Ua ʻike paha ʻoe i kēia i nā manawa a pau āu i hele ai i ke kauka. Lawe ke kauka i kēlā mea liʻiliʻi ma luna o kāna pākaukau a i ʻole a puni kona ʻāʻī, kau i ka welau poepoe a anuanu o ia mea ma kou umauma, a hoʻolohe pono. I kekahi manawa kau pū ʻo ia ma kou kua. ʻO kēia ka mea a mākou e kapa nei
he auscultation i ka lāʻau lapaʻau. I ka ʻōlelo maʻalahi, ʻo ia ka hoʻolohe ʻana i nā leo e puka mai ana mai loko mai o kou kino. ʻOiai he hoʻāʻo maʻalahi loa ia, haʻi ia i ke kauka i ka nui o ka ʻike e pili ana i kou olakino.
He aha maoli ka auscultation?
Ua hoʻolohe nā kauka i nā leo o ko kākou kino mai ka wā ma mua o ka hana ʻia ʻana o ka stethoscope. Akā i kēlā manawa, ʻaʻohe o lākou stethoscope. Hoʻolohe lākou i kēia mau leo ma ke kau pololei ʻana i ko lākou mau pepeiao i ka umauma a i ʻole ka ʻōpū o ka mea maʻi. E noʻonoʻo, ʻaʻole anei he mea hilahila iki kēlā? ʻOiai ʻo Kauka René Laennec, nāna i hana i ka stethoscope, ʻaʻole makemake ʻo ia e kau i kona mau pepeiao i ka umauma o ka mea maʻi ma kēia ʻano. Ua ʻōwili mua ʻo ia i kahi ʻāpana pepa a hoʻohālike iā ia i loko o kahi funnel a kau iā ia ma luna o ka umauma. A laila ua ʻike ʻo ia ua hoʻonui nui ʻia nā leo i loko o ka umauma i ko lākou hele ʻana ma o ia mea. Ua hoʻomohala ʻia kēlā manaʻo a ua hana ʻia ka stethoscope āu e ʻike nei i kēia lā. I ka hoʻolohe ʻana ma kēia ʻano, hoʻolohe ke kauka i kekahi mau kumu koʻikoʻi.
| He aha e hoʻolohe ai | I ka ʻōlelo maʻalahi... |
|---|
| Alapine (frequency) | Inā paha he leo kiʻekiʻe a haʻahaʻa paha ke kani āu e lohe ai. |
| Ka ikaika | Pehea ka leo nui o ke kani? |
| Ka lōʻihi | Pehea ka lōʻihi o ke kani ʻana o kekahi? |
| Helu | Ke lohe pinepine nei ʻoe i ke kani? |
| Kūlana | Pehea ke kani o ke kani? (e.g., hū ʻana, uē ʻana) |
. Hiki ke hana wikiwiki a maʻalahi hoʻi i kēlā me kēia manawa, no ka mea, aia kahi stethoscope kokoke i kēlā me kēia kauka.
Pehea e hoʻolohe ai i kou puʻuwai?
Ua lohe paha ʻoe i kou puʻuwai e kuʻi ana. "
Lub-dub " "Lub-dub"... ʻO kēia ke kani kumu o ka puʻuwai olakino. Hiki mai ke kani "lub" (S1) ke pani ʻia nā valve ʻelua o ka puʻuwai (nā valve mitral a me tricuspid). Hiki mai ke kani "dub" (S2) ke pani ʻia nā valve ʻelua ʻē aʻe (nā valve aortic a me pulmonary). E kau ke kauka i ka stethoscope ma nā wahi nui ʻehā o kou umauma. ʻO kēia no ka mea hiki ke lohe maikaʻi ʻia ke kani o kahi valve puʻuwai kikoʻī mai kēlā me kēia wahi. Ma waho aʻe o kēia mau leo pani valve, e lohe pū
ke kauka i nā leo o ke kahe ʻana o ke koko a me nā haʻalulu o ka ʻiʻo puʻuwai. ʻO kāna hana ka hoʻokaʻawale ma waena o nā leo maʻamau, olakino a me nā leo ʻē aʻe e hōʻike ana i kahi maʻi.
Eia kekahi laʻana, inā lohe ʻoe i kahi leo "s... whiz..." e puka mai ana mai kou puʻuwai, he ʻōhumu puʻuwai paha ia. ʻOiai ʻaʻole pilikia kekahi o kēia mau mea, hiki i kekahi ke lilo i hōʻailona o kahi maʻi koʻikoʻi. Pēlā nō, inā lohe ʻoe i kahi leo e like me ʻelua ʻāpana ʻili e hamo ana, he mumū paha ia o ka membrane e hoʻopuni ana i ka puʻuwai ( pericarditis ).
He aha kāu e nānā ai i ka wā e hoʻolohe ai i nā māmā?
