Imiyalezo Apical. Ngokucofa wentliziyo

Yintoni naloo intliziyo? Abasebenzi bezempilo eziqhelekileyo kakuhle le nto. Kuba abo akazalani imisebenzi zonyango, le nkcazo akunamsebenzi ukuba kakhulu. Indlela yokwenza Ngokucofa ukuchonga indawo umlawuli angxamele kwentliziyo, kwakunye ezinye bokuqonda kwale nkqubo iya kuba nomdla kumntu wonke, kunye ulwazi oluthiwe thaca kweli nqaku liza kuba luncedo kwabo bafuna nje ukufunda iziseko yokhathalelo lwempilo.

imiyalezo intliziyo

imiyalezo senhliziyo - inxalenye yama- eludongeni esifubeni akudala, nto leyo ihambelana kwamathumbu ngentliziyo. It kungabonakala xa usibona isigulane. Nangona kwezinye iimeko, edluliselwa apical abakwazi ukubona:

• ukutyeba;
• izithuba intercostal elimxinwa;
• imisipha ngophuhliso;
• zimile.

Best of bonke kuyinto olubonakalayo kubantu abane -siseko asthenic. Ukuze ufumane oko, ngaphandle kuhlolwa iviwe kummandla atrial aqingqa nendawo ngokwentshukumisa kwentliziyo, ahluze iimpawu zayo ukufumana ingcaciso engaphezulu.

Ngokucofa ubuchule

esokunene kwingqikelelo ezenzo atyhale, phakathi kwe-3 no-6 wee enyeleni intliziyo. Ukumisela yama- ngapha phezu entendeni, uze okuyo kunye incam umnwe. Kufuneka kufakelwe nkqo esifubeni. Xa pulsation ixhaphakileyo amisele indawo yayo ngasekhohlo ngokuhla. Eli nqanaba site ngokwentshukumisa intliziyo. Ke kaloku, indawo ekhethiweyo, apho ugqibe Buze esifubeni yintlama terminal yokuhlasela umnwe palpate, kunye iindawo ecaleni kwayo.

Ukuba enkcochoyini yentliziyo ukuziva inkxaso ngenxa yohlobo esifubeni kunzima, nto yenzelwa kunye Ngokucofa ibheke esifubeni phambili, okanye isigulane kubekwa kwicala lasekhohlo. Imisipha wentliziyo kwezi zikhundla esinzulu unamathele esifubeni kwaye utyhala ngohlangothi kwemiphunga ngasekhohlo.

Kwindawo osecaleni ngasekhohlo, edluliselwa intliziyo ingaphantsi nasekholo cm 2, ngoko injongo uthathe indawo isithuba intercostal, echazwe unciphiso, kodwa 2 cm medial ukuya kwindawo saliphosa. Ngokucofa imiyalezo apical ukuba uwukhuphe kwandisa amathuba yokufumanisa indawo yayo, kuba xa mzuzu uyaziphakamisa uvalo, intliziyo, ukwenza intshukumo pendulum ukuya ekhohlo phezulu, uya kwindawo tyaba, ihlaba ngohlangothi kwemiphunga ngasekhohlo.

Oogqirha kumiselwa iimpawu ezithile ngokwentshukumisa intliziyo:

• indawo;
• ukumelana;
• ukwanda;
• ukuphakama.

Indawo imiyalezo intliziyo

Ukuncitshiswa wee wentliziyo ezenza imiyalezo intliziyo. Phezulu medial kancinane ukuya kumgca yee-clavicular kwisithuba intercostal 5 ngasekhohlo. Le iqhele ngokwentelekiso ngokukhululekileyo kwaye yenza intshukumo pendulum-like. Ukuba utshintsha indawo umzimba, ushukumisa bayiqhube zalapha. Ezinye embodiments of a ukubana yokutyhiliza sele ichaziwe ngasentla.

Xa umntu phezu ethubeni kwicala lasekunene va endle ukubana pulsation atrial ayenzeki, kwaye umphunga ekhohlo, ngeli xesha, phambili intliziyo, ungahambisa ngokupheleleyo kude eludongeni esifubeni. Ngoko ke, ngokuqhelekileyo, kwicala lasekunene, pulsation atrial nga phantse shwaka.

ukubana yezifo le pulsation intliziyo

Le yama- offset zohlulwa ngokwendidi ezimbini:

1. Lisisiqalo sinxulumana nesifo sentliziyo (pneumothorax, hydrothorax, umphunga loloyiko, emphysema yemiphunga, inqanaba zatshintshwa ukuma uvalo - ascites, ukukhulelwa, flatulence, emaciation)
2. pulsation yezifo ezinxulumene nesifo sentliziyo.

