Ukuphakanyiswa ku ... Ukuguquka, ukuxubha, ukuhlaziya

Ukulinganisa, ukuxubana, ukuhlaziywa yizindlela zokuhlola okuhloswe ngazo odokotela emhlabeni wonke ekuhloleni izifo ezihlukahlukene. Lezi zindlela zisetshenziselwa ngokubambisana ne-biochemical nezinye izinhlobo zokuhlaziywa, ucwaningo lwezinsimbi, ukusebenzisa ubuchwepheshe, obukhona nenani elikhulu. Ngokuthakazelisayo, ukuhlolwa komgomo kudlala indima ebalulekile ekuxilongweni.

Ukuhlaziywa kuyindlela ephelele kunazo zonke nokufundisa. Isetshenziselwa ukuxilongwa ekuhlinzekeni, ukwelapha, izithiyo zokuzivikela, isifo sofuba. Ngosizo lendlela, lalela ukushaya kwenhliziyo yengane, thola ukuba khona kwe-pneumonia, i-bronchitis, ukukhubazeka komzimba kanye nezinye izifo eziningi ezinganeni nakubantu abadala.

Ukuvuselela kwenhliziyo endala

Kanye nokuqwashisa okukhulu, lokhu kuyinkimbinkimbi kunabo bonke izindlela zokuhlolwa komgomo. Kudinga ukuthi kube khona ukuzwa okuhle, umuzwa wokulinganisa nokuziphatha okuqhubekayo, njengoba kunenqwaba yama-nuances. Ukuxilongwa ngemithi nge-auscultation indlela kuvumela ukucacisa izifo zenhliziyo kanye ne-pulmonary pathology ekuqaleni kwentuthuko.

Ukulalela enhliziyweni kuyenzeka endaweni ejwayele noma emile. Ezinye izifo zibhekene nokushintsha kwenhliziyo yenhliziyo emva kokuzivocavoca, ngakho-ke ngezinye izikhathi, ukuze uthole ukuxilongwa okunembile, isiguli siphume endaweni yokuphumula ngokomzimba. Indlela yokukhwabanisa idinga imithetho ethile:

• Ukuhlukaniswa kwemisindo kusuka emkhatsini wemisindo;
• Ukulalela enhliziyweni kwenziwa ngokulibaziseka kokuphefumula (uma kungenzeka), kanye nokwehluleka kokuphuza nokuphumula;
• Kudingekile ukusebenzisa i-phonendoscope kanye ne-stethoscope yokuhlaziya amathoni aphezulu nephansi;
• Okokuqala qinisekisa ubukhona kanye nokucaca kwemisindo emazingeni ahlukene, bese ulalela umsindo wezobuchopho noma womzimba.

Ukucubungula kwenhliziyo

Isetshenziselwa ukucacisa imingcele yomzimba kanye nobuhlungu obukhulu benhliziyo. Muva nje, le ndlela idlulela ngemuva. Abanye ochwepheshe bayalilahla ngokuphelele, njengoba imiphumela ye-percussion ayinembile kakhulu futhi ibe nephesenti eliphezulu lokuzithoba. Le ndlela ishintshwe yi-radiography ne-ultrasound, enikeza isithombe esiphelele sobukhulu nesimo segesi.

Ukulinganisa kwenhliziyo

Isetshenziswa kabanzi ekuxilongweni. Ukuhlukaniswa kwenhliziyo kwenziwa ukuze kutholakale ngokucacile isikhundla nesimo sesiteleka se-apical ngokucindezela umunwe endaweni ehambelana nayo. Kwezinye izifo, ukuzamazama okuncane kwesifuba, noma "i-cat feline purring syndrome," kuyisici.

Amandla okulalela nokuzwa

Inhliziyo ayilaleli ngokuhlelekile. Kukhona izilinganiso ze-valve zenhliziyo esifubeni. Kunezinombolo ezine.

