Nukae ɖɔktaa tsɔa nuƒomɔ̃ ɖoa to? Mina míasrɔ̃ nu tso toɖoɖo ŋu pɛpɛpɛ!

Anɔ eme be èkpɔ ɖɔkta kpɔ ne èyi ɖɔkta gbɔ, eye wotsɔa dɔwɔnu sue ma si fa miamiamia la dana ɖe wò akɔta, akɔta, alo ƒodo dzi heɖoa to wò hena ɣeyiɣi aɖe. Míeyɔa esia be nuƒomɔ̃. Gake ɖe nèbu nusita wowɔa nu ma, nusi wosena, nusi wokpɔna tso gbeɖiɖi mawo me ŋu kpɔa? Emae nye nusi ŋu míele nu ƒom tsoe egbea. Le atikewɔwɔ me la, woyɔa esia be ``Auscultation.'' Kpuie ko la, enye toɖoɖo gbeɖiɖi siwo tso ŋutilã me.

Nuka tututue toɖoɖo ŋutilãa fia? (Toɖoɖo) .

Kpuie ko la, ``(Auscultation)`` nye ne ɖɔkta zã nuƒomɔ̃ tsɔ se gbeɖiɖi vovovo siwo tso wò dzi , lãkusi , ʋuka gãwo (ʋukawo), kple ƒodo me. Ðɔkta ɖoa to gbeɖiɖi siawo ne etsɔ nuƒomɔ̃a da ɖe wò akɔta, kɔ, akɔta, kple ƒodo dzi tẽ. Woléa ŋku ɖe nu geɖe abe gbeɖiɖi vovovoawo, woƒe nɔnɔme, alesi wosesẽe, kple ɣeyiɣi si me wodzɔna ene ŋu.

Bu eŋu kpɔ, esia nye nu bɔbɔe aɖe ŋutɔ si megblẽa nu le ŋutilãa ŋu le mɔ aɖeke nu o . Le nyateƒe me la, esia nye mɔnu xoxo aɖe ŋutɔ, gake wòwɔa dɔ ŋutɔ, si ɖɔktawo gakpɔtɔ zãna egbea tsɔ nya nu tso wò lãmesẽ ŋu. Esia nye dodokpɔ si wowɔna evɔ wometsɔa naneke dea ŋutilãa me o (si medzea ame dzi o).

Ɣekaɣie ɖɔkta ɖoa to alea?

Zi geɖe la, wowɔa toɖoɖo abe ŋutilãmedodokpɔ si wowɔna edziedzi ƒe akpa aɖe ene, eɖanye be èyia wò ɖɔkta gbɔ ƒe sia ƒe alo le atikewɔwɔ ƒe nɔnɔme bubu aɖe ta o. Ðɔktawo dina be yewoase gbeɖiɖiwo tso wò ʋuka , gbɔgbɔtsixe , kple dɔgbo ƒe dɔwɔwɔ me be woakpɔ egbɔ be wole dɔ wɔm nyuie. Esia ate ŋu akpe ɖe wo ŋu woase wò lãmesẽ bliboa gɔme, ade dzesi atikewɔwɔ me nɔnɔme ɖesiaɖe si le wo me, alo aɖo kpe dɔléle aɖe si wosusu be ele dziwò dzi.

Mɔ vovovowo li siwo dzi míato aɖo to ŋutilã ƒe akpa vovovowo, alo?

Ẽ, alesi ɖɔkta wɔa ``(Auscultation)`` sia ateŋu ato vovo le ŋutilã ƒe ɖoɖo si wòle to ɖom nu. Na míalé ŋku ɖe mɔnu veviawo ŋu.

Toɖoɖo dzi (Dzi ƒe Toɖoɖo) .

Le dodokpɔ sia me la, ɖɔktaa ɖoa to gbeɖiɖi siwo dona tso wò dzi me. Wogayɔa esia be ``Dzitodzito ƒe Toɖoɖo''. Zi geɖe la, wowɔa esia to nana be nànɔ anyi ɖe zikpui dzi tẽ alo mlɔ aba dzi le dzogoe si nye dzidzenu 45 dzi. Ɣeaɖewoɣi la, woate ŋu abia tso asiwò be nàtrɔ ɖe miame vie, ale be woate ŋu ase dzi ƒe ɖiɖiwo nyuie wu.

