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Kiʻi & Diagnostics

Hui Hoʻomaʻi Kiʻi & Hoʻopaʻa ʻana. Ke hana nei ʻo Kauka Alex Jimenez me nā diagnosticians kiʻekiʻe a me nā loea imaging. I kā mākou hui, hāʻawi nā loea kiʻi kiʻi i nā hopena wikiwiki, ʻoluʻolu, a me nā hopena kiʻekiʻe. Ma ka hui pū ʻana me kā mākou mau keʻena, hāʻawi mākou i ka maikaʻi o ka lawelawe ʻana i ke kauoha a ko mākou poʻe maʻi. ʻO ka Diagnostic Outpatient Imaging (DOI) kahi kikowaena Radiology hou ma El Paso, TX. ʻO ia wale nō ke kikowaena o kona ʻano ma El Paso, nona a mālama ʻia e kahi Radiologist.

ʻO kēia ke ʻano o kou hele ʻana i DOI no kahi hoʻokolokolo radiologic, nā kikoʻī āpau, mai ka hoʻolālā ʻana o nā lumi, ke koho ʻana o nā mea hana, nā ʻenehana i koho ʻia e ka lima, a me ka polokalamu e holo nei i ke keʻena, koho ʻia a hoʻolālā ʻia e ka Radiologist. ʻaʻole na ka mea helu kālā. ʻO kā mākou niche mākeke kekahi kikowaena o ka maikaʻi. ʻO kā mākou mau waiwai e pili ana i ka mālama maʻi: Ke manaʻoʻiʻo nei mākou i ka mālama ʻana i nā maʻi i ke ʻano o kā mākou hana ʻana i ko mākou ʻohana a e hana mākou i ka mea maikaʻi loa e hōʻoia i ka loaʻa ʻana o ka ʻike maikaʻi ma kā mākou keʻena.

E hōʻoia i ka palekana o ka maʻi: kahi hōʻailona maʻi ma kahi keʻena Chiropractic

by Kauka Alex Jimenez | ʻO ke akua, Hoʻoponopono Hua'ōlelo, ʻO Chiropractic News, maʻi Pain, Kiʻi & Diagnostics, Nā hōʻailona

Pehea e hāʻawi ai nā limahana mālama olakino i kahi keʻena chiropractic i kahi ala lapaʻau e pale aku ai i nā hewa olakino no nā poʻe i ka ʻeha?

Introduction

ʻO nā hewa lāʻau i loaʻa i ka 44,000-98,000 mau make ʻAmelika i ka haukapila i kēlā me kēia makahiki, a he nui nā mea i hoʻopilikia i nā pōʻino. (Kohn et al., 2000) Ua ʻoi aku kēia ma mua o ka nui o ka poʻe i make i kēlā me kēia makahiki mai ka maʻi AIDS, ka maʻi maʻi umauma, a me nā ulia kaʻa i kēlā manawa. Wahi a ka noiʻi ma hope aku, kokoke paha ka helu maoli o nā make i ka 400,000, e waiho ana i nā hewa lapaʻau ʻo ke kolu o ke kumu maʻamau o ka make ma US. ʻO ka pinepine, ʻaʻole kēia mau hewa i hana ʻia e ka poʻe lapaʻau kino maoli; akā, ʻo ia ka hopena o nā pilikia ʻōnaehana me ka ʻōnaehana mālama ola, e like me nā ʻano hana hoʻomaʻamaʻa like ʻole, nā pūnaewele ʻinikua i hoʻokaʻawale ʻia, underutilization a i ʻole ka nele o nā protocol palekana, a me ka mālama ʻole ʻia. Ke nānā nei ka ʻatikala o kēia lā i ke ala lapaʻau no ka pale ʻana i kahi hewa o ka lāʻau lapaʻau ma kahi kūlana lapaʻau. Kūkākūkā mākou i nā mea lapaʻau e pili ana i nā mea lapaʻau like ʻole e kōkua i nā poʻe e loaʻa ana i nā pilikia maʻi. Alakaʻi pū mākou i kā mākou poʻe maʻi ma ka ʻae ʻana iā lākou e nīnau i kā lākou mau mea lapaʻau pili i nā nīnau koʻikoʻi a paʻakikī. ʻO Kauka Alex Jimenez, DC, hoʻohana wale i kēia ʻike ma ke ʻano he lawelawe hoʻonaʻauao. Akahana

Ka wehewehe ʻana i nā hewa lapaʻau

ʻO ka hoʻoholo ʻana i ka hewa o ka lāʻau lapaʻau ka hana koʻikoʻi i kēlā me kēia kamaʻilio e pili ana i ka pale ʻana i nā hewa olakino. Hiki paha iā ʻoe ke manaʻo he hana maʻalahi kēia, akā aia wale nō a hiki i kou ʻimi ʻana i ka nui o nā huaʻōlelo i hoʻohana ʻia. Hoʻohana like ʻia nā huaʻōlelo he nui (ke kuhi hewa kekahi manawa) no ka mea hiki ke hoʻololi ʻia kekahi mau huaʻōlelo, a i kekahi manawa, pili ka manaʻo o kahi huaʻōlelo i ka loea e kūkākūkā ʻia nei.

ʻOiai ʻo ka ʻoihana mālama ola i ʻōlelo ʻo ka palekana o ka maʻi a me ka hoʻopau ʻana a i ʻole ka hōʻemi ʻana i nā hewa lapaʻau ka mea nui, ua ʻike ʻo Grober lāua ʻo Bohnen i ka makahiki 2005 ua hāʻule lākou i kahi wahi koʻikoʻi: ka hoʻoholo ʻana i ka wehewehe ʻana o "ka nīnau koʻikoʻi paha… hewa lapaʻau? ʻO ka hewa o ka lāʻau lapaʻau he hiki ʻole ke hoʻopau i kahi hana i hoʻolālā ʻia ma kahi kūlana olakino. (Grober & Bohnen, 2005) Eia naʻe, ʻaʻohe o nā huaʻōlelo i ʻike pinepine ʻia me kahi hewa olakino - nā maʻi, mālama olakino, a i ʻole kekahi mea ʻē aʻe - i ʻōlelo ʻia ma kēia wehewehe. ʻOiai ʻo kēia, hāʻawi ka wehewehe i kahi hoʻolālā paʻa no ka hoʻomohala hou ʻana. E like me kāu e ʻike ai, ʻelua ʻāpana kēia wehewehe kikoʻī:

He hewa hoʻokō: ʻAʻole hoʻokō i kahi hana i hoʻolālā ʻia e like me ka mea i manaʻo ʻia.
He hewa hoʻolālā: He ʻenehana ia, ʻoiai me ka hoʻokō pono ʻana, ʻaʻole e hoʻopuka i nā hopena i makemake ʻia.

ʻAʻole lawa nā manaʻo o nā hewa o ka hoʻokō a me ka hoʻolālā ʻana inā makemake mākou e wehewehe pono i kahi hewa lapaʻau. Hiki i kēia mau mea ma nā wahi āpau, ʻaʻole wale ma kahi hale lapaʻau. Pono e hoʻohui ʻia ka ʻāpana o ka hoʻokele olakino. Hoʻopuka kēia i ka manaʻo o nā hanana maikaʻi ʻole, i kapa ʻia ʻo nā hanana ʻino. ʻO ka wehewehe maʻamau o kahi hanana ʻino ka pōʻino i manaʻo ʻole ʻia i nā maʻi i lawe ʻia e ka lāʻau lapaʻau ma mua o ko lākou maʻi lalo. Ua loaʻa kēia wehewehe i ka ʻae honua ma kekahi ʻano a i ʻole. No ka laʻana, ma Australia, ua wehewehe ʻia ka huaʻōlelo o nā hanana i ka hopena i loaʻa ai ka pōʻino i ke kanaka e mālama i ke olakino. Aia kēia mau mea i nā ma'i, nā hā'ule hō'eha, a me nā pilikia me nā lā'au lapa'au a me nā lako lā'au. Hiki ke pale ʻia kekahi mau hanana maikaʻi ʻole.

Nā ʻano maʻamau o nā hewa lapaʻau

ʻO ka pilikia wale nō me kēia manaʻo, ʻaʻole i hiki mai nā mea maikaʻi ʻole a pau me ka manaʻo. Ma muli o ka pōmaikaʻi hope loa o ka mea maʻi, hiki mai ka hopena i manaʻo ʻia akā ʻae ʻia. I ka wā o ka chemotherapy, ʻelua mau hiʻohiʻona ka nausea a me ka poho lauoho. I kēia manawa, ʻo ka hōʻole ʻana i ka lāʻau i ʻōlelo ʻia ʻo ia wale nō ke ala kūpono e pale ai i ka hopena maikaʻi ʻole. Ua hōʻea mākou i ka manaʻo o nā hanana ʻino hiki ke pale ʻia a hiki ʻole ke pale ʻia ke hoʻomaʻamaʻa hou mākou i kā mākou wehewehe. ʻAʻole maʻalahi ka hoʻokaʻawale ʻana i kahi koho e ʻae i hoʻokahi hopena ke hoʻoholo ʻia e hiki mai kahi hopena maikaʻi i ka manawa like. Akā ʻaʻole ʻo ke kumu wale nō he kumu. (Pūnaehana palekana maʻi, 2016, para.3) ʻO kekahi laʻana o ka hewa i hoʻolālā ʻia, ʻo ia ka ʻoki ʻana i ka wāwae ʻākau ma muli o kahi maʻi maʻi ma ka lima hema, ʻo ia ka ʻae ʻana i kahi hanana maikaʻi ʻole i ʻike ʻia a wānana ʻia me ka manaʻolana o kahi hopena maikaʻi kahi i ala ʻole ai ma mua. ʻAʻohe mea hōʻike e kākoʻo i ka kali ʻana i kahi hopena maikaʻi.

ʻO nā hewa lapaʻau e hōʻeha i ka mea maʻi ke kumu o kā mākou noiʻi. Eia nō naʻe, hiki a hiki ke hana hewa nā lāʻau lapaʻau inā ʻaʻole hōʻeha ʻia ka mea maʻi. ʻO ka hiki ʻana mai o nā hala kokoke hiki ke hāʻawi i ka ʻikepili koʻikoʻi i ka wā e hoʻolālā ai pehea e hōʻemi ai i nā hewa lapaʻau i loko o kahi hale mālama olakino. Eia nō naʻe, pono e noiʻi ʻia ka pinepine o kēia mau hanana i hoʻohālikelike ʻia me nā kauka lapaʻau pinepine. ʻO nā pōʻino kokoke i nā hewa lapaʻau i hiki ke hōʻeha i ka mea maʻi, ʻoiai inā e hana maikaʻi ana ka mea maʻi. (Martinez et al., 2017) No ke aha ʻoe e ʻae ai i kahi mea hiki ke hopena i ka hoʻopiʻi kānāwai? E noʻonoʻo i ke ʻano o kahi kahu hānai, no kēlā me kēia kumu, ke nānā wale nei i nā kiʻi o nā lāʻau like ʻole a kokoke e hāʻawi i kahi lāʻau lapaʻau. Aia paha kekahi mea i loko o kona hoʻomanaʻo, a ua hoʻoholo ʻo ia ʻaʻole pēlā ke ʻano o ka lāʻau lapaʻau kikoʻī. Ma ka nānā ʻana, ʻike ʻo ia ua hāʻawi ʻia nā lāʻau lapaʻau hewa. Ma hope o ka nānā ʻana i nā pepa a pau, hoʻoponopono ʻo ia i ka hewa a hāʻawi i ka mea maʻi i ka palapala kuhikuhi kūpono. Hiki paha ke pale i ka hewa i ka wā e hiki mai ana inā loaʻa nā kiʻi o ka lāʻau kūpono i ka moʻolelo hoʻokele? He mea maʻalahi ke poina i ka hewa a me ka manawa e pōʻino ai. He ʻoiaʻiʻo nō kēlā ʻoiaʻiʻo inā paha ua laki mākou i ka loaʻa ʻana i ka manawa a i ʻole e loaʻa i nā hopena maikaʻi ʻole.

Nā hewa o nā hopena a me ka hana

Pono mākou i ka ʻikepili piha no ka hoʻomohala ʻana i nā mea e hoʻomaikaʻi ai i ka palekana o ka maʻi a hoʻemi i nā hewa lapaʻau. Ma ka liʻiliʻi loa, i ka wā o ka mea maʻi i loko o kahi keʻena lapaʻau, pono e hōʻike ʻia nā mea a pau e hiki ke hana i mea e pale aku ai i ka pōʻino a hoʻokomo iā lākou i ka pōʻino. Ua hoʻoholo ka nui o nā kauka i ka hoʻohana ʻana i nā huaʻōlelo hewa a me nā hanana ʻino i ʻoi aku ka laulā a kūpono ma hope o ka nānā ʻana i nā hewa a me nā hanana ʻino i ka mālama olakino a kūkākūkā i ko lākou mau ikaika a me nā nāwaliwali i ka makahiki 2003. ʻO kēia wehewehe hui e hoʻonui i ka hōʻiliʻili ʻikepili, me nā hewa, nā kelepona kokoke, kokoke. nalo, a hana hewa a huna. Eia kekahi, ʻo ka huaʻōlelo o nā hanana ʻino e pili ana i nā huaʻōlelo i hōʻike pinepine ʻia i ka pōʻino o ka maʻi, e like me ka hōʻeha olakino a me ka ʻeha iatrogenic. ʻO ka mea wale nō i koe e hoʻoholo inā he kino kūpono ka papa loiloi e mālama i ka hoʻokaʻawale ʻana i nā hanana ʻino a hiki ʻole ke pale ʻia.

ʻO kahi hanana kiaʻi he hanana kahi e pono ai ka hōʻike ʻana i ke Komisina Hui Pū ʻIa. Ua ʻōlelo ke Kōmike Hui he hanana i manaʻo ʻole ʻia kahi hanana kiaʻi e pili ana i kahi hōʻeha kino a i ʻole noʻonoʻo. (“Sentinel Events,” 2004, p.35) ʻAʻohe koho, no ka mea, pono e kākau ʻia. ʻO ka hapa nui o nā keʻena mālama ola, akā naʻe, mālama lākou i kā lākou mau moʻolelo e hōʻike ana i nā hanana sentinel a me nā mea e hana ai inā loaʻa kahi mea e hōʻoiaʻiʻo ai ua hoʻokō ʻia nā kūlana o ke Komisina Hui. ʻO kēia kekahi o kēlā mau kūlana i ʻoi aku ka maikaʻi o ka palekana ma mua o ka minamina. No ka mea ʻo ka "koʻikoʻi" kahi manaʻo pili, aia paha kekahi lumi wriggle i ka wā e pale aku ai i kahi hoa hana a mea hana paha. Ma kekahi ʻaoʻao, ʻoi aku ka maikaʻi o ka hōʻike hewa ʻana i kahi hanana kiaʻi ma mua o ka hōʻike ʻole ʻana i kahi hanana kiaʻi. ʻO ka hōʻole ʻole ʻana e hiki ke loaʻa nā hopena koʻikoʻi, me ka hoʻopau ʻana i ka ʻoihana.

I ka noʻonoʻo ʻana i nā hewa lapaʻau, hana hewa pinepine ka poʻe i ka nānā ʻana i nā hewa kuhikuhi. ʻAʻole kānalua pinepine nā hewa o ka lāʻau lapaʻau a pili i nā hemahema o ke kaʻina hana like me nā hewa lapaʻau ʻē aʻe. ʻO nā haʻihaʻi ma ke kamaʻilio ʻana, nā hewa i hana ʻia i ka wā o ke kau ʻana a i ʻole ka hāʻawi ʻana, a me nā mea ʻē aʻe he nui. Akā, e kuhi hewa ana mākou i ka hihia inā manaʻo mākou ʻo nā hewa lāʻau wale nō ke kumu o ka pōʻino i ka mea maʻi. ʻO kahi paʻakikī nui i ka hoʻokaʻawale ʻana i nā hewa lapaʻau like ʻole e hoʻoholo inā e hoʻokaʻawale i ka hewa e pili ana i ke kaʻina hana a i ʻole ka hopena. Ua ʻae ʻia ka nānā ʻana i kēlā mau hoʻokaʻawale ʻana ma ʻaneʻi, no ka mea, ua nui nā hoʻāʻo ʻana e hoʻomohala i nā wehewehe hana e hoʻopili ai i ke kaʻina hana a me ka hopena, ʻo ka nui o ia mau mea i hoʻokumu ʻia ma ka hana a Lucian Leape mai nā makahiki 1990.

