Control questions

1. Main respiratory signs that can be revealed at the general visual inspection

2. What type of cyanosis can be observed at the respiratory patients? Describe mechanism of its formation.

3. What types of the forced position do respiratory patients occupy? Describe and explain their.

4. What normal shapes of the chest do you know? Describe their.

5. When can the barrel and paralytic chest be formed? Describe their.

6. What pathological shapes of the chest due to deformities of the spin do you know? How they can influence to the respiratory function?

7. What normal and abnormal types of breathing do you know?

8. What data can you received performing chest palpation? Their diagnostic value.

Practical tasks

1. Performing general visual inspection of the respiratory patient

2. Assess patient’s chest shape, revealing signs of the pathologic chest

3. Performing dynamic visual inspection of the chest

4. Assess data obtained at the dynamic visual inspection of the chest

5. Performing palpation of the chest and assessment of the obtained data.

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?