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General and special methods of clinical research

For the diagnosis of animal diseases using a variety of methods. Among them are general, special (instrumental), laboratory and functional.

General methods are divided into inspection, palpation, percussion, auscultation and thermometry. They are called common because they are used in the study of virtually every patient, regardless of the nature of the disease.

Inspection [lat. inspectare - watch, observe] is performed with the naked eye in good light or with the use of reflectors, endoscopic devices. Inspection can be group and individual, general and local, external and internal.

Group inspection is carried out in the study of a large number of animals and with its help isolate sick or suspicious individuals for the disease for further comprehensive examination. Each diseased animal admitted for treatment is subjected to individual examination. A general inspection is carried out left and right, front and back, and also, if possible, from above. At the same time determine the habit, the condition of hair, skin, the presence of superficial damage, the symmetry of various parts of the body. Local inspection allows you to explore the areas of localization of the disease process and can be external or internal (through lighting).

Palpation [Latin palpatio - probe]. The feeling method is based on touch. Conduct research first healthy areas of the body, and then the affected. At the same time, palpation should not hurt the animal or resemble tickling. There are superficial and deep palpation.

Superficial examine the skin, subcutaneous tissue, muscles, joints, tendons and ligaments. By means of a dense palm application, for example, the temperature and humidity of the tissues are established, the state of the cardiac impulse, the presence of tangible noises are evaluated. The consistency and tenderness of the tissues are determined by pressing the tips of the fingers with increasing force until the animal responds. By stroking with the palm, the character of the surface is established, and with the fingers, the shape and integrity of the bones and joints are determined. By gathering the skin in a fold, its elasticity is established and zones of increased pain sensitivity are identified.

Deep palpation examines the organs of the abdominal and pelvic cavity by determining their location, size, shape, texture, pain. Deep palpation can be external and internal. By deep outdoor include:

• penetrating when pressing fingers or fist on the abdominal wall and examine a particular organ, such as the liver, scar, etc.

• bimanual, i.e. with two hands, when you manage to clasp the organ and determine its condition. The most informative in the study of small animals, foals and calves.

• a jerk or ballot when jolts from one side of the abdominal wall are caught by the palm of the other side. At the same time, it is possible to detect accumulation of fluid in the abdominal cavity, to establish the presence of a fetus in the uterus.

Deep internal palpation is carried out in large animals through the rectum (rectal examination) in order to obtain data on the condition of the organs located in the pelvic and abdominal cavities.

Percussion [lat. percussio - tapping] - a research method for determining the state and topography of internal organs from the sound obtained by tapping the surface of the body with a hammer or fingers. Striking the surface of the body causes oscillatory movements of the superficial and deep-lying tissues, which are perceived by the researcher as sound. Percussion is preferably carried out in a closed small room with respect for silence. There are direct and mediocre, as well as digital and instrumental percussion.

Direct percussion is performed with the tip of one or two (index and middle) fingers bent in the second phalanx. The blows are applied directly on the test surface. The sound thus appears weak and fuzzy. Therefore, this type of percussion is used only in the study of air cavities bounded by bones (frontal, maxillary sinuses). Sometimes these cavities are tapped, causing slack blows with a percussion hammer.

With mediocre percussion, the blows are applied not to the surface to be examined, but to a finger or a presimeter pressed to the skin. At the same time, the sound is louder and clearer, because it consists of a blow to the finger or the plysimeter, from the vibrations of the chest or abdominal wall and the column of air in the test organ.

With mediocre digital percussion, small animals and young animals are explored. The index or middle finger of the left hand is tightly applied to the skin, and the fingers of the right hand are stabbed.

Mediocre instrumental percussion is carried out in large animals with a plesemeter and a hammer of various sizes and shapes. Plemismetra tightly applied to the test area of ​​the body. The hammer is held with the index and thumb of the other hand without clamping the end of the handle. The strikes are applied perpendicularly to the plysimeter, and they must be paired, short and jerky.

With topographic percussion, the blows must be of medium or weak force, and the hammer is somewhat delayed on the plessimeter. Research is carried out, as a rule, along auxiliary lines.

When percussion in order to establish pathological changes in organs and tissues, percussion is performed with strong, short and jerky strokes. At the same time, the pleusimeter is moved in the zone of projection of the organ onto the surface of the body from top to bottom and front to back.

Auscultation [lat. auscultatio - listening] - a method of researching internal organs by listening to and evaluating the sounds produced by their work. Auscultation should be carried out whenever possible indoors and with complete silence. Listening is carried out directly by the ear or through special tools.

When listening to the ear directly, it is applied to the body of the animal covered with a sheet, while it is necessary to strictly observe safety precautions. Thus it is possible to carry out auscultation of large animals in a standing position. Listening to small and large recumbent animals is quite difficult.

