Auscultation of the chest. General and special methods of animal research

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

Inspection [lat. inspectare - watch, observe] is carried out 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 examination is carried out during the study a large number animals and with its help allocate sick or suspicious individuals for further comprehensive examination. Each sick animal admitted for treatment is subjected to an individual examination. General examination is carried out on the left and right, front and rear, and, if possible, also from above. At the same time, the habitus is determined, the state hairline, skin, availability superficial damage, symmetry of various parts of the body. Local examination allows you to explore the areas of localization of the disease process and can be external or internal (through lighting devices).

Palpation [lat. palpatio - groping]. The touch method is based on touch. Conduct a study first healthy parts of the body, and then the affected. At the same time, palpation should not cause pain to the animal or resemble tickling. Distinguish superficial and deep palpation.

Superficial examine the skin, subcutaneous tissue, muscles, joints, tendons and ligaments. By tightly applying the palm, for example, the temperature and humidity of the tissues are established, the state of the heart beat, the presence of tangible noises are assessed. The consistency and soreness of the tissues is determined by pressing the fingertips with increasing force until the animal responds. By stroking with the palm of the hand, the nature of the surface is established, and with the fingers, the shape and integrity of the bones and joints are determined. By gathering the skin into a fold, its elasticity is established and areas of increased pain sensitivity are identified.

Deep palpation examines the abdominal and pelvic cavity by determining their location, size, shape, consistency, pain. Deep palpation can be external and internal. The deep outer include:

Penetrating, when they press with the fingers of the hand or fist on the abdominal wall and examine certain body e.g. liver, scar, etc.

Bimanual, i.e. with both hands, when it is possible to grasp the organ and determine its condition. The most informative in the study of small animals, foals and calves.

Jerking or balloting, when the pushes carried out on one side of the abdominal wall are caught by the palm on the other side. In this case, you can detect the accumulation of fluid in abdominal cavity, establish the presence of the fetus in the uterus.

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

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

Direct percussion is carried out with the tip of one or two (index and middle) fingers bent in the second phalanx. Impacts are applied directly to the surface being examined. The sound in this case is weak and fuzzy. Therefore, this type of percussion is used only in the study of air cavities limited by bones (frontal, maxillary sinuses). Sometimes these cavities are tapped out causing no strong blows butt of the percussion mallet.

With mediocre percussion, blows are applied not to the surface under study, but to a finger or pessimeter pressed against the skin. In this case, the sound turns out to be louder and clearer, since it consists of a blow to a finger or a plessimeter, vibrations of the chest or abdominal wall and a column of air in the organ under study.

Small animals and young animals are examined with mediocre digital percussion. The index or middle finger of the left hand is firmly applied to the skin, and jerky blows are applied with the fingers of the right hand.

Mediocre instrumental percussion is carried out in large animals using a plessimeter and a hammer of various sizes and shapes. The plessimeter is tightly applied to the examined area of ​​the body. The hammer is held by the index and thumb the other hand without pinching the end of the handle. The blows are applied to the plessimeter perpendicularly, while they must be paired, short and jerky.

With topographic percussion, the beats should be medium or weak strength, and the hammer is somewhat delayed on the plessimeter. The study is carried out, as a rule, along auxiliary lines.

During percussion, in order to establish pathological changes in organs and tissues, percussion is carried out with strong, short and jerky strokes. At the same time, the plessimeter is moved in the area of ​​the organ projection onto the body surface from top to bottom and from front to back.

auscultation [lat. auscultatio - listening] - a method of examining internal organs by listening and evaluating the sounds generated during their work. Auscultation should be carried out whenever possible indoors and in complete silence. Listening is carried out directly by the ear or by means of special instruments.

With direct listening, the ear is applied to the body of the animal covered with a sheet, and safety precautions must be strictly observed. Thus, it is possible to auscultate large animals in a standing position. Listening to small and large recumbent animals is quite difficult.

Mediocre auscultation is carried out using stethoscopes, phonendoscopes or stethophonendoscopes. These instruments create a closed speaker system that makes sounds appear louder and more distinct. Listening begins from the center of the projection of the organ on the surface of the body (during auscultation of the lung - in the middle of the percussion triangle behind the scapula, the heart - in the place of the greatest severity of the cardiac impulse), and then sequentially assess the sounds in other areas.

thermometry [gr. thermos - warm + metreo - measure] - a method based on measuring the body temperature of an animal. Thermometry is mandatory when examining sick or suspicious animals. Carried out with thermometers various designs(mercury, electric, registering infrared radiation of the body).

In veterinary practice, they mainly use the maximum veterinary mercury thermometer with a division scale from 34 to 44 ° C (medical one has a division scale up to 42 ° C). They measure the body temperature of 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 veterinary practice, the following are most often used:

Endoscopy is a method of visual examination of abdominal and tubular organs devices with optics and electric lighting. The method finds more and more wide application for animal research, especially after the advent of fiber-optic flexible endoscopes.

