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Curs Semiologie3
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AUTORII
Conf. Univ. Dr. LAURENIU COZLEA
- medic primar Cardiologie i Medicin Intern, Doctor n Medicin, Disciplina
MedicinIntern II, Facultatea de Medicin, Universitatea de Medicin i Farmacie
TrguMure, Clinica Medical III
As. Univ. Dr. IOAN ILEA
- medic primar Cardiologie i Medicin Intern, Doctor n Medicin, Disciplina
MedicinIntern II, Facultatea de Medicin, Universitatea de Medicin i Farmacie
TrguMure, Clinica Medical III
Prep. Univ. Dr. DANIEL LAURENIU COZLEA
- medic rezident Medicin Intern, Disciplina Medicin Intern III, Facultatea
deMedicin, Universitatea de Medicin i Farmacie Trgu Mure, Clinica Medical IV

CUPRINS
CAPITOLUL ISEMIOLOGIA
GENERAL ........................................................................................................................
..................... 9
1. NOIUNI
INTRODUCTIVE .................................................................................................................
.......................... 112. CONINUTUL I ETIMOLOGIA NOIUNII DE

SEMIOLOGIE ..................................................................................... 123. FOAIA DE

OBSERVAIE
CLINIC...............................................................................................................................
163.1. Datele generale ale
bolnavului ............................................................................................................................
163.2.
Anamneza ...........................................................................................................................
................................ 173.3. Examenul
obiectiv ................................................................................................................................
.............. 194. INSPECIA GENERAL A
BOLNAVULUI ....................................................................................................................
214.1. Atitudinea
(poziia) ...............................................................................................................................
............... 214.2. MErsul
bolnavului ............................................................................................................................
................... 244.3. Faciesul
bolnavului.............................................................................................................................
................. 244.4. Statura. tipul
constituional .......................................................................................................................
.......... 294.5. Starea de
nutriie .................................................................................................................................
............... 305. EXAMENUL
TEGUMENTELOR ..............................................................................................................
..................... 315.1. Paloarea
tegumentar.........................................................................................................................
................ 325.2.
Pigmentaiile .......................................................................................................................
................................ 345.3. Roeaa tegumentelor (eritemul
cutanat) ........................................................................................................... 365.4.
Erupiile cutanate
(exantemele) .......................................................................................................................
... 375.5. Hemoragiile
cutanate ..............................................................................................................................
............ 405.6.
Icterul...................................................................................................................................
............................... 445.7.
Cianoza ...............................................................................................................................
................................ 465.8.
Edemele ..............................................................................................................................
............................... 485.9. Circulaia venoas
colateral.............................................................................................................................
.. 525.10. Tulburrile trofice
cutanate ..............................................................................................................................
. 536. STAREA PSIHIC (starea de contien). ALTERRILE SENZORIULUI (alterrile

strii de contien) ...................... 566.1. Tulburrile

somnului .............................................................................................................................
............... 566.2. Pierderi de contien
tranzitorii .........................................................................................................................
576.3. Pierderi de contien prelungite.
comele .......................................................................................................... 596.4.
Convulsiile ..........................................................................................................................
................................ 626.5. Semiologia
psihiatric ............................................................................................................................
............. 637. SEMIOLOGIA
NEUROLOGIC .................................................................................................................
.................. 647.1. Modificri statice i
dinamice .............................................................................................................................
647.2. Motilitatea voluntar
(activ) ...............................................................................................................................
657.3. Coordonarea
micrilor ............................................................................................................................
........... 657.4.
Reflexele..............................................................................................................................
............................... 667.5.
Sensibilitatea ......................................................................................................................
................................ 687.6. Micrile
involuntare...........................................................................................................................
................ 707.7. Nervii
cranieni ...............................................................................................................................
...................... 708. SEMIOLOGIA
ENDOCRINOLOGIC ........................................................................................................
................... 748.1.
Hipofiza ...............................................................................................................................
................................ 748.2.
Tiroida .................................................................................................................................
................................ 758.3.
Suprarenala ........................................................................................................................
................................. 769. SEMIOLOGIA GANGLIONILOR
LIMFATICI ................................................................................................................ 789.1.
Principii de palpare a ganglionilor
limfatici .......................................................................................................... 789.2.
Clasificarea
adenopatiilor .......................................................................................................................
............. 809.3. Diagnosticul diferenial al
adenopatiei ................................................................................................................ 81

10. SINDROMUL

FEBRIL ...............................................................................................................................
................. 8210.1. Tipuri de
febr ....................................................................................................................................
............... 8310.2.
Hipotermia ..........................................................................................................................
.............................. 8610.3. Diagnosticul bolilor
febrile ................................................................................................................................
8611. EXAMENUL
OCHILOR ...........................................................................................................................
................... 8911.1. Modificri la nivelul globilor
oculari ................................................................................................................... 8911.2.
Modificri la nivelul
pleoapelor .........................................................................................................................
9111.3. Modificri la nivelul aparatului
lacrimal ............................................................................................................. 9212.
SEMIOLOGIA
PRULUI ............................................................................................................................
................ 9312.1. Modificri de ordin
cantitativ ............................................................................................................................
9312.2. Modificri de culoare a
prului ..........................................................................................................................
9413. SEMIOLOGIA
UNGHIILOR ........................................................................................................................
................ 9513.1. Modificri de
culoare ................................................................................................................................
........ 9513.2. Modificri de
form ...................................................................................................................................
....... 9514. SEMIOLOGIA CAVITII BUCALE I
FARINGELUI .................................................................................................. 9714.1.
Modificrile cavitii bucale n patologia
respiratorie ........................................................................................ 9714.2. Modificrile
cavitii bucale n patologia
cardiovascular .................................................................................. 9814.3. Modificrile
cavitii bucale n patologia
digestiv ............................................................................................ 9914.4. Modificrile
cavitii bucale n patologia reumatismal i de
colagen ............................................................... 10014.5. Modificrile cavitii bucale n
patologia metabolic i nutriional ...................................................................
10114.6.Modificrile cavitii bucale n patologia
endocrin ............................................................................................ 10114.7.
Modificrile cavitii bucale n patologia
infecioas ......................................................................................... 10214.8.
Modificrile cavitii bucale n alte condiii
patologice ...................................................................................... 10315. SEMIOLOGIA

