Ukujonga kunye nokuchonga
IQela lokuBamba iKlinikhi eNgemva kunye neQela lokuxilonga.
Oku kuthetha ukuba xa ufika kwi-DOI kuvavanyo lwe-radiologic, zonke iinkcukacha, ukusuka kuyilo lwamagumbi, ukhetho lwezixhobo, itekhnoloji ekhethwe ngesandla, kunye nesoftware eqhuba iofisi, ikhethwe ngononophelo okanye iyilwe yiRadiologist. kwaye hayi ngomgcini-mali. I-niche yethu yemarike yindawo enye yokugqwesa. Imilinganiselo yethu enxulumene nokhathalelo lwezigulane zezi: Sikholelwa ekuphatheni izigulana ngendlela esiya kuphatha ngayo intsapho yethu kwaye siya kwenza konke okusemandleni ethu ukuqinisekisa ukuba unamava amnandi kwikliniki yethu.
by UGqr Alex Jimenez Ukujonga kunye nokuchonga , Uncedo Lwezityalo
I-Spinal stenosis kuxa indawo kwindawo ethile okanye ngaphakathi komqolo iqala ukucutha, ukuvala amandla okuhamba okuqhelekileyo / okunethezekayo kunye nokujikeleza kwemithambo-luvo. Inokuchaphazela iindawo ezahlukeneyo, kubandakanywa yomlomo wesibeleko / yomqala , i-lumbar / low back, kwaye, ngaphantsi kwesiqhelo, imimandla ye-thoracic / ephezulu okanye ephakathi MRI kungena.
I-Spinal Stenosis MRI
I-Stenosis ingaba ngumngeni wokuxilonga njengoko ininzi impawu / ingxaki kunemeko, edla ngokubangelwa yi-disc ye-herniated, i-bone spurs, imeko yokuzalwa, emva kokuhlinzwa, okanye emva kokusuleleka. I-Magnetic resonance imaging/MRI luvavanyo oluqhelekileyo olusetyenziselwa ukuxilongwa.
Ukuqondwa
Ingcali yezempilo, njenge-chiropractor, i-physical therapist, ingcali yomgogodla, okanye ugqirha, uya kuqala ngokuqonda iimpawu kunye nembali yonyango.
Uvavanyo lomzimba luya kuqhutywa ukuze lufunde ngakumbi malunga nendawo, ubude bexesha, izikhundla, okanye imisebenzi eyehlayo okanye eyenzakalisa ngakumbi iimpawu.
Iimvavanyo ezongezelelweyo zibandakanya amandla emisipha, uhlalutyo lokufumana, kunye nokuvavanya ukulinganisela ukunceda ukuqonda ngcono apho intlungu ivela khona.
Ukuqinisekisa ukuxilongwa, umfanekiso uya kufunwa ukubona ukuba kuqhubeka ntoni.
I-MRI isebenzisa umfanekiso owenziwe ngekhompyutha ukuvelisa imifanekiso ebonisa amathambo kunye nezicubu ezithambileyo, njengezihlunu, i-nerve, kunye ne-tendon, kwaye ukuba zixinzelelwe okanye zicatshukiswa.
Ingcali yezempilo kunye Ingcali ye-MRI iya kudlula kwiimfuno zokhuseleko phambi komfanekiso.
Kuba umatshini usebenzisa iimagnethi ezinamandla, akunakubakho ntsimbi emzimbeni okanye emzimbeni, njengeprothesi efakelweyo okanye izixhobo ezibandakanya: Iipakethi
Implantshi yeCochlear Iimpompo zokufakela amayeza I-intrauterine contraceptives Neurostimulators Iikliphu ze-Intracranial aneurysm Izivuseleli zokukhula kwamathambo Uvavanyo lokucinga olwahlukileyo lunokusetyenziswa ukuba umntu akanako ukuba ne-MRI njenge CT scan .
I-MRI inokususela kwimizuzu emininzi ukuya kwiyure okanye ngaphezulu , kuxhomekeke ekubeni zingaphi izikhundla eziyimfuneko ukuhlukanisa indawo eyalimala kwaye ufumane umfanekiso ocacileyo. Uvavanyo alunantlungu, kodwa ngamanye amaxesha abantu bayacelwa ukuba bagcine indawo ethile enokungakhululeki. Ingcali/iingcali ziyakubuza ukuba kukho ukungonwabi kwaye zinike naluphi na uncedo ukwenza amava alula kangangoko kunokwenzeka.
impatho
Ayizizo zonke iimeko ze-stenosis ezibangela iimpawu, kodwa kukho iindlela zonyango ezinokucetyiswa ngumsebenzi wezempilo.
Ukunyamekelwa kolondolozo yingcebiso yokuqala ebandakanya i-chiropractic, i-decompression, i-traction, kunye nonyango lomzimba.
Unyango lwandisa amandla emisipha, luphucula uluhlu lwentshukumo, luphucula ukuma kunye nokulinganisela, lunciphisa iimpawu ezingathandekiyo, kwaye lubandakanya izicwangciso zokuthintela nokulawula iimpawu.
Amayeza amiselweyo anokuba yinxalenye yesicwangciso esikhulu sonyango.
Utyando lunokuba lukhetho kwiimeko ezinzima ngakumbi apho ukhathalelo lolondolozo lungasebenzi.
IStinal Stenosis
VIDEO
Ucaphulo
I-Database ye-Abstracts yoPhononongo lweziphumo (i-DARE): ukuphononongwa komgangatho [kwi-Intanethi]. I-York (e-UK): Iziko lokuPhonononga kunye nokusasazwa (e-UK); 1995-. Ukuxilongwa kwe-lumbar spinal stenosis: ukuhlaziywa okucwangcisiweyo okuhlaziyiweyo kokuchaneka kweemvavanyo zokuxilonga. 2013. Ifumaneka ku: www.ncbi.nlm.nih.gov/books/NBK142906/
Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Ihlaziywe ngo-2022 ngoMeyi 8]. Ku: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Ifumaneka kwi: www.ncbi.nlm.nih.gov/books/NBK551669/
I-Gofur EM, uSingh P. Anatomy, uBuyela, i-Vertebral Canal Blood Supply. [Ihlaziywe 2021 Jul 26]. Ku: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Ifumaneka kwi: www.ncbi.nlm.nih.gov/books/NBK541083/
ULurie, uJon, kunye noChristy Tomkins-Lane. "Ulawulo lwe-lumbar spinal stenosis." BMJ (uphando lwezonyango) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234
Stuber, Kent, et al. "Unyango lweChiropractic ye-lumbar spinal stenosis: ukuphononongwa kweencwadi." Ijenali yamayeza e-chiropractic vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001
by UGqr Alex Jimenez Ukujonga kunye nokuchonga
Iingcali ze-Chiropractors kunye neengcali zomgogodla zisebenzisa i-imaging yomgogodla ngokusebenzisa i-X-rays, i-MRIs, okanye i-CT scans ukufumanisa ukuba yintoni ebangela iingxaki kunye neentlungu zangasemva. Ukufanekisa kuqhelekile. Nokuba i-chiropractic okanye utyando lomqolo, banceda kakhulu ukufumana imiba yangasemva kwaye bavumele umntu ukuba abone okwenzekayo. Iindidi zamatyala zibandakanya iintlungu zomqolo ukuba :
Isuka ngxakini
Uzinzile kangangeeveki ezine ukuya kwezintandathu
Ikhatshwa yimbali ye: Cancer
Fever
Ukukhupha ebusuku
Oogqirha basebenzisa le mifanekiso xa ukufumanisa imeko yomqolo . Nantsi ingqiqo kwimifanekiso yomqolo.
X-ray
I-X-reyi yeentlungu zomqolo inokuba luncedo kakhulu. An I-X-reyi isekelwe kwimitha kwaye isetyenziselwa ukuhlola iimeko zezakhiwo zamathambo. Ii-X-reyi zezona zifanelekileyo kwiithishu zethambo okanye izicubu ezenziwe nge-ossified okanye zibalwe. Basebenza kakhulu ngezicubu ezinzima, ngokukodwa amathambo. Izicubu ezithambileyo njengemisipha, iigaments, okanye iidiski ze-intravertebral azibonakali ngokunjalo.
Abantu abajongwa nge-X-reyi ngasemva baya kujongwa ngomatshini ovelisa umqadi. Umamkeli ukhetha irejista ye-beam emva kokuba idlula emzimbeni kwaye ivelise umfanekiso. Kuthatha malunga nemizuzu emihlanu ukugqiba kodwa kunokuba nde kuxhomekeke kwinani likagqirha lemifanekiso. I-X-rays iluncedo kwiinjongo ze-inshurensi kwaye ilawula iimeko zamathambo ezifana nokuqhekeka kwe-compression fractures kunye / okanye i-bone spurs. Ii-X-reyi zi-odolwa ngezizathu ezithile kwaye zihlala ziyinxalenye yophononongo lokuxilonga umzimba wonke. Oku kubandakanya i-MRI kunye / okanye i-CT scan.
CT Scan
I-CT imele I-tomography ebaliweyo . Lungcelele lweeX-reyi ezifakwa kwidijithali zibe yimifanekiso kusetyenziswa ikhompyutha. I-advanteji ye-CT scan ukuya kwi-X-rays eqhelekileyo kukuba inika iimbono/iingile ezahlukeneyo zomzimba kwaye ingaba kwi-3D. I-CT scans idla ngokusetyenziswa kwiimeko zokwenzakala okanye abantu abaye batyandwa. Bathatha malunga nemizuzu emihlanu. KwiiX-reyi, abantu bayaphakama okanye balale phantsi komatshini weX-reyi njengoko uhlola umzimba. I-CT scan yenza ukuba umntu alale phantsi kwisetyhula kumatshini ojonga idonathi oskena ngelixa ejikeleza ngexesha lomfanekiso. Abantu ngabanye banconywa ukuba banxibe iimpahla eziqhelekileyo ezikhululekile, ezikhululekile. Ngamaxesha athile idayi, okanye ukuchasana kwe-intravenous, isetyenziselwa ukufumana izicubu ze-vascular to stand out , ivelisa imifanekiso ecacileyo.
MRI
I-MRI imfutshane imaging resonance magnetic. IiMRIs zisebenzisa iimagnethi ukwenza imifanekiso. I-MRI imaging isoloko isetyenziswa kubantu abaye benziwa utyando. Bathatha ixesha elide, ngokuqhelekileyo malunga nemizuzu engama-30 ukuya kuma-45. Akukho zinto zetsimbi ezivumelekileyo kwi-MRI. Izigulane zicelwa ukuba zisuse izinto ezifana namabhanti, ubucwebe, njl. Idayi yokuthelekisa inokuba yinxalenye yeMRI. Umatshini ufana netonela. Oku kunokuba lucelomngeni kubantu abane-claustrophobia. Thetha nogqirha kwaye ufumane indlela yokukhululeka ngexesha lenkqubo.
Ezinye iifom ze-Spinal imaging
Ezinye iintlobo zomfanekiso ziquka:
CT navigation
I-CT navigation ibonisa ixesha langempela le-CT scans ngexesha lenkqubo.
Fluoroscopy
I-Fluoroscopy ibandakanya umqadi we-X-ray odlula ngokuthe ngqo emzimbeni obonisa imifanekiso ephilayo, ehambayo.
Zombini ezi ntlobo zemifanekiso yomqolo zisetyenziswa ngexesha lotyando. Kwezinye iimeko, umfanekiso we-intraoperative
omoya
I-Ultrasound ingasetyenziselwa iimeko zomgogodla. Olu luvavanyo lokucinga olusebenzisa amaza omsindo ukwenza imifanekiso. Nangona kunjalo, iimvavanyo zokucinga ezisetyenziswayo kwimifanekiso yomqolo ngokuyintloko ziiX-rays kunye neeMRIs.
Ukumiselwa kweMifanekiso
Thetha nogqirha wakho okanye i-chiropractor ngaphambi kwexesha ukuze uqonde into onokuyilindela ngexesha lenkqubo yokucinga. Baya kukwazisa ukuba ungalungiselela njani kunye nayo nayiphi na imiyalelo ekhethekileyo ngaphambi kokuqeshwa. Kanye kunye nembali yonyango kunye nokuhlolwa komzimba, umfanekiso womgogodla uyingxenye ebalulekileyo yenkqubo yokuxilonga ukufumana oko kubangela intlungu kunye nokuphuhlisa isicwangciso sonyango esilungileyo.
UkuBumbiswa kweBhunga
VIDEO
Iziphumo zexesha elifutshane zekofu kunye noxinzelelo lwegazi
I-caffeine ekwikofu yinto evuselelayo okanye into evuyisa iinkqubo zomzimba. Xa i-caffeine idliwe, abantu bafumana ukwanda kochulumanco, ngokukodwa kwinkqubo ye-cardiovascular system. Olu lonwabo lubangela ukuba ukubetha kwentliziyo kunye noxinzelelo lwegazi lunyuke kwaye emva koko lwehle umva ukuya kumgangatho wesiseko kubantu abasempilweni. Ikofu yonyusa kancinci uxinzelelo lwegazi lwexesha elifutshane. Ukusetyenziswa kwekofu ephakathi kukhuselekile kubantu abangenazo iimeko zentliziyo esele zikhona.
