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Ex.2. Read the information and speak on the diagnostic tests evaluating physiologic characteristics and pathological states within the respiratory tract.
Pulmonary function tests measure lung volumes and flow rates.
Palpation of the chest detects areas of the tenderness, masses, crepitus, (air in subcutaneous tissue).
Percussion may produce several kinds of sounds known as flat, dull, resonant, hyperresonant, or tympanic, these sounds indicate the location and density of various structures. During percussion, determining other tonal characteristics, such as pitch, intensity and quality, also will help identify respiratory structure.
Characterizing Percussion Sounds
Characteristic Pitch Intensity Quality
flat high soft extremely dull
dull medium medium thudlike(глухой)
resonant low moderate to loud hollow
hyperresonant lower than resonant every loud booming
Chest X - raysshow pulmonary edema
opacification zones (помутнение, непрозрачность)
Computed tomography scan provides a three-dimensional picture that is 100 times more sensitive than a chest X-ray.
Magnetic resonance imaging identifies obstructed arteries and tissue perfusions.
Analysis of sputum specimen permits study of sputum quantity, color, viscosity, and odor.
Special radiological investigations include fluoroscopy (or screening) of the lung and diaphragmatic movements: lateral, oblique and apical views: X-rays focused at different depths in the lung (tomography to detect local lesions; such as a cavity or tumour; and the introduction of a radio- opaque medium into the bronchial tree (broncography) to demonstrate bronchiectasis or bronchial narrowing, or into the pulmonary artery (angiography) to demonstrate arterial occlusions by embolism. Computerized axial tomography (the “CAT scan”) may be used to define the precise size, site and consistency of an intrathoracic lesion.
Ex.3. Read the text and complete the following sentences using the material in the text:
1.The very common symptoms in most respiratory disorders are…
2. There are various types of cough…
3. Sputum is…
4. According to the nature and extent the sputum may be…
5. Dyspnea means…
6. Cyanosis may be caused by…
7. Haemophysis is called…
Common symptoms of the diseases of the respiratory tract
Many of the diseases affecting the respiratory system produce common symptoms and signs.
1. Cough. This is a very common symptom seen in most diseases of the respiratory tract and usually due to some form or irritation. There are various types of cough, such as moist or dry, depending on whether the cough is accompanied by sputum or not.
2. Sputum or Phlegm. Sputum is an excretion from the lining mucous membrane of the respiratory passages. According to the nature and extent ofthe disease the sputum varies in amount and character. In the early stages of disease sputum may be absent, appearing later when the lesion in the respiratory tract has progressed. The sputum may be a clear white colour, when it is called mucoid. In more severe lesions, especially inflammatory diseases, the sputum is purulent.
3.Dyspnea. Dyspnea means difficulty in breathing or as it is most usually called, breathlessness. The underlying, cause in most cases is a deficiency of oxygen. Any disease which interferes with the proper uptake of oxygen, stimulates the respiratory centre, so that an increase in the respirations occurs to overcome this oxygen deficiency.
4. Cyanosis. In many chest diseases there is a deficient intake of oxygen which causes cyanosis. Cyanosis usually means a severe degree of involvement of the respiratory system.
5. Pain. This is usually due to pleurisy (inflammation of the pleura) which accompanies many forms of chest diseases. The inflamed layers of the pleura when rubbed together during respiration cause pain.
6. Coughing up blood is called hamoptysis and may vary from staining of the sputum to frank blood.
Ex.4. Read the text and translate it in a written form paying special attention to the sentences with underlined word-combinations .
Patients with diseases of the respiratory system
As in other branches of medicine, a careful and detailed history and physical examination are the cornerstones of an accurate diagnosis in patients with disorders of the respiratory system. In addition, the roentgenographic examination occupies a particularly important role in the evaluation of patients with lung disease. Since abnormalities of the respiratory system are frequently a manifestation of a systemic process, attention must be focused not only on the chest; a comprehensive evaluation of the patient's entire health status is essential.
The history must contain a detailed occupational and personal history with a description of exposure to hazards such as coal, silica, asbestos and so on.
The family history should consider pulmonary diseases which may be on a genetic basis.
Dyspnea is a cardinal manifestation of diseases involving the respiratory and cardiovascular systems. A detailed physical examination of both organ systems is therefore mandatory to every patient with symptom. Dyspnea secondary to cardiac disease is often recognized by the presence of other evidence of 'heart failure, of cardiac enlargement and cardiac murmurs.
Patients with diseases involving the respiratory system may also present with chest pain which is frequently caused by inflammation of the pleura, occurring in pneumonia, tuberculosis and malignancy. Pleuritic pain is usually localized to one side of the chest and is related to movements of the thorax and to respiration. Lesions confined to the pulmonary parenchyma do not produce pain, while diseases involving the organs in the mediastinum may cause local discomfort with radiation characteristic of the specific organ.