1. I-Mitral - IV imbambo, ngakwesokunxele kwe-sternum.
2. I-Aortic - III imbambo, ngakwesokunene se-sternum.
3. I-valve ye-pulmonary valve - isikhala se-intercostal se-III ngakwesobunxele.
4. I-Tricuspidum - IV isikhala se-intercostal ngakwesokudla.

Kodwa-ke, amaphuzu we-auscultation ahluke kancane ekuhloleni okuqondile, ngoba umsindo kulezi zindawo ucacile futhi uyaqondakala.

1. Phezu kwenhliziyo yi- valve ye-mitral.
2. I-space intercostal yesibili, kusukela e-sternum kuya kwesokudla - i-aortic.

Isibonakaliso esibalulekile sezifo ezibi kakhulu yomsindo wenhliziyo, okungaba unomphela noma ukuvela ngemuva komthwalo othile. Omunye kumele akwazi ukulalela kahle futhi azwe konke ukuphambuka okuvela esimeni sesigqi senhliziyo. Kubalulekile ukunquma umsindo kuphela, kodwa futhi uhlobo, kanye nendawo yokubunjwa kwayo. Ingavela ku-systole noma i-diastole.

Ukugulisa umzimba, noma umzimba, kungabi umsindo nje kuphela, kodwa futhi kuyasebenza. Ekuxilongweni kusiza ukusizwa kwenhliziyo. Amaphuzu okulalela afana nalawo achazwe ngenhla. Kungenzeka ukwakheka kwamathoni engeziwe we-III no-IV avela ezimweni ezahlukene (isikhathi sokuvala, isabelo sokuqala sesibili se-systole noma i-diastole).

Inhliziyo encane ngumthwalo omkhulu

Ukuhlaziywa kwezingane kuyingxenye ebaluleke kakhulu yokuxilongwa. Ingane, ikakhulukazi encane, ngenxa yobudala, ayikwazi ukubika ngezinkinga zayo. Udokotela wezingane kufanele abe nendlebe enhle kanye nezinga eliphakeme lokufunda nokubhala, njengoba amathoni enhliziyo yengane ashintsha ngokukhula kwakhe. Umsindo osebenzayo noma we-pathological unganqunywa. Kubalulekile ukwenza ukuhlaziywa okuqhathanisa phakathi kwamathoni okuqala nesesibili ngokuqina noma kugcizelelwe. Noma yikuphi ukuhlukunyezwa kubonisa izinqubo eziningana zomzimba emzimbeni wengane.

Ukuxilongwa okungafani kwezifo zenhliziyo ezinganeni ezisebenzisa indlela yokugudluza

Ithoni yenhliziyo	Indawo ye-Accent	I-pathology yembula (i-physiology)
Okokuqala	Iphuzu lenhliziyo	Ukuvula kwesokunxele kwe-atrioventricular kunciphile
Owesibili	I-Aorta	Isifo somfutho wegazi ophezulu noma izici zomzimba zonyaka okhulayo
Owesibili	Umshini wokugcoba	Vula i-arterial duct, i-stenosis, i-bicuspid valve insufficiency, i-septal defectis, i-pulmonary artery sclerosis, i-pulmonary fibrosis, i-myocarditis ne-phenomena e-circulatory system
Okokuqala nesesibili	Kuzo zonke amaphuzu	Inhliziyo enempilo ngemuva komthwalo (ngokomzimba noma ngokwengqondo)

Ngaphandle kokwedlula, kungenzeka ukuba buthakathaka izinhliziyo zenhliziyo noma ukuxhuma kwabo. Ukuhlelwa kwemiphumela kuveza ngokucacile uma udokotela ekwazi ukulalela.

Ukukhulelwa nokukhwabanisa

Iqabunga le-cardiac libekwe phansi futhi liqala ukuvumelanisa kakade ngesonto lesithathu lokukhulelwa, futhi ezintandathu kuyazwakala nge-ultrasound. Ukuxilongwa kokuphila komama nokomntwana kuyadingeka ngaso sonke isikhathi ikakhulukazi ngesikhathi sokubeletha. Inombolo nokugcwalisa amathoni kuguquke njalo ngokuhambisana nentuthuko ye-intrauterine.