Hoʻonui i kou nohona i kēia lā- Video

Nānā & Kāohi ʻana i nā hewa Lapaʻau

ʻO ka operative a me ka nonoperative nā ʻāpana nui ʻelua o nā hanana ʻino i ʻike ʻia e Leape a me kāna mau hoa hana ma kēia haʻawina. (Leape et al., 1991) Loaʻa nā pilikia o ka hana i nā maʻi ʻeha, nā hemahema o ke kaʻina hana, nā pilikia ʻole o ka ʻenehana, nā pilikia lohi, a me nā pilikia ʻenehana. ʻAʻole hana: nā poʻomanaʻo e like me ka lāʻau lapaʻau, misdiagnosed, hana ʻino ʻia, pili i ke kaʻina hana, hāʻule, haʻihaʻi, postpartum, anesthesia-related, neonatal, a me kahi poʻomanaʻo hopu-a pau o ka ʻōnaehana i hoʻokomo ʻia ma lalo o kēia ʻano o nā hanana ʻino. Ua hoʻokaʻawale ʻo Leape i nā hewa ma ke kuhikuhi ʻana i ke kiko o ke kaʻina hana. Ua hoʻokaʻawale ʻo ia i kēia mau poʻomanaʻo i ʻelima mau poʻomanaʻo, ʻo ia hoʻi:

System
Auana
Nā Waʻakino Drug
PalekanaEND_LINK
ʻĀneke

Nui nā hewa hana i hāʻule ma lalo o hoʻokahi kumuhana, akā kōkua lākou a pau e kuhikuhi i ke kumu kūpono o ka pilikia. Inā ʻoi aku ma mua o hoʻokahi kauka i hana i ka hoʻoholo ʻana i nā wahi kikoʻī e pono ai ka hoʻomaikaʻi ʻana, a laila pono ke nīnau hou ʻia.

Ma keʻano loea, hiki ke hana i kahi hewa lapaʻau e kekahi limahana ma kahi haukapila. ʻAʻole i kaupalena ʻia i nā ʻoihana lapaʻau e like me nā kauka a me nā kahu hānai. Hiki i ka luna ho'oponopono ke wehe i ka puka, a i 'ole e waiho 'ia e ka hui ho'oma'ema'e kekahi mea kemika i loko o ka lima o ke keiki. ʻO ka mea nui aʻe ma mua o ka ʻike o ka mea nāna i hana i ka hewa ke kumu ma hope o ia. He aha ma mua? A pehea mākou e hōʻoia ai ʻaʻole e hana hou ʻia? Ma hope o ka hōʻiliʻili ʻana i nā ʻikepili i luna a me nā mea hou aʻe, ʻo ia ka manawa e noʻonoʻo ai pehea e pale ai i nā hewa like. No nā hanana kiaʻi, ua kauoha ka Hui Hui mai ka makahiki 1997 e hana kēia mau hanana āpau i kahi kaʻina i kapa ʻia ʻo Root Cause Analysis (RCA). Eia naʻe, pono e hoʻoponopono ʻia ka hoʻohana ʻana i kēia kaʻina hana no nā hanana e pono e hōʻike ʻia i nā ʻaoʻao o waho.

He aha ke kumu o ke kumu kumu?

"Ua hopu ʻo RCA i nā kikoʻī a me ka hiʻohiʻona kiʻi nui." Hoʻomaʻamaʻa lākou i nā ʻōnaehana loiloi, ka nānā ʻana inā pono ka hana hoʻoponopono, a me ka nānā ʻana i nā ʻano. (Williams, 2001) He aha ka RCA, akā? Ma ka nānā ʻana i nā hanana i alakaʻi i ka hewa, hiki i kahi RCA ke nānā aku i nā hanana a me nā kaʻina hana ma mua o ka nānā ʻana a i ʻole ka hoʻopiʻi ʻana i nā poʻe kikoʻī. (AHRQ,2017) ʻO ia ke kumu nui loa. Hoʻohana pinepine kahi RCA i kahi mea hana i kapa ʻia ʻo Five Whys. ʻO kēia ke kaʻina o ka nīnau mau ʻana iā ʻoe iho "no ke aha" ma hope o kou manaʻo ua hoʻoholo ʻoe i ke kumu o kahi pilikia.

ʻO ke kumu i kapa ʻia ai ʻo "ʻelima kumu" no ka mea, ʻoiai ʻo ka ʻelima kahi kumu hoʻomaka maikaʻi loa, pono ʻoe e nīnau mau i ke kumu a hiki i kou ʻike ʻana i ke kumu kumu o ka pilikia. Ke nīnau pinepine nei i ke kumu e hōʻike pinepine ai i nā hewa kaʻina hana ma nā pae like ʻole, akā pono ʻoe e nīnau i ke kumu e pili ana i kēlā me kēia ʻaoʻao o ka pilikia a hiki i ka pau ʻana o nā mea ʻē aʻe i hiki ke hoʻoponopono ʻia e hāʻawi i kahi hopena i makemake ʻia. Eia nō naʻe, hiki ke hoʻohana ʻia nā mea hana ʻē aʻe ma waho o kēia i ka hoʻokolokolo kumu kumu. Nui nā mea ʻē aʻe. Pono nā RCA he multidisciplinary a kūpaʻa a hoʻopili i nā ʻaoʻao a pau i komo i ka hewa e pale i ka hoʻomaopopo ʻole a i ʻole ka hōʻike pololei ʻana i nā hanana.

Panina

ʻO nā hewa lāʻau lapaʻau i loko o nā keʻena mālama ola he mau hanana a ʻaʻole i hōʻike ʻia e hoʻoweliweli koʻikoʻi i ke olakino o nā maʻi. A hiki i ka hapaha miliona o ka poʻe i manaʻo ʻia e hala i kēlā me kēia makahiki ma muli o nā hewa o ka lāʻau lapaʻau. ʻAʻole ʻae ʻia kēia mau helu helu i ka manawa i manaʻo ʻia ʻo ka palekana maʻi ka mea nui, akā ʻaʻole nui ka hana e hoʻololi i nā hana. Inā ʻike pololei ʻia nā hewa o ka lāʻau lapaʻau a ʻike ʻia ke kumu kumu o ka pilikia me ka ʻole o ka hoʻopiʻi ʻana i nā limahana kūikawā, ʻaʻole pono kēia. Hiki ke hana ʻia nā hoʻololi koʻikoʻi ke ʻike pololei ʻia nā kumu kumu o ka ʻōnaehana a i ʻole ka hana hewa. ʻO kahi ʻano like ʻole, multidisciplinary i ka loiloi kumu kumu e hoʻohana ana i nā ʻōhua e like me nā kumu ʻelima e ʻimi ai a hiki i ka hōʻike ʻia ʻana o nā pilikia a me nā hemahema he mea kōkua. ʻOiai he mea pono ia i kēia manawa no ka hoʻomaka ʻana o nā hanana kiaʻi, hiki ke hoʻopili ʻia ka Root Cause Analysis i nā kumu kuhi hewa a pau, me nā hala kokoke.

E hoʻomaopopo '

'Oihana no ka Noi'i a me ka Pono. (2016). Hoʻolāʻau kumu kumu. Kiʻi ʻia i Malaki 20, 2017, mai psnet.ahrq.gov/primer/root-cause-analysis

Grober, ED, & Bohnen, JM (2005). Ka wehewehe ʻana i ka hewa lapaʻau. Hiki iā J Surg, 48(1), 39-44. www.ncbi.nlm.nih.gov/pubmed/15757035

Kohn, LT, Corrigan, J., Donaldson, MS, & Institute of Medicine (US). Komite no ka maikaʻi o ka mālama ola kino ma ʻAmelika. (2000). He kanaka ka hewa: ke kūkulu ʻana i kahi ʻōnaehana olakino palekana. ʻO ka National Academy Press. books.nap.edu/books/0309068371/html/index.html

Leape, LL, Brennan, TA, Laird, N., Lawthers, AG, Localio, AR, Barnes, BA, Hebert, L., Newhouse, JP, Weiler, PC, & Hiatt, H. (1991). ʻO keʻano o nā hananaʻino i nā maʻi maʻi. Nā hopena o ka Harvard Medical Practice Study II. N Engl J Med, 324(6), 377-384. doi.org/10.1056/NEJM199102073240605

Lippincott ® NursingCenter ®. Kahuna Hanai. (2004). www.nursingcenter.com/pdfjournal?AID=531210&an=00152193-200411000-00038&Journal_ID=54016&Issue_ID=531132

Martinez, W., Lehmann, LS, Hu, YY, Desai, SP, & Shapiro, J. (2017). Nā Kaʻina hana no ka ʻike ʻana a me ka nānā ʻana i nā hanana pōʻino a me nā hala kokoke i kahi hale hoʻonaʻauao kula. Jt Comm J Qual Hoomanawanui Saf, 43(1), 5-15. doi.org/10.1016/j.jcjq.2016.11.001

Pūnaehana palekana maʻi. (2016). Nā hanana pōʻino, kokoke hala, a me nā hewa. Kiʻi ʻia i Malaki 20, 2017, mai psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors

Williams, PM (2001). Nā ʻenehana no ka nānā ʻana i ke kumu kumu. Proc (Bayl Univ Med Cent), 14(2), 154-157. doi.org/10.1080/08998280.2001.11927753

Akahana

Spinal Stenosis MRI: Back Clinic Chiropractor

by Kauka Alex Jimenez | Kiʻi & Diagnostics, Ka mālama Spine

ʻO ka stenosis spinal ka wā e hoʻomaka ai ka haʻikiʻi o kahi ākea ma kahi a i ʻole ma loko o ke kuamoʻo, e pani ana i ka hiki o ka neʻe maʻamau/ʻoluʻolu a me ke kahe ʻana o ke aʻalolo. Hiki ke hoʻopili i nā wahi like ʻole, me ka ʻehaʻeha / ʻāʻī, lumbar/haʻahaʻa kua, a me ka mea maʻamau, ʻo ka ʻōpū/luna a i ʻole waena waena. ʻo ke kani ʻana, ka ʻūhā, ka ʻūhā, ka ʻeha, ka nāwaliwali o ka ʻiʻo, a i ʻole ka hui pū ʻana o ke kua, ka wāwae, ka ʻūhā, a me ka ʻāʻī. Hiki i nā kumu like ʻole ke kumu o ka stenosis; ʻO ka hoʻomaʻamaʻa pololei ʻana ka hana mua, a ma kahi o ka spinal stenosis MRI komo mai.

Spinal Stenosis MRI

Hiki ke paʻakikī ka Stenosis i ka hoʻomaʻamaʻa ʻana no ka mea ʻoi aku ka nui o kahi hōʻailona / hoʻopiʻi ma mua o kahi kūlana, pinepine ʻia e nā disc herniated, nā iwi iwi, kahi maʻi congenital, post-surgery, a i ʻole ma hope o kahi maʻi. He ho'āʻo maʻamau ka hoʻomaʻamaʻa maʻamau i hoʻohana ʻia i ka maʻi maʻi.

ʻike,

E hoʻomaka ka ʻoihana mālama ola kino, e like me ke chiropractor, ka lāʻau lapaʻau kino, ka spine specialist, a i ʻole ke kauka, me ka hoʻomaopopo ʻana i nā hōʻailona a me ka mōʻaukala olakino.
E mālama ʻia kahi hoʻokolohua kino e aʻo hou e pili ana i ka wahi, ka lōʻihi, nā kūlana, a i ʻole nā hana e hōʻemi a hoʻonui paha i nā hōʻailona.
Loaʻa nā hoʻokolohua hou aku ikaika o ka ʻiʻo, loaʻa ka nānā ʻana, a me ka hoʻāʻo kaulike e kōkua i ka hoʻomaopopo maikaʻi ʻana i kahi e hele mai ai ka ʻeha.
No ka hōʻoia ʻana i kahi hōʻoia, pono ke kiʻi ʻana e ʻike i ka mea e hana nei.
Hoʻohana ʻia kahi MRI kiʻi hana kamepiula e hana i nā kiʻi e hōʻike ana i nā iwi a me nā ʻiʻo palupalu, e like me nā ʻiʻo, nā aʻalolo, a me nā ʻiʻo, a inā ua hoʻopaʻa ʻia a hoʻonāukiuki paha.
He limahana mālama ola a ʻOihana ʻĀina MRI e hele ma luna o nā koi palekana ma mua o ke kiʻi.
Ma muli o ka hoʻohana ʻana o ka mīkini i nā magnet ikaika, ʻaʻohe metala ma luna a i loko o ke kino, e like me nā prostheses i hoʻokomo ʻia a i ʻole nā mea hana e komo pū ana:
ʻO Pacemakers
Hoʻoponoponoʻia nā pale
ʻO nā pāpaʻi infusion lāʻau
ʻO nā mea hoʻopalekana intrauterine
Nā mea hoʻoikaika kino
Nā kiʻi aneurysm Intracranial
Nā mea hoʻoulu iwi
Hiki ke hoʻohana ʻia kahi hoʻāʻo kiʻi ʻokoʻa inā ʻaʻole hiki i ke kanaka ke loaʻa i kahi MRI like a C scan.

Hiki ke loaʻa kahi MRI mai kekahi mau minuke a i hoʻokahi hola a lōʻihi paha, e pili ana i ka nui o nā kūlana e pono ai e hoʻokaʻawale i ka wahi i ʻeha a loaʻa i kahi kiʻi maopopo. ʻAʻole ʻeha ka hoʻāʻo, akā i kekahi manawa e noi ʻia nā kānaka e mālama i kahi kūlana kikoʻī i hiki ke hōʻoluʻolu. E nīnau ka technician inā loaʻa ka pilikia a hāʻawi i kekahi kōkua e hana i ka ʻike maʻalahi.

lapaʻau

ʻAʻole nā maʻi āpau o ka stenosis ke kumu o nā hōʻailona, akā aia nā koho lapaʻau e hiki i ke kauka lapaʻau ke ʻōlelo aku.

ʻO ka mālama Conservative ka ʻōlelo mua e pili ana i ka chiropractic, decompression, traction, a me ka hoʻōla kino.
Hoʻonui ka lapaʻau i ka ikaika o ka ʻiʻo, hoʻomaikaʻi i ke ʻano o ka neʻe ʻana, hoʻomaikaʻi i ke kūlana a me ke kaulike, hoʻemi i nā hōʻailona hōʻoluʻolu, a hoʻokomo i nā hoʻolālā e pale a mālama i nā hōʻailona.
Hiki i nā lāʻau lapaʻau ke lilo i ʻāpana o kahi hoʻolālā lapaʻau nui aʻe.
Hiki ke lilo ke ʻokiʻoki i koho i nā hihia koʻikoʻi ʻoi aku ka hana ʻole o ka mālama conservative.

ʻO Spinal Stenosis

E hoʻomaopopo '

ʻIkepili o nā hōʻike manaʻo o nā hopena (DARE): Nā Manaʻo loiloi maikaʻi [Internet]. York (UK): Center for Reviews and Dissemination (UK); 1995-. ʻO ka hōʻailona o ka lumbar spinal stenosis: kahi hōʻano hou o ka loiloi hou o ka pololei o nā hoʻokolohua diagnostics. 2013. Loaʻa mai: www.ncbi.nlm.nih.gov/books/NBK142906/

Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Hoʻohou 2022 Mei 8]. Ma: StatPearls [Internet]. Waiwai Waiwai (FL): StatPearls Publishing; 2022 Ian-. Loaʻa mai: www.ncbi.nlm.nih.gov/books/NBK551669/

ʻO Gofur EM, Singh P. Anatomy, Kua, Vertebral Canal Hoolako Koko. [Hoʻohou 2021 Iulai 26]. Ma: StatPearls [Internet]. Waiwai Waiwai (FL): StatPearls Publishing; 2022 Ian-. Loaʻa mai: www.ncbi.nlm.nih.gov/books/NBK541083/

Lurie, Jon, a me Christy Tomkins-Lane. "Ka mālama ʻana i ka stenosis spinal lumbar." BMJ (Clinical research ed.) vol. 352 h6234. 4 Ian. 2016, doi:10.1136/bmj.h6234

Stuber, Kent, et al. "Hoʻomaʻamaʻa Chiropractic o lumbar spinal stenosis: kahi loiloi o ka palapala." Nūpepa o ka lāʻau lapaʻau chiropractic vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001

Nā Manaʻo Spinal Imaging Back Pain

by Kauka Alex Jimenez | Kiʻi & Diagnostics

Hoʻohana nā Chiropractors a me nā loea spine i ke kiʻi spinal ma o nā X-ray, MRI, a i ʻole CT scans e ʻike ai i ke kumu o ka pilikia a me ka ʻeha. He mea maʻamau ke kiʻi kiʻi. Inā ʻo ka chiropractic a i ʻole ka spinal surgery, kōkua lākou i ka ʻike nui ʻana i nā pilikia hope a ʻae i ke kanaka e ʻike i ka mea e hana nei. Aia nā ʻano hihia ʻeha hope kēlā:

Hele mai trauma
Ua lōʻihi no ʻehā a ʻeono pule
Ua hele pū ʻia me kahi moʻolelo o:
Cancer
kuni
Nā pōmele pō

Hoʻohana nā kauka i kēia mau kiʻi i ka wā ka ʻike ʻana i kahi maʻi iwi kuamoʻo. Eia kekahi ʻike i ke kiʻi spinal.

