Ukufudumala kwesifuba sokuphefumula: yintoni na indlela yokulinganisa, isiqhelo

Ukuze uqoke ngokufanelekileyo i-anamnesis, abafundi bafunda iminyaka befunda udliwano-ndlebe, bahlolisise baze balinganise isigulane. Yonke i-art - ngokukhawuleza kwaye ngokufanelekileyo izalise ikhadi eliphambili ukwenzela ukuba nokuba ugqirha ongakaze adibane nesigulane sakho sakhawuleza. Esinye sezigaba kwimbali ye-anamnesis yiphando ye-anthropometric, equka ukugqiba ubukhulu besifuba, umthamo wokunyakaza okuphefumulayo, ukulinganisa kwabo kunye nokuphindaphinda, ukuthatha inxaxheba kwisenzo sokuphefumula.

Ubume bebhokisi

Yintoni ugqirha efuna ngexesha loviwo? Okokuqala, oku kubonakaliswa kweempawu zesifuba ekuphumleni nasekuhambeni kwenkqubo, kunye nezibonakaliso ze-spirometry, umzekelo, njengombhalo ophefumlelweyo, isivinini kunye nomoya wokuphefumula, kunye nabanye abaninzi. Ulwalamano lwabo luya kunceda ukuhlula i-pulmonological pathology kwi-neurological, kwi-trauma okanye i-edema ye-pulm.

Okokuqala, ngokuhlola okubonakalayo, sinokwakheka kwimeko yesifuba. Ukwahlula ukuhluka okulungileyo okanye okungalunganga. Emva koko, jonga ukulinganisa kwamacala omabini ayo kunye nokuhambelana kokunyakaza kokuphefumula.

Uhlobo lwesifuba

Kwi-anatomy yeklinikhi, ezi zilandelayo zikhoyo ziphuhliso:

1. I-Normostenic, xa ububanzi bomgama nobubanzi bunjalo, i-supra- kunye ne-subclavia fossa iyachukumiswa ngokukhawuleza, iimbambo zihamba ngokugqithiseleyo, umgama phakathi kwabo uhlala uqhelekileyo, isicapula sixinzeleleke kwi-thorax, kwaye i-epigastrium angle ichanekile.
2. Uhlobo lwe-asthenic ludla ngokukwenzeka kwiindawo ezincinci. Ubukhulu, obumelela ubunzulu besifuba buncinci, ngenxa yolu lwakhiwo ngumbono wokuthi unobumba obukhulu. Ngokuqhelekileyo, imikhosi kufuphi ne-clavicle iboniswa ngokukhawuleza, ulusu phezu kwabo luyancipha. Iimbambo zifumaneka ngokugqithiseleyo kunekona, i-angle eyenziwe yenkqubo ye-xiphoid iyanzima. Kubantu abanjalo, izihlunu zamagxa kunye nomva zihlala zibuthathaka, kwaye umgca ongezantsi weembambo zilula.
3. Uhlobo lwe-Hypersthenic, luhambelana nohlobo olufanayo lomzimba. I-thorax ifana ne-cylinder, ubunzulu kunye nobubanzi bunye, i-intervals phakathi kwembambo ilula, iphantse ifane. I-Supra- kunye ne-subclavia fossa ibonakala ibalaseleyo, i-epigastric angle ingenangqiqo.
4. I-thorax emphysiemous ivela kwizigulane ezine-COPD kunye ne-asthma ye-bronchial. Kufana ne-hypersthenic, kodwa kuneendawo eziphakathi kwe-intercostal, ikhosi yezimbambo zincinci, ngokuqhelekileyo ngaphandle kwe-slope, i-scapulas ifumaneka ngokuthe ngqo ngokubhekiselele kwiimbambo, akukho nto ikhethiweyo ye-supra kunye ne-subclavia.
5. Isifuba sokukhubazeka singaphandle sifana ne-asthenic. Kwenzeka kwizigulane ezineesifo sofuba, izifo ezingapheliyo zamaphaphu, i-pleura, ekudleni okungenamsoco, kubantu abathintekayo kunye neengxaki zemfuyo-i-Morphan syndrome.
6. Iirekethi, okanye i-thorax e-keeled - ivela ikakhulu kubantwana. Iimpawu zayo ezahlukileyo ziyingcamango kwindawo ephambili kwenkqubo ye- xiphoid ye- sternum. Kwakhona ubukho beempawu zobunzima, ukuqina kweso sithuba sokutshintshwa kwesigxina esingenasiphelo sombundu kwisigxina se-cartilaginous ngenxa ye-osteogenesis engalunganga.

Indlela yokuphefumla

Ukugqithisa kwesifuba akuxhomekekanga kuphela kwimihlobo kunye nokuma kwayo, kodwa nangendlela umntu ephefumula ngayo: umlomo okanye impumlo. Kule nxu lumene, iintlobo ezahlukeneyo zokuphefumla ziyahluka.

Isisu - senziwa ikakhulukazi kwabasetyhini. Kulo hlobo, umthwalo ophezulu uwela kwiintlobo ze-intercostal kunye ne-diaphragm. Ukuphefumula kwesisu kuyaqhelekileyo kumadoda. Banobudonga besisu esisemsebenzini kwisenzo sokuphefumla.

Kukho nesantya sokuphefumla (isichythmic or arrhythmic), ubunzulu (ubunzulu obunzulu, ubunzulu obuphakathi okanye ubuninzi) kunye nexesha (inani lokunyakaza okuphefumulayo ngomzuzu).

