Ivano-Frankivsk National

Medical University
Cafedra of Propedutics of
Internal Medicine
The Chairman Professor
VasylYevgenovych Neiko

Lecture
Propedeutics of internal medicine the
introduction to internal diseases
The main methods of the patients
examination
Anamnestic part of the patients history of
disease
Inspection of the patient and its role in
diagnosis

Internal medicine (morbi interni)

- the branch of clinical medicine about
ethiology, pathogenesis and the clinical
signs of internal organs diseases, that
works out the methods of their
diagnostic, medical treatment and
prophylaxis

Propedeutic of internal medicine

from the Greek propaideuo teaching previously
the beginning course, the basic
knowledge for the next study of
clinical discipline Internal
medicine

The main aim of discipline

Propedeutic of internal medicine
- to teach the students the methods of
examination, that help to recognize (to
diagnose) the symptoms and syndromes of
diseases of internal organs

Nursing the patients (hypurgia)

- the aggregation of actions to
provide a successfull treatment and
relief of the patents suffering

Scheme of the patients questioning

(interrogatio)
PASSPORT DATA
(prefatio)

COMPLAINTS of the
patient (mollestia
aegroti)
ANAMNESIS of
DISEASE (anamnesis
morbi)

ANAMNESIS OF
LIFE (anamnesis
vitae)

Name, fathers name, surname, sex, age,

acomodation, place of job, occupation,
post, date of admission to and discharge
from the hospital
The main complaints
The additional
complaints
The onset of disease. The possible
reasons.Development of
disease.Results of previous
examinations.Reasons of
hospitalisation

Heredity. Diseases in the past.

Occupation. Harmful habits. Allergic
anamnesis. Hepatitis. Tuberculosis.

The objective examination of the

patient (status praesens objectivus)

The genaral
examination
(inspectio)

Examination of
the different
parts of the body

Examination of
the systems of
organs

The general condition, consciousness,

position of the patient, posture,walk,skin
and visible mucous membrane,muscles,
bones and joints, lymph nodes

Examination of the head, face, the eyes,

lips, an oral cavity, neck, the chest,
abdomen, the limbs

Respiratory system, cardio vascular,

gastro intestinal, urinary, endocrine,
nervous, psycologic sphere

Clinical methods of investigation

Palpation
(palpatio)

The method uses touching

sensations of the doctors fingers of
one or both hands

Percussion
(percusssio)

The method of knocking of the

bodys surface to estimate
accordingly the character of the
sound the physical characteristics
of organ

Auscultation
(auscultatio)

The method of listening of the

sounds in the organs at their
functioning

Diagnosis

The short conclusion about the

character of disease after the
patients questioning and
objective examination

Initial
diagnosis

s the result of an objective

examination of the patient
(inspection, palpation,
percussion and auscultation)

Clinical
diagnosis

- after you got the results of

additional investigations
(laboratory, instrumental) and
clinical observation of the
diseases course

Final
diagnosis

- after you analysed the diseases

course and the results of medical
treatment

Disease (WHO, 1975)is a lifes disorder because

of disorder of the organisms structure and
function at the influence of external and
internal
reasons
at
mobilization
of
compensative and adaptation
mechanisms
with a general and partial decrease of
adaptability to the environment and restricted
freedom and activity of the patient
Symptoms(the signs of
disease)

SUBJECTIVE

What does the

patient feel
himself (herself)
or the complaints
of the patient

OBJECTIVE

Are detected at
examinations
(physical, laboratory,
instrumental)

The main
disease

Disease which threatened with

the patients life the most
seriously or it was the
reason of the patients death
and the doctor paid great
attention on it at medical
treatment

Concomitant
disease

Disease that at the moment

does not influence at the
general condition of the
patient and does not need an
active medical treatment

Syndromthe connected symptoms (the signs)

specific for the certain disease
A small (simple)
syndrom
The
connected
symptoms caused by
the damage of one
system or organ

A great (difficult)
syndrom
Combination
of
connected
symptoms, caused
by the damage of
several systems of
the organism

Semiotics, from the Greek semeionthe sign

science about the signs of diseases (symptoms),
the reasons of their appearance(ethyology) and
development (pathogenesis)