Kodi dokotala amamvetsera chiyani ndi stethoscope? Tiyeni tiphunzire bwino za auscultation!

Mwina mwawonanapo ndi dokotala mukapita kwa dokotala, ndipo amaika chida chozizira pachifuwa panu, kumbuyo, kapena m'mimba ndikumvetsera kwakanthawi. Timachitcha stethoscope. Koma kodi munayamba mwadzifunsapo chifukwa chake amachita zimenezo, zomwe amamva, zomwe amapeza kuchokera ku mawu amenewo? Ndicho chimene tikambirana lero. Mu zamankhwala, izi zimatchedwa "Auscultation." Mwachidule, ndi kumvetsera mawu ochokera mkati mwa thupi.

Kodi kumvetsera thupi kumatanthauza chiyani kwenikweni? (Auscultation)

Mwachidule, ``(Auscultation)`` ndi pamene dokotala amagwiritsa ntchito stethoscope kumvetsera mawu osiyanasiyana ochokera mkati mwa mtima wanu, mapapo , mitsempha ikuluikulu yamagazi (mitsempha yamagazi), ndi m'mimba. Dokotala amamvetsera mawu awa poika stethoscope mwachindunji pachifuwa chanu, pakhosi, kumbuyo, ndi m'mimba. Amamvetsera zinthu zambiri monga mawu osiyanasiyana, mtundu wawo, momwe amamvekera mokweza, komanso nthawi yomwe amachitika.

Tangoganizirani, ichi ndi chinthu chosavuta kwambiri chomwe sichivulaza thupi mwanjira iliyonse . Ndipotu, iyi ndi njira yakale kwambiri, koma yothandiza kwambiri yomwe madokotala amagwiritsabe ntchito masiku ano kuti adziwe za thanzi lanu. Iyi ndi njira yoyesera yomwe imachitika popanda kuyika chilichonse m'thupi (yosavulaza).

Kodi dokotala amamvetsera motere nthawi yanji?

Kutsegula m'mimba nthawi zambiri kumachitika ngati gawo la kuyezetsa thupi nthawi zonse, kaya mukupita kwa dokotala wanu chaka chilichonse kapena chifukwa cha matenda ena aliwonse. Madokotala amafuna kumva mawu ochokera m'thupi lanu, m'thupi lanu , komanso m'mimba kuti atsimikizire kuti akugwira ntchito bwino. Izi zingawathandize kumvetsetsa thanzi lanu lonse, kuzindikira matenda aliwonse omwe amayambitsa, kapena kutsimikizira matenda omwe akukayikiridwa.

Pali njira zingapo zomvetsera ziwalo zosiyanasiyana za thupi, sichoncho?

Inde, momwe dokotala amachitira izi "(Auscultation)" zimatha kusiyana kutengera dongosolo la thupi lomwe akumvetsera. Tiyeni tiwone njira zazikulu.

Kumvetsera mtima (Heart Auscultation)

Mu mayeso awa, dokotala amamvetsera mawu ochokera mumtima mwanu. Izi zimatchedwanso ``Cardiac Auscultation''. Izi nthawi zambiri zimachitika mwa kukhala molunjika pampando kapena kugona pabedi pa ngodya ya madigiri 45. Nthawi zina mungapemphedwe kuti mutembenukire pang'ono kumanzere, kuti mawu a mtima amveke bwino.

Dokotala adzaika stethoscope pachifuwa panu ndikumvetsera mawu a mtima wanu. Pali malo 5 enieni pachifuwa panu komwe mawu ochokera ku valve ya mtima amamveka bwino. Stethoscope idzayikidwa pamalo aliwonsewa motsatizana. Malo awa nthawi zambiri amakhala kumtunda kumanzere kwa chifuwa chanu.

Dokotala akamamvetsera kulira kwa mtima, amafufuza zotsatirazi:

• Nthawi: Nthawi yomwe mtima wanu umagunda ( kugunda kwa mtima ).
• Mphamvu: Kugunda kwa mtima mokweza.
• Kuchuluka kwa mawu: Kuthwa kwa mawu, kapena momwe amatchulidwira kuti ``pitch''.
• Kutalika: Kodi kugunda kwa mtima kamodzi kumatenga nthawi yayitali bwanji?

