Percussion - yog hais tias txoj kev? Percussion thiab palpation

Kev kho mob ntawm tej yam kab mob pib nrog thawj zaug kuaj yuav tsum tau mus nrhiav tau ib tug txheej txheem cej luam ntawm tus neeg mob, hauv lub xeev ntawm nws noj qab haus huv thiab tsim kom muaj ib qhov txuas ntawm ib tug neeg cuam tshuam nrog cev nrog kev txawv txav ntawm lwm yam kabmob nyob rau hauv lub cev. Lub ntsiab txoj kev ntawm lub daim ntawv ntsuam xyuas yog: keeb kwm kev, kev soj ntsuam ntawm tus neeg mob, auscultation, percussion thiab palpation. Cov hom kev kawm yog tuav daim ntawv ntsuam xyuas, tej yam yooj yim, pheej yig thiab kiag li txawm rau tus neeg mob.

Percussion - ib txoj kev uas tso cai rau kom paub tias kev ua txhaum nyob rau hauv qhov loj thiab configuration ntawm cov hauv nruab nrog cev, seb lawv qhov chaw nyob. Yog ib tug tapping rau ntawm lub cev nto thiab kev ntsuam xyuas tsob nyob rau hauv no lub suab, raws li cov kev noj qab nyob thiab mob cov nqaij mos suab sib txawv. Zoo txog rau palpation - los ntawm successive lawm mob.

Objectives percussion thiab palpation

Nqa percussion muaj ob lub ntsiab hom phiaj:

- mus kawm txog cov kev hloov nyob rau hauv lub cev ntawm cov huab cua ntsiab lus nyob rau hauv lawv, thiab muaj los yog tsis tuaj kawm ntawv ntawm cov khoom hais;

- los mus txiav txim rau ib thaj tsam, zoo thiab loj hauv nruab nrog cev.

Nkaus pab:

- los mus txiav txim qhov rhiab heev ntawm nruab nrog cev thiab cov nqaij thiab lawv topography;

- kwv yees qhov kub thiab txias ntawm daim tawv nqaij, vascular mem plab hnyuv kom;

- diagnosing bronchopulmonary pathology;

- txheeb xyuas cov kev zoo thiab qhov xwm ntawm tus deformation, neoplasms.

Hom ntawm percussion, palpation: txoj kev ntawm

Muaj ob lub ntsiab hom percussion:

- ncaj qha percussion tapotement yuav ib tug los yog ntau tshaj tus ntiv tes rau tus neeg mob lub cev nto.

- Indirect percussion yog tau siv tej yam khoom uas txuas mus rau lub cev uas yog ua thiab tapping.

Muaj ntau txoj kev uas ncaj percussion:

- txoj kev Yanovskogo F. G., uas yog siv cov sis plawv hniav davhlau ya nyob twg Phalanx ntawm lub Performance index los yog nruab nrab ntiv tes ntawm sab tes xis;

- txoj kev Obraztsova VP, nyob rau hauv uas lub Performance index ntiv tes, uas yog los tsoo, slides tawm rau sab nraum qab ntawm lub ntiv tes thib peb;

- Auenbryuggera txoj kev, uas tapping nws cov ntiv tes ib nrab-bent thiab daim ntau quav tso lawm nws lub hauv siab (tsis tshua muaj siv niaj hnub no);

- Tsiv percussion - yog ib txoj kev ntawm nqa tawm lub daim ntawv ntsuam xyuas uas siv cov kev sis plawv hniav ntawm ob peb cov ntiv tes, uas tso cai rau heev meej txiav txim seb tus ciam teb cov tub ceev xwm.

Indirect percussion kuj yuav nqa tawm nyob rau hauv ob peb txoj kev:

- cov ntiv tes hla plessimetru;

- rauj rau plessimetru;

- ntiv tes ntiv tes txujci.

Indirect percussion - yog qhov zoo tshaj niaj hnub txoj kev xeem raws li kev siv plessimetra tau txais suab nrov thiab dlaim phaj.

Nyob rau ntawm qhov tob ntawm immersion ntawm cov ntiv tes los yog txhais tes nyob rau hauv cov ntaub yog distinguished:

- ces dag palpation. Nws yog ib txoj kev indicative, ua ntej daim ntawv ntsuam xyuas. Siv los mus txiav txim qhov kub thiab txias, humidity, ceev thiab rhiab heev ntawm cov ntaub so ntswg. Yam nto stroking pab txiav txim seb qhov xwm ntawm tus nto, mus qhia tej tsim los yog sealing ntawm daim tawv nqaij, subcutaneous cov ntaub so ntswg, mob nro kuaj nyob rau hauv nqua, rov qab, plab mog. Ces dag palpation yuav tsum tau yog ib tug los yog ob tug ob txhais tes. Cov ntiv tes li ntev, siab nyob rau probed nto yuav tsum tsis txhob yuav.