Probing is a method of examining channels and cavities with special rubber or other (plastic, PVC) tubes called probes. They are administered to animals through oral cavity or nasal passages. Probes also examine wound channels, fistulas, abscess cavities, etc. Probing allows you to establish the patency of the body, the presence of foreign bodies, as well as to get the contents, such as the stomach. In some cases, probes are used with therapeutic purpose– for extracting metal foreign objects from a grid and a scar in a large cattle, restoring the patency of the esophagus, gastric lavage.

Catheterization is carried out with special flexible or rigid tubes - catheters made of various materials. So, when examining the organs of urination by catheterization, patency is established urethra, get urine, wash bladder etc.

Graphical methods involve obtaining a document, it can be a graph, photograph, radiograph, etc. Rhinography (recording the stream of exhaled air) and pneumography (recording of respiratory movements chest) allow you to determine the frequency of respiratory movements in an animal, their strength, rhythm, which is important for recognizing 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 diagnosing arrhythmias. With the help of electrocardiography (recording of biopotentials of the heart), the functional state of the heart is assessed and almost all types of cardiac arrhythmias are recognized. With phonocardiography, sound phenomena are recorded in a beating heart. These and some other graphic methods, their diagnostic significance, are discussed in more detail in the sections devoted to the study of individual systems and organs.

X-ray methods based on the use electromagnetic oscillations a certain wavelength - x-rays. Depending on the receiver used for these rays, a distinction is made between fluoroscopy (obtaining a shadow image of a body area on a fluoroscopic screen) and radiography (an x-ray image on a special photographic film, which, after development, is called a radiograph). There are also types of radiography - fluorography, electroroentgenography, X-ray photometry, etc.

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

It should be borne in mind that the list of special methods for studying animals is constantly expanding with the development of science and technology. Veterinarians have successfully used clinical practice echography (obtaining an image of organs and tissues by means of ultrasonic waves), biotelemetry (registration of information at a distance from the object of study), radioisotope research(study of the function and structure of organs with the help of radioactive substances introduced into the body) and many other methods.

Laboratory methods involve the study of blood, urine, feces, expiration, punctures, secrets. A general clinical blood test consists of determining the erythrocyte sedimentation rate, hemoglobin concentration, counting the number of erythrocytes, leukocytes and platelets, removing the leukogram and calculating color index. Biochemical research blood includes the determination of indicators characterizing protein, carbohydrate, lipid, mineral, vitamin and other types of metabolism. Laboratory analysis urine, faeces, effusions, etc. carried out in the following areas: the study of the physical properties of the material (quantity, color, consistency, smell, impurities, relative density and etc.); chemical research to determine the presence of certain substances; microscopic examination.

Functional methods are used to assess the function of the body systems as a whole or its individual organs. They are usually used when the animal shows a decrease in productivity or performance, and clinical and laboratory studies fail to detect any major changes. In addition, knowledge of the functional capacity of the system is necessary to formulate the prognosis of the disease. In veterinary medicine, the most developed methods functional research cardiovascular, respiratory, digestive, nervous systems, urinary organs (kidneys), endocrine organs and hematopoietic organs.

The purpose of the lesson. To master the general methods of studying animals: examination, palpation, percussion, auscultation; master the technique of thermometry; familiarize yourself with special research methods.

Research objects and equipment. Horses, cows, dogs.

Percussion hammers, plessimeters, phonendoscopes, stethoscopes, sheets or towels for auscultation, thermometers.

Common methods of clinical examination include inspection, palpation, percussion, auscultation, and thermometry. Mastering these research methods is one of the main conditions that allow a specialist to identify pathology. In most cases, to clarify the diagnosis, along with general methods, it is additionally necessary to apply special methods research: instrumental and laboratory methods.

Inspection (from lat. inspection- examination, verification). This is the simplest and available method animal research. Inspection is preferably carried out in natural light (daylight) or in good artificial light. Inspection can be performed with the naked eye or with the use of special instruments. The animal is first subjected to a general and then a local examination. General inspection. Involves examination of the entire body of the animal, regardless of possible localization painful process. At the same time, it is possible to draw conclusions about the position of the body in space, fatness, physique, the condition of the skin and hair, superficially located lesions, discharge from natural openings, the condition of the eyes, identify excitation, depression or other signs characteristic of violations of the functions of organs and systems of the body.

Local inspection. This is an examination of the injuries or parts of the body found during a general examination of the animal, where the disease process is mainly localized.

Local examination can be divided into external, when the outer integuments of the animal's body are examined, and internal, when areas located not on the surface of the body, but in depth, such as the cavity of the larynx, pharynx, etc., are subject to examination.

In the study, various instruments can be used, including those equipped with light sources. With the use of instruments, the following can be examined: oral and nasal cavities, pharynx, larynx, vagina, rectum, bladder, etc.

Palpation (from lat. .palpatio- feeling). The method in which groping is applied, i.e. based on the sense of touch. The method of palpation allows you to determine the physical condition of the organs and tissues of the body.

