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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.

«______»_______________ 200 ___ y.

Guidelines for Third-year Students of the Medical Department

Subgect	Propedeutics of the internal medicine
Module №	1
Enclosure module №	1
Topic	Percussion as an objective method of patient examination. Comparative and topographic percussion of the chest
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- 2007

1. Importance of the topic

Percussion of the chest is one of the basic, informative methods of examination of the respiratory patients. It allows revealing diagnostic signs of the respiratory diseases without modern additional investigations. Today, when doctor has a lot of additional diagnostic devices importance of percussion is less then before. But if doctor uses percussion during patient examination his diagnostic research becomes more efficient and fruitful. This method is very useful when doctor could not perform modern investigation and in an emergency situation. It is very important part of the diagnostic process.

2. Concrete aims:

• Master principles, types and rules of percussion of the chest

• Learn physical grounds of percussion

• Perceive clear lung sound and it changes: dull and tympanic, their characteristics.

• Performing and assessing comparative percussion of the chest

• Know chest points and lines used for topographic percussion of the lung

• Performing and assessing topographic percussion of the lung

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
Clear lung sound	heard on percussion of the chest areas over an unchanged lung tissue
Dull sound	heard over the solid tissue without air like dense parenchymatous organs
Tympanic sound	heard over the tissue containing a lot of air
Passive excursion of lung	Moving lower lung border when patient changes his position from stand to lying
Active excursion of lung	Moving lower lung border due to deep inhaler and exhaler