- sib sib zog nqus palpation yog siv los ntsuam xyuas hauv lub xeev ntawm nruab nrog cev thiab cov nqaij nyob sib sib zog nqus rau hauv lub cev.

Rau cov kev xav ntawm ntau yam nqaij, pob qij txha, thiab lwm qhov chaw siv los ntawm txawv variants ntawm sib sib zog nqus palpation:

• Rau txoj kev tshawb no ntawm cov leeg, cov pob txha nyob rau hauv cov nqaij txheej ntawm tus txha qhov chaw yog siv palpation ntawm sib sib zog nqus immersion ntxeev ntawm ib los yog ntau tshaj cov ntiv tes.
• Kabmob ntawm lub plab kab noj hniav yog kawm los ntawm txoj kev sib sib zog nqus dov palpation.
• Nyob rau hauv ib txoj kev tshawb no ntawm daim siab, mob plab mob thiab ascites siv jerky khiav los yog palpation.
• Yuav kom ntes kua txuam nyob rau hauv lub hauv caug kws kho mob yuav siv ntau yam ntiv tes jerky siab.
• Tshawb lub tsev me nyuam, zes qe menyuam, hu ua pelvic qog, dab teg, hauv caug thiab luj tshib pob qij txha pab bimanual palpation nqa tawm ob txhais tes.

Cov kev siv ntawm lub tej yam uas percussion: percussion hom

Lub zog ntawm cov percussion pin muaj feem xyuam rau lub tsev ntawm vibrational taw nyob rau saum npoo thiab nyob rau hauv qhov tob rau ib tug laus siv thiab tus nqi ntawm cov huab cua uas yog tsav nyob rau hauv ib tug oscillatory tsab ntawv tsa suab. Muab tag nrho cov uas percussion yog muab faib mus rau hauv:

- sib sib zog nqus (muaj zog los yog nrov nrov);

- nto (tsis muaj zog los yog ntsiag to).

Sib sib zog nqus (mob loj heev) cov ntaub so ntswg percussion muab oscillation ntawm tus nto rau 5 cm nyob rau hauv tob -. 6 cm Acoustic kheej nto (tsis muaj zog) percussion ob zaug me me tshaj zog. Nyob rau lesion volume, qhov tob thiab qhov chaw ntawm lub hom phiaj kev soj ntsuam tus kws kho mob yuav siv los sis ntau tshaj, los yog tsawg mob siab heev percussion.

Percussion suab hom

1. Clear ntsws suab yog hnov thaum tapped rau hauv siab ncaj qha tshaj lub saum npoo ntawm lub ntsws.
2. Lub femoral, los yog npub suab thaum tapped tshwm sim tshaj tuab airless nruab nrog cev thiab cov nqaij.
3. Decorated tympanic suab rau percussion yog qhia vozduhosoderzhaschih kabmob xws li cov suab, lub raj cua los yog cov hnyuv.

Soj ntsuam kev siv ntawm percussion

By lub sij hawm emit ob hom percussion:

- Comparative, uas yuav daim ntawv thov vaj huam sib luag quab yuam percussion cwj nrag ib symmetrical qhov chaw cheeb tsam tshawb fawb. Feem ntau siv nyob rau hauv qhov kev xeem ntawm lub ntsws.

- topographical, defining rau ib thaj tsam thiab qhov ntev ntawm lub cev thiab tej yaam num no mus rau ib thaj tsam ntawm lub cev nto. Topographic percussion yuav tsum tau uas tsis muaj nto percussion thiab kev siv ntawm ib luv luv strike.

Percussion ntawm lub plawv los mus txiav txim qhov luaj li cas, zoo thiab txoj hauj lwm ntawm lub cev thiab lub vascular nras. Lub plawv yog ib tug npag hloov khoom nruab nrog, airless, tag nrho ntawm cov ntshav, yog li tus tsis stupidity ntawm percussion band suab yog npub. Sab laug thiab sab xis ntawm nws yog them nrog lub teeb - lub cev muaj huab cua, thiab yog li ntawd lub suab nyob rau hauv cov cheeb tsam no yuav tsum blunted. Feem ntau, lub plawv percussion ua nyob rau hauv ib tug sawv los zaum xav nrog nws ob txhais tes, ua tsis taus pa ntawm lub tib lub sij hawm yuav tsum ua twj ywm.

