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Sawirka & Cilad-sheegista

Kooxda Sawirka & Baadhitaanka ee Rugta dambe. Dr. Alex Jimenez waxa uu la shaqeeyaa dhakhaatiirta qiimaynta sare leh iyo khabiiro sawir-qaadista. Ururkayaga, khabiirada sawir-qaadista waxay bixiyaan natiijooyin degdeg ah, xushmad leh, iyo natiijooyin tayo sare leh. Anagoo la kaashanayna xafisyadayada, waxaan bixinaa tayada adeega waajibaadka bukaankeena oo ay mudan yihiin. Cilad-sheegidda Bukaan-socodka Bukaan-socodka (DOI) waa xarun-Radiology-ga casriga ah ee El Paso, TX. Waa xarunta kaliya ee nooceeda ah ee ku taal El Paso, oo uu leeyahay oo uu maamulo khabiirka Raadiyaha.

Tani waxay ka dhigan tahay marka aad u timaaddo DOI si aad u hesho imtixaan shucaac ah, faahfaahin kasta, laga bilaabo naqshadeynta qolalka, xulashada qalabka, farsamada gacanta lagu doortay, iyo software ka shaqeeya xafiiska, waxaa si taxadar leh u doortay ama naqshadeeyay Raajo-yaqaanka mana aha xisaabiye. Suuqayadu waa hal xarun oo heer sare ah. Qiimahayada la xidhiidha daryeelka bukaanka waa: Waxaan aaminsanahay in loola dhaqmo bukaanada sida aan ula dhaqmi lahayn qoyskayaga, waxaanan ku dadaali doonaa inaan hubinno inaad khibrad fiican u leedahay rugtayada.


Laf-dhabarka Stenosis MRI: Dhakhtarka dhabarka ee dhabarka

Laf-dhabarka Stenosis MRI: Dhakhtarka dhabarka ee dhabarka

Laf-dhabarta laf-dhabarta waa marka meel bannaan oo la socota ama gudaha laf dhabarta ay bilaabato inay soo koobto, xirto awoodda dhaqdhaqaaqa caadiga ah / raaxada leh iyo wareegga neerfaha. Waxay saameyn kartaa meelo kala duwan, oo ay ku jiraan afka ilmo-galeenka/qoorta, lumbar/dhabar hoose, iyo, si ka yar, gobollada xuubka/sare ama dhexe oo keena jidhidhico, kabuubyo, casiraad, xanuun, daciifnimo muruqa, ama isku-darka dhabarka, lugaha, bowdada, iyo barida. Waxaa jiri kara arrimo kala duwan oo keena stenosis; ogaanshaha saxda ah waa tallaabada ugu horreysa, iyo halka stenosis laf dhabarta MRI yimaado.

Laf-dhabarka Stenosis MRI: Dhaawicida Dhaawicida Daawada Chiropractor

Spinal Stenosis MRI

Stenosis waxay noqon kartaa mid dhib badan in la ogaado maadaama ay ka badan tahay calaamado / dhib badan marka loo eego xaalad, oo badanaa ay keento saxanadaha herniated, lafaha lafaha, xaalad lagu dhasho, qaliinka ka dib, ama ka dib caabuqa. Sawir-qaadista resonance magnetic/MRI waa baaritaan caadi ah oo loo isticmaalo ogaanshaha.