Ex.5. Assessment of the respiratory system begins with a thorough patient history. Ask the patient to describe his respiratory problem.
A. Put the words in the correct order to make questions.
B. Make up a dialogue using these questions.
1. Does he smoke long how?
2. Severity, persistence and duration is its what?
3. Has long how had he it?
4. One attack differ does from another?
5. He a is smoker?
6. What the in when position is patient occurs dyspnea?
7. Got has he a cough?
8. The symptoms relieves what?
9. Does each how long attack last?
10. Any in particular or make it worse does activity an attack bring on?
11. At night it only occur does during sleep?
Ex.6. Read the texts. Find out and put down the expressions describing throat and voice pathology. Make up your own sentences using these expressions.
The outstanding symptom of acute pharyngitis, regardless of cause, is a sore throat. About two-thirds of all acute illnesses in families are viral infections of the upper respiratory tract, with varying degree of pharyngeal discomfort present. The acute pharyngitis can be classified into three groups: (1) treatable infections, (2) untreatable infections, and (3) noninfectious disorders.
Physical examination of the pharynx mucosa may reveal changes varying in intensity from mild redness and congestion of blood vessels (many viral infections) to intense red-purple color, patchy yellow exudate, hypertrophy of all the lymphoid tissue, and marked vascular injection. Symptoms may be variable, and may range from a complaint of “scratchy throat” to pain so severe that swallowing of saliva is difficult. The presence of exudate does not establish a specific etiology any may be noted in infections.
Ulceration involving the posterior pharyngeal wall and/or tonsils are characteristically present in fungobacterial infections, tuberculosis, following local trauma to the pharynx.
The tonsils are often involved in the course of viral and bacterial pharyngitis; they may be markedly reddened and swollen.
The etiologic diagnosis of acute pharyngitis is difficult to establish on the basis of visual examinations of the throat.
Change in the voice that makes it more harsh or coarse.
Symptoms: Change in tone or quality of voice to a coarse, harsher sound, need to clear the throat; sometimes fever, swallowing difficulty and throat pain or discomfort, depending on cause.
Cause: The voice box (larynx) becomes inflamed as a r4esult of inhaling smoke, chemical fames, gases, vapors or dust, overuse or abuse of voice; excessive use of alcohol; diseases such as sinusitis, tonsillitis, bronchitis, flu, the common cold, pneumonia and pharyngitis, polyps in the throat, cancer and others.
Treatment: Depends on basis for problem. However, initial treatment usually includes “not talking” in order to rest the larynx, no smoking or drinking; an increase in fluids and medication if seemed necessary. Further treatment would depend on the cause of the hoarseness.
Ex.7. Read the text and find the answers to:
1. What is bronchitis?
2. What are the clinical manifestations of the disease?
3. What are the causes of bronchitis?
4. How to prevent chronic bronchitis?
Acute inflammation of the tracheobronchial tube (air passage).
Symptoms: Cough that is initially hacking and dry. Then gradually becomes loose, with production of mucus or yellow sputum. There may be fever (if infection is present), generalized malaise and fatigue, sensation of tickling or tightness in chest and sensation or sound of rafting in the chest. If the bronchitis follows a cold, there may also be congestion of the nose and postnasal dry. Coughing is often worse in the morning than at night.
Cause: Acute Bronchitis may result from infection as a complication of a cold (upper respiratory infection) or as a result of irritation of a lining of the air passages by inhaling substances such as smoke, pollen, dust, fumes or fibers.
The irritant type of bronchitis may progress to involve infection also.
Severity of problem: Usually of mild to moderate severity and resolves with treatment. If cause is not corrected, it may become chronic.
Contagious: Usually not except if caused by a view.
Treatment: Depends on cause but involves removing or avoiding any irritants (stopping smoking, avoiding dust), drinking much fluid and resting. Moisture in the air (involving steam) is sometimes soothing. If the cough is dry and irritating, or interferes with sleep, medication to suppress it might be recommended. Antibiotics may be prescribed by the doctor if bacterial infection is suspected or known.
Prevention: Avoid smoking, exposure to airborne dust or irritants.
Discussion: Mild, acute Bronchitis is almost always present temporarily with upper respiratory infection (common cold) and does not require antibiotic treatment unless high fever occurs, or sputum becomes yellow or greenish rather than white or clear.
Chronic Bronchitis is a real problem in adults, problem thought to be “Chronic Bronchitis” in infants and children are more likely to be asthma or other illness. Bronchitis where there is a lot of wheezing can be suspected of being asthma. People with moderate to severe chronic Bronchitis should probably receive influenza vaccines (‘flu shots’).
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