Yini udokotela ayilalela nge-stethoscope? Ake sifunde ngqo nge-auscultation!

Cishe uke wabona udokotela uma uya kudokotela, bese bebeka leyo nto encane ebandayo esifubeni sakho, emhlane, noma esiswini bese belalela isikhashana. Sikubiza ngokuthi i-stethoscope. Kodwa wake wazibuza ukuthi kungani benza lokho, lokho abakuzwayo, lokho abakutholayo kuleyo misindo? Yilokho esizokhuluma ngakho namuhla. Kwezokwelapha, lokhu kubizwa ngokuthi "i-Auscultation." Kalula nje, ukulalela imisindo evela ngaphakathi emzimbeni.

Kusho ukuthini ngempela ukulalela umzimba? (Ukulalela umzimba)

Kalula nje, "(Auscultation)" yilapho udokotela esebenzisa i-stethoscope ukulalela imisindo ehlukene evela enhliziyweni yakho, emaphashini , emithanjeni yegazi emikhulu (imithambo yegazi), kanye nasesiswini. Udokotela ulalela le misindo ngokubeka i-stethoscope ngqo esifubeni sakho, entanyeni, emhlane, nasesiswini. Inaka izinto eziningi njengemisindo ehlukene, uhlobo lwayo, ukuthi inomsindo kangakanani, nokuthi ivela nini.

Cabanga nje, lokhu kuyinto elula kakhulu engalimazi umzimba nganoma iyiphi indlela . Eqinisweni, lena yindlela endala kakhulu, kodwa ephumelela kakhulu odokotela abasayisebenzisa nanamuhla ukuthola impilo yakho. Lokhu ukuhlolwa okwenziwa ngaphandle kokufaka noma yini emzimbeni (okungahlaseli).

Kunini lapho udokotela elalela kanje?

Ukuhlolwa kwe-Auscultation kuvame ukwenziwa njengengxenye yokuhlolwa ngokomzimba okuvamile, kungakhathaliseki ukuthi uvakashela udokotela wakho minyaka yonke noma nganoma yisiphi esinye isimo sezokwelapha. Odokotela bafuna ukuzwa imisindo evela ohlelweni lwakho lokujikeleza kwegazi , ohlelweni lokuphefumula , kanye nohlelo lokugaya ukudla ukuqinisekisa ukuthi isebenza kahle. Lokhu kungabasiza baqonde impilo yakho iyonke, bathole noma yiziphi izimo zezokwelapha eziyisisekelo, noma baqinisekise ukugula okusolwayo.

Kunezindlela eziningana zokulalela izingxenye ezahlukene zomzimba, akunjalo?

Yebo, indlela udokotela ayenza ngayo le "(Auscultation)" ingahluka kuye ngohlelo lomzimba alulalelayo. Ake sibheke izindlela eziyinhloko.

Ukulalela inhliziyo (I-Heart Auscultation)

Kulesi sivivinyo, udokotela ulalela imisindo evela enhliziyweni yakho. Lokhu kubizwa nangokuthi "i-Cardiac Auscultation". Lokhu kuvame ukwenziwa ngokukwenza uhlale uqonde esihlalweni noma ulale embhedeni nge-engeli engama-degree angu-45. Ngezinye izikhathi ungase ucelwe ukuthi uphendukele kancane ngakwesobunxele, ukuze imisindo yenhliziyo izwakale kahle.

Udokotela uzobeka i-stethoscope esifubeni sakho futhi alalele imisindo yenhliziyo yakho. Kunezindawo ezi-5 eziqondile esifubeni sakho lapho imisindo evela kuma-valve enhliziyo izwakala khona kakhulu. I-stethoscope izobekwa endaweni ngayinye ngokulandelana. Lezi zindawo zivame ukutholakala ohlangothini oluphezulu kwesobunxele sesifuba sakho.

Uma udokotela elalele ukububula kwenhliziyo, ubheka okulandelayo:

• Isikhathi: Ukuthi inhliziyo yakho ishaya kangaki ( isilinganiso senhliziyo ).
• Ukuqina: Ukuthi inhliziyo ishaya kakhulu kangakanani.
• Imvamisa: Ukubukhali komsindo, noma ukuthi ubizwa kanjani ngokuthi ``pitch''.
• Ubude besikhathi: Kuthatha isikhathi esingakanani ukushaya kwenhliziyo okukodwa?

