BOLI ENDOCRINE

Hipotiroidian/
Hipertiroidian
 =”spaima inghetata”
 Fata= tegm fine, umede
eritematoase;
 Ochii: exoftalmie;
asinergie: oculo-
frontala/palpebrala/
de convergenta
 Pleoape= edem, hiperpigm
orbitara, retractie pleoapa
sup, clipit rar
mixedematos
 =”luna pliana”, tumefiat
=absent, lent, adormit
 Par= aspru, rar, carunt
precoce
 Ochii: enoftalmie;
 Pleoape= edem+ fante
 Sprancene= rare 1/3 ext
 Tegm= edem(periorbitar)
+ uscat
Acromegalic In Sdr Cushing In boala Addison In diabet zaharat
 =aspect grosolan
 Nas= mare, proeminent
 Craniu= alungit, mare <= insuf suprarenaliana
 =” luna plina”, congestiv
 Reliefuri osoase  =aspect obosit, batran
 Gat= scurt, gros  “rubeoza
exagerate (pometi,  Tegm: brun inchis
 Pilozitatea/ hirsutism diabetica”=
arcade zigom/ spranc  Hiperpigm: muc bucal/
 Frecvent” alopecie pometi roz
bose frontale) gingival/buze
 Buze groase
 Macroglosie
 Prognatism

BOLI CARDIACE
Cardiopatii congenitale
Mitral Shattuck De elf Pletoric Aortic
cianogene
<= stenoza aorta congen
<=stenoza/ boala mitrala Fata alungita+ micrognatie <= HTA = col.albastra-violacee:
<= valvulopatii tricuspida <= insuf aortica
=cianoza: pometi,buze,nas Urechi jos implantate =congestiv,eritematos pometi, buze, menton,
Icter + cianoza= cul.verzuie =col. palid-galbuie
+palid: tenul Gura larga Pometi: telangectazii pavilion ureche
plioz sprancenara

BOLI PULMONARE BOLI DIGESTIVE

In pneumonie In BPOC
a) Pink puffer:emfizem
=vultuos, congestiv
 Facies roziu
 Cu transpiratii
b) Blue bloater:bronsita
 Roseate unilat pomet
 Cianotic, exoftalmic,
de partea penumoniei
buhait, somnolent
Diabet bronzat
ftizic Hipocratic( peritoneal) Cirotic
(hemocromatoza)
<= peritonite acute
<= TBC pulm
 Palid, teros =col. palid-galbui
 Facies emaciate, teros
 Enoftalmie  Icter sclero-tegm Col. brun-cenusie metalica
 Pometi congestivi
 Obraji supt + nas ascutit  Buze carminate
 Tegm+lb= uscate,cianotice

*semn Jellineck= hiperpigmentare orbitara *triada Hutchinson= nas in sea+ cheratita interstitiala+ incisive prost plantati cu striatii
*semn Stellwag= clipit rar *pterygium coli= pliu cervical post
*semn Hertoghe= sprancene rarite/ absente in 1/3 ext
*semn Jaccoud= roseata unilaterala a pometului de partea pneumoniei
*semn Bell= cand la comanda de inchidere a ochiului acesta deviaza sup-ext
 Parkinson
BOLI NEUROLOGICE Tetanus (“risus sardonicus”)
De Janus (paralizie n.VII)
Claude- Bernard- Horner
Pourfour du Petit
= “de masca”= imobil+ inspaimantat+ inexpresiv
= contrast: trist( frunte incretita) + ras (gura, nas, ochi<= contractia rizorius)
[ pe partea afectata= ] hipotonie musc + stergerea pliurilor nazo-geniene + epifora (scurgere lacrimi pe obraz) +
` lagoftalmie + semnul Bell
= enoftalmie+ mioza+ ptoza palpebrala+ eritem hemifacial+ absenta sudoratie
<= cancer pulm, hemoragie talamica, ramolisment bulbar (<= afectare (S) cervical/ intracranial)
= exoftalmie+ midriaza+ lagoftalmie+ paloare
<= afectare (S) cervical, leziuni intracraniene, tumori mediastinale, anevrism a.carot.int

Insuf renala cronica = palid( anemie) + teros (hiperpigm<= acumulare urocromi la niv tegm); pielea uscata
Lupus eritematos diseminat = tip “future”: eruptie eritemato- scuamoasa la niv nasului si pometilor
Sclerodermie = “icoana bizantina”: inexpresiv + tegm ingrosate, intinse, fara cute+ buze,nas: subtiri
Rujeola = ”de paiata”: patat (eritem) + plangaret (congestia muc conjunctivala)
Lues congenital Triada Hutchinson
Frunte jos implantata, hipertelorism ocular, ptoza palpebrala, epicantus, sclere albastre, nistagmus
Sdr. Turner
Micrognatie, urechi jos implantate, pterygium colli + comisuri bucale tractionate inf + nas infundat la radacina
Sdr. Down = mongoloid: fante palpebrale oblice, epicantus, hipertelorism, micrognatie+ intarziere mentala