Mukukumbukira pamene munapita kukaonana ndi dokotala ndipo munayikidwa stethoscope yozizira pachifuwa ndi kumbuyo kwanu ndipo munamvetsera mosamala? Tonsefe takumanapo ndi izi. Kodi simunayambe mwadzifunsapo kuti, "Dokotala akumva chiyani kwenikweni kuchokera pa izi?" Yankho la funsoli ndi mayeso azachipatala omwe tikukamba lero otchedwa 'Auscultation.' Musadandaule, ndi osavuta, osapweteka, koma ndi chinthu chofunikira chomwe chimakuuzani zambiri za thanzi lanu.
Mwachidule, kodi auscultation ndi chiyani?
Kutsegula mawu (kotchedwa: "o-skul-ta-tion") ndi njira yosavuta kwambiri. Imafuna kugwiritsa ntchito stethoscope kuti mumvetsere mawu ochokera m'ziwalo zanu zamkati, monga mtima wanu, mapapo, mitsempha yamagazi, ndi matumbo . Dokotala adzayika stethoscope pachifuwa panu, pakhosi, kumbuyo, ndi pamimba ndikuyang'ana zinthu monga mtundu, liwiro, voliyumu, ndi kayimbidwe ka mawu awa.
Iyi ndi mayeso osavulaza konse, otetezeka kwambiri. Ndi imodzi mwa mayeso akale komanso osavuta omwe madokotala amagwiritsabe ntchito masiku ano.
Kodi mayeso a auscultation amachitidwa liti?
Mukapita kukayezetsa thupi nthawi zonse, dokotala wanu mwina adzachita mayesowa. Izi zimakupatsani lingaliro lomveka bwino la momwe dongosolo lanu lozungulira magazi , dongosolo lopumira , ndi dongosolo la m'mimba zimagwirira ntchito.
Izi zikutanthauza kuti mayeso osavuta awa ndi othandiza kwambiri pakumvetsetsa momwe thanzi lanu lilili, komanso kutsimikizira kapena kuchotsa vuto lililonse lachipatala lomwe likukayikiridwa.
Kodi njira zazikulu zochitira auscultation ndi ziti?
Mayesowa akhoza kugawidwa m'magawo angapo, kutengera chiwalo chomwe dokotala akumvetsera. Tiyeni tiwone zomwe zili.
| Chiwalo chowunikira | Momwe mungachitire izi ndi zomwe muyenera kuzifufuza |
|---|---|
| Mtima | Mudzakhala pansi kapena mutakhala pansi pa ngodya ya madigiri 45, ndipo stethoscope idzayikidwa pamalo osiyanasiyana pachifuwa chanu. Apa, dokotala adzamvetsera makamaka madera 5 omwe ma valve a mtima amamveka bwino. Adzayang'ana nthawi ya kugunda kwa mtima wanu., kumveka bwino kwa mawu (Kulimba) , kukwera ndi kutsika kwa mawu (Kuchuluka/Kukwera) , ndi nthawi yomwe kugunda kamodzi kumatenga (Kutalika). |
| Mapapu | Mudzapemphedwa kuti mukhale molunjika ndi kupuma mpweya wambiri kudzera pakamwa panu. Kenako, stethoscope idzayikidwa mbali zosiyanasiyana za chifuwa chanu ndi kumbuyo kuti muyerekezere mawu ochokera m'mapapo anu mbali zonse ziwiri. Izi zidzayang'ana nthawi yomwe mukupuma ndi kutulutsa mpweya, mtundu wa mawuwo, ndi mawu aliwonse osazolowereka monga kulira mluzu. |
| Mitsempha ya magazi (Mitsempha yamagazi) | Mitsempha ikuluikulu yamagazi m'khosi, m'mimba, ndi impso imathanso kumvedwa. Apa, phokoso losazolowereka lotchedwa bruit (phokoso losazolowereka lomwe limachitika magazi akamayenda kudzera m'mitsempha yamagazi) ndi kugunda kwa mtima kofooka (mphamvu) zimayesedwa. Izi zingathandize kuzindikira zopinga zilizonse pakuyenda kwa magazi. |
| Mimba | Mudzagonekedwa pansi ndipo stethoscope idzayikidwa m'malo osiyanasiyana a m'mimba mwanu kuti mumve mawu ochokera m'matumbo mwanu. Izi zidzayang'ana ngati mungamve mawu ochokera m'matumbo mwanu (Kukhalapo) , kangati mumamva mawuwo (Kuchuluka) , komanso mtundu wa mawuwo. |
Kodi mawu awa amatanthauza chiyani?
Tsopano tiyeni tiwone zomwe mawu abwinobwino ndi osazolowereka awa akunena zokhudza thanzi lanu.
Mafunso a Mtima
Kawirikawiri, mtima wathanzi umapanga mawu awiri ofanana ndi rhythm otchedwa "lub-dub". Awa amatchedwanso S1 ndi S2. Mawu amenewa amapangidwa pamene ma valve a mtima atsekedwa.