Ukukhula kwe-fetus kuyindlela elula futhi ephumelelayo kakhulu yokunquma ukusebenza kwayo. Ukwenza lo msebenzi olula, udinga i-stethoscope ye-obstetric (isithombe ngezansi). Uma kunesidingo, sebenzisa i-phonendoscope.

Kungenzeka ukuthi uhlukanise isimo sonke isikhathi sokukhulelwa ngezikhathi eziningana (ngokuvumelana nesimiso sezinkinga zokugula komzimba we-fetus, kanye nesimo sokugcwala kwazo).

Kuyathakazelisa ukuthi ngeviki lesithupha emva kokukhulelwa kwenhliziyo inhliziyo ingane ivumelana nomama. Umehluko ungaba yizingcingo ezintathu ohlangothini olukhulu noma oluncane. Khona-ke inani lokusikeka liqala ukukhula. Uma sicabangela ukuthi izinga lentliziyo yansuku zonke likhuphuka ngemivimbo engu-3, kuvunyelwe ukucacisa iminyaka yobudala besisu.

Inhliziyo ngokwayo emva kwezinyanga ezimbili zokukhulelwa ihlukaniswe izingxenye zibe ngamakamelo amane - i-atrium kanye ne-ventricles. Lesi sakhiwo sinomzimba omdala. Ekuqaleni kweviki lesishiyagalolunye, inhliziyo ye-embryo yenza cishe ukushaya okungu-175 ngomzuzu. Ngaphezu kwalokho, imvamisa iyancipha futhi, kusukela ekuqaleni kwe-trimester yesibili, isimiso se-fetus siba nemivimbo engu-140-160. Noma yikuphi ukuphambuka kuwo kubonisa ukuthi i-hypoxia, ne-tachycardia ihlukanisa izinga lokuqala lokuntuleka kwe-oksijini, futhi i-bradycardia isigaba esibucayi esidinga ukungenelela ngokushesha.

Ukulinganisa kwe-fetus

Ukulinganisa engxenyeni yesibili yokukhulelwa kunganquma isikhundla se-fetus kanye nezingxenye zayo ezilodwa esibelethweni. Ngaphezu kwalokho, ubude bokukhulelwa kunqunywa ukuphakama kokuma kwe-uterine fundus, futhi nangenhloko yengane: uma igxilile ngokuqinile ekungeneni kwesikhumba esincane, laba yizimbangi zokuqala zokubeletha. Ezingqineleni, indlela kaLeopold isetshenziswa, equkethe amasu amane ayisisekelo.

Ukuvuthwa nokubeletha

Ukunganaki kwezinhliziyo zomzimba kungabonakala kokubili kokugula, kanye nobunzima bokuqala bokulalela. Lokhu kwenzeka lapho udonga lomama lukhuni (ukukhuluphala ngokweqile), umfutho wesimiso usesimweni esingalungile (isibonelo, ukubukwa komuva ngemuva kwesethulo se-occipital noma glutal), i-polyhydramnios, njll Ngokukhethekile kaningi ukuvuthwa kwezwi lokushaya kwenhliziyo kwenzeka ngesikhathi sokusebenza. Ukuxilongwa kwe-fetus ngalesi sikhathi kubaluleke kakhulu.

Enye yezindlela zokuhlola owesifazane okhulelwe yi-palpation. Kuyasiza ukunquma indawo ye-fetus, isethulo sayo. Kodwa umphumela ofanayo ungafinyelelwa lapho kusetshenziswe inhlanhla yenhliziyo ukuxilonga ukuthuthukiswa kwe-intrauterine. Amaphuzu okulalela yizici. Uma ukushaya kwenhliziyo kunqunywe ngokucacile ngaphezu kwenkaba yomama, ingane yakho inesethulo sokubhujiswa, uma iphansi - ikhanda. Ingane ingaba yingozi, iphendulela "kusukela kolunye uhlangothi" sonke isikhathi sokubeletha. Ukulalela amathoni ahlanzekile kuvelini kubonisa isikhundla esinqamulayo.