Nā kaumākū X

Hiki ke kōkua nui i nā kukui X no ka ʻeha hope. He Hoʻohana ʻia ka X-ray no ka nānā ʻana i nā kūlana o nā iwi. ʻO nā kukui X ka mea maikaʻi loa no ka ʻiʻo iwi a i ʻole nā ʻiʻo i hoʻoheheʻe ʻia a i hoʻopaʻa ʻia paha. Hana maikaʻi lākou me nā ʻiʻo paʻakikī, ʻoi aku ka iwi. ʻAʻole ʻike ʻia nā ʻiʻo palupalu e like me nā ʻiʻo, nā ligaments, a i ʻole nā ʻāpana intravertebral.

E nānā ʻia ka poʻe e hoʻopaʻa ana i ka X-ray hope e kahi mīkini e hoʻohua ai i ke kukui. Hoʻopaʻa inoa ka mea hoʻokipa i ke kukui ma hope o ka hele ʻana i loko o ke kino a hana i kahi kiʻi. Ma kahi o ʻelima mau minuke e hoʻopau ai akā hiki ke lōʻihi ma muli o ka helu o nā kiʻi o ke kauka. He mea kōkua ka X-ray no ka ʻinikua a hoʻokuʻu i nā kūlana iwi e like me ka haʻi ʻana a me/a i ʻole nā iwi iwi. Ua kauoha ʻia nā kukui X no nā kumu kikoʻī a he ʻāpana pinepine ia o kahi noiʻi diagnostic kino holoʻokoʻa. Loaʻa kēia i ka MRI a / a i ʻole CT scan.

Kāleka CT

ʻO CT ke kū nei kaomi kikowaena huaʻōlelo. He ʻano ia o nā hihi X i hoʻopaʻa ʻia i nā kiʻi me ka hoʻohana ʻana i ke kamepiula. ʻO ka maikaʻi o ka CT scan i nā kukui X maʻamau, ʻo ia ka hāʻawi ʻana i nā manaʻo ʻokoʻa / nā kihi o ke kino a hiki i ke 3D. Hoʻohana pinepine ʻia nā CT scans i nā hihia trauma a i ʻole ka poʻe i loaʻa i ke ʻoki. Lawe lākou ma kahi o ʻelima mau minuke. No nā kukui X, kū i luna a moe paha nā kānaka ma lalo o ka mīkini X-ray i kona nānā ʻana i ke kino. Ma kahi CT scan e moe ke kanaka i lalo i loko o ka mīkini ʻike donut pōʻai e nānā ana i ka wā e kahuli ana i ka wā o ke kiʻi. Paipai ʻia kēlā me kēia kanaka e komo i nā lole ʻoluʻolu a me ka ʻoluʻolu. I kekahi manawa hoʻohana ʻia ka wai kala, a i ʻole intravenous contrast, i mea e kū ai nā ʻiʻo vascular, e hana ana i nā kiʻi maʻemaʻe.

MRI

He pōkole ka MRI kiʻi hoʻopaneʻe magnetic. Hoʻohana nā MRI i nā magnet e hana i nā kiʻi. Hoʻohana pinepine ʻia ke kiʻi MRI i nā poʻe i hana i ka ʻoki. ʻOi aku ka lōʻihi, ma kahi o 30 a 45 mau minuke. ʻAʻole ʻae ʻia nā mea metala ma ka MRI. Noi ʻia nā mea maʻi e wehe i nā mea e like me nā kāʻei, nā mea nani, etc. Hiki ke lilo ke kala hoʻohālikelike i ʻāpana o ka MRI. Ua like ka mīkini me kahi tunnel. Hiki i kēia ke lilo i mea paʻakikī no nā poʻe me ka claustrophobia. E kūkākūkā me ke kauka a e ʻike pehea e ʻoluʻolu ai i ka wā o ke kaʻina hana.

Nā ʻano ʻē aʻe o ke kiʻi spinal

ʻO nā ʻano ʻano kiʻi ʻē aʻe:

Hoʻokele CT

Hōʻike ka hoʻokele CT i nā scan CT manawa maoli i ka wā o ke kaʻina hana.

ʻOhana

Hoʻopili ka Fluoroscopy i kahi kukuna X-ray e hele pololei ana ma ke kino e hōʻike ana i nā kiʻi ola a neʻe.

Hoʻohana ʻia kēia mau ʻano kiʻi spinal ʻelua i ka wā o nā ʻoki. No kekahi mau hihia, kiʻi intraoperative hoʻohana ʻia. Ke hoʻohana nei kēia ʻano kiʻi kiʻi i nā robotics kiʻekiʻe e kōkua i nā poʻe kaukō e hoʻokele i nā wahi paʻa i ka wā o ke kaʻina hana. Hoʻonui kēia i ka pololei o ke kauā a hoʻemi i ka nui o ka ʻoki.

'Ohanahana

Hiki ke hoʻohana ʻia ke kani ultrasound no nā kūlana spinal. He ho'āʻo kiʻi kēia e hoʻohana ana i nā nalu kani e hana i nā kiʻi. Eia naʻe, ʻo nā hoʻāʻo kiʻi i hoʻohana ʻia i ke kiʻi spinal ʻo ia ka X-ray a me MRI.

Koho Kii

E kamaʻilio me kāu kauka a chiropractor ma mua o ka manawa e hoʻomaopopo i ka mea e manaʻo ai i ka wā o ke kaʻina hana kiʻi. Na lākou e hōʻike iā ʻoe pehea e hoʻomākaukau ai a me nā ʻōlelo kuhikuhi kūikawā ma mua o ke koho ʻana. Me ka mōʻaukala olakino a me ka hoʻokolokolo kino, ʻo ka spinal imaging kahi ʻāpana koʻikoʻi o ke kaʻina diagnostic e ʻike ai i ke kumu o ka ʻeha a hoʻomohala i ka hoʻolālā lapaʻau maikaʻi loa.

Hui Hui

Nā hopena pōkole o ke kofe a me ke koko

ʻO ka caffeine i loko o ke kofe he mea hoʻoulu a mea hoʻonanea paha i nā ʻōnaehana o ke kino. Ke ʻai ʻia ka caffeine, ʻike ka poʻe i ka piʻi ʻana o ka hauʻoli, ʻo ia hoʻi i ka ʻōnaehana cardiovascular. Hoʻonui kēia hauʻoli i ka piʻi ʻana o ka puʻuwai a me ke kahe koko a hoʻi i lalo i kahi pae kumu no nā kānaka olakino. Hoʻonui iki ka kofe i ke koko no ka wā pōkole. He palekana ka ʻai ʻana i ka kofe no ka poʻe i loaʻa ʻole nā maʻi cardiovascular.

E hoʻomaopopo '

Komisina Hooponopono Nukelea o Amerika Huipuia. (Mei 2021) "Nā Doses in Our Daily Lives" www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

X-Ray no ka ʻeha hope: Nā Manaʻo o kēia manawa ma Musculoskeletal Medicine. (ʻApelila 2009) "He aha ke kuleana o ke kiʻi kiʻi i ka ʻeha haʻahaʻa haʻahaʻa?" www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/

Nā Kōkua Hoʻonaʻauao Pediatric Diagnostic Imaging Hoʻokokoke | El Paso, TX.

by Kauka Alex Jimenez | Kiʻi & Diagnostics

He hōʻikeʻano pokole kēia no kekahi o nā hoʻopiʻi kūpono o ka pediatric i loaʻa i kaʻoihana o ka lāʻau.
ʻO ke kahumaʻa nui me ke kahe poʻo poʻo
ʻO ka hana maʻamauʻole i nā keiki (keiki paʻakikī)
Nā Pahūpili Musculoskeletal (ʻAi'Apopathicis Juvenile, scoliosis,
ʻO nā neoplasma pediatric maʻamau (CNS & me nā mea ʻē aʻe)
Hoʻoponopono
ʻO ka maʻi maʻi

ʻO ka maʻi pediatric nui:

ʻO nā ʻeha FOOSH (e laʻa, hāʻule mai ka pahu monkey)
ʻO Supracondylar Fx, kuʻehiwi. Maikaʻi mau i ka ulia pōpilikia. <10-yo
Paʻa hou Fx
Ua hoʻokuʻu loaʻia nāʻili kūlana o Gartland i nāʻeha iʻole e mālama ponoʻia me kaʻoluʻoluʻole o ka'ā'ī.
Hoʻopilikia ka hopena o ka huliʻana i ka hopena inā pili ka mālama (Volkmann hana)
He mea koʻikoʻi ka hōʻike Radiological: hōʻailona peʻa a me ka hōʻailona momona momona o hope me ka laina humeral mua i kū ʻole i ka waena / 2/3 o Capitellum.

Fx piliʻole i ka pediatric:

ʻO ka hapa nui ma <10 yo Greenstick, Torus, Plastic aka Bowing deformity
ʻO keʻano o ka ho'ōla maikaʻi, mālamaʻia me ka mālamaʻole me ka immobilization
ʻO ke kīnā palika inā> 20-kekelē koi i ka hoʻēmi pani
Hiki ke hoʻomohala ʻia ka haʻi poʻo ping pong ma hope o ka ʻeha, ka hāʻawi ʻana i ka forceps a me nā pilikia o ka ʻeha hānau. Pono paha e loiloi ʻia e ka pediatric neurosurgeo.n

Nāʻanoʻeha o ka palahalaha kino o Salter-Harris
Kuhi like 1-slip. e like me ka hoʻopiʻiʻana i ka hopena o ka wahine. ʻO keʻano,ʻaʻole iʻikeʻia nā iwi haʻihaʻi
E hoʻokomo i ka 2-M / C me kaʻike maikaʻi
ʻO keʻano 3-intra-articular, no laila ke kū nei ka pilikia o ka'ōmua osteoarthritis a ke koi aku i kahi mālama mālama d / t paʻakikī
Kūkulu i ka 4-Fx ma nāʻaoʻao a pau e pili ana i nā kauka. ʻO ka'ōkuhi hewa a me ka pōkole lima
5ʻano-pinepineʻole he hōʻailona o kaʻoki'ākau maoli. ʻO ka poino prognosis d / t ka hōʻeha i kaʻeha a me ka palaʻino me ka limu o ka lālā
He mea koʻikoʻi kaʻike loiloi

ʻO ka hōʻeha kinoʻole (NAI) ma nā keiki

Loaʻa nāʻano likeʻole o ka hoʻomāʻewaʻewa keiki. Hiki ke hoʻopiliʻia ka maʻi ma muli o kaʻehaʻili o kaʻili i nā maʻiʻeha MSK a me nā pūnaewele e pili ana i nā iwi a me nāʻiʻo maʻemaʻe. He mea koʻikoʻi ke kiʻi a hiki ke hoʻomaopopo i nā hōʻailona hōʻailona e hoʻomanaʻo ana i nā mea lapaʻau a me ka hoʻolahaʻana i nā lawelawe mālama pale keiki a me nā keʻena e mālama i nā kānāwai e pili ana i ka hoʻomāinoino i ka lāʻau
I ke keiki kamaliʻi: Hiki ke hōʻike ʻia me ka hōʻailona CNS me ka haehae ʻana o ka naʻau liʻiliʻi a me ka hematoma subdural i hiki ke make. ʻO Retinal hemorrhaging pinepine ke kuhi. He mea koʻikoʻi ke poʻo CT.
Nā MSK Radiological Red Flags:
1) iwi nui Fx ma kahi keiki'ōpio (0-12 mo)
2) NĀ MĀKAHI MANAʻO FX: hikiʻole ke loaʻa i kahi pahuhopu / d pilikia. ʻO nā papahana likeʻole: hopu a pākaha i kahi keiki a kūke paha.
3) Nā Ui houʻia me nā hōʻailona hōʻano manawa likeʻole,ʻo ia hoʻi, nā mea hoʻoheheʻe iwi e hōʻike ana i ka hopena o ke kino maʻamau
4) Ke kihi Metaphseal Fx aka Ke kiko o ka Buke Fx, pinepine ka pathognomonic no NAI i nā keiki. Ke hanaʻia ka hopena o ka hopena i hoʻopilikiaʻia.
5)ʻO kaʻokiʻana o nā iwi lōʻihi i loko o ke keiki, he hiʻohiʻo hou nō ia o ka NAI.
Nāʻike'ē aʻe'ē aʻe o ka NAI. ʻO nā moʻolelo kuhihewa i hoʻolakoʻia e nā kahu / mālama. ʻAʻohe hōʻailona o nāʻona likeʻole me keʻano o ka hui me ka Osteogenesis Impfectfect or Rickets / osteomalacia etc.
NB Ke haʻi aku nei nā kahu o ke keiki i ka mōʻaukala e hōʻike nei i ka hāʻule a me nā ulia pōpilikia i loko o ka hale.
Hoʻomākala i ka hana hoʻomāinoino o nā keiki ma Illinois:
www2.illinois.gov/dcfs/safekids/reporting/pages/index.aspx

ʻO ka MSK Imaging Approach ma nā Pediatrics

ʻO ka Arthritis Juvenile Idiopathic (JIA)-e manaʻo ʻia ʻo M / C maʻi mau o ka wā kamaliʻi. ʻO Clinical Dx: ʻeha hui / pehu no 6-wiki a ʻoi aku paha i ke keiki <16-yo Nā ʻano like ʻole: He mea koʻikoʻi ʻo Dx Early e pale i nā pilikia lohi.
Nāʻano maʻamau o ka JIA:
1) Pauciarticular maʻi (40%)- m / c keʻano o JIA. ʻOi aku ka pilikia o nā kaikamāhine. Hōʻike ʻia e like me ka arthritis ma <4 ami: kuli, kuʻekuʻe wāwae, lima. Kohu. Hōʻike kēia ʻano i ka pilina kiʻekiʻe me ke komo ʻana o ka maka e like me ka iridocyclitis (25%) hiki ke alakaʻi i ka makapō. Nā Labs: RF-ve, ANA maikaʻi.
2) Ka maʻi Polyarticular (25%): RF-ve. Ua pilikia nui nā kamaliʻi. Hāʻawe i nā hui liʻiliʻi liʻiliʻi i nā maʻi liʻiliʻi a me nā hui nui
3) Keʻano pūnaewele o JIA (20%):ʻike pinepineʻia me ka hōʻikeʻike pūnaewele maikaʻi e like me nā fevers spiking, arthralgias, myalgias, lymphadeno [alanui, hepatosplenomegaly, polyserositis (pericardial / pleural volume). ʻO nā hiʻohiʻona Dx nui nā hiʻohiʻona'ōmaʻomaʻo maʻemaʻe ma luna o nā poʻo a me ke kumu. ʻO ka'ōnaehana System ka hemahema o ke komoʻana o ka lolo. ʻO nā hui likeʻole he kāpiliʻole e like me nāʻano'ē aʻe. No laila,ʻaʻole iʻike pinepineʻia ka lukuʻana

Kiʻi kiʻi ma JIA

Hoʻopiliʻia ka iwi o ka hui i ka hoʻohālua o ka hemololina patella / iwi i hoʻololiʻia DJD
ʻO nā kikī a me nā iwi lōʻihi i ka wēʻana o ke kino a me ka pōkole o ka lālā
ʻO ka DDx kekuli me ka wāwae: Hemophilic arthropathy Rx: DMARD.
Hiki i nā pilikia ke ulu i ka hoʻohuiʻiaʻana, ka uluʻana o ka uluʻana / lālā hapa, ka makapō, nā pilikia pilikino, ke kīnā.

