Ugqirha uphulaphula ntoni nge-stethoscope? Masifunde ngqo malunga ne-auscultation!

Mhlawumbi ukhe wambona ugqirha xa usiya kugqirha, aze abeke eso sixhobo sincinci sibandayo esifubeni sakho, emqolo, okanye esiswini sakho aze amamele okwethutyana. Siyibiza ngokuba yi-stethoscope. Kodwa ngaba wakha wazibuza ukuba kutheni besenza loo nto, oko bakuvayo, oko bakufumanisayo kwezo zandi? Yiloo nto siza kuthetha ngayo namhlanje. Kwizonyango, oku kubizwa ngokuba yi-"Auscultation." Ngamafutshane, kukumamela izandi ezivela ngaphakathi emzimbeni.

Kuthetha ukuthini kanye kanye ukumamela umzimba? (Auscultation)

Ngamafutshane, ``(Auscultation)`` kuxa ugqirha esebenzisa i-stethoscope ukumamela izandi ezahlukeneyo ezivela entliziyweni yakho, emaphaphu , kwimithambo yegazi emikhulu (imithambo yegazi), nakwisisu. Ugqirha umamela ezi zandi ngokubeka i-stethoscope ngqo esifubeni sakho, entanyeni, emqolo, nakwisisu. Zinika ingqalelo kwizinto ezininzi ezifana nezandi ezahlukeneyo, uhlobo lwazo, ukuba zikhulu kangakanani, kunye nokuba zenzeka nini.

Khawucinge nje, le yinto elula kakhulu engonakalisi umzimba nangayiphi na indlela . Enyanisweni, le yindlela endala kakhulu, kodwa esebenzayo kakhulu esetyenziswa ngoogqirha nanamhlanje ukufumanisa ngempilo yakho. Olu luvavanyo olwenziwa ngaphandle kokufaka nantoni na emzimbeni (olungangenisi).

Kunini apho ugqirha ephulaphula ngolu hlobo?

Uvavanyo lwe-Auscultation ludla ngokwenziwa njengenxalenye yovavanyo lomzimba oluqhelekileyo, nokuba undwendwela ugqirha wakho minyaka le okanye nakweyiphi na imeko yezonyango. Oogqirha bafuna ukuva izandi ezivela kwinkqubo yakho yokujikeleza kwegazi , kwinkqubo yokuphefumla , nakwinkqubo yesisu ukuqinisekisa ukuba zisebenza kakuhle. Oku kunokubanceda baqonde impilo yakho iyonke, bafumane naziphi na iimeko zempilo ezifihlakeleyo, okanye baqinisekise isifo esirhanelwayo.

Kukho iindlela ezahlukeneyo zokumamela amalungu ahlukeneyo omzimba, akunjalo?

Ewe, indlela ugqirha awenza ngayo lo ``(Auscultation)`` inokwahluka ngokuxhomekeke kwinkqubo yomzimba ayimameleyo. Makhe sijonge iindlela eziphambili.

Ukumamela intliziyo (Intliziyo Evakala Kakuhle)

Kolu vavanyo, ugqirha umamela izandi eziphuma entliziyweni yakho. Oku kukwabizwa ngokuba yi-"Cardiac Auscultation". Oku kwenziwa ngokuhlala uthe nkqo esihlalweni okanye ulale ebhedini nge-engile ye-45-degrees. Ngamanye amaxesha unokucelwa ukuba ujike kancinci uye ngasekhohlo, ukuze izandi zentliziyo ziviwe ngokucacileyo.

Ugqirha uza kubeka i-stethoscope esifubeni sakho aze amamele izandi zentliziyo yakho. Kukho iindawo ezi-5 ezithile esifubeni sakho apho izandi ezivela kwiivalvu zentliziyo zivakala khona kakhulu. I-stethoscope iza kubekwa kwindawo nganye kwezi ngokulandelelana. Ezi ndawo zihlala zikwicala eliphezulu lasekhohlo lesifuba sakho.

Xa ugqirha emamele intliziyo ikhala, ukhangela oku kulandelayo:

• Ixesha: Ukuba intliziyo yakho ibetha kangaphi ( isantya sentliziyo ).
• Ukuqina: Indlela intliziyo ebetha ngayo.
• Ukuphindaphinda: Ubukhali besandi, okanye indlela esibizwa ngayo ngokuba yi-``pitch''.
• Ubude bexesha: Intliziyo enye ihlala ixesha elingakanani?

