Palpation nke imeju: ụgbọelu, na iwu na transcript

Palpation - otu n'ime ndị kasị ihe ọmụma ụzọ nke nchọpụta nsogbu, rụrụ site na dọkịta na ogbo nke mbụ nnyocha nke onye ọrịa. Banyere ya taa na anyị ga na-ekwu okwu.

imeju Mmebe

Tupu mwube inyocha nke nke palpation nke imeju, anyị kwesịrị kọwaa Mmebe na aru ọrụ. Imeju odude ozugbo n'okpuru diaphragm, aka nri na n'elu nke afo, na naanị obere akụkụ nke aru nke onye okenye dị n'aka ekpe (dị na pụtara akara). A mụrụ ọhụrụ, na imeju na-na-ewe a ịrịba òkè nke afo.

Topographically imeju nwere ihe abụọ na-ebupụta na abua. The ihu (elu) n'elu-ekpe ka elu nke diaphragm na fụliri elu ime ya curvature. Lower na-emi odude n'azụ, na-n'okpuru, na a ole na ole amụta site n'akụkụ akụkụ. Elu na nke ala-ebupụta iche iche site na ala ihu nkọ, nke ọzọ ihu (caudineural), na iche, nnọọ dull, ya mere na ọ nwere ike ekewet ahụ n'azụ n'elu.

Ịmata ihe dị iche na imeju abụọ n'akụkụ: a nnukwu nri na ala aka ekpe, iche site na a mpekere onwa ọgọdọ na free akụkụ nke nke dabeere a na ok fibrous eriri - na-akpọ okirikiri ọgọdọ na gbatịrị si otube na bụghị karịa ihe tojuru alọ akwara.

Nri n'ọnụ ọnụ na-iche site na n'ahịrị n'ahịrị n'ime ọtụtụ abụọ mbak. Na otu n'ime ndị a grooves na-emi odude gallbladder na vena Vienna (ala) iche site na a mpempe imeju anụ ahụ a kpọworo tailed abụba.

Otu n'ime ihe dị mkpa akụkụ ahụ bụ a miri emi transverse uzo na-ezo dị ka ụzọ ámá imeju. Site na nke a guzobere na ahụ bụ nnukwu hepatic akwara ụzọ ámá Vienna na irighiri akwara, na-ahapụ ya efferent hepatic duct (esi kpọpụ mmadụ nile nke bile na gallbladder) na lymphatics.

Nri n'ọnụ ọnụ ahụ dịpụrụ adịpụ square nta na dị nanị n'ọnụ ụzọ ámá nke imeju, na a gburugburu ọgọdọ fossa nke gallbladder, na caudate n'ọnụ ọnụ inyịme n'etiti ọnụ ụzọ ámá, hepatic portal akwara.

imeju ọrụ

• Metabolic (akara nke mgbanwe ọmụmụ, minerals na vitamin, homonụ, amino asịd, lipids, ndi na-edozi, carbohydrates).
• Na-edebe (ke idem akpọkọtara BZHU, vitamin, minerals, homonụ).
• Secretory (bile mmepụta).
• Detox (rụrụ n'ihi eke imeju nzacha - hepatic macrophages).
• Excretory (site nkịtị glucuronic acid na igirigi ibu sulphuric nsi indole, tyramine, skotola).
• Homeostatic (imeju aka ke akara angiogenic na metabolic hemostasis nke organism).

N'ihi na morphological na ọtọ atụmatụ nke imeju bụ mgbe ezi tụrụ na dịgasị iche iche nke ndị na-abụghị communicable na communicable ọrịa. Ọ bụ ya mere na mgbe mbụ ndidi ọgwụgwọ dị mkpa iji na-eduzi palpation nke ahu.

Palpation na percussion imeju

Tupu probing imeju ike ikwu iji percussion iji chọpụta ókè ya. Nke a ga-bụghị naanị iche na ahụ na-abawanye, ma ịghọta ebe ọ ga na-amalite palpation. Mgbe percussion imeju anụ ahụ na-enye a masịrị (dull) ụda ya, ma n'ihi na eziokwu na ala nke akpa ume ikpe na-ekpuchi ọ bụ ike ikpebi na-abua ókè: ezi na zuru imeju-acha ọbara ọbara, ma ọtụtụ mgbe kọwaa a ókè (ala na elu) nke zuru nzuzu.

