Topographic percussion

The position of upper levels of lung apices:

	Anteriorly	Posteriorly
Right	___ cm above clavicle	at the level of spinous process of the _____ ^th cervical vertebra
Left	___ cm above clavicle	at the level of spinous process of the _____ ^th cervical vertebra

The width of the right Kronig’s isthmus is ___ cm

the width of the left one is ___ cm.

The position of lower borders of lungs:

Topographical lines	Right lung	Left lung
Parasternal line	lower edge of the _____ ^th rib	-
Midclavicular line	lower edge of the _____ ^th rib	-
Anterior axillary line	lower edge of the _____ ^th rib	lower edge of the _____ ^th rib
Midaxillary line	lower edge of the _____ ^th rib	lower edge of the _____ ^th rib
Posterior axillary line	lower edge of the _____ ^th rib	lower edge of the _____ ^th rib
Scapular line	lower edge of the _____ ^th rib	lower edge of the _____ ^th rib
Paraspinal line	at the level of spinous process of the _____ ^th thoracic vertebra	at the level of spinous process of the _____ ^th thoracic vertebra

The respiratory mobility of the lower border of lungs:

Topographical lines	Right	Left
Midclavicular line	_____ cm	-
Midaxillary line	_____ cm	_____ cm
Scapular line	_____ cm	_____ cm

AUSCULTATION

Character and intensity of basic breath sounds:

Vesicular bronchovesicular bronchial

Vesicular diminished increased puerile harsh cogwheel absence

Bronchial physiological in the parts of its auscultation

pathological increased decreased amphoric stenotic metallic

Relative duration of inspiration and expiration

Sites of any abnormality ________________________________________________

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Adventitious sounds not auscultated

Dry rales sibilant sonorous

Moist (humid) rales crackles crepitation coarse/large bubbling medium fine/small consonating/sonorous non-consonating/non-sonorous

Sites of any abnormality ________________________________________________

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Pleural friction rub

Vocal resonance not changed equal unequal on symmetrical points

intensified decreased absent

Sites and description of any abnormality ________________________________

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FUNCTIONAL TESTS OF RESPIRATION DELAY

Timed inspiratory capacity (Shtange test) _______ sec

Timed expiratory capacity (Gencha test) _______ sec

Cardiovascular System

INSPECTION

Visible chest deformities in the precordium absent humpback

Visible point of maximal impulse present absent

Abnormal apex beat high diffused displaced to the left downward

Abnormal pulsations cardiac beat epigastric jugular fossa in the 2^nd 3^rd 4^th intercostal space to the right to the left of the sternum carotid pulsation "carotid shudder" de Musset’s sign absent

Visible venous pulse positive negative absent

PALPATION

Point of maximal impulse

Apex beat impalpable

Position in the ___ ^th intercostal space, ____ cm from the left midclavicular line toward the sternum laterally

Area ________ cm² normal diffuse concentrated

height normal high low

strength normal forceful weak

Cardiac beat present absent

Thrills systolic diastolic presystolic apex base of heart

Epigastric pulsation present absent

Pulse synchronous non- synchronous identical different on both hands

rate _______ beat per minute infrequent

rhythm regular irregular

volume normal large-volume/full small-volume

equality uniform unequal/non-uniform

tension normal hard/tense soft

swiftness not changed swift/quick/abrupt slow-rising

vessel wall normal

pulse deficit absent present = _______ beat

dicrotic pulse pulsus paradoxus anacrotic pulse filiform pulse

peripheral pulses (normal, reduced, absent, aneurismal: radial, brachial, carotid, femoral, popliteal, posterior tibial, dorsalis pedis)

Sites and description of any abnormality ________________________________

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PERCUSSION

The borders of relative cardiac dullness:

right: in ____ ^th intercostal space, along the right edge of sternum ____ cm laterally

left: in ____ ^th intercostal space, ____ cm from left midclavicular line toward the sternum laterally along left midclavicular line

upper: lower edge of the ______ rib.

The borders of absolute cardiac dullness:

right: in ______ ^th intercostal space, along the left edge of the sternum _____ cm medially laterally

left: in ______ ^th intercostal space, ___ cm medially of left border of relative cardiac dullness

upper: lower edge of the ______ rib.

The width of vascular bundle in the 2^nd costal interspace is _____ cm.

The outline of the heart normal mitral aortal dilated

The right dimension (md) = ____ cm the left dimension (ms) = ____ cm

the diameter of the heart (Т) = ____ cm md: ms = 1÷_____

AUSCULTATION

Heart sounds regular irregular ____ beat per minute

Basic sounds

S1 normal soft muffled loud splitting over apex 4^th point

A2 normal soft accentuated loud splitting

P2 normal soft accentuated loud splitting

Added sounds S3 S4 opening snap

“quail” rhythm “gallop” rhythm presystolic protodiastilic summation

Murmurs present absent

Systolic diastolic early late middiastolic presystolic continious

Location apex 2^nd 3^rd 4^th 5^th points of auscultation

Radiation absence axilla neck back armpit subscapular area

where loudest soft harsh

intensity 1 (very quite) 2 (quite) 3 4 5 6 (audible without stethoscope)

duration short long

effect of position change intensification decrease disappearance

pericardial friction rubs pleuropericardial friction murmurs

Vascular bruits Duroziez’ double "Nun’s murmur" Traube’s doubled tone

Systolic pressure is ______ mm Hg, diastolic pressure is _____ mm Hg, pulse pressure is _____ mm Hg.

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Дата добавления: 2015-11-14