MEDICAL SEMEIOTICS, VETERINARY CLINICAL METHODOLOGIES AND LABORATORY DIAGNOSTICS
Learning outcomes of the course unit
Objectives of the course (preferably expressed in terms of learning outcomes and competences): The course aims at providing theoretical and practical knowledge for the clinical approach to the patient. The history, the general impression and the examination of the patient aim at investigating the clinical signs and at performing a diagnosis. The student must be able to record the history, to examinate symptoms and clinical signs and to apply collateral diagnostic tools, namely laboratory investigations (clinical pathology) and instrumental tools.
Competences on physiology, general pathology and physio-pathology are needed.
Course contents summary
Definitions: hystorical view; procedures of the physical examination: inspection, palpation, percussion, auscultation, measurements, instruments and diagnostics. Sampling of urine, liquids, gastric and rumen contents, microbiological exams.
Scheme for a physical examination. History and the approach to the client and patient. Identification of the patient.
Present status: general impression and Objective Examination. Skeleton and constitution, nutritional conditions, level of consciousness and behaviour, locomation, coat and subcutaneous tissue, mucosae, lymphnodes; temperature.
Kidney and urinary tract.
Skin, hair and nails.
Definition of semeiology; brief history on the evolution of the semeiologic technique; direct or physical semeiological processes: inspection, palpation, percussion, auscultation, measurement, thermometry, polls, catheterizations, exploratory bites. indirect or instrumental semeiological processes: urine, feces, blood, transudate, exudate, gastric and ruminal juice, microbiological tests, allergy tests and serological tests.
Semiological test scheme. History: environmental, collective, individual, remote, proximate, physiological, pathological. Signaling and identification of the subject.
Examinations (present state): skeletal development and constitution; nutritional status and muscle tone, sensory status, attitudes, and distinguishing features; skin and subcutaneous connective tissue, mucosal membranes; lymphnodes, temperature, pulse, breathing, major organ functions .
Special Semiology: examination of the body systems in the species of veterinary interest.
Examination of the digestive system
Appetite, thirst, degeneration of taste; intake of food and beverages; alterations of mastication, swallowing disorders, rumination, belching, vomiting, defecation. Examination of the oral cavity: inspection of the labial (size and appearance of salivary flow, lesions of the lips, mobility of the lower jaw); examination of the buccal vestibule and mouth (temperature, salivary secretion, smell, feel, appearance); review the language. Examination of the teeth. Examination of the pharynx and esophagus. Examination of the abdomen in horses and small animals: inspection, palpation, percussion, auscultation. Examination of the perineum. Rectal examination in horses, cattles and dogs. Rhino-esophageal intubation in the horse; gastric intubation in small animals. Examination of stomachs of cattle: inspection, palpation, percussion, auscultation of the rumen; collection and examination of rumen content; e Evidence of diaphragmatic and peritoneal pain in cattle: compression, percussion with heavy hammer, and Kalchschmidt test. Examination of the intestine in cattle; intraperitoneal exploration in cattle; exploration endoruminoreticolare in cattle; rectal examination in cattle; survey rhino-esophageal in cattle; survey in the bovine rumen. Puncture of the abdomen (paracentesis) in the horse, in cattle, in small animals. Examination of the payment of the serous cavities: physical examination, chemical, microscopic, bacteriological. Stool examination: macroscopic examination, microscopic examination, bacteriological examination and culture, blood research. Examination of the liver: physical examination, functional tests, liver biopsy. Examination of the spleen.
Examination of the respiratory system
Semeiologic examination of the upper respiratory tract: examination of the nostrils and the nasal mucosa; examination of the breasts; examination of the larynx; provocation, characters and genesis of cough; examination of the trachea. Inspection, palpation, percussion, auscultation of the chest; functional examination of the breath.
Examination of the cardiovascular system
Capillaries Arteries: inspection, palpation (arterial pulse), auscultation. Veins, swelling and increase in volume, decrease or disappearance; venous pulsations. Heart: inspection, palpation, percussion, auscultation of the heart region; outbreaks of auscultation, heart sounds and tones; extracardiac noise. Laboratory Tests of cardiovascular function: measurement of blood pressure, phonocardiographs, electrocardiography.
Examination of the blood and blood-forming organs. Blood-forming organs: lymph nodes, spleen, bone marrow and laboratory evaluation semeiologic of homeostasis.
Examination of the urinary tract
Supplement medical history. Direct physical examination: inspection, palpation, rectal examination. Functional examination: urine test chemical and physical blood tests, renal function tests.
Examination of the integumentary system. Direct physical examination: inspection, Smelling, palpation, percussion. Microscopic examination of material obtained by cutaneous scarification.
Examination of the endocrine glands
Semeiological direct and functional examination of pituitary, thyroid, parathyroid, adrenal glands and pancreas.
Examination of the neuro-muscular system
State of the sensorium, standing and gait; Postural reactions. Sensory examination. Examination of cranial and spinal reflexes. EMG and EEG investigations.
Methodological principles of decision-making procedure in veterinary medicine
Symptoms, signs and clinical data; Causes of errors in the detection of symptoms, Normality and Pathology; Measurement of symptoms, The clinical explanation; Programming the diagnosis, The minimization of errors and costs of the diagnosis, The diagnostic choice ; Medical practice and practice of clinical research.
Haematology: Blood cell count; Enzymes and substrates; Laboratory investigations for the evaluation of: liver function; Kidney and urinary tract function + urinalyses; disorders associated with cardiopathy; gastrointestinal disorders; endocrin disorders; muscular and skeleton diseases; autoimmune disorders; metabolic disorders; acid-base balance. Biological fluid examination.
Paolo Ciaramella. Semeiologia Clinica Veterinaria. Poletto Editore, 2014, Vermezzo (MI)
PALTRINIERI-BERTAZZOLO-GIORDANO: Patologia clinica del cane e del gatto. Approccio pratico alla diagnostica di laboratorio,1° ed., Elsevier-Masson, 2010
Academic lessons in classroom
Assessment methods and criteria
Oral exam based on questions and answers