Please demonstrate the lungs auscultation method on a volunteer/dummy, demonstrating communication skills and commenting your actions in the process. Provide a general conclusion.
Information for examiner: please evaluate student's communication and clinical skills in lungs auscultation in accordance with below-mentioned criteria.
No. of steps
Steps evaluation criteria
Perfect*
Acceptable**
Needs correction***
Inacceptable****
1.
Student greets, presented himself, asked for permission to perform examination and explained the nature of examination.
7,5
5,0
2.
Student stood on the right of dummy. He started auscultation from apexes of lungs at the front above and under clavicles; then he continued auscultation at the front, along middle clavicular lines in II, III intercostal spaces, applying phonendoscope in strictly symmetrical areas of the chest on both sides; on the right he continued in IV, V intercostal spaces.
7,5
5,0
3.
Student started auscultation of lateral surfaces from axillary cavities and continued strictly on symmetrical areas along middle axillary lines on the level of IV ? VI intercostal spaces, emphasizing that patient's hands are above his head.
7,5
5,0
Student started lung auscultation from behind, standing on the left of dummy, indicating that patient's head should be slightly declined and hands crossed on chest, he started from suprascapular areas; then he continued in interscapular region and finished in subscapular areas (at that, he noticed that patient's hands should be down), applying phonendoscope on strictly symmetrical areas.
7,5
5,0
Student indicated that in norm over lungs surface, vesicular respiration will be auscultated, he explained mechanism of vesicular breathing formation, its features at auscultation, auscultation phases. He depicted the vesicular respiration graphically. He completely characterized its changes: weakening, absence, improvement.
7,5
5,0
Student named and explained causes, mechanism of physiological weakening or strengthening of vesicular breathing (obesity, childhood, cachexia, physical stress, asthenic chest form).
7,5
5,0
Student named and explained causes of vesicular breathing weakening or absence during extrapulmonary (anasarca) and bronchopulmonary pathology (hydrothorax, pneumothorax, atelectasis, decreased alveolar wall elasticity in inflammatory lung tissue infiltration, increased airiness).
7,5
5,0
Student explained vesicular respiration formation mechanism and its features during auscultation, auscultation phases.
7,5
5,0
Student named and showed places of bronchial respiration auscultation (over larynx and trachea) on anterior (jugular fossa and place of joint of presternum and mesosternum) and posterior (VII cervical vertebra and until III ? IV thoracic vertebrae) surfaces of chest.
7,5
5,0
Student explained causes and mechanism of pathological bronchial respiration formation during lung tissue consolidation syndromes and presence of a cavity.
