E ʻike kākou i ka pulse pololei o ka puʻuwai? - Nā mea āpau e pili ana i ka Apical Pulse

Ua ʻike mākou a pau pehea e nānā ai i ko mākou pulse ma ka hoʻopā ʻana iā ia ma ko mākou pulima a i ʻole ma nā ʻaoʻao ʻelua o ko mākou ʻāʻī. Akā ua ʻike anei ʻoe aia kahi pulse kūikawā e hāʻawi ana i ka ʻike pololei e pili ana i ka hana o ka puʻuwai, kahi i lohe ʻia ma ke kau ʻana i kahi ʻōmole ma luna o ka umauma? ʻO ia ka mea a mākou e kapa nei ʻo 'Apical Pulse'. He mea nui loa kēia, no laila e kamaʻilio kākou e pili ana i kēia lā.

He aha kēia Apical Pulse?

I ka ʻōlelo maʻalahi, ʻo ka Apical Pulse kahi e hiki ai iā ʻoe ke loaʻa ka manaʻo pololei loa o kou helu puʻuwai . Ua kapa ʻia hoʻi ʻo ia ʻo 'Point of Maximal Impulse' (PMI) a me ka 'Apex Beat'.

ʻO ka maʻamau, nānā mākou i ko mākou pulse ma ka pulima (i kapa ʻia ʻo 'radial pulse') a i ʻole ma nā ʻaoʻao ʻelua o ko mākou ʻāʻī (i kapa ʻia ʻo 'carotid pulse'), ʻeā? ʻO kēia nā pulse e holo ana ma nā kīʻaha koko o ko mākou kino, ʻo ia hoʻi, ma nā 'arteries'. Hiki iā mākou ke ʻike maʻalahi i kēia mau pulse ma ke kau ʻana i ʻelua a ʻekolu paha mau manamana lima ma luna o lākou. A laila hiki iā mākou ke ʻike i nā nalu kaomi e kū mai ana i kēlā me kēia manawa e kuʻi ai ka puʻuwai.

Akā, he ʻokoʻa kēia Apical Pulse. ʻAʻole kēia he pulse i loko o ke aʻa. ʻAʻole ʻoe e manaʻo i kahi nalu kaomi ma ʻaneʻi. ʻO ka mea āu e manaʻo ai, a i ʻole ka mea a ke kauka e lohe ai, ʻo ia ka ʻūlū ʻana o ke keʻena haʻahaʻa ma ka ʻaoʻao hema o kou puʻuwai, ʻo ia ka 'Left Ventricle'. E noʻonoʻo, i kēlā me kēia manawa e paʻi ai kou puʻuwai, ʻo ia ka Ventricle Hema e pamu i ke koko i ke kino holoʻokoʻa ma o ke kīʻaha koko nui i kapa ʻia ʻo 'Aorta'.

ʻAʻole anei he mea kupaianaha ka hiki iā kākou ke ʻike i ko kākou puʻuwai ponoʻī e kuʻi ana? Akā i kekahi manawa hiki ke paʻakikī iki ka loaʻa ʻana o kēia pulse apical me kou mau manamana lima wale nō. Inā ua hele ʻoe i kahi haukapila, ua ʻike paha ʻoe i nā limahana lapaʻau e nānā ana i kēia pulse apical.

Aia i hea ka Apical Pulse?

Aia kēia Apical Pulse ma luna pono o ka piko o kou puʻuwai. Ua ʻike anei ʻoe i ke kiko o ka puʻuwai? ʻO ia ka ʻāpana e like me ka piko o kou puʻuwai e kuhikuhi ana i lalo ma ka ʻaoʻao hema, ʻo ia hoʻi ka piko haʻahaʻa loa o ka Ventricle Hema. Eia nō naʻe, i nā hihia kakaikahi, hiki ke hoʻohuli ʻia ka puʻuwai o kekahi poʻe i ka ʻākau, a mākou e kapa nei ʻo 'dextrocardia'. I loko o ia kanaka, aia ka piko o ka puʻuwai ma ka ʻaoʻao ʻākau.

No laila, ma hea pololei ka piko o ka puʻuwai i nā pākeke?

I ke kanaka makua, aia ia ma ka ʻaoʻao hema o ka umauma, ma waena o nā iwi ʻaoʻao ʻelima a me ke ono, e helu ana mai luna o ka pā iwi ʻaoʻao a i lalo. Ua kapa ʻia kēia e nā kauka ʻo 'fifth intercostal space', ʻo ia ka hakahaka ma waena o nā iwi ʻaoʻao.

ʻAuhea nā keiki liʻiliʻi?