Palpation is carried out with fingertips (pads), without causing pain to the animal. In some cases, palpation can be performed with a fist, hand, back of the hand.

Palpation is divided into superficial and deep.

Superficial palpation is performed by placing a palm or fingertips on the study site, by gently pressing and sliding over the area under study. This method allows you to explore the skin, subcutaneous tissue, lymph nodes, superficial vessels, tendons, muscles, joints, etc. Palpation can determine local temperature, soreness, configuration and size of the formation, consistency, nature of the surface, etc.

Palpation should always begin with a healthy area of ​​the body, gradually moving to the affected area. The movements of the fingers or palms should be smooth, soft, not causing additional pain to the animal.

Deep palpation is a method by which deeply located organs and foci are examined. To varieties deep palpation include: penetrating; bimanual; jerky (balloting).

When conducting penetrating palpation fist or vertically placed fingers carry out a gradual, but strong pressure through the abdominal wall, reaching the organ under study and determining its physical condition. In this way, the scar, abomasum is examined.

Bimanual palpation(palpation with two hands) is performed on the stomach of small animals. The method consists in simultaneous, gradual pressure with both hands on both sides of the abdominal wall. Research is carried out while standing behind the animal. Bimanual palpation is also used in the study of the pharynx, especially in large animals.

If you suspect the presence of fluid, neoplasms or an enlarged organ in the abdominal cavity, apply jerky (balloting) palpation. With jerky palpation, studies are carried out with jerky movements of the fingers or fist. The palpation technique is as follows: they bring the fingers or fist to the wall of the abdominal cavity and perform a push, while at the end of the push the hand is not taken away from the abdominal wall (this is especially important if ascites is suspected), in the presence of a neoplasm or an enlarged organ, the hand immediately encounters this organ or neoplasm, and in the presence of fluid, a push through the abdominal wall is not felt immediately, but after some time (the return of the fluid that recoiled during the push).

Deep internal palpation allows diagnosing the state of organs located in cavities far from the surface of the body (pharynx, organs of the pelvic and abdominal cavities).

The study of the organs of the pelvic and abdominal cavities through the wall of the rectum is called rectal examination. In large animals, rectal examination is carried out with a hand inserted into the rectum, while in small animals it is possible to examine in best case organs of the pelvic cavity, as it is performed with a finger.

Percussion (from lat. percussio- tapping). The method is based on the ability of each tissue or organ to give a characteristic sound during percussion. Depending on the physical condition organ, this sound can change, and by the nature of the changed sound, one or another state of the organs and tissues of the body is judged.

Percussion is best done indoors, so as not to interfere with extraneous noise. Distinguish between direct and mediocre percussion.

Direct percussion consists in the fact that blows to the place of study are applied directly with a finger or hammer. The maxillary and frontal sinuses are subjected to direct percussion. In other areas of the body, direct percussion is ineffective, since the conditions for the appearance of sounds are negligible.

Direct percussion, carried out with a finger, is called digital, and performed with the help of a percussion hammer - instrumental.

With mediocre percussion, blows to the place of examination are not applied directly to the skin, but through a finger (digital) or a plessimeter (instrumental).

According to the method of striking, topographic and research percussion are distinguished. When, after a blow, a finger or a hammer is slightly delayed on a finger or a plessimeter, this method is called topographic and is used to determine the boundaries of an organ or pathological focus. Jerky percussion, without delay of the hammer or finger, is called staccato and is used to study an organ or focus.

Digital percussion is of particular value in the study of small animals (dogs, cats, small cattle, rabbits, birds, calves, foals, piglets, lean adult pigs). In the study of large animals, digital percussion is not very informative, but can be used in the absence of instruments (plessimeter and hammer).

Digital percussion is carried out by pressing the middle finger of one hand to the place of study and applying short paired blows perpendicular to it with the middle finger of the other hand.

With instrumental percussion, instruments are used - a plessimeter and a percussion hammer. They can be different in shape, mass and performance (Fig. 1.12).

Rice. 1.12. Animal percussion instruments different types: a- percussion hammers; b- plessimeters

The hammer is taken large and index fingers, and the handle with the remaining fingers is pressed to the palm of your hand. The arm is bent at the wrist joint.

Plessimeters with a narrow working platform are most convenient to use, and the size of the malleus depends on the size of the animal. For the study of large animals, large hammers are preferable, for small animals - small ones.

When carrying out instrumental percussion, the plessimeter is pressed tightly against the skin at the place of study (for example, if it is the chest wall, then strictly in the intercostal spaces) and paired blows are applied to it with a percussion hammer with a small gap and always of the same strength. The blows must be directed perpendicular to the plessimeter. The plessimeter during percussion should be moved one step. In the study of small animals or animals of unsatisfactory fatness, the blows should be weaker. Percussion of the same strength is used when determining the boundaries of an organ or a pathological focus. However, it must be remembered that the percussion method can be used to examine the animal's organs to a depth of up to 7 cm from the body surface, i.e. more deeply located organs and their parts, as well as lesions are inaccessible to percussion examination.