Ucaphulo
IKhomishini yoLawulo lweNyukliya yase-United States. (ngoMeyi 2021) “Iidosi kuBomi bethu bemihla ngemihla” www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html
I-X-Ray ye-Umva Ubuhlungu: Uphononongo lwangoku kwi-Musculoskeletal Medicine. (Aprili 2009) “Iyintoni indima yokuba umfanekiso-ngqondweni kwiintlungu eziqatha zomqolo?” www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/
by UGqr Alex Jimenez Ukujonga kunye nokuchonga
Olu luhlalutyo olufutshane lwezinye izikhalazo ezibalulekileyo zezingane ezisemthethweni.
I-Traumatic Acute iquka intlekele enkulu yentloko
Ingxaki engeyiyo ingozi kubantwana (umntwana ohlaselwe)
Izikhalazo ze-Musculoskeletal (i-Juvenile Idiopathic Arthritis, i-scoliosis,
Iimpawu eziqhelekileyo zabantwana (i-CNS kunye nabanye)
Sulelo
Isifo seMetabolic
Ulungelelaniso lwezonyango lwezilwanyana:
Ukonzakala kwe-FOOSH (umzekelo, ukuwa kwi-monkey-bar)
Supracondylar Fx, elbow . Soloko d / t ukwenzakala ngengozi. <10-yoI-Fx eyongezelelweyo
AmaGartland amacandelo amacandelo amacandelo athatywayo aphucukileyo aphunywe ngokuphathwa okulula kunye ne-posterior elbow dislocation
Umngcipheko onokuthi ungangqinelani nongxaki xa ukukhathazeka kuphuculwa (isivumelwano seVolkmann)
Uvavanyo lweRadiological lubalulekile: uphawu lwaseseyile kunye nophawu lwenqatha lwamanqatha angasemva kunye nomgca wangaphandle wokungaphumeleli wehlulekile ukunqumla phakathi / 2/3 weCapitellum.
I-Fx yabantwana abangapheliyo:
Uninzi kwi <10 yo Greenstick, Torus, Plastic aka Bowing deformity
Ukuphulukisa ngokuqhelekileyo, unyango ngokuzenzekelayo
Ukukhubazeka kweplastiki ukuba> iidigri ezingama-20 zifuna ukuncitshiswa okuvaliweyo
I-Ping pong skull fracture inokukhula emva kokwenzakala, unikezelo lweforceps kunye neengxaki zokwenzakala ekuzalweni. Kusenokufuneka kuvavanywe yi-peediatric neurosurgeo.n
Iindidi zeSalter-Harris zokulimala kwamacwecwe okukhula
Uhlobo lwe-1-slip. umzekelo, iSlipped Capital Femoral Epiphysis. Ngokuqhelekileyo akukho catshulwa kwethambo esaziwayo
Thayipha i-2-M / C ngokuchaneka kakuhle
Uhlobo lwe-3- intra-articular, ngaloo ndlela lubeka umngcipheko wokukhawuleza osteoarthritis kwaye ingadinga ukunakekelwa kokusebenza d / t ukungaqiniseki
Uhlobo lwe-4- Fx kuyo yonke imimandla malunga ne-physis. Ukungavumelekanga ukuhlaziya kunye nokunciphisa kwesitho
Uhlobo lwe-5- kaninzi alukho ubungqina bentshontsho. Ukugqithisa kakubi d / t ukuchoboza umonakalo kunye nomonakalo we-vascular kunye nesincinci sokunciphisa
Ukuphonononga okubalulekileyo kubalulekile
Ukulimala okungenzile ngengozi (NAI) kubantwana
Kukho iindlela ezahlukeneyo zokuxhaphazwa kwabantwana. Ukuxhatshazwa ngokwemvelo kungabangela ukulimala kwesikhumba kwiindlela ezahlukeneyo ze-MSK / i-systemic ezithinta amathambo kunye nama-tissue alula. Ukucinga kubalulekile kwaye kunokuchonga izibonakaliso ezicacileyo ezichazela ababoneleli ngezokwelapha kunye nokwazisa iinkonzo zokukhusela abantwana kunye nee-arhente zokunyanzelisa umthetho ngokusetyenziswa kakubi ngokomzimba.
Kusana: �Isifo somntwana esishukumayo� sinokuvela kunye neempawu ze-CNS d/t ukukrazuka kwemithambo engekavuthwa yokuvala ibridging vein kunye ne-subdural hematoma enokubulala. Ukopha kwiretina kudla ngokuba ngumqondiso. Intloko yeCT ibalulekile.I-MSK Radiological Red Flags: I-1) ithambo elikhulu Fx kwi-child-ambulatory emncinci kakhulu (0-12 mo)
I-2) Iimbambo zangasemva Fx: ngokwemvelo ayisoze yavela ngengozi yed / t. Uninzi lwezixhobo: ukumbamba kunye nokucima umntwana okanye utshintshi ngqo.
I-3) Izihlunu ezininzi ezinamaxesha ahlukeneyo wokuphulukiswa kwamaqondo, oko kukuthi, amathambo e-bonewa abonisa ukukhathazeka ngokuphindaphindiweyo ngokomzimba
I-4) Ikhonkco le-Metaphyseal Fx aka Ibhakethi yokuphatha i-Fx, ihlala i-pathognomonic kwi-NAI kubantwana. Ivela xa iphetho elichaphazelekayo liqhutywe kwaye lisontekile.
I-5) Ukuphuka komzimba wamathambo amathambo kumntwana omncinane ngumnye umzekelo we-NAI.
Ezinye izinto ezibalulekileyo ze-NAI. Iimbali ezingahambelaniyo zinikezelwa ngabalondolozi / abanonophelo. Akukho bungqina bentsholongwane yokuzalwa / ye-metabolic engaqhelekanga njenge-Osteogenesis Imperfecta okanye iRickets / osteomalacia njl.
Qaphela: Xa abagcini babantwana bechaza imbali yokuba iingxelo zokuwa kunye neengozi endlwini, kubalulekile ukwazi ukuba ngokucacileyo iingozi ezininzi / ukuwa endlwini kunqabile kakhulu okanye akunakwenzeka ukuba kubangele ukuphuka okukhulu kwamathambo.
Ukuxhatshazwa kwabantwana base-Illinois: www2.illinois.gov/dcfs/safekids/reporting/pages/index.aspx
Indlela yokuTyekisa i-MSK kwi-Pediatrics
I-Juvenile Idiopathic Arthritis (JIA) -Ukuqwalaselwa kwesifo esinganyangekiyo se-M / C sobuntwana. I-Clinical Dx: iintlungu ezidibeneyo / ukudumba iiveki ezi-6 okanye ngaphezulu emntwaneni <16-yo Iifom ezahlukeneyo zikhona: I-Dx yokuqala ibalulekile ekuthinteleni iingxaki ezibambezelekileyoIindlela ezininzi eziqhelekileyo zeJIA:
I-1) Isifo se-Pauciarticular (40%)- m / c ifom ye-JIA. Amantombazana asengozini enkulu. Ibonisa njenge-arthritis kwi-<4 joints: amadolo, amaqatha, i-wrist. Elbow . Olu hlobo lubonisa ukudibanisa okuphezulu kunye nokubandakanyeka kwe-ocular njenge-iridocyclitis (i-25%) enokuthi ibangele ukungaboni. Labs: RF-ve, ANA positive.
I-2) Izifo ze-polyarticular (25%): RF-ve. Amantombazana asemngciphekweni omkhulu. Ukuchaphazela amancinci amancinci kunye amaninzi atyhaphazela umgudu wesibeleko
I-3) Ifom ye-JIA (i-20%): ihlala iveza ngokubonakalisa i-systemic ebonakalayo njengemfiva ye-spiking, i-arthralgias, i-myalgias, i-lymphadeno [i-pathy, i-hepatosplenomegaly, i-polyserositis (i-pericardial / pleural effusion). Iimpawu ezibalulekileyo zeDx iimpawu ezibonakalayo ze-salmon i-salmon i-pink rush in the end and trunk. Ifom ye-Systemic ine- Amalungu amaninzi afake isicathulo, akukho ntshukumo efaniswa nezinye iintlobo. Ngaloo ndlela intshabalalo ehlangeneyo ayibonakaliyo
Ukucinga kwiJIA
I-bone mix effusion ethwele i-squaring ye-patella cartilage / ukukhukhula kwamathambo e-DJD
Iminwe kunye namathambo amathambo omdala ukuvalwa kwe-physeal / incinci yokunciphisa
I-Rad DDx idolo / i-ankle: I-Hemophilic arthropathy Rx: DMARD.
Iingxaki ezinokuthi zenzeke intshabalalo edibeneyo, ukulinda ukukhula / ukunciphisa umlenze, ukungaboni, ubunzima beenkqubo, ukukhubazeka.
Uninzi oluqhelekileyo lwezilwanyana zezilwanyana ezingcolileyo ze-Bone Neoplasms
I-Osteosarcoma (OSA) kunye ne-Ewing's sarcoma (ES ) i-1 st kunye ne-2nd M / C yamathambo ayisifo esisiswini samathambo ebuntwaneni (ukuphakama kwe-10-20 yo) Kwizonyango: iintlungu zethambo, utshintsho kwintsebenzo, imitha yamastastistim yokuqala, imitha yamapulmoni ingenzeka. Ukugqithisa kakubiIi-Ewings zinokubakho ngeentlungu zamathambo, umkhuhlane kunye ne-ESR/CRP ephakamileyo elinganisa usulelo. I-Dx yangaphambili enemifanekiso kunye nesiteji ibalulekile.
Ukulinganisa kwe-OSA kunye ne-ES: X-ray, elandelwa yi-MRI, isifuba i-CT, i-PET / i-CT. Kwi-x-reyi: I-OSA inokuchaphazela naliphi na ithambo kodwa uninzi lwayo lubonakala njengamathambo anobundlobongela enza i-neoplasms malunga nedolo (iimeko ezingama-50%) ngakumbi njenge-osteoid eyenza isilonda esinoburhalarhume kwi-metaphysis ene-sunburst periostitis kunye ne-Codman triangle. Ukuhlaselwa kweethishu ezithambileyo.I-ES ingabonisa kwi-shaft kwaye ibonise ukusasazeka kwethambo ezincinci. I-MRI ibalulekile ekuboniseni ubungakanani bethambo kunye nokuhlasela kwe-ST, i-MRI efunekayo ekucwangciseni ukucwangcisa
I-OSA kunye ne-ES Rx: Umdibaniso wotyando, imitha, i-chemo. Iindlela zokulungisa amalungu zenziwa ngamanye amaxesha. Ukuxela kakubi xa kufunyenwe kade.
Umfanekiso we-Ewing's sarcoma
Ukuphelisa ukuphazamiseka kwethambo
Ukuhlasela kwangaphambili kunye neentlobo ezincinci
Impendulo enokugxothayo ngexesha elimnandi kunye ne-laminated (i-onion skin) impendulo
I-Saucerisation yetshe ye-cortical (itywala ye-orange)
Isilonda siqhelekile yi-diaphyseal kunye nokwandiswa kwe-metaphyseal
Eyaziwa ngokuba yiRound cell tumor kunye neMultiple Myeloma kunye neLymphoma
Izibhambathiso eziqhelekileyo zabantwana
Neuroblastoma (NBL ) Ukuxhatshazwa kwe-M / C ebuntwaneni. Iphuma kwiiseli ze-neural crest aka PNET tumors (umzekelo, i-ganglia enovelwano). Uninzi lwenzeka kubantwana <24-iinyanga. Abanye babonisa i-prognosis elungileyo kodwa> i-50% yeemeko ezikhoyo zinesifo esiphezulu. I-70-80% kwiminyaka eyi-18-inyanga okanye ngaphezulu ikhona kunye ne-metastasis ephezulu. I-NBL inokukhula kwi-adrenal medulla, i-ganglia enovelwano kunye nenye indawo. Ibonisa ubunzima besisu, ukugabha. > i-50% ibonisa iintlungu zethambo d/t metastasis. Ngokonyango: ukuhlolwa komzimba, iilebhu, ukucinga: isifuba kunye ne-abd x-rays, isisu se-CT kunye nesifuba kubalulekile kwi-Dx. I-MRI inokunceda. I-NBL inokumetastaze kukhakhayi kwaye ingene kwimibhobho ebonisa uphawu njenge-pathological sutural diastasis.I-Lymphoblastic Leukemia yinto yokutshatyalaliswa komntwana. I-pathology: ukungena kwintsholongwane yamathambo okubangela intlungu yesifo kunye nokutshintshwa kwamanye amangqamuzana e-marrow aemia, i-thrombocytopenia, i-neutropenia kunye neengxaki ezinxulumene nazo. Amaseli enomkhuhlane angangenelela kwezinye iindawo ezibandakanya i-CNS, istile, ithambo kunye neminye imimandla. I-Dx: I-CBC, amazinga e-serum lactate dehydrogenase, i-Bone marrow aspiration biopsy yintloko. Ukucinga kunokunceda kodwa kungabalulekanga ukuxilongwa. Kwi-radiografi, ukungena kwesifo kwethambo kungabonakala njengamaqhekeza adibeneyo kwiplani yokukhula. I-Rx: i-chemotherapy kunye nokunyangwa kweengxaki
Medulloblastoma : I-CN / ne-CNS engeyiyo i-neoplasm ebantwaneniUninzi lukhula phambi kwe-10-yo
Indawo ye-M / C: i-cerebellum kunye ne-posterior fossa
Ubomi bakhe bumele uhlobo lwe-PNET uhlobo lwe-glioma njengoko kwakucingelwa okokuqala
MBL, kunye ne-Ependymoma kunye ne-CNS i-lymphoma, kunokukhokelela ekuhlahleni i-metastasis nge-CSF kwaye ngokuthe kongeza imele iyingqamaniso engafani nezinye izicathulo ze-CNS zibonisa ukusabalala kwe-metastatic ngaphandle kwe-CNS, m / c kwithambo
I-50% ye-MBL inokwenziwa ngokutsha
Ukuba i-Dx kunye nonyango kuqala phambi kwe-metastasis, ukusinda kwe-5-year yi-80%
Ukucingwa kubalulekile: Ukusetyenziswa kwe-CT kungasetyenziselwa kodwa indlela yokucinga yokuzikhethela yi-MRI eya kuthi yongezelela ukunika uvavanyo oluphezulu kakhulu lwe-neuraxis yonke ye-metastasis.
