Тема 15. Клинические методы обследования больного

CLINICAL METHODS OF PATIENT’S EXAMINATION

Задание 1. Запомните произношение следующих слов. Повторяйте их за диктором:

1. symptom

2. auscultation

3. palpation

4. percussion

5. crepitation

6. hypertension

7. hypotension

8. tonometer

9. cytologic

10. allergy test

11. Mantoux’s test

12. tuberculosis

13. roentgenologic

14. ultrasound

15.biopsy

Задание 2. Выучите следующие слова и словосочетания. Повторяйте их за диктором:

1. method of examination метод осмотра, обследования

2. clinical examination клиническое обследование

3. physical examination физикальное обследование

4. treatment лечение

5. to make diagnosis поставить диагноз

6. cause of a disease причина заболевания

7. to reveal обнаруживать, выявлять

8. complete полный

9. inquiry опрос, расспрашивание

10. inspection осмотр

11. to count pulse rate измерять частоту пульса

12. to measure blood pressure измерять артериальное давление

13. X-ray examination рентгеновское исследование

14. laboratory study лабораторное исследование

15. to complain of жаловаться на

16. complaint жалоба

17. onset начало, приступ (заболевания)

18. past history анамнез перенесенных заболеваний

19. family history семейный анамнез

20. hereditary наследственный

21. disorder расстройство, нарушение

22. immediate relatives близкие родственники

23. to assess, assessment оценить, оценка

24. mental умственный

25. valuable ценный

26. appearance внешний вид

27. build телосложение

28. skin кожа

29. mucous membrane слизистая оболочка

30. tongue язык

31. pupil зрачок

32. salivary gland слюнная железа

33. elasticity упругость

34. rigidity неподвижность

35. outline контур

36. swelling припухлость

37. oedema отек

38. growth новообразование, опухоль

39. heart sound сердечный тон

40. crepitation хруст, крепитирующие звуки

41. râle хрип (в легких)

42. dullness притупленность (звука)

43. to ascertain установить, выяснить

44. to suffer from страдать от

45.method of investigation метод исследования

46. blood кровь

47. urine моча

48. sputum мокрота

49. bile желчь

50. swab, smear мазок

51. cytologic examination цитологическое

исследование

52. allergy аллергия

53. biopsy биопсия

54. specimen образец

55. to specify уточнить

56. tumour опухоль

57. investigation исследование

58. shape очертание, контур

59. internal внутренний

60. patient’s case history история болезни пациента

Задание 3. Прослушайте текст и постарайтесь понять его содержание:

CLINICAL METHODS OF PATIENT’S 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.

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 patient’s 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 patient’s 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.

Patient’s swabs or smears are taken for cytologic examination. If the patient suffers from any kind of allergy it is necessary to make allergy tests. Mantoux’s 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, laborаtоry and instrumental investigations аre recorded into the patient’s case history.