Palpation na hanta: da dabarun, dokoki da kwafi

Palpation - daya daga cikin mafi m hanyoyin da ganowa, za'ayi da likitoci a mataki na binciken farko na haƙuri. Game da shi a yau kuma za mu yi magana.

hanta haltta

Kafin kafa fita don gano batun palpation na hanta, ya kamata mu ayyana Anatomy da jikin ayyuka. Hanta located nan da nan a kasa da diaphragm, to dama a saman ciki, da kuma kawai karamin sashi na jiki na ya fara tasawa located a kan hagu (daidai da ma'anar line). A jarirai, da hanta daukan wani gagarumin rabo daga ciki.

Topographically hanta yana da biyu saman da kaifi biyu. A cikin agara (babba) surface shigeba, to surface na diaphragm da kuma bulges maganganun da ta curvature. Lower aka located a baya da kuma a kasa, tare da 'yan kwaikwayo daga m gabobin. Manya da ƙananan saman rabu da ƙananan kaifi baki, da sauran baki (caudineural), da bambanci, sosai maras ban sha'awa, kuma haka shi za a iya dangana ga jiki raya surface.

Bambanta a cikin hanta sassa biyu: a babban dama da ƙananan hagu, rabu da wani jinjirin wata jijiya a cikin free ɓangare na abin da ya ta'allaka da wani m fibrous igiyar - abin da ake kira madauwari jijiya cewa kara daga cibiya da ba fiye da wani overgrown cibiyarki jannayẽnsa.

The dama lobe da aka rabu da furrows cikin da dama na biyu hannun jari. A daya daga wadannan GROOVES suna located gallbladder da vena Vienna (m) rabu da wani yanki na hanta nama an cinye tailed appendage.

Daya daga cikin muhimman sassa na jiki ne mai zurfi mai gangara tsagi cewa an kira a matsayin kofa hanta. Ta hanyar wannan samuwar a cikin jiki ne manyan hanta jijiya ƙofar Vienna da jijiyoyi, da kuma barin shi efferent hanta bututu (fitarwa na bile a cikin gallbladder) da kuma lymphatics.

The dama lobe jiki ya zama ruwan dare square sulusi da murabba'i cewa yana da iyaka zuwa cikin ƙofar hanta, da kuma wani mai zagaye jijiya fossa na gallbladder, da kuma caudate lobe mikawa akwai tsakanin kofa da kuma hanta portal jannayẽnsa.

hanta aiki

• Rayuwa (iko na musayar ruwa, ma'adanai da kuma bitamin, ba ji ba gani, amino acid, lipids, sunadarai, carbohydrates).
• An ajiye (a cikin jiki tara BZHU, bitamin, ma'adanai, ba ji ba gani).
• Secretory (bile samarwa).
• Detox (da za'ayi saboda da na halitta hanta tace - hanta macrophages).
• Excretory (ta dauri glucuronic acid da sulfuric guba abubuwa indole, tyramine, skotola).
• Homeostatic (hanta da hannu a cikin iko da angiogenic da kuma na rayuwa hemostasis da kwayoyin).

Saboda da morphological da kuma aikin fasali na hanta ne sau da yawa quite mamakin iri-iri na ba-communicable da communicable cututtuka. Wannan shi ne dalilin da ya sa a lokacin da na farko haƙuri magani wajibi ne a gudanar da palpation na jiki.

Palpation kuma feat. Irfan hanta

Kafin probing hanta bayar da shawarar yin amfani da feat. Irfan domin sanin iyakokinta. Wannan zai ba kawai zaton cikin jiki karuwa, amma kuma ya fahimci inda ya kamata a fara palpation. Lokacin feat. Irfan hanta nama bada m (maras ban sha'awa) sauti, amma saboda gaskiyar cewa ƙananan ɓangare na huhu partially rufe da shi, shi ne zai yiwu domin sanin biyu iyakoki: da gaskiya da cikakkar hanta dullness, amma sau da yawa ayyana wani iyaka (ƙananan kuma babba) na cikakkar wawanci.

Palpation na jiki (m)

Lokacin da yake bincike da hanta dole ne ka bi wasu sharudda:

• A matsayi na magana - (kwance) ga baya, tare da shugaban dan kadan dagagge, da ƙafafunsa kawai tankwasa a gwiwoyinsa, ko madaidaiciya. Hands a kan kirji, domin rage ta motsi lokacin da inhaling da shakata your na ciki tsokoki.
• A likita ne da 'yancin mutum ga mãsu haƙuri.
• Dan kadan lankwasa hannun dama likita kayansa mãsu lebur a kan haƙuri ta ciki a yankin na dama hypochondrium, kasa da uku zuwa biyar santimita, abin da yake da iyaka da hanta baya a tsare feat. Irfan. Tare da hannunsa na hagu likita maida hankali ne akan kirji (ta kasa dama), tare da hudu yatsunsu ya kamata a sanya a baya, da kuma daya (babban) yatsa ya sa a kan costal baka. Wannan hanya za ta samar da immobility daga cikin kirji a lokacin inhalation da kuma kara da korar da diaphragm zuwa ƙasa.

• Lokacin da haƙuri exhales, likita effortlessly jan saukar da fata da kuma, jefa hannunsa na dama a cikin kogon ciki, ta tambaya da mãsu haƙuri ga numfasa. A wannan lokaci, gefen (ƙananan part) na jiki da dama, da ke shiga cikin halitta aljihu da kuma nunin faifai a kan yatsu. A lokaci guda palpable hannu dole ne zama na kullum. Idan saboda wasu dalilai tausa hanta kasa, da hanya an maimaita, amma yatsunsu an tarwatsa 'yan santimita up. Nuna wannan magudi, motsi mafi girma da kuma mafi girma, yayin da hannun dama ba ya tuntuɓe a kan costal baka, ko har da bincike hanta baki.