I-MBL ibonakala ngathi i-hypo, i-iso kunye ne-hyperintense lesion kwi-T1, T2 kunye ne-FLAIR (umfanekiso ophezulu) xa uthelekisa kumathambo engqondo. Ngokuqhelekileyo icindezela i-4th ventricle ene-hydrocephalus ephazamisayo. I-tumor ngokuqhelekileyo ibonisa ukuphuculwa kokungafani kwi-T1 + C gad (umfanekiso osezantsi osekhohlo). Yehlisa i-metastasis ukusuka kwi-MBL ene-T1 + C yokunyusa isilonda kwintambo
Izifo ezithintekayo zezilwanyana
Kwi-neonate / kwiintsana <1month: fever> 100.4 (38C) inokubonisa ibhaktiriya kunye nosulelo lwentsholongwane. I-Strep B, i-Listeria, i-E.Coli inokukhokelela kwi-sepsis, meningitis. Inkqubo: I-x-ray yesifuba, ukugqobhoza i-lumbar kunye nenkcubeko, inkcubeko yegazi, i-CBC, uvavanyo lwe-urinalysis
Kubantwana abancinci, iHemophilus influenza hlobo B (HIB) inakhokelela ku-Epiglottitis ingxaki engabonakaliyo kodwa engathandekiyo. I-vaccine yangoku iyanceda ukunciphisa inani lamatyala e-Epiglottitis kunye nezinye izifo ezihlobene ne-HIB.
IParainfluenza okanye i-RSV intsholongwane ingakhokelela kwiCroup okanye iLaryngotracheobronchitis.I-Epiglottitis neCroup ziyi-Dx ekliniki kodwa i-AP kunye ne-lateral soft tissue neck x-ray zinceda gqitha
I-Epiglottitis ibonisa uphawu �ubhontsi olufana nokujiya kwe-epiglottis d/t epiglottic edema. Oku kunokuba yimeko kaxakeka ebeka esichengeni iindlela zomoya (phezulu ekhohlo)
Croup inokubonisa �uphawu lwebhotile yewayini� enophawu lwebhotile yewayini� enehypopharynx ethe qelele njengokucutheka okubukhali kwendlela yomoya engaphantsi kwi-AP kunye nentamo esecaleni ethambileyo yex-reyi (phezulu ekunene)I-Syncytia Virus yokuphefumula (RSV) kunye nomkhuhlane ungakhokelela kwipilumoniya yentsholongwane enokubakho ubunzima obusongela ubomi kwi-immunocompromised, incinci kunye nabantwana abanama-comorbidity. I-CXR ibalulekile (ephakathi kwesasekhohlo)Streptococcal pharyngitis Usulelo lwe-GABHS lunokukhokelela kwiingxaki eziqatha okanye zilibazisekile (umzekelo, iRheumatic fever)I-Peritonsillar abscess (ngasentla ephakathi kwesokudla) inokuphuhliswa kwezinye iimeko kwaye iyanzima ngokusasaza ngeenqwelo ezincinci ezintanyeni entanyeni enokubangela ukusabalalisa kwizikhalazo ezingaphantsi / eziphantsi kwe-submandibular (uLudwig Angina) xa iifudu zomoya zifuna ukulawulwa kwisebe ye-d / t yolwimi i-edemaUkuphuhliswa kwekhefu le-retropharyngeal lingakhokelela ekusasazeni intsholongwane ngokuthetha ngokukhululeka kwentamo ye-fascia okubangelwa kukunyanga kwe-mediastinitis, i-Lemmier syndrome kunye nokuhlaselwa kwezikhala ze-carotid (zonke zizinto ezinokubangela ingozi yokuphila)
I-Griesel syndrome- (ngasentla ngasekhohlo) ukuxhamla okungaqhelekanga kwimiba yesifo somzimba / isifo somzimba esasasazeka kwi-prevertebral space ekhokelela kwi-C1-2 ligaments laxity and instabilityEzinye izifo ezibalulekileyo kubantwana zifana ne-bacterial (Pneumococcal) pneumonia, ukusuleleka kwe-Urinary tract and Acute Pyelonephritis (ngakumbi kwimantombazana) kunye ne-Meningococcal Meningitis
Izifo zeMetabolic Disease Rickets: kuqwalaselwa i-osteomalacia kwi-skeletally immature. Ummandla wokubalwa kwesikhashana kwiplani yokukhula ye-epiphyseal ichaphazeleka ngokukodwaIiklinikhi iveza ngokulinda ukukhula, ukuqubuda komda, i-rachitic rosary, isifuba se-pigeon, izibilini ezixinezelekileyo, izibilini ezinwebezelekileyo nezikhukhulayo, kunye neenqaqa, i-skull deformity
I-Pathology: I-vit D kunye ne-calcium engafaniyo yiyo m / c. Ukungabi nelanga lokukhanya kwelanga esp. Umntu omnyama onobuhlungu, iimpahla ezithintekayo ekukhanyiseni ukukhanya, ukuxilisa okwexesha elide, i-veganism, i-malabsorption syndromes ye-gut, umonakalo wenzalo kunye nabanye
Ukucingela: i-metaphysis yecrafhysis yenziwe ngophawu lokutshiza, i-flaring, ukuphakama kwiplani yokukhula, ikhonkco ye-costochondral njenge-rachitic rosary, igqibe
I-Rx: ukuphatha izizathu ezingundoqo, ukuchithwa kwesondlo esifanelekileyo, njl
Ucaphulo
by UGqr Alex Jimenez Ukujonga kunye nokuchonga
Ukuxilongwa kwezifo zesisu kungafakwa phakathi:
Ukungavumelekanga kwe esisisu Iphecana (isisu, isisu, amathumbu amancinci & amakhulu, kunye nesihlomelo)
Ukungaqhelekanga kwamalungu okwenziwa kokugaya ukutya (i-Hepatobiliary kunye ne-pancreatic disorders)
Ukungaqheleki kwilungu lokuzala kunye namalungu okuzala
Ukungaqhelekanga kwodonga lwesisu kunye neempahla ezinkulu
Le nkcazo-ntetho ijolise ekunikeni olona lwazi lusisiseko jikelele ukucinga ngomfanekiso indlela kunye nolawulo olufanelekileyo lwekliniki yezigulane ezinezifo eziqhelekileyo zesisu
Iindlela zokucinga ezisetyenziswe ngexesha lophando lwezikhalazo zesisu:
AP isisu (KUB) kunye neCXR eqondileyo
Ukuskena kwe-CT emathunjini (kunye nokwahlukana komlomo kunye ne-IV kunye nenye)
Ucwaningo oluphezulu kunye nolwasezantsi lwe-Barium
Ultrasonography
I-MRI (esetyenziswa kakhulu njenge-Liver MRI)
Ubuchwephesha beMRI kunye ne-enteroclysis
MRI rectum
I-Endoscopic Retrograde i-Cholangiopancreatographyography (ERCP) - kakhulu i-hepatobiliary ne-pancreatic pathology
Imifanekiso yeNyukliya
Kutheni uLawula i-X-ray yesisu?
Bandakanya uvandlakanyo lokuqala lwerhasi yamathumbu kwimeko engxamisekileyo. Ngokomzekelo, uphando olubi kwisigulane esincinci sinokuthi sithintele isidingo se-CT okanye ezinye iinkqubo eziphazamisayo.
Uvavanyo lweetyhubhu zeradiopaque, imigca, kunye nemizimba yangaphandle yeradiopaque
Ukuvavanywa kwenkqubo emva kwe-procedraperitoneal / retroperitoneal gas ezamahala
Ukubeka esweni isantya segesi kunye nesisombululo se-elius postoperative (i-adynamic)
Ukubekwa esweni kwendima yokuhlukelelana phakathi kweembilini
Izifundo zokuhamba ngeColonic
Ukubeka esweni i-calalli ye-renal
Yintoni ekufuneka uyiqaphele kwi-AP Iisisu: Phakamisa ngokuphambene noVukani kunye neCububitus
Umoya wamahhala (i-pneumoperitoneum)
Isithintelo samathumbu: I-loops edibeneyo: i-SBO vs LBO (umgaqo we-3-6-9) i-SB-upper umda-3-cm, i-LB-upper limit-6-cm, i-Caecum-upper limit-9-cm. Qaphela ilahleko ye-haustra, ukunyuswa kwenqaku (ubukho) be-valvule conivente (plica semilunaris) kwi-SBO
I-SBO: Qaphela ubude obahlukeneyo amanqanaba olwelo lomoya kwileli yefilim ethe tye � imbonakalo, eqhelekileyo ye-SBO
Phawula ukuphulukana kwegesi yamacoloni (i-evacuated) kwi-SBO
Iskena se-CT esiswini -ukuziphatha okwenziwe ngexesha lokuphanda izikhalazo ezisisigxina ezingapheliyo kubantu abadala. Ngokomzekelo, ukubola kwesisu kungaxilongwa ngempumelelo kwaye kwenziwe ukunikezela ngolwazi lweklinikhi yokucwangcisa ukunakekelwa Isisu, i-renal ne-pelvic ultrasound inokwenziwa ukunceda ukufumanisa isifo se-appendicitis (esp. ebantwaneni), isifo esiqatha nesinganyangekiyo semithambo, ukungahambi kakuhle kwe-hepatobiliary, isifo sokubelekisa kunye nesifo somhlazaUkusetyenziswa kwemitha ye-ionizing (i-x-reyi kunye ne-CT) kufuneka kuncitshiswe ebantwaneni nakwamanye amaqela abuthathaka.
Ukuqhelanisa ukuGqala kwezifo eziMkhulu zeSistim seNtlungu
I-1) Izifo ezixhasayo
2) I-gastric carcinoma
3) I-Gluten Inensitive Feelings
4) Izifo ezithintekayo zezifo
5) I-adenocarcinoma ye-Pancreatic adenocarcinoma
6) I-carolooma ehambayo
7) I-Acute Appendicitis
I-8) Isithintelo samancinci
9) Volvulus
Iingxaki ze-Esophageal
I-Achalasia (i-achalasia yokuqala): Ukungaphumeleli kwe-esophageal peristalsis d/t ukuphumla okungahambi kakuhle kwe-esophageal sphincter (LOS) kunye nokwandiswa okuphawulweyo kommizo kunye nokutya. Ukuvaleka kommizo we-distal (kaninzi ngenxa yethumba) kuye kwabizwa ngokuba “yi-achalasia yesibini” okanye “pseudoachalasia. . I-vagus neurons nayo inokuchaphazelekaIiprayimari: 30 -70, M: F elinganayo
Isifo sikaChagas (iTrypanosoma Cruzi usulelo) ngokutshatyalaliswa kwe-Myenteric plexus neurons yenkqubo ye-GI (megacolon & esophagus)
Nangona kunjalo, intliziyo yinxalenye echaphazelekayo ye-M / C
Klinikhi: I-Dysphagia zombini isisulu kunye notywala, xa kuthelekiswa ne-dysphagia yeziqulatho kuphela kwiimeko ze-esophageal carcinoma. Intlungu yesifuba nokuhlaziywa. I-M / C ephakathi kwe-squamous cell carcinoma malunga ne-5% ngenxa yokugwenxa okungapheliyo kwe-mucosa nge-stasis yokutya kunye nemfihlo. Ukuphefumlelwa kwepneumonia kunokukhula. Candida esophagitisUkwenza umfanekiso: �Umlomo wentaka� kumphezulu we-GI barium ukugwinya, ummizo owolukileyo, ukulahlekelwa yiperistalsis. Uvavanyo lwe-endoscopic lubalulekile.
Rx: kunzima. I-calcium blockers blockers (ixesha elifutshane) .I-Pneumatic dilatation, esebenzayo kwi-85% yezigulane ezine-3 -5% ingozi yokuphuma kwegazi / ukuchithwa. Inaliti yetyhefu ye-botulinum ihlala malunga kuphela. Iinyanga ezili-12 ngonyango ngalunye. Ingakrazula i-submucosa ekhokelela kumngcipheko owonyukileyo wokugqobhoza ngexesha le-myotomy elandelayo. I-myotomy yotyando (Heller myotomy)
I-10 -30% yezigulane zihlaziya i-reflux ye-gastroesophageal (GERD)
Presbyesophagus: esetyenziselwa ukuchaza ukubonakaliswa kwemisebenzi yemoto ephazamisayo kwi-esophagus yokuguga> 80-yo Ngenxa yokuphazamiseka kwe-arc ye-reflex kunye nokunciphisa ukuvakalelwa kwi-distension kunye nokuguqulwa kwe-peristalsis.Izigulane zinokukhalaza nge-dysphagia okanye intlungu yesifuba, kodwa uninzi alubonakali
Ukusabalalisa / ukusabalalisa i-spasm esophageal (DES) yintlungu ye-motility ye-oopopus engabonakala ngathi i-coorkscrew okanye i-rosary bead esophagus kwi-barium ingumgwinya.I-2% yeentlungu ezingezizo zomzimba zesifuba
I-Manometry yimivavanyo yokuhlola i-standard-gold.
