysteria
Bradypnea: Slow and deep respiration is seen in cerebral
compression
Snoring noise: Paralysis of the soft
palate causes an inspiratory.
Central cyanosis seen in
tongue showing bluish

Icterus
• Deﬁnition: In jaundice, there is icteric tint of the skin, due to
presence of bilirubin, which varies from faint yellow of viral
hepatitis to dark olive greenish yellow color of obstructive
jaundice
• Site where you should look of icterus:The places where one
should look for icterus are sclera of the eyeball
nailbed, lobule of ear, tip of the nose and under surface of
tongue
• Hypercarotenemia: Jaundice may be confused with
hypercarotenemia in which yellow pigment of carotene is
unequally distributed and is particularly seen in the face, palm
and soles but not in the sclera. It occurs mostly in vegetarians

Skin
Appearance ( Rashes, sores, lumps or itching ,history of
sun exposursure
Color : Anemia and jaundice.
Texture : Dehydration (skin is dryed),Atropheid skin ( age
and in Glucocorticoods treatments).
Signs: Petechial hemorrhage indicating blood
dyscrasias.
Edema: Acute nephritis marked with swollen face at
raising in morning.

Head
Headache : Persistent , intermittent ,localized ,
generalized. Unilateral , bilateral or frontal.
Site:
Radiation:
Severity oTiing and duration:
Character: Shooting or pricking
Occurrence or aggravation: What brings it on, and what
makes it worse.
Relief:

Jaws
Normal landmark: Normal anatomic landmarks to be
identiﬁed include mandibular border, angle of mandible,
condyle and coronoid process, maxillary bone, lingual
notch and maxillary sinus.
Tenderness over the jaws: Note any tenderness over
the joint or masticatory muscles
Trauma:

TMJ
History: Rheumatoid arthritis, degenerative joint disease, osteoarthritis
trigeminal neuralgia, multiple sclerosis, glossopharyngeal neuralgia,
temporal arteritis, migraine headache, angina pectoris,
pulpoperiodontal disease, salivary gland inﬂammation, duct blockage,
otitis, sinusitis and psychogenic pain.
symmetry of face :
Interincisal opening : Normal(35-50mm), degree of opening pain begin.
Mandibular movement: Normal lateral ( 8-10mm).
– Does the TMJ click or pop on opening or closing?
– Has there been limitation in the movement or deviation
of the lower jaw on opening?
– Has the jaw ever locked or dislocated on opening?
– Has the patient experienced pain and dysfunction in
other joints of the body?
Pretragus palpation method
Intra-articular palpation method

Palpation of joint :listen for
clicking and crepitus during the opening and closing of the jaw.
Use stethoscope to characterize and locate this sound accurately.
Explore the anterior wall of external auditory
meatus for tenderness and pain that are usually
associated with arthritic changes

Methods of palpation
‫ﻓﮑﯽ‬ ‫ﺻﺪﻏﯽ‬ ‫ﻣﻔﺼﻞ‬ ‫ﺗﻔﺘﯿﺶ‬ ‫ﻣﯿﺘﺪ‬
1. Pretragus palpation: patient should be requested to slowly open
and close the mouth while the doctor bilaterally palpates the
pretragus depression with his/ her index ﬁngers.

2. Intra-auricular palpation: It is also performed by
inserting the small ﬁnger into the ear canal and pressing
anteriorly.
Methods of palpation
‫ﻓﮑﯽ‬ ‫ﺻﺪﻏﯽ‬ ‫ﻣﻔﺼﻞ‬ ‫ﺗﻔﺘﯿﺶ‬ ‫ﻣﯿﺘﺪ‬

Signiﬁcance of palpation::
Whether the condyle moves symmetrically
Rotation & Translation
Clicking and crepitus
Subluxation

‫ﺟﻮﻧﺪه‬ ‫ﻋﻀﻼت‬ ‫ﺗﻔﺘﯿﺶ‬
‫ﻋﻀﻠﻪ‬
Masseter
‫دﻫﻦ‬ ‫ﺟﻮف‬ ‫ﺧﺎرج‬ ‫و‬ ‫داﺧﻞ‬ ‫از‬ ‫ﻣﺘﺪاوم‬ ‫ﻓﺸﺎر‬ ‫اﺟﺮای‬ ‫ﺑﺎ‬ :
‫ﺑﺎﻣﺎﻧﻮال‬ ‫ﺷﮑﻞ‬ ‫ﺑﻪ‬
Bimanual palpation
.
‫ﻋﻀﻠﻪ‬
Lateral pterygoid
:
‫ﺧﻠﻒ‬ ‫ﺑﻪ‬ ‫اﻧﮕﺸﺖ‬ ‫ﮐﺮدن‬ ‫داﺧﻞ‬ ‫ﺑﺎ‬
Maxillary Tubrosity
‫ﻋﻀﻠﻪ‬ ‫ﮐﻪ‬ ‫ﺟﺎﯾﯽ‬
pterygoid
‫ﻗﺮار‬
‫ﺣﺮﮐﺎت‬ ‫ﺑﺎ‬ ‫و‬ ‫ﻣﯿﺸﻮد‬ ‫داده‬ ‫ﻗﺮار‬ ‫دارد‬
AnterioPosterior
‫ﻣﻨﺪﯾﺒﻮﻻ‬ ‫ﻣﯿﺪﯾﺎل‬ ‫اﻣﺘﺪاد‬ ‫ﺑﻪ‬
‫دﻫﻦ‬ ‫ﺟﻮف‬ ‫ﻓﺮش‬ ‫ﻃﺮف‬ ‫ﺑﻪ‬
‫ﻋﻀﻠﻪ‬ ‫ﺑﺮﺳﯽ‬ ‫ﺑﺮای‬
median pteregoid
.

2. Diagnostic procedures in oral medicine پوسیجر های تشخیص در امراض غشای مخاطی .pdf

2. Diagnostic procedures in oral medicine پوسیجر های تشخیص در امراض غشای مخاطی .pdf

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2. Diagnostic procedures in oral medicine پوسیجر های تشخیص در امراض غشای مخاطی .pdf