ʻO ka hapa nui o nā maʻi maʻi'ōpiopio o nā keiki

Osteosarcoma (OSA) & Ewing's sarkoma (ES) o ka 1 st a me ka 2nd M / C kino'ākau poʻoʻole o ka'ōpiopio (kūmole ma 10-20 yo) Clinical: kaʻeha iwi, ka loliʻana o ka hana, ke kau mua o ka metastasis ma kahi o nā pulmonary mets. Kaumahaʻole i kaʻike
E noho pū paha ʻo Ewing me ka ʻeha o ka iwi, ke kuni a me ka ESR / CRP kiʻekiʻe e mimike ai i ka maʻi. ʻO ka Dx mua me ke kiʻi a me ka hoʻokalakupua koʻikoʻi.
Kiʻi o OSA & ES: x-ray, ukali ʻia e MRI, umauma CT, PET / CT. Ma nā x-ray: hiki i ka OSA ke hoʻopili i kekahi iwi akā ʻo ka hapa nui loa e like me ka iwi hakakā e hana ana i nā neoplasms e pili ana i ke kuli (50% mau hihia) keu hoʻi me ka osteoid e hana nei i kahi lesion huhū i ka metaphysis me ka speculate / sunburst periostitis & Codman triangle. Hoʻouka kaua palupalu.
Hiki iā ES ke hōʻike ma ka'āpana a hōʻike i ka'ōwili nui o ka pulupulu. He mea nui ka MRI e hōʻike i ka nui o ka iwi a me ka hoʻokūkū ST, MRI e koiʻia no ka hoʻolālāʻana
OSA & ES Rx: ʻO kahi hui pū ʻana o ke kaha ʻana, radiation, chemo. Hana ʻia nā ʻano hana hoʻopulapula ma kekahi mau hihia. Wānana maikaʻi ʻole inā ʻike lohi.

ʻO ke kiʻi ʻana o ka sarcoma o Ewing
Hoʻopauʻia ka iwi i mea e hihia ai
ʻO ka hopenaʻoluʻolu o ke kino a me ka lōʻihi
ʻO ka hopena o ka lōʻihi me ka laulā (ka'akike)
Hoʻoponoponoʻia o ka iwi maha (arrow arrow)
He diaphyseal maʻamau ka Lesion me kekahi hoʻonui metaphyseal
ʻIke ʻia ʻo Round cell tumor me Multiple Myeloma a me Lymphoma

Ka Noho Malikūʻana

Neuroblastoma (NBL) M/C ʻinoʻino o ka wā kamaliʻi. Loaʻa mai nā pūnaewele neural crest aka PNET tumors (eg, sympathetic ganglia). Loaʻa ka hapa nui i nā keiki <24-mahina. Hōʻike kekahi i ka wānana maikaʻi akā ʻoi aku ka 50% o nā maʻi me ka maʻi holomua. ʻO 70-80% i ka makahiki 18-mahina a ʻoi aku paha me ka metastasis kiʻekiʻe. Hiki ke ulu ka NBL ma ka adrenal medulla, sympathetic ganglia a me nā wahi ʻē aʻe. Hōʻike ʻia ma ke ʻano he nui o ka ʻōpū, luaʻi. > 50% ka 'eha iwi d/t metastasis. Ma ke kino: hoʻokolohua kino, labs, kiʻi kiʻi: pahu a me nā x-ray, CT ʻōpū a me ka umauma he mea koʻikoʻi iā Dx. Hiki ke kōkua ʻo MRI. Hiki i ka NBL ke hele i ka iwi po'o a ho'okomo i ka humuhumu me kahi hi'ohi'ona e like me ka pathological sutural diastasis.
Ka maʻi leukemia liʻiliʻi ʻo ka m / c kino o ka'ōpiopio. Hoʻomalohua: ka liʻiliʻi liʻiliʻi cell o ka iwi o ka iwi e hiki ai i kaʻeha o ka iwi a me nā kinai maʻamau'ē aʻe e like me ka anemia, thrombocytopenia, neutropenia a me nā pilikia e pili ana. Hiki i nā kinipuni Leukemic ke hoʻokomo i kekahi mau pūnaewele'ē aʻe, me CNS, splenen, iwi a me nāʻaoʻao'ē aʻe. Dx: CBC, nā kumuhana lactate dehydrogenase,ʻO ke kīʻo ka momona o ka momona o ka momona. Hiki i ke kiʻi ke kōkua akāʻaʻole pono i kaʻike. Ma luna o ka radiography, hiki i ka lekikemiki infiltration o ka iwi keʻikeʻia he mau huahana radiolucent i ka papa ulu ulu. Rx: ke kūkino a me ka hoʻopilikiaʻana i nā pilikia

Medulloblastoma: M / C kino CNS neoplasm ma nā keiki
Hoʻonuiʻia ka nui ma mua o 10-yo
Kahi M / C: nā mele a me ka hope
He pilikino ka hopena o ka PNETʻaʻole he glioma e like me ka mea i manaʻo muaʻia
MBL, a me Ependymoma a me ka CNS lymphoma, hiki ke alakaʻi i ka waihoʻana i nā metastasis ma o CSF a hōʻano hou i kahi hiʻona e likeʻole me nā pūpū CNS e hōʻike ana i ka pāpili i waho o ka CNS, m / c i ka iwi
50% o ka MBL loa loa
Inā hoʻomaka mua ka Dx a me ka lāʻau ma mua o ka metastasis,ʻo 5% ka makahiki ola olakino%
He mea koʻikoʻi ke kiʻi: E hoʻohanaʻia ka Csc ma kaʻikeʻana akāʻo ka MRI koho pono ka mea e hāʻawi hou i kahi loiloiʻoi aʻe o nā neuraxis holoʻokoʻa no ka metastasis.
Hōʻikeʻia ka MBL e like me heterogenous hypo, ka lehe me ka hyperintense ma luna o T1, T2 a me FLAIR scans (kiʻi kiʻekiʻe) inā e hoʻohālikelikeʻia i ka lolo o ka lolo. I ka manawa pinepine e hoʻokau i ka 4th ventricle me ka hydrocephalos obstructive. Hōʻike ka piko i ka hoʻonuiʻana i ka hoʻonuiʻana ma luna o T1 + C gad (ke kiʻi haʻahaʻa i lalo). E hoʻomohala i nā metastasis mai MBL me ka T1 + C e hoʻonui i nā leona ma kaʻaha

Nā Paʻi Pediatric Nui

I ka neonate / pēpē <1month: fever> 100.4 (38C) hiki ke hōʻike i ka maʻi bacteria a me kekahi maʻi maʻi viral. Hiki iā Strep B, Listeria, E. Coli ke alakaʻi i ka sepsis, meningitis. Hiki
I nā'ōpiopio'ōpio,ʻo Hemophilus ka pulupili type B (HIB) hiki ke alakaʻi i ka Epiglottitis he paʻakikī paʻakikī. Ke kōkua ka lāʻau lapaʻau i kēia manawa e ho'ēmi i ka helu o nā hihia o ka Epiglottitis a me nā maʻi o ka HIB'ē aʻe.
ʻO Parainfluenza a RSV paha hiki i ka huakino ke alakaʻi iā Croup aiʻole Laryngotracheobronchitis maʻi.
ʻO ka Epiglottitis a me ka Croup nā Dx o ke kālepa akāʻo ka AP a me ka'ā'ī leʻaleʻa āpau nā māmā-x kōkua nui
Hōʻike ʻo Epiglottitis me kahi hōʻailona umbthumb-- e kūlike me nā epiglottis mānoanoa d / t edig epiglottic. Hiki i kēia ke lilo i mea hoʻoweliweli e hōʻino nei i nā alaloa (luna hema)
Kuhi hiki ke hōʻike i kahi ―steeple sign a i ʻole “ʻōmole ʻōmole waina me ka hypopharynx distaced e like me ka hoʻonui ʻana o ke alaloa subglottic ma AP a me ka ʻāʻī o nā ʻāʻī x-ray (ʻākau ma luna)
ʻO ka'ōlohelohe o ka maʻi Hinaika (RSV) a me ka dianeza hiki ke alakaʻi i ka pneumonia viral i hiki ke loaʻa i nā pilikia pilikino i loko o nā keiki i kālaiʻoleʻia, nā'ōpio a me nā kamaliʻi me nā kuunaʻole. He mea nui ka CXR (ka hema)
ʻO ka pharyngitis Streptococcal me ka maʻi GABHS hiki ke alakaʻi i kekahi mau pilikia koʻikoʻi a lohi paha (e laʻa, Rheumatic fever)
Ke kuhi o Peritonsillar (ma luna'ākau) hiki ke ulu i kekahi mau pilikia a paʻakikī ma ka hoʻopiliʻana ma nā'ōlili lele ma ka'ā'ī e hiki ai ke hoʻolaha i loko o nā mokulele sublingual / submandibular (Ludwig Angina) i ka wā e pono ai e hoʻomaluʻia ka holoʻana o ke ea no ka'ōlelo edema
Hoʻomākaukauʻia ka pukaʻokoʻa retropharyngeal i ke ala e hiki ai ke alakaʻi i ka hoʻolahaʻana o ka maʻi ma o ka'ā'ī maʻamau maʻamau i loaʻa i ka necrotizing mediastinitis, ka maʻi Lemmier a me ka hoʻouka kauaʻana o nā mokulele (he mau mea hōʻeha ka hopena ola)
Ka maʻi Griesel- (ma lalo aʻe hema) ka pilikia nui o nā maʻi āpau āpau āpau āpau o ka'āpana o ka'āpana o ka'āina i hiki ke hoʻolaha i kahi ākea e hiki ai i ka C1-2 lixments lixity a me ke kūlana
ʻO nā maʻi'ē aʻe'ē aʻe iʻoi aku i nā keiki heʻano maʻi bacteria (Pneumococcal) ka nikonia, ka maʻi o ka Urinary a me ka Pyelonephritis Pute (especially in girls) and Meningococcal Meningitis

ʻO ka maʻi maʻi pediatric Metabolic
Nā Rickets: i manaʻoʻia he osteomalacia i loko o ka'ōlohelohe o ke kīhā. Hoʻopilikiaʻia ka lālā o ka hoʻopiliʻana i ka papahana epiphyseal
ʻO nā haʻawina hōʻailona me ka uluʻana o ka ulu, ka piko o ke kukui, ka rosary rachitic, ka umauma lūlū, nā pūpū kaumaha, nā lima ākea, a me nā wāwae, a me nā wāwae
ʻO ka pāʻana:ʻO ka Vit D a me ka meaʻole kūlohelohe ka mea m / c. ʻAʻoheʻike o ka lā esp. kaʻaʻahuʻeleʻele, ka lole palekana i kaʻike mālamalama, ka umaumaʻana i ka manawa, ka veganism, ka maʻi palbsorption o ka'ōpū, ka hewa nui a me nā mea'ē aʻe
ʻO ke kiʻi: nā mea iʻikeʻia i ka paʻiʻana i ka palahalaha me ka pālahalahaʻana, ka hoʻonuiʻana o ka pālahalaha ulu, ka hoʻolālā costochondral bulbous e like me ka rachitic rosary, ka piko kūlou
Rx: mālama i nā kumu kumuhana, kūponoʻaiʻole, a pēlā aku.

E hoʻomaopopo '

ʻO kaʻEdoma: Hoʻonāʻike kiʻi kiʻi | El Paso, TX.

by Kauka Alex Jimenez | Kiʻi & Diagnostics

Hiki ke hoʻohālikeʻia ka hōʻailona o nā maʻi o ka'ōpū i:
Nā meaʻino o ka ke kinaike tract (esophagus, ʻōpū, liʻiliʻi a me ka ʻōpū nui, a me ka pākuʻi)
Nā pono ʻole o nā mea kōkua digestive (Hepatobiliary & maʻi pancreatic)
Nā mea kūpono ʻole o nā genitourinary & nā mea hoʻohua
Nā meaʻino o ka paia a me nā moku nui
Ke manaʻo nei kēia hōʻike e hāʻawi i ka ʻike kumu loa o ka laulā ʻike kiʻi diagnost ka hoʻokokoke a me ka hoʻokele kino kūpono o nā maʻi me nā maʻi maʻamau o ka ʻōpū
Nā hoʻolālā kiʻi i hoʻohanaʻia i ka wā e hoʻokolokoloʻia ai nā'ōhumu kōpū:
ʻO ka'ōpana AP (KUB) a me ka CXR pololei
ʻO ka'Abdominal CT scanning (me ka waha a me ka IV a me ka w / o keʻano likeʻole)
Ke aʻo haʻawina kiʻekiʻeʻo GI Barium
ʻO ke kamepiula
MRI (hoʻohana nuiʻia e like me MRI MRI)
ʻO MRI enterography & enteroclysis
MRI kuhi
Endoscopic Retrograde Cholangiopancreatography (ERCP) - ka nui o nā maʻi hepatobiliary a me nā pancreatic ductal
Nuʻukia Nuclear

No ke aha i koho ai i kahi'oniuma Abdominal X?

E hoʻokomo i kahi loiloi mua o ke kinoea ʻōpū i kahi kūlana e puka mai ana. No ka laʻana, hiki i kahi haʻawina maikaʻi ʻole i kahi mea maʻi haʻahaʻa haʻahaʻa e pale i ka pono o kahi CT a i ʻole nā kaʻina hana invasive.
ʻO ke aʻoʻana i nā pulupulu radiopaque, nā laina, a me nā kino'ē aʻe
Ke hoʻolālā kūpono i ka hoʻopiʻi kūpono / retroperitoneal gas
Ke kiaʻi i ka nui o kaʻilikai a me ka hoʻoholo o ka postoperative (dynamic) ileus
Ke nānā i kaʻokoʻa o kaʻokoʻa ma o ka'ōpū
ʻO nā haʻawina pili i nā kolonā
Mālama i ka'ōkuhi kidal

He aha eʻike ai ma ka AP Abdomen: Supine vs. Pono vs. Decubitus

Hawaiian Airlines (pneumoperitoneum)
Hoʻopukaʻia Bowel:ʻO nā puka loulou:ʻO SBO me LBO (3-6-9 kapu) SB-nui palena-3-cm, LB-top limit-6-cm, Ka palena-nui-9-cm. No ka hala o ka haustra, no kaʻike o ka valvule conivente (plica semilunaris) ma SBO
SBO: e nānā i nā kiʻekiʻe kiʻekiʻe o nā wai-wai ma nā ʻanuʻu ʻoniʻoni kū i luna, ke ʻano o ka SBO
E nānā i ka paukū o ka gas (rectangular gas) (ka hoʻokuʻuʻia) i ka SBO

ʻO ka pā'ālua CT e nānā -e koho pono i ka manawa o ka hoʻokolokoloʻana i nā'ōhumu āpau a me ka hoʻomau pūʻana o nā'ōpiopio. ʻO kahi laʻana, hiki ke hoʻomaopopo ponoʻia ka maʻi malū āpau a mālama i ka hoʻolakoʻana i nāʻike no ka hoʻolālāʻana i nā lawelawe
ʻO ka abdominal, ke kūpona a me ke pelvic ultrasound hiki ke hoʻokō ʻia e kōkua i ke kuhi ʻana o ka appendicitis (esp. i nā keiki), pathology ākea a me ka maʻi pinepine, nā ʻano ʻino o ka hepatobiliary, ka maʻi obstetric a me nā gynecological pathology.
ʻO ka hoʻohana ʻana i ka radiation ionizing (x-ray & CT) e pono e hoʻēmi ʻia i nā keiki a me nā hui nāwaliwali.

