It, Definitely, Raises Comfort By Preparation For Employment

It, definitely, raises Comfort by preparation for employment and lectures. However in some cases It was necessary to me, where it is possible, to add short references and to keep Drawings on separate sites. A disk with the text of last editing, Illustrations, clips and references it is possible to order also (the postage + record cost on CD). Orders for the edition, a disk with drawings, references and clips khramov1@rambler.ru The author, professor Hramov Jury Afanasevich. (PHOTO 2) Copying of printing materials is protected terrible and without the written approval of the author it is forbidden. Response (on the first edition) <<The electronic version of the textbook Offered the reader on To propaedeutics of internal illnesses (introduction in a speciality) is The fourth added edition of a lecture course in due time Read for students of medical faculty Novosibirsk Medical institute. In this edition the basic sections are considered Diagnostics of internal illnesses, last recommendations of some the expert Councils about construction of diagnostic plans of inspection of patients, To revealing specific and few specific symptoms and Syndromes.

Approximately 20 % Of Patients With COPD And

Approximately 20 % of patients with COPD and normal arterial pressure of oxygen in blood have night, not connected with oxygen insufficiency. Pulmonary blood circulation - Usually blood with low vascular resistance and high In capacity of pool of blood. Value of the high pulmonary arterial Pressure at consists that it increases an impedance (the specific Resistance) for right at the moment of exile. Excessive The increase in an impedance after loading often conducts to a sudden stop Hearts. Pulmonary arterial hypertension (LOG) It is defined as average pressure in a pulmonary artery () more than 25 mm Hg in rest or, at least, 30 mm Hg at the physical To loading. Increases it is almost always connected with increase of the pulmonary Vascular resistance (PVR) and average pulmonary pressure Jammings. Pressure of the right is thus final-diastolicheskoe for acknowledgement of the diagnosis the LOG should be less than 15 mm Hg. Thus, continuous eminence and PVR Causes an overload and a stop right and conducts to Inability of heart to support blood circulation with the subsequent death The patient.

Resolve Members Of A Family And Friends To

Resolve members of a family and friends to participate in discussion of questions. Describe the scheme of diagnostic and medical problems of the patient. Offer the patient some variants of inspection and treatment. Induce the patient to the self-help, including kinds of the therapy, supplementing traditional. Complicate dialogue: 1. A language barrier and speech infringements. 2. Questions on a sexual life of the patient. 3. Malignant diseases. 4. Mental restrictions of dialogue and mental diseases. 5. Barreness. 6. Undesirable pregnancy. 7. Difficult medical questions and . I consider that it is necessary - to Avoid complicated questions - Not to include in questions of concept "norm" and medical and-or special Terms, words as the patient they are often not clear. Detection (=) a symptom, a syndrome Demands its greatest possible qualitative and quantitative Descriptions at the moment of survey, interrogation. The medical terms stated The patient, its knowledge of syndromes and the diagnosis should be specified questions And-or medical documents (it is better primary - an electrocardiogram, ultrasonic, The roentgenograms, given laboratory researches, Inquiries, etc.

Patients With The Minimum Signs Of A Pulmonary

Patients with the minimum Signs of a pulmonary hypertension on an electrocardiogram or on the roentgenogram should It is obligatory to undergo to a two-dimensional echocardiography with Research of streams Doppler, Which is considered the most informative test for detection Pulmonary hypertension and exception congenital heart pathologies. The Ehokardiografichesky Criteria of a pulmonary hypertension are based on identification and measurement a stream (TR), absent at healthy faces. Measurement TR in m / provides an estimation of a return stream between right and the right auricle. Bernoulli results the equation [p=4 (TR2)] which transforms speed of a stream to a pressure gradient. All patients from the suspect Pulmonary hypertension should be exposed to a complex estimation for Findings-out of the nature of a high pressure. To identify or exclude The reasons of a pulmonary hypertensia, meaning the differential diagnosis. If the reason of a pulmonary hypertension remains, Obscure, should be excluded chronic the pulmonary Arteries as this condition can clinically imitate the primary Pulmonary hypertensia.

The REASONS : An Inflammation - Sharp Pneumonia

The REASONS : an inflammation - sharp Pneumonia (crepitatio indux, crepitatio redux). ; plasmas in alveoluses (a lung heart attack, a hypostasis of lungs) Hypoventilation of lungs (, ). Noise of a friction of a pleura: ALWAYS the PATHOLOGY. It is connected with Fibrin adjournment on and pleura leaves. It is listened in both phases of breath, reminds a sound of a leather belt Folded double at bending and . The sound disappears at a delay Breath also amplifies at pressing . Sounds of a friction of a pleura-normal leaves and pleurae slide smoothly and without is noisy the friend about The friend during the breath certificate. If the pleura loses smoothness of a surface Also grows coarse for any reason, the scratching, rubbing sounds connected with By breath are heard from the earliest stages of pathological process. You Can hear even the easiest sound, pressing a stethoscope to the chest To cage and having asked the patient to breathe deeply. Such sounds often Have limited on a zone of auscultation character, but repeatability Sounds steady enough.

All These Changes Result To Creation Of A

All these changes result To creation of a trap and progressing restriction of a stream of air. Thus, changes, Which occur at patients with COPD, include hyperproduction of slime, Dysfunction bronchial tubes, restriction of streams of air, Pulmonary hyperventilation, defective exchange gas and pulmonary Hypertension and signs of pulmonary heart. With progressing COPD, proceeding Pathological changes cause artful, a little appreciable symptoms and Syndromes which testify to clinical course deterioration. Under hyperventilation Process, when air which has entered into lungs after each is understood Breath, because of infringements of ventilation and volumes, still completely it is not removed Exhalation. That is air is inhaled each time before occurs Full exhalation. At patients with COPD Exhalation time is always increased in connection with the phenomena of hyperventilation and Hypoventilation of alveoluses. Consider that hyperventilation - hypoventilation Is the central mechanism COPD.

It Is Recommended To Add Approximately Two Minutes

It is recommended to add approximately two minutes in a week to reach The purposes - 10-15 minutes 3 times weekly. Installation for hands It is necessary to begin at level convenient for the patient. Patients can To begin trainings from 10-15 repetitions of each exercise. It is possible to add additional 200 gramme of loading each 2-3 weeks, If the patient adapts for the previous loading. THE MAINTENANCE Introduction 1. The short review of anatomy and functions of bronho-pulmonary system 2. Ways of revealing of syndromes of diseases of bronho-pulmonary system * Complaints of patients and feature of the questionnaire of quality of a life * Cough and its versions * Features of pains in a thorax at diseases of respiratory organs * Short wind and its kinds * History of disease, life and hereditary factors 3. Fizikalnye researches and clips on this theme * Research of the patient (a head; ears; Nose; nose bosoms; a throat; smells of the person; a neck; the chest Cage; etc.) * Fizikalnoe research of an air line, lungs and a diaphragm * () nose bosoms 4.

If Pressure Which Develops At Air Giving Through

If pressure which develops At air giving through a nasal course it is transferred in a middle ear, The Eustachian tube is passed. Thus the doctor should turn the special Attention to any form or occurrence of dizziness, which Could be connected with presence of a chronic internal infection of an ear Or to be caused fistula presence in the horizontal semicircular channel Ear. Reception of Valsalva (Valsalva aneuver). Reception it is carried out at survey membranes of the patient, Which thus deeply inhales and closes a mouth. It or it Simultaneously densely holds a nose and does attempt to exhale. Movements ear membranes in a step with exhalation attempts testify about Passableness of the Eustachian tube. Estimation of possible false sounds When the patient complains of extraneous sounds, To check up it it is possible by means of following actions: For example, unusual The pulsing sound can be connected with occurrence of a fistula or aneurysms With involving of arteries (more often sleepy).

=: ( + ) 100 %, Where -

=: ( + ) 100 %, where - is true-negative results, - is false positive results of Ds in percentage and the above the percent also is expressed, the the sign is more specific. Diagnostic efficiency can be calculated as follows: J = ( + ): ( + + + ) 100 % Probability that any result (a sign, The symptom) can be recognised by norm or a pathology depends on three The reasons: 1) from the chosen value of norm; 2) from a relative proportion Two populations of the people for example healthy and sick (disease + Morbidity of the population); 3) from degree of "overlapping" of an indicator - Imposings of fields of an arrangement of three a standard deviation. In some cases the forecast indicator is considered also - value (): = : ( + ) 100 % It is possible to estimate (about) percent of interrelation with treatment, influence of any factor: Interrelation of signs = ( ) - ( ): ( ) + ( ). But it is a special problem and to discuss it it is possible only after careful studying of statistics. http://www.

1990. Page 241. Strained (= ) Arises At

1990. page 241. Strained (= ) arises At progressive accumulation of air in a cavity and at , Which leads to increase pressure with a compression systems . It can cause Menacing lives of a condition which demands high level of the clinical The help and immediate intervention. Signs of necessity of the immediate help at : (1) Accruing SHORT WIND and . (2) Blown up, intense veins of a neck, tachycardia, Hypotension, the unconsciousness and-or a stop of the warm is frequent Activity. (3) Deviation of a trachea towards a healthy lung. (4) Perkutorno a hyperresonance (= a box sound) over area . (5) Reduced or absent sounds of breath over a zone . (6) Roentgenogram of a thorax reveals with a deviation structures. More in detail sm-Wyatt JP, Illingworth RN, et al. Oxford Handbook of Accident and Emergency Medicine. Oxford University Press. 1999. page 346. * Rules in clips and the basic indicators of diseases under the analysis of a pleural liquid Syndrome of a congestion of a liquid in a pleural cavity (=, =).

- The Yellowish Shade Of A Skin And

- The yellowish shade of a skin and assumes Diseases of a liver and ways (yellowness arises At concentration of bilirubin in whey of blood about 40-50 microns/l that It is twice more than norm); - Vascular asterisks - indirect signs Liver diseases. Vascular asterisks can sometimes appear on To skin of the top part of a thorax in second half Pregnancy (usually disappear further in some hours after Sorts). Vascular asterisks appear also at women in The climacteric period of a life. Occurrence of vascular asterisks is possible At it is long the remaining raised warm emission of blood from Left hearts at an arterial hypertensia. Zhilbera-Ano a symptom (N.A.Gilbert, 1858-1927; V.Ch. Hanot 1844-1896), - presence small forms on a face skin and trunks at Chronic illnesses of a liver. - Vascular small hypodermic vessels on the person is called . - K, the sanguineous, bloated person often testifies to an alcoholism, , a syndrome of Kushinga. - Illness of Parkinsona - . The inactive person, a rare blinking; -- Turner's syndrome - a century, the small bottom jaw, low located ears, folds on a neck, deafness.

(http://www.pph-net.org/pph-symptoms-pph-diagnosis.htm) In The General Practice Allocate 3 Degrees

(http://www.pph-net.org/pph-symptoms-pph-diagnosis.htm) In the general practice allocate 3 degrees respiratory Insufficiency; and, if it is very short 1 degree - a short wind at usual To physical activity; 2nd degree - a short wind at insignificant physical To loading; 3rd degree - a short wind in rest. At interrogation of the patient specify about what The nature of a short wind which can be "functional" and "organic" The nature. In "a functional" short wind, usually, results Stress, fright, psychoemotional excitation, physical Overstrain and other kinds of loadings. "The organic" nature of a short wind, as a rule, It is connected with a large quantity of diseases which lead To infringement of interface of function of breath and blood circulation through lungs: diseases of respiratory organs (the chronic Bronchitis, bronchial asthma, emphysema of lungs, sharp extensive pneumonia Etc.); Diseases of cardiovascular system (, Rheumatism with development of heart diseases, etc.);) blood diseases (Including a pulmonary artery and its branches, an anaemia various Aetiologies).

