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. valuable ценный
58. investigation исследование
59. shape очертание, контур
60. internal внутренний
61. 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.
Exercises
Задание 1.Ответьте на следующие вопросы по содержанию текста:
1. What is correct diagnosis based on?
2. What are the usual methods of patient’s examination?
3. What does inquiry reveal?
4. What does inspection reveal?
5. What can be determined by palpation, auscultation and percussion?
6. How does the doctor take the patient’s temperature, blood pressure?
7. What is the patient’s normal pulse?
8. Which are the usual laboratory studies?
9. In what case is it necessary to make biopsy?
10. What modern methods of investigation do you know?
Задание 2. Переведите следующие слова и словосочетания на английский язык:
Осмотр пациента, частота пульса, пальпировать лимфатические и слюнные железы, жалобы пациента, страдать от, цитологические исследования, тоны сердца, начало заболевания, рентгенологическое исследование, мазок, внутренние органы, внешний вид пациента, мокрота, причина смерти, перкуссия, определять, современные методы исследования.
Задание 3. Выберите нужное слово или словосочетание для того, чтобы закончить предложение:
1. Inquiry reveals … (past history, patient’s appearance, family history).
2. Palpation reveals … (edema, family history, growth).
3. Counting the pulse reveals … (blood count, pulse rate, respiratory rate).
4. X-ray examination reveals … (hypertension, bone lesions).
5. Inspection reveals … (heart sounds, past history, appearance of the patient).
Задание 4.Ответьте на предложенные вопросы согласно модели:
Model: A.: - When do we ask the patient “How old are you?”
B.: - We ask it if we want to find out his age.
1. Who are you? – (name).
2. What are you? – (occupation).
3. When did you fall ill? – (date of the onset of the disease).
4. What are you complaining of? – (patient’s symptoms and complaints).
5. What diseases have you had? – (patient’s past history).
Задание 5. Согласно модели, назовите инструменты, которые используются при осмотре и обследовании больного:
Model: a) Bronchoscope – to inspect the interior of the bronchi.
b) A broncoscope is an instrument used for inspecting the interior of the bronchi.
1. Gastroscope – to inspect the interior of the stomach.
2. Phonendoscope – to perform auscultation.
3. Cystoscope – to examine the bladder.
4. Otoscope – to inspect the ear.
5. Thermometer – to take the patient’s temperature.
6. Opthalmoscope – to visualize the eyeground.
7. Reflex hammer – to check the patient’s reflexes.
Текст на аудирование
Задание 1.Запомните значения следующих слов и словосочетаний.
1. vital(ly) жизненный
2. device устройство, механизм
3. accurate точный
4. screen экран
5. to stress подчеркивать
6. to possess владеть, обладать
7. to enable давать возможность, позволять
8. proper нужный, необходимый
Задание 2. Прослушайте текст и постарайтесь понять его содержание:
TEXT
Great progress of medical science and technology made it possible to control over the vitally important functions of the human organism using advanced diagnostic apparatuses and instruments.
Computer ultrasound devices make an accurate diagnosis of a great variety of diseases of the heart, blood vessels, lungs, stomach, etc.
Everything happening in the patient’s organs is immediately registered and shown on screens and indicators. By studying the results of these investigations the physician can make a correct diagnosis and plan the necessary treatment. For example, doctors know much about cardiovascular diseases thanks to radiographic examination of the heart and other methods of ultrasound diagnostics.
It must be stressed that each hospital now possesses new ultrasonic apparatuses, which enable physicians to make diagnosis and administer proper treatment.
Задание 3. Ответьте на вопросы к тексту.
1) What diagnostic apparatuses help doctors to control over the functions of the human organism?
2) Do you know the examples of using ultrasonic devices for diagnostics?
3) Are there any ultrasonic apparatuses in hospitals and clinics in your town?
Задание 4. Воспроизведите текст на английском языке.
Dialogue
1. substernal area загрудинная область
2. to strip to the waist раздеться до пояса
3. to catch a bad cold сильно простудиться
Задание 1. Прослушайте диалог. Воспроизведите его в парах:
Patient: - How do you do, Doctor?
Doctor: - How do you do. Sit down. What is the matter with you?
P.: - You see, I feel a bad pain in the substernal area and I have temperature and bad cough.
D.: - Please, take the temperature. Oh, it is 37.8°C! Now I want to listen to your lungs and heart. Strip to the waist, please.
(Doctor listens to his lungs and heart).
P.: - Tell me, Doctor, is it very serious?
D.: - It will be serious, if you don’t follow my instructions. You have only caught a bad cold. I want you to make blood and urine analyses and X-ray examination.
P.: - All right. I shall.
D.: - I’ll give you a prescription. Take a dose of this drug three times a day. You must follow a bed regimen. Come and see me again in 3-4 days. Good-bye for the present.
P.: - Good-bye, Doctor. Thank you very much.