No nā keiki ma lalo o 7 makahiki, ʻokoʻa iki kēia wahi. Aia ka piko o ko lākou puʻuwai ma waena o nā iwi ʻaoʻao ʻehā a me ʻelima. ʻO ia hoʻi, ma ko lākou 'wahi intercostal ʻehā'.

No ke aha e ana ʻia ai ka pulse apical?

Hiki i kāu kauka ke aʻo i ka nui o ka ʻike waiwai ma ke ana ʻana i kēia pulse apical. Aia i kēia manawa nā mea hana aunoa e ana koke a hōʻike i ka helu pulse. ʻOiai ke hōʻike nei lākou i ka helu o ka puʻuwai, ʻaʻole lākou e hōʻike pololei i ke ʻano o ka puʻuwai a i ʻole ka ikaika o ka pulse. Eia nō naʻe, hiki i ka pulse apical ke hāʻawi i kēia ʻike āpau me ka wikiwiki, me ka hoʻohana ʻana i kahi stethoscope wale nō .

Hiki i ke kauka ke ana i kāu pulse apical no kēia mau kumu:

• E nānā i kou olakino holoʻokoʻa a me kou noho maikaʻi ʻana .
• E nānā i ke olakino o kou puʻuwai .
• E nānā i kou ʻano ma hope o kahi hoʻāʻo, lāʻau lapaʻau, a ʻoki kino paha .
• E hōʻiliʻili i ka ʻike kumu i hiki ke hoʻohālikelike ʻia me nā nānā pulse i ka wā e hiki mai ana.

Pehea e ana ʻia ai ka Apical Pulse?

Hoʻohana ke kauka i kahi stethoscope e ana i ka pulse apical. Hoʻokomo pololei ʻia ia ma kou ʻili e hoʻolohe. No laila, hana ʻia kēia ʻoiai ʻoe e uhi ʻia me kahi lole a i ʻole kahi pākeke e pale i kou pilikino, inā pono.

Ma ke ʻano maʻamau, hahai ke kauka i kēia mau hana:

• E noi ʻia ʻoe e moe ma kou kua , a i ʻole e huli iki i ka hema. Hana ʻia kēia e ʻike maikaʻi ai i ka paʻi ʻana o kou puʻuwai.
• Hoʻohana lākou i ko lākou mau manamana lima e ʻike ai i kahi o ka pulse apical.
• Ua kau ʻia ka hopena o ka ʻōmole (ʻo ia hoʻi ka 'bell' a i ʻole ka 'diaphragm') ma kou umauma.
• E hoʻolohe pono lākou no kahi o 60 kekona. Mai hopohopo inā ʻaʻole lākou e ʻōlelo i kekahi mea i kēia manawa, a i ʻole inā me he mea lā e lōʻihi ana. He mea maʻamau kēia. Pono ke kauka e hoʻolohe pono loa e ʻike i ka puʻuwai o ka naʻau.
• A laila e wehe ke kauka i ka ʻōmole mai kou umauma mai.

I kekahi manawa e nānā paha kāu kauka i kou pulse ma nā wahi ʻē aʻe. No ka laʻana, makemake paha lākou e ana i kāu 'apical-radial pulse'.

He aha ka pulse apical-radial?

Makemake paha ke kauka e ana i kāu pulse apical a me kāu pulse radial, kahi i ana ʻia ma ka pulima. Hōʻike kēia i ka maikaʻi o ka neʻe ʻana o ke koko mai kou puʻuwai a i ke koena o kou kino. Pono paha ke kauka e loaʻa i kekahi kanaka ʻē aʻe ke kōkua me kēia. ʻOiai kekahi kanaka e ana i ka pulse apical, e nānā kekahi kanaka i ka pulse radial i loko o 60 kekona.

ʻO ke kūpono, pono e like kāu pulse apical a me ka pulse radial. Eia nō naʻe, inā nāwaliwali kou puʻuwai a i ʻole he maʻi vascular kou,, ʻoi aku paha ka haʻahaʻa o kāu pulse radial ma mua o kāu pulse apical. ʻO ka ʻokoʻa ma waena o kēia mau waiwai ʻelua ua kapa ʻia ʻo 'pulse deficit' . Kōkua kēia pulse deficit i kāu kauka e ʻike a nānā i nā ʻano maʻi like ʻole e hoʻopilikia i kou puʻuwai a me nā kīʻaha koko.

He aha ka pae maʻamau o ka pulse apical?

ʻO ka pae pulse apical maʻamau no ka hapa nui o nā pākeke ma waena o 60 a me 100 mau kuʻi i kēlā me kēia minuke (bpm) . ʻO kēia ka pae kūpono e noho ai i ka wā e hoʻomaha ai ʻoe. Eia nō naʻe, hiki i nā mea e like me kēia ke hoʻohaʻahaʻa loa i kāu pulse:

• Inā ʻoe e hoʻoikaika kino .
• Inā ʻoe e inu i nā mea i loaʻa ka caffeine (e like me ke kī, kofe).
• Ke kaumaha a hopohopo paha ʻoe.