Kumvetsera mapapu (Kutsegula m'mapapo)

Mu izi, dokotala amamvetsera mawu ochokera m'mapapu anu. Izi zimachitika mwa kukupangitsani kukhala molunjika, ngati n'kotheka. Dokotala amaika stethoscope pachifuwa panu ndikukupemphani kuti mupume mpweya wakuya kudzera pakamwa panu. Kenako, stethoscope imasunthidwa kupita kumalo osiyanasiyana m'mapapu anu otchedwa ``Pulmonary Auscultation Points''. Dokotala amamvetsera mawu ochokera pamwamba pa mapapu anu, kuwayerekeza mbali zonse ziwiri.

Pambuyo pomvera mawu a m'mapapo kuchokera kutsogolo kwa thupi lanu, dokotalayo amaika stethoscope kumbuyo kwanu. Monga kale, amamvetsera kuchokera pamwamba mpaka pansi, mbali ndi mbali, ndikumvetsera kuti mpweya utuluke mokwanira (kupuma ndi kupuma) pamalo amodzi. Kenako, amayerekeza mawu omwe amamveka kuchokera kutsogolo ndi mawu omwe amamveka kumbuyo.

Dokotala akamamvetsera phokoso la m'mapapo, ayenera kutsatira malangizo awa:

• Kutalika: Nthawi yomwe imakutengerani kuti mupumule ndi kutulutsa mpweya.
• Kuchuluka kwa mawu: Kuthwa kwa mawu (pitch).
• Kuchuluka kwa mpweya: Kumveka kwa mpweya mokweza (kumveka mokweza/mphamvu).
• Ubwino: Kodi pali mawu achilendo, mwachitsanzo, kupuma movutikira ?

Kumvetsera mitsempha ikuluikulu yamagazi (Mitsempha)

Ngati kuli kofunikira, dokotala angamvetserenso mitsempha ikuluikulu yamagazi (mitsempha) m'khosi mwanu, m'mimba, ndi m'impso .

Apa, dokotala akuyang'ana zinthu izi:

• Chidule: Ili ndi phokoso lovuta komanso lopweteka lomwe limapangidwa ndi magazi omwe akuyenda kudzera m'mitsempha yamagazi. Izi zikutanthauza kuti magazi sakuyenda bwino kudzera m'mitsempha, mwina chifukwa cha kutsekeka. Ikhozanso kukhala chizindikiro chakuti magazi omwe amafika m'thupi achepa.
• Mphamvu: Yang'anani ngati kugunda kwa mtima kwanu kuli kofooka kapena kulibe. Izi zitha kutanthauza kuti mtsempha wamagazi watsekeka.

Kutulutsa Mimba

Mu mayeso awa, dokotala amamvetsera mawu ochokera m'matumbo mwanu. Izi zimachitika mwa kukugonetsani bwino pabedi ndi pilo pansi pa mutu wanu. Mungapatsidwenso chithandizo chaching'ono pansi pa mawondo anu kuti chikhale chomasuka.

Dokotala amaika stethoscope pamimba panu ndikuyisuntha kupita kumadera osiyanasiyana a mimba yanu kuti amve mawu ochokera m'matumbo anu.

Akamamvetsera phokoso la m'mimba, madokotala amafufuza:

• Kukhalapo: Kaya mawu akumveka kuchokera m'matumbo kapena ayi.
• Kuchuluka: Ngati phokoso lamveka, kodi limamveka kangati.
• Ubwino: Kaya phokosolo lili ndi makhalidwe enaake kapena lachilendo.

Kodi madokotala amamvetsa chiyani kuchokera ku mawu awa?

Chabwino, tsopano tiyeni tiwone zomwe madokotala akupeza kuchokera ku phokoso lomwe limamveka kulikonse.

Zinthu zomwe zimanenedwa kudzera mu mawu a mtima

Mtima wabwinobwino komanso wathanzi umamveka bwino mu kamvekedwe kokhazikika, "lub-dub". Phokoso loyamba limatchedwa `(S1)` ndipo lachiwiri limatchedwa `(S2)`. Phokoso ili limamveka ndi dokotala wanu akatseka ma valve a mtima wanu.

