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
Modul №	1
Enclosure module №	1
Topic	Auscultation of the lungs as an objective method of patient examination. Procedure of the lung auscultation. Main respiratory sounds.
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

Importance of the topic

Auscultation of the chest is one of the basic, informative methods of examination of the respiratory patients. It allows hearing normal and pathological changed sounds produced during act of breathing. Most of the respiratory diseases are accompanied with certain auscultation phenomena their determining is one of clues at the diagnostic process of the respiratory patients.

2. Concrete aims:

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

• Learn physical grounds of auscultation, mechanisms of production of normal and abnormal respiratory sounds

• Characteristics of the bronchial and vesicular respiratory sound, their distinguishing

• Qualitative and quantative changes of the vesicular respiratory sound, their diagnostic importance.

• Pathological bronchial respiratory sound, mechanism of its production

• The mechanisms for bronchophony, whispered pectoriloquy

3. Basic training level

Previous subject	Obtained skill
Biological physics	Principles of sound formation and spreading
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
Bronchial breath sound	Heard over trachea and major bronchus, formed in vocal fissure due to moving airflow through it
Vesicular breath sound	heard over all areas of the chest distal to the central airways, formed in alveoli due to their walls vibration at the pitch of inspiration
Bronchophony	Louder and clearer voice sounds over the affected lung area
Stridor	Indicates narrowing of the upper airway, loud sound can be heard at a distance from the patient
Whispered pectoriloquy	Clarity transmitting whispering to the chest wall at the patient with consolidation of the lung tissue