E hoʻomanaʻo i kou hele ʻana e ʻike i ke kauka a kau ʻia kēlā stethoscope anu ma kou umauma a me kou kua a hoʻolohe pono? Ua loaʻa iā kākou a pau kēia ʻike. ʻAʻole anei ʻoe i noʻonoʻo, "He aha ka mea a ke kauka e lohe nei mai kēia?" ʻO ka pane i kēlā nīnau ʻo ia ka hoʻāʻo lapaʻau a mākou e kamaʻilio nei i kēia lā i kapa ʻia ʻo 'Auscultation.' Mai hopohopo, he maʻalahi loa ia, ʻaʻohe ʻeha, akā he mea nui ia e haʻi nui iā ʻoe e pili ana i kou olakino.
I ka ʻōlelo maʻalahi, he aha ka auscultation?
He hana maʻalahi loa ka Auscultation (puana ʻia: "o-skul-ta-tion"). Pili ia i ka hoʻohana ʻana i kahi stethoscope e hoʻolohe i nā leo e puka mai ana mai kou mau ʻōpū o loko, e like me kou puʻuwai, nā māmā, nā kīʻaha koko, a me nā ʻōpū . E kau ke kauka i ka stethoscope ma kou umauma, ʻāʻī, kua, a me ka ʻōpū a nānā i nā mea e like me ke ʻano, ka wikiwiki, ka leo, a me ke mele o kēia mau leo.
He hoʻāʻo palekana loa kēia, ʻaʻole ia he mea ʻino. ʻO ia kekahi o nā hoʻāʻo kahiko loa a maʻalahi hoʻi e hoʻohana ʻia nei e nā kauka i kēia lā.
I ka manawa hea e hana ʻia ai kahi hoʻāʻo auscultation?
Ke hele ʻoe no kahi hoʻokolohua kino maʻamau, e hana paha kāu kauka i kēia hoʻokolohua. Hāʻawi ia iā ʻoe i kahi manaʻo maʻamau o ka hana ʻana o kāu ʻōnaehana kahe koko , ʻōnaehana hanu , a me ka ʻōnaehana gastrointestinal .
ʻO ke ʻano kēia, he mea kōkua nui kēia hoʻāʻo maʻalahi i ka loaʻa ʻana o kahi ʻike o kou kūlana olakino holoʻokoʻa, a me ka hōʻoia ʻana a i ʻole ke kāpae ʻana i kekahi kūlana olakino i manaʻo ʻia.
He aha nā ʻano hana nui o ka auscultation?
Hiki ke hoʻokaʻawale ʻia kēia hoʻāʻo i kekahi mau ʻāpana, ma muli o ke kino a ke kauka e hoʻolohe nei. E nānā kākou i ke ʻano o lākou.
| ʻO ka ʻōpū hoʻokolokolo | Pehea e hana ai a me nā mea e nānā ai |
|---|---|
| Puʻuwai | E noho ʻia ʻoe a i ʻole e hoʻomoe ʻia ma kahi kihi 45-degere, a e kau ʻia ka stethoscope ma nā wahi like ʻole ma kou umauma. Maanei, e hoʻolohe pono ke kauka i 5 mau wahi kahi e lohe maopopo ʻia ai nā valves o ka puʻuwai. E nānā lākou i ka manawa o kou puʻuwai., ke akāka o ke kani (Intensity) , nā kiʻekiʻe a me nā haʻahaʻa o ke kani (Frequency/Pitch) , a me ka lōʻihi o ke kuʻi ʻana o hoʻokahi (Duration). |
| Nā māmā | E noi ʻia ʻoe e noho pololei a hanu hohonu ma kou waha. A laila, e kau ʻia ka stethoscope ma nā ʻāpana like ʻole o kou umauma a me kou kua e hoʻohālikelike i nā leo e puka mai ana mai kou mau māmā ma nā ʻaoʻao ʻelua. E nānā kēia i ka lōʻihi o kou hanu ʻana a me ka hanu ʻana i waho, ke ʻano o ke kani, a me nā leo ʻē aʻe e like me ka hū ʻana. |
| Nā kīʻaha koko (Arteries) | Hiki ke hoʻolohe ʻia nā kīʻaha koko nui ma ka ʻāʻī, ka ʻōpū, a me nā puʻupaʻa. Maanei, e nānā ʻia kahi leo ʻē i kapa ʻia ʻo bruit (kahi leo 'walaʻau' ʻē i hana ʻia i ka wā e kahe ai ke koko ma o kahi kīʻaha koko) a me ka wikiwiki o ka pulse nāwaliwali (ikaika) . Hiki i kēia mau mea ke kōkua i ka ʻike ʻana i nā mea keakea i ke kahe koko. |
| ʻōpū | E hoʻomoe ʻia ʻoe i lalo a e kau ʻia ka stethoscope ma luna o nā wahi like ʻole o kou ʻōpū e hoʻolohe i nā leo e puka mai ana mai kou ʻōpū. E nānā kēia inā hiki iā ʻoe ke lohe i nā leo mai kou ʻōpū (ʻOla) , pehea ka pinepine o kou lohe ʻana iā lākou (Ka nui) , a me ke ʻano o nā leo. |
He aha ke ʻano o kēia mau leo?
