What are the medical examination standards for the procuratorate to cooperate with the police?

1. Visual diagnosis: the appearance of thyroid gland in normal people is not prominent, and the puberty in women is slightly increased. Let the patient swallow, and you can see that the swollen thyroid moves up and down with swallowing. Pay attention to its size, shape and symmetry.

2. Palpation: The doctor stands behind the client, with his thumb behind his neck and other fingers touching the thyroid cartilage from both sides; You can also stand in front of the patient and touch the thyroid cartilage with your right thumb and other fingers; At the same time, let the patient swallow. Pay attention to the degree of swelling, symmetry, hardness, surface condition (smooth or nodular feeling), tenderness and tremor.

Judging the degree of goiter:

Grade I: Thyroid gland is palpable and its diameter is less than 3cm.

Grade II: The thyroid gland can be found by visual inspection and palpation during swallowing, with a diameter of 3-5cm.

ⅲ degree: thyroid gland can be found without swallowing, with a diameter of 5-7cm.

Ⅳ degree: the goiter is obvious, the appearance of the neck has changed, and the diameter is 7-9cm.

ⅴ degree: The goiter is extremely obvious, with a diameter of more than 9cm, and most of them are accompanied by nodules.

3, auscultation: pay attention to the presence of vascular murmur.

(2) Lymph node examination

1. Examination sites: pre-ear, post-ear, mastoid region, suboccipital region, submandibular region, submental region, anterior and posterior cervical triangle, supraclavicular fossa, armpit, pulley and groin.

2. Examination contents: whether lymph nodes are swollen, swollen position, size, number, hardness, pain, mobility, adhesion and fusion, and whether local skin is swollen, scarred, ulcerated or fistula.

(3) Breast examination:

1. Check posture: sit or lie down during the check.

2, visual diagnosis: pay attention to whether the breast contour is symmetrical. Whether the nipples on both sides are on the same horizontal line, whether there is invagination, swelling, overflow or erosion, and whether the skin is damaged, pigmented or orange peel-like.

3. Palpation: The examiner puts his fingers and palms flat on the breast, gently applies pressure, and starts from the upper part of the lateral side of the left breast and touches it clockwise from shallow to deep. Check the right breast counterclockwise in the same way. Palpation examination should include four quadrants: external upper, external lower, internal lower and internal upper (including axillary extension of breast). Pay attention to whether there are lumps or nodules, as well as the location, number, size, texture, boundary, tenderness, activity, fluctuation or cystic feeling of the lumps and the relationship between the lumps and the skin. Then check the nipple and areola, gently press around the areola with your fingers, and pay attention to whether there is overflow and the nature of the overflow (bloody, yellow or bloody liquid or pus, etc.). ).

4. Men should observe the development of their mammary glands and pay attention to the existence of abnormal tumors through palpation.

(4) Spinal examination:

The examinee should fully expose his back and check his standing posture, sitting posture, squatting posture and lying posture respectively; When checking the spinal movement, you should be careful to walk slowly, and it is strictly forbidden to check the movement quickly or violently.

1, curvature of spine: four physiological curvatures of normal spine, with the neck slightly protruding forward; Lumbar segment is obviously lordosis; The thoracic segment is slightly backward convex; The sacrum has a large kyphosis. When standing upright, the normal spine has no scoliosis; Pathologically, humpback, humpback and scoliosis may occur.

2. Spine mobility: the mobility of neck and waist is large, the mobility of thoracic vertebra is very small, and the sacrum is almost inactive. Under normal circumstances, the neck section can bend forward and extend backward by 45, bend left and right by 45 and rotate by 60. The waist section can bend forward 45 degrees, stretch backward 35 degrees, bend left and right 30 degrees and rotate 45 degrees with the hips fixed.