Ukumamela imiphunga (Lung Auscultation)

Kule meko, ugqirha umamela izandi ezivela emiphungeni yakho. Oku kwenziwa ngokukwenza uhlale uthe nkqo, ukuba kunokwenzeka. Ugqirha ubeka i-stethoscope esifubeni sakho aze akucele ukuba uphefumle nzulu ngomlomo wakho. Emva koko, i-stethoscope ifuduselwa kwiindawo ezahlukeneyo emiphungeni yakho ezibizwa ngokuba yi-"Pulmonary Auscultation Points". Ugqirha umamela izandi ezivela phezulu emiphungeni yakho, ezithelekisa kumacala omabini.

Emva kokumamela izandi zemiphunga ezivela ngaphambili emzimbeni wakho, ugqirha ubeka i-stethoscope emqolo wakho. Njengangaphambili, bamamela ukusuka phezulu ukuya ezantsi, ecaleni ukuya kwelinye, baze bamamele ukuphefumla ngokupheleleyo (umjikelo wokuphefumla-wokuphefumla) kwindawo enye. Emva koko, bathelekisa izandi eziviwa ngaphambili nezandi eziviwa ngasemva.

Xa ephulaphula izandi zemiphunga, ugqirha uya kunikela ingqalelo kwezi zinto zilandelayo:

• Ubude bexesha: Ixesha olithathayo ukuphefumla nokuphefumla.
• Ireyithingi: Ubukhali besandi (iphimbo).
• Ukuphakama: Indlela umoya ovakala ngayo phezulu (isandi/ubukhulu).
• Umgangatho: Ngaba kukho izandi ezingaqhelekanga, umzekelo, ukuphefumla ?

Ukumamela imithambo yegazi emikhulu (imithambo yegazi)

Ukuba kuyimfuneko, ugqirha angaphulaphula imithambo yegazi emikhulu (imithambo yegazi) entanyeni yakho, esiswini, nasezintsoni .

Apha, ugqirha ujonga ezi zinto:

• Ingxolo: Esi sisandi esirhabaxa nesirhabaxa esenziwa ligazi elihamba ngemithambo yegazi. Oku kuthetha ukuba igazi alihambi kakuhle ngemithambo yegazi, mhlawumbi ngenxa yokuvaleka. Isenokuba luphawu lokuba igazi eliya kwinxalenye yomzimba liyancipha.
• Ukuqina: Jonga ukuba i-pulse yakho ibuthathaka okanye ayikho na. Oku kunokuthetha ukuba umthambo wakho uvalekile.

Ukuhlaselwa kwesisu

Kolu vavanyo, ugqirha umamela izandi eziphuma emathunjini akho. Oku kwenziwa ngokukulalisa kamnandi ebhedini nomqamelo phantsi kwentloko yakho. Unganikwa nenkxaso encinci phantsi kwamadolo akho ukuze kube lula ngakumbi.

Ugqirha ubeka i-stethoscope esiswini sakho aze ayihambise kwiindawo ezahlukeneyo zesisu sakho ukuze amamele isandi esivela emathunjini akho.

Xa bemamele isandi sesisu, oogqirha bakhangela oku kulandelayo:

• Ubukho: Nokuba izandi ziyavakala na emathunjini okanye azivakala.
• Ubungakanani: Ukuba isandi siviwa, siviwa kangaphi.
• Umgangatho: Nokuba isandi sineempawu ezithile okanye asiqhelekanga.

Yintoni abayiqondayo oogqirha kwezi zandi?

Kulungile, ngoku makhe sibone ukuba oogqirha bafumanisa ntoni kwizandi ezivakalayo kwindawo nganye.

Izinto ezithethwa ngesandi sentliziyo

Intliziyo eqhelekileyo nephilileyo ivakala ngesingqisho esiqinileyo, esithi "lub-dub". Isandi sokuqala sibizwa ngokuba yi-`(S1)` kwaye isandi sesibini sibizwa ngokuba yi-`(S2)`. Esi sandi siviwa ngugqirha wakho xa iivalvu zentliziyo yakho zivala.