It Is Necessary To Remember That A Curve

It is necessary to remember that a curve of an average portion Stream or the forced stream of an exhalation, at 50 % volume of the exhaled Air of the patient (=FEV25-75 %), can fall below the lowermost Limit of normal values even when indicators FVC, FEV1 and FEV1/FVC % Have normal amounts. Lower values for indicator specifications FEV25-75 % can be and less than 50 % from average settlement (= ' due ') Sizes. It is the important feature of measurement can be used for Revealings of the bottom limits of individual normal values with Confidential interval of 95 % from average due size. However Sizes FEV25-75 very strongly depend on the general time of an exhalation. If Time of the forced exhalation the patient any way changes more than On 10 % after application it it is difficult To interpret. The truth and earlier end of a breath with application often moves a curve of the middle of the forced The exhaled volume to the exhalation beginning. Additional special researches with the help Estimation of vital capacity of lungs in position of the patient lying on a back: The estimation of force of a diaphragm can be executed through Measurement of vital capacity in vertical or a sitting position The patient and comparison of these indicators with the measurements made in Position of the patient lying on a back.

Estimation Of A Condition Of A Thorax First

Estimation of a condition of a thorax First of all the volume of excursions is estimated and Frequency of respiratory movements of a thorax. Pay attention (and Often also measure) a parity of duration of a breath and an exhalation. [01 [02] Listen to obvious to respiratory sounds, allocating from them pathological. Always observe possible use of additional muscular efforts at breath. Thus it is necessary to estimate symmetry Thorax of the patient, presence of curvatures and change a rebottom The back size. [03] Whether check up as there is a trachea strictly on the centre of an average line of a neck. [04] Estimation of probable expansion the chest Cages it is spent by means of deep breaths and exhalations, and a deviation It is identified by means of a centimetric tape. By means of a centimetric tape it is necessary To measure two circles of a thorax at level of nipples of chest glands ( At men) - one on the maximum breath and, another, on maximum Exhalation. The difference of lengths of circles at healthy faces makes 5 - 13 sm ( 2-5 ").

Reflex Cough The Basic Receptors Of Cough Are

Reflex cough The basic receptors of cough are in a nose, To nasopharynx, throats, the top part of a trachea and the main bronchial tubes (). Other sites of receptors of cough: an ear membrane, a diaphragm, Gullet, pericardium, etc. the Centripetal nerves participating in the certificate Cough: trigeminal, glossopharyngeal, top and vagus. Efferentnye nerves: returnable guttural, vagus, a path And peripheral nerves. The cough reflex begins with a deep breath, It is accompanied by closing of a vocal crack, a relaxation of muscles of a diaphragm and Reduction of the chest and belly muscles participating in an exhalation. Thus rises intrachest and Intrapleural pressure 100-300 mm Hg and the subsequent opening Vocal crack allows to exhale sharply a stream of air with a speed 12 L/s Productive cough - "normal" The quantity at cough is not known; usually cleared through a road clearance bronchial tubes, at the healthy allocate to 1,5 Litre a day. This is swallowed imperceptibly and spontaneously through Gullet in a gastroenteric path.

Long The Opinion That All Dominated The Slavic

Long the opinion that all dominated The slavic tribes occupying East European plain, occur From one centre on the average Pridneprove, in territory modern Ukraine. From this ancestral home so was considered, there was a settling of Russian Territories to Ryazan and Suzdal and further to Pskov and Great Novgorod. It was supposed that originally there was also a uniform language. Rich Data of excavation in Novgorod, studying of anthropological types, ceremonies, Ceramics, even constructions confirm that Slavs have got on northwest territories of modern Russia from southern coast of Baltic. And Suzdal was occupied all the same from the south Russia. In XIII-IV centuries distinction of dialects on Russian earths gradually It is erased. But whence there was a name "Russian"? In these territories In the peace neighbourhood there lived Finno-Ugrian tribes , , Slavs. Still in ancient times them the Varangians who have imposed a severe tribute - have seized with Each man on the squirrel skin. Without having sustained violence, tribes Have banished Varangians, but a palm among themselves have not divided and again Have decided to call on reigning of foreigners.

At Auscultation The New Can Be Found Out

At auscultation the new can be found out Warm noise or noise on a course of a large vascular trunk. The diagnosis Aorta aneurysms should be confirmed by an objective method, for example CT a tomography or aortas. If stratifying an aorta aneurysm passes Completely through all three layers walls, it leads to rupture Aortas. It is accident almost always leads to death of patients, Die before hospitalisation. Full death rate from aorta ruptures in the USA More than 80 %. and a reflux The gullet is a muscular tube which spends Food portions from a mouth in a stomach. Bottom from three a gullet Is a specialised part of muscular system, which Functions as similarity of the valve for deduction of a contained stomach from Return to a gullet cavity. If work of this valve is broken (), stomach contents, including sour digestive juice, Can come back, support and irritate mucous a gullet. A gastroezofagalnyj reflux (gastroesophageal reflux disease) It can be shown by sensations of burning in a breast and a pain in the top part Stomach () which rises to a throat and can cause Sensations of sour taste in a drink and in a mouth.

Virus, Bacterial Both Others Infectious And Toxic (asbestos)

Virus, Bacterial both others infectious and toxic (asbestos) agents can To lead to an inflammation of leaves of a pleura and occurrence of the centre of a pain in the chest To cage. This pain arises at a deep breath is more often and is described as The pleural. Virus illnesses - the most frequent modern reason Pleurisy though there are many other infectious reasons, including Tuberculosis tuberculosis. Other illnesses which lead to occurrence of pleural pains include: The collagenic illnesses similar system red (systc lup eryth) and ; a cancer cancer; nephritic insufficiency kidney failure; an arthritis rheumatoid arthritis; complications beam and chemotherapy radiation therapy; chemotherapy; complications at and after operational treatment. Fizikalnoe research of the patient can be A little informatively, showing only a site of a friction of a pleura. If thus there is an essential quantity pleural , The space between a lung and a chest wall can be filled with a liquid And intensity of a pain will decrease.

Then Ask The Patient To Inhale Deeply And

Then ask the patient to inhale deeply and To detain an exhalation for some seconds. define size Displacement of the dulled sound downwards also put the second mark. Further Ask the patient to exhale and hold the breath as much as possible on an exhalation. Thus define displacement of border of the dulled sound Upwards in the area of measurement also give the third mark. (06 ++) Range of changes a sound (= mobility, excursion Diaphragms) on the right and at the left at healthy faces it should be identical and, Usually, 3-5 sm (sportsmen have more). Measurements Repeat some times on the right and at the left and write down average sizes Mobility of a diaphragm from both parties. Besides there is a set of radiological techniques of measurement of functions of a diaphragm of the person. For example, (J.G.Dillon's) Dillon's phenomenon, - definition displacement accelerations diaphragm domes Up in a phase of the maximum exhalation, testifying to the partial Preservation by it abilities. Thorax walls ( and ).

Are Available Messages That Churg-Strauss The Syndrome Is

Are available Messages that Churg-Strauss the syndrome is connected with some kinds of treatment Asthmas, so-called modifiers. Signs Churg-Strauss of a syndrome - Fever, loss of weight of a body and frequent inflammations of bosoms and mucous a nose At patients with a bronchial asthma. Cough, a short wind and a chest pain Amplify, as in lungs develops . On finitenesses Can appear hypodermic . A diarrhoeia (Da) And belly-aches arise, when with the inflammation of the blood develops Vessels in a stomach cavity. The inflammation of small vessels can be shown in Bladder and . Weakness and sensitivity loss Finitenesses are connected with nervous trunks. Definitive The diagnosis comes to light usually after the involved fabrics. In 1998 WHO (Evian) the classification system (illustration sm), which has been offered Aspired to designate various forms of a pulmonary hypertension (LOG) According to various to mechanisms, clinical To representations and therapeutic approaches. In 2003 in Venice were Updatings to this system for the purpose of creation of more all-round are made And easier for clinical physicians of descriptions.

Lit.lib.ru/h/hramow_j_a. There Can Be To Whom That And Will

lit.lib.ru/h/hramow_j_a. There can be to whom that and will help, though "knowledge multiplies grief". Other reasons and impressions of the author can be looked on a site. In July, 2009 a planet population The person will reach 6,8 . And by 2050th year, under forecasts the CART, The population of Russia will decrease for 33 million persons, Japan - on 25 million, Ukraine - on 15 million and Germany on 8,4 million Thus reduction of the size Families and life expectancy increase will lead to acceleration Processes of ageing of the population all over the world. So for example in 1950 year quantity of people in Age of 60 years also is more senior made on the Earth of 8 %, and by 2009th year this The share has increased to 11 %. In 2050 year percent of older persons on the Earth, Especially in the developed countries, will make already 22 % and will exceed number of children in Age of 15 years! Population ageing generates the numerous Mediko-social and economic problems and as demands working out And realisations of new approaches to diagnostics, treatment and rehabilitation Elderly patients.

The Most Reliable Method In This Case Is

The most reliable method in this case is Viewing of a lung with radioactive preparations This method Differentiations chronic c a pulmonary hypertension from Primary pulmonary hypertensia. One or more segments, and also The big defects vessels of a small circle - a sensitive marker . Picture viewing and ventilation of lungs at Primary pulmonary hypertensia looks or normal or Shows non-uniform defects. It is shown that irrespective of an aetiology, serious Or menacing forms of a pulmonary hypertension often conduct to the sudden To cardiac arrest. Signs of a pulmonary hypertension at patients not always Happen appreciable and \or uncertain. As a result it is not rare There is a delay between displays of signs of a pulmonary hypertension and Statement of the diagnosis of a pulmonary hypertension. Development serious the warm Dysfunctions remain the main obstacle to a survival for patients about the LOG . However with specification a syndrome and occurrence new Medicines and ways of influence for therapy the LOG, also as Uses of new appearing schemes of therapy a situation slowly Varies and enters during a new era.

Sometimes Contents Of Bosoms Suck Away By Means

Sometimes Contents of bosoms suck away by means of a cylinder of Polittsera. For passableness definition bosoms with Nose cavity spend their sounding. Probe frontal bosoms is more often, Less often , sounding bosoms usually not Make. In some cases for diagnostics of the pathological Changes in nose bosoms use - survey of bosoms with The help of optical devices (). Bosoms usually carry out through an aperture in a bottom nasal course, Formed at radical operation on a bosom, the frontal Bosoms - through an aperture generated in a forward or bottom wall Bosoms. In rare instances for lightness definition Nose bosoms apply by means of the small device, Supplied with an electric bulb,-diafanoskopa which place in Oral cavity of the investigated. At normal lightness in the dark bosoms Have a red luminescence, at its decrease as a result of a thickening Mucous membrane, presence of polyps or intensity Luminescences and bosom contours vary. Wide circulation, mainly at Research bosoms, has received the radiological Research and especially tomography, including computer.