Symmetry

Uhambo lokuphefumula lwe-thorax ngokuqhelekileyo luyingqamaniso. Ukuze uhlolisise lo mqondiso, kufuneka ukhangele ukuhamba kwamacangci angaphantsi kweengqayi ngexesha lokuphefumlelwa nokuphefumlelwa. Ukuba enye ye-scapulae ayihambelani nelinye, ibonisa ukuphulwa komsebenzi wokuphefumula kwangaphandle kwaye ingabonisa iinkqubo zokuvuvukala, ezifana ne-pleurisy. Ukongeza, i-asymmetry iyakubonwa emva kokuhlinzwa kwi-esifubeni, ngokubambana kompompo ngenxa yeengcingo ezingcolileyo okanye i-necrosis.

Omnye umzekelo apho ukuqhuma kwesifuba kunokuphazamiseka kukunyuka kwengqondo kwimpompo. Le meko ingabonwa nge-emphysema, isifo se-bronchoectatic, i-exudative exudative okanye i-pleurisy exudative, i-pneumothorax evaliweyo.

Inkqubo yokulinganisa

Indlela yokunquma ukuhamba kwesifuba? Ngokulula: ngokulinganisa nokubala okulula.

I-examinee icelwa ukuba imele ibhekane nogqirha kwaye isasaze izandla zayo kumacala. Kuyinto enqwenelekayo ukuba inxalenye ephezulu ye-trunk ngexesha elifanayo ikhululiwe kwiingubo. Emva koko ugqirha uthatha i-tentimenti yecentimitha kwaye uyayifaka ukuze idlule emacaleni omhlaba. Umphandi uyamenywa ukuba athabathe umoya kwaye agcine umoya. Ngeli xesha, ukulinganisa kokuqala kwenziwa. Emva koko isigulane sinokukhupha kwaye siphinde siphefumle, ukuze ugqirha aphinde ahlole umlinganiselo wesifuba. Enyanisweni, oku kwakukufuphi kwesifuba. Indlela yokulinganisa ukuvakala kokuphefumula okanye ubunzulu bawo kwiilitha? Kulula kakhulu, ukuba kukho izixhobo ezongezelelweyo, ezifana newashi kunye ne-picofluometer.

Ukuguqulwa kwesifuba

I-excursion yesifuba kufuneka iqheleke ngokulinganayo kuzo zonke iindawo, kodwa ngamanye amaxesha ukungaxhatshazwa kweendonga zayo kungabonakali uxinzelelo lomoya. Kwaye kubonakala ukukhutshwa okanye ukuhoxiswa. Ukutshintshwa ngokuqhelekileyo kubangelwa yi-fibrosis okanye i-lung atelectasis. Ukuvuvuka komzimba omnye kwesibindi kungabonisa ukuqokelela umbane okanye umoya kule ndawo.

Ukujonga ubungqamaniso, ugqirha kufuneka abeke izandla zakhe emva kwisigulane ngaphesheya kwikholam yomgcini kwaye ucele ukuphefumula okumbalwa. Umgudu wesinye seziqingatha unokuxelela ugqirha ukuba umntu ukhulisa i-pleurisy okanye i-pneumonia, kwaye i-uniform eyancipha okanye ukungabikho kwempompo kungakhokelela kwingcamango ye-emphysema.

Umsebenzi oqhelekileyo

Enyanisweni, akukho zikhokelo ezicacileyo, ezifanele ukutyelela isifuba. Isiqhelo (cm) sinxulumene kwaye sixhomekeke kwiminyaka, umzimba, ubulili bomntu. Ngokomyinge, ivela kumgama omnye ukuya kwiisentimitha ezintathu. Ingqungquthela yesifuba - kunye nexabiso elixabisekileyo, kuphela kubantwana kukho itafile ezikhethekileyo ezibonisa ukuguquguquka nokuvisisana nophuhliso lwabo.

Izinga lokuphefumula

Xa i-chest excursion ichongiwe, ugqirha ubandakanyeka ekubaleni ukuphefumula. Kulo mzuzwana kubalulekile ukuphazamisa isigulane kwenye into, ngaphandle koko iyakwazi ukuphazamisa iziphumo, ukuphefumla kaninzi okanye, ngokuthe ngqo, ngokuthe rhoqo.

Ngenxa yoko, engaqapheli isigulane, oyingcali unesandla phezu kwesifuba. Oku kulungeleka xa ubala i-pulse kwaye ubale inani lokunyakaza ngomzuzu. Uhambo oluqhelekileyo lwesifuba lubandakanya ukunyakaza okulishumi elinambini okanye amabini okuphefumula. Ukuba isigulane asifinyeleli umda ophantsi wesiqhelo, ngoko ke, ngokukhawuleza uza kubonisa iimpawu ze-neurologic, kodwa ukuba i-frequency iphakamileyo kakhulu, ukuxilongwa okubonakalayo kunxulumene neentsholongwane ezithintela umntu ekuphefumla ngokujulile (ukuchithwa kwamanzi, ukuhlukana kwezimbambo, i-neuralgia, njl. .). Ukongezelela, ukukhawuleza kokuphefumla kungabonwa ngenxa yesimo sengqondo se-labile, ekuphakameni komkhuhlane, okanye ekufundiseni kwangaphambili.

Ukuqhutyelwa kwesifuba (umahluko phakathi kwesikhokelo phakathi kokuphefumlelwa nokuphefumlelwa) akusoloko kuqukwa kwiinkalo eziphambili zezilwanyana eziphuthumayo okanye izibhedlele ze-somatic. Oku kubonwa njengomsebenzi oqhelekileyo, nangona kungafanelekanga. Ngaphambili, xa i-ultrasound, i-MRI kunye ne-CT engasetyenziswanga ngokubanzi, oogqirha babenokubonisa ukufihlakeleka, ukubeka isandla kwisifuba sesigulane.