Тиббиётнинг долизарб муаммоси

Examination of the vessels:
Examination of vessels of the neck: vessels are not changed, visible pulsation of carotid artery, swelling veins, pulsation of veins (positive, negative venouse pulse.)
Examination of peripheric vessels: visual pulsation, no arteries.
Hypogastric pulsation (due to hypertrophy of the right ventricle, hepatic pulsation). Examination and palpation of radial, carotid, femoral arteries and foot artery: untwisted, twisted, push. Pulsation at the base of the heart(mild, hard, noduled). To determine tourniquet (Konchalovsky) symptoms.
Investigation of pulse: rhythm – regular, irregular(anomalous), pulse rate, intension, filling (full, empty, thread-like), height, size, rapid pulse.
Comparison of pulse on the right and left hand. Auscultation of large arteries(double tone Traube’s, double murmur of Vinogradov-Durozye).
Measure of arterial pressure according to Korotkov’s method: maximal and minimal. Indicate pulse pressure. Examination and feeling of veins: pulsation of veins, exactly indicating the pulsation point, synchronity with arterial pulsation. Vein dilation of the area of the chest, belly, extremities with exactly indicating the area and degree of dilation. Induration and painfulness of veins, indicating the vein and length of induration or painfulness.


DIGESTIVE SYSTEM.


Complaints: (has, hasn’t):

1. 
   Appetite: good, lacking, disgust for food (which). Saturation : normal, rapid,
   

constant feeling of hunger.

2. 
   Thirst, dryness in the mouth(amount of drunk fluid).
   
3. 
   Taste in the mouth (what kind) unpleasant, bitter taste, acidic taste, metal taste.
   
4. 
   Salivation.
   
5. 
   Chewing: good mastication (if no, due to what reasons: lacking of teeth, pain and so on).
   
6. 
   Swallowing and food passing through esophagus: free, painful, difficult, what food doesn’t pass.
   
7. 
   Disceptic phenomena: a) heartburn, how often, in what conditions;b) belch: food, empty, sour, bitter, rotten egg, tainted food; c) nausea: depending on a kind of food and how often.
   
8. 
   Vomiting: a) on an empty stomach, after meals (immediately or after some period of time); b) the character of emetic mass, vomiting immediately after eaten meals or eaten long before vomiting, vomiting with acidic fluid, bile; c) blood in vomiting mass: fresh, dark, vomiting mass of coffee ground colour; d) smell of vomiting mass: unpleasant, putrid, sour or without smell.
   
9. 
   Pain in epigastric region: a) localization, pain irradiation; b) attitude towards food taking – before meals, after meals (in what period of time), hungry, night pains; c) if vomiting relieves the pain, d) appearance and change of pain intensiveness, depending on food character: hard, fatty, sharp and so on; e) the character of pain – acute, ache, dull, as an attack of permanent growing pain, length; pain irradiation.
   
10. 
    Intestines: a) pain in the abdomen – dependence on time of taking food and character of food. Cessation or appearance of pain after stool; b) abdominal gaseous swelling. Discharging out abdominal gases: normal, increased, with difficulty; c) burning, itch, and pain in the anus area; d) stool: regular, non-regular, spontaneous or after some procedures. Consistency and form of feces (hard, fluid, water-like). Color of feces: brown, grey, black.
    

Admixtures: mucosa, blood, remains of undigested food, tape-worm; d) hemorrhoids: pains, bleeding, prolapse of rectum.