These Researches Have Confirmed That At Teenagers With

These researches have confirmed that at teenagers with Diagnosis ADHD irrespective of, whether symptoms in the adult remain Condition, most likely in the future there will be problems because of infringement Dream, such as a sleeplessness, night nightmares, and a snore. What is insomnia understood as the term? The epidemiological Researches show higher prevalence at The senior age group, than at younger individuals. To 40 % People of the senior 60 years can have this or that type ; - frequent Awakening or superficial, with frequent interruptions, a dream. Insomnia - It some the general concepts at the description of qualities of a dream. National The institute of Health of the USA defines chronic insomnia as a condition lasting more than 30 days. This definition includes inability to fall asleep, support a dream or Early morning awakening and it is certain with the broken Day functioning of the patient. It is thus noticed that Intermittence and early morning awakening are more typical for persons The senior age group of patients.

Congenital It Is Characterised By Hyperpigmentation Already At

congenital It is characterised by hyperpigmentation already at a birth (other bodies without Changes), later joins brushes of hands. Konstitutsionalnaja hyperpigmentation is observed at chestnut-coloured children Mainly the people of the Mediterranean. brown It is characteristic for insufficiency (illness of Addisona), at To which skin hyperpigmentation is expressed in places of pressure upon it (Vertebras, interphalanx, elbow and knee joints), pleated Bodies, on surfaces, a mucous membrane of gums. To very often result , Pancreas and lungs. At these hyperpigmentation It is caused by superproduction a hormone and , in Which the sequence of amino acids is identical. - Typical sign , late skin , motley . At hyperpigmentation serovato-brown or Brown also it is indistinguishable from that at illness of Addisona, and the diagnosis Can be established by data skin at which come to light Adjournment in glands and melanin adjournment. At Late skin the diagnosis is established on , to bubbles, to stains, to changes and rashes on To skin of open parts of a body, and proves to be true presence of the increased Maintenances in urine (a parity uro-porfirina and in norm more 3:1) or red fluorescence The acidified urine.

Set Of Symptoms Meets At Healthy And Sick

Set of symptoms Meets at healthy and sick people. In connection with the infinite A variety of combinations of syndromes and symptoms of various illnesses, Primary definition of many diseases becomes enough difficult Problem. http://groups.csail.mit.edu/ http://www.pubmedcentral.nih.gov The CART warns that in The nearest 10 anniversary the world will face even considerable quantity of the new Deadly illnesses, comparable with AIDS, a fever and an atypical pneumonia (a sharp respiratory syndrome). On supervision of experts The organisations, new diseases appear with a speed, never Observed in the history of mankind, - one in a year. Moreover, new Deadly diseases are steady against antibiotics. Scientists assert that Today new virus diseases arise from the unprecedented In the speed - on one in a year. By data the CART, the basic danger proceeds From the African continent where for last three years of supervision was The greatest quantity of cases of occurrence of viruses - 228 is fixed Flashes.

Usual Duration 250 , A Tonality (= A

Usual duration 250 , a tonality (= a timbre) About 400 Hz. Damp rattles - frequency of a sound usually less than 200 The Hz also depends on diameter of bronchial tubes At auscultation of damp rattles It is necessary to define their localisation loudness, calibre, height of a sound, Duration, etc. properties. It is important to note a breath phase when arise Also rattles, changes after cough disappear and at position and pose change The patient. When rattles are revealed, it is necessary to pay attention On a timbre, borders of a zone of their revealing and the period of the certificate of breath, when the such Rattles appear. It is necessary to note changes of their force and a timbre during the periods Breath and exhalation. It is important to estimate changes of rattles in the vertical thus Position of the patient and as lying on a back and kolenno - elbow (decubitus) positions. Allocate rattles small bubbly and it is large Bubbly (and, sometimes, and bubbly). More often it is supposed that extended High-pitch tone rattles are present at sick of a bronchial asthma or COPD.

Short Additions To . (Look Illustrations) It Is

Short additions to . (Look illustrations) it is a lot of reasons, including it Can occur because of a trauma of a breast, the excessive barometric Pressure upon lungs (scuba diving), or in connection with illnesses of a lung Type COPD, asthmas, , a tuberculosis or strong cough. (COPD), (aa), (cyc fs), (ts), (wg cgh). In certain cases spontaneous it is not possible to find out the reason. See also (sps px). Signs: 1. The sudden sharp unilateral chest pain worsening in communication by a deep breath and \or cough (chest pn). 2. A short wind (Ss of bth). 3. Restriction of mobility of a thorax at breath. 4. Weariness, weakness (Ey fe). 5. A tachycardia (Rd ht re). 6. Accruing (Bsh cr). Signs quite often can begin in rest or a dream. The additional signs often connected with this syndrome: Anxiety and pressure (Nl fg Ay, ss, and n). Low arterial pressure (low bd pe). Auscultation of a thorax by a stethoscope reveals reduction or disappearance of respiratory sounds by the amazed party. Additional tests include: Radiological inspection allows to define presence of air out of a lung (in a pleural cavity) Chest x-ray Research of arterial gases of blood Marx J.

Features Of Pains In A Thorax At Diseases

Features of pains in a thorax at diseases of respiratory organs The important basic Sign of many diseases of a thorax and respiratory organs is Intensity, character and duration of a chest pain. Measurement Intensity of a pain strongly depends on set of the reasons, however to The present remains subjective enough criterion. There is variety of techniques, algorithms and the schemes allowing approximately, To floor - in the quantitative way on a special scale (illustration sm) To measure intensity of a pain. Pains at breath. Pains at breath (more often In total are connected with a pleura) it is necessary to distinguish from:) ; Intercostal neuralgia; ; surrounding depriving; Damages of edges; , bruises, etc. SO chest pain principal causes include: Menacing conditions: 1) heart troubles: - Myocardium heart attack; - a stenocardia; - ; 2) illnesses Sosudov:-stratifying an aorta aneurysm; - pulmonary Arteries; 3) illnesses : - ; - gullet damage; 4) illnesses of respiratory organs: - a lung heart attack; - ; - Pleurisy; - a pneumonia.

Diet Working Off, Including Change Of Weight Of

Diet working off, including change of weight of a body for weighing below norm and having surplus of weight Recommendations about distinction of floors (sexuality) and affinity problems Problems and tactics of judgements about the life end. The general recommendations for planning of exercises at patients, for example, with COPD In detail scheme of loadings and exercises is defined by National Institute of Health (NIH) the USA as planned, The structured, repeated movements of a body which are spent, that To improve or support one or quantity of aspects of the physical Activity. In advantages of regular physical activity Include: * risk cardiovascular illnesses and connected with Them risk factors, * functions systems, Increase in the maximum consumption of oxygen, transport of oxygen to Fabrics and * fall of requirements of a myocardium to oxygen. Persons with COPD can receive as the additional Advantages on shipping of a short wind, fears and fears The panic, connected with the compelled short wind.

Each Source Of A Chest Pain Can Have

Each source of a chest pain can have as Traditional representation as are available also essential, Imposed signs for each condition, an age, sex and race. The pain can be caused almost each structure in a thorax. Various bodies can cause various types of pains, but, unfortunately, The pain does not characterise the concrete reason. Each of following reasons It is explained in detail in articles: Broken or bruised ribs pleurisy Pneumothorax Shingles Pneumonia Pulmonary embolus Angina Heart attack Pericarditis aortic dissection reflux esophagitis abdominal pain Key to the diagnosis and choice of basic symptoms in 80 % Cases remains behind the detailed analysis of the case record and a life. The analysis Quality and other characteristics of a pain, its communication with other signs and Risk factors, should help to the doctor to estimate probability of the potential The diagnosis. At patients with a pain of a breast it is a lot of potential Diagnoses which lives can threaten. The patient thus should To answer various questions which will help the doctor to understand Quality and, probably, the pain nature.

Sensitivity Research Is Necessary At Least Skin And

Sensitivity research is necessary at least Skin and reflexes reflexes nervous system. stroke the Optical path (the retina both optical nerves and vessels of eyes) should be investigated with eyes: They provide a window not only in a zone of brain vessels, but also Specify in possible brain damages and type conditions Hypertensions, a diabetes and . At the first survey of the patient Some simple researches are assumed. Urine should be It is investigated on sugar presence (instructions on a diabetes), (Instructions nephritic illnesses), or a bile-sterko-bilirubin pigment (Instructions on illness of a liver and \or a bilious bubble). The following stage Inspections at not certain syndrome or illness involves Various laboratory blood ions immune system microorganism diarrhoea and histologic researches biopsy breast. Presently methods of various research of images of bodies X-rays Or systems became actually universal and The popular. Ultrasonic scanning has allowed to consider not Only a picture of intrawarm haemodynamics, but also was Especially at inspection in frustration.

On Roentgenograms And Tomograms Not Changed Bosoms Of

On Roentgenograms and tomograms not changed bosoms of a nose form The sites of the raised transparency limited to bone walls. Artificial nose bosoms () carry out in Those cases when survey pictures and tomograms do not give enough Full data on character and prevalence of the pathological Process. Last years more and more popular to become use digital photoroentgenography () for radiological inspection Nose bosoms. It is justified not only a low dose of an irradiation of the patient, but Also has the important practical value as gives the considerable Reduction of terms of recognition of pathological processes. A technique and Technics of additional cavities of a nose is simple and popular and allows To receive the quality images, not conceding on the qualitative To indicators to roentgenograms and ultrasonic research. A pathology. Developmental anomalies include: Excessive bosoms, presence in them Additional partitions, absence of some bosoms, and also ; congenital defects of bone walls which can To cause the bosom message among themselves with a cavity of an eye-socket, a lobby and Average cranial poles.

New Principles Of Preventive Maintenance And Asthma Treatments

New principles of preventive maintenance And asthma treatments are defined as 4 mainstreams: 1. Measures on To estimation and asthma treatment; 2. Formation of patients out of the medical Establishments; 3. The control concerning influence of factors of environment, Capable to cause or strengthen asthma signs; 4. Principles and schemes Pharmacotherapy. "As a whole, all these components Have passed test by time and many of earlier recommendations was Are unanimously confirmed by additional research during Last years, "Buss (the head of experts NAEPP has told ). "For example, inhalation still the best long-term The program of treatment and the control for patients with an asthma of all age" Recommendations in these 4 areas for patients with an asthma the following: 1. An estimation and the control: degree Definition The future risk of occurrence or aggravation of a current of an asthma should To be considered as risk for progressive loss of function of a lung or Other adverse effects connected with dynamics and treatment of an asthma.

J Am Acad Nurse Pract 1999; 11:57 [NLM

J Am Acad Nurse Pract 1999; 11:57 [NLM Cit ID: 99434545] Basic symptoms of a tracheitis and Classical signs of an inflammation - a pain, a redness and deterioration are considered Functions. A bronchitis Basic signs and bronchitis diagnostics. Bronchitis concerns to most To frequent diseases of lungs. Actually they are the basic group Chronic obstructive diseases - pulmonary system. Chronic bronchitis - The clinical diagnosis is put on the basis of following basic :* Cough with presence or without allocation lasting more than what Three months within two last years and in the presence of signs Obstructions of respiratory ways of lungs. The basic clinical signs of it Diseases are considered: * in a breast, * with and Indisposition. They always are present at various degree as well as Obstruction of respiratory ways. These signs and it is frequent Are connected with other diseases. On it research allows To estimate (documenting) size and degree of convertibility of obstruction Respiratory ways.