Ma hope o ka hoʻolohe ʻana i kou puʻuwai, e hoʻolohe kāu kauka i kou mau māmā. E hoʻomaka pinepine ʻo ia ma kekahi ʻaoʻao o kou umauma a hoʻoneʻe i ka stethoscope i lalo. A laila e hoʻoneʻe ʻo ia i ka stethoscope i kekahi ʻaoʻao ma ke ʻano like. A laila e kau ʻo ia i ka stethoscope ma kou kua a hana like. I kāna hana ʻana i kēia, e hoʻohālikelike ʻo ia i nā leo mai nā māmā ʻelua. I kekahi manawa, e noi aku kāu kauka iā ʻoe
e kūlou i mua a kau i kou mau lima ma kou umauma . E kōkua kēia i kou mau ʻiʻo hope e hoʻomaha a hoʻonui i ka ʻāpana o kou mau māmā (triangle of auscultation). E kōkua kēia iā ʻoe e lohe maopopo i nā leo. E hoʻolohe pono ʻo ia i nā leo āu e hana ai i kou hanu ʻana (inspiration) a me ka exhale (expiration). Ma waho aʻe o nā leo hanu maʻamau, inā he maʻi kou, e lohe paha ʻoe i kēia mau leo ʻē:
| Walaʻau ʻē | Ka wehewehe a me nā kumu kūpono |
|---|
| Nā ʻūhū | He leo hūʻū kiʻekiʻe. ʻO ka maʻamau, hana ʻia kēia e ka hānō, COPD, a i ʻole ka hōʻiliʻili ʻana o ka mucus i loko o nā māmā. |
| Nā ʻūlū | He leo "crackling" a "crackling". Hiki mai kēia leo ke piha nā alaea i ka mucus a i ʻole ka wai. Hiki ke hana ʻia e ka maʻi māmā, COPD, a i ʻole ka maʻi puʻuwai. |
| ʻO ka hamo ʻana o ka pleural | Ua like ia me ʻelua ʻāpana pepa one e hamo ana. Hōʻike kēia he pilikia me ka membrane e hoʻopuni ana i nā māmā (pleura). |
| ʻO Stridor | He leo nui a kiʻekiʻe e puka mai ana mai ka puʻu i ka wā e hanu ana. Hōʻike kēia i kahi ālai ʻia ma ke ala ea o luna (puʻu, larynx). |
No ke aha ʻoe e kau ai i ka stethoscope ma kou ʻōpū?
ʻAe, e kau pū ke kauka i kahi stethoscope ma kou ʻōpū a hoʻolohe. Ua ʻike anei ʻoe i ke kumu? E hoʻolohe i nā leo e puka mai ana mai kou ʻōpū. Ke hoʻoheheʻe ʻia ka meaʻai a mākou e ʻai ai a neʻe i lalo e like me ka ʻōpala, hana nā ʻōpū i kahi leo.
Hoʻopuka pinepine nā ʻōpū o ke kanaka olakino i kahi kani "gurgling" i kēlā me kēia 5-10 kekona.
Inā ʻaʻohe o kēia mau leo a palupalu loa paha, hiki iā lākou ke hōʻike i ka paʻa ʻana o ka ʻōpū a i ʻole ke ālai ʻana o ka ʻōpū (ileus). Inā nui a leo nui kēia mau leo, he hōʻailona paha ia o kahi maʻi e like me ka maʻi diarrhea. I kekahi manawa, hiki ke ʻike ʻia ke ālai ʻana o ka ʻōpū e kēia mau leo.
Ua hala ka manawa o kēia ʻano hana i kēia manawa?
Manaʻo paha kekahi me nā ʻenehana holomua e like me ka CT scan a me ka MRI scan, ua kahiko ka hoʻolohe ʻana me kēia stethoscope i kēia manawa. ʻOiaʻiʻo, aia kekahi mau pilikia me ka stethoscope kuʻuna. He palupalu loa ke kani, he paʻakikī ke lohe i kahi walaʻau, a he mea hiki ʻole ke hoʻolohe kekahi i kāu mea e lohe ai. Akā i kēia lā, ua hiki mai nā hoʻonā i kēia.Hiki i
nā stethoscopes uila ke hoʻonui i nā leo a hoʻomālamalama iā lākou. Hiki iā lākou ke hoʻopaʻa i nā leo ma ke ʻano he faila kikohoʻe a hoʻouna iā lākou i kekahi kauka ʻē aʻe no ka loiloi. He mea nui loa kēia i ka telemedicine. Hiki i kekahi mau mea hana ke nānā like i kahi EKG (Electrocardiogram) e hōʻike ana i ka helu o ka puʻuwai i ka wā e hoʻolohe ana i ka puʻuwai. Eia nō naʻe, ʻaʻole pau ka auscultation. Hiki i kēia i ke kauka ke loaʻa koke kahi manaʻo kumu o kou kūlana. Ma muli o kēlā manaʻo, hiki iā ia ke hoʻoholo pololei i nā hoʻokolohua e hana ai ma hope. Hōʻalo pū kēia i nā hoʻokolohua pono ʻole a pipiʻi. Eia naʻe, ʻo ka holomua o kēia e hilinaʻi wale ʻia ma
ke akamai o ke kauka, ka ʻike, a me ka makemake e hoʻolohe pono .
Leka Lawe-Home
- He hoʻāʻo maʻalahi loa ka Auscultation, palekana, akā he mea nui loa ia e hana ʻia e ke kauka.
- Hiki i kēia hoʻāʻo maʻalahi ke haʻi iā ʻoe i nā mea he nui e pili ana i ka hana o kou puʻuwai, nā māmā , a me nā ʻōpū.
- Ma muli o nā leo i lohe ʻia ma o ka stethoscope, e hiki i ke kauka ke kōkua iā ʻoe e hoʻoholo i ka hoʻāʻo a i ʻole ka lāʻau lapaʻau āu e pono ai.
- He hoʻokolohua lapaʻau ʻoihana kēia. No laila, mai heluhelu e pili ana i kēia a hele e nānā iā ʻoe iho me kahi stethoscope. E waiho i kēlā hana i kāu kauka.
Hoʻolohe, stethoscope, hoʻokolokolo lapaʻau, kani o ka puʻuwai, kani o ka māmā, kani o ka ʻōpū, kauka
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