Zenker diverticulum (ZD) isikhwama se-aka pharyngealUkugqithiswa kwinqanaba le-hypopharynx, nje lixhomekeke kwi-sphincter ephezulu ye-esophageal, eyaziwa njenge-Killian dehiscence okanye iKillian triangle
Izigulane ziyi-60-80 yo kwaye ziza kunye ne-dysphagia, i-regurgation, i-halitosis, i-globus sensation
Unokubangela inkxalabo ngeempembelelo kunye nokungaqhelekanga kwempompo
Izigulane zinokuqokelela amayeza
I-ZD- i-pseudodiverticulum okanye i-diverticulum yokukhupha ngenxa yokuhlanjululwa kwe-submucosa ngokusebenzisa i-Killian dehiscence, eyenza isikhwama apho ukutya kunye nezinye izinto ezingenakunokuziqokelela.
Isifo seMallory-Weiss ibhekisa kwiinyembezi ze-mucosal kunye ne-submucosal ye-plexus ye-esophageal ye-venous ehambelana nobudlova / ukuhlanza kunye nokuqikelelwa kwesiqulatho sesisu ngokuchasene nomzantsi wommizo. Abanxila basengozini enkulu. Iimeko ezikhoyo kunye ne-hematemesis engenabuhlungu. Unyango ludla ngokuxhasa.I-Dx: umfanekiso udlala indima encinci, kodwa ukuchasana kwe-esophagram kunokubonisa iinyembezi ze-mucosal ezizaliswe ngumahluko (umfanekiso osezantsi osekunene). I-CT scanning inokunceda ukungabandakanyi ezinye izizathu zokopha kwe-GI ephezulu
I-Boerhaave syndrome: ukuphulukana nokuqhaqhazela kwesibini ukuhlanza ngamandlaUkunikezelwa: M> F, ukuhlanza, intlungu yesifuba, i-mediastinitis, i-septic mediastinum, i-pneumomediastinum, i-pneumothorax i-pleural effusion
Kwixesha elidlulileyo, kwakunokubulawa
Iinkqubo zibandakanya ukugxothwa ngenkani kwesiqulatho sesisu ngakumbi ngokutya okukhulu okungagatywanga xa ummizo ukhontraktha ngamandla ngokuchasene neglottis evaliweyo nge-90% eyenzeka ngakudonga lwasekhohlo lwasemva.
IHiatus hernias (HH): Ukuxutywa kwezinto eziswini lomzimba ngokusebenzisa i-hiatus ye-esophageal ye-diaphragm kwisigxina se-thoracic.Izigulana ezininzi ezine-HH azibonakalisi zimpawu, kwaye kukufunyaniswa kwengozi. Nangona kunjalo, iimpawu zinokubandakanya intlungu ye-epigastric / esifubeni, ukugcwala emva kokutya, isicaphucaphu kunye nokuhlanza.
Ngamanye amaxesha i-HH ithathwa njengefana nesifo se-gastro-oesophageal reflux (GORD), kodwa kukho unxulumano olubi phakathi kwezi meko zimbini!
2-iintlobo: sliding hiatus hernia 90% & rolling (paraoesophageal) hernia 10%. Le yokugqibela inokukrwitsha okukhokelela kwi-ischemia kunye neengxaki.
Leoomyomyoma yaseEsophageal yiM/C enobungozi bommizo we-neoplasm. Idla ngokuba nkulu kodwa ayiphazamisi. Iithumba zeGastrointestinal stromal (GIST) zezona ziqhelekileyo kummizo. Kufuneka yahlulwe kwi-Esophageal carcinomas.Ukucinga: u-esophagram ohlukileyo, ingxube ye-GI ye-Barium, i-CT. I-Gastroesophagoscopy yindlela ekhethekileyo yeDx.
I-Esophageal carcinoma: zinikezwa ngokunyuka kwama-dysphagia, okokuqala ukuya ezinqabileyo kunye nokuqhubela phambili kutywala kunye nokuphazamiseka kwiimeko eziphambili<1% yazo zonke i-cancer kunye ne-4-10% yazo zonke izifo ezinobungozi ze-GI. Kukho ukwaziwa kwangaphambili kwamadoda kunye neesquousous cell subtype ngenxa yokutshaya notywala. I-Barrett esophagus kunye ne-adenocarcinoma
M: F 4: 1. Abantu abamnyama banomdla ngaphezu koBantu abamhlophe 2: 1. Ukugqithisa kakubi!
Ingxube ye-barium ingaba neengxaki ekuboniseni ubunzima be-esophageal. I-Gastroesophagoscopy (endoscopy) iqinisekisa ukuxilongwa nge-biopsy yeesishu
Ngokugqithiseleyo ukugula okuqhelekileyo yi-2ndary fundal carcinoma ehlasela i-distal esophagus
Iseli le-squamous ifunyanwe kwi-middleopopus, i-Adenocarcinoma kwingingqi ye-distal
Gastric carcinoma: isifo esisisiseko se-epithelium esiswini. Kudala ngaphambi kwexesha le40. Iminyaka yobudala ekuxilongweni e-United States yiminyaka eyi-70 yabesilisa kunye ne-74 iminyaka kubafazi. IJapan, iSouth Korea, iChile, kunye namazwe aseMpuma yeYurophu anesinye sezinga eliphezulu kakhulu lomdlavuza wesisu emhlabeni. Iqondo lomdlavuza wesisu linciphela kwihlabathi jikelele. Umhlaza wesisu ngumdla we-5th wokufa komhlaza. Umbutho kunye no-Helicobacter pylori usulelo lwe-60- 80%, kodwa i-2% yabemi kunye no-H. Pyloris bahlakulela umhlaza wesisu. I-8-10% inelifa lentsapho elizuze ilifa.I-Gastric Lymphoma idibaniswa noHerrys. Isisu seStromal Cell Tumor okanye i-GIST yinye isisu esichaphazela isisu
Klinikhi: Akukho zibonakaliso xa zingekho kwaye ziyakwazi ukuphilisa. Ukufikelela kwi-50% yezigulane zinokuba nezikhalazo ze-GI ezingezizo. Izigulana zingabonisa nge-anorexia kunye nokulahleka kwesisindo (95%) kunye neentlungu ezingavaliyo esiswini. Ukuxubusha, ukuhlanza, kunye nokukhuselwa kwantoni-ntshukumo yokuqala kungenzeka ngezilwanyana ezinobunzima okanye izilonda ezingenangqondo ezingaphazamisekanga isisu.Ukuxela: Uninzi lweengcambu zesifo segciwane ezixilongwe emva kwexesha kwaye zingabonakalisa ukuhlasela kwendawo kunye ne-adenopathy yesithili, isibindi, kunye nokusabalaliswa kwe-mesenteric. Inani le-5 lokusinda kwe-20% okanye ngaphantsi. EJapan naseSouth Korea, iinkqubo zokuhlola ukuqala kwandisa ukwanda kwe-60%iMifanekiso: Isifundo se-Barium esiphezulu se-GI, ukuskena kwe-CT. Uvavanyo lwe-Endoscopic yindlela yokukhetha ukuxilongwa. Ekucingeni, umhlaza wesisu unokuvela njenge-exophytic (polypoid) ubunzima okanye uhlobo lweFungative, Ulcerative okanye Infiltrative / diffuse type (Linitis Plastica). Ukuskena kwe-CT kubalulekile ukuvavanya uhlaselo lwasekhaya (iindawo, i-mesentery, isibindi, njl.)
Izifo ze-Celiac zika-non-tropical sprue aka I-Gluten-sensitive sensopathy: I-T-cell mediated autoimmune ye-autoimmune ye-gluten-induced mucosal umonakalo okhokelela ekulahlekeni kwe-villi kwi-proximal bowel encinci kunye ne-gastrointestinal malabsorption (okt, i-sprue). Kucingelwa kwezinye iimeko zokunqongophala kwe-iron anemia yesizathu esingaqinisekanga. Ixhaphakile eCaucasus (1 kwi-200) kodwa inqabile kubantu baseAsia nabamnyama. Iincopho ezimbini: iqela elincinane ebuntwaneni bokuqala. Ngokuqhelekileyo kwi-3rd kunye ne-4th yamashumi eminyaka yobomi.Klinikhi: Intlungu yesisu ngumonakalo we-m / c, i-malabsorption yezondlo / iivithamini: i-IDA kunye nezigulane ezigugu, isifo sohudo, ukugcoba, i-steatorrhea, ukulahleka kwesisindo, i-osteoporosis / osteomalacia, i-dermatitis herpetiformis. Ukwandisa ubudlelwane kunye ne-T-cell lymphoma, Ukunyuka kunye ne-esophageal squamous cell carcinoma, i-SBOI-Dx: I-endoscopy ephezulu ye-GI eneendidi ze-biopsies ezininzi zicingelwa umgangatho wokuhlola isifo esiqwengileyo. I-Histology ibonisa ukungena kwe-T-cell kunye ne-lymphoplasmacytosis, i-Villi atrophy, i-Crypts hyperplasia, i-Submucosa ne-Serosa. Rx: ukupheliswa kweemveliso ezine-gluten
Ukucinga: Akukho mfuneko kwi-Dx kodwa kwi-Barium igin fluoroscopy: i-mucosal atrophy kunye nokutshabalalisa i-mucosal folds (iimeko eziphambili kuphela). Ukuhluthwa kwe-SB kukufumana ngokuqhelekileyo. I-nonodityity ye-duodenum (bubbly duodenum). Ukuguqulwa kwamagqabi ejejethi kunye nealeal mucosal:
�Ijejunam ijongeka njengeleum, ileum ifana nejejunum, ize iduodenum ifane nesihogo.
Isifo samathumbu esivuthayo: Isifo seCrohn (CD) kunye neUlcerative Colitis (UC)
CD: ukuguquka okungaqhelekiyo okubuyisela ngokutsha okuchaphazela nayiphi na inxalenye yephepha le-GI ukusuka emlonyeni ukuya kwi-anus kodwa ekugqibeleni ngokuqhelekileyo kubandakanya i-leum yokuphela. Inkcazo ye-M / C: iintlungu zesisu / ukuxubha kunye ne-diarrhea. Indlela: Ukwakhiwa kwe-granulomata engafaniyo ne-UC yintshukumo, eyinokuthi ikhokelela kwimigangatho. Iindawo ezichaphazelekayo ukuvuvukala ngokuqhelekileyo zichanekileIingxaki zininzi: i-malabsorption yezondlo / iivithamini (i-anemia, i-osteoporosis, ukulibaziseka kokuphuhliswa kwabantwana, ukuthinteka kwi-GI, ukukhutshwa komzimba, ukuveliswa kwe-fistula, ukubonakaliswa kwesisu esiswini: i-uveitis, i-arthritis, i-AS, i-erythema nodosum kunye nabanye.10- 20% unokufuna ukuhlinzwa kwesisu emva kwe-10-iminyaka eyiCD ngokuqhelekileyo ukwenzela ukugqithisa, i-fistiluzation, i-BO.
I-Dx: iiklinikhi, i-CBC, i-CMP, i-CRP, i-ESR, iimvavanyo zeserological: i-DDx ye-IBD: i-anti-saccharomyces cerevisiae antibodies (ASCA), i-anti-nuclear antibody (p-ANCA) okanye i-serum. Uvavanyo lwe-Fecal Calprotectin lunceda iDDx IBS kwaye livavanye impendulo kwonyango, umsebenzi wesifo / ukubuyela kwakhona.
Dx yokukhetha: i-endoscopy, i-ileoscopy, kunye ne-biopsies ezininzi zingabonisa ukutshintsha kwe-endoscopic kunye neenguqu zakhe. I-capsule endoscopy yeVideo (VCE), ukucingwa kunokunceda ngeDx yeengxaki. I-Rx: iziyobisi ezingenayo i-immunomodulatory, unyango olongezelelweyo, ukutya, i-probiotics, ukusebenza. Akukho unyango kodwa injongo kukukhuthaza ukuxolelwa, ukulawula iimpawu nokukhusela / ukunyanga iingxakiUkufanekisa i-Dx: KUB kuya kwi-SBO ye-DDx, i-enum ye-Barium (ngokungafani kunye nokuphindwe kabini), isilwanyana esilandelayo silandela. Iziphumo: ukuqhekeka izilonda, i-aphthous / isilonda esisisigxina, iifistula / amaphetshana wesinasi, uphawu lwesigxina, inqanaba ehambayo iphosa i-LB, ukubonakalisa i-cobblestone d / t izifungo / izilonda zinyusa i-mucosa, i-CT yokutshekisha nge-oral and IV.