Thus Often There Is A Symptom "the Plentiful

Thus often there is a symptom "the plentiful One-stage "allocation . Superfluous allocation and Exhausting cough - frequent signs of a bronho-alveolar cancer (=). Foamy with a pink shade, - a hypostasis sign Lungs, with rusty inclusions, - the certificate Pneumonia. Other characteristics of cough - a cough Sound Low tone it is usually connected with the basic changes of the main things air Lines-throats, a trachea and the main bronchial tubes. Barking cough or a croup with Illnesses of a throat. Sudden, type of exclamations paroxysms of cough with Whooping cough. Night cough - with warm insufficiency, bronchial Asthma and a reflux. If food intake often causes Fits of coughing, - search for a diaphragm hernia, or a reflux. Radiological researches The direct And lateral roentgenogram of a thorax The roentgenogram () bosoms CT a thorax Laboratory tests (, IgE, , tests For definition of collagenic vascular illnesses, , infections) Tests according to pulmonary functions (, tests with , etc.

I Result Differential Criteria Hemoptysis And Hematemesis Signs

I result differential criteria Hemoptysis and Hematemesis Signs Hemoptysis Hematemesis The case record There is no nausea and vomitings; Presence of illness of a lung; Possible ; There is a nausea and vomiting; Presence of illnesses of a liver and \or ; is not present ; Estimation The foamy; liquid, ; brightly red or pink; Foamy it is rare; coffee colour; Brown-black; The given laboratories pH> 7; a mix of macrophages and ; pH <7; a mix of particles of food; The diagnosis At the first stage of diagnostics The nature () it is important to establish that blood Arrives from respiratory ways. In these cases blood always the foamy. Blood occurrence is preceded usually by sensations in a throat and Requirement for cough. The anamnesis allows to specify the diagnosis: for example, Chronic at the young woman without symptoms of another Diseases gives ' the right to suspect ' a bronchial tube adenoma; at patients with chronic allocation purulent Often testifies to presence ; , a weight loss And an anorexia at the smoker are suspicious on lungs; and with a sharp pleuritic pain allows to suspect a heart attack Myocardium or lung ().

Unproductive Cough Is Usually Connected With Irritation Of

Unproductive cough is usually connected with Irritation of respiratory ways also can be mechanical, chemical, Temperature, inflammatory and other nature. Complications at cough arise and Can be connected with persistent cough, the paroxysms stimulating Vomiting; and dizzinesses; an exhaustion; crises of edges; Anguishes of muscles and sheaves; crises of vertebras; the head Pain; spleen ruptures; expansion of veins of a gullet; The phenomena of stress, etc. Diagnostic features of revealing of sharp and chronic cough Sharp or chronic The sharp: virus or ljaringo-traheo-bronchial and at inhalation of allergen or irritating substance. The chronic: a chronic bronchitis (cough With within 3 months in a year not less than 2th years), , a tuberculosis, , an asthma, etc. Productive or unproductive (in norm is not present; small quantity - to 30 ml/days; average quantity - 30-100 ml/days; a considerable quantity - 100 ml/days and more. The structure is defined by its place Origins, vagus - or influence, quality and in volume Defeats systems, age of the patient, accompanying Pathology and factors.

Episodes Occurrence Of Barriers Lead To Occurrence To

Episodes Occurrence of barriers lead to occurrence to blood on To oxygen and awakenings of the patient from a dream. Syndrome OSAH is connected and with Excessive day drowsiness not at stages of the primary Survey approximately at 80 % of patients. The Patofiziologichesky scheme of infringements at Syndrome OSAH - the top part of an air line of passage of air in The set of additional functions and a barrier to air stream has lungs In lungs can arise for a number of reasons. The majority of patients with OSAHS shows obstruction presence in the top part is more often Air line or at soft palate level (that is in areas) or at level of a root of language. Recent Research have shown that in syndrome development are important as anatomic And components, and factors. Anatomic factors of type increased (Sm classification in illustrations), or wrong Positions and an arrangement top, and the bottom jaw, reduce the entrance Aperture of an air line and-or increase aerodynamic pressure. Both these of the factor and defects of management roto-glotkoj in Time of a dream of patients increase probability of displays OSAHS.

Usually There Is A Fever, High Blood With

Usually There is a fever, high blood with the left shift. Others Signs or syndrome signs include a pain in joints, And, sometimes, . Skin damages develop within hours or Days also can be shown as bubbles. Stains, usually plural, and Necks, a trunk and extremities can settle down on a head skin. Usually it is required skin damages to confirm the diagnosis Sweet'a A syndrome. Crops of dabs on microflora Besides, are required and Special colourings for revealing of microorganisms to exclude The infectious reason of a syndrome. Though the syndrome can develop at Patients with infectious diseases, spotty damages of a skin, Should be sterile. Principal cause Sweet of a syndrome - the malignant Diseases. Damages of a skin at such patients can sometimes be Similar on (gangrenosum). Communications with the malignant Processes include illnesses and firm tumours, More probable at men and women on the average and advanced age. - physical The phenomenon, at which saturation by oxygen of haemoglobin of the blood flowing From lungs, does not exceed 5/dl Clinically it is shown Change of colouring of a skin and mucous membranes which get Sinevato-pink (cyanotic) shade.

In 1819 To Year Laennec Has Published The

In 1819 To year Laennec has published the big treatise "De l'auscultation mdiate", Where has in detail described normal sounds of lungs, and then identified Considerable quantity of pathological sounds of a thorax at breath - , , metal type of sounding, sounds of the burst Pot, various rattles, etc. a part of work Essential on volume It is devoted diagnostics of the tuberculosis which examples in those days was It is a lot of. Laennec also investigated features of sounds of heart at Healthy and sick. It has described for the first time , and characteristics of noise and heart sounds. It has shown to the first that Various defects of valves of heart can be diagnosed an ear still During lifetime of the patient. The new method of diagnostics was also with success It is applied in the diagnosis of crises, stones bilious and a bladder and Liver abscesses. The invention of Laenneka has quickly extended in The world. In the nineteenth century began to improve stethoscopes and technics Auscultations of noise of a body of the person.

The Factor Which Brings The Contribution To The

the factor which brings the contribution to the successful Employment are brought by feeling of necessity, benefit and pleasure at Realisation of exercises and an exception of any connected by realisation Exercises of financial expenses, safety and conveniences at loadings and Exercises. Examples and components of physical activities Way Walking or (bicycle) Frequency 3-5 times a week a minimum (it is ideal 6-7 in a week) Duration 20-30 mines (plus warm-up and rest) Intensity A. on 0.5-3.0 miles at an o'clock within 20-30 minutes or B. A stationary bicycle at 30 turns a minute of 20-30 minutes or C. Before achievement of a warm rhythm of 60 %-85 % from the maximum specification or D. Before occurrence of sensations of "difficulty" of execution on the scale of scale Borg'a. Councils about selection of patients for restoration of pulmonary function Patients with initial and easy symptoms, type From "moderated to obvious" with chronic illnesses of lungs can be Always candidates on the rehabilitation program (PR).

* Always Should Consult With Experts In Palliative

* always should consult with Experts in palliative medicine, when necessary, that To help with the decision of palliative situations out of level of competence of the doctor. Concrete practical recommendations and conditions The palliative help for adults and children with serious illnesses The respiratory treatise and critical conditions include the following: * and short wind treatment (dyspnea) Demands consideration of features of the basic illness, and as syndromes Or conditions of type of an anaemia, a pleurisy, warm insufficiency, Time obstruction of an air line of bronchial tubes, , compressions Or a barrier in one of the main bronchial tubes. Important as to consider Condition social factors, - mental infringements, kind changes Activity of the patient, behavioural factors and the general respiratory Strategy of anxieties, including therapy by energizers or a combination Preparations for depression treatment. * and the expressed short wind should be treated in Combination to other receptions of restoration of functions of lungs, including Training to special exercises, psycho-social support, Rational dietary therapy and the self-help organisation rather Breath strategy.

Other Sites Of Receptors Of Cough: An Ear

Other sites of receptors of cough: an ear membrane, a diaphragm, Gullet, pericardium, etc. the Centripetal nerves participating in the certificate Cough: trigeminal, glossopharyngeal, top and vagus. Efferentnye nerves: returnable guttural, vagus, a path And peripheral nerves. The cough reflex begins with a deep breath, It is accompanied by closing of a vocal crack, a relaxation of muscles of a diaphragm and Reduction of the chest and belly muscles participating in an exhalation. Thus rises intrachest and Intrapleural pressure 100-300 mm Hg and the subsequent opening Vocal crack allows to exhale sharply a stream of air with a speed 12 L/s Productive cough - "normal" The quantity at cough is not known; usually cleared through a road clearance bronchial tubes, at the healthy allocate to 1,5 Litre a day. This is swallowed imperceptibly and spontaneously through Gullet in a gastroenteric path. Accumulation, superfluous manufacture and allocation occurs at: Excessive manufacture in connection with change of the air environment; Changed physical properties ; Change of quality mucous bronchial tubes; Imperfect carrying out of calculations of quantity .

Bronchial Asthma * Age And Fast Change Of

Bronchial asthma * age and fast change of signs * brightly vary within night and er mornings * allergies, a sinusitis and-or skin Signs and * families and a family tree * tests change Stagnant warm insufficiency of the Heart trouble in the anamnesis * Increase in the sizes of a shade of heart * rattles at * and indicators on Bronhoektatichesky illness * cough with a great volume purulent , Usually connected with a bacterial infection. * hour glasses and drum-type fingers * bronchial drawing of lungs. A tuberculosis * pulmonary drawing on a X-ray * acknowledgement * local prevalence of a tuberculosis Obliterating * age at the non-smoking * history an arthritis * a picture at the computer tomogram * at young non-smoking men * all have chronic * widespread small Shades not lungs (or the computer tomogram). Look illustrations more in detail. Some patients with a bronchial asthma not always Can be allocated on presence of an emphysema of lungs (COPD). In these cases Is accepted that these two illnesses (asthma/emphysema) co-exist also them Treatment should be spent as at an asthma.

The Anamnesis Allows To Specify The Diagnosis: For

The anamnesis allows to specify the diagnosis: for example, chronic at the young woman without symptoms of other disease gives ' the right to suspect ' a bronchial tube adenoma; at Patients with chronic allocation purulent it is frequent Testifies to presence ; , a weight loss and Anorexia at the smoker are suspicious on lungs; and with a sharp pleuritic pain allows to suspect a heart attack Myocardium or lung (). (Illustration sm). The short list of the reasons : Inflammatory the Bronchitis; ; the Tuberculosis; a lung Abscess; a Pneumonia in particular caused by bacteria Klebsiella; septic a pulmonary artery. Tumoral a lung Cancer: , , , a bronchial tube adenoma. Others ; Insufficiency; a mitralnyj stenosis; the Trauma, including a contusion of a lung and Foreign matter; the Primary pulmonary hypertensia; ; a syndrome of Ejzenmengera; lungs, including and a syndrome of Gudpaschera; Idiopatichesky pulmonary ; ; the Haemorragichesky diathesis, including therapy. Chronic Cough Constant cough lasting more than what 2 Weeks without the convincing proof of the reasons or conventional Aetiologies is called as chronic cough and is a serious clinical problem.