Cilad-

  • Xirfadlaha daryeelka caafimaadka, sida lafopractor, daaweeyaha jireed, khabiirka laf dhabarta, ama dhakhtarka, ayaa bilaabi doona fahamka calaamadaha iyo taariikhda caafimaadka.
  • Baaritaan jireed ayaa la sameyn doonaa si wax badan looga barto goobta, mudada, boosaska, ama hawlaha hoos u dhiga ama ka sii dara calaamadaha.
  • Tijaabooyin dheeri ah waxaa ka mid ah xoogga muruqa, falanqaynta helitaanka, iyo tijaabinta dheelitirka si ay u caawiyaan in si fiican loo fahmo halka xanuunku ka imanayo.
  • Si loo xaqiijiyo ogaanshaha, sawir-qaadid ayaa loo baahan doonaa si loo arko waxa socda.
  • MRI ayaa la isticmaalaa sawir-kumbuyuutar-ku-abuuray si loo soo saaro sawiro muujinaya lafo iyo unugyo jilicsan, sida murqaha, neerfaha, iyo seedaha, iyo haddii ay yihiin kuwo la cadaadiyo ama xanaaqsan.
  • Xirfadle daryeel caafimaad iyo Farsamo yaqaanka MRI ka gudbi doona shuruudaha badbaadada ka hor sawirka.
  • Sababtoo ah mashiinku wuxuu isticmaalaa magnets awood leh, ma jiri karto bir jidhka ku jirta ama ku jirta, sida qalabyada la rakibay ama qalabka ay ka mid yihiin:
  • Gawaarida
  • Qalabka Cochlear
  • Bambooyin faleebo daawada
  • Ka hortagga uurka ee intrauterine
  • Neurostimulators
  • clips aneurysm intracranial
  • Kiciyeyaasha koritaanka lafaha
  • Tijaabo sawir oo kala duwan ayaa la isticmaali karaa haddii shakhsigu aanu yeelan karin MRI sida a CT scan.

MRI waxay u dhaxaysaa dhowr daqiiqo ilaa saacad ama ka badan, iyadoo ku xiran inta boos ee lagama maarmaanka u ah in la go'doomiyo aagga dhaawacan oo la helo sawir cad. Tijaabadu waa xanuun la'aan, laakiin mararka qaarkood shakhsiyaadka ayaa la waydiiyaa inay ilaaliyaan boos gaar ah oo aan raaxo lahayn. Farsamoyaqaanku waxay weydiin doonaan haddii ay jirto raaxo-darro waxayna ku siinayaan caawimaad kasta si ay khibradda ugu fududeeyaan sida ugu macquulsan.

Daaweynta

Dhammaan kiisaska qallafsanaantu ma keenaan calaamado, laakiin waxaa jira doorashooyin daweyn oo uu xirfadlaha daryeelka caafimaadku ku talin karo.

  • Daryeelka konserfatifka ayaa ah talada ugu horreysa ee ay ku jiraan xanuunka loo yaqaan 'chiropractic', depression, jiid-jiid, iyo daaweynta jireed.
  • Daaweyntu waxay kordhisaa xoogga muruqa, waxay wanaajisaa dhaqdhaqaaqa kala duwan, waxay wanaajisaa booska iyo dheelitirka, waxay yaraysaa calaamadaha raaxo la'aanta, waxayna ku daraysaa xeeladaha looga hortagayo laguna maareeyo calaamadaha.
  • Daawooyinka dhakhtarku qoray waxay noqon karaan qayb ka mid ah qorshe daaweyn oo weyn.
  • Qalliinku wuxuu noqon karaa ikhtiyaar xaaladaha aadka u daran ee daryeelka muxaafidka ahi aanu shaqaynayn.

Spinal Stenosis


tixraacyada

Database of Abstracts of Reviews of Effects (DARE): Dib u eegista tayada la qiimeeyay [Internet]. York (UK): Xarunta Dib u eegista iyo Faafinta (UK); 1995-. Cilad-sheegidda laf-dhabarka laf-dhabarka ee lumbar: dib-u-eegis nidaamsan oo la cusbooneysiiyay ee saxnaanta imtixaannada ogaanshaha. 2013. Waxaa laga heli karaa: www.ncbi.nlm.nih.gov/books/NBK142906/

Ghadimi M, Sapra A. Is-hortaagga Resonance Imaging [La cusbooneysiiyay 2022 May 8]. Gudaha: StatPearls [Internet]. Treasure Island (FL): Daabacaada StatPearls; 2022 Jan-. Waxaa laga heli karaa: www.ncbi.nlm.nih.gov/books/NBK551669/

Gofur EM, Singh P. Anatomy, Back, Vertebral Canal Blood Supply. [La cusbooneysiiyay 2021 Jul 26]. Gudaha: StatPearls [Internet]. Treasure Island (FL): Daabacaada StatPearls; 2022 Jan-. Waxaa laga heli karaa: www.ncbi.nlm.nih.gov/books/NBK541083/

