211 lines
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HTML
211 lines
12 KiB
HTML
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<title>Changing the Face of Medicine | The Doctor Is In</title>
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<h1>The Doctor Is In</h1>
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<h2>Overview</h2>
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<p>You use your senses every day to understand the world around you. Look. What
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do you see? Touch. What do you feel? Listen. What do you hear? </p>
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<p>Doctors use their senses to determine their patients’ health. Often
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they rely on tools that help enhance their senses. The ophthalmoscope (Of-<strong>thal</strong>-mah-scope
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) is an instrument with a special mirror that allows doctors to examine the
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interior of the eye. The otoscope (<strong>oh</strong>-toe-skope) is a flashlight with a magnifying
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lens that helps doctors to examine the inside of the ear. The stethoscope (<strong>steh</strong>-thuh-skope)
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enhances the sounds inside of the body so that the doctor can listen in. </p>
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<h2>Looking and Listening</h2>
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<h3>Ophthalmoscope (of-thal-mah-scope) </h3>
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<ul class="lesson">
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<li><strong>Pupil</strong><br />
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The pupil (<strong>pyoo</strong>-pul) is the dark opening in the middle of your eye that lets
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light in.</li>
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<li><strong>Iris</strong><br />
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The iris (<strong>eye</strong>-riss) is the colored ring around your pupil. Muscles expand
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or shrink the iris to control the amount of light entering the pupil.</li>
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<li><strong>Lens</strong><br />
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The lens is a clear disk that focuses light on the back of the eye.</li>
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<li><strong>Retina</strong><br />
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The retina (<strong>reh</strong>-tin-ah) is a thin wall in the back of your eye. It changes
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the images that appear on it into signals for the brain.</li>
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<li><strong>Optic nerve</strong><br />
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The optic nerve sends signals from the retina to the brain, so that you can
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make “sense” of what you see.</li>
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</ul>
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<p><strong>Normal</strong><br />
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Using the ophthalmoscope (of-<strong>thal</strong>-mah-scope), the doctor examines the thin,
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back wall of the eye, or the retina. The thin red lines that you see in this
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healthy retina are the blood vessels that provide the eye with nutrients
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while taking away waste products. The light area on the left is where the
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optic nerve connects to the retina.</p>
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<p><strong>Condition 1</strong><br />
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See how many more blood vessels are in this eye than in the normal eye? This
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patient has proliferative retinopathy (<strong>pro</strong>-liff-er-uh-tiv reh-ton-<strong>ah</strong>-pa-thee).
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Her blood vessels are damaged and are releasing a chemical that makes unhealthy
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new blood vessels grow. These new vessels leak blood very easily and can
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harm the eye. Regular eye exams can identify this problem before the unhealthy
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blood vessels start to leak.</p>
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<p><strong>Condition 2</strong><br />
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See the orange areas? Fat and fluids have leaked out of weakened blood vessels.
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This patient has diabetic macular edema (die-uh-beh-tick mack•you•lar
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eh-dee-muh). The buildup of fluid in his eyes makes his vision blurry. Eye
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surgery can help fix this condition.</p>
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<p><strong>Condition 3</strong><br />
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See the red and yellow blotches? This retina has been infected with a virus
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and appears swollen and irritated. The red areas are blood and the yellowish-white
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areas are where fluid has pooled. This patient has cytomegalovirus (site-uh-<strong>meg</strong>-uh-low-vi-rus)
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and her immune system is too damaged to fight it off. She needs immediate
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treatment to save her vision. </p>
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<h3>Otoscope (<strong>oh</strong>-toe-skope) </h3>
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<ul class="lesson">
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<li><strong>Ear canal</strong><br />
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The ear canal is a passageway that funnels sounds to the middle ear inside
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of your head. </li>
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<li><strong>Eardrum </strong><br />
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The eardrum is a thin membrane that caps the ear canal. It is stretched
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tight like a drum and vibrates when sound waves hit it.</li>
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<li><strong>Ossicles </strong><br />
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The ossicles (<strong>ah</strong>-sih-kulz) are the three tiniest bones in your body. They
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work together to carry vibrations from the eardrum to the inner ear. </li>
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<li><strong>Eustachian tube</strong><br />
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The eustachian (yoo-<strong>stay</strong>-shun) tube lets air from the nose into the middle
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ear. It balances air pressure within the middle ear.</li>
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<li><strong>Cochlea</strong><br />
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The cochlea (<strong>co</strong>-klee-uh) is a coiled, liquid-filled tube lined with special
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cells that change sound vibrations into nerve signals for the brain.</li>
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</ul>
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<p><strong>Normal</strong><br />
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Using the otoscope (<strong>oh</strong>-toe-skope) the doctor examines the eardrum. Healthy
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eardrums are semi-transparent and the doctor can see the shapes of the ossicles
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on the other side. </p>
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<p><strong>Condition 1 </strong><br />
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See the dark orangey yellow color towards the bottom of this left eardrum?
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This patient has otitis media (oh-<strong>tite</strong>-uhs <strong>mee</strong>-dee-uh), an inflammation of
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the inner ear. The color indicates that fluid is collecting in the inner
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ear. The bright white material is plaque (plack) buildup from previous infections.