Ukuhlushwa kokuthola izifo ze-pulmonary

Ukuhlaziywa yindlela edlala indima eqondile ekuxilongweni kwezifo zamaphalenda. Qhathanisa ukuphefumula okulungile (noma vesicular) nezinhlobo ezahlukene zokungajwayelekile. Futhi, isibonakaliso sokwehluka kwezifo ezihlukahlukene kukhona imibono eyomile noma emanzi, enezici ezithile zokulalela. Amaphuzu okukhuphuka kwamaphaphu atholakala nge-symmetrically.

Ukuphefumula kwe-vesicular ngokwemvelo

Uma umuntu enhle noma, ngokuphambene nalokho, isisindo somzimba esingasetshenziselwa kahle, kukhona izicubu ezinamafutha e-hypertrophied, ushintsho lokuphefumula lungase luqondise ukulinda noma ukuqiniswa kwalo. Ukulalela kwenzeka ngokusebenzisa i-phonendoscope.

Ukuqinisa ukuphefumula kwe-vesicular kuyinto ephawulekayo ebuntwaneni. Elinye igama elingase lizwakale emibuthanweni yezokwelapha i-puerile. Kukhona isici esisodwa sesici - ukuphefumula okufanayo ezindaweni ezilinganiselwe ezinhlangothini ezilungile nangakwesobunxele.

Ukuxilongwa kwe-bronchitis nge-auscultation

Ukuhlaselwa nge-bronchitis kwenziwa ngendlela evamile. Uma ulalela isigaba esibucayi, ukuphefumula okungokwemvelo kokuhlobo olunzima kuyisici. Lona impendulo yomzimba ekuvuvukeleni naseqenjini lama-bronchioles. Ngokumelene nesimo senkimbinkimbi yemifantu eyomile yokuphefumula inqunywa, futhi ingahluka ngethoni, iphinde ibonakale ihlaziye futhi ikhwelo. Kuncike ngobukhulu be-bronchi kanye nezinga lokuzigcwalisa ngemfihlo. Zizwakala kahle kuzo zombili izigaba zokuphefumula.

Njengoba i-bronchitis iqala, ukukhiqizwa kwe-mucus kwimikhumbi ye-airways kwanda, futhi nge-auscultation, imibukiso emaphakathi ye-bubble yembula.

Ukulalela amaphaphu kungcono uma isiguli simile. Kudingekile ukuqhathanisa imisindo yokuphefumula futhi ugijime ngamaphuzu afanayo esakhiweni sokunene nesesobunxele. Kukhona ukulandelana okuthile kwamaphoyinti okulalela we-auscultation-yamaphaphu.

Udinga ukuqala kusuka eziqongweni bese uhlola ubuso obuseduze, bese uhlangothi nangemuva. Nge-bronchitis ende, umsindo owengeziwe ungabanjelwa, isibonelo, ukugcoba, okubonisa ukuguquka kokuvuvukala emkhakheni ophansi wokuphefumula.

Ukuphakama kwamaphaphu kuqhutshwa ngezigaba eziningana: ngokuphefumula okujwayelekile nokujulile nangemva kokukhwehlela. Amaphuzu okutadisha okuningiliziwe okucwaninga, okuyinto "enolisayo" kakhulu kudokotela.

Ukuxilongwa kwe-bronchitis engapheli kubuye kusekelwe emininingwaneni ye-auscultation kanye nezifundo ze-laboratory zezinto eziphilayo. Lapho ulalela amaphaphu, ukuphefumula kohlobo lwe-vesicular kunqunywa phambi kokuba uphume isikhathi eside noma kunzima, njengasezingeni elimangalisayo. Ngezinye izikhathi i-bronchitis engapheli ivuselela isifo esibi kakhulu- emphysema. Kulesi simo, ukuphefumula kuya "kudotshwa." Ngesikhathi sokukhukhumazeka, i-wheezing izwakala yonke indawo emaphashini.