Ðɔktaa atsɔ nuƒomɔ̃ aɖe aɖo wò akɔta eye wòaɖo to wò dzi ƒe ɖiɖi. Teƒe 5 koŋ le wò akɔta si gbeɖiɖi siwo tso dzitodzito me ʋukawo me sena le wu. Woada nuƒomɔ̃a ɖe teƒe siawo dometɔ ɖesiaɖe ɖe wo nɔewo yome. Zi geɖe la, teƒe siawo nɔa wò akɔta ƒe miame le etame.

Ne ɖɔkta ɖo to dzitodzito me liʋiliʋilili la, wodia nu siwo gbɔna:

• Ɣeyiɣi: Zi nenie wò dzi ƒoa ( dzi ƒe tsotso ).
• Sesẽme: Alesi dzia ƒoa sesĩei.
• Frequency: Gbeɖiɖia ƒe ɖaɖɛ, alo alesi woyɔnɛ be ``pitch''.
• Ɣeyiɣi Didime: Ɣeyiɣi didi kae dzi ƒe tsotso ɖeka nɔa anyi?

Toɖoɖo lãkusiwo (Lung Auscultation) .

Le esia me la, ɖɔktaa ɖoa to gbeɖiɖi siwo dona tso wò lãkusi me. Wowɔa esia to nana be nànɔ anyi dzɔdzɔe, ne anya wɔ. Ðɔktaa tsɔa nuƒomɔ̃a dana ɖe wò akɔta eye wòbiana tso asiwò be nàgbɔ ya sesĩe to wò nu me. Emegbe la, woɖea nuƒomɔ̃a yia teƒe vovovowo le wò lãkusi me si woyɔna be ``Pulmonary Auscultation Points''. Ðɔktaa ɖoa to gbeɖiɖi siwo tsoa wò lãkusi tame, eye wòtsɔa wo sɔna kple wo nɔewo le akpa eveawo.

Ne ɖɔktaa se aɖuɖɔtoewo ƒe gbeɖiɖiwo tso wò ŋutilã ƒe ŋgɔgbe vɔ la, etsɔa nuƒomɔ̃a dana ɖe wò akɔta. Abe tsã ene la, woɖoa to tso dzi va anyi, tso axa ɖeka yi axa ke, eye woɖoa to gbɔgbɔ blibo (gbɔgbɔ-gbɔgbɔ ƒe tsatsam) le teƒe ɖeka. Emegbe, wotsɔa gbeɖiɖi siwo wosena tso ŋgɔgbe la sɔna kple gbeɖiɖi siwo wosena tso megbe.

Ne ɖɔktaa le to ɖom aɖuɖɔtoewo ƒe gbeɖiɖiwo la, alé ŋku ɖe nusiwo gbɔna ŋu:

• Ɣeyiɣi Didime: Ɣeyiɣi si wòxɔna hafi nègbɔa ya heɖea ya.
• Frequency: Gbeɖiɖia ƒe ɖaƒoƒo (gbeɖiɖi ƒe sesẽme).
• Amplitude: Alesi gbɔgbɔa ɖina sesĩe (sesẽme/sesẽme).
• Nyonyome: Ðe gbeɖiɖi aɖewo li siwo mebɔ o, le kpɔɖeŋu me, ʋuʋudedi ?

Toɖoɖo ʋuka gãwo (Arteries) .

Ne ehiã la, ɖɔkta ate ŋu aɖo to ʋuka gã (ʋuka) siwo le wò kɔ, ƒodo, kple ayiku me hã .

Le afisia la, ɖɔkta la léa ŋku ɖe nu siawo ŋu:

• Bruit: Esia nye gbeɖiɖi sesẽ aɖe si me ʋuʋudedi le si ʋu si sina toa ʋuka aɖe me wɔna. Esia fia be ʋu mele sisim to ʋukaa me nyuie o, ɖewohĩ le esi wòxe ta. Ate ŋu anye dzesi hã be ʋu si yia ŋutilã ƒe akpa aɖe dzi ɖe kpɔtɔ.
• Sesẽme: Kpɔe ɖa be wò ʋu ƒe sisi gbɔdzɔ alo mele eme o hã. Esia ate ŋu afia be ʋuka aɖe xe wò.