And Wiggins, R.D. And Higgs, P. And Blane,

And Wiggins, R.D. And Higgs, P. And Blane, D.B. (2003) as a measure Qualities of a life (CASP-19). Aging and Mental Health, 7 (3). pp. 186-194. ISSN 13607863 Measurement of a full scale of quality of a life (HR-QOL) with Use of special scale of quality of well-being (QWB) and Six additional certain areas of a state of health (HR-QOL) in research (the Short Review of a state of health on a basis SF-36). Lancet 1996; 347:1141-1145. Are defined and are offered to use Some schemes of an estimation of abstract quality of a life (QoL) with a measure estimation Satisfactions of requirements QoL in early and advanced age of patients. Such schemes usually have four sections: the control (=) Behaviour, degree of independent stay, level of pleasures and Self-realisation degree. The offered questionnaire includes 22 points, which Through post questionnaire to patients at the age of 65-75 Years. It is shown that four sections of the questionnaire have values of an alpha of Kronbacha From 0.6 to 0.

Vascular The Network On The Average Nasal Pass

Vascular The network on the average nasal pass of a partition is called vascular The texture of Kisselbaha, also is the most frequent place nasal Bleedings. Epistaxis (a nasal bleeding) as it is known, Meets at 60 % of the population and this frequency of occurrence has 2 peaks - 1st in the childhood and 2nd at persons is more senior 60 years. The majority of people with Bleedings from a nose does not demand the special medical Service also can stop with use of the simple Instructions, including application of direct pressure upon lateral surfaces Nose or influence () nostrils a gauze or cotton wool. Some reasons of bleedings from a nose: Chronic rhinitises and sinusitis; nose traumas; Foreign matters in a nose; inside nasal polyps and new growths; (for example, a cigarette smoke); medicines (for example, aspirin, Anticoagulants, not steroid resolvents); Deformation or punching of a partition of a nose; vascular defects or (plural mucous membranes and Skin assume syndrome Osler-Weber-Rendu); a hypertension; a leukaemia; Cirrhosis and infringements of coagulability of blood.

In More Details Sm - Pulmonary Embolism. Heart.

In more details sm - Pulmonary Embolism. Heart. The reasons of pains in a thorax can be: Ischemic heart trouble (), including a myocardium heart attack and " an attack" (Angina ) - The term specifying in vascular type of pains or a pain, which Arises, because blood vessels to a cardiac muscle are narrowed and Reduce a stream of blood and delivery of enough of oxygen. The anginoznyj attack can be presented as (heart attack ) Classical - with a pressure sense in a breast, with radiation of pains in the left Hand or neck, presence of fear, a short wind and or in the atypical Variants. (weakness) Unfortunately, not all people represent danger Classical both atypical signs and character of a chest pain sometimes not Each patient manages to describe correctly them. Sometimes instead of an attack of typical pressure behind a breast or their equivalent, The cholecystitis, short wind or others comes to light diarrheas, Diseases. It is necessary to remember that a basis of diagnosis and an attack - clinical signs and their dynamics.

Rosen's. St. Louis, Mo: Mosby; 2002. Simple Enough

Rosen's. St. Louis, Mo: Mosby; 2002. Simple enough calculations allow to estimate The sizes and volume . For this purpose it is necessary to measure a vertical On the thorax roentgenogram en face: (1) = average diameter in cm; (2) average diameter of a lung in cm = (it is made from Average diameter in cm) (distance from edge of a lung to Thorax walls in cm) == (average diameter in cm) (Width in cm) = Technical problems at measurements: (1) Shades of a shovel and big should not coincide at . (2) Sizes of fields of the roentgenogram at lying on To back of the patient should not be used, as marks of a lung, Since they can be stretched on a thorax wall. Expansion Lung in percentage it is possible to calculate so = ((diameter of a lung) ^3) / ((Diameter in cm) ^3) * 100 % Restrictions: calculation makes sense, if It is supposed that each element - sphere. The form could be better It is described by the type formula . More in detail sm - Light RW. Pleural Diseases, Second Edition. Lea and Febiger.

G., At A Stenosis Of The Top Respiratory Ways).

g., at a stenosis of the top respiratory ways). Short wind pulmonary (d. pulmonalis), caused Pulmonary obstructive, or the respiratory Insufficiency. Short wind reflex (d. reflectoria)., Caused by reflex influence on the respiratory centre, e.g. at Pleura damages. Short wind warm (d. caidialis), caused The warm insufficiency leading to stagnation of blood in lungs, To decrease in elasticity of a pulmonary fabric and its reduction of the respiratory Surfaces. Short wind mixed (d. mixta) in the form of difficulty of a breath and an exhalation. Short wind thermal (d. thermica), arising at Organism overheating in quality the increase mechanism . Short wind central (d. Centralis); . Cerebral, - caused by infringements of activity respiratory The centre, e.g. At poisonings with some poisons. Short wind (d. Exspiratoria) - difficulties of an exhalation (e.g., at a bronchial asthma). 2.3.3 Gastroenteric system (section 5 in detail see) http://www.med.ucla.edu/ and the book GASTROENTEROLOGY 2007! 2.

Time Out Of Chest Barriers, As A Rule,

Time out of chest barriers, as a rule, show reduction of streams of air on a breath During the forced breaths with preservation Exhalation streams. A principal cause of the reduced stream during a breath - Narrowing of a gleam of an air line secondary to a stream of air pressure, Exceeding pressure during a breath. The reasons of the such Type of infringements are usually unilateral and bilateral paralysis Vocal chords, throat compression, a hypostasis of a throat, a condition a dream and Other The top types of obstruction for an air line on , as a rule, show a plateau on a stream curve in Current of all forced breath and exhalation. The reasons in Such cases there are craws, inside new growths or Slime congestions, a stenosis of the main bronchial tubes, a post Damages, a post damages and complications. Cardiopulmonary Stress Testing It is necessary to remember that it is almost always necessary Condition estimation the top respiratory ways at all Patients, but especially at not corpulent adult persons with signs a dream (OSAHS).

As Factors, Promoting Asthma Development Are Considered Chronic

As factors, Promoting asthma development are considered Chronic illnesses, including rhinitises and a sinusitis, Reflux, excess weight or fatness, sleepy , stresses and-or Depressions. 4. Pharmacotherapy: As well as in the previous Recommendations about an asthma, EPR-3 confirms advantages step-by-step The approach in asthma treatment. It is considered correct that is necessary To increase dosages of medicines and their types only necessarily and To reduce their every time when it is possible. EPR-3 are reconsidered Step-by-step diagrammes of treatment of an asthma (illustration sm) which are expanded, To conduct treatment in 3 age groups: from 0 till 4 years, from 5 to 11 Years and 12 years or is more senior. IN EPR-3 Also have updated recommendations about treatment the asthmas based on last The data on safety of preparations. As well as in the previous recommendations, EPR-3 confirm that patients with the constant form an asthma defined as day attacks more often than twice a week or night signs of an asthma more often than twice a month, should have, at least, two the approach to the control and asthma treatment.

In More Details Sm - Pulmonary Embolism. Heart.

In more details sm - Pulmonary Embolism. Heart. The reasons of pains in a thorax can be: Ischemic heart trouble (), including a myocardium heart attack and " an attack" (Angina ) - The term specifying in vascular type of pains or a pain, which Arises, because blood vessels to a cardiac muscle are narrowed and Reduce a stream of blood and delivery of enough of oxygen. The anginoznyj attack can be presented as (heart attack ) Classical - with a pressure sense in a breast, with radiation of pains in the left Hand or neck, presence of fear, a short wind and or in the atypical Variants. (weakness) Unfortunately, not all people represent danger Classical both atypical signs and character of a chest pain sometimes not Each patient manages to describe correctly them. Sometimes instead of an attack of typical pressure behind a breast or their equivalent, The cholecystitis, short wind or others comes to light diarrheas, Diseases. It is necessary to remember that a basis of diagnosis and an attack - clinical signs and their dynamics.

However, In The Presence Of Destructions Of Fabrics,

However, in the presence of destructions of fabrics, Connected with an emphysema, processes of regeneration of a fabric to the adequate form Are changed also balance of restoration of a pulmonary fabric it is broken. In the final The account, long superfluous a pulmonary fabric Comes to an end with development of an emphysema of lungs which is characterised Increase in alveoluses and structural damages . 1. Shared problems (classifications and criteria of age of the person) and conditions - dream problems, Hyperdrowsiness, Noticed at patients of the senior age group can be caused Partially infringements normal a rhythm. Known as the long period (syndrome) of a stage of a dream (ASPS), it is very frequent at elderly patients. Patients with ASPS In general become sleepy in the evenings and clear up it is vulnerable in the morning, Then periodically plunging into a short superficial dream. It is shown that with the years Manufacture and concentration in blood and fabrics decreases. This hormone is considered as the perspective candidate for treatment Persistent at patients of advanced age.

At It There Are 2 Distinctive Conditions As

At It there are 2 distinctive conditions as which allow to recognise these Syndromes at adults. The Roman criteria III allocate: a syndrome of the cyclic Vomitings (CVS) and chronic a nausea (CIN). These syndromes Are allocated in separate from group on the basis of the analysis of factors and Clinical criteria. Changes of a skin and nails at diseases The general pigmentation of a skin, especially on the person, brushes Hands, in natural folds of a skin (+ polyposes, , belly-aches and Other) can be a sign of a syndrome of Kronkajta (1955. For example, Koudena illness (it is described in 1963 To year) - plural polyps and good-quality formations hollow Bodies and systems, , a rash in the form of the multi-coloured 2 - 4 mm in diameter, located on a skin ear Bowls, lateral surfaces of a skin of a neck, round a mouth, eyes and wings Nose. Changes mucous a mouth meets at 80 % of patients, the rash has The tendency to merge and formation of surfaces of type " Roadway ". The syndrome of Rajli - Bannajana - Ruvalkaba is described as Presence , , including a digestive path.

Diagnosis CCHS It Is Established After An Exception

Diagnosis CCHS It is established after an exception pulmonary, warm, metabolic Or a neurologic cause of illness. Patients from the moment of detection Syndrome CCHS demand lifelong support of artificial ventilation in The dream period, and in hard cases of display of this syndrome is required 24-hour support of ventilation of lungs. Fatness and hypoventilating syndrome At patients with fatness often There is a hypoventilating syndrome and they have also the big sphere Actions of various restrictive defects on ventilation. Numerous researches have shown that patients with fatness and Hypoventilating syndrome have on 20 % smaller general capacity of lungs And the maximum forced speed of an exhalation, which usually on 40 % More low than at other patients. Usually these patients always show Excessive work of breath (= breath) and the increased manufacture 2. Force of muscles, especially on a breath and respiratory volumes in rest also Are reduced at corpulent patients in comparison with control group Patients with normal weight of a body.

Change Of Periodicity Of Chronic Cough, Its Wearisome

Change of periodicity of chronic cough, its wearisome character At smoking of cigarettes, allows to suspect a lung cancer. Complications Cough: 1) the Faint as a result of progressing reduction venous Inflow; 2) rupture with formation ; 3) Edge crisis can occur at the healthy subject in the rest. I result differential criteria Hemoptysis and Hematemesis Signs Hemoptysis Hematemesis The case record There is no nausea and vomitings; Presence of illness of a lung; Possible ; There is a nausea and vomiting; Presence of illnesses of a liver and \or ; is not present ; Saliva estimation () The foamy; liquid, ; brightly red or pink; Foamy it is rare; coffee colour; Brown-black; The given laboratories pH> 7; a mix of macrophages and ; pH <7; a mix of particles of food; The diagnosis At the first stage of diagnostics of the nature () it is important to establish that blood arrives from Respiratory ways. In these cases blood always the foamy. To occurrence Blood usually precede sensations in a throat and requirement in Cough.