SISTEMULUI MUSCULOADIPOS ..................................................................................................... 10515.1.

PALPAREA
TEGUMENTELOR ..............................................................................................................
........... 10515.2. Palparea esutului celuloadipos .......................................................................................................................
10515.3. Semiologia
musculaturii..........................................................................................................................
.......... 10716. SEMIOLOGIA SISTEMULUI
OSTEOARTICULAR .....................................................................................................
10816.1. Kinetica articular - activ i
pasiv ...................................................................................................................
10916.2. Examenul sistemului osteoarticular .................................................................................................................
11016.3. Sindroame clinice n
artropatii ...........................................................................................................................
11517. SIMPTOME
MAJORE .............................................................................................................................
.................. 11917.1.
Durerea ...............................................................................................................................
.............................. 11917.2.
Cefaleea..............................................................................................................................
.............................. 12017.3.
Vertijul..................................................................................................................................
............................. 12317.4.
Astenia.................................................................................................................................
............................. 12517.5. Transpiraia (secreia
sudoral) .........................................................................................................................
12617.6.
Pruritul ................................................................................................................................
.............................. 12717.7. Scderea
ponderal ............................................................................................................................
.............. 128

CAPITOLUL IISEMIOLOGIA APARATULUI

RESPIRATOR ..................................................................................................................
129
1. SIMPTOME ALE BOLILOR APARATULUI
RESPIRATOR ............................................................................................ 1311.1.
Tusea ..................................................................................................................................
................................ 1311.2.
Expectoraia ........................................................................................................................

................................ 1321.3. Durerea

toracic ...............................................................................................................................
.................. 1341.4.
Dispneea..............................................................................................................................
............................... 1362. EXAMENUL OBIECTIV AL APARATULUI
RESPIRATOR ............................................................................................. 1422.1.
Topografia toracopulmonar ...........................................................................................................................
... 1422.2. Inspecia aparatului
respirator .............................................................................................................................
1462.3. Palparea
toracelui ..............................................................................................................................
................. 1522.4. Percuia
toracelui ..............................................................................................................................
.................. 1552.5. Auscultaia toracopulmonar ...........................................................................................................................
.. 1603. INVESTIGAIILE PARACLINICE N BOLILE APARATULUI
RESPIRATOR ................................................................... 1693.1. Puncia
pleural ...............................................................................................................................
................... 1693.2.
Pleuroscopia .......................................................................................................................
................................ 1723.3.
Bronhoscopia ......................................................................................................................
................................ 1723.4.
Bronhografia .......................................................................................................................
................................ 1733.5. Examenul de laborator al
sputei .........................................................................................................................
1733.6. Examenul radiologic al aparatului
respirator ....................................................................................................... 1743.7.
Explorarea funcional a aparatului
respirator ..................................................................................................... 1774. BOLILE
APARATULUI
RESPIRATOR .....................................................................................................................
...... 1805. SINDROAMELE
BRONICE .........................................................................................................................
............... 1815.1. Bronita
acut ...................................................................................................................................
.................. 1815.2. Bronita
cronic ................................................................................................................................
.................. 1835.3.
Broniectazia ......................................................................................................................
................................ 1855.4. Sindromul clinic din obstrucia bronic
(atelectazia) .......................................................................................... 1885.5. Astmul
bronic.................................................................................................................................

................... 1916. SINDROAMELE PARENCHIMULUI

PULMONAR ....................................................................................................... 1986.1.
Sindromul de condensare
pulmonar .................................................................................................................
1986.2. Sindromul cavitar
pulmonar .............................................................................................................................
... 2196.3. Sindromul de hiperaeraie pulmonaremfizemul
pulmonar ................................................................................ 2207. SINDROAMELE
PLEURALE .........................................................................................................................
............... 2247.1. Afeciunile pleurale inflamatorii
neexsudative .................................................................................................... 2247.2.
Afeciuni pleurale inflamatorii
exsudative ........................................................................................................... 2257.3.
Revrsate lichidiene pleurale
neinflamatorii ....................................................................................................... 2337.4.
Revrsatele aerice
pleurale................................................................................................................................
. 2347.5. Sechelele pleurale (simfiza pleural, pahipleurita, calusul
pleural) ...................................................................... 2358. SINDROMUL MEDIASTINAL
......................................................................................................................................
2369. SINDROMUL INSUFICIENEI
RESPIRATORII ............................................................................................................
2419.1. Insuficiena respiratorie
acut .............................................................................................................................
2419.2. Insuficiena respiratorie
cronic ..........................................................................................................................
243ANEXE ..........................................................................................................................
................................................... 24710.
BIBLIOGRAFIE ...................................................................................................................
....................................... 265
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SEMIOLOGIA GENERAL

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