ʻO ka diagnostics ma keʻano o nā maʻi nui o ka Gastrointestinal System

1) Nā maʻi o ke kino
2)ʻO Carcinoma Gastric
3) Gluten Ke 'Ikepili Enteropathy
4) Pāʻaniʻo Bowel
5) Pancreatic ductal adenocarcinoma
6) Carcinoma kūpono
7) Acute Appendicitis
8) Ke hoʻopili liʻiliʻi liʻiliʻi
9) Volvulus

Nā pilikia o ka hoʻopiliʻana

ʻO'Achalasia (mualaslasia): ka hemahema o ka esophageal peristalsis i hoʻonohonoho ʻia d/t i ka hoʻomaha hoʻomaha ʻana o ka haʻahaʻa esophageal sphincter (LOS) me ka hoʻonui ʻia ʻana o ka esophagus a me ka stasis meaʻai. Ua kapa ʻia ʻo ke keʻakeʻa ʻana i ka esophagus mamao (ma muli o ka maʻi maʻi) he "achalasia lua" a i ʻole "pseudoachalasia. . Hiki ke hoʻopili ʻia nā neurons vagus
Palani: 30 -70s, M: F like
ʻO ka maʻi Chagas (ka maʻi ʻo Trypanosoma Cruzi) me ka luku ʻia o nā Myenteric plexus neurons o ka ʻōnaehana GI (megacolon & esophagus)
Eia naʻe,ʻo ka naʻau ka'ōwili M / C
ʻO Clinical: ʻO Dysphagia no nā meaʻelua a me nā wai inu, ke hoʻohālikelikeʻia i ka dysphagia no nā mea paʻakikī wale nō i nā hihia o ka carcinoma āpau. ʻO kaʻeha a me ka hoʻomalu. M / C ma waena o ka cellicocal cell cell carcinoma ma ka 5% no ka hoʻonāukiuki o ka mucosa i kaʻai a me ka hūnā. Hiki ke hoʻolālāʻia ka hanu wai. ʻO Candida esophagitis
Kiʻi: irdBird -beak-- ma luna o ka GI barium e ale, dilated esophagus, nalo o nā peristalsis. He mea koʻikoʻi kahi hōʻike endoscopic.
Rx: paʻakikī. ʻO nā mea hoʻopaʻa ʻana i ke kahawai calcium (pōkole) .Pneumatic dilatation, pono i ka 85% o nā maʻi me 3 -5% pilikia o ke koko / perforation. ʻO ka loaʻa ʻana o ka botulinum toxin injection ma kahi wale nō. 12 mahina no ka lapaʻau ʻana. Hiki ke ʻeha i ka submucosa a hiki i ka piʻi ʻana o ka perforation i ka wā o ka myotomy ma hope. ʻO ka myotomy ʻokiʻoki (Heller myotomy)
10 -30% o nā maʻi e hoʻolālā i ka reflux gastroesophage (GERD)

Keoki: Hoʻohana ʻia e wehewehe i nā hōʻike ʻana o ka hana kaʻa degenerating i ka esophagus ʻelemakule> 80-yo Ma muli o ka pau ʻana o ka reflex arc me ka emi ʻana o ka naʻau i ka distension a me ka hoʻololi ʻana i ka peristalsis.
Hiki i nā maʻi ke hoʻopiʻi i ka dysphagia a i ʻole ka ʻeha o ka umauma, akā ʻo ka hapa nui he asymptomatic
Ho'ālahalaha / hoʻokaʻawale spasm (DES) ʻO ka pilikiaʻole o ka esophagus e hiki ai ke hōʻike mai he kūkoki a iʻole ka hau a me ka rosary bea esophagus ma ka barium.
2% o ka maʻi kaumaha o ka naʻauʻole
ʻO nā manometry ka ho'āʻo diagnostical standard-gold.

Hoʻopiʻi Zenker (ZD) aka pharyngeal pouch
ʻO ka pukaʻana ma ka kiʻekiʻe o ka hypopharynx, kokoke kokoke i ka sphincter o ka paepae kiʻekiʻe, i kapaʻiaʻo Killian dehiscence a iʻole Killian triangle
ʻO nā maʻi he 60-80 yo a hōʻikeʻia me ka dysphagia, regurgitation, hanosis, globus sensation
Mei i hoʻopili i nā hopena a me nā meaʻino
Hiki i nā maʻi ke hōʻiliʻili i nā lāʻau
ʻO ZD- kahi pseudodiverticulum a iʻole ka pulupulu diverticulum e loaʻa ana mai ka herniation o ka submucosa ma o ka Killian dehiscence, e hana ana i kahiʻeke kahi e hoʻonui ai i kaʻai a me nā mea'ē aʻe.

ʻO Mallory-Weiss maʻi e pili ana i ka mucosal a me ka submucosal waimaka o ka distal oesophageal venous plexus e pili ana me ka hoʻokuʻu ʻana a me ka luaʻi ʻino a me ke kuhi ʻana o nā mea ʻōpū i ka esophagus haʻahaʻa. Pilikia ka poe inu rama. Loaʻa nā hihia me ka hematemesis ʻeha ʻole. Kākoʻo maʻamau ka mālama ʻana.
Dx: liʻiliʻi ke kuleana o ke kiʻi, akā hōʻike paha ka contrast esophagram i kekahi mau waimaka mucosal i hoʻopiha ʻia e ka contrast (kiʻi ʻākau lalo). Hiki ke kōkua ʻo CT scanning i ka wehe ʻana i nā kumu ʻē aʻe o ke koko GI kiʻekiʻe

Nā maʻi maʻi Boerhaave: ʻO ka'ōpū o ka mokuahi ka lua o ka luaʻiʻana
Ke hōʻike: M> F, ka luaʻi, kaʻeha o ka umauma, mediastinitis, septic mediastinum, pneumomediastinum, kahawai pneumothorax
I ka wā i hala aku nei, ua make mau loa
Hoʻokomo ʻia nā mīkini i ka hoʻokuke ikaika ʻana i nā mea ʻai o ka ʻōpū, ʻoi aku hoʻi me nā meaʻai nui ʻaʻole i hoʻoheheʻe ʻia i ka wā e ʻaelike ikaika ai ka esophagus e kūʻē i ka glottis i pani ʻia me ka 90% e kū ana ma ka paia posterolateral hema.

Hiatus hernias (HH): ka hilinaʻi o nā mea ma loko o ka'opiʻi hiatus o ka diaphragm i loko o ke kīla.
ʻO ka nui o nā maʻi me HH he asymptomatic, a he mea ʻike ʻole ia. Eia nō naʻe, hiki i nā hōʻailona ke komo i ka ʻeha epigastric/chest, piha ma hope o ka ʻai ʻana, nausea a me ka luaʻi.
I kekahi manawa ua manaʻo ʻia ʻo HH e like me ka maʻi gastro-oesophageal reflux (GORD), akā aia kahi pilina maikaʻi ma waena o nā kūlana ʻelua!
2-ʻano: paheʻe hiatus hernia 90% & ʻolokaʻa (paraoesophageal) hernia 10%. Hoʻopili paha ka hope i ke alakaʻi ʻana i ka ischemia a me nā pilikia.

ʻO ka Leopio Leopio ʻo ia ka M / C benic esophageal neoplasm. He nui ka nui aʻaʻole naʻe e pāpā. ʻO nā'ōpū diabolalinal steroid (GIST) ka mea maʻamau i loko o ka esophagus. Pono e hoʻokaʻawaleʻia mai kahi carcinomasopopona.
ʻO ke kiʻi: keʻano o ka esophagram, ka'ahuʻula GI nui e loli, CT scanning. ʻO Gastroesophagoscopy ka māhele Dx i koho.

ʻO Carcinoma Kahepila: i hōʻikeʻia me ka hoʻonuiʻana i ka dysphagia, i ka hoʻomakaʻana e palekana a holomua i nā wai kīkī i nā meaʻoi aʻe
<1% o nā maʻi ʻino a pau a me 4-10% o nā maʻi maʻi GI āpau. ʻIke ʻia ka preponderance kāne me ka subtype o ka cell squamous ma muli o ka puhipaka a me ka waiʻona. ʻO Barrett esophagus a me adenocarcinoma
M: F 4: 1. ʻOi aku ka maʻalahi o nā poʻeʻeleʻele ma mua o nā mea keleʻele 2: 1. Poino prognoosis!
Hiki ke mālama i kahi hauumoku i kaʻikeʻana i ka nui o ka pae honua. ʻO Gastroesophagoscopy (endoscopy) hōʻoia i ka hōʻailona me ka biopsy kiko
ʻO ke kaʻinaʻana o ka malignancy maʻamau ka 2ndary gastric fundal carcinoma e hoʻopiʻi ana i ka esophagus disal
Loaʻa ka pūmoku liʻiliʻi i ka midophobia, Adenocarcinoma ma ka'āpana'āpana

Gastric carcinoma: ka malignancy ma mua o ka epithelium gastric. Ka liʻiliʻi ma mua o ka makahiki 40. ʻO ka makahiki waena ma ka hōʻoiaʻana maʻAmelika Hui Pūʻiaʻo 70 makahiki no nā kāne a me nā makahiki 74 no nā wāhine. ʻO Japan, Kekuika Kupa, Chile, a me nā'āina Pelekāne Komohana kahi o ka nui o ka nui o ka maʻi hanu i ka honua. Ke emi nei ka nui o nā maʻi āpau i ke ao holoʻokoʻa. ʻO ka maʻi hōʻehaʻo 5th ka hopena o ka makeʻana o ka maʻi. ʻO ka hui pū me ka XIUMX-60% Helicobacter pylori, akāʻo 80% ka nui wale nō ka heluna me H. Pyloris e ulu ana i ka maʻiʻeha. 2-8% loaʻa kahi waeʻohana.
ʻO Gastric Lymphoma pū kekahi i pili pū me H. Pyloris. ʻO ke kīponaʻokoʻa Stromal Cell a GIST paha kahi neoplasm e pili ana i ka'ōpū
ʻO Clinical: ʻAʻohe hōʻailona inā heʻuʻuku a hiki ke mālama. Hiki i nā 50% o nā maʻi ke loaʻa nā hoʻopiʻi kūikawā GI. Hiki i nā maʻi ke hōʻike me ka pauʻole o ka anorexia a me ke kaumaha (95%) a me kaʻehaʻeha o ka'ōpū. ʻO ka Nausea, ka luaʻiʻana, a me ka paʻakai wawe hiki ke hana i ka ulupala a me nā maʻiʻeleʻele a me nāʻehaʻeha e hoʻopōʻino ai i ka'ōpū.
Hoʻoponopono: ʻO ka hapanui o nā maʻi pipili iʻikeʻia i ka hopena a hiki ke hōʻike i ka hoʻoukaʻana o ka'āpana me ka adenopathy ākea, ka hānai, a me ka hoʻolaha pūʻia. ʻO ka 5 makahiki no ka ola olapū o 20% a emiʻole. I Iapana a me S. Korea, ua hoʻonui ka mālama olaʻana i nā polokalamu hoʻoponopono wikiwiki i ka 60%
kiʻi: ʻO ke aʻo ʻana o ka GI kiʻekiʻe ʻo Barium, CT scanning. ʻO ka hoʻokolohua Endoscopic ke ala koho no ka maʻi maʻi. Ma ke kiʻi kiʻi, ʻike ʻia ka maʻi maʻi ʻōpū ma ke ʻano he exophytic (polypoid) nui a i ʻole ʻano Fungative, Ulcerative a Infiltrative/diffuse type (Linitis Plastica). He mea nui ka nānā ʻana o CT no ka loiloi ʻana i ka hoʻouka kaua kūloko (nodes, mesentery, ate, etc.)

ʻO Celiac ka maʻiʻaʻole non-tropical sprue aka'Amomo enteropathy-keʻano o Gluten: ʻO kahi T-cell mediated autoimmune chronic gluten-induced mucosal pōʻino i hopena i ka nalowale o ka villi i loko o ka ʻōpū liʻiliʻi kokoke a me ka malabsorption ʻōpū (ʻo ia hoʻi, sprue). Manaʻo ʻia i kekahi mau hihia o ka anemia deficiency hao o ke kumu ʻike ʻole ʻia. He mea maʻamau i nā Caucasians (1 i 200) akā kakaikahi i nā poʻe ʻAsia a me nā ʻeleʻele. ʻElua piko: he puʻupuʻu liʻiliʻi i ka wā kamaliʻi. ʻO ka maʻamau i nā makahiki 3 a me 4 o ke ola.
ʻO Clinical: ʻO kaʻeha o ka'ōpū ka m / c hōʻailona, malabsorption o nā meaʻai / huaʻai: IDA a me guaiac-poses stools, diarrhea, constipation, steatorrhea, paʻakikū kaumaha, osteoporosis / osteomalacia, dermatitis herpetiformis. Hoʻonuiʻia ka huiʻana me ka lymphoma T-cell, Ka uluʻana me ka cell carcome cell cell, SBO
Dx: Ke kūlana kiʻekiʻeʻo GI me nāʻano biopsies duodenal nui he a ke diagnostical standard no ka maʻi lolac. Hōʻike ka moʻolelo e hōʻike i ka infiltration cell a me ke lymphoplasmacytosis, ke kahakaha o Villi, ka hyperplasia Crypts, Submucosa, a me Serosa. Rx: ka hoʻoneʻeʻiaʻana o nā huaʻai gluten
Ke Kiʻi:ʻAʻole i koiʻia no Dx akā ma Barium e hoʻoulu i ka fluoroscopy: i ke atrophy mucosal a me ka hoʻokauʻiaʻana o nā pōpopo mucosal (nā mea kūlana kiʻekiʻe). ʻO ka SB dilation ka meaʻike loa. Nodularity o ke duodenum (bubbly duodenum). Ke hoʻololi o ka 'aha hoʻokolokolo a me ka haleal mucosal:
�Ua like ka jejunum me ka ileum, ua like ka ileum me ka jejunum, a ua like ka duodenum me he po.�

ʻO ka maʻi maʻi maʻi hanu: Crohn Disease (CD) & Ulcerative Colitis (UC)

CD: ka hopena e hoʻokuʻu ana i ka mīkini palemoʻole e pili ana i kekahi mahele o ka pūnaewele GI mai ka waha i ka anus akā ma ka hopena e pili ana i ka home terminal. Ka wānana M / C: kaʻehaʻeha a me ka pēhea. Kahi: nā papahana papahana e like me ka UC he transmural, hiki ke alakaʻi i ka paʻi. ʻO nā wahi i hoʻopōʻia e ka mumuna, keʻano paʻakikī
He nui nā hopena: malabsorption o nā meaʻai / huaʻai (anemia, osteoporosis, hoʻomohala ulu i nā keiki, hikiʻole i ka malupali GI, ka hōʻehaʻana i ka hanu, ka hanu fistula, nā hōʻailona keu-abdominal: uveitis, arthritis, AS, erythema nodosum a me nā mea'ē aʻe.) 10- 20% hiki iā ia ke koi i ka pīpī āpau ma hope o 10-makahiki o ka CD no ke kūʻana o ka hōʻailona, ke kālepaʻana, BO.
Dx: ke kelepona, CBC, CMP, CRP, ESR, nā ho'āʻo lelological: DDx o IBD: hōʻailona anti-Saccharomyces cerebia (ASCA), antiinepatrophil cytoplasmic antibody (p-ANCA) histologically a ma ka maʻamau. Nā kōkua Calcaltectin Fecal i kōkua i DDx IBS a no ka loiloiʻana i ka pane i ka lāʻau hoʻomalu, ka hana maʻi.
Dx o ka wae: ka hopena, ka haleoscopy, a me nāʻano biopsies nui e hōʻike i nā loli o endoscopic a me nā loli. ʻO ka wikiō hoʻopihapiha Video (VCE), hiki ke kōkua i ke kiʻi me Dx o nā pilikia. Rx: nā lāʻau lapaʻau immunomodulatory, nā lawelawe lapaʻau, nā meaʻai, nā hana pākuʻi, ka hana. ʻAʻohe mea e ola ai, akā,ʻo ka pahuhopu e hoʻoikaika i nā hōʻailona kalahala, nā māmā a me ke kāohi / mālama i nā pilikia
Hoʻokaʻaʻike Dx: KUB i DDx SBO, Barium enema (hoʻokahi a me keʻano lua), ke ukali liʻiliʻi. ʻImi: hōʻalo i nā liona, aphthous / hohonu ulcerations, fistula / tracts, hōʻailona hōʻailona, nā'ōpili momona o ka LB, ke kiʻikuʻu pōhaku / i nā mea hana a me nā maʻiʻeha e hoʻouka i ka mucosa, CT scanning with oral and IV contrast.