Komabe, nthawi zina mungamve mawu osazolowereka monga awa:

• Kung'ung'udza: Awa ndi mawu achilendo omwe amamveka pamene mtima ukugunda. Ali ngati "phokoso logwedezeka" lopangidwa ndi madzi oyenda pang'onopang'ono. Amayambitsidwa ndi kuyenda kwa magazi kosasunthika pamene magazi akuyenda kudzera m'ma valve a mtima. Pali mitundu yambiri ya "kung'ung'udza", ndipo ena akhoza kukhala chizindikiro cha matenda aakulu a mtima.
• Kupukuta kwa Pericardial Friction: Uku ndi phokoso lamphamvu komanso lozungulira. Limamveka ngati zidutswa ziwiri za chikopa zikukukuta pamodzi. Izi zitha kukhala chizindikiro cha matenda a mtima otchedwa ``pericarditis.''
• Kugunda kwa Mtima Kosazolowereka: Zitsanzo zikuphatikizapo `(Atrial Fibrillation)` (kugunda kwa mtima kosazolowereka), `(Tachycardia)` (kugunda kopitilira 100 pamphindi), ndi `(Bradycardia)` (kugunda kochepera 60 pamphindi).

Zinthu zoti munene zokhudza mawu a m'mapapo

Phokoso labwinobwino lomwe limamveka kuchokera m'magawo osiyanasiyana a mapapo anu nalonso limasiyana pang'ono. Koma, kawirikawiri, mapapo athanzi amakhala ndi phokoso lofewa komanso lopanda kanthu. Dokotala wanu adzamva phokosoli mukapuma.

Komabe, mungamvenso mawu osazolowereka monga awa:

• Stridor: Phokoso ili limachitika pamene pali kutsekeka kwa njira yanu yopumira ya m'mwamba. Ndi phokoso lalikulu, lapamwamba, komanso lakuthwa. Likhoza kuyambitsidwa ndi epiglottitis, anaphylaxis (kutupa kwakukulu), kapena kusagwira bwino ntchito kwa mawu.
• Kupuma movutikira:Phokoso la mluzu limeneli limachitika pamene njira zanu zopumira zimakhala zochepa. Ndi phokoso la mluzu lokwera kwambiri. Lingatanthauze kuti mapapu anu sakudzaza ndi mpweya wonse chifukwa cha chinthu chonga mamina. Izi zitha kumveka m'mikhalidwe monga `(Asthma)` (asthma), `(Chronic Obstructive Pulmonary Disease - COPD)` (pulmonary edema)` (madzimadzi m'mapapu).
• Rhonchi: Phokosoli limayamba chifukwa cha kutsekeka kwa njira zopumira. Limafanana ndi kukodola. Limamveka m'mikhalidwe monga `(Chibayo)` (Chibayo), `(COPD)`, `(Cystic Fibrosis)`.
• Kusweka/Kusweka: Izi zimamveka ngati tsitsi la zingwe ziwiri likukhutchumuka pamodzi. Zimachitika pamene madzi akusonkhana m'njira zopumira chifukwa cha matenda a m'mapapo, monga chibayo, kapena vuto la mtima monga kulephera kwa mtima.
• Kupukuta kwa pleural: Izi zikumveka ngati kupukuta kwa sandpaper pamodzi. Izi zitha kutanthauza kuti minofu yozungulira mapapu anu yakwiya. Ikhoza kukhala chizindikiro cha matenda monga pleurisy, pneumothorax, kapena pleural effusion.
• Kulira: Izi zimatchedwanso phokoso lalifupi kapena phokoso lolira. Phokosoli lingayambitsidwe ndi kusintha kwa njira zanu zopumira. Limamveka ngati kuphatikiza kwa kupuma movutikira ndi kugwedezeka. Likhoza kukhala chizindikiro cha matenda monga `(Pulmonary Fibrosis)`, `(Bronchiolitis)`, `(Chibayo)`.

Tangoganizirani, mawu onsewa ali ngati mawu ochokera ku zida zosiyanasiyana zomwe zili m'gulu la nyimbo mkati mwa thupi lanu. Nthawi zina, chimodzi mwa zida zimenezo chingakhale kachilombo. Kachilombo kameneka ndi komwe dokotala akukhudza.

Zinthu zomwe zimanenedwa kudzera m'mawu am'mimba

Phokoso labwino komanso labwino la m'mimba ndi phokoso lotsika komanso lomveka bwino. Phokoso limeneli nthawi zambiri limamveka masekondi 5 mpaka 10 aliwonse. Zimatanthauza kuti chakudya chikuyenda m'matumbo mwanu ndipo kugaya chakudya (GI Tract) kwanu kukugwira ntchito bwino.