Nangona kunjalo, ngamanye amaxesha unokuva izandi ezingaqhelekanga ezifana nezi:

• Ukumbombozela: Ezi zizandi ezingaqhelekanga ezinokuviwa ngelixa intliziyo ibetha. Zifana "nesandi sokushukuma" esenziwe ngumsinga wamanzi ohamba kancinci. Zibangelwa kukuhamba kwegazi okuphazamisayo njengoko igazi lihamba kwiivalvu zentliziyo. Kukho iintlobo ezininzi "zokumbombozela", kwaye ezinye zinokuba luphawu lwesifo sentliziyo esinzulu.
• I-Pericardial Friction Rub: Esi sisandi esivakala siphezulu nesirhabaxa. Sivakala ngathi ziziqwenga ezibini zesikhumba zikhuhlana kunye. Oku kungaba luphawu lwesifo sentliziyo esibizwa ngokuba yi-"pericarditis."
• Iintliziyo ezingaqhelekanga: Imizekelo ibandakanya `(Atrial Fibrillation)` (ukubetha kwentliziyo okungaqhelekanga), `(Tachycardia)` (ngaphezulu kwee-beats ezili-100 ngomzuzu), kunye `(Bradycardia)` (ngaphantsi kwee-beats ezingama-60 ngomzuzu).

Izinto onokuzithetha malunga nezandi zemiphunga

Izandi eziqhelekileyo eziviwa kwiindawo ezahlukeneyo zemiphunga yakho nazo zahlukile kancinci. Kodwa, ngokubanzi, imiphunga esempilweni inesandi esithambileyo nesingenanto. Ugqirha wakho uya kusiva esi sandi xa uphefumla.

Nangona kunjalo, usenokuva izandi ezingaqhelekanga ezifana nezi:

• IStridor: Esi sandi senzeka xa kukho ukuvaleka kwendlela yakho yokuphefumla ephezulu. Sisandi esikhulu, esivakala kakhulu, nesibukhali. Sinokubangelwa yi-epiglottitis, i-anaphylaxis (impendulo enzima ye-allergy), okanye ukungasebenzi kakuhle kwelizwi.
• Ukuphefumla:Esi sandi sokukhala kwempempe senzeka xa iindlela zakho zomoya zincipha. Sisandi esivakala kakhulu nesivakalayo. Singathetha ukuba imiphunga yakho ayizali ngokupheleleyo ngumoya ngenxa yento efana ne-mucus. Oku kunokuviwa kwiimeko ezifana ne-`(Asthma)` (asthma), `(Chronic Obstructive Pulmonary Disease - COPD)` (pulmonary edema)` (ulwelo olukwimiphunga).
• I-Rhonchi: Esi sandi sibangelwa kukuvalwa kweendlela zomoya. Sifana nokurhona. Sivakala kwiimeko ezifana ne-`(Pneumonia)` (Pneumonia), `(COPD)`, `(Cystic Fibrosis)`.
• Iinkqayi/Iinkqayi: Ezi zivakala ngathi ziinwele ezimbini ezixubanayo. Zenzeka xa ulwelo luqokelelana kwimibhobho yomoya ngenxa yosulelo lwemiphunga, njenge-pneumonia, okanye imeko yentliziyo efana nokusilela kwentliziyo okuxineneyo.
• I-Pleural Rub: Oku kuvakala ngathi kukukhuhlana kwephepha lesanti. Oku kunokuthetha ukuba izicubu ezijikeleze imiphunga yakho ziyacaphuka. Kungaba luphawu lwemeko efana ne-pleurisy, i-pneumothorax, okanye i-pleural effusion.
• I-Squawk: Oku kukwabizwa ngokuba yisandi esifutshane sokukhala okanye sokukhala. Esi sandi sinokubangelwa lutshintsho kwindlela yakho yomoya. Sivakala ngathi yindibaniselwano yokuphefumla nokukrazuka. Sinokuba luphawu lweemeko ezifana ne-`(Pulmonary Fibrosis)`, `(Bronchiolitis)`, `(Pneumonia)`.

Khawucinge nje, zonke ezi zandi zifana nezandi ezivela kwizixhobo ezahlukeneyo zomculo ngaphakathi emzimbeni wakho. Ngamanye amaxesha, esinye sezo zixhobo sinokuba yincukuthu. Eso ncukuthu yinto echukunyiswa ngugqirha.

Izinto ezithethwa ngesandi sesisu

Isandi esiqhelekileyo nesisempilweni samathumbu sisandi esiphantsi nesidumayo. Esi sandi sidla ngokuvakala rhoqo emva kwemizuzwana emi-5 ukuya kweli-10. Oku kuthetha ukuba ukutya kuhamba emathunjini akho kwaye inkqubo yakho yokugaya ukutya (i-GI Tract) isebenza kakuhle.

