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Semey state medical university Discipline: Propaedeutics of internal diseases Chair of Propaedeutics of internal Semey state medical university Discipline: Propaedeutics of internal diseases Chair of Propaedeutics of internal diseases SIW Laboratory and instrumental investigation of musculoskeletal system diseases. L/O/G/O Prapared by: Oralkan Aset Chacked by: Balashkevich N. A. Semey 2013

Plan of my work Introduction Questioning Physical methods of investigation Laboratory and instrumental investigation Plan of my work Introduction Questioning Physical methods of investigation Laboratory and instrumental investigation Concludion List of literature

Introduction • Musculoskeletal system diseases very are spread worldwide and take important part in Introduction • Musculoskeletal system diseases very are spread worldwide and take important part in diagnostic, treatment and prevention of it. Because most of this diseases cause seriously problems and even invalidism , if not be founded and treated when disease is start. Methods of diagnostic are very different and effective, about of which we’ll discuss….

Questionin g Methods Physical methods of investigation Laborator y and instrumen tal investigati on Questionin g Methods Physical methods of investigation Laborator y and instrumen tal investigati on

Questioning complaints if the patient complained of pain and difficulty in movement joints, you Questioning complaints if the patient complained of pain and difficulty in movement joints, you need to thoroughly clarify the features of pain (location, intensity, duration and effect of the load, and other factors which may provoke pain, etc. ).

 • Anamnesis of disease It should figure out how to start and later • Anamnesis of disease It should figure out how to start and later proceeded disease, find out the factors that served as the impetus for the development of joint disease and systemic lesions

Physical methods of investigation • Inspection • Important to study the characteristics of the Physical methods of investigation • Inspection • Important to study the characteristics of the patient gait, which in some cases provides very valuable information for the diagnosis. Paralytic gait (with hemiplegia) shows that the patient drags the paralyzed leg. Paretic gait is characterized by difficulty in movement of the patient due to the "sticking" of his feet to the floor. It occurs at contracture limb paresis spinal origin. A unilateral lesion of the joints of the lower limb is accompanied by sparing her when walking (due to pain), claudication.

 • Palpation • When the feeling of the joints can identify local heat, • Palpation • When the feeling of the joints can identify local heat, and swelling of the skin around them ( in acute diseases ), their pain, deformity. Carefully holding palpation, can accurately determine whether a limited or joint disease and captures the soft tissue around it, and in some cases eliminate rough joint disease , despite the presence of pain on palpation of the respective dvizheniyah. Pri also examined various passive mobility of the joints : it may limit be the result of joint pain ( arthritis , arthrosis ) and ankylosis (ie, stiffness of joints , from the Greek. ankylos - curve , curved).

Producing passive movements alternately in all joints and muscles feeling , you can fairly Producing passive movements alternately in all joints and muscles feeling , you can fairly accurately determine the status of their tone Hypotonia is most often occurs in lesions of peripheral nerves, muscle during prolonged immobility. Muscle hypertension is caused by lesions of the pyramidal and extrapyramidal systems: the muscles become tight , passive movements are carried out with difficulty , with the sharper and faster motion is made , the more resistance there is to it.

With increasing speed and tone of the plastic power of passive motion does not With increasing speed and tone of the plastic power of passive motion does not affect the power of resistance of the muscles, the muscle may remain in any state of tension, keeping its hypertonicity, most often this condition is not observed in diseases of the muscles themselves, and with the defeat of think tanks - pale nucleus and substantia nigra. Muscle strength is determined in two ways. The first time a patient is actively resisting the efforts of a doctor to bend or straighten his limb ("static force"), with the second method, the patient makes an attempt to make any movement and overcomes the hands of exploring ("dynamic force").

Laboratory and instrumental investigation Biopsy X-ray examination Laboratory diagnostic Dynamometry Laboratory and instrumental investigation Biopsy X-ray examination Laboratory diagnostic Dynamometry

Biopsy • A biopsy is of great importance in the diagnosis of rheumatic diseases. Biopsy • A biopsy is of great importance in the diagnosis of rheumatic diseases. A biopsy is indicated for suspected tumor nature of diseases, myopathies system, to determine the nature of muscle, especially when kolleganov diseases.

X-ray examination • X-ray examination can detect calcifications in the soft tissues that appear X-ray examination • X-ray examination can detect calcifications in the soft tissues that appear in particular systemic scleroderma, but the most valuable data it provides for the diagnosis of lesions of bone and articular apparatus. Tend to produce X-rays of bones and joints. Suitable as the method of image registration xeroradiography with no X-ray film, and paper (with a special apparatus). In addition, for comparison and identification of pathological changes necessarily produce X-rays of the bones and joints symmetrical in at least two projections.

Laboratory diagnostic • Laboratory diagnosis of systemic connective tissue lesions focused mainly on the Laboratory diagnostic • Laboratory diagnosis of systemic connective tissue lesions focused mainly on the determination of the activity in her inflammatory and destructive processes. Active pathological process in these systemic diseases leading to changes in the content and quality of blood serum proteins.

Dynamometry • Dynamometry - a method to objectively measure muscle strength. The most common Dynamometry • Dynamometry - a method to objectively measure muscle strength. The most common metering device for this purpose is the dynamometer. It looks like a steel spring, the center of which there are measurement scale and the arrow moves when the compression dynamometer hand. There is also a so-called postural dynamometer, which allows to measure the strength of the muscles - the extensor trunk (it is an essential part of the spring working on a stretching).

Concludion Thus, instrumental and laboratory investigation of musculoskeletal system diseases are main remedy to Concludion Thus, instrumental and laboratory investigation of musculoskeletal system diseases are main remedy to determine diagnosis and to treatment correctly. List of literature Propaedeutics of internal diseases by Mukhin N. A. , Moiseev V. S. Pages of internet, especially Wikipedia

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