UKRAINIAN MINISTRY OF PUBLIC HEALTH

Vinnytsya National Medical University n.A. M.I. Pyrogov

«APPROVED»

At the methodological meeting of the internal medicine propedeutics department

Chief of the department

____________ prof. Mostovoy Y.M.

«______»_______________ 2013 y.

Guidelines for Third-year Students of the Medical Department

Subgect	Propedeutics of the internal medicine
Modul №	1
Enclosure module №	1
Topic	General visual inspection, visual inspection and palpation of the chest. Diagnostic value
Course	3
Faculty	Medical № 1

Methodical recommendations are made in accordance with educationally-qualifying descriptions and educationally-professional programs of preparation of the specialists ratified by Order MES of Ukraine from 16.05 2003 years № 239 and experimentally - curriculum, that is developed on principles of the European credit-transfer system (ECTS) and Ukraine ratified by the order of MPH of Ukraine from 31.01.2005 year № 52.

Vinnytsya- 2013

1. Importance of the topic

Visual inspection of patients is one of the basic, informative methods of examination. Doctor performs it during the first contacts with the patient and inquiring him. Doctor is assessing patient general condition, its severity and forming the first opinion about patient. It allows recognizing visual signs of disease and points diagnostic search on the right way. Respiratory patients sometimes have a lot of specific signs of diseases that must be reveal and rightly assess. It is very important part of the diagnostic process.

2. Concrete aims:

• Master principles and methods of the general visual inspection

• Revealing main signs of the respiratory diseases during general visual inspection

• Performing and assessing static visual inspection of the chest

• Performing and assessing dynamic visual inspection of the chest

• Master method of palpation of the chest

• assessment of the data obtained at palpation of the chest

3. Basic training level

Previous subject	Obtained skill
Normal anatomy	Anatomy of the airways and lungs, their blood supply and innervation
Normal physiology	Mechanics of breathing, gas exchange in the lung and tissues of system organs
Histology	Ontogenesis of the respiratory tract, histological structure of the respiratory tract and alveoli

4. Task for self-depending preparation to practical training

4.1. List of the main terms that should know student preparing practical training

Term	Definition
Active position	the patient can change his position as he wants
Passive position	taken due to exclusively the law of gravity
Forced position	taken instinctively or consciously to elicit the suffering
Constitution	Body-building
Cyanosis	Bluish color of the skin
Hyperemia	Reddish color of the skin due to increased blood circulation
Tachypnea	Increased respiratory rate
Bradypnea	Decreased respiratory rate
Barrel chest	Increased rounded shape of the chest with horizontal position of the ribs, equal front and side size
Paralytic chest	Diminished and flat chest with vertical position of the ribs
Terminal types of breathing	Breathing patient with severe injury of the respiratory center in the brain (Cheyne-Stokes, Biot’s, Grocco’s, Kussmaul respiration)