Ukucingwa kwisigulane sikaCrohn esinesigqithiso esincinci sokukhupha. (A) I-CT scan ibonisa ukudumba okungaqhelekanga kanti (B) I-MRE yendawo enye ibonisa ukuqina kwe-fibrostenotic
UC: Ngokwesiqhelo ibandakanya ikholoni kuphela kodwa i-backwash ileitis inokuphuhla. Ukuqala ngokuqhelekileyo kwi-15-40s kwaye kuxhaphake kakhulu kumadoda, kodwa ukuqala emva kweminyaka engama-50 kuqhelekileyo. Okuqhelekileyo kuMntla Melika naseYurophu (hygiene hypothesis). I-Etiology: Indibaniselwano yokusingqongileyo, imfuzo kunye notshintsho lwe-microbiome yamathumbu luyabandakanyeka. Ukutshaya kunye ne-appendectomy yokuqala idla ngokubonisa unxulumano olubi kunye ne-UC, ngokungafaniyo ne-CD iqwalasele ezinye zezinto ezinobungozi.Impawu zonyango: Ukopha kwi-rectal (okuqhelekileyo), urhudo, ukukhutshwa kwe-rectal mucous discharge, i-tenesmus (ngamathuba athile), iintlungu ezisezantsi zesisu kunye nokuphelelwa ngamandla kwamanzi okuphuma kwi-purulent rectal discharge (kwiimeko ezinzima, ngakumbi kubantu abadala), i-fulminant colitis kunye ne-megacolon enetyhefu inokuba yi-fetus kodwa ziingxaki ezinqabileyo. . I-Pathology: Akukho granulomata. Izilonda zichaphazela i-mucosa kunye ne-submucosa. I-pseudopolyps ibonakala njenge-mucosa ephakamileyo egciniweyo.Inkqubo yokuqala ihlala ichaphazela i-rectum kwaye ihlala isifo sendawo (proctitis) kwi-25%). I-30% Ukwandiswa kwesifo esikufutshane kunokwenzeka. I-UC inokubonisa njengecala lasekhohlo (55%) kunye ne-pancolitis (10%). Uninzi lwamatyala luphakathi ukuya phakathi
I-Dx: i-colonoscopy ene-ileoscopy ene-biopsies ezininzi iqinisekisa i-Dx. IiLabs: CBC, CRP, ESR, Fecal calprotectin, Iingxaki: anemia, megacolon enetyhefu, umhlaza wekholoni, isifo samathambo, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: I-5-aminosalicylic acid yonyango yomlomo okanye ye-rectal, i-corticosteroids, i-immunomodulatory drugs, i-colectomy yonyango.
Ukucinga: akufuneki kwi-Dx kodwa i-barium enema inokubonakalisa izilonda, i-thumbprinting, kwiimeko eziphambili ukulahlekelwa kwe-haustra kunye nokunciphisa ikholoni evelisa ikholoni ye-lead-pipe. iimeko. I-CT inokunceda nge-Dx yeengxaki. Umfanekiso wefilim engenanto uveza �ikholoni yombhobho okhokelayo� kunye nesacroiliitis njengeEnteropathic arthritis (AS)
I-Colorectal carcinoma (CRC) m / c umhlaza wephepha le-GI kunye ne-2nd eyona nto ixhaphakileyo kubantu abadala. I-Dx: i-endoscopy kunye ne-biopsy. I-CT yeyona ndlela isetyenziswa rhoqo kwiqonga. Uqhaqho loqhaqho lunonyango nangona izinga lokusinda leminyaka emihlanu lingama-40- 50% ngokuxhomekeke kwiqonga. Izinto ezinobungozi: i-fiber ephantsi kunye namafutha aphezulu kunye nokutya kweprotheni yezilwanyana, ukukhuluphala (ingakumbi kumadoda), isifo esingapheliyo se-ulcerative colitis. I-colon adenomas (iipolyps). I-Familial adenomatous polyposis syndromes (I-Gardener syndrome) kunye ne-Lynch syndrome njenge-polyposis engeyiyo yosapho.Klinikhi: Ukuqala okungaqondakaliyo kunye nemikhwa etshintshileyo yamathumbu, igazi elitsha okanye i-melena, i-anemia yokunqongophala kwe-iron ekulahlekeni kwegazi okungapheliyo ngokukodwa kwi-tumor yasekunene. Ukuvaleka kwamathumbu, intussusception, ukopha kakhulu kunye nesifo se-metastatic ngokukodwa kwiSibindi kunokuba yintetho yokuqala. Indlela: I-98% i-adenocarcinomas, ivela kwi-colonic adenomas esele ikhona (i-polyps ye-neoplastic) kunye nokuguqulwa okubi. Umyinge weminyaka emihlanu wokusinda yi-40-50%, kunye nenqanaba ekusebenzeni eyona nto ibalulekileyo echaphazela ukuxilongwa. I-M / C i-rectosigmoid tumors (55%),NB Ezinye i-adenocarcinomas esp. iintlobo ze-mucinous zivezwa ngokukhawuleza kwaye zihlala zixhatshazwa ngenxa yokungeniswa kwexesha kunye ne-mucin kunye nokusabalalisa kwendawo
Ukucinga: I-Barium enema yi-sensitivities ye-polyps> 1 cm, umehluko omnye: 77-94%, ukuchasana kabini: 82-98%. I-Colonoscopy yindlela ekhethwa yokuthintela, ukufumanisa, kunye nokuchongwa kwe-colorectal carcinoma. I-CT scanning eyomeleziweyo isetyenziselwa ukubeka kunye novavanyo lwe-prognosis ye-mets.
Ukuhlola: i-colonoscopy: amadoda 50 yo-10-iminyaka xa eqhelekileyo, iminyaka eyi-5 ukuba i-polypectomy, i-FOB, i-1st degree kunye ne-CA iqalise ukuhlola kwi-40 yo
Cancer Pancreatic: i-adenocarcinoma ye-epithelial (90%), i-prognosis ephosakeleyo kakhulu kunye nokufa okuphezulu. I-3rd M / C yomhlaza wesisu. I-Colon ngu-#1, isisu #2. I-cancer ye-Pancreatic i-22% yabo bonke abantu abafa ngenxa yokunyangwa kwesisu, kunye ne-5% yabo bonke abantu ababulawa ngumhlaza. I-80% yamatyala kwi-60 +. Ukutshaya i-cigarette yinkalo eyingozi kakhulu yendalo engqongileyo, ukutya okucebileyo kumafutha kunye neeprotheni. Ukunyanya. Imbali yentsapho. I-M / C ifunyenwe entloko kwaye iyancipha inkqubo.Dx: I-CT scanning ibalulekile. Ukuhlaselwa kwe-Superior Mesenteric Artery (SMA) kubonisa isifo esingenakulinganiswa. I-90% ye-pancreatic adenocarcinomas ayinakwenzeka kwi-Dx. Uninzi lwezigulane zifa ngaphakathi kwe-1-year ye-Dx. Ngokonyango: i-jaundice engenabuhlungu, abd. Iintlungu, i-gallbladder ye-Courvoisier: i-jaundice engenabuhlungu kunye ne-gallbladder eyandisiweyo, i-Trousseau's syndrome: i-migratory thrombophlebitis, isifo seswekile esitsha, i-metastasis yengingqi kunye nekude.
CT Dx: ubunzima be-pancreatic ene-demoplastic reaction eyomeleleyo, ukuphuculwa okulambathayo, kunye nokuncipha kancinci xa kuthelekiswa nedlala eliqhelekileyo elikufutshane, uhlaselo lwe-SMA.
Appendicitis: imeko eqhelekileyo kwi-radiology jikelele kwaye yimbangela enkulu yokuhlinzwa kwesisu kwizilwanyana eziselulaI-CT yindlela yokuziphatha ekhethekileyo yokubona ukulungiswa kwezixhobo
I-Ultrasound kufuneka iqeshwe kwizigulane kunye nabantwana
I-KUB Radiographs akufanele idlale indima ekuxilongweni kwe-appendicitis
Kumfanekiso, i-appendicitis ityhila isihlomelo esidumbileyo esinodonga olujiyileyo, ulwandiso, kunye ne-periappendiceal fat stranding. Iziphumo ezifanayo zokuqina kodonga kunye nokwandiswa ziphawulwe e-US. Uphawu oluqhelekileyo �uphawu oluphawulwe kumgca omfutshane we-US.
Ukuba i-appendix i-retro-caecal kunokuba i-US ingaphumeleli ukubonelela nge-Dx kunye ne-CT echanekileyo
I-Rx: yokusebenza ukuphepha iingxaki
Umngcipheko omncinci (SBO) -80% yazo zonke izithintelo zamathumbu emathunjini; i-20% eseleyo ngenxa yesithintelo esikhulu seembilini. Unesilinganiso sokufa se-5.5%M / C kubangele: nayiphi na i-Hx yokuhlinzwa kwangasemva kwesisu kunye nokunamathela
Inkcazo ye-Classical is constipation, ukwandisa isisu esiswini kunye nesisulu kunye nokuhlanza
Ii-radiographs ziphela kuphela ze-50% ezithintekayo kwi-SBO
I-CT iya kubonisa imbangela ye-SBO kwi-80% yamatyala
Kukho imigaqo echaseneyo yokunciphisa isilwanyana esincinci, kodwa i-3.5 cm iyingqikelelo engalindelekanga yembilini
Kwi-Abd x-reyi: supine vs. upright. Izibilini ezinwetshiweyo, ivalvulae eyoluliweyo (i-mucosal folds), amanye amanqanaba olwelo lomoya � ileli yokunyathela.
Rx: utyandwa �esisisu esibukhali.�
Volvulus-m/c kwi-Sigmoid colon esp. kubantu abadala. Esona sizathu: ukuqhinwa okungapheliyo kunye nokujija okungafunekiyo kwe-sigmoid kwi-sigmoid mesocolon. Ikhokelela ekuthinteleni kwamathumbu amakhulu (LBO). Abanye oonobangela abaqhelekileyo: ithumba kwikholoni. Sigmoid vs. Caecum volvulus
Ngokonyango: iimpawu ze-LBO kunye nokuqhina, ukuqunjelwa kwesisu, intlungu, isicaphucaphu, kunye nokuhlanza. Ukuqala kunokuba qatha okanye kungapheliyo
NgokweRadiographically: ilahleko ye-haustra kwi-LB, LB distension (>6-cm), �uphawu lwembotyi yekofu� isilayidi esilandelayo, isiphelo esisezantsi sevolvulus ikhomba kwi-pelvis
I-NB: Umgaqo wesithupha kwisilonda esincinci kufuneka ube ngu-3-6-9 apho i-3-cm SB, i-6-cm LB kunye ne-9-cm Coecum Rx: utyando �esisisu esibukhali.�
Ucaphulo
by UGqr Alex Jimenez Ukujonga kunye nokuchonga
I-Anoremics engundoqo
Qaphela izizukulwana zomthi we-tracheal-bronchial, ii-lobes, iisegmenti, kunye neentanda. Qaphela i-lobule yesibini yemiphunga (1.5-2-cm)-iyunithi esisiseko yokusebenza kwemiphunga eqatshelwe kwi-HRCT. Qaphela ulungelelwaniso olubalulekileyo lwezithuba ze-alveolar kunye nonxibelelwano phakathi (iipore ze-Kohn kunye nemijelo yaseLambert) evumela ukukhukuliseka komoya kwaye ngendlela efanayo ivumela ulwelo oluphumayo okanye oluguquguqukayo ukuba lusasazeke kwimiphunga kwaye lume kwindawo yokuqhekeka. Qaphela i-anatomy ye-pleura: i-parietal eyinxalenye ye-endothoracic fascia kunye ne-visceral eyenza i-lung edge � isithuba sepleural phakathi.
I-Mediastinum: ijikelezwe yi-pleura kunye nomphunga. Izibonelelo ezinkulu ziqukethe i-lymph nodes ezininzi (jonga umzobo obonisa i-nodes mediastinal kunye nokubandakanyeka kwabo eLymphoma
Iindlela eziqhelekileyo zoPhando lweziPhulo
Uviwo lwe-Radiographic (i-X-ray CXR); 1st inkulu. Iindleko eziphantsi, ukunyuka kwamayeza emancinci, ukuhlaziywa kwezikhalazo zeeklinikhi ezininzi
I-CT scan: isifuba CT, High-Resolution CT (HRCT)
Indlela yokukhubazeka kwesifuba:
I ngxaki
Sulelo
Neoplasms
Edema
Emphysema
Atelectasis
Ukukhubazeka kwempilo
Mediastinum
I-PA kunye ne-CXR esecaleni
Iimbono ezongezelelweyo zingasetyenziswa:
Umbono we-Lordotic: unceda ukuvavanya imimandla ye-apical
Iimbono zeCububitus ngakwesokudla nangesesinxele: uncedo lokuhlola ukunyakaza kwamanzi okuphambuka, i-pneumothorax kunye nezinye izifo
I-CXR PA eqhelekileyo kunye nembono yeLateral. Qinisekisa ukubonakaliswa okuhle: Iidiski ze-T-spine kunye neenqanawa ngentliziyo zibonwa kumbono we-PA. Bala i-9-10 yeembambo zangasekunene ukuqinisekisa iinzame ezaneleyo zokukhuthaza. Qalisa uphando olucokisekileyo usebenzisa le ndlela ilandelayo: Ngaba Zininzi Izilonda zemiphunga A-isisu / uvalo, udonga lweT-thorax, M-mediastinum, L-lungs ngokukodwa, Imiphunga yomibini. Phuhlisa ipatheni elungileyo yokukhangela
1) Isifo se-Airspace aka alveolar lung disease? Ukuzaliswa kwe-alveoli yomphunga, i-acini kunye nayo yonke i-lobe ene-fluid okanye into ebonakalayo nayiphi na into (i-blood, ipus, amanzi, iproteinaceous material okanye iiseli) I-Radiographically: i-lobar okanye isabelo esisodwa, i-airspace nodules ingaqatshelwa, ukuthambekela kokubambisana, umoya i-bronchograms kunye nesalathisi sesalathisi. Ukusabalalisa kweBatwing (ibhathengwane) echazwe apha (CHF). Ukutshintsha ngokukhawuleza ngexesha, oko kukuthi, ukwanda okanye ukunciphisa (iintsuku)
I-2) Isifo esisisigxina: ukungena kwe-pulmary interstitium (i-alveoli septum, i-lung parenchyma, iindonga zetyana, njl njl.) Umzekelo ngeentsholongwane, ibhaktheriya encinci, iiprotozoans. Kwakhona ukungena ngamaseli afana nesibalo sokuvuvukala / esilumkileyo (umz., I-lymphocytes) Echazwe njengophawu lomgca we-lung emzimbeni kunye nomzobo oxubileyo, odibeneyo, odibeneyo. Iimpawu ezahlukeneyo: ukuvutha izifo , i-fibrosing isifo sesifo se-lung, isifo sesifo somphunga, isifo se-viral / mycoplasma, i-TB, i-sarcoidosis lymphoma / leukemia nezinye ezininzi.