When conducting percussion, it is necessary to observe following conditions: silence, the ear of the researcher (doctor) should be at the same level with the place of percussion, the force of impact and pressure of the plessimeter throughout the percussion should be the same, it is recommended to place the animal at a distance of no closer than 1 m from the wall to avoid resonating the sound.

Percussion determines the boundaries of the organ and focus, which makes it possible to establish their size, as well as to identify changes in the physical properties of organs.

Auscultation (from lat. auscultatio- listening). With the help of auscultation, you can listen to sounds that occur in the organs and cavities of the body of the animal.

Distinguish between direct auscultation, when one or another organ is heard with the ear without instruments, and mediocre, when the organ is used with instruments (phonendoscope, stethoscope, stethophonendoscope) (Fig. 1.13).

Rice. 1.13.

• 1 - pelota; 2 - head of a phonendoscope; 3 - pilot holder;
• 4 - flexible sound duct; 5 - headband; 6 - membrane; 7 - horn of a stethoscope; # - phonendoscope head cover

Direct auscultation is performed as follows: the ear is applied through a sheet or towel (hygienic accessory) to the surface of the animal's body in accordance with the topography of the organs that need to be heard. The advantage of the method is that it can be performed under any conditions; the sounds emitted by the organs are not distorted; allows you to pick up sounds from a relatively large surface of the body (although this possibility is in some cases a disadvantage, since it makes it difficult to accurately determine the source of the sound).

Direct auscultation has found wide application in veterinary practice, especially in the study of large and calm animals.

Mediocre auscultation is carried out using stethoscopes, phonendoscopes, stethophonendoscopes. It allows you to listen to sounds from a more limited area than with direct auscultation. Stethoscopes are used to listen to individual components - heart sounds (for example, with defects), etc.

The narrow end of the cone-shaped extension is applied to the place of study, and the ear is applied to the wide end, the hand is taken away from the stethoscope.

If auscultation is carried out with a phonendoscope with a membrane, then it is necessary to press it tightly against the body of the animal in order to exclude friction of the membrane against the animal's hairline, which can introduce extraneous noise into the main ones coming from the organ under study. This should be especially remembered when examining the valvular apparatus of the heart.

Thermometry. This is a mandatory method of animal research, which is performed when an animal is received, regardless of the goals of the research.

Thermometry - very important method clinical research, since most diseases, especially infectious diseases, initially manifested precisely by a change in body temperature.

To measure body temperature, you can use different thermometers (mercury, electronic). Each thermometer must be checked before use for correct readings. To do this, the tested thermometer is lowered into a vessel with water with a tested control thermometer, after 10 minutes they are removed and the readings of the tested and control thermometers are compared. A thermometer with incorrect readings is discarded.

The internal body temperature of the animal is measured in the rectal cavity. Before inserting the thermometer, the readings are checked, disinfected, lubricated with petroleum jelly or vaseline oil. The animal is preliminarily fixed, the tail is lifted and the thermometer is inserted into the rectum with rotational movements, giving it an inclined position so that the tip of the thermometer comes into contact with the mucous membrane, after which it is fixed to the tail with a tail bag, clamp or ribbons.

To measure body temperature in birds, a special “bird thermometer” is used, in which the temperature reading scale is designed for digital values ​​greater than in animals.

Body temperature should be measured as initial appointment animal, and at all subsequent examinations.

In cases where it is not possible to examine the body temperature in the rectum, the thermometer is inserted into the vagina, remembering that the temperature in the vagina is 0.3-0.5 ° C higher than the rectal temperature.

Special research methods. Special methods include: studies conducted in laboratories (laboratory) and performed using special tools and equipment (instrumental). Laboratory research exposed to body fluids and tissues. Among instrumental research most commonly performed electrocardiography (ECG), ultrasound procedure heart (EchoCG), x-ray diagnostics, ultrasound (ultrasound), endoscopy (many types), magnetic resonance imaging (MRI), computed tomography(CT), etc.

Special methods in any necessary combination are additional methods research and allow you to clarify the diagnosis.

Special research methods are described in the relevant chapters of this workshop.

Basic (physiological) and adnexal (pathological) breath sounds. Auscultation of the lungs allows you to detect sound phenomena that occur in the lungs during breathing, evaluate their nature, strength, localization and relation to the phases of breathing. Listening in large animals can be carried out directly, but mediocre auscultation is much more convenient, using a phonendoscope, stethoscope or stethophonendoscope.

Auscultation is recommended to start from the areas where the breath sounds are best expressed, and then move on to places where breathing is less pronounced (draw a triangle with areas that are sequentially listened to). In cattle, one should also listen to the prescapular pulmonary percussion field. At each point, it is enough to listen to 3-4 respiratory movements (inhale-exhale), after which you should move the phonendoscope capsule to another place.

It is advisable to listen to the lungs in two steps. Initially, an approximate auscultation of the entire region of the lungs on the right and left is carried out. This allows you to get information about the condition of the entire lung and the presence of any abnormalities. Next, it is necessary to listen in detail to the areas where pathological sound phenomena are noted or where changes can be assumed based on the results of examination, palpation and percussion.