Ƒodo ƒe Toɖoɖo

Le dodokpɔ sia me la, ɖɔktaa ɖoa to gbeɖiɖi siwo tso wò dɔgbo me. Wowɔa esia to nana be nàmlɔ aba dzi bɔbɔe eye akɔtaɖonu le ta te. Woate ŋu ana kpekpeɖeŋu sue aɖe hã wò le wò klowo te be wòaɖe dzi ɖi wu.

Ðɔktaa tsɔa nuƒomɔ̃a dana ɖe wò ƒodo dzi eye wòtsɔnɛ yia wò ƒodo ƒe akpa vovovowo be wòase gbeɖiɖi siwo tso wò dɔgbo me.

Ne ɖɔktawo le to ɖom ƒodo ƒe gbeɖiɖiwo la, wodia:

• Anyinɔnɔ: Ne wose gbeɖiɖiwo tso dɔgbowo me alo womese wo o.
• Agbɔsɔsɔme: Ne wose gbeɖiɖi aɖe la, zi nenie wosenɛ.
• Nyonyome: Eɖanye nɔnɔme aɖewo koŋ le gbeɖiɖia ŋu loo alo mebɔ o.

Nukae ɖɔktawo se egɔme tso gbeɖiɖi siawo me?

Enyo, azɔ na míakpɔ nusi ɖɔktawo kpɔ tso gbeɖiɖi siwo wose le teƒe ɖesiaɖe me ɖa.

Nusiwo wogblɔna to dzi ƒe gbeɖiɖiwo dzi

Dzi si sɔ, si le lãmesẽ me la ɖina le ɣeyiɣi si meʋãna o, "lub-dub" me. Woyɔa gbeɖiɖi gbãtɔ be `(S1)` eye woyɔa gbeɖiɖi evelia be `(S2)`. Gbeɖiɖi siae wò ɖɔkta sena ne wò dzitodzito ƒe ʋukawo tu.

Gake ɣeaɖewoɣi la, àte ŋu ase gbeɖiɖi siwo mebɔ o abe esiawo ene:

• Liʋiliʋilili: Esiawo nye gbeɖiɖi siwo mebɔ o siwo woate ŋu ase ne dzia le ƒoƒom. Wole abe ``gbeɖiɖi si le ʋuʋum'' si tsi si le sisim blewu wɔna ene. Ʋu ƒe sisi le tɔtɔ me esime ʋu le sisim to dzitodzitowo me gbɔe wotsona. ``Liʋiliʋilili'' ƒomevi geɖewo li, eye ɖewo ateŋu anye dzidɔ sesẽ ƒe dzesi.
• Pericardial Friction Rub: Esia nye gbeɖiɖi si kɔkɔ ŋutɔ, si nye grating. Eɖina abe lãgbalẽ kakɛ eve siwo le ƒoƒom ɖe wo nɔewo ŋu ene. Esia ateŋu anye dzidɔ si woyɔna be ``pericaditis'' ƒe dzesi.
• Dzi ƒe tsotso si mesɔ o: Kpɔɖeŋu aɖewoe nye `(Atrial Fibrillation)` (dzi ƒe tsotso si mesɔ o), `(Tachycardia)` (dzi ƒe tsotso si wu 100 le miniti ɖeka me), kple `(Bradycardia)` (dzi ƒe tsotso si mede 60 le miniti ɖeka me o).

Nusiwo woagblɔ tso lãkusi ƒe gbeɖiɖiwo ŋu

Gbeɖiɖi siwo sɔ siwo wosena tso wò lãkusi ƒe akpa vovovowo hã to vovo vie. Gake, le goawo katã me la, gbeɖiɖi fafɛ si me do le la nɔa lãkusi siwo le lãmesẽ me. Wò ɖɔkta ase gbeɖiɖi sia ne èle gbɔgbɔm.

