Test for self-control

1. What type of percussion sounds may you hear over health lung?

a. Tympanic

b. Clear lung

c. Dull

d. Stony dull

e. Resonant.

2. When may you hear dull percussion sound over lung?

a Thickened pleura.

b Collapse of lung.

c. Consolidation of lung.

d. Fluid in pleural cavity.

e. Everything mentioned above.

3. When may you hear hyper-resonant percussion sounds over the lung?

a. Emphysema,

b. Pneumothorax,

c. Above the level of pleural effusion

d. Large cavity

e. Everything mentioned above.

4. What pathological condition can produce dull percussion sound?

a. Pneumonia

b. Emphysema

c. Large cavity

d. Bronchitis

e. Pneumothorax.

5. What percussion sound is heard of the lobular pneumonia?

1. Tympanic
2. Impaired
3. Dull
4. Clear lung
5. Resonant.

6. What percussion sound is heard of emphysema?

1. Tympanic
2. Impaired
3. Dull
4. Clear lung
5. Resonant.

7. What percussion sound is heard of acute bronchial asthma?

a. Tympanitic

b. Impaired

c. Dull

d. Clear lung

e. Resonant.

8. What percussion sound is heard of pleural effusion?

a. Tympanic

b. Impaired

c. Dull

d. Clear lung

e. Resonant.

9. What percussion sound is heard of collapse of the lung lobe resulting from obstruction of the bronchus lumen?

1. Tympanitic
2. Impaired
3. Dull
4. Stony dull
5. Resonant.

10. What percussion sound is heard of the focal pneumonia near root of lung?

1. Tympanitic
2. Impaired
3. Dull
4. Clear lung
5. Resonant.

11. What is determined on topographic percussion of the lung?

1. Position of the height of the lung apex
2. Lung border mobility
3. Position of the lower border
4. Kronig's fields width
5. All mentioned above

12. What lines is topographic percussion done along?

1. Scapular
2. Paravertebral
3. Parasternal
4. Medioclavicular
5. Everything mentioned above.

13. What is the first line along which the lower border of the left lung is determined?

1. Scapular
2. Paravertebral
3. Parasternal
4. Medioclavicular
5. Axilar anterior

14. What is the first line along which the lower border of the right lung is determined?

1. Scapular
2. Paravertebral
3. Parasternal
4. Medioclavicular
5. Axilar anterior

15. What is position of the lower border of the right lung along medioclavicular line?

1. 6^th interspace
2. 10^th interspace
3. 7^th interspace
4. 5^th interspace
5. Not determine

16. What is position of the lower border of the left lung along medioclavicular line?

1. 6^th interspace
2. 10^th interspace
3. Not determine
4. 5^th interspace
5. 8^th interspace

17. What is the normal height of the lung apex?

1. 6-8 sm
2. 3-5 sm
3. 8-10 sm
4. 5-7 sm
5. 1-2 sm

18. What are the causes of increase height of the lung apex?

1. Pulmonary emphysema
2. Inflammatory infiltration of the lungs
3. Pleural effusion
4. Pleural obliteration
5. Everything mentioned above.

19. What are the causes of reduced mobility of the lower border?

1. pulmonary emphysema
2. inflammatory infiltration of the lungs
3. fluid in the pleural cavity
4. pleural obliteration
5. everything mentioned above.

20. What are the causes of upward displacement of the lower border?

1. pulmonary emphysema
2. pneumosclerosis
3. abscess
4. obturation atelectasis
5. everything mentioned above.

Control questions

1. What is percussion?

2. What types of percussion do you know; their diagnostic importance?

3. What are purpose and rules of the comparative percussion?

4. What percussion sound may be obtained over health lung, mechanism of its origin?

5. What is dull percussion sound, its origin and diagnostic importance?

6. What is tympanic (resonance) percussion sound, its origin and diagnostic importance?

7. What distinguished lines and points on chest do you know?

8. What is normal position of the right lower border of the lung? How it can change in pathology?

Practical tasks

1. Performing comparative percussion of the chest of the respiratory patient

2. Assess findings of the comparative percussion

3. Determine position of the lower border of the left lung.

4. Determine position of the lower border of the right lung.

5. Determine height of the lung apex, assess obtained findings

6. Determine active excursion of the lower border of the lung, assess findings

Situation tasks

Task 1

29-year-old male patient noted repeated every day attacks of breathlessness during last 7 years. At the visual inspection patient skin is light cyanotic, the ribs are horizontal, the intercostal spaces are narrow, supra- and subclavicular fossae are not seen, the epigastric angle is obtuse. The upper portion of the chest is especially wide.

1. Why is patient skin cyanotic?

2. What types of the chest does patient have?

3. What position in the bed does patient occupy during attack of breathlessness?

Task 2

57-year-old female patient complains of dyspnea, cough and left side chest pain. The symptoms appeared after hard work and overcooling 3 days before. At the visual inspection skin is pale and cyanotic, respiratory rate is 32 and left part of the chest is left behind from right

1. How is increased respiratory rate named? Why does patient have this sign?

2. Why is one half of the chest left behind from other?

3. What position may patient occupy in the bed? Why?

Task 3

24-year-old female was admitted to pulmonology department with severe mixed dyspnea, high fever (39°C), cough with rusty sputum, piercing chest pain. Her mother said the patient was exited and had visual hallucinations. During examination patient is calm, her respiratory rate is 36. Skin is red and hot.

1. What is general condition of the patient? Which department should patient be admitted?

2. What disorder of consciousness does patient have? Why?

3. How should you palpate the patient chest? What signs of the respiratory disease may you reveal?

Task 4

73-year-old male patient notes increasing dyspnea, cough with purulent sputum production during last week after overcooling. Patient condition is moderate severe. He sits fixing the shoulder girdle. His exhalation is longer than inhalation. Skin is cyanotic.

1. What type of the chest shape may be at the patient? Why?

2. What change of his finger can you find? Why?

3. How is vocal fremitus changed at the patient? Why?

Date: 2015-12-18; view: 1275