Ke kiʻiʻana mai kahi maʻi o Crohn i loaʻa kahi pūpū liʻiliʻi no ka pale.
(A) Hōʻike CT hōʻike i ka mumū kikoʻī ʻole
(B) MRE o kahi'āpana e hōʻike ana i ke koʻikoʻi fibrostotic

UC: 'O ka ma'i wale nō e pili ana, akā, hiki ke ulu i ka backwash ileitis. ʻO ka hoʻomaka maʻamau ma 15-40s a ʻoi aku ka nui o nā kāne, akā maʻamau ka hoʻomaka ʻana ma hope o ka makahiki 50. ʻOi aku ka maʻamau ma ʻAmelika ʻĀkau a me ʻEulopa (hygiene hypothesis). Etiology: Hoʻohui ʻia ka hoʻololi o ke kaiapuni, genetic a me gut microbiome. ʻO ka puhi paka a me ka appendectomy mua e hōʻike i kahi pilina maikaʻi ʻole me UC, ʻaʻole like me ka CD i manaʻo ʻia kekahi o nā kumu pilikia.
Nā Kinohi Pūnaewele: ʻO ke kahe koko (maʻamau), ka maʻi paʻi, ka hoʻokuʻu ʻana o ka mucous rectal, tenesmus (i kekahi manawa), ka ʻeha o ka ʻōpū haʻahaʻa a me ka maloʻo nui ʻana mai ka purulent rectal discharge (i nā hihia koʻikoʻi, ʻoi aku i ka poʻe ʻelemakule), fulminant colitis a me ka megacolon meaʻawaʻawa hiki ke lilo i fetal akā he mau pilikia koʻikoʻi. . Pathology: ʻAʻohe granulomata. Hoʻopilikia nā ʻeha i ka mucosa a me ka submucosa. Hōʻike ʻia nā pseudopolyps ma ke ʻano he mucosa i mālama ʻia.
Hoʻopilikia mau ʻia kahi kaʻina hana mua i ka rectum a noho mau i kahi maʻi kūloko (proctitis) i (25%). 30% Hiki ke hoʻonui ʻia ka maʻi kokoke. Hiki ke hōʻike ʻia ka UC ma ka ʻaoʻao hema (55%) a me ka maʻi maʻi (10%). ʻO ka hapa nui o nā hihia he haʻahaʻa a haʻahaʻa
Dx: colonoscopy me ka ileoscopy me nā biopsies he nui e hōʻoia i ka Dx. Nā Labs: CBC, CRP, ESR, Fecal calprotectin, Nā pilikia: anemia, megacolon toxic, colon cancer, extra-conic maʻi: arthritis, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: 5-aminosalicylic acid oral or rectal topical therapy, corticosteroids, immunomodulatory drugs, colectomy is curative.
Kiʻi kiʻi: ʻaʻole koi ʻia no Dx akā ʻo ka barium enema hiki ke hōʻike i ka ʻulaʻula, ka paʻi manamana lima, i nā hihia koʻikoʻi ka nalowale o ka haustra a me ka haʻikiʻi o ke kolone e hoʻopuka ana i ka "lead-pipe colon". hihia. Hiki ke kōkua ʻo CT me Dx o nā pilikia. Hōʻike ʻia ke kiʻi kiʻi ʻoniʻoni maʻemaʻe i ka "lead-pipe colon" a me ka sacroiliitis ma ke ʻano he Enteropathic arthritis (AS)

ʻO ka carcinoma kapu (CRC) m / c ka maʻi kanesa o ka ʻāpana GI a me ka lua o ka maʻi maʻi maʻi maʻamau i nā pākeke. Dx: endoscopy a me ka biopsy. ʻO CT nā ʻano hana i hoʻohana pinepine ʻia no ka hoʻokūkū. Hiki ke ho'ōla ʻia ka ʻoki ʻoki ʻana ʻoiai ʻo ka helu ola ʻelima mau makahiki he 2-40% ma muli o ka hoʻonohonoho ʻana. ʻO nā kumu pilikia: ka fiber haʻahaʻa a me ka momona kiʻekiʻe a me ka meaʻai protein holoholona, ka momona (ʻoi loa i nā kāne), ka ulcerative colitis mau loa. ʻO nā adenomas colonic (polyps). ʻO nā maʻi adenomatous polyposis ʻohana (Gardener syndrome) a me Lynch ma ke ʻano he polyposis ʻohana ʻole.
ʻO Clinical: ʻO ka hoʻomaka ʻana me ka hoʻololi ʻana i ke ʻano o ka ʻōpū, ke koko hou a i ʻole ke melena, ka anemia deficiency hao mai ka hoʻoheheʻe ʻana o ke koko occult mau loa ma nā ʻaoʻao ʻaoʻao ʻākau. ʻO ke keʻakeʻa ʻana o ka ʻōpū, ka intussusception, ke koko kaumaha a me ka maʻi metastatic ʻoi aku ka nui o ke Aʻo i hōʻike mua ʻia. Alanui: 98% he adenocarcinomas, e ala mai ana mai na colonic adenomas (neoplastic polyps) me ka hoololi ino. ʻO 40-50% ka helu ola ʻelima mau makahiki, me ka pae ma ka hana ʻo ia ka mea nui loa e pili ana i ka prognosis. M/C rectosigmoid tumors (55%),
NB Kekahi mau koleka esp. nāʻano mucous i hōʻikeʻia i ka hopena o ka manawa a me ka nui o ka hōʻailona kūpono no ka hopena o ka hōʻike a me ka hoʻonaninani hopena a me kahi mamao mamao
Kiʻi kiʻi: Barium enema he sensitivities no polyps> 1 knm, hoʻokahi ʻokoʻa: 77-94%, pālua pālua: 82-98%. ʻO ka Colonoscopy kahi ʻano koho no ka pale ʻana, ʻike, a me ka ʻike ʻana i ka carcinoma colorectal. Hoʻohana ʻia ka nānā ʻana i ke ʻano hoʻohālikelike CT no ka hoʻonohonoho ʻana a me ka loiloi prognosis o nā mets.
Nānā: colonoscopy: nā kāne 50 yo-10-mau makahiki inā he mea maʻamau, 5-makahiki ināʻikeʻia ka polypectomy, FOB, 1st kaʻaleʻa pili me CA ke nānā ma 40 yo.

Pancreatic Cancer: ʻO ka epithelial adenocarcinoma (90%), ka hōʻailona kūpono loa me ke olakino kiʻekiʻe. ʻO ka 3 M M a C. ʻO Colon ka #1, ka'ōpū #2. ʻO ka maʻi pancreatic ka helu no 22% o nā make a pau no ka malignancy gastrointestinal, a me ka 5% o nā maʻi make. 80% o nā hihia ma 60 +. ʻO ka mea'umepa kūpaka ka meaʻoi loa o ka hihia kaiapuni, kahi meaʻai i nā momona a me ka protein. ʻO ka nui. Pūʻuluʻohana. Uaʻikeʻiaʻo M / C i ke poʻo a me ke kaʻina hanaʻole.
Dx: He mea koʻikoʻi ka nānā ʻana CT. ʻO ka hoʻouka ʻana i ke ʻano o ka Mesenteric Artery (SMA) e hōʻike ana i ka maʻi hiki ʻole. ʻO 90% o nā adenocarcinomas pancreatic ʻaʻole hiki ke wehe ʻia ma Dx. ʻO ka hapa nui o nā maʻi e make i loko o 1-makahiki o Dx. Ma ke kino: jaundice ʻeha ʻole, abd. ʻEha, ʻo ka ʻōpū o Courvoisier: ka jaundice ʻeha ʻole a me ka nui o ka gallbladder, Trousseau's syndrome: migratory thrombophlebitis, ka maʻi diabetes mellitus hou, ka metastasis kūloko a me kahi mamao.
CT Dx: pancreatic mass me ka hopena desmoplastic ikaika, hoʻonui maikaʻi ʻole, a me ka attenuation haʻahaʻa haʻahaʻa i hoʻohālikelike ʻia i ka gland maʻamau pili, SMA invasion.

Appendicitis: ka mea maʻamau i ka papahana radiology a he kumu nui ia o ke kāpili āpau i nā poʻe'ōpiopio
ʻO ka CT keʻano maʻalahi no kaʻikeʻana i ka appendicitis
Hoʻohanaʻia ke kahahana ma nā maʻi maʻi a me nā keiki
ʻAʻole pono ka KUB Radiographs i ka ʻike o ka appendicitis
Ma ke kiʻi kiʻi, hōʻike ka appendicitis i ka appendix inflamed me ka mānoanoa o ka paia, ka hoʻonui ʻana, a me ka paʻa ʻana o ka momona periappendiceal. ʻIke ʻia nā ʻike like o ka mānoanoa o ka pā a me ka hoʻonui ʻia ma US. ʻIke ʻia ka 'hōʻailona pahuhopu' maʻamau ma ke axis pōkole kūlana ʻimi US.
Ināʻoi aku ka hope o ka hoʻopiʻiʻana ma mua o ka US ināʻaʻole pono e hāʻawi pono i kaʻike pono Dx a me CT
Rx: kūpono e pale i nā pilikia

ʻO ka hoʻopili liʻiliʻi liʻiliʻi (SBO) -80% o ka hoʻokuʻuʻana i ka hanu mechanical; ʻo ka mea i koe ka 20% i loaʻa mai ka hanuʻana o ka ululāʻau nui. Loaʻa ka piʻiʻana o ka makeʻana o 5.5%
M / C kumu: hiki i kekahi Hx o ke kīʻahaʻokoʻa ma mua a me nā kuʻuna
ʻO ka'ōkuhi kahiko ka hopena, ka piʻiʻana o ka'ōpū me ka nausea a me ka luaʻiʻana
ʻO nā lekaōkalaula he 50% wale nō no SBO
E hōʻikeʻo CT i ke kumu o SBO ma 80% o nā hihia
Loaʻa nā pae hoʻololi no ka paleʻana o ka liʻiliʻi liʻiliʻi, akāʻo ka 3.5 cm he mahele mālama kūpono o ke kīla kaula
Ma ka Abd x-ray: moe kū pololei. ʻO ka ʻōpū i hoʻopaʻa ʻia.
Rx: hana ma ke ʻano he � ʻōpū acute.�

Volvulus-m/c i loko o ke kolo Sigmoid esp. i ka poe elemakule. ʻO ke kumu nui: ʻo ka constipation mau me ka hoʻololi ʻana o ka sigmoid ma ka sigmoid mesocolon. Alakaʻi i ka ʻākea ʻōpū nui (LBO). ʻO nā kumu maʻamau ʻē aʻe: kahi maʻi koko. ʻO Sigmoid vs. Caecum volvulus
Ma ke kino: nā hōʻailona o ka LBO me ka constipation, ka ʻōpū o ka ʻōpū, ka ʻeha, ka nausea, a me ka luaʻi. ʻO ka hoʻomaka ʻana he maʻi a maʻi paha
Ma ka lekiō: nalo ka haustra ma ka LB, LB distension (>6-cm), �hōʻailona pīni kope� paheʻe hope aʻe, ʻo ka hope haʻahaʻa o ka volvulus kuhikuhi i ke pelvis
NB: Lula o ka manamana nui no ka ʻōpū i hoʻonui ʻia ʻo 3-6-9 kahi 3-cm SB, 6-cm LB & 9-cm Coecum
Rx: operative as �acute opu.�

E hoʻomaopopo '

Nā maʻi o ka ʻaoʻao o ka pahu i ke kiʻi Diagnostic

by Kauka Alex Jimenez | Kiʻi & Diagnostics

Core Anatomy

E nānā i nā hanauna o ka lāʻau tracheal-bronchial, lobes, ʻāpana, a me nā māwae. E hoʻomaopopo i ka lobule pulmonary lua (1.5-2-cm) - ka ʻāpana hana kumu o nā māmā i ʻike ʻia ma HRCT. E noʻonoʻo i ka hoʻonohonoho hoʻonohonoho koʻikoʻi o nā ākea alveolar me nā kamaʻilio ma waena (pores o Kohn & canals of Lambert) e ʻae ai i ka neʻe ʻana o ka ea a ma ka hana like e ʻae ai i ka wai exudative a transudative e laha i loko o ka māmā a kū ma ka māwae. E nānā i ke anatomy o ka pleura: parietal he ʻāpana o ka endothoracic fascia a me ka visceral i hana i ka ʻaoʻao māmā – pleural space ma waena.

ka nānāʻana i ka hoʻonaninaniʻana i ka helu ma ka puʻupuʻu.

Mediastinum: i hoʻopuniʻia e ke aloha a me ka'ōpū. Noho i nā hale nui i loko o nā hanana lymph (hanana i ke kiʻikuhi e hōʻike ana i nā kōlani mediastinal a me ko lākou komoʻana i Lymphoma

Ka Manawa Kūpono i kaʻImiʻana i nā'Ōlelo Hōʻino

'Imikelaʻikepili (Kekini X-ray CXR); maikaʻi maikaʻi 1st. ʻO ke kumu kūʻai haʻahaʻa, ka liʻiliʻi liʻiliʻi, ka hoʻonuiʻana i ka loiloiʻana i nā loiloi
CT scanning: CT CT, High Resolution CT (HRCT)
Ke kākoʻo o nā maʻi:
Kaumaha
Hoʻoponopono
Neoplasms
'Epauma Pulmonary
ʻO ka emphysema pulmonary
Atelectasis
Nā hana pilikino
Mediastinum

PA & ʻAoʻao CXR

Hiki ke hoʻohanaʻia kekahi mau manaʻo'ē aʻe:
Ka nānā akuʻo Lordotic: kōkua i ka loiloiʻana i nāʻaoʻao apical
ʻO ka manaʻo ma ka'ākau a me ka hema: kōkua i ka loiloiʻana i ka hōʻoiaʻana o ka hōʻailona, ka pneumothorax a me nāʻano maʻi'ē aʻe

Nā hiʻohiʻona CXR PA maʻamau & Lateral. E hōʻoia i ka hōʻike maikaʻi: ʻike ʻia nā kīʻaha T-spine a me nā moku ma ka puʻuwai ma ka nānā PA. E helu i 9-10 iwi aoao hope akau e hooiaio i ka hooikaika hooikaika. E hoʻomaka i kahi noiʻi hohonu me ka hoʻohana ʻana i kēia ʻano hana: He nui nā ʻeha ma ka māmā A- ʻōpū/diaphragm, paia T-thorax, M-mediastinum, L-māmā pākahi, ʻo nā māmā-ʻelua. E hoʻomohala i kahi ʻano hulina maikaʻi

1) ʻO ka maʻi lewa aka maʻi māmā alveolar? ʻO ka hoʻopiha ʻana i ka alveoli o ka māmā, acini a ma hope iho o ka lobe holoʻokoʻa me ka wai a i ʻole ka waiwai o kekahi haku mele (koko, pus, wai, mea proteinaceous a i ʻole nā pūnaewele) I ka radiographically: lobar a māhele ʻāpana paha, e ʻike ʻia nā nodules airspace, ke ʻano o ka hui ʻana, ea. bronchograms a me ka hōʻailona silhouette. ʻIke ʻia ka puʻunaue Batwing (butterfly) e like me (CHF). Hoʻololi wikiwiki i ka manawa, ʻo ia hoʻi, hoʻonui a emi paha (lā)
2) ʻO ka maʻi interstitial: infiltration o ka pulmonary interstitium (alveoli septum, lung parenchyma, nā paia moku, a me nā mea ʻē aʻe) e ka laʻana e nā maʻi virus, bacteria liʻiliʻi, protozoans. Hoʻokomo pū ʻia e nā pūnaewele e like me nā cell inflammatory/malignant (eg, lymphocytes) Hōʻike ʻia ma ke ʻano he accentuation o ka interstitium māmā me kahi ʻano reticular, nodular, hui pū ʻia. Nā etiologies like ʻole: inflammatory nā maʻi maʻi autoimmune, fibrosing lung ma'i, occupational lung ma'i, viral/mycoplasma infection, TB, sarcoidosis lymphoma/leukemia a me na mea e ae.