Xa ugqirha ephulaphula izandi zesisu, ukhangela izinto ezingaqhelekanga ezifana nezi:

• Ukulahlekelwa sisandi: Ukuba awuva sandi siphuma emathunjini akho kangangemizuzu engaphezu kwemibini, oko kungaba luphawu lwemeko ebizwa ngokuba yi-"Ileus." Oku kwenzeka xa umxholo wamathumbu uqokelelana kwaye amathumbu ayeka ukuhamba okwethutyana.
• Isandi esinciphileyo: Ukuba izandi eziviwa emathunjini zithule, ukuba ziphantsi kakhulu, oko kuthetha ukuba umsebenzi wamathumbu uhlile, okanye ukuba une-``(Ukuqhinwa)```.
• Ukwanda kwengxolo: Ukuba uva izandi ezinkulu neziqhelekileyo ezivela emathunjini akho, oko kungathetha ukuba amathumbu akho asebenza nzima, okanye ukuba unesifo sorhudo.
• Izandi zokubhonga okanye ezivakala kakhulu: Ukuba uva isandi sokubhonga okanye esivakala kakhulu siphuma emathunjini akho, usenokuba unesithintelo samathumbu.

Yintoni le "Triangle of Auscultation"?

Oku kuvakala kancinane ngokwezonyango, kodwa kulula ukukuqonda. I-"Triangle of Auscultation" yindawo encinci emqolo wakho. Kulapho kudibana khona izihlunu ezintathu emqolo wakho (i-trapezius, i-latissimus dorsi, kunye ne-scapula). Xa unqumla iingalo zakho esifubeni sakho kwaye ugoba phambili, ezi zihlunu ziyanwebeka kwaye zibe ncinci. Le ndawo inxantathu iyavezwa. Xa ugqirha ephethe i-stethoscope kule ndawo, izandi ezivela emiphungeni yakho zinokuvakala ngokucacileyo.

Zeziphi iindawo ezi-5 eziphambili zokumamela intliziyo?

Kukho iindawo ezi-5 eziphambili oogqirha abaphulaphula kuzo nge-stethoscope ukuvavanya impilo yentliziyo. Ezi zifumaneka kwiindawo ezithile zesifuba, ezinxulumene neevalvu zentliziyo.

Bazi:

• Indawo ye-Aortic: Le ndawo ikwicala lasekunene lethambo lesifuba sakho (sternum), phakathi kwembambo yesibini neyesithathu.
• Indawo yePulmonic: Nayo ikwicala lasekunene, njenge-aorta enkulu, kodwa ikwicala lasekhohlo.
• I-Erb's Point: Le ikwicala lasekhohlo lomzimba, kwindawo ephakathi kwembambo yesithathu neyesine. (Ezinye ii-`(Murmurs)` zinokuviwa ngcono kule ndawo.)
• Indawo yeTricuspid: Le iphakathi kwembambo yesine neyesihlanu.
• Indawo yeMitral: Le ikwincopho yentliziyo, oko kukuthi, kwinqanaba eliphantsi lentliziyo.

Ngoko ke, yintoni esifanele siyifunde koku?

Usenokungazi, kodwa umzimba wakho uhlala usenza izandi. Kufana ne-symphony yebhayoloji! Nangona kunjalo, ngamanye amaxesha ezinye zezi "zixhobo zomculo" zinokuba zingasebenzi kakuhle. Ezo zandi zingasebenzi kakuhle, oko kukuthi, izandi ezingaqhelekanga, zinokuxelela ugqirha okuninzi ngempilo yakho. Okanye, banokubanika izikhokelo zokufumanisa imeko yezonyango ngokwenza uvavanyo olongezelelweyo.

Eyona nto ibalulekileyo kukuba, ukuba ugqirha umamela umzimba wakho ngolu hlobo aze afumane into engaqhelekanga, ungoyiki ukubuza imibuzo ngayo. Lilungelo lakho ukucela ingcaciso yokuba yintoni na, kutheni isenzeka, kunye nento omawuyenze emva koko.

Ngoko ke, kwixesha elizayo xa ugqirha ebeka i-stethoscope emzimbeni wakho aze amamele, uyazi ukuba benza into ebaluleke kakhulu!

Uvavanyo lwe- Auscultation, i-stethoscope, izandi zentliziyo, izandi zemiphunga, izandi zesisu, ukuxilongwa, iimvavanyo zonyango, uhlolo lwempilo