Percussion - njira kuti? Percussion ndi palpation

Chithandizo cha matenda alionse akuyamba ndi koyamba Kupenda thupi chofunika kupeza mwachidule za wodwalayo, ukupeza wake ndiponso kukhazikitsa kugwirizana pakati pa ziwalo munthu anakhudzidwa ndi kuvutika ziwalo zina m'thupi. Njira yaikulu ya kafukufuku ndi: mbiri kutenga, kupenda mtima wa, auscultation, percussion ndi palpation. njira izi ndi nkhani kafukufuku, zosavuta, zotchipa ndi wowona mwamtheradi wodwalayo.

Percussion - njira kuti amalola kudziwa kuyan'anila mu kukula ndi kasinthidwe ziwalo mkati, kudziwa malo awo. Ndi pogogoda padziko thupi ndipo ziyenera akuwuka mu cizindikiro ici, monga minofu wathanzi ndi matenda kuwomba osiyana. Sizisiyana ndi palpation - by motsatizana ukudwala.

Zolinga percussion ndi palpation

Kunyamula percussion ali zolinga zikuluzikulu ziwiri:

- kuphunzira za kusintha kwa matupi a okhutira ndi mphyeya mwa iwo, ndi kukhalapo kapena kusapezeka kwa zinthu olimba;

- kudziwa malire, mawonekedwe ndi kukula kwa ziwalo.

Kumverera amathandiza:

- kudziwa tilinazo ziwalo ndipo zimakhala ndi zimachititsa chilumbachi awo;

- amanena kutentha kwa khungu, mtima pulsation m'mimba motility;

- Kupeza Vuto bronchopulmonary kudwala;

- azindikire ndi mawonekedwe ndi chikhalidwe cha mapindikidwe a, neoplasms.

Mitundu ya percussion, palpation: njira ya

Pali mitundu iwiri waukulu percussion:

- mwachindunji percussion tapotement kumafuna zala kapena zambiri pa thupi wodwalayo pamwamba.

- sitipereka percussion imagwiridwa ntchito iliyonse chinthu Ufumuyo thupi limene amapangidwa ndi pogogoda.

Pali njira zambiri percussion mwachindunji:

- njira Yanovskogo F. G., ndiko ntchito zamkati osachiritsika phalanx wa index kapena chala chapakati cha dzanja lamanja;

- njira Obraztsova VP, imene index chala, amene akumenya zithunzi kuchokera kumbuyo kwa chala chitatu;

- Auenbryuggera njira, yokhudza pogogoda zala zake theka akuyesetsa ndi otsekeredwa pamtima (kawirikawiri ntchito lero);

- Kupita percussion - pali njira pochita kafukufuku ntchito zamkati chala angapo, zimene zimathandiza kwambiri molondola kudziwa akuluakulu malire.

Sitipereka percussion angathe kuchitidwa mu njira zingapo:

- chala kudutsa plessimetru;

- nyundo pa plessimetru;

- njira chala-chala.

Sitipereka percussion - ndi zothandiza kwambiri njira zamakono kulipenda monga ntchito plessimetra analandira kulira mokweza ndi momveka.

Malinga kuzama kwa ubatizo wa zala kapena manja mwa nsalu amadziŵika:

- zachiphamaso palpation. Ndi njira zimasonyeza, kuyambirira kafukufuku. Ntchito kudziwa kutentha, chinyezi, kachulukidwe ndi tilinazo, zimakhala ndi. Ofananira pamwamba stroking thandizo kudziwa chikhalidwe cha pamwamba, kuti awulule mapangidwe kapena kusindikiza a khungu, subcutaneous minofu, kuphwanya kwa thupi wapezeka mu miyendo, kumbuyo, pamimba. Zachiphamaso palpation angathe kuchitidwa kapena dzanja limodzi kapena awiri. zala Choncho kuwonjezera, kuthamanga padziko probed sayenera.

- palpation kwambiri ntchito kuwunika boma ziwalo ndipo zimakhala inali kwambiri m'thupi.

Malingaliro a minofu zosiyanasiyana, mfundo, ndi m'madera ena ntchito ndi mitundu yosiyanasiyana ya palpation chakuya;

• Phunziro minofu, mafupa pansi minofu wosanjikiza malo olowa ntchito palpation a kwambiri kumiza nsonga ya chala chimodzi kapena zingapo.
• Ziwalo za zinthu zonse m'mimba amaphunzira kudzera kwambiri anagubuduza palpation.
• Mu kuphunzira chiwindi, chotupa m'mimba ndi ascites ntchito jerky akuthamanga kapena palpation.
• Kudziwa kudzikundikira madzimadzi mu dokotala bondo akhoza kugwiritsa ntchito zala angapo kuthamanga jerky.
• Onani chiberekero, mazira, m'chiuno chotupa dzanja, bondo ndipo chigongono mfundo kuthandiza bimanual palpation ikuchitika ndi manja onse awiri.

Mphamvu ya mmene percussion: percussion mitundu

Mphamvu ya pini percussion amakhudza yogawa kayendedwe vibrational padziko ndi mwakuya pa mawu mwamphamvu ndiponso kuchuluka kwa mpweya umene anathamangitsidwa mu zoyenda oscillatory. Popeza percussion kuti onse lagawidwa:

- kwambiri (amphamvu kapena mokweza);

- padziko (ofooka kapena chete).