Ukuqaphela iipateni ezahlukeneyo zesifo se-pulmonary kunokunceda ngeDDx. IMisa ngokuBambisana nokuQinisa (ngasekhohlo). Qaphela iipatheni ezahlukeneyo zezifo zepulmoni: isifo se-airspace njengesigxina sokudibanisa esibonakalisa inkemoniya, ukudibanisa i-diffuse yokubonisa i-edema ye-pulmona. I-Atelectasis (ukuwa kunye nokulahleka kwevolumu). Iipatheni zesigxina se-pulmonary disease: i-reticular, nodular okanye ixutywe. I-SPN ngokudibanisa ngokubanzi kweengqungquthela (iigununu) ngokubhekiselele ukumela amamitha angene kwi-septic engena ngaphakathi
A = intraparenchymal
B = ukukhala
C = i-extrapleura
Qaphela indawo ebalulekileyo yezilonda zesifuba
Izimpawu ezibalulekileyo: Uphawu lwesilathisi: uncedo kunye nolwazi lweDDx. Umzekelo: Umfanekiso osezantsi osekhohlo: i-radiopacity kumphunga wesokudla, phi na? Ngokufanelekileyo MM ngenxa yokuba umda wentliziyo entle ophantsi kwendawo ye-lobe ephakathi ayibonakaliyo (ayikhoyo) I-bronchogram ye-Air: umoya oqukethe i-bronchi / bronchioles ejikelezwe ngamanzi
I-Chest Trauma
I-Pneumothorax (PTX): umoya (i-gas) kwindawo yesikhalazo. Ezininzi izizathu. Iingxaki:
Intlawulo ye-PTX: ukunyuka okuqhubekayo komoya kwindawo evulekileyo eyenza ngokukhawuleza i-mediastinum kunye nemiphunga ngokukhawuleza ekunciphiseni ukubuyela kwintliziyo. Ingaba yingozi xa ingaphathwa ngokukhawuleza
I-PTX yokuzenzekelayo: iiprayimari (abantu abadala abancinci (30 -40) ikakhulu abade, abhityileyo.Oonobangela abongezelelekileyo: Isifo seMarfan s, i-EDS, iHomocystinuria, ukusilela kwe-1 -antitrypsin.Secondary: Iipts ezindala ezinesifo se-parenchymal: neoplasms, abscess, emphysema , lung fibrosis kunye ne-honeycombing, i-catamenial PTX d / t endometriosis kunye nezinye.
I-pneumothorax ephazamisayo: ukuphazamiseka kwemiphunga, ukuphazamiseka okukhulu, iatrogenic (iibhobho zesifuba, njl.
I-CXR: inqaku elibhekiselele kwi-pleural line aka aka lung edge. Ukungahambi kwamathambo / iinqanawa ezingaphaya komgca we-visceral pleural. I-pneumothorax epholileyo ingabikho. Kwiindawo ezimileyo, umoya okhulayo kunye ne-PTX kufuneka ifunwe phezulu.
I-Rib fractures: v.common. Ukuxhatshazwa okanye ukugula (umz., Imitha, MM) Iingqungquthela zeebhanki x - ii-ray ayiluncedo kakhulu kuba i-CXR kunye / okanye ukutshekisha kwe-CT kubaluleke kakhulu ukuvavanya i-PTX ye-posttraumatic (ngaphantsi kwesobunxele)
Sulelo
I-pneumonia: ibhaktheriya okanye i-virus okanye i-fungal okanye kwi-immunocompromised host (umzekelo, i-Cryptococcus kwi-HIV / AIDS)
I-pneumonia: i-community-acquired vs. hospital-acquired. I-tynetic bacterial pneumonia okanye i-Lobar (engekho i-segmental) i-pneumonia enezinto ezihlambulukileyo zokuzalisa i-alveoli kwaye isasazeka kuyo yonke i-lobe. I-M / C i-OrganicStreptococcus I-Pneumonia okanye i-Pneumococcus
Abanye: (Staph, Pseudomonas, Klebsiella esp. Kwizidakwa ezinokuthi zikhokelela kwi-necroSIS / imiphunga yesiphunga) I-Mycoplasma (i-20-30s) ihamba nge-pneumonia, njl njl.
Iiklinikhi: ukukhwehlela okuvelisayo, umkhuhlane, intlungu yesifuba sentlungu ngezinye ihemoptysis.
I-CXR: i-confluent airspace opacity egcinwe kuyo yonke i-lobe. I-bronchograms yomoya. Uncedo lwezandla lwezandla kwindawo.
Intsholongwane: I-Influenza, i-VZV, i-HSV, i-EBV, i-RSV, njl. Ikhokelela ekuphelelweni kokuphefumula
I-pneumonia ye-Atypical kunye ne-Fungal Pneumonia: I-Mycoplasma, isifo seLegionnaire, kunye nesinye isifo / i-Cryptococcus pneumonia ingabonisa isifo se-lungs.
Ikhefu lokuphanga: ukuqokelela okuthelelekileyo kwezinto ezihlambulukileyo emiphakeni evame ukuhamba. Inokukhokelela kwiinkxalabo eziphambili ze-pulmonary and system / life-threating.
Kwi-CXR okanye kwi-CT: iqoqo elijikelezayo kunye nemida ebanzi kunye ne-necrosis ephakathi enezinga lomoya. DDx kwi-empyema ephazamisa umphunga kunye nesiseko esekelwe
I-Rx: i-antibiotics, i-antitifungal, i-anti-antial agents.
I-pneumonia idinga ukulandelwa kunye nokuphinda iCXR ukuqinisekisa ukugqiba ngokupheleleyo
Ukungabi nokuphuculwa kwe-radiographic ye-pneumonia kungabonisa ukukhulelwa komzimba, ukuchasana kwamagciwane, i-pulmonary carcinoma okanye ezinye izinto ezinzima
Pulmonary TB
Usulelo oluqhelekileyo emhlabeni jikelele (ihlabathi lehlabathi le-3rd). I-1 kubantu be-3 emhlabeni wonke ichaphazeleka yi-TB. I-TB ibangelwa nguMycobacterium TB okanye i-Mycobacterium Bovis. I-bacillus ye-Intracellular. I-Macrophage idlala indima ephambili.
I-TB yamayeza ePrayimari kunye ne-TB yasemva kweprayimari. Ifuna ukubhengeza okuphindaphindiweyo ngokuphefumla. Kwiindawo ezininzi ezingenakukwazi ukuzikhusela, intsholongwane esebenzayo ayikhuli
I-TB ibonisa njenge-1) igqitywe ngumphathi, i-2) igxothwe kwi-Latent Tuberculosis Infection (LTBI) i-3) ibangela i-TB esebenzayo. Izigulane nge-LTBI azifaki i-TB.
Ukucinga: CXR, HRCT. I-TB yaseprayimari: ukudityaniswa kwendawo yomoya yemiphunga (60%) yeelobes ezisezantsi, i-lymphadenopathy (95% - hilar & paratracheal), ukungxengxezeleka kwesicelo (10%). Ukusasazeka kwesifo sephepha esisisiseko ikakhulu kukungaziphathi kakuhle nabantwana.
I-TB yezigidi: i-pulmonary and system complication broadcast that can be deadly
I-post-primary (yesibini) okanye ukusuleleka kwintsholongwane: Ininzi kwi-Apices kunye namacandelo angaphantsi kwe-lobes) phezulu i-PO2), i-40% -kukhupha izilonda, isifo okanye i-confluent airspace isifo, i-fibrocalcific. Iimpawu zeLatent: ukubalwa kwamanqaku.
I-Dx: i-bacidi-fast bacilli (AFB) ne-culture (sputum). I-serology ye-HIV kuzo zonke izigulane ezine-TB kunye ne-HIV engaziwayo
I-Rx: I-regimen ye-4-drug: isoniazid, rifampin, pyrazinamide, kunye ne-ethambutol okanye i-streptomycin.
I-Pulmonary Neoplasms (umdlavuza oyimpompo oyintloko kunye nemetastasis yamapulmata)
Umdlavuza womlenze: umdlavuza wam / c kumadoda kunye ne-6 yesifo somdlavuza oqhelekileyo kubasetyhini. Unxulumano olunamandla kunye ne-carcinogens inhalation. Iikliniki: ukufumanisa emva kwexesha, kuxhomekeke kwindawo yesikhumba. Iipathology (iintlobo): Incinci encinci (SCC) kunye ne-Non-small cell cell
Incinci encinci: (i-20%) ivela kwiseli ye-neuroendocrine aka Kultchitsky, ngoko iyakwazi ukukhupha izinto eziphilayo ezisetyenziswayo kunye ne-paraneoplastic syndrome. Eyona ndawo ingundoqo (i-95%) okanye kufuphi ne-system / lobar bronchus. Uninzi lubonisa ukunyanzeliswa kwezinto ezimbi kunye nokungaqiniseki.
I-cell engeyiyo encinci: I-adenocarcinoma ye-Lung (i-40%) (Umhlaza wesi-M / C), i-M / C kubasetyhini nabangabhemi. Abanye: i-squamous cell (ingabonisa nge-lesion cavitation), inkulu enkulu kunye nabanye
Ifilimu ye-Plain (CXR): i-lesion entsha okanye eyandisiweyo, ekhulisa i-mediastinum icetyiswa ngokubandakanyeka kwe-lymph node, ukuxhatshazwa kwenzondo, i-atelectasis kunye nokudibanisa. I-SPN-inokuthi imele umhlaza wesifo somphunga ikakhulu xa iqulethe imida engafanelekanga, iinqanawa zokutya, udonga oluninzi, kumaphaphu aphezulu. Amanqamu amaninzi emiphunga amele ukuba amele i-metastasis.
Ukuziphatha ngokufanelekileyo: HRCT ngokuchasene.
Ezinye izifuba zesifuba: I-lymphoma i-v. Eqhelekileyo esifubeni ngokukodwa kumanqaku amancinci angaphakathi.
Ngokubanzi i-M/C pulmonary neoplasms yi-metastasis. Amanye amathumba abonisa ukuthambekela okuphezulu kokuhlangana kwemiphunga, umzekelo, iMelanoma, kodwa nawuphi na umhlaza unokumetastasize emiphungeni. Ezinye iimet ezibizwa ngokuba yi "Cannonball" metastasis
I-Rx: i-radiation, i-chemotherapy, i-resection
I-edema yePulmonary: Ixesha eliqhelekileyo lichaza ukuqokelela okungekho ngokwemvelo ngaphandle kwezakhiwo ze-vascular. Ukwahlukana ngokubanzi kwiCardiogenic (umz., I-CHF, i-mitral regurgitation) kunye ne-Non-cardiogenic enezinto ezininzi (umz., Ukugqithiswa kwamanzi, ukutshatyalaliswa emva kwegazi, izizathu ze-neurological, i-ARDS, kufuphi nokucwina / ukuphazamiseka kwemvelo, i-heroin overdose, kunye nabanye)
Iimbangela: ukwanda kwinycinezelo ye-Hydrostatic vs. ukunciphisa kwixinzelelo lwe-oncotic.
Ukucinga: I-CXR kunye ne-CT: I-2-iintlobo zeentlobo zezikhukhula ze-Interstitial and Alveolar. Ukubonakalisa ukubonisa kuxhomekeke kwizigaba
Kwi-CHF: Inqanaba loku-1: ukuhanjiswa kwakhona kwe-vascular flow (10- 18-mm Hg) kuphawulwe njenge-�cephalization� ye-pulmonary vasculature. Inqanaba lesi-2: I-edema ye-Interstitial (18-25-mm Hg) I-edema ye-Interstitial: i-cuffing ye-peribronchial, imigca ye-Kerley (i-lymphatics ezaliswe ngamanzi) A, B, C imigca. Inqanaba lesi-3: I-Alveolar edema: isifo sendawo yomoya: ukudityaniswa okungamabala kukhula kube sisifo sendawo yomoya: I-Batwing edema, iibronchograms zomoya.
I-Rx: Iinjongo eziphambili ze-3: I-O2 yokuqala ukugcina i-O2 kwi-90%
Okulandelayo: (1) ukunciphisa ukubuyiswa kweengxowankulu zamapulmoni (ukuphungulwa kwangaphambili kwezinto), (2) ukunciphisa ukunyanzeliswa kwe-vascular system (i-postload reduction), kunye ne-3 inkxaso ye-inotropic. Ukuphatha izizathu ezisisiseko (umzekelo, i-CHF)
Lung atelectasis : ukwandiswa okungaphelelanga kwepramonary parenchyma. Igama elithi "ukuphazamisa imiphunga" ngokuqhelekileyo ligcinwa xa yonke imiphunga iphelaI-1) I-atelectasis yokukhusela (yokuphazamiseka) iyenzeka ngenxa yesithintelo esipheleleyo somoya (isib. Isisu, izinto ezifakwe ngaphakathi, njl.