Lurie, Jon, iyo Christy Tomkins-Lane. "Maareynta stenosis laf-dhabarka lumbar." BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234

Stuber, Kent, iyo al. "Daawaynta lafdhabarta ee lafdhabarta lumbar: dib u eegista suugaanta." Joornaalka daawada xanuunka loo yaqaan 'chiropractic medicine vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001

Rajooyinka Kiliiniga Xanuunka Dhabar -dhabarka

Rajooyinka Kiliiniga Xanuunka Dhabar -dhabarka

Dhakhaatiirta laf dhabarta iyo kuwa ku takhasusay laf dhabarta waxay isticmaalaan sawirka laf dhabarta iyada oo loo marayo raajo, MRIs, ama CT scans si loo ogaado waxa keenaya dhibaatooyinka dhabarka iyo xanuunka. Sawirku waa wax caadi ah. Haddi ay noqoto xanuunka loo yaqaan 'chiropractic' ama qaliinka laf-dhabarka, waxay kaa caawinayaan in si weyn loo ogaado arrimaha dhabarka waxayna u oggolaadaan qofka inuu arko waxa dhacaya. Noocyada kiisaska waxaa ka mid ah dhabar xanuunka in:

  • Ka yimi shooga
  • Waxay raagtay afar ilaa lix toddobaad
  • Waxa la socda taariikh:
  • Kansarka
  • Qandho
  • Dhidid habeenkii ah

Dhakhaatiirtu waxay isticmaalaan sawiradan marka ogaanshaha xaalad laf dhabarta. Halkan waxaa ah xoogaa aragti ah oo ku saabsan sawirka laf dhabarta.

 

Rajooyinka Kiliiniga Xanuunka Dhabar -dhabarka

Raajooyin

Raajooyinka dhabar xanuunka aad bay u caawin karaan. An Raajo ayaa ku salaysan shucaac waxaana loo isticmaalaa in lagu baaro xaaladaha dhismayaasha lafaha. Raajooyinku waxay ugu fiican yihiin unugyada lafaha ama unugyada lafaha la soo saaray ama la kala saaray. Waxay sida ugu fiican ugu shaqeeyaan unugyo adag, gaar ahaan lafaha. Unugyada jilicsan sida murqaha, seedaha, ama saxanka intravertebral ayaan sidoo kale soo bixin.

Shakhsiyaadka lagu sameeyo raajo dhabarka waxaa lagu sawiri doonaa mishiin soo saara iftiin. Qaadayuhu wuxuu soo qaadanayaa diiwangeliyaha iftiinka ka dib marka uu soo maro jirka oo uu sameeyo sawir. Waxay qaadataa ku dhawaad ​​shan daqiiqo in la dhammaystiro laakiin way ka dheeraan kartaa iyadoo ku xidhan tirada sawirada dhakhtarka. Raajooyinka ayaa waxtar u leh ujeedooyinka caymiska waxayna meesha ka saarayaan xaaladaha lafaha sida jabka jabka iyo/ama lafaha lafaha. Raajooyinka waxaa loo dalbadaa sababo gaar ah oo inta badan waa qayb ka mid ah daraasadda ogaanshaha jirka oo dhan. Tan waxaa ku jira MRI iyo/ama CT scan.

CT Scan

CT waxay u taagan tahay tirakoobka tomography. Waa raajo taxane ah oo lagu sawiray sawiro iyadoo la isticmaalayo kombuyuutar. Faa'iidada CT-ga ee raajada caadiga ah waa in ay bixiso aragtiyo kala duwan oo jirka ah waxayna noqon kartaa 3D. Baaritaannada CT-ga waxaa inta badan loo isticmaalaa xaaladaha dhaawacyada ama shakhsiyaadka qaliinka lagu sameeyay. Waxay qaataan ku dhawaad ​​shan daqiiqo. Raajooyinka, shakhsiyaadka ayaa istaaga ama hoos jiifsada mashiinka raajada marka ay baarayaan jirka. Sawirka CT-ga ayaa qofka ku seexanaya mishiin wareeg ah oo u eg donut oo sawiraya marka uu wareegayo sawirka. Shakhsiyaadka waxaa lagula talinayaa inay xidhaan dhar dabacsan oo raaxo leh. Mararka qaar dheeha, ama isbarbardhigga xididada, ayaa loo isticmaalaa si loo helo unugyada xididada si ay u soo baxaan, dhalinaya sawiro cad cad.