Gake àte ŋu ase gbeɖiɖi siwo mebɔ o abe esiawo ene hã:

• Stridor: Gbeɖiɖi sia dona ne xexe aɖe xe le wò gbɔgbɔtsixe ƒe akpa si le etame. Enye gbeɖiɖi sesẽ aɖe si nu sẽ, eye wòsesẽna. Ate ŋu atso epiglottitis, anaphylaxis (nulɔdɔ sesẽ aɖe), alo gbeɖiɖi ƒe dɔmawɔmawɔ nyuie gbɔ.
• Wheeze:Gbeɖiɖi sia si le ɣli dom la dona ne wò yaƒoƒomɔ̃wo va le kpuie. Enye gbeɖiɖi si nu sẽ, si le ɣli dom. Ate ŋu afia be ya mele wò lãkusiwo me yɔ fũu keŋkeŋ o le nane abe ʋuʋudedi ene ta. Woateŋu ase esia le nɔnɔmewo abe `(Asthma)` (asthma), `(Chronic Obstructive Pulmonary Disease - COPD)` (aklã me ʋuʋu)` (tsi si le lãkusi me).
• Rhonchi: Gbeɖiɖi sia tsoa yaƒoƒomɔ̃wo ƒe xexe gbɔ. Eɖi aɖuɖɔtoe. Wosenɛ le nɔnɔmewo abe `(Aklãdɔ)` (Aklãdɔ), `(COPD)`, `(Cystic Fibrosis)`.
• Crackles/Rales: Esiawo ɖina abe taɖa eve siwo le ƒoƒom ɖe wo nɔewo ŋu ene. Wodzɔna ne tsi ƒo ƒu ɖe yaƒoƒomɔ̃wo me le aɖuɖɔtoedɔléle, abe aklãdɔ ene, alo dzidɔ abe dzitodzito ƒe dɔmawɔmawɔ nyuie ene ta.
• Pleural Rub: Esia ɖi abe sandpaper si le ƒoƒom ɖekae ene. Esia ate ŋu afia be lãkusi siwo ƒo xlã wò lãkusiwo do dziku. Ate ŋu anye nɔnɔme aɖe abe aklãdɔ, aklãdɔ, alo aklã me tsi ƒe sisi ene ƒe dzesi.
• Squawk: Wogayɔa esia be gbeɖiɖi kpui aɖe si nye ɣlidodo alo ɣlidodo. Gbeɖiɖi sia ate ŋu atso tɔtrɔ siwo va le wò yaƒoƒomɔ̃wo me gbɔ. Eɖina abe ʋuʋudedi kple ʋuʋudedi ƒe ƒuƒoƒo ene. Ateŋu anye nɔnɔmewo abe `(Pulmonary Fibrosis)`, `(Bronchiolitis)`, `(Pneumonia)` ƒe dzesi.

Bu eŋu kpɔ, gbeɖiɖi siawo katã le abe gbeɖiɖi siwo tso haƒonu vovovo siwo le haƒoha aɖe me le wò ŋutilã me ene. Ɣeaɖewoɣi la, haƒonu mawo dometɔ ɖeka ate ŋu anye nudzodzoe. Nudzodzoe mae nye nusi ɖɔktaa le asi kam.

Nusiwo wogblɔna to dɔgbo ƒe gbeɖiɖiwo dzi

Gbeɖiɖi si sɔ, si le lãmesẽ me le dɔgboa me nye gbeɖiɖi si le bɔbɔe, si le ɖiɖim. Zi geɖe la, wosea gbeɖiɖi sia le sɛkɛnd 5 va ɖo 10 ɖesiaɖe me. Efia be nuɖuɖu le zɔzɔm to wò dɔgbowo me eye be wò nuɖuɖumeŋusẽ (GI Tract) le dɔ wɔm nyuie.

Ne ɖɔkta le to ɖom dɔgbo ƒe gbeɖiɖi la, wodia nusiwo mesɔ o abe:

• Gbeɖiɖi ƒe bu: Ne mèse gbeɖiɖi aɖeke tso wò dɔgbo me wu miniti eve o la, ateŋu anye nɔnɔme aɖe si woyɔna be ``Ileus'' ƒe dzesi.Esia nye esime dɔgboa me nuwo ƒo ƒu eye dɔgboa dzudzɔ ʋuʋu hena ɣeyiɣi aɖe.
• Gbeɖiɖi si dzi ɖe kpɔtɔ: Ne gbeɖiɖi siwo wose tso dɔgboa me le ɖoɖoezizi me, ne wole bɔbɔe ŋutɔ la, ate ŋu afia be dɔgboa ƒe dɔwɔwɔ dzi ɖe kpɔtɔ, alo be ``(Aɖuɖɔtoe)`` le ŋuwò.
• Toɣliɖeɖe si dzina ɖe edzi: Ne èse gbeɖiɖi sesẽ siwo ɖina enuenu tso wò dɔgbowo me la, ate ŋu afia be wò dɔgbowo le dɔ wɔm sesĩe wu, alo be aɖuɖɔtoe le ŋuwò.
• Gbeɖiɖi siwo le ɣli dom alo esiwo le ɖiɖim sesĩe: Ne èse gbeɖiɖi siwo le ɣli dom alo esiwo le ɖiɖim sesĩe tso wò dɔgbo me la, àte ŋu axe mɔ na wò dɔgbo.