Palpation nke aru (Usoro)

Mgbe probing imeju ga-eso iwu ụfọdụ:

• Ọnọdụ nke isiokwu - dina ya azụ, na isi ubé elu, ya na ụkwụ ya sonso kpudo n'ụkwụ ma ọ bụ kwụrụ ọtọ. Aka na ya obi, iji amachi ya agagharị mgbe inhaling ma zuru ike gị abdominal mọzụlụ.
• The dọkịta bụ ezi onye na onye ọrịa.
• Ubé kpebisiri n'aka nri dọkịta eweta ewepụghị na ọrịa afo ke ebe nke nri hypochondrium, n'okpuru atọ ruo ise sentimita, ihe bụ ókè nke imeju na mbụ kọwaa percussion. Ya aka ekpe dọkịta na-ekpuchi obi (ya ala n'aka nri), na mkpịsị aka anọ ga-enịm n'azụ, na otu onye (nnukwu) mkpịsị aka na-etinye na costal njiko. Usoro a ga-enye ịnọrọ nke obi n'oge inhalation ma dịkwuo Ndahie nke diaphragm ala.

• Mgbe onye ọrịa exhales, dọkịta effortlessly akwusila ala akpụkpọ, olulu ya n'aka nri na abdominal uji eze, ọ na-ajụ onye ọrịa na-a miri emi ume. N'oge a, na onu (ala akụkụ) nke ahụ dara, penetrates n'ime kere n'akpa uwe na ihe nkiri slide na mkpịsị aka. N'otu oge palpable ogwe aka ga-anọgide na anyịnya. Ọ bụrụ na n'ihi ihe ụfọdụ tụlee ọdịdị imeju ada ada, usoro a ugboro ugboro, ma na mkpịsị aka na-obibi a ole na ole sentimita elu. Mepụta a mkpachapụ, na-akpụ akpụ elu elu, mgbe aka-nri-adịghị asụ ngọngọ na costal aak, ma ọ bụ ruo mgbe nyocha imeju nsọtụ.

atụmatụ

• Mepụta palpation imeju na-emekarị site kpọmkwem abdominal muscle (ya mpụta onu) ma ọ bụ nri ufọt ufọt clavicular akara. Ma ọ bụrụ na ọ dị mkpa edemede, probing mepụtara ise edoghi (si ihu axillary ikike okologrudinnoy ekpe).
• N'ihe banyere ìgwè abdominal palpation nke nnukwu mpịakọta nke ọmụmụ ihe siri ike. Mgbe ahụ malitere probing na-agba ọsọ jerky ahu. N'ihi nke a, nke abụọ, nke atọ na nke anọ mkpịsị aka nke aka-nri-igba-otiti na n'ihu abdominal mgbidi, na-amalite na ala na-agwụcha na ndị costal njiko ruo nchọpụta nke e guzobere ok - imeju. N'oge mbụ n'ahụ gbatịrị miri n'ime nku, na mgbe na-abịa azụ na bumps na mkpịsị aka (a mgbaàmà na-akpọ "sere n'elu mpempe ice").

Interpretation nke nsonaazụ (nkịtị)

Gịnị na-kwesịrị igosi palpation nke imeju?

• Nọmalị, 88% nke ọrịa ahụ ala onu na-emi odude gburugburu costal njiko, na akara na ufọt ufọt clavicular akara aka nri.
• Na a ike n'ahụ mmadụ ọnu a nkọ ma ọ bụ ubé mechie. Ọ bụ nro, enweghi mgbu, mfe podvorachivaetsja na palpation, ire ụtọ.

Evaluation nke data (daa ọrịa)