MRI

MRI waa gaaban tahay magnetic resonance imaging. MRIs waxay isticmaalaan magnets si ay u abuuraan sawirro. Sawir-qaadista MRI waxaa badanaa loo isticmaalaa shakhsiyaadka qaliinka lagu sameeyay. Waxay qaataan waqti dheer, badanaa qiyaastii 30 ilaa 45 daqiiqo. Wax macdan ah looma ogola MRI-ga. Bukaan-socodka waxaa la weydiisanayaa inay iska bixiyaan alaabta sida suumanka, dahabka, iwm. Midabka isbarbardhigga wuxuu noqon karaa qayb ka mid ah MRI. Mashiinku waa sida tunnel oo kale. Tani waxay caqabad ku noqon kartaa shakhsiyaadka qaba claustrophobia. La tasho dhakhtar oo ogow sida aad u heli lahayd raaxo inta lagu jiro hawsha.

Qaababka kale ee Sawirka laf dhabarta

Noocyada kale ee sawir-qaadista waxaa ka mid ah:

CT navigation

  • Navigation CT wuxuu muujinayaa baarista CT-ga ee waqtiga-dhabta ah inta lagu jiro hawsha.

Fluoroscopy

  • Fluoroscopy waxay ku lug leedahay raajo raajo ah oo si toos ah u dhex mara jidhka taas oo muujisa sawirro nool, dhaqdhaqaaq leh.

Labadan nooc ee sawirka laf dhabarta waxaa la adeegsadaa xilliga qalliinka. Xaaladaha qaarkood, sawirka qalliinka loo isticmaalo. Sawir-qaadista noocan ah waxay isticmaashaa qalab-roobotik-farsamo sare si ay u caawiyaan dhakhaatiirta qalliinka inay dhex maraan meelo cidhiidhi ah inta lagu jiro hawsha. Tani waxay kordhinaysaa saxnaanta dhakhtarka qalliinka waxayna yaraynaysaa cabbirka jeexitaanka.

ultrasound

Ultrasound waxaa loo isticmaali karaa xaaladaha laf dhabarta. Kani waa tijaabo sawireed adeegsata hirarka dhawaaqa si ay u abuurto sawiro. Si kastaba ha noqotee, imtixaannada sawir-qaadista ee loo isticmaalo sawir-qaadista laf-dhabarta ayaa ah ugu horreyn raajo iyo MRIs.

Ballanta Sawirka

La hadal dhakhtarkaaga ama lafopractor ka hor wakhtiga si aad u fahamto waxa laga filayo inta lagu jiro habka sawirka. Waxay ku ogeysiin doonaan sida loo diyaariyo iyo tilmaamo kasta oo gaar ah ka hor ballanta. Iyadoo ay weheliso taariikhda caafimaadka iyo baaritaanka jireed, sawirka laf-dhabarka waa qayb muhiim ah oo ka mid ah habka ogaanshaha si loo helo waxa xanuunka keena iyo in la horumariyo qorshaha daaweynta ugu fiican.


Nooca Dhismaha


Saamaynta muddada-gaaban ee kafeega iyo cadaadiska dhiigga

Caffeine-ta ku jirta kafeega ayaa ah wax kiciya ama walax kicinaysa hab-dhiska jidhka. Marka caffeine la geliyo, shakhsiyaadka ayaa la kulma kor u kaca xiisaha, gaar ahaan habka wadnaha iyo xididada. Farxaddani waxay keentaa garaaca wadnaha iyo cadaadiska dhiigga inay kor u kacaan ka dibna dib u hooseeya ilaa heerka aasaasiga ah ee shakhsiyaadka caafimaadka qaba. Qaxwaha wax yar ayaa kordhiya cadaadiska dhiigga ee muddada gaaban. Isticmaalka qaxwaha dhexdhexaadka ah ayaa ammaan u ah shakhsiyaadka aan lahayn xaaladaha wadnaha ee hore u jiray.

tixraacyada

Guddiga Xakamaynta Nukliyeerka ee Maraykanka. (Maajo 2021) "Qiyaasyada Nolol maalmeedkeena" www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

raajada dhabar xanuunka: Dib u eegisyada hadda ee daawaynta murqaha. (Abriil 2009) "Waa maxay doorka sawir-qaadista ee xanuunka dhabarka hoose ee ba'an?" www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/

Dacwooyinka Carruureedka Qaababka lagu ogaanayo ogaanshaha | El Paso, TX.