When auscultating the lungs, it is necessary to first determine the nature of the main (physiological) noise, and then the presence of possible adnexal (pathological) noises.

Basic (physiological) breath sounds. Above the lungs in healthy animals, two respiratory sounds are heard: vesicular and physiological bronchial. Bronchial murmur is absent on the chest in horses and camels; its presence in these animals always indicates lung pathology.

Vesicular breathing is heard over for the most part surface of the lung and it can also be called alveolar, because. occurs in lung alveoli as a result of the rapid straightening of their walls when air enters during inhalation and their decline during exhalation. At the same time, the walls of the alveoli come into tension and, oscillating, produce a sound characteristic of vesicular respiration.

Vesicular noise has the following features: 1. It is soft in nature, reminiscent of the sound when you pronounce the letter "F" and at the same time slightly draw in air. 2. It is heard throughout the entire period of inhalation and only at the beginning of exhalation. This is because inhalation is active phase breathing, in which the walls of the alveoli straighten out gradually. Exhalation is passive, the walls of the alveoli quickly subside and therefore the vesicular noise is heard only at the very beginning of exhalation.

In healthy animals, vesicular breathing on the chest is heard with unequal strength. It is most intense just behind the scapula in the middle part of the lung percussion field. In the horse, the vesicular murmur is gentle, soft, and weak. In large and small cattle it is rather rough and loud, in sheep and goats it is also heard on the shoulder blade. In dogs and cats - the most intense, sharp and close to bronchial breathing. It should also be borne in mind that the vesicular noise in young animals is louder and rougher than in adults, and even more so in older animals.

There are weakening and strengthening of vesicular respiration, which, in turn, can be physiological and pathological. Physiological weakening is a consequence of a deterioration in the conduction of sounds, for example, with above-average fatness or obesity of the animal. At the same time, breathing is weakened evenly over the entire lung surface. Physiological enhancement of vesicular respiration occurs during exercise, as well as in the presence of a thin chest wall (in young animals).

Pathological weakening of vesicular respiration occurs in diseases of both the lungs and the pleura. A pronounced uniform weakening occurs with emphysema, tk. elasticity decreases lung tissue and the alveoli are full of air. With focal (lobular) pneumonia, at the beginning lobar pneumonia part of the alveoli is turned off from breathing and breathing also weakens. The same picture is observed in the syndrome of fluid accumulation in the pleural cavity, when fluid accumulates (exudate - exudative pleurisy, transudate - dropsy, blood - hemothorax). weakening up to total absence, vesicular breathing is observed with pneumothorax (accumulation of air in the pleural cavity), with chest injuries, especially with fractures of the ribs.

Pathological increase in vesicular respiration may be due to compensatory mechanism from the side healthy lung. This happens with unilateral croupous pneumonia, exudative pleurisy, hydro- or hemothorax, i.e. on the affected side, breathing is weakened, and on the healthy side, on the contrary, it is increased.

If there is a sharp and uneven narrowing of the lumen of the small bronchi and bronchioles due to inflammatory edema of their mucous membrane (bronchitis, bronchopneumonia), then breathing is heard both on inhalation and on exhalation. It acquires a rough, hard character and is called hard breathing. Bronchial physiological breathing is a kind of laryngotracheal, audible on the chest in the bronchi. This is a coarse respiratory noise resembling the sound "X m", which is heard both on inhalation and exhalation. Bronchial physiological respiration is heard in all animals (with the exception of a horse and a camel) in the region of the shoulder girdle up to 3-4 intercostal spaces, and in dogs - throughout the chest.

Adnexal (pathological) breath sounds. Adnexal (pathological) noises include sounds that are formed in excess of the main respiratory noises in the lungs. There are bronchopulmonary accessory noises that form in the lungs - wheezing, crepitation, crepitating wheezing, pathological bronchial breathing and extrapulmonary (pleural) noises that form outside the lungs - these are friction and splash noises.

Bronchopulmonary adnexal breath sounds. Adnexal (pathological) bronchopulmonary murmurs include, first of all, wheezing. These are additional breath sounds that occur in the airways of the lungs in pathology. They are formed in the following cases: 1) the presence of liquid contents in the bronchi, alveoli or pathological cavities; 2) violation of bronchial patency (bronchospasm, swelling of the mucous membrane); 3) damage to the walls of the alveoli, or bronchioles.

According to the mechanism of formation and sound perception, wheezing is divided into dry and wet.

Dry rales are formed only in the bronchi. They occur when the lumen of the bronchi narrows or when there is a viscous secret in them, located in the form of threads, films and jumpers. Air, passing through these areas, forms eddies, cycles, etc. what is perceived as whistling, buzzing, buzzing, etc.

Dry rales are divided into low and high. Low ones are buzzing and buzzing, they are formed in large and medium bronchi. High - it's luminous, occur in the small bronchi and bronchioles. Dry rales are heard in both phases of breathing - on inspiration and on expiration, after physical activity they get louder.