I-2) Ukuphumla (ukuphumla) i-atelectasis yenzeka xa unxibelelwano phakathi kweparietal kunye ne-visceral pleura luphazamiseka (pleural effusion & pneumothorax)
I-3) I-atelectasis enoxinzelelo iqhutyelwa ngenxa yeso siphene esine-thoracic-compressing compressing the pulp and forcing air out of the alveoli
I-4) I-atelectasis yamacandelo: ivela ngenxa yesigqabi okanye i-fibrosis eyanciphisa ukwandiswa kwemiphunga njengesifo segranulomatous, pneumonia ne-radiation fibrosis
I-5) I-adhesive atelectasis i-Adhesive atelectasis ivela kwi-infactant lack and collapse alveolar
6) I-plate-like or discoid yayivame ukuphuhliswa emva kokulandela i-anesthesia jikelele
I-7) Impawu yokucinga: ukuwa kwempompo, ukufuduka kwemiphunga yemiphunga, ukuphambuka kwe-mediastinum, ukunyuka kwesithsaba, ukunyuka kwe-hyperinflation kwimiphunga engaphazamiseki
I-Mediastinum: i-pathology ingahlukaniswa kwizinto ezibangelwa kukukhululeka okanye ezo ziza kubangela izifo ezahlukileyo ezibandakanya i-mediastinum. Ukongezelela, umoya ungangena kwi-mediastinum kwi-pneumomediastinum. Ulwazi lwe-mediastinal anatomy lunceda iDx.
Izidumbu zasemdeni zangaphambili: i-thyroid, thymus, i-teratoma / i-germ tumors tumors, i-lymphoma, i-lymphadenopathy, inyuke kwi-aortic aneurysms
Abantu abaphakathi kwe-mediastinal: i-lymphadenopathy, i-vascular, iilononalons etc.
Amasundu omzimba osemva: ama-tumor neurogenic, i-aortic aneurysms, i-mass-esophageal masses, i-spinal mass, i-aortic chain adenopathy
I-pulmonary emphysema: ukulahlekelwa kweethambo eziqhelekileyo ze-elastiki / i-elastic recovery of the lungs ngokutshabalalisa i-capillaries kunye ne-septum / interstitium.
Ukutshatyalaliswa kwemiphunga yephampyrama ngenxa yokuvuvukala okungapheliyo. Ukutshatyalaliswa kweprotease-elastin. Ukubanjwa komoya / ukwandiswa kwe-airspace, i-hyperinflation, i-pulmonary blood pressure, kunye nezinye iinguqulelo. Iiklinikhi: i-dyspnea eqhubekayo, engenakuphikiswa. Ngethuba ixesha lokunyanzeliswa komqulu kwi-1 yesibini (FEV1) liwile kwi-50% isigulane siphefumula xa sisebenza ngokuncinci kwaye sitshintshela kwiindlela zokuphila.
I-COPD yimbangela yesithathu yokubangela ukufa kwabantu emhlabeni jikelele. Ichaphazela i-1.4% yabantu abadala base-US. M: F = 1: 0.9. I-Pts 45 iminyaka kunye nangaphezulu
Izizathu: Ukutshaya kunye ne-1-Antitrypsin ukusilela (ihlukaniswe kwi-centrilobula (ukutshaya) kunye ne-panacinar.
Ukucinga; iimpawu ze-hyperinflation, ukuxhamla umoya, i-bullae, i-pulperary hypertension.
by UGqr Alex Jimenez Ukujonga kunye nokuchonga
Intlekele yeNtloko: i-Skull Fractures
I-SKULL FX: OKUQHELEKILEYO KWIINTLOKO ZEZINTLOKO ZEZINTLOKO. I-SKULL FX OFTEN POINT KWAMANYE AMAZIKO OKUZIPHUMA: INTRA-CRANIALHEHING, UKUQHUBA OKUQHELEKILEYO KWEZIXHOBO NEMINYE IMIBUZO EYINTLOKO
I-X-RAYS YOKHAKHA LUPHATHELELE UKUVAVANYA UKWENZAKALA ENTLOKO. I-CT SCANNING W/O CONTRAST LELONA NYATHELO LOKUQALA liBALULEKILEYO WOVAVANYO LWENTLOKO EBUCHULE TRAUMA . I-MRI HASA AMAKHONA OKUMNTU WOKUBONISA UKWAKHIPHA KUKAKHAKHA, KWAYE AYIQHELEKILEYO UKUSETYENZISWA KWI-DX YOKUQALA YENTLOKO TRAUMA .
I-SKULL FX IYAZISWA NJENGOBA I-FXS YE-VAULT SKULT, ISIKHAKATHI SOKUKHAKHA NOKUBA NGEZIKHONO ZONYAKA ZONKE EZIKHENZEKILEYO NEZIXHUMA EZIMISEBENZI KUNYE NOKUNCEDA UKUTHETHA I-PREDICT.
I-LINEAR SKULL FX: I-VAULT SKULT. M / C FX. ISICWANGCISO SOKUPHILA UKUHLOLA I-ARTERIALEXTRADURAL HEMORRAGING
X-RAY DDX: SUTURES VS. UKHAKHA LWEMPILO FX. I-FX THINNER, �BLACKER� oko kukuthi, I-LUCENT ENGAKUMBI, IZIXHOBO EZIPHELAYO, KUNYE NEZIGCAWU ZEVASCULAR, UKULACKSSERATIONS
I-RX: UKUBA KUNYE UKUVUNYWA KWE-INTRACRANIAL THAT NO TREATMENT. UKUQHALWA KWENKQUBO YENKQUBO NOKUBHALISWA KWE-SC SCING
IFX SKX DEPRESSED: 75% KWI-VAULT. UNGAKWAZI. UFUNYELEYO NGOKWENZA I-FX. IINKCUKACHA EZINTSHONA KUNYE I-NEUROSURGICALEXPLORATION EZIQHELEKILEYO IMICWANGCISO EYAFUTSHANE> I-1-CM.I-APPLICATIONS: UKUPHATHWA KWE-VASCULAR / HEMATOMAS, I-PNEUMOCEPHALUS, IMENINGITIS, I-TBI, i-CSF LEAK, UKUQHUBA UKUBHALA ETC.IMAGING: ISICWANGCISO SESICWANGCISO SE-W / O
BASILAR SKULL FX: INGABULALA. RHOQO KUNYE OKUNYE OKUNENTLOKO OMKHULU WE-VAULT KUNYE NE-FACIALSKELETON, OKUQHILEYO KUNE-TBI KUNYE NE-HEMORRHAGING OMKHULU. KUQHALA KWENZEKA NJENGENTLOKO � IMPUMELELO YEMPEMBELELO KUNYE NOXINISEKISO LWEMCHWEPHEKO NGENXA YOMSEBENZI NAMATHAMBO ETHUTYANA NGESPHENOID KUNYE NEZINYE IZISEKO ZAMATHAMBO OKHAKHA. EKLINIKI: I-RACCOON EYES, UMQONDISO WE-BATTEL, CFRHINO/OTORRHEA.
IFractures Facial
IZIMBONO ZEMISEBENZI: I-45% YE-ALLFACEFXM / I-IMPACT YI-LATERAL (I-FIST BLOW ETC.) UKUBA UKUBHALISWA KWE-UNDISPLACEDNO, UKUBA KUFANELE UKUFAKA UKUPHATHA KWE-AIR NE-RESPIRATORY PASSAGE, KUBAQHUBANISWA NAMANYE OKUQHELEKILEYO / OKUQHELEKILEYO. X-RAYS I-80% INTSHINTSHELO, YELANDELWE NGOKWENZA KWI-CT INCOMPLEX.UKUBHALA OKUQHELEKILEYO FX: UKWENZAKALA OKUQHELEKILEYO I-D/T IMPEMBELELO KWI-GLOBU KUNYE/OKANYE NE-ORBITAL THAMBO. FX yoMgangatho we-ORBITAL INTOMAXILLARY SINUS VS. UDONGA LWEETHMOID SINUS. IINGXAKI: ENTRAPPEDINFERIOR RECTUS M, PROLAPSEORBITAL FAT, � NEZISHUMI ezithambileyo, I-HEMORRHAGING AND OPTIC NERVE UMONAKALO. I-RX: IINGXAKI NGOKWENZAKALA KWE-GLOBU KUBALULEKILE, NGOKUBANZI KUNYANWA NGOKUQHELEKILEYO UKUBA AKUKHO NGXAKI EZIKHOYO
I-TRIPOD FX: I-2ND M / C I-FACIAL FX#EMVA kwe-NASAL (i-40% ye-MIDFACEFX) I-3-POINT FX-ZYGOMATICARCH, INKQUBO YE-ORBITAL YE-ZYGOMATIC BONE & NE-SIDE OF MAXILLARY SINUS WALL, INKQUBO MAXILLARY YE-ZYGOMATIC BONE.COMPLICATED INTCIVERATED NERPOTED YI-NERPOMATIC. I-CT SCANNING INGAKUMBI ENGAKUMBI UKUBA X-RAYS (UMBONO WAMANZI).UKUSEBENZA FX: IZINDAWO ZEMFUSHANE EZIFUNKILEYO ZIQONDA IIPHEYIDIDI ZE-PTERYGOID, UKUPHATHISWA KWENKQUBO YOKUPHATHA KWENKQUBO NENKQUBO YO-ALVEOLAR NE-TEETH FROM SKULL. IINKCUKACHA: I-AIRWAYS, HEMOSTASIS, AMAKHUNGA OKUSEBENZA. ISICWANGCISO SESICWANGCISO SICELO. I-RISK YENKQUBO YENKQUBO YOKUSEBENZA KWI-BASXAR SKX FX
I-PING-PONG FX: �KUPHELELEYO KWIINTSANE. I-FX D/T FOCALDEPRESSION ENGAPHELELEYO: UKUNYANZELEKA UKUNIKEZELWA, OKUNZIMA KWEMISEBENZI ETC. I-FOCALTRABECULAR MICROFRACTURIINGLEAVING UXINEKO LUFANA NE-APING-PONG. I-DX IBONAKALA KAKHULU NJENGESIFO ESIQINISEKILEYO �UKUXINEZELEKA� KUKHAKHA. NGOKUQHELEKILEYO NEUROLOGICAL INTACT. I-CT INGAKUNCEDA UKUBA KUCELEKELELWA ukuba UKWENZAKALA KOBUCHOPHO. RX: UKUQWALASELWA VS. UTYANDO KWINGOZI EZINGCACISIWEYO. SPONTANEOUSREMODELING INGXELO
I-CYST (UKUKHULA ISIKHAKATHI ESIKHULULEKILEYO) - KUNYE UKUHLOLA OKUQHELEKILEYO OKUTHUTHUKISWA KWE-POSTTRAUMATIC ENCEPHALOMALACIAAYINYE I-CYST, KUNYE NOKUPHUMA KWESENCEPHALOMALACIA EBONA IINYANGA EZINYE I-POST-TRAUMA NEZINDLELA ZOKUPHILA KWEENKQUBO ZOKUBHALWA KWEENKQUBO ZENKQUBO YENKQUBO YOKUBHALA KWEENKQUBO ZENKQUBO YOKWENZA I-CSF. I-CT INTSHA YOKUPHAKATHI KWE-PATHOLOGY. IXHUMA: UKUKHULULELA KWI-FX NOKWENZA I-ENCEPHALOMALACIA NJENGOBAWO ABASEBENZINI.
ICLINICALLY: UKWENZISWA KWEKHARITYHULAM, UKUPHILA, IIMPAWU ZEZINGQUBO / IZINZUZO. I-RX: UKUQHUBA KWE-NEUROSURGICAL KUNYE
I-DDX: IINKCWADI ZOKUXHALISA / I-METS / EZINYE IZINDLELA ZE-NEOPLASMSINTO, EG, ETC INFECTION.
MANDIBULAR FXS: OKUQHUBILEYO. I-POTENTIALLYCONSIDERED FX D / V I-INTRA-ORALEXTENSION. I-40% INKQUBO YENKQUBO YENKQUBO YOKUBA I-RING. IMPACT DIRECT (ASSAULT) I-M / C I-MECHANISMI-PXOLOGICAL FX D / T BONE NEOPLASS, I-ETC INFECTION. I-IATROGENIC NGOKUSETSHENZISWA KWE-ORAL (UKWENZISWA KWE-TOOTH)
IMAGING: IMINYAKA E-X-RAYS, IPANOREX, CT SCANNING ESP. KWIINKCUKACHA ZE-ASSOCIATEDFACE / KWI-TRAUMA
UKUZIPHATHA: I-AIRWAY STRSTRUCTION, I-HEMOSTASIS YINXAQOQOQO, UKUPHUMA KWAMANDIDAR N, I-OSTEOMYELITIS / I-CELLULITIS NOKUPHUMA KWENKQUBO NGOKUPHUMA KWEMITHETHO (LUDWIGANGINA) NE-NECK FASCIAL SOFT TISSUES INTOMEDIASTINAM. AWAKHO UKUBA UKUQHUBEKA I-D / T EZIKHULUMENTE ZEMATRIKI.