Thus Define Displacement Of Border Of The Dulled

Thus define displacement of border of the dulled sound Upwards in the area of measurement also give the third mark. (06 ++) Range of changes a sound (= mobility, excursion Diaphragms) on the right and at the left at healthy faces it should be identical and, Usually, 3-5 sm (sportsmen have more). Forward wall of a thorax as it is spent on certain points and lines (illustration sm) and from top to down. At compare symmetry of sounding and define sonority scale. Approximate general interpretation Character a sound Value a sound Stupid (= femoral) Lobarnaja pneumonia or a pleurisy The normal Healthy lungs, bronchial tubes and pleura Box = Emphysema or Auscultation Use the diaphragm of the stethoscope to auscultate breath sounds. Posterior Chest Auscultate from side to side and top to bottom using the pattern shown in the illustration. Omit the areas covered by the scapulae. Compare one side to the other looking for asymmetry. Note the location and quality of the sounds you hear. Anterior Chest Auscultate from side to side and top to bottom using the pattern shown in the illustration.

It Is Possible To Recommend Walking For The

It is possible to recommend walking for the majority of patients with COPD and Other diseases of lungs (and hearts!). Creation of the optimum Aerodynamic conditions can improve endurance and will allow To carry out performance of some kinds of works, increases consumption Oxygen (VO2) and its effective use, increases the warm Emission, reduces and minute ventilation of lungs. Tolerance training to physical activities Include exercises with manual cargo, wall pulleys, elastic bands, work Against weight of a body, etc.). Tolerance training to physical activities Improves endurance of patients, increases a tone of muscles, improves the general Stability, prevents many elements Damage, improves density of bones increases dynamic force and Improves tolerances to physical activities. Realisation of exercises on flexibility training Concerns elements of extension and increase in a range of movement. Flexibility reduces painful sensitivity and risk of a damage to muscles in The periods of attacks of an asthma.

Substances Raises. A Lack Food Conducts To Decrease

substances raises. A lack Food conducts to decrease in their concentration in blood and, these changes, in Dependences on the maintenance of other biologically active substance, Named , leads to occurrence of feeling of hunger. It is known that can estimate requirement of an organism for food Not only on level of hormones-intermediaries, but also directly - on Concentration in blood of those or others nutritious and biologically active Substances. To one of such alarm substances can serve malonil-koferment A.Eto connection is a metabolism product Fats, and its concentration in blood well correlates with senses of fulness and hunger. It was possible also To show that really regulates appetite in Dependences on concentration fluctuations malonil-kofermenta And, and this The alarm system has appeared more strongly, than known hormonal. Diarrhoeia syndrome (= , ). Diagnostic criteria of functional illnesses (the Roman criteria, 1999) diarrhoeia syndromes are defined as sensitive pains or the discomfort, limited area are closer to an average line of a body.

Consider That Has Come To Investigate Time Intellectual

Consider that has come to investigate time Intellectual and physical health as the incorporated factors reflecting The general indicators of health. All above listed more often Testifies only to prospective or possible malfunctions in Organism of the patient. More in detail sm Gastroenteric path in many respects still Insufficiently investigated system which consists from various on To functions of sections. For example, lips, and a drink form an oral cavity, a teeth Also prepare for digestion in a stomach the mixed lump of food. A stomach Continues digestion and crushing process for the portion the arriving Food. Anatomy and references on a theme Liquid addition in a human body Makes about 8-10 l/sut, including 2 l of water arrive through Mouth. The water most part is soaked up in a small intestine, other part It is added from metabolic processes. Vsasyvanie liquids in the thick To gut in norm makes 0,05-2 l/sut, (about 6 l/sut are maximum). Water soaked up in a small intestine, passively follows the active Transport of ions Na +, 1 ', glucose and bilious salts.

Thus Try To Avoid Contact With With A

Thus Try to avoid contact with with a nose partition is very much Sensitive zone for the patient. The most general reasons Nose partitions include an infection, a syphilis, a tuberculosis, collagenic Vascular diseases, Vegenera, system , an arthritis, toxic influences, for example, use Cocaine and a poisoning with chrome derivatives. -- Transillumination of bosoms of a nose For carrying out of research of bosoms of a nose black out a room to the greatest possible degree. (++) Place a bright tiny and COLD source Light in an oral cavity = external survey, or over acting corner of the top Jaws = internal survey (++). At an internal variant of survey on mucous a mouth, Especially in a hard palate projection, look at outlines of shades and search Borders of change of symmetry and colour. Changes of colour and symmetry of shades Bosoms will help to define or emptiness of Gajmorovyh of bosoms Nose. At a premise of the COLD bright light source In an oral cavity as contours of Gajmorovyh of bosoms and, partially, a bosom are visible Face-to-face bone.

10. Other Illnesses Connected With Raised Risk Of

10. Other illnesses connected with raised risk of development OSAHS . This condition is frequent It has been connected with development OSAHS; however, recent have shown, That prevalence at patients with OSAHS - not above Than in the general cohort the population and patients with OSAHS usually should not To be exposed to additional researches on , except, Probably, elderly women. Nevrologicheskkie syndromes, syndrome type Postpoliomyelitis, dystrophies and infringements of the independent nervous Systems of type Shy - Drager'a a syndrome undoubtedly lead OSAHS. A stroke. Frequency of relation OSAHS to to illnesses it is still found out, defined and It is specified. The demonstrative base that prevalence OSAHS grows Increases at patients who had a stroke. However, whether is OSAHS a risk factor for a stroke or the stroke leads to development OSAHS, remains while not clear. Additional data on this theme: References; Obstructive Sleep Apnea-Hypopnea Syndrome; Differential Diagnoses; Obstr Apnea-Hypopnea Syndrome; Clips - (Obstructive Sleep Apnea-Hypopnea Syndrome) Technical reasons on quality of record ATS experts offer recommendations for the standardised technics of record PFT (=) , Which includes spirometric standards.

6.4 Urea And Blood. 6.5 Syndrome . And

6.4 Urea and blood. 6.5 Syndrome . and false . 6.6 Syndrome . Ways of revealing . 6.7 Syndrome . 6.8 Syndrome . 6.9 Syndrome . 6.10 Research of separate functions of kidneys. 6.10.0 Test With With Zimnitsky. Test Reberga - Tareeva. 6.10.1 Complications of illnesses of kidneys and urine of deducing system. 6.11 Chronic nephritic insufficiency. Section 1 Broad-brush observations to classifications of illnesses Estimation of the most significant directions in medicine As decreasing importance the majority of experts gives the XXI-st centuries in Following order: 1. Allergic diseases. 2. Psychological diseases (increase in frequency of genetic defects). 3. Cardiovascular diseases (influence of a way of life). 4. Malignant new growths (quality of water, air, food) 5. Endokrinnye diseases. 6. Nonspecific diseases of lungs. 7. Traumas and poisonings. 8. Children's death rate. The CART: the world is threatened with epidemics Each of these sections includes hundreds Diseases, conditions, syndromes and symptoms.

THORAX - A Condition Estimation Definition Of The

THORAX - a condition estimation Definition of the major functions systems Diagnostics of some diseases systems at the elderly Features of diagnostics of syndromes warmly - vascular system at elderly Definition of the major functions warmly - vascular system Stomach vessels - on a skin, at , at and on ultrasonic Vessels of the bottom finitenesses - arteries and veins. Rhythm infringements - the simplified estimation of infringements of a rhythm-ekstrasistolija, vibrating , etc. Features of diagnostics of diseases at the elderly Language, gullet, stomach, intestines, etc. Diagnostics of some diseases systems at elderly men and women. THE CONCLUSION References to sources, illustrations and clips and clips Dear readers The author all approaches to that age, when more close The knowledge of gerontology to become necessity for introspection. Set of the errors separated and the inconsistent information in The Internet on these subjects includes also opinion of the author. Therefore, if Consider it necessary, read and unpack free of charge on the printer That has turned out and is exposed on page http://www.

Restriktivnyj Syndrome Reduction Of Volumes FVC Against Normal

Restriktivnyj syndrome Reduction of volumes FVC against normal or The increased volumes of parity FEV1 to FVC it should be considered as Diagnostic signal for an exception (restrictive) Illnesses of lungs. As FEV1 is fraction (share) FVC, Parity FEV1 to FVC can be kept on normal or slightly The raised level. Total amount measurement helps with such cases Lungs (TLC) and residual volume of lungs (RV) which can To confirm a syndrome lungs. (Sm of illustration Media File). Quantitative definition of changes of spirometric indicators At normal values of indicators (FVC, FEV1 and relation FEV1 to FVC) they, usually, above the bottom Settlement level according to the formula and a due limit. Most The low limit of such normal values is certain by expert group GOLD on the basis of results of the average predicted value , the floor of patients based on factors, age and Growth a minus 1.64 (a standard error of tests at studying of specifications For population). If value of the bottom limit of norm is not known or It is inaccessible, FVC and FEV1 for comparison should be big or To equal 80 % to volumes from due (= or predicted), and Relation FEV1 to FVC should be no more, than on 8-9 absolute Points of percent below the predicted parity.

2. Formation Of Patients: It Is Necessary To

2. Formation of patients: It is necessary To recommend to patients corresponding skills of self-checking, management Current and asthma aggravations. Thus a written plan of action at For asthma it is necessary for each patient. This plan should include Instructions for daily treatment also as strategy for detection And managements of an aggravation of asthma attacks. Unlike the previous recommendations and principles, EPR-3 Underlines necessity of strengthening and achievement of possibilities out of Medical institution of training and training of patients on the new Program points. These points include drugstores, schools, public The centres and special houses of patients. 3. The control of factors of environment and other starting mechanisms of development of attacks of an asthma: Measures of isolation for restriction of influence of an allergy and other trigger Mechanisms of development of an asthma in practice seldom happen sufficient for The concrete patient so rules EPR-3 consider for Uses of a combination from several strategy.

- Vials Round A Lip Assume A Herpes.

- Vials round a lip assume a herpes. - Petehii on lips help to notice infringements of system of curling sometimes. - The painless long ulcer on a lower lip assumes a lip cancer. - Firm formation on a lower lip assumes . - Otechnaja with the changed colour an upper lip often Testifies about a hypostasis. top and bottom Lips with a hemorrhage sometimes assume Stephen's syndrome - Johnson. -- The pale skin round a mouth and a fever demands a scarlet fever exception (a sign of Filatova) from the patient. Estimation of a mucous mouth Lips, gums, a teeth, the mouth sky, language and a drink usually looks round with the lighter. (pharynx). For this research are necessary bright light and . In the beginning Attentively examine colour mucous a mouth which is one of The most sensitive places for hyperpigmentation occurrence. For example, Brown stains on mucous a mouth assume illness of Addisona. Pay attention to that the Afro-Americans sometimes have the brown Stains on a cheek against molars.