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The middle of the eardrum is sucked in because of pressure within the inner
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ear. This patient has a painful earache and needs antibiotics (an-tie-by-<strong>ah</strong>-tics)
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to clear it up.</p>
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<p><strong>Condition 2 </strong><br />
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See how this right eardrum is sucked in to the point where you can really see
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the structures behind it? This patient has an advanced case of otitis media
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(oh-<strong>tite</strong>-uhs <strong>mee</strong>-dee-uh), or inflammation of the inner ear. The Eustachian
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(yoo-<strong>stay</strong>-shun) tube, which opens to balance air pressure within the middle
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ear, has been blocked because of infection. Liquid is building up in the
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middle ear and can't drain out.</p>
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<p><strong>Condition 3</strong><br />
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See how this left eardrum has a mark on the lower left side? It is actually
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a tear. This patient received a blow to the head. Most eardrum tears, or
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perforations, (perf-or-<strong>a</strong>-shuns) will heal on their own. Sometimes surgery
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is required to repair a large perforation. This condition is not painful
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if it doesn’t get infected, but it can limit hearing. </p>
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<h3>Stethoscope (<strong>steh</strong>-thuh-skope) </h3>
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<ul class="lesson">
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<li><strong>Right atrium,Left atrium</strong><br />
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The right atrium (<strong>ay</strong>-tree-um) receives blood that needs to go to the lungs
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while the left atrium receives blood ready to go out to the body. Together,
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these pumps are called the atria (<strong>ay</strong>-tree-uh).</li>
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<li><strong>Valves </strong><br />
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When these valves open, blood is pumped from the two atria to the ventricles
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below.</li>
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<li><strong>Right ventricle,
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Left ventricle </strong><br />
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The right ventricle (<strong>ven</strong>-trick-ul) pumps oxygen-poor blood to the lungs.
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At the same time, the left ventricle pumps oxygen-rich blood out to the
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body. </li>
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<li><strong>Valves </strong><br />
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These valves open to let the ventricles pump blood out to the lungs and
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body. </li>
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</ul>
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<p><strong>Normal</strong><br />
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Using the stethoscope (<strong>steh</strong>-thuh-skope) the doctor listens to the heart. Hear
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the soft sound followed by the loud sound? The soft sound is made when the
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valves letting blood into the heart’s two atria (<strong>ay</strong>-tree-uh) close.
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The loud sound is made when the valves controlling blood flow from the ventricles
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(<strong>ven</strong>-trick-ulz) out to the body close. Doctors describe this healthy sound
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as a “lub dub.”</p>
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<p><strong>Condition 1</strong><br />
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Can you hear an extra sound after the “lub dub?” This patient has
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dilated cardiomyopathy (<strong>dye</strong>-uh-late-ed <strong>card</strong>-ee-oh-my-<strong>op</strong>-ah-thee). Her heart
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is not doing a good job pumping blood and is filling up with extra blood to
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try to make up for it. The extra sounds come from the additional blood rushing
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into the heart.</p>
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<p><strong>Condition 2</strong><br />
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Can you hear the “vroom?” This patient has a hole in his heart.
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Blood from the left side of the heart is flowing through the hole into the
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right side of the heart. If the hole is really small, it might not cause too
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much of a problem, and may even close up on its own.</p>
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<p><strong>Condition 3</strong><br />
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Can you hear the “lub dub?” It’s hard to, because there is
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so much other noise. This patient has aortic stenosis (ay-<strong>or</strong>-tic sten-<strong>oh</strong>-sis).
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One of her heart valves has become damaged and is too narrow. The extra sounds
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come from blood trying to flow through this narrowed valve.</p>
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<h2>Pick Up Your Tools</h2>
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<p>You use your senses every day to understand the world around you. Look. What
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do you see? Touch. What do you feel? Listen. What do you hear? </p>
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<p><strong>Tool 1 </strong><br />
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What is the right tool for the job? <br />
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Click on the part of the body that is examined with an ophthalmoscope (of-<strong>thal</strong>-mah-scope).</p>
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<p><strong>Tool 2 </strong><br />
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What is the right tool for the job? <br />
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Click on the part of the body that is examined with an otoscope (<strong>oh</strong>-toe-skope).</p>
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<p><strong>Tool 3 </strong><br />
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What is the right tool for the job? <br />
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Click on the part of the body that is examined with a stethoscope (<strong>steh</strong>-thuh-skope).</p>
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<h2>A Doctor Making a Difference</h2>
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<p>Dr. Virginia Apgar used her powers of observation to help newborn babies.
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In 1953 she developed a special scoring system that helps a doctor to decide
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whether a baby needs extra medical help. The doctors examine a baby one minute
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after birth. During the exam, they make five different observations and “score” the
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baby’s condition. They repeat the exam four minutes later. A high score
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means that the baby is healthy. A low score means that the baby will need medical
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help. This system is called the “Apgar score” and is used by doctors
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around the world. </p>
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<p>Ten years after Dr. Apgar published her scoring system, another doctor came
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up with this chart to help medical students remember the five scoring categories. </p>
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<p><strong>A Appearance (skin color)</strong><br />
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0 points: Blue-grey, pale all over. 1 point: Normal, except for extremities.
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2 points: Normal over entire body.</p>
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<p><strong>P Pulse</strong><br />
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0 points: Absent. 1 point: Below 100 beats per minute. 2 points: Above 100
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beats per minute.</p>
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<p><strong>G Grimace (reflex irritability)</strong><br />
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0 points: No response. 1 point: Grimace. 2 points: Sneeze, cough, pulls away.</p>
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<p><strong>A Activity (muscle tone)</strong><br />
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0 points: Absent. 1 point: Arms and legs flexed. 2 points: Active movement.</p>
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<p><strong>R Respiration</strong><br />
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0 points: Absent. 1 point: Slow, irregular. 2 points: Good, crying.</p>
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<br />
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