Moist rales occur when fluid accumulates in the airways (exudate, transudate, bronchial secretion, blood). They are caused by the formation of rapidly bursting air bubbles when air passes through liquid secret. The sound accompanying the rupture of air bubbles on the surface of the liquid is heard during auscultation as wheezing. Wet rales are heard mainly on inspiration, because. speed during inhalation air flow the highest.

The size of the resulting air bubbles depends on the diameter (caliber) of the bronchi or the size of the pathological cavity in which wheezing is formed. If wet rales occur in the alveoli, bronchioles and the smallest bronchi, then they resemble the sound of bursting bubbles in a glass of carbonated water and are called fine bubbling. These rales are heard with bronchopneumonia, soaking lung blood(lung infarction), at the beginning of pulmonary edema (phase of auscultatory manifestations).

With the formation of moist rales in the bronchi of medium caliber or small cavities, they are perceived as the sound of air bubbles blown through the liquid through a thin straw. Such wheezes are called medium bubbling. They are detected in pneumonia with multiple small abscesses, pulmonary edema.

If rales are formed in the large bronchi, in the pulmonary caverns, which contain effusion fluids, then loud and prolonged sounds are heard, which are called large bubbling rales. They are detected most often with pulmonary hemorrhage, macrobronchitis.

The nature of both dry and wet rales can change under the influence of coughing, during the development of the pathological process. So, for example, with bronchitis, dry, wet, then again dry can be heard alternately.

Crepitus - the sound formed in the alveoli during inflammation, similar to a crackle or crunch. Listen for crepitus more often inflammation of the lung, as a result of which the walls of the alveoli are compacted and covered from the inside with a layer of sticky exudate. In this case, on exhalation, the alveoli collapse and stick together. On inspiration (at its height), the walls of the alveoli are sticking and are accompanied by the formation of a peculiar sound resembling a crack.

Crepitant rales resemble a crunch, crackle. They are sharp, rough and appear with emphysema. In this case, damage to the walls of the alveoli and bronchioles occurs, air penetrates into the interstitial tissue and the resulting air bubbles, when exhaled, move towards the root of the lung, destroying the lung tissue. The presence of crepitant wheezing is a sign of severe damage to the lung tissue.

In the differential diagnostic assessment of moist and crepitant rales, as well as crepitus, the following features should be taken into account: 1) moist rales are heard in both phases of breathing; 2) moist rales after coughing weaken or even disappear; 3) crepitant rales are heard during exhalation, do not change after coughing; 4) crepitus appears on inspiration.

Bronchial pathological breathing is bronchial breathing heard on the chest in animals behind (caudal) 3-4 intercostal spaces, and in horses on the entire chest. The cause of this noise is the compaction of the lung tissue with simultaneously free bronchi. It is noted in emphysema, in initial stage infiltration of the lung parenchyma, with narrowing of the lumen of the bronchi.

Amphoric respiratory noise is detected in the presence of cavities or cavities in the lungs (at least 5-6 cm in diameter) with smooth, even walls, which communicates with a large bronchus. According to the laws of resonance, this cavity amplifies sound phenomena, and its compacted walls conduct noise well, which resembles a puff of air over a vessel with a narrow neck, such as a bottle. Such noise occurs with tuberculosis, lung gangrene, extensive bronchiectasis. Extrapulmonary (pleural) breath sounds. Pleural friction noise is a sound that forms between the sheets of a pathologically altered pleura: with dry pleurisy, sharp dryness of the pleural sheets due to the rapid loss of a large amount of fluid by the body (diarrheal syndrome, exsicosis syndrome, dyspeptic neonatal syndrome, with massive blood loss). This noise is reminiscent of the creaking of skin or the creaking of freshly fallen snow in frosty weather. Pleural friction rub should be differentiated from crepitus and moist, finely bubbling rales. The main differences are as follows: the pleural friction noise is heard both on inspiration and on expiration; is heard directly under the capsule with a phonendoscope, i.e. superficial; aggravated by pressure with a phonendoscope; does not change when the patient coughs; often accompanied by severe pain and, as a consequence, saccaded breathing. Splashing noise occurs if there is fluid and some gas in the pleural cavity. It is noted with purulent-putrefactive pleurisy. The noise of a pulmonary fistula occurs when cavities form in the lung, which open into the pleural cavity below the level of fluid accumulated there. This noise resembles a gurgling or gurgling during the inhalation phase, it is rare in pulmonary gangrene in horses, with rampant pneumonia in cattle.

Respiratory diseases are widespread among animals, especially young animals. In their study, first of all, the respiratory rate is set in 1 min, type, rhythm and symmetry, the presence or absence of shortness of breath and cough. AT calm state in adult animals, the respiratory rate in 1 min is: in cattle 12 - 30, in a horse 8 - 16, in a sheep and goat 16 - 30, in a pig 15 - 20, in a dog 14 - 24, in a cat 20-30.