Nukae nye "Triangle of Auscultation" sia?

Esia sɔ vie le atikewɔwɔ me, gake egɔmesese le bɔbɔe. "Triangle of Auscultation" nye teƒe sue aɖe le wò akɔta. Afi siae wò akɔta ƒe lãmeka etɔ̃ (trapezius, latissimus dorsi, kple scapula) do go le. Ne ètso wò abɔwo ɖe wò akɔta eye nèbɔbɔ ɖe ŋgɔ la, lãmeka siawo kekena eye wova nɔa tsɛ. Emegbe woɖea teƒe sia si le dzogoe etɔ̃ me la ɖe go. Ne ɖɔkta lé nuƒomɔ̃ ɖe nɔnɔme sia me la, woate ŋu ase gbeɖiɖi siwo tso wò lãkusi me la nyuie ŋutɔ.

Teƒe vevi 5 kawoe wòle be nàɖo to dzia le?

Teƒe vevi 5 li siwo ɖɔktawo ɖoa to kple nuƒomɔ̃ tsɔ daa dzia ƒe lãmesẽ kpɔ. Esiawo le akɔta ƒe akpa aɖewo koŋ, siwo do ƒome kple dzitodzito me ʋukawo.

Woawoe nye:

• Aortic Area: Esia le wò akɔtaƒu (sternum) ƒe ɖusime, le akɔta evelia kple etɔ̃lia dome.
• Aklã ƒe Teƒe: Esia hã le ɖusime, abe aorta gã la ene, gake le miame.
• Erb ƒe Teƒe: Esia le ŋutilãa ƒe miame, le teƒe si le akɔta etɔ̃lia kple enelia dome. (Woateŋu ase `(Murmurs)` aɖewo nyuie wu tso nuto sia me.)
• Tricuspid Area: Esia le akɔta enelia kple atɔ̃lia dome.
• Mitral Area: Esia le dzia ƒe ta, si fia be le dzia ƒe akpa si le anyime wu.

Eyata nukae wòle be míasrɔ̃ tso esia me?

Ðewohĩ màkpɔe adze sii o, gake wò ŋutilã le ɖiɖim ɣesiaɣi. Ele abe nugbagbewo ƒe haƒoha aɖe ene! Ke hã, ɣeaɖewoɣi la, "haƒonu" siawo dometɔ aɖewo ate ŋu ato vovo. Gbeɖiɖi mawo siwo mesɔ o, si fia gbeɖiɖi siwo mebɔ o, ate ŋu agblɔ nu geɖe na ɖɔkta tso wò lãmesẽ ŋu. Alo, woate ŋu ana kpeɖodziwo wo be woatsɔ anya atikewɔwɔ me nɔnɔme aɖe to dodokpɔ bubuwo wɔwɔ me.

Nu vevitɔe nye be, ne ɖɔkta ɖo to wò ŋutilã alea eye wòkpɔ nane si mebɔ o la, mègavɔ̃ be yeabia nya tso eŋu o. Enye wò gome be nàbia be woana numekɔkɔ tso nusi wònye, nusita wòle dzɔdzɔm, kple nusi nàwɔ emegbe ŋu.

Eyata ɣebubuɣi si ɖɔkta aɖe atsɔ nuƒomɔ̃ ade wò ŋutilã me ahaɖo toe la, ànya be wole nu vevi aɖe wɔm!

` Toɖoɖo, nuƒomɔ̃, dzi ƒe gbeɖiɖi, lãkusi ƒe gbeɖiɖi, dɔgbo ƒe gbeɖiɖi, dɔlélewo didi, atikewɔwɔ me dodokpɔwo, lãmesẽ dodokpɔ