Koma nthawi zina mungamve mawu osiyanasiyana, osazolowereka. Koma kumbukirani kuti, si mawu onse osazolowereka omwe ndi chizindikiro cha matenda aakulu.
| Phokoso lachilendo | Kodi zikutanthauza chiyani? |
|---|---|
| Kudandaula kwa Mtima | Uwu ndi mawu akuti "swishing", ofanana ndi mphepo. Ukhoza kuchitika chifukwa cha kusokonezeka kwa kuyenda kwa magazi kudzera m'ma valve a mtima. Ngakhale kuti kulira kwina sikuvulaza, kwina kungakhale chizindikiro cha matenda aakulu a mtima. |
| Kupukuta kwa pericardial friction | Phokoso lochepa, lokhala ngati kuti zidutswa ziwiri za khungu zikukhutchumuka pamodzi. Izi zitha kuchitika chifukwa cha kutupa kwa thumba lozungulira mtima (pericarditis). |
| Kugunda kwa mtima kosazolowereka | Matenda monga kusakhazikika kwa mtima (atrial fibrillation), kuthamanga kwambiri (tachycardia - kugunda kopitilira 100 pamphindi), kapena pang'onopang'ono kwambiri (bradycardia - kugunda kochepera 60 pamphindi). |
Mafuwa a Mapapo
Mapapu abwino amatulutsa phokoso lofewa komanso lopanda kanthu mukapuma. Komabe, nthawi zina mumamva phokoso losiyana.
| Phokoso lachilendo | Kodi zikutanthauza chiyani? |
|---|---|
| Kupuma movutikira | Limamveka ngati phokoso lolira mokweza pang'ono. Phokosoli limapangidwa pamene njira zopumira mpweya zachepetsedwa ndi chinthu chonga ntchofu. Limamveka nthawi zambiri m'matenda monga mphumu kapena COPD. |
| Rhonchi | Phokoso lokweza komanso lokweza. Lingayambitsidwe ndi mamina kapena zinthu zina zomwe zimamatira m'njira yopumira. Likhoza kukhala chizindikiro cha matenda monga chibayo. |
| Mikwingwirima | Phokoso la "chit chit", ngati tsitsi la zingwe ziwiri likukhutchumuka pamodzi. Phokosoli limayamba chifukwa cha madzi omwe amasonkhana m'mapapo (chibayo, kulephera kwa mtima). |
| Stridor | Phokoso lamphamvu komanso lopumira lomwe limamveka popuma. Limayamba chifukwa cha kutsekeka kwa pakhosi kapena njira yodutsa mpweya. Izi zitha kukhala zadzidzidzi . |
Phokoso la m'mimba
Kawirikawiri, matumbo athu amapanga phokoso lofewa, "lotumphuka" masekondi 5-10 aliwonse. Izi zikutanthauza kuti kugaya chakudya kukugwira ntchito bwino.
- Palibe phokoso: Ngati palibe phokoso lomwe lamveka kwa mphindi zoposa ziwiri, likhoza kukhala chizindikiro cha vuto lotchedwa ileus.
- Kuchepa kwa mawu: Ngati mawu ambiri ndi otsika kapena mawuwo ndi ofewa kwambiri, mwina chifukwa cha vuto monga kudzimbidwa.
- Kuwonjezeka kwa phokoso: Ngati mukumva phokoso lalikulu kuposa masiku onse, likhoza kukhala chizindikiro cha vuto monga kutsegula m'mimba.
- Kung'ung'udza kapena phokoso lalikulu: Ngati mukumva phokoso losazolowereka kapena phokoso lotsika kuchokera m'matumbo mwanu, izi zitha kukhala chizindikiro cha kutsekeka kwa matumbo.
Kodi pali malo ena omwe madokotala amamvetsera makamaka?
Inde, ndithudi ilipo.
Pali malo apadera kumbuyo kwanu, pakati pa mapewa anu, otchedwa "triangle of auscultation." Minofu m'derali ndi yopyapyala, kotero mawu ochokera m'mapapo amatha kumveka bwino kwambiri.
Komanso, pomvetsera mtima, pali malo asanu enieni pachifuwa pomwe phokoso la ma valve a mtima limamveka bwino. Dokotala adzayika stethoscope m'malo awa ndikuwayang'ana.
Popanda kuzindikira, thupi lanu limapanga mawu osiyanasiyana nthawi zonse. Zili ngati gulu la nyimbo. Kumvetsera nyimbo ndi mwayi kwa dokotala kufunsa ngati zida zilizonse mu gululi zikusewera molakwika.
Choncho nthawi ina dokotala wanu akagwiritsa ntchito stethoscope yake ndikumvetsera, musachite mantha. Ikhoza kukupatsani zambiri zofunika zokhudza thanzi lanu. Ngati mumva chinthu chachilendo, musazengereze kufunsa dokotala wanu za icho.
Uthenga Wopita Nawo Kunyumba
- Kumvetsera mawu kuchokera mumtima, m'mapapo, ndi m'matumbo pogwiritsa ntchito stethoscope. Iyi ndi njira yosavuta, yotetezeka, komanso yopanda ululu.
- Iyi ndi mayeso oyambira omwe amachitidwa nthawi zonse akamayesedwa ndi dokotala.
- Ngakhale kuti mawu osazolowereka amenewa angapereke zizindikiro za matenda osiyanasiyana, si mawu onse osazolowereka omwe ndi chizindikiro cha matenda aakulu.
- Ichi ndi chida chimodzi chokha chomwe dokotala amagwiritsa ntchito. Ngati pali kukayikira kulikonse, adzachita mayeso ena kuti adziwe matenda molondola.
- Musamaope kufunsa mafunso okhudza zomwe dokotala wanu adamva ndi tanthauzo lake. Ndi ufulu wanu kudziwitsidwa za thanzi lanu.
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