I kēia manawa, e nānā kākou i ka mea a kēia mau leo maʻamau a me nā leo ʻē e ʻōlelo ai e pili ana i kou olakino.
Nā Leo o ka Puʻuwai
ʻO ka maʻamau, hoʻopuka ka puʻuwai olakino i ʻelua leo mele i kapa ʻia ʻo "lub-dub". Ua kapa ʻia kēia mau mea ʻo S1 a me S2. Hoʻopuka ʻia kēia mau leo i ka wā e pani ai nā valves o ka puʻuwai.
Akā i kekahi manawa lohe paha ʻoe i nā leo like ʻole a ʻano ʻē. Akā e hoʻomanaʻo, ʻaʻole nā leo ʻē a pau he hōʻailona ia o kahi maʻi koʻikoʻi.
| Walaʻau ʻē | He aha ke ʻano o ia mea |
|---|---|
| Nā ʻŌhumu Puʻuwai | He leo "swishing" kēia, e like me ka makani. Hiki ke hana ʻia e ka haunaele o ke kahe ʻana o ke koko ma o nā valves o ka puʻuwai. ʻOiai ʻaʻole pōʻino kekahi mau murmurs, hiki i kekahi ke lilo i hōʻailona o ka maʻi puʻuwai koʻikoʻi. |
| Ka hamo ʻana o ka pericardial | He leo palupalu a ʻūlū, me he mea lā e hamo ana ʻelua ʻāpana ʻili. Hiki ke hana ʻia kēia e ka mumū o ka ʻeke a puni ka puʻuwai (pericarditis). |
| Nā puʻuwai puʻuwai maʻamau ʻole | Nā kūlana e like me ke ʻano puʻuwai kūpono ʻole (atrial fibrillation), wikiwiki loa (tachycardia - ʻoi aku ma mua o 100 mau kuʻi i kēlā me kēia minuke), a lohi paha (bradycardia - emi ma mua o 60 mau kuʻi i kēlā me kēia minuke). |
Nā Leo o ka Māmā
Hoʻopuka nā māmā olakino i kahi leo palupalu a hakahaka ke hanu ʻoe. Eia nō naʻe, i kekahi manawa hiki iā ʻoe ke lohe i kahi leo ʻokoʻa.
| Walaʻau ʻē | He aha ke ʻano o ia mea |
|---|---|
| Huhū | He kani haʻahaʻa kona leo. Hana ʻia kēia kani ke hoʻohaiki ʻia nā ala ea e kahi mea e like me ka mucus. Lohe pinepine ʻia ia i nā maʻi e like me ka hānō a i ʻole COPD. |
| ʻO Rhonchi | He leo ʻūhū a palahalaha. Hiki ke hana ʻia e ka mucus a i ʻole nā mea ʻē aʻe e paʻa ana i loko o nā alaea. Hiki ke lilo ia i hōʻailona o kahi maʻi e like me ka niumonia. |
| Nā ʻūlū | He leo "chit chit", e like me ʻelua mau lauoho e hamo ana. Hoʻokumu ʻia kēia leo e ka hōʻiliʻili ʻana o ke wai i loko o nā māmā (pneumonia, hāʻule puʻuwai). |
| ʻO Stridor | He leo kiʻekiʻe, wheezing i hana ʻia i ka wā e hanu ana. Hoʻokumu ʻia ia e kahi poloka i ka puʻu a i ʻole ke ala ea o luna. Hiki i kēia ke lilo i pilikia . |
Nā Leo ʻŌpū
ʻO ka maʻamau, hana ko kākou mau ʻōpū i kahi leo palupalu, "pehu" i kēlā me kēia 5-10 kekona. ʻO ke ʻano kēia e hana maikaʻi ana ka ʻōnaehana hoʻoheheʻe.