ʻO ka hoʻomaopopo ʻana i nā ʻano like ʻole o ka maʻi pulmonary hiki ke kōkua me DDx. Mass vs. Consolidation (hema). E nānā i nā ʻano maʻi like ʻole o ka maʻi ʻāʻī: ka maʻi ea e like me ka lobar consolidation e hōʻike ana i ka pneumonia, diffuse consolidation indicative of pulmonary edema. Atelectasis (ka hāʻule a me ka poho o ka leo). Nā hiʻohiʻona interstitial o ka maʻi pulmonary: reticular, nodular a hui pū paha. SPN vs. Ho'ohui pū 'ia he nui (nodules) e hō'ike ana i nā mets infiltrates vs. septic infiltrates

A = ke kauwela
B = nā kumu
C = nā hua'ōlelo hou
Eʻike i ka wahi koʻikoʻi o nāʻeke

Nā hōʻailona koʻikoʻi: Hōʻailona Silhouette: kōkua me ka localization a me DDx. Ke Laʻana: Ka lalo haʻahaʻa hema: ka lepa uila ma ka'ākau'ākau, ma heaʻo ia? Kākau pono no ka meaʻaʻole iʻikeʻia ka'ākau pono e pili ana i ka waenakonu waenakonu (silhouetted) Hawaiian airways: air containing bronchi / bronchioles surrounded by fluid

ʻO Chet Trauma

Pneumothorax (PTX): ke ea (kinoea) i loko o ke kahua. Nui nā kumu. Nā pilikia:
PTX Voltage: ka hoʻonui mauʻana o ka ea i loko o ke kikowaena e wikiwiki ana i ka mediastinum a me ka huhu e hoʻoemi wikiwiki ana i ka hoʻihoʻiʻino i ka naʻau. Hiki ke make keʻole e mālama kokeʻia
ʻO PTX kūlohelohe: kumu mua (ʻōpio ʻōpio (30 -40) ʻoi loa nā kāne lōʻihi a lahilahi. Nā kumu hou aʻe: Marfan's Syndrome, EDS, Homocystinuria, a - 1 -antitrypsin deficience , pulupulu fibrosis a me ka meli, ka catamenial PTX d / t endometriosis a me nā mea ʻē aʻe.
ʻO ka pneumothorax traumatic: ʻokiʻoki ʻana o ka ʻāmāmā, ʻeha ʻeha, iatrogenic (nā ʻūhā umauma, etc.) acupuncture, etc.
CXR: e nānā i ka laina pleural visceral aka ka lihi māmā. ʻO ka loaʻa ʻole o nā kiko o ka pulmonary / moku ma ʻō aku o ka laina pleural visceral. Hiki ke ʻike ʻia ka pneumothorax maʻalea. Ma ke kūlana kū, e piʻi ka ea a e ʻimi ʻo PTX ma luna.
ʻAha iwi ʻaoʻao: v.common. Traumatic a pathological (e laʻa, mets, MM) ʻAʻole maikaʻi loa nā hihi X no ka mea ʻoi aku ka mea nui o ka CXR a/a i ʻole CT scanning no ka loiloi posttraumatic PTX (hema hema) lung laceration a me kekahi ala nui.

Hoʻoponopono

Pneumonia: bacterial vs. viral a fungal a i ʻole i loko o ka mea hoʻokipa immunocompromised (e laʻa, Cryptococcus i ka HIV/AIDS) Pulmonary TB

Poniumonia: loaʻa i ka hapakū a me ka hōʻailona-loaʻa. ʻO ka pneumonia paʻakikī likeʻole aiʻole ka Lobar (non-segmental) ka hanu me ka purulent mea piha i ka alveoli a me ka hoʻolahaʻana i ka lobe piha. ʻO ka M / C ke kumuhanaStreptococcus Pneumonia a iʻole ka Pneumococcus
ʻO nā mea ʻē aʻe: (Staph, Pseudomonas, Klebsiella esp. in alcoholics potentially leading to necroSIS/lung gangrene) Mycoplasma (20-30s) aka hele wāwae pneumonia, etc.
ʻO Clinical: kahi maʻi hua, wela,ʻeha o ka umauma pumehana i kekahi manawa hemoptysis.
CXR: ka hoʻolālā o ka mokulele o ka moana i hoʻopaʻaʻia i ka lobe. Nā Air bronchograms. Hōʻailona ka Silhouette i ka wahi.
Viral: Influenza, VZV, HSV, EBV, RSV, a me nā mea ʻē aʻe e hōʻike ʻia nei ma ke ʻano he maʻi ʻāʻā interstitial i hiki ke lilo i bilateral. Hiki ke alakaʻi i ka pilikia hanu
Pneumonia Atypical a me Fungal Poniumonia: Ma muli o ka maʻi lolo, ka maʻi Legionian, a me kekahi mau maʻi / Cryptococcus pneumonia e hiki ai ke maʻi me ka maʻi o ka lolo.
ʻO ka pulmonary abscess: kahi hōʻiliʻili o nā mea purulent i loko o ka māmā e necrotizes pinepine. Hiki ke alakaʻi i nā pilikia nui o ka pulmonary a me ka ʻōnaehana / hoʻoweliweli i ke ola.
Ma ka CXR a iʻole ka CT: ka hōʻiliʻili puni me nā mākauʻeleʻele a me ka necrosis ma waena o kaʻilikai. ʻO DDx mai ka pulina e hoʻopunipuni i ka'ōpū a me ke kumu
Rx: nā lāʻau'alopelo, antifungal, nā mea āpau.
Pono e hoʻopiliʻia ka'ōpona i ka CXR hou e hoʻoholo i ka hoʻoholo piha
Hikiʻole ka hana hou o ka leka uila i ka hōʻemiʻole i ka palaka, ka pale o ka lāʻauʻokoʻa, ka carcinoma a me nā mea hoʻonāukiuki.

Ka PB Pulmonary

ʻO ka maʻi maʻamau i ke ao holoʻokoʻa (nā'āina honua 3rd). 1 i ka 3 poʻe i ke ao holoʻokoʻa e ka TB. Kuhiʻia ka TB e Mycobacterium TB aiʻole Mycobacterium Bovis. ʻO ke kīpoki pūpū. Hanaʻo Macrophage i kahi kuleana koʻikoʻi.
ʻO ka pulmonary TB nui a me ka TB Post-mua. Koi hou hōʻike ma o inhalation. I ka hapanui o nā pūʻali immunocompetent, ʻaʻole ulu ka maʻi maʻi
HB i ka hoʻopiʻiʻia e ka mea hoʻohana, 1) i hoʻokomoʻia i ka Latent Tuberculosis Infection (LTBI) 2) e hoʻonāʻia ka maʻi TB. ʻO nā maʻi me LTBIʻaʻole lākou e hoʻolaha ana i ka TB.
Kiʻi: CXR, HRCT. ʻO ka TB mua: consolidation airspace pulmonary (60%) lobes haʻahaʻa, lymphadenopathy (95% - hilar & paratracheal), pleural effusion (10%). ʻO ka pālahalaha ʻana o ka TB mua loa i ka immunocompromised a me nā keiki.
ʻO ka TM Milliary: ka pulmonary a me ka hoʻomohala pūnaewele i hiki ke make
Ke poʻo inoa kiʻekiʻe (ke kula kiʻekiʻe) a iʻole ka hopena hou aʻe:ʻO ka nui ma nā Apices a me nā hope hope o nā lobes kiʻekiʻe) PO2 kiʻekiʻe), 40% -e wehewehe i nā liona, palekana aʻaʻohe maʻi o nā mokulele, fibrocalcific. Nā Hoʻohui Latent: nā kikowaena nodal.
Dx: Hoʻopiʻi kūʻokoʻa (AFB) a me ka moʻomeheu (sputum). ʻO ka serology HIV i nā maʻi a pau me ka maʻi hānai a me kaʻikeʻole o ka maʻi HIV
Rx:ʻO ka 4 ka lāʻau lapaʻau: isoniazid, rifampin, pyrazinamide, a me ka ethambutol a streptomycin paha.

ʻO ka Pulmonary Neoplasms (ke kēnia maʻi pīpī mua me ka'āpana pulmonary metastasis)

ʻO ka maʻi kano: m / c ka maʻi maʻi ma nā kāne a me ka 6th pinepine i ka maʻi maʻi i loko o nā wāhine. ʻO ka ikaika i ka huiʻana me nā maʻi kino. ʻO Clinical:ʻike i ka hopena, e pili ana i kahi o ka piko. Nāʻano pilikino (keʻano): Kekahi liʻiliʻi (SCC) vs. Carcinoma liʻiliʻi liʻiliʻi
Ke kele liʻiliʻi: (20%) e ulu ana mai ke neuroendocrine aka Kultchitsky cell, hiki ke hūnā i nā meaʻoihana biologically e hōʻike ana me ka maʻi pale. ʻO kahi maʻamau (95%) maʻamau a ma kahi kokoke i ka pūnaewele manu nui. ʻO ka hapa nui o ka hōʻailona kūponoʻole a me ka meaʻole.
ʻO kahi liʻiliʻi liʻiliʻi:ʻO ka adenocarcinoma o ka pulupulu (40%) (M / C) i ka M / C i loko o nā wahine a me nā mea pumeʻole. ʻO nā mea'ē aʻe: Kāpena maʻamau (hiki ke hōʻikeʻia me nā leona hoʻolele), Kapi nui a me kekahi mau mea'ē aʻe
Kiʻiʻoniʻoni maʻemaʻe (CXR): hou a i ʻole i hoʻonui ʻia i ka ʻeha ʻeha, hoʻonui ʻia ka mediastinum e hōʻike ana i ke komo ʻana o ka pūnāwai lymph, pleural effusion, atelectasis, a me ka hoʻohui ʻana. ʻO SPN-hiki ke hōʻike i ka maʻi kanesa maʻi maʻi maʻi inā loaʻa nā palena ʻokoʻa, nā kīʻaha hānai, ka pā mānoanoa, ma ka māmā o luna. ʻO nā nodule māmā he nui paha e hōʻike i ka metastasis.
ʻO nā hana maikaʻi loa: HRCT me keʻano likeʻole.
ʻO kekahi o nā neoplasms o ka umauma:ʻO Lymphoma he v. Ka mea maʻamau i ka umauma, ma nā'ōlelo maʻamau a me loko.
ʻO ka nui o nā neoplasms pulmonary M/C he metastasis. Hōʻike kekahi mau maʻi ʻaʻai i ka predilection kiʻekiʻe no nā mets lung, e laʻa, Melanoma, akā hiki i kēlā me kēia maʻi maʻi ke hiki ke metastase i ka māmā. ʻO kekahi mau hui i kapa ʻia ʻo �Cannonball� metastasis
Rx: ka hoʻonāʻeweʻe, ka chemotherapy, ka pūnaewele

ʻO ka edema pulmonary: he huaʻōlelo maʻamau e wehewehe i ka hōʻiliʻili ʻana o ka wai ma waho o nā hale vascular. Hoʻokaʻawale nui ʻia i Cardiogenic (eg, CHF, mitral regurgitation) a me Non-cardiogenic me nā kumu he nui (eg, overload fluid, post-transfusion, neurological cause, ARDS, near drowning/asphyxiation, heroin overdose, a me nā mea ʻē aʻe)
Nā kumu: hoʻonuiʻia i ka ikaika o ka makani vs. ho'ēmi iki i ka pēpona i ka lolo.
Kaha kiʻi: CXR a CT: 2-mauʻano Interstitial a me Alveolar kahe. ʻO ka hoʻolālā kiʻi e pili ana i nā papa
I ka CHF: Ka Papa 1: ka puʻunaue hou ʻana o ke kahe koko (10-18-mm Hg) i ʻike ʻia ma ke ʻano he 'cephalization' o ka pulmonary vasculature. ʻO ka pae 2: ʻO ka edema interstitial (18-25-mm Hg) ʻO ka edema interstitial: peribronchial cuffing, Kerley lines (lymphatics piha i ka wai) A, B, C laina. 'Āpana 3: Alveolar edema: ma'i lewa: ho'ohui pu'upu'u e ulu ana i ma'i ākea ākea: Batwing edema, air bronchograms
Rx: Nā 3 pahuhopu nui: Hoʻokumu i'O2 e mālama iā'O2 ma 90% hoʻohui
Aʻe: (1) ka ho'ēmiʻana o ka pulmonary venous return (preload reduction), (2) ka ho'ēmiʻana o ka systemic vascular resistance (afterload reduction), a me (3) ke kākoʻo inotropic. E mālama i nā kumu kumu (e laʻa, CHF)

ʻO ka lolilectlectis: ka hoʻonui piha ʻole o ka parenchyma pulmonary. Mālama ʻia ka huaʻōlelo “collapsed lung” no ka wā e hāʻule ai ka māmā holoʻokoʻa
1) Loaʻa ka atelectasis resorptive (obstructive) ma muli o ke keʻakeʻa piha ʻana o ke ala ea (e laʻa me ka maʻi ʻaʻai, nā mea inhaled, etc.)
2) Passive (hoʻomaha) atelectasis ke hana ʻia ka pilina ma waena o ka parietal a me ka visceral pleura (pleural effusion & pneumothorax)
3) Loaʻa ka mea hoʻohana ma ka hopena o nā līpī āpau e hoʻokomo i ka puluma a hoʻoikaika i ka wai mai loko mai o ka alveoli.
4) Cicatricial atelectasis: loaʻa ma muli o ka ʻulaʻula a i ʻole ka fibrosis e hōʻemi ana i ka hoʻonui ʻana o ka māmā e like me ka maʻi granulomatous, necrotizing pneumonia, a me ka radiation fibrosis.
5) Haʻaweʻia ka pulp atelectasis mai ke kino o nā mea maʻamau a me ka hāʻuleʻana o ke ala
6)ʻO nāʻano pālahalaha likeʻole iʻikeʻia ma hope o ka hahaiʻana i nā kaʻina maʻamau
7) Nā hiʻohiʻona kiʻi: ka hāʻuleʻana o ka puluna, ka migration o ka hanu māmā, ka'ānaiʻana o ka mediastinum, ka piʻiʻana o ka diaphragm, ka hyperinflation o ka huhu lehua.

Mediastinum: hiki ke hoʻokaʻawaleʻia nā maʻi pilikino i loko o ka hopena i loaʻa i kahi kūlana kiʻekiʻe a iʻole nā hopena e hopena i nā maʻi ākea e pili ana i ka mediastinum. Hoʻopāʻia, hiki ke nānā i ka ea i ka mediastinum i ka pneumomediastinum. ʻO kaʻike o ka anatomy mediastinal ke kōkua i ka Dx.
Ka nui o nā meaʻenelani media:ʻo ka thyroid, kamusic, teratoma / pūmoku kamera, lymphoma, lymphadenopathy, piʻiʻana aneurysms aortic
Ka nui o ka mediastinal masses: lymphadenopathy, vascular, bronchial lions, etc.
Nā kānaka o ka mediastinal kiʻekiʻe: nā maʻi koko neurogenic, aneurysm aortic, lehulehu o nā mokuahi, nā'ā'ī'ōpū, a me ka adenopathy aortic

ʻO ka emphysema Pulmonary: ka naloʻana o nā mea e ola ai nā mea maʻamau / ka hoʻopiliʻana o ka'ōpū me ka lukuʻana o nā capillaries a me nā septum / interstitium.
ʻO ka pauʻana o ka papanyma pulupulu ma muli o ka mumū mau loa. Pau ka palekana o ka elastin. ʻO ke eaʻana o ka air / airspace, ka hyperinflation, ka nui o ka pulmonary hypertension, a me nā hoʻololi'ē aʻe. Nä haumäna: i ka dyspnea holomua, hiki ke hana. Ma ka manawa i hoʻonuiʻia ka volia o ka hoʻonuiʻana i ka 1 lua (FEV1) i ka 50% ua maʻi ka mea maʻi ma ka liʻiliʻi iki a ua hoʻololi i nāʻano ola.
ʻO COPD ke kumu nuiʻekolu o ka makeʻana o ka honua. Paʻi iā 1.4% o nā mākua ma ka US. M: F = 1: 0.9. Nā makahiki 45 o ka makahiki a me ka nui
Nā kumu:ʻAiʻawa a me ka X-NUMX-Antitrypsin hapa (i hoʻokaʻawaleʻia i centrilobular (smoking) a me ka panacinar.
ʻAno kiʻi; nā hōʻailona o ka hyperinflation, kaʻiliʻana o ka makani, ka poli, ka piʻiʻana o ka pulmonary.

ʻO ke poʻo poʻo a me nā ʻano kiʻi kiʻi pilikino Intra-Cranial

by Kauka Alex Jimenez | Kiʻi & Diagnostics

ʻO ke poʻo o ke poʻo: Skull Fractures

ke kiʻi nei i ke kiʻi ma ka puʻupuʻu o ka māhele.