Ukulalela amaphaphu (i-Lung Auscultation)

Kulokhu, udokotela ulalela imisindo evela emaphashini akho. Lokhu kwenziwa ngokukwenza uhlale uqonde, uma kungenzeka. Udokotela ubeka i-stethoscope esifubeni sakho bese ekucela ukuthi uphefumule ngokujulile ngomlomo wakho. Ngemuva kwalokho, i-stethoscope ithuthelwa ezindaweni ezahlukene emaphashini akho ezibizwa ngokuthi "Ama-Pulmonary Auscultation Points". Udokotela ulalela imisindo evela phezulu emaphashini akho, eyiqhathanisa nhlangothi zombili.

Ngemva kokulalela imisindo yamaphaphu evela ngaphambili komzimba wakho, udokotela ubeka i-stethoscope emhlane wakho. Njengakuqala, balalela kusukela phezulu kuya phansi, ohlangothini nohlangothi, bese belalela ukuphefumula okugcwele (umjikelezo wokuphefumula nokuphefumula) endaweni eyodwa. Bese, baqhathanisa imisindo ezwakala ngaphambili nemisindo ezwakala ngemuva.

Uma elalele imisindo yamaphaphu, udokotela uzonaka okulandelayo:

• Ubude: Isikhathi osithathayo ukuphefumula nokukhipha umoya.
• Imvamisa: Ubukhali bomsindo (iphimbo).
• Ukuphakama: Ukuthi umoya uzwakala uphezulu kangakanani (umsindo/ukuqina).
• Ikhwalithi: Ingabe kukhona imisindo engavamile, isibonelo, ukuvunguza komoya ?

Ukulalela imithambo yegazi emikhulu (imithambo yegazi)

Uma kudingeka, udokotela angalalela nemithambo yegazi emikhulu (imithambo yegazi) entanyeni yakho, esiswini nasezinso .

Lapha, udokotela ubheka lezi zinto:

• Isisho: Lona umsindo onzima, ozwakala sengathi igazi ligeleza ngemithambo yegazi. Lokhu kusho ukuthi igazi aligelezi kahle ngemithambo yegazi, mhlawumbe ngenxa yokuvaleka. Kungaba futhi uphawu lokuthi ukuphakelwa kwegazi engxenyeni ethile yomzimba kunciphile.
• Ukuqina: Hlola ukuthi ukushaya kwenhliziyo yakho kubuthakathaka noma akukho. Lokhu kungasho ukuthi une-artery evalekile.

Ukwehliswa Kwesisu

Kulesi sivivinyo, udokotela ulalela imisindo ephuma emathunjini akho. Lokhu kwenziwa ngokukulalisa ngokukhululeka embhedeni nomcamelo ngaphansi kwekhanda lakho. Ungase futhi unikezwe ukwesekwa okuncane ngaphansi kwamadolo akho ukuze kube mnandi kakhulu.

Udokotela ubeka i-stethoscope esiswini sakho bese eyihambisa ezindaweni ezahlukene zesisu sakho ukuze alalele imisindo evela emathunjini akho.

Uma belalele imisindo yesisu, odokotela bafuna:

• Ukuba khona: Kungakhathaliseki ukuthi imisindo izwakala emathunjini noma cha.
• Ubuningi: Uma kuzwakala umsindo, kuzwakala kangaki.
• Ikhwalithi: Kungakhathaliseki ukuthi umsindo unezici ezithile noma awujwayelekile.

Yini odokotela abayiqondayo ngale misindo?

Kulungile, manje ake sibone ukuthi odokotela bathola ini ngemisindo ezwakalayo endaweni ngayinye.

Izinto ezishiwo ngemisindo yenhliziyo

Inhliziyo evamile, enempilo izwakala ngesigqi esiqinile, "lub-dub". Umsindo wokuqala ubizwa ngokuthi `(S1)` kanti owesibili ubizwa ngokuthi `(S2)`. Lo msindo uzwakala udokotela wakho lapho ama-valve enhliziyo yakho evala.