Increased breathing is observed in many diseases accompanied by impaired gas exchange (edema, inflammation and emphysema of the lungs, rhinitis and bronchitis, anemia, cardiovascular insufficiency and etc.).

In most animals (with the exception of dogs), the chest and abdominal wall participate equally in respiratory movements(chest breathing). Shortness of breath is a frequent manifestation of respiratory rhythm disorder. Distinguish between inspiratory, expiratory and mixed dyspnea.

When examining the upper respiratory tract, the nature of nasal effusions is established, nasal cavity and adnexal cavities of the nose, larynx and trachea. In clinical practice, examination and palpation of the chest, percussion and auscultation of the lungs are usually performed. An important indicator pathological condition respiratory system is a cough. In the presence of a cough, its nature, frequency, strength, duration, and soreness are determined. Chronic bronchitis often accompanied by seizures painful cough lasting several minutes. Palpation of the chest checks the integrity of the ribs, the degree of soreness of the chest and the localization of the pain focus.

In the study of the lungs, comparative percussion is used. Topographic percussion is performed to determine the posterior borders of the lungs.

Auscultation of the lungs allows you to compare the nature of respiratory sounds (wheezing, splashing, friction noise, etc.) Wheezing different nature appear with bronchitis, bronchopneumonia, hyperemia and pulmonary edema. Noises occur during inflammation of the pleura with fibrin deposits on it, the formation of connective tissue scars, adhesive processes.

The treatment of an animal should not cause him concern. Excitable animals should be accustomed to their presence for some time, since their excitement, especially carnivores, piglets, sheep, leads to an increase in heart rate, respiratory rate, etc., which does not allow obtaining objective clinical and physiological data. Contact with an animal should be built in accordance with the characteristics of its state of health and disposition.

When calm, affectionate treatment of an animal does not provide necessary conditions for full-fledged medical work, use coercive measures of taming.

Common methods for clinical examination of animals include: inspection, palpation, percussion, auscultation, and thermometry.

Inspection- the simplest and most accessible research method. It is carried out in good daylight or using artificial sources. For a more thorough local inspection, headlamps, magnifiers, and reflectors are used. However, under artificial lighting, it is more difficult to recognize the intensity and nature of the discoloration of unpigmented skin and mucous membranes.

General examination begins with the head, then inspect successively the neck, chest, spinal column, abdomen, limbs left and right, front and back, paying attention to general state, fatness, development and correctness of physique, integrity and symmetry of individual parts of the body. During a local examination, the nature, intensity, prevalence, stage of development and other features of possible pathological changes on the body of the animal are studied.

Palpation is based on the use of the sense of touch and stereometric sensation when touching individual areas of the body. Gives an idea of ​​the size, shape, consistency, temperature, sensitivity, mobility, homogeneity, elasticity and some functional manifestations(frequency and quality of pulse, respiration, rumenation, etc.).

Superficial palpation carried out with one or both hands without significant pressure on the tissue. Allows you to recognize minor pathological changes in the surface of the body, neoplasms on the skin, violations of integrity, changes in moisture, greasiness of the skin and hairline; strength and prevalence of cardiac impulse, chest movement; temperature, skin sensitivity.

It is used in the study of the main vessels (arteries and veins), the abdomen in small animals; joints, bones and ligaments.

deep palpation used to study the localization, size and shape of internal changes.

It is carried out with one or more fingers, depending on the elasticity of the tissues and their sensitivity to pressure, using the methods of sliding, penetrating, bimanual and balloting palpation.

sliding palpation used in the study of abdominal organs in small animals.

The fingertips are gradually advanced deep into the abdomen, successively palpating the adjacent tissues.

At penetrating palpation vertically to the surface of the body with fingers or a fist, gradual and strong pressure is applied in a limited area. This method, in particular, determines the filling of the scar and the consistency of its contents, soreness in the mesh area in cattle. During bimanual palpation, the area under study is held with one hand, and the pharynx, esophagus, pregnant uterus in small animals, kidneys, intestines, liver, etc. are palpated with the other.

Balloting (jerky) palpation carried out with fingers pressed to each other, as well as with a half-closed or clenched fist. Jerky movements explore the spleen, liver; they are used in the diagnosis of deep pregnancy, ascites, massive tumors and other neoplasms (echinococcosis). Internal palpation is carried out in large animals and consists in a manual examination of the cheeks, gums, teeth, palate, pharynx, larynx, tongue with a hand inserted into the open oral cavity of the fixed animal.

Percussion (percussio - tapping) allows you to determine physical properties and the boundaries of the internal tissues, organs and cavities of the body projected onto the surface of the body in terms of amplitude, frequency and duration of sound. The acoustic properties of percussion sounds in normal and pathological conditions depend on the massiveness, elasticity, tissue tension, the amount of gas in the cavities, on the method and force of percussion, the distance of the substance under study from the body surface, skin thickness and subcutaneous tissue, density of hairline, fatness, age, live weight of animals, as well as on the intensity, stage of development, physical form, the focus of the pathological process.