Kwimeko yokugqibela, lo shift ekhohlo kwenzeka ngenxa yokwanda kwe ventricle lasekhohlo, maxa wambi kumgca axillary akudala, kwaye izithuba intercostal phantsi ku 6,7,8. Ukwandiswa ventricle ekunene likwanika lisisiqalo ukuya umda wasekohlo wentliziyo, kodwa kuhlabana 5 isithuba intercostal.

Ubukho pulsation intliziyo

lunamaqoqo Square imiyalezo kwentliziyo imalunga 2 cm². Ukuba mkhulu, ngoko sithetha ehlasela okanye ukusasaza nokuhlambulukileyo kunye jerk. Kwindawo ephantsi ngayo anqongophele.

pulsation Common kwenzeka xa intliziyo uninzi kumphezulu wayo kuhamba ecaleni kodonga esifubeni. It yaphawula:

• nge umoya;
• nokukhulelwa;
• e yamathumba ye mediastinum kunye nabanye.

Xa engekho ezi meko iphalale ukothuka isenokuba ngenxa yokwanda intliziyo (bonke okanye naziphi na iinxalenye zayo).

imiyalezo Limited wentliziyo kwenzeka xa intliziyo indawo encane ezikufutshane esifubeni. Isizathu sokuba oku kungaba:

• emphysema;
• uvalo eliphantsi ukuma;
• effusion pericardial ;
• ophehlwa, pnevmoperikard.

Ukuphakama ngokwentshukumisa intliziyo

Wentliziyo ukuphakama angxamele - le awo wesahlulo eliguquguqukayo apha esifubeni. Ukwahlula ngokwentshukumisa phezulu, ephantsi eqhelekileyo inhliziyo. Ibangela sityhafile ziyafana ngenxa limited. Ngako oko, ezibangela ifomu ehlasela ngokwentshukumisa eliphezulu apical. Oku kwenzeka kwakhona xa tachycardia thyrotoxicosis ngenxa, ifiva, abatshayayo, phantsi ombane aphezulu.

Resistant imiyalezo wentliziyo - pulsation, enika imvakalelo shinyi, ashinyeneyo Ngokucofa kwezihlunu, uxinzelelo akululanga ngesandla. Ngoko ke, ukuba kusekho kwentamo, umlinganiswa eyomeleleyo, ngoko ke ichazwa njenge mnqweno apical lwale-ezimile. Ngokuqhelekileyo, akuyi, kodwa amiliswe kunye lwegazi okanye iziphene aortic xa ekuphuhliseni ventricular hypertrophy ngasekhohlo.

imiyalezo ongafanele inhliziyo

Uyazisola kodonga esifubeni kule ndawo ngokwentshukumisa kwentliziyo ngexesha systole - a mnqweno elibi apical. Yena livela ukwandiswa oluvela ventricle ekunene, leyo utyhala ngomva ngencam ventricle ekhohlo. nokuncipha iSystolic ngayo ukwenza into enjalo.

Uyazisola lezithuba intercostal lwenzeka xa pericarditis kwakuse.

enye pulsation

Diagnostically okunzulu olube pulsation le aorta, pulmonary kunye epigastrium yama- nzi. Eyokuqala kubo ayibonakali eqhelekileyo. yama- nzi yezifo efanayo ibonakala II isithuba intercostal ekupheleni ekunene kwentamo. Izizathu ivela ziquka:

• loloyiko lung sokunene;
• ukwandisa aorta (negcushuwa, kwemithambo le aorta elinyukayo, iziphene vana aortic).

Pulsation pulmonary (II isithuba intercostal ukuya ekhohlo kwentamo) - isiphumo nomfutho yemiphunga iziphene valve mitral.

pulsation Epigastric ibanjiwe kwi fossa epigastric. Izizathu ivela khona;

• ptosis le ventricle ngasekunene;
• kwemithambo esiswini aortic.

isiphelo

Iindlela ezichazwe ngentla-yophando kubalulekile kwiingcali, kodwa ngokunxulumene nophuhliso uxilongo yentsimbi, oogqirha ukuzibophelela ekumiseleni ngezifo ngu uhlolo olubonakalayo kunye Ngokucofa leminyaka edlulileyo iye yehla kakhulu.

Kwangaxeshanye, imfuneko yokuqhubeka lomkhuba ngasentla liphezulu kakhulu. Iingcali ukucacisa imiyalezo apical ngu Ngokucofa, kufuneka bakhuthazwe yaye ngokubonakalayo ukuhambisa inkcazelo engakumbi isicelo yale ndlela amayeza.

Kwiimeko ezininzi, ukusetyenziswa Ngokucofa kwakhokelela ekubeni iziphumo ezihle, kubandakanywa uxilongo ekuqaleni kwesi sifo. Ekhethiweyo imiyalezo abanezakhono apical (in ezimbi eqhelekileyo ezahlukeneyo) i parameter ebalulekileyo ekusekeni iindlela zokunyanga izigulane.