Chakuya (aakulu) minofu percussion amapereka oscillation a padziko cm 5 mwakuya -. 6 masentimita lamayimbidwe dera padziko (ofooka) percussion kawiri zing'onozing'ono kuposa amphamvu. Malinga chotupa buku, kuya ndi malo chandamale Kupenda dokotala angagwiritse ntchito kapena zambiri kapena zochepa kwambiri percussion.

Percussion zikumveka mitundu

1. Chotsani m'mapapo phokoso likumveka pamene amapatutsidwa pa chifuwa mwachindunji pamwamba pa m'mapapo.
2. The femoral, kapena kusokoneza phokoso pamene amapatutsidwa limapezeka kopo- wandiweyani airless ziwalo ndipo zimakhala.
3. Chokongoletsedwa tympanic phokoso pa percussion chaululidwa ziwalo vozduhosoderzhaschih monga kholingo trachea kapena matumbo.

Chipatala ntchito percussion

Mwa maikidwe zimatulutsa mitundu iwiri percussion:

- poyerekeza, zimene zimaphatikizapo ntchito ofanana mphamvu percussion zikwapu pa symmetrical mbali kuphunzira malo. Amagwilitsidwa ntchito mosamala m'mapapo.

- mtunda, kumasulira malire ndi miyeso ya matupi ndi ntchito imeneyi kwa malire a pamwamba thupi. Topographic percussion amafuna otsika pamwamba percussion ndi ntchito yochepa amenye.

Percussion za mtima kudziwa kukula, mawonekedwe ndi malo a thupi ndi mtolo mtima. The mtima ndi akulu limba, airless, ndi mwazi, choncho kupusa mtheradi wa percussion gulu phokoso kuzimiririka. Kumanzere ndi woyenera wa iyo ali ndi kuwala - thupi munali mpweya, choncho chilema malowa adzakhala blunted. Childs, mtima percussion anachita mu ataima kapena pansi udindo ndi manja ake, mpweya nthawi yomweyo ayenera kukhala bata.

Percussion chiwindi monga thupi wandiweyani, amapereka kuzimiririka phokoso pamene percussion. Percuss ayenera kukhala pamwamba, kumene phokoso ndi yomveka ndiponso kutsatira mpaka phokoso yosamveka. Audio Sinthirani ndi chifukwa chiwindi mwina sichimva ndi kuwala. Percussion chiwindi kwenikweni kuchitidwa mu malo yopingasa. zikhomo mtunda ndi nthiti ndi mizere ofukula makonzedwe thorax. Pambuyo percussion ayenera palpation, kapena thupi kumverera, amene amalola kudziwa kusintha kugwirizana, mawonekedwe ndi pamwamba pa chiwindi, malo chowawa, amalola kupeza thupi m'munsi kwa malire.

Kudziwa udindo wa mapapo mu chifuwa ndi poyerekezera ndi ziwalo zina topographic percussion a m'mapapo. Norma percussion phokoso pa minofu m'mapapo - phokoso bwino. Ichi ndi malo ndi percussion kuwomba mowonekera mwa thupi lonse. Palpation m'chifuwa kudziwa kake, malo chowawa, kukana ndi kugwedeza mawu. Kumverera wopangidwa ndi manja onse nthawi imodzi. Anawulula m'dera chowawa probed bwinobwino. Ngati chifuwa ndi kudziwa kukana mosavuta wothinikizidwa, izo svidetelstveut degradability ake ndi elasticity, kuti imatengedwa ponseponse. Mukhoza Finyani onse kutsogolo ndi kumbuyo, ali symmetrically anaika manja ake, ndiponso m'mbali, pamene bere zambiri supple.

Makamaka ana percussion

Percussion ana, makamaka chaka choyamba cha moyo, amafuna molondola dokotala matupi odwala ang'ono, woonda pachifuwa khoma ndipo khungu ndi wosakhwima.

Mu kuphunzira kuwala n'kofunika kupereka ulemu wapadera kwa vuto la mwanayo, amene pachifuwa ali pabwino symmetrically. Sitipereka percussion ntchito, tikafuna ana okulirapo, ana komanso ntchito mwachindunji. Backrest pogogoda ubwenzi kapena kukhala pansi ndi miyendo anawoloka, ndi lateral pamwamba pa chifuwa - mu malo pansi, ndi mikono anawonjezera patsogolo kapena mfundo kumbuyo, ndi chifuwa - mu malo supine.

Percussion zitha kukhala chete: chala, chala kapena pafupi. Mkulu ndi momveka percussion phokoso ana ali ponseponse. mwina kusintha tympanic pa nthawi ya maliro.

Percussion: malamulo ambiri

1. Chipinda ayenera kukhala ofunda ndi wachete.
2. Udindo wa dotolo - yabwino.
3. Wodwala zimadalira zaka kwakukulu ndi chikhalidwe. Vzroly munthu angakhoze kuima kapena pansi mu malo ambiri omasuka. Makanda mu malo woongoka ayenera kugwira atagwira naye kwa mayi ake.
4. Percussing matupi amaliseche.
5. Doctor wa manja - ofunda, wouma ndi woyera.
6. Percussion nkhonya ziyenera kukhala zosavuta, mphamvu yomweyo, lalifupi zotanuka.
7. Fingernail, conductive percussive akamenyedwa waufupi.

Palpation ndi percussion - kufufuza mankhwala ziwalo njira ochuluka omwe amalola mwachikulu kuunikira mthupi mwawo ndiponso udindo, zofuna chisamaliro dokotala ndi chidwi.