SKULL FX: KA HOʻOPIʻI MA KA HOʻOPI'ĀINA O NĀ HULA. SKULL FX NO KA POʻI HOPENI I NĀ HANA HANA KAPUʻIA: INTRA-CRANIALHEMORRHAGING, Hoʻopiʻiʻia TRAUMATIC BRAIN INJURY a me nā hōʻailona'ē aʻe
PALAPALA KA POE X-RAY I KA ANA I KA EHA POO. ʻO ka CT SCANNING W/O CONTRAST ka mea nui loa i ka hoʻomaka ʻana i ka loiloi o ke poʻo acute. TRAUMA. ʻAʻole hiki i ka MRI ke hōʻike i nā haʻihaʻi o ka poʻo, ʻaʻole i hoʻohana maʻamau no kahi DX mua o ke poʻo acute. TRAUMA.
E mālamaʻia SKULL FX AS FXS OF SKULL VAULT, SKULL LEASE, A ME KA LĀKAHI E MAKAHI I HAWAIʻI MA KE HOPE AKU A ME KA HELO E PILI AI I KA COMPLICATION.
LINEAR SKULL FX: SKULL VAULT. M / C FX. CT SCANNING KE KEKAHI I KA HOʻOLOHOLO I KA HAUMĀNA HAUMĀNA
X-RAY DDX: SUTURES VS. LINEAR SKull FX. ʻO THINNER FX, LBLACKERʻI MEI KEKAHI MAKAHI, KEKAHI KULA, A ME KEKAHI VASCULAR, LACKSSERRATIONS
RX: I KA NOHAU ANA I NĀ KĀNĀKĀKALANI NO KA LĀINA. NĀ KOʻU NEUROSURICI KE KAULIA E CT SCANNING

PAULO SKULL FX: 75% I KE ALOHA. KA HIKOLELO KA APUA. E hoʻopaʻi i ka OPEN FX. KEKAHI MAU KEKAHI MAILOSURGICALEXPLORATION ESPECIALLY IFFRAGEMENT DEPRESSEDED> 1-CM.COMPLICATIONS: VASCULAR INJURY / HEMATOMAS, PNEUMOCEPHALUS, MENINGITIS, TBI, CSF LEAK, BRAIN HERNIATION ETC.
IMAGING: CT SCANNING W / O CONTRAST

PAU MAI SKX FX: Hiki ke make. I KA PAU O NA POO MAJOR TRAUMA O KA VULT AME FACIALSKELETON, IA ME TBI A ME MAJORINTRACRANIAL HEMORRHAGING. E HANA pinepine ai ma ke 'ano he `headband' ka hopena o ka hopena a me ka ho'opa'apa'a mechanical ma o ka occiput a me ka manawa ma o ka sphenoid a me ke kumu o na iwi po'o. KANAKA: NA MAKA RACCOON, KA HOailona BATTEL, CSFRHINO/OTORRHEA.

Nā Fractures Fcial

LOA PAKAI 45% OF ALLFACEFXM / C IMPACT LATERAL (FIST BLOW ETC.) Inā hōʻoiaʻo UNDISPLACEDNO, KA HOʻOPIʻI KA MAKAHI AIR FLOW a me ka PALAPALA PALAPALA, E MAHUI I KA MAKAHI MAKAHI MAKAHIKI / HUI PALAPALA. X-RAYS 80% NĀ KOʻOLA, HOʻOHOLOIA E NA HUI KĀNĀ HUI.
MAHI ORBITAL BLOW OUT FX: KA INJURY D / T KA HANA MA KA LĀINA O KA LIMA A ME / A I OLE KA IWI ORBITAL. ʻO FX OF ORBITAL FLOOR INTOMAXILLARY SINUS VS. PALAPALA PALAPALA I KA SINUS ETHMOID. NĀ PONO: ENTRAPPEDINFERIOR RECTUS M, PROLAPSEORBITAL FAT, IS A ME NĀ PALAPALA HOLOHOLO, HEMORHAGING A ME OPTIC NERVE POINO. RX: HE mea nui nā CONCERNS o GLOBE INJURY, MAU I KA HANA ANA I KA HOʻOPIʻI ANA I NĀ MEA.

TRIPOD FX: 2ND M / C FACIAL FX # MAHOPE O NASAL (40% O MIDFACEFX) 3-POINT FX-ZYGOMATICARCH, KA PALAPALA HUI O KA POHA ZYGOMATIC & KAHI O KA PALAPALA SINUS MAXILLARY, KEKAHI PALAPALA A ZYGOMATIC BONE.COMPLICATED INAL. ʻOi aku ka ʻike o CT SCANNING I X-RAYS (NĀ WAI).
KA HOPE FX: ʻO SERIOUS FX ALWAYS NĀ KAUMANA PETYGOID PLATES, HE PALAPALA HUI A ME KA ALVEOLAR PROCESS ME KA LEETH MAI KE KULA. NĀ KĀNĀ: AIRWAYS, HEMOSTASIS, NĀ PONO NERVE. E HĀ'ĀNAʻIA CT SCANNING. KA POTENTIAL RISK OF BASILAR SKULL FX

PING-PONG FX:�OIAI I NA KEIKI. HE FX D/T FOCALDEPRESSION OLE: KA PAKAI, KA HANA PAKIKI, ETC. FOCALTRABECULAR MICROFRACTURIINGLEAVING DEPRESSION E KOKE ANA I KA APING-PONG. ʻIke nui ʻia ʻo DX ma ke ʻano he FOCAL DEFECT ‘DEPRESSION’ i loko o ke poʻo. TYPICALLYNEUROLOGICALLY INTACT. HE KOKUA MAI NEI KA CT INA E MANAOIA KA EHA LOA. RX: KA HOʻOMAʻI VS. KA HANA I NA EHA PILIPII. UA HOIKEIA KA SPONTANEOUSREMODELING

KEKAHIKI KAULANA CYST (GROWING SKULL FX) - HE KANAWAI HOʻOMAʻI I KA HOʻOLOHE A ME KA HOʻOMALOPA I NĀ HOPE I KA POSTTRAUMATIC ENCEPHALOMALACIA
ʻAʻole ia he CYST, akā, he hoʻopauʻiaʻana o ka hoʻolālāʻana e like me ka mea iʻikeʻia i ka manawa e pili ana i ka nohoʻana me ka piliʻana i ka pili o ka hoʻopiʻi. KE AINA I KA MAKAHIKI ATDX KAUA I KA PATHOLOGY. NĀ INDICATES: KA HOʻOPIʻI A ME KA HOʻOPIʻI ANA ENCEPHALOMALACIA MA FOCALHYPOATTENUATING LESION.
NĀ KUMU: PALPABLE NĀ KUMU KAUAʻI, PAIN, NĀ KAUAKE NUI / SEIZURES. RX: NĀ NĀ NĀ NEUROSURGICAL CONSULT
DDX: INFILTRATING CELLS / METS / NUI NEOPLASMSINTO SUTURES, EG, INFECTION ETC.

MANDIBULAR FXS: ʻO COMMON. NĀ POTENTIALLY KOMO I KE OPEN FX D / T INTRA-ORALEXTENSION. 40% FOCAL BREAK DESPITEMANDIBLE MA KA HUI. DIRECT IMPACT (ASSAULT) M / C MECHANISM
KA PATHOLOGICAL FX D / T BONE NEOPLASMS, INFECTION ETC. ʻO IATROGENIC MA KE KAPALI KANAKA (KA HUI HĀLĀINA)
IMAGING: MANDIBLE X-RAYS, PANOREX, CT SCANNING ESP. MA KE KĀNĀ KĀNĀ KĀMĀKA / KE AKU
NĀ HĀINA: AHUKAHI AIRWAY, HEMOSTASIS KO KE NĀ HOʻOPIʻI MAKAHIKI, KA PALAPALA I MANDIBULAR N, OSTEOMYELITIS / CELLULITIS AND SPREAD POTENTIAL MA KA PALAPALA O KA MANA (LUDWIGANGINA) A NECK FASCIAL SOFT TISSUES INTOMEDIASTINUM. ʻAʻole hiki iāʻoe ke hōʻoiaʻia D / TʻOLE MAKAHI KAI MAU.
RX: KEKAHI HOPE. KA OPERATIVE

Ka Ilamorira Mīkī Intracranial

EPI AKA EXTRADURAL: (EDH) KA HUAKAHI KAUAHI ANA O MENINGEAL ARTERIES (MMA CLASSIC) me ka wikiwiki e hana ana i ka HEMATOMA ma waena o ka skull o loko a me waho o DURA. ʻO KE SC SCANNING KE KI O DX: PRESENTS AS ENTLENTIFORM IE BICONVEX COLLECTION o ACute (HYPERDENSE) KOKO I HIKI I KE KOLOHE A ME KOKUA ME DDX O KA HEMATOMA LOA. CLINICALLY: HA, LUCID EPISODE INITIALLY AND DETERIORATING IN A FEW HORS. NĀ KUMU KULA: KA HANA BRAIN, CN PALSY. ʻO / A PROGNOSIS MAIKAI inā wikiwiki i hoʻopau.
KA SUBDURAL HEMATOMA (SDH): KA HUI ANA O BRIDGINGVEINS MAWENA DURA I loko a me ka ARACHNOID. SLOW AKA PROGRESSIVE koko. Hiki i ka poʻe ʻōpio a me nā ʻelemakule a ma nā makahiki a pau (MVA, FALLS, ETC.) ke ulu aʻe i loko o "Shaken Baby SYNDROME". Hiki ke hoʻopaneʻe ʻia ʻo DX a hoʻomāinoino i ka prognossis me nā mea ʻeha kiʻekiʻe. I KA KAHIKO PO'O TRAUMA HE MILI A I OLE E HOIKEIA. HE mea koʻikoʻi ke kiʻi mua ʻana me CT. PRESENTS AS CRESCENTSHAPEDCOLLECTION I HIKI I KE KEA I NA SUTURE AKA I KIKI I NA NANAO DURAL. KA HOʻOKEʻAʻI MA CT D/T Nā ʻanuʻu like ʻole o ka hoʻoheheʻe koko: ACUTE, SUBACUTE, a me CHRONIC. MAY FORM A CHRONIC COLLECTION-CYSTICHYGROMA. KANAWAI: VARIABLE PRESENTATION, 45-60% PRESENT ME KE KULANA CNS NUI LOA, PUPILLARY INQUALITY. ʻO ka pinepine me ka hoʻomaka ʻana o ka lolo, a laila he ʻāpana LUCID ma mua o ka hoʻohaʻahaʻa ʻana. Iloko o 30% o na ma'i eha lolo ka SDH. RX: NEUROSURGICAL KOKI.

SUBARACHNOID HEMORRHAGE (SAH): KOKO I KA SUB-ARACHNOID SPACE MA KA HUA O KA TRAUMATIC OR NON-TRAUMATIC ETIOLOGY: BERRY ANEURYSMS AROUND CIRCLE OF WILLIS.SAH 3% o STROKES, 5% o FETAL ASCLOKES: PRESCLINISCALLYSMS. HEAHE' WEHE 'IA HE `WORST HA INLIFE'. HI'ule'a ka PT I LOA A I OLE E HOI MAI KA MANAO. PATHOGY: DIFFUSE BLOOD INSA SPACE 1) SUPRASELLAR CISTERN WITH DIFFUSE PERIPHERAL EXTENSION, 2) PERIMESENCEPHALIC, 3) BASAL CISTERNS. LUKE KE KOKO I loko o ka lewa UNDERARTERIAL PRESSURE HOI KA PALAPALA PALAPALA I KA INTRACRANIAL PRESSURE, ACUTE GLOBAL ISCHEMIA I NUI E VASOSPASM a me na hoololi e ae.
DX: IMAGING: KA HANA HANA I NĀ WĀWAI KĀNĀWAI W / O KEKAHI, KA HUI ANA I KA HELU I KA RULE OUT 99% OF SAH. LUMBAR PUNCTUREMAY HELP I KA PĀNĀ HOPE. MAHOPO o DX HUI: MR ANGIOGRAPHY HELU NO KA'ĀNA I KE KŪMĀ A ME NĀ KUMU HANA MANAʻO
ʻO NĀ HANA HANA:ʻO KA LUMA HOPE HYPERDENSE ON CT. NO KA MAKAHIKI: PERIMESENCEPHALIC, SUPRASELLA, BASAL, VENTRICLES,
RX: NĀ MEDS ANTIHYENTERIVES MAKAHI, OSMOTIC AGENTS (MANNITOL) NO DECREASEICP. NEUROSURGICAL CLIPPING A me nā meaʻokoʻa'ē aʻe.

CNS Neoplasms: Benign vs. Malignant

NĀ KUMU BRA NO NĀ LĀKĀ 2% NO KĒKĀ KAUMĀNA. KA LUNA MAKAHI MAKAHIKI, NO KA METASTATIC BININ DESIONS KA MEA MAKAHIKI
PRESENTE CLINICALLY ME LOCAL CNS ABNORMALITIES, INCREASED ICP, INTRACEREBRAL BLEEDING a pela aku. NĀ HUAHANA: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 E hoʻonui i ka hopena. I NĀ KĀLĀ: M / C ASTROCYTOMAS, EPENDYMOMAS, PNETNEOPLASMS (EG MEDULLOBLASTOMA) a pēlā aku. DX: KUMU MA KAHI CLASSIFICATION.
NĀ KĀNĀWAI: M / C BENIGN NEOPLASM: MENINGIOMA. M / C PRIMARY: GLIOBLASTOMA MULTIFORME (GBM) METSESPECIALLY MAI LUNG, MELANOMA, BAND BREAST. NO HERS: CNS LYMPHOMA
KA HUI IMAGING: HUI KUMU I KA MAKAHI MAKAHI, KA HAUA AIA I HA. HOʻOHOLOIA E CT AND MRIʻO IV GADOLINIUM.
NĀ PALAPALA HUI: INTRA-AXIAL VS. EXTRA-AXIALNEOPLASMS. NĀ METE MAI KA'ĀINA'ĀINA MĀMĀNA MAYO CCUR VIA CSF a LOCAL VESSELS INVASION
NĀ KUMU AXIAL CT SLICE OF MENINGIOMA A ME KA HOʻOMALU HOʻOLA.
KE AXIAL MRI ON FLAIR PULSE SEQUENCE HOOHOLO I NĀ NEOPLASM A ME KA MAʻIA CYTOTOXIC EDEMA O KA BANIN PARENCHYMA KA HĀNĀ ANA O GRADE IV GLIOMA (GBM) ME KA MEA HOPE MAKAHI. MAKAHI KOMO MAKAHI KULA: AXIAL MRI FLAIR: KA PALAPALA MANAʻO MAI KA PALAPALA HOPE. KA MELANOMA E PALAPALA MANAʻO I KA BANIN (KA PATI PATHIMO PATH) MRI KE KAHI DIAGNOSTIC D / KA MAKAHI MAKAHI MA KA LĀKĀKAHI T1.
RX: NEUROSURGICAL, RADIATION, CHEMOTHERAPY, IMIMMUNOTHERAPY TECHNIQUES e ulu nei

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He aha ke kumu o ke kumu kumu?

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Spinal Stenosis MRI: Back Clinic Chiropractor

Spinal Stenosis MRI

ʻike,

lapaʻau

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E hoʻomaopopo '

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Kāleka CT

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Hoʻokele CT

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'Ohanahana

Koho Kii

Hui Hui

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E hoʻomaopopo '

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ʻO ka maʻi pediatric nui:

Fx piliʻole i ka pediatric:

ʻO ka hōʻeha kinoʻole (NAI) ma nā keiki

ʻO ka MSK Imaging Approach ma nā Pediatrics

Kiʻi kiʻi ma JIA

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Ka Noho Malikūʻana

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No ke aha i koho ai i kahi'oniuma Abdominal X?

He aha eʻike ai ma ka AP Abdomen: Supine vs. Pono vs. Decubitus

ʻO ka diagnostics ma keʻano o nā maʻi nui o ka Gastrointestinal System

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PA & ʻAoʻao CXR

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Hoʻoponopono

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ʻO ka Pulmonary Neoplasms (ke kēnia maʻi pīpī mua me ka'āpana pulmonary metastasis)

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Ka Ilamorira Mīkī Intracranial

CNS Neoplasms: Benign vs. Malignant

Nā hua'ōlelo inflammatory CNS Pathology

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