RX: I-VS. EPHAKATHI
I-Hemorrhage eyi-Intracranial
I-EPI AKA ENGAPHEZULU: (EDH) UKUxhwilwa NGOKUXOXAYO KWEMISHIYA YE-MENINGEAL (MMA CLASSIC) EYENZA NGOKUKHAWUZIYO I-HEMATOMA PHAKATHI KOKHAKHA LWANGANGAPHAKATHI KUNYE NE-DURA NGAPHANDLE. I-CT SCANNING LISISITSHIXO KWI-DX: IBONISA NJENGOKO �LENTIFORM� Okt. I-BICONVEX UKUQOKELELWA KWEGAZI ELI-ACUTE (HYPERDENSE) ELINGENZI INGQUNGQWESHO KWAYE UNCEDA NGE-DDX YE-HEMATOMA ENGAPHAMBILI. EKLINIKI: HA, LUCID EPISODE EKUQALENI FUTHI SIYAHLELA KWIIYURE EZIMBALWA.IINGXAKI: I-BRAIN HERNIATION, CN PALSY. O/ INKCAZELO ELUNGILEYO UKUBA UKHUSILE NGOKUKHAWULEZA. HEMATOMA (SDH) : UKUxhwilwa KWEBridgeGINGVEINS PHAKATHI KWE-DURA YANGANGAPHAKATHI NE-ARACHNOID.I-COCOY KODWA I-PROGRESSIVE ABLEED. INOKUCHAPHAZELA KAKHULU ABATSHA NABANTU ABADALA KAKHULU KUYO YONKE IMINYAKA (MVA, FALLS ETC.) BUNOKUPHUHLISA KWI-SYNDROME YOMNTWANA �. I-DX IYA KULIBAZISWA YAYE AYIQHELE INKCAZELO NGOKUBULAWAYO OKUPHEZULU. KWINTLOKO YABANTU ABADALAYO KUSENOKUBA NCINANE OKANYE UNGAKHUMBULWA. UKUQWALASELA NGE-CT KUBALULEKILE. BONAKALA NJENGQOKELELWANO LOKUCRESCENTSHAPED ELINOKUWENZA IZIXHOBO KODWA ZIMYEKE KWISIBONAKALISO ESIDILI. UMEHLUKO KWI-CT D/T AMABANGA AHLUKENEYO OKWEGAZI: ACUTE, SUBACUTE, � AND CHRONIC. EKLINIKI: INKCAZELO EYAHLUKENEYO, 45-60% IKHO NGEMEKO YE-CNS EXINWE KAKHULU, UKUNGALINGANI KOMNTU. NGOKUQHILEYO NGOKUQHUBEKA OKUQALA KOBUCHOPHO, KUZE KUBE ISIQEPHU ESILUCID PHAMBI KOKUWOHLELA KAKHULU. KWI-30% IMIBUZO YOKWENZAKALA KOBUCHOPHO OKUFANELEKILEYO IZIGULI ZINE-SDH. I-RX: I-NEUROSURGICAL EXAMISEKILEYO.
I-SUBARACHNOID HEMORRHAGE (SAH): IGAZI KWI-SUB-ARACHNOID SPACE NJENGESIPHUMO SE-TRAUMATIC OR NOT-TRAUMATIC ETIOLOGY: BERRY ANEURYSMS AROUND CIRCLE OF WILLIS.SAH 3% OF STOKES, 5% OF FETLESCNDERTHUS: IINTLOKO� ICHAZWE � NJENGEYONA INGXESHA ENGAPHILAYO�. I-PT IGQIBELEKA OKANYE ANGABUYELI SIYAZI. I-PATHOGY: I-DIFFUSE BLOOD INSA SPACE 1)SUPRASELLAR CISTERN ENOKWANISWA KOMPHANDO, 2)�PERIMESENEPHALIC, 3) BASAL CISTERNS. IGAZI ELICHAPHAZELEKILEYO KWISITHUBA SASE-SA UXINEZELEKO LWE-UNDERARTERIAL LUYENZA UKUNYUKA KWEHLABATHI LONKE KUXINZEKELO LWE-INTRACRANIAL, I-ACUTE GLOBAL ISCHEMIA IYANGENZIWA YI-VASOSPASM NONYE UTSHINTSHO.
DX: IMAGING: URGENT CT SCANNING W / O UKUPHATHA, I-CT I-ANGIOGRAPHY INCEDA UKUNCEDA UKUSETSHENZA I-99% YE-SAH. I-LUMBAR PUNCTUREMAY INCEDO NGOKWENZISWA KWEENKQUBO. NGEMVA KWEMISEBENZI YE-DX: INGXELO YENKQUBO YENKQUBO YENKQUBO YONYAKA YOKUNCEDA UKUFUNA UKUQHUBEKA KUNYE NEMINYE IMIBUZO EVALUIIMPAWU ZOKWENZA UMFANEKISO: IGAZI ELIQHELEKILEYO LIYAQHUBEKA KWI-CT. IFUMANEKA KWI-DIFFERENTCYSTERNS: I-PERIMESENEPHALIC, SUPRASELLA, BASAL, VENTRICLES,
I-RX: I-MEDS I-ANTHIYEMERTENSIVE MEDS, AMAGENCI OSMOTIC (MANNITOL) UKUQHUBA ISICELO. UKUQALA KWE-NEUROSURGICAL NAKWANYE AMAKHONO.
I-CNS Neoplasms: iBenign kunye neMalignant
ZOKUBHALA I-2% YONYAKA YONKE YAMANCERS. UMTHETHO OMTHETHO UNYE MALIGNAN, YOKUBA IZIHLOKO ZEMATASTATIC IZIHLOKO ZIKHULUNGOKUPHELELEYO NGOKWEZINTLOKO KUNYE NEZINXIBELELWANE ZE-CNS ZASEKUHLALENI, UKWANDISWA KWE-ICP, UKOPHELWA KWE-INTRACEREBRAL NJL. IINTSAPHO ZOSAPHO: I-VON-HIPPEL-LANDAU, I-TUBEROUS SCLEROSIS, I-TURCOT SYNDROME, i-NF1 kunye ne-NF2 YENZA UMNGCIPHEKO. KWABANTWANA: M / C ASTROCYTOMAS, EPENDYMOMAS, PNETNEOPLASMS (EG MEDULLOBLASTOMA) NJL. I-DX: ISEKELWE KUHLELO LWABO.
ABADALA: M/C BENIGN NEOPLASM: MENINGIOMA. M/C PRIMARY: GLIOBLASTOMA MULTIFORME (GBM)METSE NGOKUKHOLWA UKUSUKA KULUNG, MELANOMA,�KUNYE NEBELE.EZINYE: CNS LYMPHOMA
UKUPHILA KUNYE OKUQHUBILEYO: IMICIMBI YEMIQESHO YOKUBA YENZEKA NJENGOBUHLOBO, IMIBUZO YE-ICP HA. I-EVALUATED BY CT NOMRIYA NE-IV GADOLINIUM.
IMAGING IQINISELA: INTRA-AXIAL VS. I-EXTRA-AXIALNEOPLASMS. IINKCUKACHA EZIPHUMA ZAMASIPALA EZIPRAYIMARI MAYO CCUR VIA CSF NAKWIINTLOKO ZEZEMVELO
QAPHELA I-AXIAL CT SLICE OF MENINGIOMA NE-AVIDCONTRAST ENHANCEMENT.
I-AXIAL MRI KWI-SEXENCE YENKQUBO YOKUPHELEKILEYO YOKUPHILA I-NEOPLASM NE-CYEMOTOXIC EDEMA YE-BRAIN I-PARENCHYMA INKCAZELO YEZIBAKALA IV IGLIOMA (GBM) NE-PROGNOSIS EZIHLEKILEYO. ISITHOMBE SENKQUBO YOKWENZEKA KWEMFARU: UMHLABA WEMIHLALO YOMHLABA: UKUQALA UMETASTASIS KWI-CANCER YEBREAST. I-MELANOMA YI-METASTASIZESTO OKUQHELEKILEYO (FUNDA UKUPHATHA KWEMIHLOKO) IMRI YAKHO YIKHULUMENTE I-DIAGNOSTIC D / T ISIHLOKO ESIKHONKILEYO KWI-T1 NE-CONTRAST ENHANCEMENT.
I-RX: I-NEUROSURGICAL, I-RADIATION, I-CHEMOTHERAPY, � IIINDLELA ZOKUGCINA EZINGAPHAMBILI ZIYASUKA
I-CNS Pathology evuthayo
Izifo zeNCS
KWABANTU
KWI-MYCOBACTERIAL
FUNGAL
VIRAL
IPASASI
by UGqr Alex Jimenez Ukujonga kunye nokuchonga , Ukunyamekela
Uninzi lwababoneleli bonyango basebenzisa x-ray njengethuluzi lokuxilonga ukunyanga iintlobo zezikhalazo zezigulane, kubandakanywa nezigulane. Baya kunceda oogqirha baqaphele umthombo wengxaki okanye ukuba kukho into eqhubekayo. I-ray-ray inokukunceda abancedisi be-chiropractors ukuba banqume indlela efanelekileyo yokunyango. Ukuze siqonde ngakumbi, makhe sijonge ngokubhekisele ukuba zeziphi kunye nendlela esetyenziswa ngayo kwiiofisi ezininzi ze-chiropractic.
Ziziphi ii-ray?
I-x-reyi luhlobo olunamandla kakhulu lwemitha ye-electromagnetic efana namaza erediyo, imitha ye-ultraviolet, ii-microwaves, okanye ukukhanya okubonakalayo okusetyenziselwa ukujonga ukubunjwa kwangaphakathi komntu okanye into. Umqadi ugxile kwindawo ethile yomzimba womntu, njengasemva, uvelisa umfanekiso wedijithali skeletal isakhiwo.
Umqadi udlula ngokulula eluswini nakwezinye izihlunu ezithambileyo�kodwa awukwazi ukudlula emathanjeni nasemazinyweni. Izihlunu ezithambileyo ezixineneyo, ezifana namalungu, iiligaments, kunye nezihlunu, ziya kubonakala; kodwa ziya kubanjwa zibe ngwevu. Iindawo ezifana nezibilini okanye imiphunga zibonakala kwifilimu zimnyama.
Ukusetyenziswa kwe-chiropractic x-ray
I-X-ray ye-Chiropractic inikezela ngolwazi olubalulekileyo olunokuchaphazela indlela i-chiropractor ikhetha ukunyanga ngayo isigulane. Kwezinye iimeko, ukunakekelwa kwe-chiropractic okanye ukunyanzeliswa komgogodla kungabi yinkqubo efanelekileyo yesenzo ngelo xesha, kwaye isigulane sinokuqalwa ngonyango oluhlukileyo, oluncinci.
Ngamanye amaxesha, inokubonisa i-chiropractor indlela yokuqhubeka nokunyanga isigulana. Ngamafutshane, izigulana zinokufumana ukhathalelo olungcono, olulungelelanisiweyo olunokuthi luququzelele ngcono ukuphilisa kunye nokulawulwa kweentlungu.
Ezinye zeenzuzo ze i-chiropractic x-ray ziquka:
Chonga imeko okanye uphawu, olufana nethumba lomqolo okanye isilonda-eya kubonelela ngesizathu sonyango sokuba inkambo ethile yokhathalelo mayingenziwa.
Fumana ulwazi olubalulekileyo lwe-biomechanical olungancedisa ekukholeni unyango.
Ukuhlala unolwazi kunye nokugcina irekhodi yenkqubo yokuwohloka kwesigulana.
Uncedo ekufumaneni iziphulo zomgudu kunye namalungu angachaphazela unyango.
Ivumela izigulana ukuba ziqonde imeko yazo kunye nocwangciso lwezocwangco olungcono, zibavumela ukuba bathathe ubunini beenkqubo kwaye babandakanyeke ngakumbi kunyango lwabo nokuphilisa.
Yintoni eyenziwa yi-chiropractor kwifilimu ye-x-ray?
Xa chiropractor ithatha i-x-reyi yesigulana, bafuna izinto kwiindawo ezininzi ezithile. Into yokuqala abayijongileyo kukuqinisekisa ukuba akukho ziqhushumbisi, ukwaphuka, umhlaza, usulelo, amathumba, okanye ezinye iimeko ezinokuba yingozi.
Bese bekhangela ukuphakama kwedisk kunye nezinye iimpawu zokuguqulwa kwediski, ukuxinwa kwethambo, ukuxhamla kwethambo, izithuba ezidibeneyo kunye nokulungelelaniswa. Oku kuvumela ukuba bafumane iinkalo ezifana ne-scoliosis kunye nezinye iimeko ezingadinga iindlela ezithile zonyango.
Abaninzi be-chiropractors bakhetha ukuba isigulane sisesimweni sobunzima xa sithatha x-ray . Oku kwahluke kuninzi lwezonyango ezibonela isiguli.
I-advanteji ye-x-reyi ethwala ubunzima njengesixhobo sokuxilonga� kukuba ivumela ukulinganisa, oko kukuthi, ukunqongophala kobude bomlenze, i-scoliosis, kunye nokucutha kwendawo edibeneyo. Ingabonisa kwakhona ukuba amathambo athile, afana ne-tibia kunye ne-fibula, ayahlula into enokuthi ibe ngumqondiso we-tendon eqhekekileyo okanye ingxaki ngokudibeneyo. I-x-reyi engenabunzima ayinakubonelela ngembono efanayo, kwaye imikhondo ebalulekileyo kwimeko yesigulana inokuphoswa.
Uphulo lweentlungu
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