Dokotala akamamvetsera phokoso la m'mimba, amafufuza zinthu zina monga:

• Kutaya mawu: Ngati simukumva mawu aliwonse ochokera m'matumbo anu kwa mphindi zoposa ziwiri, izi zitha kukhala chizindikiro cha vuto lotchedwa ``Ileus.'' Apa ndi pamene zomwe zili m'matumbo zimasonkhana ndipo matumbo amasiya kuyenda kwakanthawi.
• Kuchepa kwa mawu: Ngati mawu omwe amamveka kuchokera m'matumbo ali chete, ngati ali otsika kwambiri, zingatanthauze kuti ntchito ya m'matumbo yachepa, kapena kuti muli ndi ``(Kudzimbidwa)```.
• Kuwonjezeka kwa phokoso: Ngati mukumva phokoso lalikulu komanso lobwerezabwereza kuchokera m'matumbo anu, zingatanthauze kuti matumbo anu akugwira ntchito molimbika, kapena kuti mukutsegula m'mimba.
• Kung'ung'udza kapena phokoso lalikulu: Ngati mukumva phokoso lalikulu kapena phokoso lalikulu likuchokera m'matumbo mwanu, mwina muli ndi vuto la matumbo.

Kodi "Triangle of Auscultation" iyi ndi chiyani?

Izi ndi zomveka bwino pankhani ya zamankhwala, koma n'zosavuta kuzimvetsa. "Triangle of Auscultation" ndi malo ang'onoang'ono kumbuyo kwanu. Apa ndi pomwe minofu itatu kumbuyo kwanu (trapezius, latissimus dorsi, ndi scapula) imakumana. Mukadutsa manja anu pachifuwa chanu ndikuwerama patsogolo, minofu iyi imatambasuka ndikukhala yopyapyala. Malo amakona atatuwa amaonekera. Dokotala akagwira stethoscope pamalo awa, mawu ochokera m'mapapu anu amatha kumveka bwino kwambiri.

Kodi ndi malo 5 ati ofunikira kumvetsera mtima?

Pali malo 5 akuluakulu omwe madokotala amamvetsera pogwiritsa ntchito stethoscope kuti aone thanzi la mtima. Malo amenewa amapezeka m'malo enaake pachifuwa, okhudzana ndi ma valve a mtima.

Ali:

• Malo Olumikizira Mitsempha: Malo awa ali kumanja kwa fupa la pachifuwa (sternum), pakati pa nthiti yachiwiri ndi yachitatu.
• Malo Opatsirana M'mapapo: Izi zilinso kumanja, monga mtsempha waukulu wamagazi, koma kumanzere.
• Erb's Point: Ili lili kumanzere kwa thupi, m'malo pakati pa nthiti yachitatu ndi yachinayi. ('Murmurs' ena amatha kumveka bwino kuchokera kuderali.)
• Malo Okhala ndi Minofu Yaikulu: Malo awa ali pakati pa nthiti yachinayi ndi yachisanu.
• Malo a Mitral: Awa ali pamwamba pa mtima, ndiko kuti, pansi kwambiri pa mtima.

Ndiye, kodi tiyenera kuphunzira chiyani kuchokera pa izi?

Mwina simungazindikire, koma thupi lanu limapanga mawu nthawi zonse. Zili ngati nyimbo zamoyo! Komabe, nthawi zina zina mwa "zida zoimbira" izi zimatha kukhala zosamveka bwino. Mawu osamveka bwino, kutanthauza kuti, mawu osazolowereka, amatha kuuza dokotala zambiri za thanzi lanu. Kapena, angawapatse zizindikiro zodziwira matenda mwa kuchita mayeso ena.

Chofunika kwambiri ndichakuti, ngati dokotala akumvetsera thupi lanu motere ndipo akupeza chinthu chachilendo, musaope kufunsa mafunso okhudza icho. Ndi ufulu wanu kufunsa kuti akufotokozereni bwino chomwe chikuchitika, chifukwa chake chikuchitika, komanso choti muchite kenako.

Kotero, nthawi ina dokotala akadzayika stethoscope m'thupi lanu ndikumvetsera, mudzadziwa kuti akuchita chinthu chofunikira kwambiri!

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