Тиббиётнинг долизарб муаммоси

The examination of the thorax:
The shape of the thorax: conical, cylindrical, emphisematosical (barrellike), rachitic and others, asymmetry, (retraction, outpouching). Deformation of the spine (cyphosis, scoliosis, lordosis). Supraclavicular and subclavicular spaces, position and shape of the collarbone, position of the bladebone, intercostal spaces, epigastric corner (sharp, right, obtuse). Dynamic and static examination of the thorax. Symmetry of thorax during the breathing – calm and deep. Normal: mixed with the domination of abdominal breathing at males and costal at females.
Costal type of respiration. Abdominal type of respiration Dyspnea, accelerated respiration with the increasing of its depth.
Types of breathing depth and rythm (normal, Chein Stoks respiration). Rate of respiration per minute , breathlessness: inspiratory , expiatory , mixed (on which conditions). Non-deep respiration (tachypnea). Orthopnea.
Palpation of the chest.
Tenderness on palpation of the ribs costal interspaces, mediastinum. Defining voice vibration (slight, moderate, stable). Respiratory excurtion of the4 thorax (measurement of thoracic circumference at the levelof shoulder-blade and the ribs on the front, during quiet breathing, deep breathing in and out).


Percussion of the Lungs.

1. 
   Comparatrive percussion.
   

On percussion on symmetric areas (in the frontat the levelof underclavicular regions, fontal surface of the thorazx, breast hipples, over-, inter-, under-scapular), to define the character of the percutorie sound: clear-pulmonary, dull, tympanic, box-like with exact determination of every voice borders in vertical position on the ribs, intercostal spaces, in horizontal direction according topographic lines. To point out physiologically changed areas.

2. 
   Topographic Percussion.
   

1. 
   Defining the height of apexes of the lungs in front towards the
   

collar-bones, behind towards the osteous projection of the 7^th cervical vertebrae-from the right and lft sides.

2. 
   Defining the width of grening`s fields (the width of the apexes of
   

the lungs) in cmes from both sides.

3. 
   Defining the lower borders of the lungs from all vertical
   

topopgraphic lines of th chest from both sides:

• 
  Near the chest only from the right
  
• 
  In the clavicular middle only from the right
  
• 
  Front axillary
  
• 
  Back axillary
  
• 
  Near the spine
  

4. 
   Defining the respiratory mobility of the lower border of the lungs is carried out along the scapula and middle axillary lines in cmes from both sides: on breathing in and out, the sum.