CLINICAL METHODS OF PATIENTS EXAMINATION
1. . :
1. symptom
2. auscultation
3. palpation
4. percussion
5. crepitation
6. hypertension
7. hypotension
8. tonometer
9. cytologic
10. allergy test
11. Mantouxs test
12. tuberculosis
13. roentgenologic
14. ultrasound
15. biopsy
2. . :
1. method of examination ,
2. clinical examination
3. physical examination
4. treatment
5. to make diagnosis
6. cause of a disease
7. to reveal ,
8. complete
9. inquiry ,
10. inspection
11. to count pulse rate
12. to measure blood pressure
13. X-ray examination
14. laboratory study
15. to complain of
16. complaint
17. onset , ()
18. past history
19. family history
20. hereditary
21. disorder ,
22. immediate relatives
23. to assess, assessment ,
24. mental
25. valuable
26. appearance
27. build
28. skin
29. mucous membrane
30. tongue
31. pupil
32. salivary gland
33. elasticity
34. rigidity
35. outline
36. swelling
37. oedema
38. growth ,
39. heart sound
40. crepitation ,
41. râle ( )
42. dullness ()
43. to ascertain ,
44. to suffer from
45.method of investigation
46. blood
47. urine
48. sputum
49. bile
50. swab, smear
51. cytologic examination
52. allergy
53. biopsy
54. specimen
55. to specify
56. tumour
57. valuable
58. investigation
59. shape ,
60. internal
61. patients case history
3. :
CLINICAL METHODS OF PATIENTS EXAMINATION
Before the treatment of a disease it is necessary to make diagnosis, to determine the cause of the disease, and all symptoms by which it can be revealed.
Correct diagnosis must be based on a complete clinical examination of the patient.
The usual methods of physical examination which doctors use in daily practice are: inquiry, inspection, auscultation, palpation, percussion, taking the temperature, counting the pulse rate, taking the blood pressure, making X-ray examinations and various laboratory studies.
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By questioning the patient the doctor learns about his complaints, the onset and duration of present illness. It is important to take a careful past history, family history, to reveal hereditary disorders and causes of death of immediate relatives. Assessment of mental and emotional state of a patient may also give valuable information to the doctor.
Inspection is the method by which doctor reveals the appearance of the patient, his build, the state of his skin, mucous membranes, tongue, pupils, etc. Doctor must observe the patients hands, feet, shape of the chest. He must palpate lymphatic and salivary glands.
By palpation the doctor determines elasticity or rigidity of the abdomen, the outlines or the enlargement of the abdominal organs, swelling, edema and existence of growth.
While auscultating the patient, the physician can determine the abnormal heart sounds, crepitations and râles in the lungs.
Percussion reveals dullness of sound and distribution of fluids in the body.
The temperature is taken by means of thermometer to ascertain whether the patient has or has no temperature.
The blood pressure is measured by means of tonometer to find out whether the patient is suffering from hypertension or hypotension.
The patients pulse is counted to assess its rate and rhythm. The normal pulse rate is 65-70 beats per minute.
In diagnostics of diseases various laboratory and instrumental methods of investigation are applied.
The laboratory investigations such as various blood and urine tests, stool studies and sputum, bile examinations may be very informative.
Patients swabs or smears are taken for cytologic examination. If the patient suffers from any kind of allergy it is necessary to make allergy tests. Mantouxs test is used to detect the presence of tuberculous infection.
Biopsy specimens are taken to specify the character of tumour.
Valuable information may be obtained using modern roentgenologic, endoscopic and ultrasound methods of investigation. With the help of these investigations it is possible to determine position, shape, size, structure and pathology of the internal organs.
The methods of instrumental investigations require special preparation of the patients.
The results of physical examination, labortry and instrumental investigations re recorded into the patients case history.
Exercises
1. :
1. What is correct diagnosis based on?
2. What are the usual methods of patients examination?
3. What does inquiry reveal?
4. What does inspection reveal?
5. What can be determined by palpation, auscultation and percussion?
6. How does the doctor take the patients temperature, blood pressure?
7. What is the patients normal pulse?
8. Which are the usual laboratory studies?
9. In what case is it necessary to make biopsy?
10. What modern methods of investigation do you know?
2. :
, , , , , , , , , , , , , , , , .
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3. , :
1. Inquiry reveals (past history, patients appearance, family history).
2. Palpation reveals (edema, family history, growth).
3. Counting the pulse reveals (blood count, pulse rate, respiratory rate).
4. X-ray examination reveals (hypertension, bone lesions).
5. Inspection reveals (heart sounds, past history, appearance of the patient).
4. :
Model: A.: - When do we ask the patient How old are you?
B.: - We ask it if we want to find out his age.
1. Who are you? (name).
2. What are you? (occupation).
3. When did you fall ill? (date of the onset of the disease).
4. What are you complaining of? (patients symptoms and complaints).
5. What diseases have you had? (patients past history).
5. , , :
Model: a) Bronchoscope to inspect the interior of the bronchi.
b) A broncoscope is an instrument used for inspecting the interior of the bronchi.
1. Gastroscope to inspect the interior of the stomach.
2. Phonendoscope to perform auscultation.
3. Cystoscope to examine the bladder.
4. Otoscope to inspect the ear.
5. Thermometer to take the patients temperature.
6. Opthalmoscope to visualize the eyeground.
7. Reflex hammer to check the patients reflexes.
1. .
1. vital(ly)
2. device ,
3. accurate
4. screen
5. to stress
6. to possess ,
7. to enable ,
8. proper ,
2. :
TEXT
Great progress of medical science and technology made it possible to control over the vitally important functions of the human organism using advanced diagnostic apparatuses and instruments.
Computer ultrasound devices make an accurate diagnosis of a great variety of diseases of the heart, blood vessels, lungs, stomach, etc.
Everything happening in the patients organs is immediately registered and shown on screens and indicators. By studying the results of these investigations the physician can make a correct diagnosis and plan the necessary treatment. For example, doctors know much about cardiovascular diseases thanks to radiographic examination of the heart and other methods of ultrasound diagnostics.
It must be stressed that each hospital now possesses new ultrasonic apparatuses, which enable physicians to make diagnosis and administer proper treatment.
3. .
1) What diagnostic apparatuses help doctors to control over the functions of the human organism?
2) Do you know the examples of using ultrasonic devices for diagnostics?
3) Are there any ultrasonic apparatuses in hospitals and clinics in your town?
4. .
Dialogue
1. substernal area
2. to strip to the waist
3. to catch a bad cold
1. . :
Patient: - How do you do, Doctor?
Doctor: - How do you do. Sit down. What is the matter with you?
P.: - You see, I feel a bad pain in the substernal area and I have temperature and bad cough.
D.: - Please, take the temperature. Oh, it is 37.8C! Now I want to listen to your lungs and heart. Strip to the waist, please.
(Doctor listens to his lungs and heart).
P.: - Tell me, Doctor, is it very serious?
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D.: - It will be serious, if you dont follow my instructions. You have only caught a bad cold. I want you to make blood and urine analyses and X-ray examination.
P.: - All right. I shall.
D.: - Ill give you a prescription. Take a dose of this drug three times a day. You must follow a bed regimen. Come and see me again in 3-4 days. Good-bye for the present.
P.: - Good-bye, Doctor. Thank you very much.