Mediocre auscultation is performed using stethoscopes, phonendoscopes or stethophonendoscopes. These instruments create a closed speaker system, so that sounds are perceived to be louder and clearer.
Listening starts from the center of the organ projection onto the body surface (in case of auscultation of the lung - in the middle of the percussion triangle behind the scapula, the heart - in the place of the most pronounced cardiac impulse), and then the sounds in other areas are consistently evaluated.

Thermometry [Greek thermos - warm + metreo - measure] - a method based on measuring the body temperature of an animal. Thermometry is required when examining sick or suspicious animals. Conducted by means of thermometers of various designs (mercury, electric, recording the infrared radiation of the body).

In veterinary practice, a maximum veterinary mercury thermometer with a scale of division from 34 to 44 ° C is generally used (medical has a scale of division to 42 ° C). They measure body temperature in animals in the rectum (in birds - in the cloaca) for 5-7 minutes. After each examination, the thermometer must be cleaned and disinfected.

Special (instrumental) methods require the use of various instruments. Among the methods of this group in the veterinary practice the most frequently used are the following:

• Endoscopy is a method of visual examination of cavities and tubular organs with instruments with optics and electric lighting. The method is becoming more widely used for the study of animals, especially after the appearance of fiber-optic flexible endoscopes.

• Probing is the method of studying channels and cavities with special rubber or other (plastic, PVC) tubes called probes. They are administered to animals through the oral cavity or nasal passages. Probes also examine the wound canals, fistulas, abscesses cavities, etc. Sounding allows you to establish the patency of the body, the presence of foreign bodies, as well as get the contents, such as the stomach. In some cases, the probes are used for therapeutic purposes - to extract metallic foreign objects from the mesh and the scar in cattle, restore the patency of the esophagus, gastric lavage.

• Catheterization is carried out with special flexible or rigid tubes - catheters made of various materials. So, in the study of the organs of urination by catheterization, the patency of the urethra is established, urine is obtained, the bladder is washed, etc.

• Graphic methods involve the receipt of a document, it may be a graph, photograph, radiograph, etc. Rhinography (recording of exhaled air) and pneumography (recording of respiratory movements of the chest) make it possible to determine the frequency of respiratory movements in an animal, their strength, rhythm, which is important for recognition of shortness of breath. Gastrography and rumenography are used to assess the motor function of the stomach and scar, respectively. Sphygmography (recording of arterial pulse wave) is important for the diagnosis of arrhythmias. With the help of electrocardiography (recording of biopotentials of the heart), the functional state of the heart is evaluated and almost all types of cardiac arrhythmias are recognized. When phonocardiography record sound phenomena in the heart of work. These and some other graphical methods, their diagnostic significance, are discussed in more detail in the sections devoted to the study of individual systems and organs.

• X-ray methods are based on the use of electromagnetic oscillations of a certain wavelength - X-rays. Depending on the receiver used, these rays distinguish roentgenoscopy (obtaining a shadow image of a body region on a fluoroscopic screen) and X-rays (an X-ray image on a special film, which is called an x-ray after development). There are also varieties of radiography - fluorography, X-ray, X-ray photometry, etc.

• Operative surgical methods allow obtaining material for subsequent laboratory and other studies. Among them, the most frequently used biopsy and puncture. Biopsy - intravital excision of a piece of organ tissue. Puncture - puncture of the body cavity or vessel in order to obtain a biological fluid or tissue cells. Operative surgical operations are carried out with special needles with mandrins or trocars of a specific design, with strict adherence to the rules of surgical intervention.

It should be borne in mind that the list of special methods for the study of animals with the development of science and technology is constantly expanding. Veterinary specialists are successfully used in clinical practice echography (obtaining images of organs and tissues using ultrasound waves), biotelemetry (recording information at a distance from the object of study), radioisotope studies (studying the function and structure of organs using radioactive substances introduced into the body). methods.

Laboratory methods involve the study of blood, urine, feces, outflows, punctate, secrets. General clinical blood analysis consists of determining the erythrocyte sedimentation rate, hemoglobin concentration, counting the number of erythrocytes, leukocytes and platelets, removing leukogram and calculating the color index. Biochemical blood tests include the determination of indicators characterizing protein, carbohydrate, lipid, mineral, vitamin and other types of metabolism. Laboratory analysis of urine, feces, bleed, etc. carried out in the following areas: the study of the physical properties of the material (quantity, color, texture, odor, impurities, relative density, etc.); chemical research to determine the presence of certain substances; microscopic examination.

Functional methods are used to assess the function of the systems of the body as a whole or its individual organs. They are usually used when the animal has a decrease in productivity or efficiency, and clinical and laboratory research can not detect any major changes. In addition, knowledge of the functional capacity of the system is necessary to formulate a prediction of the disease. In veterinary medicine, the most developed methods are functional studies of the cardiovascular, respiratory, digestive, nervous systems, urinary organs (kidneys), endocrine organs, and blood-forming organs.
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