• Ọ bụrụ na imeju na-abawanye, palpation ọ ga-emi odude n'okpuru costal njiko, nke nwekwara ike na-agba àmà nke ya nnofega. Na nkwado nke a ma ọ bụ na ihu ọma dị mkpa iji percussion, iji chọpụta ókè nke ahu.
• Ọ bụrụ na nke nke imeju na-agbanwe agbanwe, ma ókè nke hepatic-acha ọbara ọbara gbanwere ala - a ịrịba ama nke ngwa prolapse.
• Dechapụ naanị na ala ókè-egosi ihe na-abawanye na imeju na-aputa ihe n'akparamagwa venous stasis, mbufụt na imeju na-na biliary tract, nnukwu na-efe efe (ịba, ọrịa ọgbụgbọ na ọnyụnyụ, ọrịa ịba, ọnyụnyụ ọbara), imeju (mbụ ogbo).
• Ọ bụrụ na ala ịgba na-gbanwere elu, ọ bụ omume na-enyo Mbelata na ahu size (e.g., na ọnụ nkebi nke imeju).
• Rearranging hepatic elu ókè (elu ma ọ bụ ala) adịkarịghị egosi mmebi nke ngwa (e.g., imeju cancer ma ọ bụ echinococcosis). Ọtụtụ mgbe ọ na-hụrụ ruru akwa ọnọdụ nke diaphragm n'oge ime, ascites, flatulence, n'ihi na ala aperture ndokwa visceroptosis, pneumothorax, emphysema, nakwa dị ka ikpe nke a n'ahụ aperture na imeju n'ihi ìgwè gas.
• Akpa ume infarction, wrinkling ya ala akụkụ, oyi baa, pleurisy kwadoro nwekwara ike simulate elu Ndahie ókè elu ahu.
• Mgbe ụfọdụ, dị bụghị nanị palpation nke ọnu nke imeju, kamakwa dum. Iji mezuo nke a, na mkpịsị aka na-enịm na n'okpuru nri costal njiko. The dibịa nwayọọ n'ịgba, eji mmegharị imeju ọmụmụ, na-eleru ya elu (nodular, ezigbo, ezigbo), udidi (na ok, adụ), ọnụnọ / enweghị ihe mgbu.

• Myagkovataya, ewepụghị, ezigbo elu ma ahazi ọnu nro - ịrịba ama nke mbufụt ke ahu ma ọ bụ ngosipụta nke nnukwu ọbara stasis ruru ka obi ọdịda.
• Lumpy, bumpy, oké ọnu a hụrụ na echinococcosis na syphilis. Nnọọ na ok ( "osisi") kpebisiri ike site imeju mebiri emebi akụkụ site cancer mkpụrụ ndụ.
• Plotnovata ọnu imeju na-atụ aro ịba ọcha n'anya, na na njikọ na tuberositi - imeju.
• Pain on palpation imeju nwere ike ime n'ihi na mkpali Filiks, ma ọ bụ site na ya distension Capsule (na congestive imeju).

Palpation nke imeju na ụmụ

Probing nwa ọhụrụ imeju, na-emekarị rụrụ na ufọt ufọt clavicular na ihu axillary edoghi site na-akpụ akpụ palpation. Na nke a n'aka nyochasịkwara pediatrician slide anya ọnu nke imeju, na-eme ka o kwere omume ọ bụghị naanị na iji chọpụta size nke ahụ, kamakwa palpation ntule nke n'ọnụ ọnụ ya. Norm mụrụ ọhụrụ bụ arụmọrụ nke hepatic ihu costal njiko na abụọ (ma ọ bụghị karịa) nke a sentimita. Evaluation e ekenịmde ke midclavicular akara. ahụ ihu na otú a ga-enweghi mgbu, ezigbo, nkọ na juu agbanwe.

Na ike ụmụ n'okpuru afọ asaa onu nke imeju, na-emekarị sikwa si costal njiko na nri dị maka palpation. Maka ahụ ike ụmụaka ruo afọ atọ, na-ahụkarị bụ definition nke imeju onu bụ 2 ma ọ bụ 3 cm n'okpuru nri costal oke. Mgbe afọ asaa nke imeju ókè-ederịta akwụkwọ ozi ndị okenye.

Nchọpụta nke imeju n'ụzọ Kurlova

Iji gosi na nchoputa nke a ma ọ bụ na daa ọrịa nke na-eduga a distortion nke ahụ size, ọ dị mkpa na-ebu palpation nke imeju Kurlov. N'ihi na nke a na-eji na ịme ọpịpị (percussion) chọpụta elu ịgba na mgbe palpated (ma ọ bụ percussion) - ala. Ọzọkwa, dị na ihe oblique N'ezie nke ala ọnu ya ókè, na anya n'etiti elu na nke ala ókè na-ekpebisi ike site na atọ ihe. The mbụ kwekọrọ na midclavicular akara, nke abụọ - na midclavicular, na nke atọ - ekpe costal njiko. The Prefecture size kwesịrị 9, 8, 7 na-ezo karị.