Ukucubungula kwamaphaphu

Ukuhlolwa okuzenzekelayo kungenziwa ngezindlela ezintathu: ukushaya ngqo endaweni ehlolwe, ngokusebenzisa ipuleti noma umunwe ngomunwe. Njengamanje, owokugcina yiyona esebenza kakhulu. Le ndlela ayidingi udokotela ukuba abe nemishini eyengeziwe, futhi ekuhloleni kwamaphaphu kuyasiza kakhulu.

I-Percussion ingaba nokuqhathanisa noma ibe nokuqondisa kwezobuchwepheshe. Okuthandwa kakhulu yiyona ndlela yokuqala, esetshenziselwa ukunquma i-foci ye-pathological. Ziyizibonakaliso, ngakho umsindo wezingcingo phezu kwabo uyisithulu ngaphezu kwezingubo zamaphaphu enempilo.

Kukhona inombolo enkulu ye-shades namathoni akhishwe lapho ehlola imisindo. Ngokuvamile, kufanele kube phezulu, ukukhala nokude. Uma kunesithulu, ithoni epholile, i-metallic tint, ibhokisi noma i-tympanitis-lokhu kubonisa ukuthi isiguli sinokuvutha noma ezinye izinqubo emaphashini adinga ukungenelela kwezokwelapha.

Ukuhlushwa kokuthola izifo zendlela yokugaya ukudla

Ukulalela kusetshenziswe njengendlela yokuthola isibalo sezifo zesigcawu somathumbu. Ucwaningo lwenziwa udokotela osebenzisa i-stethoscope noma ngokusebenzisa indlebe emdongeni wesisu. Ngalendlela, ukutholakala (ukungabikho) kwe-peristalsis emathunjini noma esiswini kunqunywa.

Ukuhlaziywa kwenziwa ngesisekelo sokuqhathanisa, okungukuthi, ukuthola isithombe esanele, kudingeke ukuba ulalele emazingeni ahlukahlukene. Ukuqhuba ucwaningo kubalulekile ekuthuleni futhi, uma kungenzeka, ngaphandle kokucindezela esiswini.

Ukuhlukaniswa kwesisu

Ekuhloleni kwezitho zesisu esiswini lomzimba, inani eliphezulu lokufundisa lithwala indlela yokwaziswa. Kuqhutshwa ukucindezela okuphansi kwesisu. Qala ngendawo engakwesobunxele ephethe izandla ezifudumele, ukuze ungadli kahle isiguli. Lokhu kudingeke ukuba kungabandakanyi ukucindezeleka okuxilisayo kwodonga lwesisu.

Ukuhlolwa kwenziwa ngenqubo yokuhlaziywa kokuqhathaniswa kwesigamu sokunene nesesobunxele kusuka phansi kuya phezulu. Ukucindezela endaweni ye-epigastrium kuyinto yokugcina. Ngosizo lwalokhu, ukukhathazeka kunqunywe, ezithombeni ezihlukahlukene, ukuhlukunyezwa kwodonga lwesisu, ukutholakala kohlobo lwamanzi emzimbeni wesisu (isifo sokushintshashintsha kwesisu ).

I-Percussion yesisu

Indlela ye-percussion ikuvumela ukuthi unqume imingcele yesibindi nesipelisi, ngoba inomsindo ongeyena (femoral). Ngaphezu kwalokho, uma kuqhathaniswa ne-tympanitis yesisu nangomathumbu, udokotela angakwazi ukuthola ukuthi kunjani eminyangweni.

Ubunzima obukhulu be-hepatic ngokuvamile bubekwe eceleni kwesokudla kwesigaba se-intercostal IV ngokwezinga le-midline ye-ingono. Uma umsindo we-tympanic utholakala ngenkathi kuhlolwa le ndawo, lokhu kubonisa ukuthi i-perforation yezingxenye, okuwukuthi, kukhona uketshezi emgodini.

Ukuguqulwa kwesipelingi akusho lutho olubalulekile: umngcele walo ophansi ulula kalula.