Htm Blood Vessels. Type Hypodermic Vascular Network On Hands,

htm Blood vessels. type Hypodermic vascular network on hands, feet and a trunk. In addition to It is desirable for estimation of a condition of the patient to estimate its mental faculties , Memory state and emotional level. Further I result more detailed description of sequence of objective inspection. 2.9.0 Survey and heads and necks . the impression about the patient is designated by the term: HABITUS (armour) - Appearance, appearance. A constitution, a bearing, colour of a skin, expression Persons, eyes and . The signs, allowing to assume a condition Health of the patient and / either predispositions to what or to diseases (Adiposity, , and ).: HABITUS MITRALIS - Low growth, a flush on cheeks, lips, a nose tip , Lobes of the ears, the expressed pallor of a skin of a forehead, a triangle And the raised humidity of a skin of brushes of hands. HABITUS PHTHYSICUS - Asthenic or slender constitution, thin skin, gentle Flush on the cheeks, is bluish - shining , expressed In axillary hollows.

) At Research Of Streams Of Air As One

) At research of streams of air as one of the major functions of lungs should consider 1. The maximum forced volume of an exhalation for 1 second (FEV1) which should be repeated three times in 2-3 minutes. 2. To estimate lung volumes, the core from Which is (= TLC), thus if TLC <80 % follows To consider the reasons diseases of lungs. And at TLC> 120 % - presence of the diseases leading to an emphysema. Increase RV (Residual volume) and increase in parity RV/TLC mean Obstructive conditions. 3. An estimation of streams of air of type a loop-volume (analogue 1 = FEV1) Graphic record of simultaneously received Lung volume for the first second of the forced exhalation can be It is useful to full representation about a condition of pulmonary function, but Most precisely this indicator reflects a condition of obstruction of the top Respiratory ways. 4. Diffuzionnaja function of lungs. The condition of this function depends on qualities alveolar and capillary Surfaces of membranes, and as from a condition blood and Conditions of blood circulation limits of a small circle.

Expressiveness Of A Short Wind The Uncertain 1

Expressiveness of a short wind The uncertain 1 At lifting on 2-3 steps of a ladder 2 At lifting on 1-2 flights of stairs 3-4 Short wind in rest 5 6. Treatment influence Treatment was not used 1 Periodically beta-agonist 2 Through a mouth theophylline it is continuous 3 Regular use cromolyn' 4 Aerosols or per os 5 Gravity of illness estimate as the SCORE for all 6 signs. Interpretation: the minimum sum = 6 points; maximum = 30. The low sum specifies on low reactance Bronchial tree at patients with a bronchial asthma (are required more High doses for the spastic answer of bronchial tubes); High The sum specifies on high activity of the bronchial Tree. More in detail sm Brooks SM, Bernstein IL, et al. J Allergy Clin Immunol. 1990 17-26. Additional signs which can be connected with this illness: Chest pains; a thorax; change of a regularity of breath (= heterogeneities); Intermittence of a rhythm of breath, etc. Additional tests and tests on revealing of signs of an asthma: Estimation of a condition of an allergy it can be useful In identification of early forms of an asthma at patients with frequent attacks Asthma.

The Elementary Questionnaire According To Quality Of Cough

The elementary questionnaire according to quality of cough (Cough). The usual reasons of chronic cough Long hyperventilation of lungs; a nasopharynx Pathology; - a syndrome Other reasons (more rare) of chronic cough Lung cancer; illnesses of a throat; illnesses of an ear; Medicinal allergies (for example ACE ); the psychological Factors. Reflex cough The basic receptors of cough are in a nose, To nasopharynx, throats, the top part of a trachea and the main bronchial tubes (). Other sites of receptors of cough: an ear membrane, a diaphragm, Gullet, pericardium, etc. the Centripetal nerves participating in the certificate Cough: trigeminal, glossopharyngeal, top and vagus. Efferentnye nerves: returnable guttural, vagus, a path And peripheral nerves. The cough reflex begins with a deep breath, It is accompanied by closing of a vocal crack, a relaxation of muscles of a diaphragm and Reduction of the chest and belly muscles participating in an exhalation. Thus rises intrachest and Intrapleural pressure 100-300 mm Hg and the subsequent opening Vocal crack allows to exhale sharply a stream of air with a speed 12 L/s Productive cough - "normal" The quantity at cough is not known; usually cleared through a road clearance bronchial tubes, at the healthy allocate to 1,5 Litre a day.

At Patients Without Superfluous Production As There Is

At patients without superfluous production as there is an obstructive syndrome, a bright sign Which the emphysema of lungs is. Younger patients (till 30 years) With signs of an early emphysema and an obstructive syndrome, especially not Smokers, should be investigated on presence an alpha-1-antitripsinovogo Deficiency. It is necessary to notice that average terms of a survival at patients with FEV1 less than make 1 litre on the statistican four years. Research of some indicators of blood. Estimation blood counts at Chronic bronchitis out of an aggravation it is a little informative, however at The extensive and expressed inflammation this test is informative. Detection Signs which are usually shown at late stages Illnesses, and detection of these changes in arterial gases of blood Testifies about a chronic bronchitis and expressed Ventilating insufficiency of lungs which always are Secondary in relation to a bronchospasm and an inflammation. Accompanying almost always it is connected with deterioration of ventilation of lungs.

The Mezomorfnyj Face Type Is Usually Combined With

The mezomorfnyj face type is usually combined with fine muscles (from the kostno-muscular system is formed). The ektomorfnyj type is characterised Triangular type the form of the person. it is usually covered by the fine Thick hair. The skull form testifies to the considerable Intellectual inclinations. On expression, the form, a condition of a skin and Hypodermically-fatty persons it is possible to assume not features Character and behaviour, but also some diseases or conditions The patient. For example: - It is often possible to find out in elderly patients on a face skin and bodies the brown become horny plaques - senile (it is necessary to distinguish from a cancer of a skin - bazalno-cellular and brown - ); (foto 6a1). (foto 6a2). - Often enough there is a hyperpigmentation of sites Skin of a forehead, the cheeks, connected with hormonal changes at pregnancy, Long application contraceptives, is more rare - with action of decorative cosmetics; a symptom (A.Jeffrey, 1844-1908), - absence of wrinkles at attempt to frown, Observed at patients a toxic craw.

The Modern Person, According To The New Researches,

The modern person, according to the new Researches, has occurred from region adjoining on modern Sahara Central-east Africa the Source: DNA of modern people has kept also the distinct Traces of ancient migrations of the person. "Each drop of human blood Comprises the book of history written by language of our genes ", - has told Spenser Vells - one of participants of the project. A genetic code, Or a gene, the person on 99,9 % it is identical at all human individuals, in Each part of the world. Only remained 0,1 % answer (partly) for ours Specific features, such as colour of eyes or predisposition To certain illnesses. the American scientists have found out, why to us so It is difficult to notice individual external distinctions of representatives of others Races. As it is known, for the European all Chineses or Japanese look Identical, and inhabitants of Asia, in turn, hardly distinguish the friend From the friend of Europeans. Before was considered that this matter of habit - people with Other colour of a skin seem us so unusual that them We simply do not perceive individual distinctions.

The Reasons Of A Bronchitis - Infections And

The reasons of a bronchitis - infections and a tobacco smoking Smoking - One of the important risk factors for occurrence and development Chronic bronchitis. More than 90 percent from patients with the chronic Bronchitis have the experience of the smoker, though only 15 % from all smokers in The final account diagnose further an obstructive syndrome of lungs. In connection with it is shown that full 10-year-old death rate after Statements of the diagnosis of a chronic bronchitis makes about 50 percent With typical development of respiratory insufficiency. In a final stage Bronchitis are marked as strengthening respiratory Aggravations of a bacterial infection with the advent of purulent , Fevers and deterioration of signs of ventilation of lungs. Another known and The conventional reason of a sharp chronic bronchitis are virus And bacterial associations in the top respiratory ways and a nasopharynx, Infectious diseases, seasonal changes of the weather, some medicines, and air. As the most frequent associations of bacteria of a nasopharynx and the top part of a trachea and the main bronchial tubes consider Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.

Presence , , Backlog In Intellectual And Physical

Presence , , backlog in intellectual and physical development, Distinguishes this rare an inherited syndrome from illness of Koudena. As additional signs at this syndrome the pigmentary serve at men Stains on a head of a sexual member, often Gothic sky and Hypermobility of joints. You have read 7 the text of the book of professor Hramova And Therapeutic syndromes. GASTROENTEROLOGY 2007-2008 THE MAINTENANCE Introduction 1. The short review of anatomy and functions Bronho-pulmonary system (it is a pity that on page there is no possibility To place fine illustrations, algorithms and clips). 2. Ways of revealing of syndromes of diseases of bronho-pulmonary system * Complaints of patients and feature of the questionnaire of quality of a life * Cough and its versions * Features of pains in a thorax at diseases of respiratory organs * Short wind and its kinds * History of disease, life and hereditary factors 3. Fizikalnye researches and clips on this theme (Bronchospasm asthma emphysema) * Research of the patient (a head; ears; Nose; nose bosoms; a throat; smells of the person; a neck; the chest Cage; etc.

To Check Up It, Attentively Listen To A

To check up it, attentively Listen to a carotid and-or spend its ultrasonic Research. Thus, if soft pressing an artery during time Listenings are changed by quality of the sound perceived by the patient. It Testifies that the sound reason is connected with a carotid pathology. Patients with ventrikulo-peritonealnymi shunts (At low intracranial pressure) can sometimes hear the soft Smooth sound. Patients with attacks can hear click sounds. Well-known that negligent procedure an internal hollow vein on lines can sometimes To cause sensations and sounds of vials in ears. Eustachian tube inflammation often It is accompanied by obvious sounds of clicks which hears even the investigating The doctor through during time when the patient swallows. Sometimes this symptom (Leudet'á) it is shown as a ring in ears. At an inflammation of a middle ear patients sometimes hear own sounds of breath. Ring in ears with dizziness or dizziness Separately, which disappears at the big height (= flights in the plane), Offers possible illness of Minera (symptom Bigger').

At Survey Of Such Patients Always Typical Signs

At survey of such patients always Typical signs of change of the form of a thorax, come to light - Box sound, absent-minded sonorous dry (and sometimes and Mixed damp) rattles and always - lengthening of time of an exhalation. Often enough it is possible to listen to the rough The cracklings beginning with a breath and rattles after the compulsory Tussiculations and exhalation strengthenings. The symptom is almost always marked , Drum-type sticks and other signs chronic . The status of consciousness of the patient can be lowered It (is oppressed) at serious increase PaCO2 (more than 50 mm ). Patients With the central alveolar hypoventilation, COPD and fatness The hypoventilating syndrome can testify and to the pulmonary Hypertensions. The last include: strengthening of a pulmonary component of the second Tone (P2) a warm sound, the big component of "wave" of venous pulse to a pole, a deviation of the right border of heart to the right, Superfluous pulsation in , etc. Sometimes it is possible for area To listen to noise and S4 on the right (in vertical position The patient).