Percussion siab raws li ib tug tuab neeg lub cev, muab npub suab thaum percussion. Percuss yuav tsum nyob rau sab saum toj, qhov chaw uas lub suab yog tseeb thiab ua raws li cia kom txog thaum lub blunt suab. Suab Swap yog vim hais tias lub siab yog tej zais los ntawm lub teeb. Percussion siab tas yuav tsum tau nqa tawm nyob rau hauv ib tug kab rov tav txoj hauj lwm. Topographical landmarks yog tav thiab ntsug kab conditional qab plab. Tom qab percussion yuav tsum palpation, los yog lub cev lawm, uas tso cai rau los mus txiav txim cov kev hloov nyob rau hauv lub taub hau, zoo thiab nto ntawm lub siab, mob qhov chaw, tso cai rau kom nrhiav lub qis lub cev ntawm tus ciam teb.

Txiav txim seb txoj hauj lwm ntawm lub ntsws nyob rau hauv lub hauv siab thiab nyob rau hauv kev sib raug zoo mus rau lwm cov kabmob yuav topographic percussion ntawm lub ntsws. Norma percussion suab tshaj lub ntsws cov ntaub so ntswg - ntshiab suab. Qhov no yog qhov chaw nrog rau cov percussion sound lub clearest nyob rau hauv tag nrho lub cev. Palpation ntawm lub hauv siab los mus txiav txim nws zoo lawm, thiab mob heev qhov chaw, kuj thiab lub suab co. Nkaus yog ua nrog ob txhais tes ib txhij. Ices heev cheeb tsam probed kom huv si. Yog hais tias lub hauv siab yog nyob rau hauv kev txiav txim kuj yog yooj yim compressed, nws svidetelstveut nws degradability thiab elasticity, uas yog suav hais tias yog cai. Koj muaj peev xwm nyem ob pem hauv ntej thiab nram qab lub, yog symmetrically muab tso rau nws ob txhais tes, thiab nyob rau hauv sab, qhov twg lub mis ntau supple.

Tshwj xeeb tshaj yog cov me nyuam percussion

Percussion nyob rau hauv cov me nyuam, tshwj xeeb tshaj yog thawj xyoo ntawm lub neej, yuav tsum tau raug tus kws kho mob raws li lub cev ntawm cov neeg mob yog me me, nyias siab phab ntsa thiab daim tawv nqaij yog heev me.

Nyob rau hauv ib txoj kev tshawb no ntawm lub teeb yog tsim nyog los them nyiaj tshwj xeeb mloog mus rau cov teeb meem ntawm tus me nyuam, nyob rau hauv uas lub hauv siab yog positioned symmetrically. Indirect percussion yog siv thaum coj cov me nyuam hlob, cov me nyuam yaus kuj siv ncaj qha. Backrest tapping sawv los zaum nrog hla ob txhais ceg, lub sab nto ntawm lub hauv siab - nyob rau hauv lub zaum txoj hauj lwm, nrog rau caj npab ncua nyob rau hauv pem hauv ntej ntawm los yog nyob rau tom qab ntxiv, thiab ob lub mis - nyob rau hauv ib tug supine txoj hauj lwm.

Percussion yuav tsuas yuav nyob ntsiag to: ntiv tes, ntiv taw xoo los yog nyob ze. High thiab meej percussion suab rau cov me nyuam yaus yog lub cai. tej zaum nws yuav hloov nyob rau hauv lub tympanic thaum lub sij hawm ntawm kev quaj ntsuag.

Percussion: kev cai

1. Cov chav tsev yuav tsum sov thiab nyob ntsiag to.
2. Txoj hauj lwm ntawm tus kws kho mob - yooj yim.
3. Tus neeg mob nyob rau hauv lub hnub nyoog thiab lub heev ntawm tus mob. Vzroly neeg yuav sawv los yog zaum ntsiag to nyob rau hauv lub feem ntau relaxed txoj hauj lwm. Cov me nyuam mos nyob rau hauv ib tug upright txoj hauj lwm yuav tsum tuav, tuav nws rau nws niam.
4. Percussing lub cev liab qab.
5. Tus kws kho mob txhais tes - sov, qhuav thiab huv si.
6. Percussion tshuab yuav tsum yooj yim, tib lub dag lub zog, luv luv elastic.
7. Tes, conductive percussive blows yuav luv luv.

Palpation thiab percussion - ib tug kho mob kev soj ntsuam ntawm hauv nruab nrog cev cov tswv yim uas cia objectively soj ntsuam lawv raws li txoj cai thiab txoj hauj lwm, uas yuav tsum tau ib tug kws kho mob kev kho mob thiab saib xyuas.