Nokho, ngezinye izikhathi ungase uzwe imisindo engavamile efana nale:

• Ukububula: Lena imisindo engavamile engase izwakale ngenkathi inhliziyo ishaya. Ifana "nomsindo wokushelela" owenziwe umfula wamanzi ogeleza kancane. Ibangelwa ukugeleza kwegazi okuguquguqukayo njengoba igazi ligeleza ngama-valve enhliziyo. Kunezinhlobo eziningi "zokububula", futhi ezinye zingaba uphawu lwesifo senhliziyo esibi.
• I-Pericardial Friction Rub: Lona umsindo ozwakala phezulu, ohlabayo. Kuzwakala sengathi izingcezu ezimbili zesikhumba ziyahlikihlana. Lokhu kungaba uphawu lwesifo senhliziyo esibizwa ngokuthi "i-pericarditis."
• Ukushaya Kwenhliziyo Okungavamile: Izibonelo zifaka phakathi `(Atrial Fibrillation)` (ukushaya kwenhliziyo okungajwayelekile), `(Tachycardia)` (ukushaya kwenhliziyo okungaphezu kwe-100 ngomzuzu), kanye `(Bradycardia)` (ukushaya kwenhliziyo okungaphansi kwama-60 ngomzuzu).

Izinto ongakusho ngemisindo yamaphaphu

Imisindo evamile ezwakala ezingxenyeni ezahlukene zamaphaphu akho nayo ihlukile kancane. Kodwa, ngokuvamile, amaphaphu aphilile anomsindo othambile, ongenalutho. Udokotela wakho uzowuzwa lo msindo uma uphefumula.

Nokho, ungase uzwe imisindo engavamile efana nale:

• I-Stridor: Lo msindo uvela uma kukhona ukuvaleka kwendlela yakho yokuphefumula engenhla. Umsindo omkhulu, ophakeme, nobukhali. Ungabangelwa yi-epiglottitis, i-anaphylaxis (ukusabela okukhulu kokungezwani komzimba), noma ukungasebenzi kahle kwezwi.
• Ukuphefumula:Lo msindo wokukhala kwekhwela uvela lapho izindlela zakho zomoya ziba zincane. Umsindo wokukhala kwekhwela ophezulu. Kungasho ukuthi amaphaphu akho awagcwali umoya ngokuphelele ngenxa yento efana ne-mucus. Lokhu kungazwakala ezimweni ezifana ne-`(Asthma)` (asthma), `(Chronic Obstructive Pulmonary Disease - COPD)` (pulmonary edema)` (uketshezi emaphashini).
• I-Rhonchi: Lo msindo ubangelwa ukuvaleka kwemigudu yomoya. Ufana nokuhona. Uzwakala ezimweni ezifana ne-`(Pneumonia)` (Pneumonia), `(COPD)`, `(Cystic Fibrosis)`.
• Ama-Crackles/Rales: Lokhu kuzwakala njengezinwele ezimbili ezihlikihlana ndawonye. Kwenzeka lapho uketshezi luqoqana emigudwini yomoya ngenxa yokutheleleka kwamaphaphu, njenge-pneumonia, noma isimo senhliziyo njengokwehluleka kwenhliziyo okuhlanganisiwe.
• I-Pleural Rub: Lokhu kuzwakala njengokuhlikihlana kwephepha lesihlabathi. Lokhu kungasho ukuthi izicubu ezizungeze amaphaphu akho ziyacasuka. Kungaba uphawu lwesimo esifana ne-pleurisy, i-pneumothorax, noma i-pleural effusion.
• I-Squawk: Lokhu kubizwa nangokuthi umsindo omfishane wokushaya ikhwela noma umsindo wokubhonga. Lo msindo ungabangelwa izinguquko emigudwini yakho yomoya. Kuzwakala njengenhlanganisela yokuphefumula nokubhonga. Kungaba uphawu lwezimo ezifana ne-`(Pulmonary Fibrosis)`, `(Bronchiolitis)`, `(Pneumonia)`.

Cabanga nje, yonke le misindo ifana nemisindo evela eziculweni ezahlukene zomculo ngaphakathi emzimbeni wakho. Ngezinye izikhathi, enye yalezo zinsimbi ingaba yiphutha. Leso phutha yilokho udokotela akuthintayo.

Izinto ezishiwo ngemisindo yesisu

Umsindo ojwayelekile nonempilo wamathumbu uwumsindo ophansi, odumayo. Lo msindo uvame ukuzwakala njalo ngemizuzwana emi-5 kuya kweyi-10. Kusho ukuthi ukudla kuhamba emathunjini akho nokuthi uhlelo lwakho lokugaya ukudla (i-GI Tract) lusebenza kahle.