Pathological Processes Can Make Also Sounds Of Type

Pathological processes Can make also sounds of type of a scratch at joints joints; at crises of tubular bones; liquid splash in a stomach and Other Creaking sounds fabrics round the infected wound - The awful sign testifying to a gas gangrene. Absence Pulsation sounds can be as ominous at the blocked stream Blood in a large artery. Silence in a belly cavity as demands Urgent inspection of the patient. endoscopy. Today's students and doctors listen more often Three basic organno-system zones: heart, lungs and a belly cavity. At auscultation of heart, the doctor define correct and wrong Sounds and rhythms, including warm noise, a rhythm of heart and others Additional sounds (S2; S3; S4 and ). At auscultation of a thorax and lungs Breath sounds, types and features of rattles and noise are defined. Auscultation of a belly cavity pursues the aim of definition and Classifications of noise of intestines and vessels. Sm as in addition lungs. At auscultation (= ) lungs allocate three basic types of sounds - Sounds of a friction of a pleura; - Rattles; - Krepitatsija; Versions of rattles: "a sound of a falling drop" "noise Water pipe "" noise of splash of Gippokrata ", - different shades.

However, In Practice There Are Still Many Episodes

However, in practice there are still many episodes of hypodiagnostics . Risk factors for development pulmonary usually include: * like a confinement to bed, trips to the plane, the bus, etc. * operation or crisis of bones * contraceptives in a combination to smoking (birth control pills) * veins of the bottom finitenesses * * * * Depending on volume , diameter of a trunk Pulmonary artery and quantity of a fabric of the lung deprived of blood, The patient can represent as the patient in a critical condition with Considerably changed criteria of life-support and to seem outwardly In a satisfactory condition. The help in diagnostics can render Dynamic supervision over an electrocardiogram where signs are periodically shown Loadings on the right departments of heart. It is important to investigate and dynamics Conditions of curtailing system of blood. But more all to exact diagnostics promotes CT scan With radionuklidov - a method allowing to localise a branch of a pulmonary artery. Confirming objective Research possible , if necessary, can become the bottom finitenesses and veins of a small basin (ultrasound) and .

1. Shared Problems - Classifications, Criteria And Ways

1. Shared problems - classifications, Criteria and ways age of the person; some conditions -- Dream problems, mental features of elderly persons, including change , dizzinesses, problems and balance, Conditions, a sleeplessness, etc. How to define age of the patient? As it is known, age - concept not only Biological, but also psychological. Feeling of the person not always It is measured by quantity of the lived years, and the same it is possible to tell about Condition of its body. To begin that fading of functions various Bodies occurs not simultaneously: for example, at the 70-year-old person a number Bodies can work at level of 50-year-old age, whereas The others function at level of 70 years or is more senior. For this reason Definition of real age represents a problem as for physicians, And for psychologists. A critical problem Gerontology - ability of the elderly person effectively To function. As it is precisely noticed "if the youth was able, yes if The old age could ". Researches of criteria Qualities of work of elderly patients have shown that the functional , daily household skills and actions are closely connected with Duration of illness and age.

(Overview Of Streptococcal Throat Infection.). It Three Recognised

(Overview of streptococcal throat infection.). It Three recognised leading bacterial pathogenic agents at a bronchitis, in Difference from an aetiology and the reasons of an acute bronchitis which include more often Mycoplasma pneumoniae and Chlamydia trachomatis. However studying of population with aggravations of a bronchitis at patients with an obstructive syndrome (COPD) have not shown prevalence of these microorganisms in more than 50 % of cases. Not bacterial (type of viruses, Chlamydia, Mycoplasma And their versions) also seldom meet separately at patients with Chronic bronchitis and their role in development of defeat mucous bronchial tubes And possible proinflammatory provocation are still badly studied. One From speculative explanations of communication between an infection and chronic By bronchitis it is based on a postulate that colonisation by bacteria of the low Intensity of the bottom department of the respiratory treatise can provoke Inflammatory reaction. This assumption is based on the concept that Patients at which have been found such bacteria with specific IgE, have caused the raised exit after repeated infection with the same bacteria.

Compare One Side To The Other Looking For

Compare one side to the other looking for asymmetry. Note the location and quality of the sounds you hear. Thorax auscultation More often doctors use a stethoscope with two To expansions on the end. One has races - with a diaphragm and it Expansion (strengthens sounds) listen to weak sounds the chest is more often Cages - for example, breath sounds. Pay attention to place and quality of sounds which are listened. Interpretation Breath sounds are produced by turbulent air flow. They are categorised by the size of the airways that transmit them to the chest wall (and your stethoscope). The general rule is, the larger the airway, the louder and higher pitched the sound. Vesicular breath sounds are low pitched and normally heard over most lung fields. Tracheal breath sounds are heard over the trachea. Bronchovesicular and bronchial sounds are heard in between. Inspiration is normally longer than expiration (I> E). [2] Breath sounds are decreased when normal lung is displaced by air (emphysema or pneumothorax) or fluid (pleural effusion).

An Inflammation Mucous A Stomach, A Spleen, A

An inflammation mucous a stomach, a spleen, a liver or a bilious bubble (gallbladder) Can originally give uncertain complaints to pains which can To be connected and with uncertain discomfort in a breast. Attentive research and time often allow to consider the correct The diagnosis. For example, the pain in top a stomach can originally To be shown as: - a myocardium Heart attack - a back wall left hearts. - A pneumonia, especially at an inflammation of a fabric of a lung near to a diaphragm. - Stratifying an aorta aneurysm can To be presented a chest pain in a combination to a belly pain in Dependences on where there is a stratifying of a wall of an aorta. Some remarks on a problem of a syndrome of a short wind SHORT WIND and its kinds---- So As the short wind is heavy enough suffering for the patients, new Recommendations about diagnostics and treatment of a bronho-pulmonary pathology, Included since 2007 in the official publication of the American Chest Society (ATS) it is confirmed ATS by board of Directors in March, 2007 and it is published on April, 15th, 2007 in the American Magazine of Respiratory and Urgent Medical aid (A.

Defining Value On Phenomenon Revealing Last Phase Of

Defining value on phenomenon revealing last phase of a breath (= has the breath termination). With Intensity of other sounds, position of the patient, cough and By tonality of rattles , usually, it is not connected. The nature of sounds it is connected with cyclic disappearance and Destruction of walls of alveoluses. Air entering into alveoluses in the end of a breath, Against insufficiency (covering at each cycle Breath!) alveoluses from within, with a crash moves apart alveolus walls ( Listen under the reference in the end of the book). Sometimes It is heard in the end of a breath and at the very beginning of an exhalation, it is frequent in a prone position And in the mornings, is a certificate of a superfluous congestion of a liquid in a fabric Lung (warm insufficiency, a hypostasis of lungs, etc.) (listen on To the reference in the end of the book). So, to and and and I listened over Area of lungs reminds a snow crunch in frosty day or The crackling arising at a friction of a lock of hair about an ear.

Now There Are Some Accessible Devices Which Are

Now there are some accessible Devices which are developed and intended for preservation or Optimisation of quality of mastering of oxygen from a stream . These Devices are simple, inexpensive and improve efficiency of delivery of oxygen In 4 times. Training of the top humeral belt Many patients COPD at a short wind Use for the help to breath the top finitenesses. Not , The hands (hand) lifted above a shoulder, movement by hands demands the competitive Uses of additional muscles of breath. Lifting of hands also increases Use of oxygen and manufacture CO2. Consecutive performance of exercises for a hand Conducts to reduction of requirements to ventilation of lungs, therefore allows Gradually to improve tolerance to physical activities, ADLS Also reduces intensity and frequency of a short wind. Training to exercises with Use of hands can include cyclic work with the manual approximately to 50 turns in a minute. Initial rate - Without resistance within 4-6 minutes throughout the first week.

Diastolichesky Noise Are Indicative For Insufficiency Valves Of

Diastolichesky noise are indicative for insufficiency Valves of a pulmonary artery also testify to a phenomenon . At patients with late stages of disease Obvious signs of insufficiency of the right departments of heart (cor develop pulmonale) and it often lifts venous pressure with visible V wave At . Practically always at patients hypostases of the bottom are expressed Finitenesses and proof . Thus long, proof The pulsation and always testifies to the expressed blood in right hearts. Sometimes ( But not always) signs come to light. The reasons The hypoventilation syndrome can be secondary on To basis of several mechanisms , including depression of the respiratory The centre, infringements, defects of a wall of a thorax, Fatness, and COPD. * Chronic obstructive illness of lungs; an emphysema; a chronic bronchitis. * infringements ( Lateral sclerosis; muscular dystrophies; a diaphragm paralysis; a syndrome Guillain-Barr; pregnant women); * Defects of a chest wall - ; ; ; * Neurologic frustration - , traumas.

Visitings Of Doctors For Such Patients Should To

Visitings of doctors for such patients should To be more frequent (it is proportional to degree of the Russian Academy of Sciences!). The majority Experts consider necessary to spend an estimation of a functional class and Tolerances to physical activity through tests, type of 6-minute walking Or the test at each visiting of the patient. 10. Any infringements which increase Loading on the left departments of heart, including arterial pressure, , dysfunctions and illnesses the device, Can end with pressure lifting in a pulmonary artery. In the rare Cases specific therapy PAH - can be considered as the basic The reason of infringements. When, for example, PCW it is normal or is minimum lifted, And a gradient of pressure and PVR are lifted. Last phenomenon is known as "disproportionate" PH or than Expected effect on the basis of high in warm pressure at the left. Potential adverse effects from specific therapy PAH at Such patients are included by signs of a worsening delay of a liquid, Episodes of a hypostasis of lungs with interface infringement and ventilation Lungs.

Pressure Of Carbonic Acid In Blood (PaCO2) In

Pressure of carbonic acid in blood (PaCO2) in Normal conditions it is strongly supported in a range 39-41 mm Hg. On Ventilation of lungs influence and PaCO2, PaO2 and Indicators pH located in a trunk of a brain, which in commonwealth with Nervous impulses from receptors of a stretching of a lung and impulses from Fabrics of a bark of a brain operate breath biomechanics. Refusal of any of these Mechanisms leads to hypoventilation development, and . alveoluses a venous stream of blood from Pulmonary capillary network allows a pulmonary fabric to participate in Gas exchange of an organism. The gas exchange includes delivery of oxygen to To capillary bed and elimination 2 from a blood stream in a small circle Blood circulations. Effective and long removal 2 from blood depends From adequate ventilation of lungs. Relations between ventilation and PaCO2 Can be presented as follows: PaCO2 = (k) (VCO2)/VA. In Which VCO2 is a metabolic stream (manufacture) 2 (that Is, maintenance 2 in a blue blood), k - a constant and VA - speed Alveolar ventilation.

). Thus, For Exact Calculation Of Specificity Sign, Its

). Thus, for exact calculation of specificity Sign, its diagnostic importance all available symptoms and Syndromes can be divided conditionally on: 1. Is true-positive () 3. Is false positive () 2. Is true-negative () 4. Is false negative () In a general view the diagnostic importance of any symptom looks as The following formula: (io-lp): (ip-lo) = { (:ÉÕ ()} x {P (\): (\)} In practice use more often and estimate Variety of separate tests, symptoms, signs. Diagnostic Their specificity essentially differs. For example, efficiency Laboratory tests considerably varies at the expense of change of borders Sensitivity and specificity of the chosen signs. For revealing of basic signs and symptoms of concrete disease it is necessary to define diagnostic sensitivity (), diagnostic specificity () and diagnostic efficiency () a concrete sign, a syndrome and . = : + 100 %, where - is true-positive results, - is false-negative results of Dch the percent, the better an indicator for revealing of the given disease is expressed in percentage and the above.