- ʻAʻohe leo: Inā ʻaʻohe leo i lohe ʻia no nā minuke ʻelua a ʻoi, hiki ke hōʻailona ia o kahi ʻano i kapa ʻia ʻo ileus.
- Ka emi ʻana o ke kani: Inā haʻahaʻa ke alapine (frequency) o nā leo a palupalu loa paha ke kani, ma muli paha ia o kahi kūlana e like me ka paʻa ʻana o ka ʻōpū.
- Hoʻonui ʻia ka walaʻau: Inā lohe ʻoe i nā leo he nui aʻe ma mua o ka maʻamau, hiki ke lilo i hōʻailona o kahi maʻi e like me ka maʻi diarrhea.
- Nā leo ʻūhū a kiʻekiʻe paha: Inā lohe ʻoe i ke kani ʻūhū ʻole a i ʻole nā leo haʻahaʻa e puka mai ana mai kou ʻōpū, he hōʻailona paha ia o kahi ālai ʻana o ka ʻōpū.
Aia kekahi mau wahi e hoʻolohe pono ai nā kauka?
ʻAe, ʻoiaʻiʻo nō.
Aia kekahi wahi kūikawā ma kou kua luna, ma waena o kou mau ʻūhā poʻohiwi, i kapa ʻia ʻo "triangle of auscultation." He lahilahi ka papa ʻiʻo ma kēia wahi, no laila hiki ke lohe maopopo ʻia nā leo mai nā māmā.
Eia kekahi, i ka hoʻolohe ʻana i ka puʻuwai, aia he 5 mau wahi kikoʻī ma ka umauma kahi e lohe nui ʻia ai nā leo o nā valves o ka puʻuwai. E kau pono ke kauka i ka stethoscope ma kēia mau wahi a nānā iā lākou.
Me kou ʻike ʻole, ke hana mau nei kou kino i nā leo like ʻole. Ua like ia me kahi hui mele. ʻO ka Auscultation kahi manawa kūpono no ke kauka e nīnau ai inā e pāʻani ana kekahi o nā mea kani ma kēia hui ma ke kī hewa.
No laila, i ka manawa aʻe e kau ai kāu kauka i kāna stethoscope a hoʻolohe, mai makaʻu. Hiki iā ia ke hōʻike i ka nui o ka ʻike waiwai e pili ana i kou olakino. Inā lohe ʻoe i kahi mea ʻē, mai kānalua e nīnau i kāu kauka e pili ana i ia mea.
Leka Lawe-Home
- ʻO ka Auscultation ke kaʻina hana o ka hoʻolohe ʻana i nā leo e puka mai ana mai kou puʻuwai, nā māmā, a me nā ʻōpū me ka hoʻohana ʻana i ka stethoscope. He hoʻāʻo maʻalahi loa kēia, palekana, a ʻeha ʻole.
- He hoʻāʻo maʻamau kēia i hana maoli ʻia i ka wā o kahi hoʻokolohua lapaʻau maʻamau.
- ʻOiai hiki i kēia mau leo ʻē ke hāʻawi i nā hōʻailona i nā ʻano maʻi like ʻole, ʻaʻole nā leo ʻē a pau he hōʻailona o kahi maʻi koʻikoʻi.
- He mea hana hoʻokahi wale nō kēia a ke kauka e hoʻohana ai. Inā he kānalua, e hana lākou i nā hoʻokolohua hou aʻe e hana i kahi hōʻailona pololei.
- Mai makaʻu e nīnau e pili ana i nā mea a kāu kauka i lohe ai a me kona manaʻo. He kuleana kou e ʻike ʻia e pili ana i kou olakino.
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