Physical examination (Objective examination).

The development of business in Minsk is ensured and supported by the acting normative-legal system of the Republic of Belarus, and also by different commercial and business organizations.

By the 1^st of August 2006 more than 22 000 organizations and subjects of small business were registered in Minsk which form nearly 90% of all subjects of management.

According to the statistics, almost 60% of all private subjects of management of the country and also 1\3 of all individual businessmen of the Republic are registered in Minsk. On the whole, the private sector makes up over 36% of industry production, more than 72% of the retail turnover, almost 39% of paid services for the population, 35% of investments and 80% of contract work in the city. Private sector provides 70% of foreign trade turnover which made about 4 billion US dollars and more than 35% of tax proceeds to the city budget in 2005.

By the 1^st of August 2006 28 commercial banks and 9 representations of foreign banks are registered in Minsk.

The general management of bank system in the Republic of Belarus is realized by the National Bank.

Physical examination (Objective examination).

(Status praesens)

Those pathological changes which are found out at research of the patient are needed to describe, and at their absence describe a physiological condition of organs and systems.

General assessment

General inspection (observation) (inspectio).

General condition: good, satisfactory, moderate middle grave, grave, extremely grave.

Consciousness: clear, deranged (stupor, sopor, coma, twilight state, delirium).

Habitus (includes constitution i.e. body-build, high and body weight): normosthenic, hypersthenic, asthenic; stature – cm (normal, dwarfism (nanism, cretinism), gigantism), body weight – kg (normal, gain in weight, loss of weight).

Posture of the patient: active, active with restriction, forced (standing upright position, sitting position, (intolerance of the recumbent position) – orthopnoea, supine posture, the position lying on the side (on the affected or healthy side), opistotonus, the prone position (lying face down), on several pillows, the forced “knee-elbow position”, the state of restless etc.), passive.

Gait:

The skin: color (usual, pale, red, bronze, cyanotic, yellow or icteric: a degree of expressiveness – subicterus or jaundice, tint of icteric — lemon-yellow (haemolytic), orange-yellow, greenish-yellow, grayish-brown or brown); local hyperpigmentation, grayish (dirty), depigmentation. Turgor and elasticity, sweating (normal, hyperhydrosis), dryness, peeling, eruption (erythema, roseola, papula, vesicla, pustule, weals or urticaria, hemorrhage lesions (petechia, ecchymoses, purpura, hematoma), telangiectasia,) — site (localization), solitary, plural, confluent; vascular "asterisks" (size, localization); scars: posttraumatic, postoperative (size, localization); trophic changes: ulcer, pressure sore (localization, size, character of a surface). Hair: baldness (premature, partial, general), canities, hypertrichosis. Nails: fragility, deformations (watch-glass nails, hypertrophic (sclerohychia), spoon-shaped (koilonychia), onychia diabetica, half and half nails etc.).

Tunica mucosa of lips, nose, eyelids: color — pink, red, pale, cyanotic discoloration; pigmentation.

Subcutaneous fat: degree of expressiveness (normal fat, skinfold thickness in hypochondrium: deficiency, excessive), accumulation of fat mainly (upper part of body, abdomen, buttock, legs), obesity (or peripheral or buttock-thigh and android or central or abdominal), insufficient accumulation, emaciation (demetritio, dystrophia, cachecxia).

Oedema: localization (podedema, cruses, loin, face, general) (general, local), expressiveness (slight, small, moderate, significant, anasarca), consistency (friable, easily move on a gravity at change of position, dense), genesis (cardiac failure, hypoproteinaemia, renal, congestive, cachectic, hypothireoidum etc.).

The lymph nodes: localization palpable units (submandibular, parotid, cervical, occipital, supraclavicular, infraclavicular, axillary, cubital, inguinal, under knee), size (to specify in cm), shape (roundish, awkward), consistency (soft, elasticity, firm), surface (smooth, rough), pain (painful, painless), mobility (adherence together and with surrounding tissues (matted, not matted)), color of the skin over lymph nodes.

The locomotor system:

Muscular system: the level of development (good, moderate, weak), hypotrophy and atrophy, tenderness (at what groups) or painlessness, tremor of extremity, muscular tonus, cramps, contractures.

Bones system: deformities (visible and palpable), tenderness at palpation or percussion; hippocratic fingers (clubbing of the terminal phalanges and toes).

Joints system (articulations): shape, configuration (usual, deformity, defiguration, swelling), symmetrical. Active, passive movements (it is enough, it is limited, contracture, anchylosis — which joints), tenderness at palpation or movements (active, passive), a crunch in joints, fluctuation, hyperemia, nodules in periarticular tissue (so-called Heberden’s nodes); vertebral column: without features, pathological curvatures (lordosis, kyphosis, scoliosis, kyphoscoliosis), restriction of mobility, tenderness at movements.

Countenance: usual, excited, indifferent, masklike, stupid (blunt), puffy, Cushing’s syndrome - "moon-like", Corvisart’s face, febrilis, cyanotic ruddiness, erythema as «butterfly», nose’s wings participation in breathing.

Eyes: Eyeball: exophthalmia, enophthalmia, anophtalmia, microphtalmia, squint (strabismus), nystagmus. Eyelids: ptosis, oedema, symptoms of Gref, Moebius, Shelvag. Eye slit: epicanthus, hyperthelorism. Sclera (color, icteritiousness or jellow, bleeding into the conjunctive); Kayser-Fleischer ring. Pupils: identical, anisocoria, miosis, mydriasis, reaction to light (alive, languid, absent), accommodation, convergence.

The Mouth. Mucous membrane: color (yellowish, pale etc), pigmentation, enanthema, haemorrhages, ulcers. Tongue: clean, coated or furred (white, white-grey, white-dirty, white-yellow, crimson-red etc.), dry or moist; papillary layer (usual, atrophy, hypertrophied), surface (smooth, grooved (fissured tongue), "polished", local thickening "geographical"). The Gums (gingiva): usual, swollen, hypertrophied, bleeding. Teeth: caries, missing teeth. The tonsils: not increased, increased, hyperemic, presence purulent proside in lacunas, hemorrhage. Smell (from a mouth): halitosis, putrefactive, «rotten eggs», fruit, uric.

The thyroid gland: size: is not increased, enlargement (goitre) (degree of increase), consistence (elastic, soft, dense, presence of separate units in it), surface (smooth, tuberous), pain, tenderness.

Date: 2015-01-02; view: 1220