Hihiko apical. Palpation o te ngakau

He aha te mea he hihiko cardiac? E pai te mōhio ki tenei ariā kaimahi hauora. Hoki te hunga e kore e nei i pā ana ki ngā mahi hauora, tenei whakamāramatanga e kore mea nui. Me pēhea te ki te hanga palpation ki te tautuhi i te wāhi o te hihiko cardiac, me te etahi o nga mita o tenei tikanga ka waiho o te moni ki te katoa, me te mōhiohio aroaro i roto i tenei tuhinga ka kia whai hua mo te hunga e hiahia noa ki te ako i nga taketake o te tiaki hauora.

hihiko cardiac

hihiko cardiac - he wahi pōkare o te taiepa pouaka he mārōrō, e hāngai ana ki te contractions ngakau. Ka taea te kite te reira i ka tirohia i te manawanui. Ahakoa i roto i ētahi wā, e kore e taea e hihiko apical kite:

• mōmona;
• wāhi intercostal kuiti;
• whakawhanakehia uaua;
• u nui.

Best o katoa he mea kite i roto i te iwi ki te kaupapa ture asthenic. Hei kitea reira, i tua atu i palpated tirohanga rohe Atrial me te whakatau i te wāhi o te hihiko cardiac, arotake ona āhuatanga mō ētahi atu mōhiohio.

tikanga palpation

ringa matau i roto i te ngä kiia pana, i waenganui i 3 me te 6 i roto i te tihi mata o te ngakau. Te whakatau i te pōkare puta noa te mata o te nikau, a ka localize reira ki te matamata o te maihao taupū. Me tāuta te reira hāngai ki te pouaka. I roto i te otu'itu'iraa tino noa whakatau tona rohe maui, me raro. Tenei wāhi Ko te pae o te hihiko cardiac. Ratau, te wahi tīpakohia, te wahi e takoto ai protrusion pouaka penupenu kāpeka phalanx maihao palpate, me nga papa taha o reira.

Ki te ki te tihi o te ngakau ite i te whakanui e tika ana ki te āhua o te pouaka he uaua, kua whakamana reira ki palpation tītaha pouaka whakamua, whakanohoia te manawanui kei i runga i te taha ki maui ranei. Ko te uaua o te ngakau i roto i enei tūranga piri piri ki te pouaka, me te pana i te mata o te pūkahukahu mahue.

I roto i te tūnga lateral mahue, he raro me ki te maui 2 cm hihiko cardiac, na te aki tango wahi te wāhi intercostal, tautuhia nei te whakaiti, engari mo te 2 cm medial ki te rohe aki. Palpation hihiko apical ki te exhale faarahi te tūponotanga o te whakatau i tona wāhi, no te mea i te kau o te hiki i te HWM, ngakau, hanga he kaupapa tāwēwē ki te maui, me te ake, haere ki te tūnga whakapae, e aki ana i te mata o te pūkahukahu mahue.

takoto Doctors etahi āhuatanga o hihiko cardiac:

• tauwāhi;
• resistance;
• nuinga;
• teitei.

Wāhi hihiko cardiac

Whakaiti tihi cardiac hanga hihiko cardiac. Kei te paku te runga medial ki te aho waenganui-clavicular i roto i te wāhi intercostal 5 i runga i te maui. Kei te Kei te reira i ngā noa me hanga kaupapa tautau-rite. Ki te huri koe i te tūranga o te tinana, nekehanga, me te pana localization. Ētahi taatou o te displacement pana kua whakaahuatia ana i runga.

A, no te faaite i te tangata i runga i te tahuri taha matau mara displacement kore e otu'itu'iraa Atrial puta, me te pukapuka i mahue, i tenei wa, atu i te ngakau, e taea tino neke atu i te taiepa pouaka reira. Na reira, te tikanga, i te taha ki matau, otu'itu'iraa Atrial taea tata ngaro.

displacement pathological o te otu'itu'iraa ngakau

Ko te pōkare wāhikē wehea ki e rua momo:

1. Ko te wāhikē kore e pā ana ki te mate ngakau (pneumothorax, hydrothorax, pūkahukahu scarring, emphysema pūkahukahu, taumata puta ke o tu HWM - ascites, hapūtanga, flatulence, emaciation)
2. otu'itu'iraa pathological e pā ana ki te mate ngakau.