I kou wā ʻelemakule, hiki ke lohi iki kou puʻuwai. Eia kekahi, hiki i kekahi mau lāʻau lapaʻau a me nā kūlana olakino ke hoʻopilikia i kou puʻuwai. ʻOi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e ʻike pono i ka pae puʻuwai olakino nou.

He mea maʻamau no nā keiki ʻōpio ke loaʻa ka puʻuwai kiʻekiʻe ma mua o nā pākeke. ʻOkoʻa kēia pae maʻamau ma muli o ko lākou mau makahiki. ʻO nā pēpē ma lalo o ʻekolu mahina ka nui o ka puʻuwai (123-164 mau kuʻi i kēlā me kēia minuke). E emi mālie ana kēia helu i ko lākou ulu ʻana. E kamaʻilio me ke kauka o kāu keiki e aʻo hou e pili ana i nā pae puʻuwai kūpono no kāu keiki ma nā makahiki like ʻole.

He aha nā mea e hiki ke aʻo ʻia mai ka Apical Pulse?

Hiki i ka pulse apical ke hōʻike i nā hōʻailona o nā ʻano maʻi like ʻole . ʻO kēia no ka mea hiki i ke kauka ke lohe i nā mea ʻoi aku ma mua o kou helu puʻuwai. ʻO kēia mau mea:

• Pehea ke ʻano o ka ikehu i loko o kēlā me kēia puʻuwai ?
• ʻEhia ka lōʻihi o kēlā me kēia puʻuwai ?
• Pehea ke ʻano holoʻokoʻa o ka puʻuwai ?

Hiki i kēia pulse apical ke kōkua i kāu kauka e ʻike i nā kūlana e like me:

• Nā maʻi o ka puʻuwai (arrhythmias) , no ka laʻana, ka atrial fibrillation.
• ʻO ka maʻi kīwila puʻuwai , no ka laʻana, ke kahe ʻana o ke koko mai nā kīwila (regurgitation) a i ʻole ka hāiki ʻana o nā kīwila (stenosis).
• Ka mānoanoa o ka ʻiʻo o ka puʻuwai (Hypertrophic Cardiomyopathy) .
• Ka hoʻonui ʻia ʻana o nā keʻena o ka puʻuwai ('Diluted Cardiomyopathy') .

Hiki ke paʻakikī ke loaʻa i ka Apical Pulse i kekahi manawa?

ʻAe, i kekahi manawa ʻaʻole hiki i ke kauka ke loaʻa i kāu pulse apical. Hiki paha kēia ke hihia inā loaʻa iā ʻoe kekahi o kēia mau kūlana:

• Momona(Ua kapa ʻia kēia ʻo 'ka momona nui', ʻo ia hoʻi ka momona nui loa).
• Ka maʻi māmā mau loa (Chronic Lung Disease) .
• Ka hōʻiliʻili ʻana o ka wai a puni ka puʻuwai (pericardial effusion) .
• Ka hōʻiliʻili ʻana o ka wai a puni ka māmā hema ('Left Pleural Effusion') .

Inā hana ʻia kēlā, e nānā ke kauka i kou pulse ma nā wahi ʻē aʻe, a inā pono, e hana i nā hoʻokolohua puʻuwai ʻē aʻe. ʻAʻohe mea e hopohopo ai.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻOiai he nui nā mea hana a mākou i kēia mau lā, ʻo ka nānā ʻana i kou pulse he ʻāpana koʻikoʻi loa ia o ka lāʻau lapaʻau. ʻO kāu pulse apical kahi hōʻailona koʻikoʻi koʻikoʻi e kōkua i kāu kauka e ʻike i nā pilikia me kou puʻuwai. Hiki i kāu kauka ke nānā i kāu pulse apical i ka wā o ka nānā maʻamau. Inā ʻoe ma ka haukapila, e nānā pinepine kāu hui lapaʻau i kāu pulse apical.

No laila, e kamaʻilio me kāu kauka e pili ana i kou pulse apical a me kāna ʻōlelo e pili ana i ke olakino o kou puʻuwai. Mai hopohopo, he hoʻāʻo maʻamau wale nō ia, akā he mea nui loa ia! Hiki iā ia ke haʻi i kāu kauka i nā mea he nui e pili ana i kou puʻuwai.

ʻO ka pulse apical, ka helu o ka puʻuwai, ka hoʻolohe ʻana, ke olakino o ka puʻuwai, ka pulse, ka ʻōlinolino o ka puʻuwai, ka maʻi puʻuwai