The results of percussion are evaluated by the strength, pitch, duration, and nuances of the sound (tympanic, atympanic, boxy, metallic, cracked pot sound, etc.).

The study is carried out by direct and mediocre percussion. With direct percussion, tapping is carried out with the tips of one or two (index, middle) fingers bent in the second phalanx. Jerky blows are applied to the surface of the skin of the area under study, bending and unbending the carpal joint. Direct percussion is used in the study of the frontal, maxillary sinuses, air sac in horses, as well as in the study of small animals, especially with low fatness. With mediocre percussion, percussion is applied not to the skin, but to the index or middle finger of the other hand (digital percussion) or a percussion hammer weighing from 60 to 250 g according to the plessimeter (instrumental percussion).

When examining organs and parts of the body that are dense and homogeneous from a physical (acoustic) point of view (heart, liver, muscles), topographic percussion is of practical interest, and when examining physically heterogeneous tissues (lungs), it is important diagnostic value acquires also qualitative (comparative) percussion. When pathological changes in tissues are detected, staccato percussion- jerky, short, relatively strong hammer blows on the plessimeter, and when determining topographic boundaries - leggato- slow blows but to the pessimeter with a delay of the percussion hammer on it.

Rice. 1. Graphic representation of percussion sound:
1 - loud; 2 - quiet; 3 - long; 4 - short; 5 - high; 6 - low.

With deep percussion, tissues are involved in the acoustic process to a depth of up to 7 cm and a radius of up to 4-6 cm, and with superficial percussion - to a depth of up to 4 cm in a radius of 2-3 cm. When determining the boundaries of organs (for example, absolute and relative dullness of the heart) use " threshold percussion”, acoustic phenomena in which occur at the “boundary of auditory perception” (a person perceives sounds in the frequency range from 16 to 20,000 Hz). Percussion sounds qualitatively differ in loudness (strength), pitch, duration and timbre (Fig. 1).

Auscultation (auscultatio) is based on the auditory perception of sounds and noises arising in the body.

According to the place of occurrence, intensity, prevalence, time, the nature of the manifestation of sounds and noises and their acoustic properties, anatomical and morphological and functional state individual bodies and systems. The perception of internal sounds can be carried out by the ear through a napkin applied to the surface of the body (direct auscultation), or mediated through stethoscopes, phonendoscopes and stethophonendoscopes of various designs.

The positive side of direct auscultation is that the sounds perceived by the ear are almost not distorted during transmission. However, it is not always applicable, especially in the study of small animals, as well as topical diagnostics. Rigid and flexible stethoscopes are made. A solid stethoscope is a tube with a double-edged funnel-shaped extension of different diameters: the narrow part of the stethoscope is applied to the surface of the body of the animal under study, and the wider part - to the ear of the researcher. To obtain objective data during stethoscopy, it is necessary that the cavity of the stethoscope between the ear of the researcher and the skin of the animal form closed space. A flexible stethoscope is usually made in combination with a phonendoscope.

Phonendoscope - one of the most common and sensitive devices for auscultation.

The use of a pelota makes it possible to capture sound phenomena that occur in a small area, which is especially important in topical diagnostics, including the differentiation of heart defects. The frequency response of sound phenomena is affected by the degree of pressure of the head of the phonendoscope to the surface of the body. The stronger the head is pressed, the clearer the high-frequency components stand out. At the same time, the thicker the membrane, the weaker the “low-frequency” components are reproduced and the higher frequencies stand out more strongly. Thus, the black membrane of the M-031 phonendoscope, having a thickness of 0.5 mm, provides the greatest suppression of low-frequency components, and the transparent membrane 0.12 mm thick is designed for operation without a pilot and makes it possible to perceive the studied sounds with maximum intensity. You can also listen to sound phenomena using amplifying devices - audiometers (Fig. 2).

Rice. 2. Clinical audiometer AK-02.

Thermometry (thermometria) in animals- obligatory method of clinical research.

Changes in body temperature are often noted even before the appearance of other signs of the disease, and the dynamics of temperature in the course of the disease objectively characterizes the trends in its development and the effectiveness of treatment.

Body temperature in animals is usually measured rectally. mercury or electronic thermometers. Before inserting the thermometer into the rectum, it is shaken, disinfected, lubricated with petroleum jelly and fixed. The thermometry lasts at least 5 minutes, after which the thermometer is removed, wiped with a cotton swab and the result is read. Clean mercury thermometers are stored in a bottle with disinfectant. Digital Thermometer treated with antiseptics before use and after thermometry.

If rectal thermometry is not possible, vaginal temperature is measured. Normally, it is 0.3-0.5 ° C lower than the rectal one.

It should be noted that the skin temperature in animals is significantly lower than the rectal one and is not the same in different parts of the body (Fig. 3). This should be taken into account in studies requiring maximum accuracy.

Rice. 3. Pig skin temperature in various parts of the body.

In addition to general methods, many other special methods are used in the study of animals - electrocardiography, oscillography, gastroenterography, pneumography, x-ray methods, functional tests etc.