Features

• Nuna palpation da hanta yawanci ta kai tsaye ciki tsoka (ta m baki) ko dama tsakiyar clavicular line. Amma idan da bukatar taso, probing kayan biyar Lines (daga cikin agara axillary dama zuwa hagu okologrudinnoy).
• A cikin hali na jari na ciki palpation na babban kundin na ruwa wuya. Sa'an nan suka komo gare probing ne a guje jerky jiki. A saboda wannan dalili, na biyu, na uku da na hudu yatsunsu na hannun dama harbi-thrusts a gaban ciki bango, faro daga kasa da kuma kawo karshen tare da costal baka up zuwa ganewa na samuwar wani m - hanta. A lokacin farko jiki kara zurfi a cikin reshe, sa'an nan ya zo da baya da kuma bumps a kan yatsunsu (a alama da ake kira "iyo yanki na kankara").

Fassarar sakamakon (al'ada)

Abin da sakamakon ya kamata ya nuna palpation na hanta?

• Yadda aka saba, 88% na marasa lafiya jiki ƙananan baki aka located a kusa da costal baka, a layi tare da tsakiyar clavicular line ga dama.
• A wani lafiya jikin mutum gefen kaifi ko dan kadan taso keya. Shi ne m, m, sauki podvorachivaetsja a palpation, santsi.

Evaluation na data (Pathology)

• Idan hanta ne kara girman, palpation shi za a located kasa da costal baka, wanda kuma iya bãyar da shaida da ta motsa. A goyon bayan wannan ko da amincewa wajibi ne don feat. Irfan, don ƙayyade da iyakoki na jiki.
• Idan girman da hanta da aka ba su canja ba, amma da iyakoki da hanta dullness canja saukar - da wata ãyã daga sashin jiki prolapse.
• Biya diyya kawai ƙananan iyakar nuna wani karuwa a cikin hanta da ya auku a venous stasis, kumburi a cikin hanta da kuma biliary fili, m cututtuka (zazzabin cizon sauro, kwalara, typhoid, dysentery), cirrhosis (da farko).
• Idan ƙananan iyaka da aka canja zuwa sama, yana yiwuwa ya zargin raguwa a jiki size (msl, a m matakai na cirrhosis).
• Rearranging hanta babba iyaka (sama ko žasa) da wuya nuna lalacewar na sashin jiki (msl, hanta ciwon daji ko echinococcosis). A mafi yawan lokuta shi ne kiyaye saboda da babban matsayi na diaphragm a lokacin daukar ciki, ascites, flatulence, domin a low budewa tsari visceroptosis, pneumothorax, emphysema, kazalika da a lokuta da wani sallama budewa a kan hanta saboda jari na gas.
• Na huhu infarction, wrinkling ta ƙananan part, ciwon huhu, pleurisy gefe iya canzawa cikin sama kawar da iyaka babba jiki.
• A wasu lokuta, akwai ba kawai don palpation na gefen hanta, amma kuma na dukan jiki. Don wannan karshen, da yatsunsu suna sanya kai tsaye a karkashin dama costal baka. A likita m turawa, zamiya ƙungiyoyi hanta nazarin, kimantawa da ta surface (nodular, da santsi, m), irin zane (m, m), gaban / rashi na zafi.

• Myagkovataya, lebur, m surface da kuma taso gefen taushi - ãyõyin kumburi a jikinsa ko bayyanuwar m jini stasis saboda zuciya rashin cin nasara.
• Lumpy, Bumpy, m baki aka lura a echinococcosis da syphilis. Very m ( "itace") ne m da hanta lalace gabobin da ciwon daji Kwayoyin.
• Plotnovata gefen hanta da shawara hepatitis, kuma a tare da tare da tuberosity - cirrhosis.
• Pain a kan palpation da hanta iya faruwa saboda kumburi tafiyar matakai, ko da ta distension kwantena (a congestive hanta).

Palpation na hanta a yara

Probing jariri hanta, yawanci da za'ayi a tsakiyar watan clavicular da agara axillary Lines da motsi palpation. A wannan bangaren, ya duba pediatrician nunin faifai kashe gefen hanta, yin yiwu ba kawai domin sanin girman da jiki, amma kuma palpation kima ta baki. Na kullum ga jarirai ne da wasan kwaikwayon na hanta gefen costal baka a kan biyu (amma ba mafi) na wani santimita. Evaluation da aka gudanar a cikin midclavicular line. jiki baki haka ya zama m, m, kaifi da kuma taushi roba.

A lafiya yara kasa da shekaru bakwai gefen hanta, yawanci protrudes daga costal baka da dama ne don palpation. Domin lafiya yara har zuwa shekara uku, na kullum ne definition na hanta baki ne 2 ko 3 cm kasa da dama costal gefe. Bayan shekara bakwai na hanta iyakoki dace ga waɗanda a cikin manya.

Bincike na hanta hanya Kurlova

Don tabbatar da ganewar asali na wannan ko Pathology da take kaiwa zuwa wani murdiya na jiki size, wajibi ne don gudanar da wani palpation na hanta Kurlov. Domin wannan amfani da tapping (feat. Irfan) ƙayyade na sama da iyaka sa'an nan palpated (ko feat. Irfan) - ƙananan. Haka kuma, a daidai da wani QFontDatabase shakka daga cikin ƙananan gefen iyakar, da kuma nĩsa tsakanin manya da ƙananan suna iyaka ƙaddara da maki uku. A farko yayi dace da midclavicular line, na biyu - da midclavicular, da kuma na uku - da bar costal baka. A prefecture size ya zama 9, 8, 7 miƙa bi da bi.