Uma udokotela elalele imisindo yesisu, ubheka izinto ezingavamile ezifana nalezi:

• Ukulahlekelwa umsindo: Uma ungezwa msindo ophuma emathunjini akho isikhathi esingaphezu kwemizuzu emibili, kungaba uphawu lwesimo esibizwa ngokuthi "Ileus." Lokhu kwenzeka lapho okuqukethwe emathunjini kuqongelela khona futhi amathumbu eyeka ukunyakaza okwesikhashana.
• Umsindo onciphile: Uma imisindo ezwakala emathunjini ithule, uma iphansi kakhulu, kungasho ukuthi ukusebenza kwamathumbu kwehlile, noma ukuthi une-``(Ukuqunjelwa)``.
• Umsindo owandayo: Uma uzwa imisindo emikhulu nevame kakhulu emathunjini akho, kungasho ukuthi amathumbu akho asebenza kanzima, noma ukuthi unesifo sohudo.
• Ukubhonga noma imisindo ephezulu: Uma uzwa umsindo wokubhonga noma imisindo ephezulu iphuma emathunjini akho, ungase ube nokuvaleka kwamathumbu.

Iyini le "Triangle of Auscultation"?

Lokhu kuzwakala kahle ngokwezokwelapha, kodwa kulula ukukuqonda. I-"Triangle of Auscultation" yindawo encane emhlane wakho. Yilapho imisipha emithathu emhlane wakho (i-trapezius, i-latissimus dorsi, kanye ne-scapula) ihlangana khona. Uma uhlanganisa izingalo zakho esifubeni sakho bese ugoba phambili, le misipha iyanwebeka futhi ibe mincane. Le ndawo engunxantathu iyavezwa. Uma udokotela ephethe i-stethoscope kulesi simo, imisindo evela emaphashini akho ingezwakala kahle kakhulu.

Yiziphi izindawo ezi-5 eziyinhloko zokulalela inhliziyo?

Kunezindawo ezi-5 eziyinhloko odokotela abazilalela nge-stethoscope ukuze bahlole impilo yenhliziyo. Lezi zitholakala ezindaweni ezithile zesifuba, ezihlobene nama-valve enhliziyo.

Kunjalo:

• Indawo ye-Aortic: Lokhu kutholakala ngakwesokudla kwethambo lesifuba sakho (sternum), phakathi kwezimbambo zesibili nezesithathu.
• Indawo Yamaphaphu: Nayo ingakwesokudla, njenge-aorta enkulu, kodwa ingakwesobunxele.
• Iphuzu lika-Erb: Lokhu kutholakala ohlangothini lwesobunxele lomzimba, esikhaleni esiphakathi kwezimbambo zesithathu nezesine. (Amanye ama-`(ama-Murmur)` azwakala kahle kule ndawo.)
• Indawo Enezimbambo Ezinezinqe: Lokhu kutholakala phakathi kwezimbambo zesine nezesihlanu.
• Indawo ye-Mitral: Lokhu kutholakala esicongweni senhliziyo, okungukuthi, endaweni ephansi kakhulu yenhliziyo.

Ngakho-ke, yini okufanele siyifunde kulokhu?

Ungase ungaqapheli, kodwa umzimba wakho uhlala wenza imisindo. Kufana ne-symphony yezinto eziphilayo! Kodwa-ke, ngezinye izikhathi ezinye zalezi "zinsimbi zomculo" zingase zingabi nomsindo. Lezo misindo engajwayelekile, okungukuthi, imisindo engavamile, zingatshela udokotela okuningi ngempilo yakho. Noma, zingabanika izinkomba zokuxilonga isimo sezokwelapha ngokwenza izivivinyo ezengeziwe.

Into ebaluleke kakhulu ukuthi, uma udokotela elalela umzimba wakho ngale ndlela bese ethola into engavamile, ungesabi ukubuza imibuzo ngayo. Kuyilungelo lakho ukucela ukucaciselwa ukuthi iyini, kungani yenzeka, nokuthi yini okufanele uyenze ngokulandelayo.

Ngakho-ke, ngesikhathi esizayo udokotela ebeka i-stethoscope emzimbeni wakho futhi elalele, uyazi ukuthi benza into ebaluleke kakhulu!

Ukuhlolwa kwe - Auscultation, i-stethoscope, imisindo yenhliziyo, imisindo yamaphaphu, imisindo yesisu, ukuxilongwa, ukuhlolwa kwezokwelapha, ukuhlolwa kwempilo