I roto i te take whakamutunga, puta te neke maui tika ki te hua o te mānawanawa maui, i ētahi wā ki te raina axillary mārōrō, a ki raro ki te 6,7,8 wāhi intercostal. homai te roha o te mānawanawa matau ano te wāhikē ki te rohe i mahue o te ngakau, engari ko te pana he 5 wāhi intercostal.

Ko te nuinga o te otu'itu'iraa cardiac

protrusions Square hihiko cardiac ko e pā ana ki te 2 cm². Ki te he te reira nui, ka korero matou o ruia ana ranei horapa te ma, me te takiri. I te wāhi o raro he mea iti.

puta otu'itu'iraa Common ina he pātata ki te taiepa pouaka te ngakau o te nuinga o tona mata. kite te reira i:

• ki te manawa hohonu;
• hapūtanga;
• i roto i te pukupuku o te mediastinum me etahi atu.

I roto i te ngaro o enei tikanga i maringi ai hei ru te hua o te roha o te ngakau (o katoa i tetahi o ona wahi ranei).

puta Limited hihiko cardiac ka te ngakau, ko te he pātata ki te pouaka i te wāhi iti. Ko te take mō tenei e taea e:

• emphysema;
• HWM tu iti;
• effusion pericardial ;
• hurihiko, pnevmoperikard.

Ko te tiketike o te hihiko cardiac

teitei hihiko cardiac - te kaha tīwera o te wahi pumanawa o te pouaka. Te wehe tiketike, iti, me te noa hihiko cardiac. Ko te taua rite mo te iti ai iti. Nä, ko te take o te puka E ruia ana hihiko apical tiketike. Ka puta mai hoki, no te tachycardia thyrotoxicosis tika, kirika, kaipaipa, i raro i ngaohiko tiketike.

Ātete hihiko cardiac - otu'itu'iraa, e homai te mana'o o matotoru, palpation uaua mātotoru, e kore he ngāwari ki te ringa pēhanga. Na, ki te mea he reira E ruia ana tonu, huru kaha, ka kua tautuhi reira rite te hihiko apical dome-āhua. Tikanga, e kore e whakaritea ai, engari kei te hanga e ki takawhita hē te pūtahi o ranei ka whakawhanake hypertrophy ventricular maui.

hihiko cardiac tōraro

Retraction o te taiepa pouaka i roto i te rohe o te hihiko cardiac i roto i systole - he hihiko kino apical. puta ia ki te toronga faaite o te mānawanawa matau, e pana te matamata posterior o te mānawanawa maui. hukihuki Systolic taea whakaputa reira he āhuatanga taua.

Retraction o ngā wāhi intercostal puta ka te pericarditis piripiri.

atu otu'itu'iraa

Diagnostically nui rerekē he otu'itu'iraa o te haoraora, iatuku pūkahukahu me te epigastrium pōkare. Ko te tuatahi o ratou he e kitea ki noa. puta taua pōkare pathological i roto i II wāhi intercostal i te mata matau o te whaturei. Ko te take mo tona takanga ngā:

• mātānawe pūkahukahu matau;
• haoraora whakawhänui (pakewakewa, aneurysm o te haoraora e piki, hē piha te pūtahi o).

Otu'itu'iraa iatuku pūkahukahu (II wāhi intercostal ki te maui o te whaturei) - te hua o te takawhita pūkahukahu i roto i hē piha mitral.

kitea otu'itu'iraa Epigastric te i roto i te fossa epigastric. Ko te take mo tona takanga:

• ptosis o te mānawanawa matau;
• puku aneurysm te pūtahi o.

mutunga

He nui hoki ngā te tikanga i runga ake-whakaahuatia o te rangahau, engari i roto i te hononga ki te whanaketanga o tātaritanga pūmārō, kua heke tākuta fafauraa ki te tāutu i māuiuitanga i te tirohanga ataata, me te palpation o te tekau tau whakamutunga tino.

I te wa ano, i te hiahia ki te haere tonu te mahi i runga ake he tiketike rawa. Mataotao whakatau i hihiko apical i palpation, kia whakatenatena me te ueue i kaha ētahi atu pārongo i runga i te tono o tenei tikanga i roto i te rongoa.

I roto i te rahiraa o te taime, te whakamahi o te palpation arahina ki ngā hua pai, tae atu ki te tātaritanga wawe o te mate. Tīpakohia hihiko apical mohio (i roto i pathologies noa, me te ngā) ko he tawhā nui mō te haamauraa i tikanga o te rongoā tūroro.