Dacwooyinka Carruureedka Qaababka lagu ogaanayo ogaanshaha | El Paso, TX.

  • Tani waa dib-u-eegis kooban oo ku saabsan qaar ka mid ah cabashooyinka muhiimka ah ee carruurta ee la kulma dhaq-dhaqaaqa bukaan-socodka.
  • Dhaawac ba'an oo ay ku jiraan jug daran oo madaxa ah
  • Dhaawac aan shil ahayn oo ku dhaca carruurta (ilmaha la garaacay)
  • Cabashada Murqaha (Juvenile Idiopathic Arthritis, scoliosis,
  • Neoplasms carruurta caadiga ah (CNS iyo kuwa kale)
  • Caabuqa
  • Cudurka dheef-shiid kiimikaadka

Dhaawaca Carruurta ee Ba'an:

sawirka ogaanshaha carruurta el paso, tx.
  • Dhaawacyo FOOSH ah (tusaale, ka soo dhacay baarka daanyeer)
  • Supracondylar Fx, xusul. Had iyo jeer d/t dhaawac shil ah. <10-yo
  • Fx-ka-dheeraad ah
  • Kala soocidda Gartland dhaawacyada ugu yar ee barokacay dhaawacyada fudud ee lagu daweeyay dhaqdhaqaaq fudud iyo suxulka dambe oo leexsan si qalliin ah
  • Khatarta suurtagalka ah ee tanaasulka ischaemic haddii daryeelka dib loo dhigo (Volkmann contracture)
  • Imtixaanka shucaaca waa muhiim: calaamada shiraaca iyo calaamada baruurta dambe ee leh xariiqda xumeralka hore waxay ku guuldareysteen inay is gooyaan bartamaha/2/3 ee Capitellum.

Fx ee carruurta aan dhamaystirnayn:

sawirka ogaanshaha carruurta el paso, tx.
  • Inta badan <10 yo Greenstick, Torus, Plastic aka Bowing deformity
  • Caadi ahaan si fiican u bogso, si taxadar leh loola dhaqmo dhaqdhaqaaq la'aan
  • Qallafsanaanta balaastikada haddii>20-degrees u baahan tahay dhimis xiran
  • Jabka madaxa ee Ping pong ayaa laga yaabaa inuu soo baxo ka dib dhaawacmo, xoog dhalista iyo dhibaatooyinka dhaawaca dhalashada. Waxaa laga yaabaa in loo baahdo in uu qiimeeyo neurosurgeo.n
sawirka ogaanshaha carruurta el paso, tx.
  • Noocyada Salter-Harris ee dhaawacyada saxanka koritaanka physeal
  • Nooca 1-slip. Tusaale ahaan, Epiphysis caasimeedka Femoral ee sibitaan. Caadiyan wax lafo jaban lama xusin
  • Nooca 2-M/C oo leh saadaal wanaagsan
  • Nooca 3-intra-articular, sidaas darteed wuxuu xambaarsan yahay khatarta ah inuu degdeg u dhaco osteoarthritis waxaana laga yaabaa inay u baahdaan daryeelka qalliin d/t inay noqoto mid aan degganayn
  • Nooca 4- Fx iyada oo loo marayo dhammaan gobollada ku saabsan fiisigiska. Saadaasha aan fiicnayn iyo gaabin addimada
  • Nooca 5- inta badan ma jiraan wax caddaynaya jabka dhabta ah ee lafaha. Saadaasha liidata d/t waxay burburisaa dhaawaca iyo dhaawaca xididdada dhiigga oo ay gaabinayaan addimada
  • Qiimaynta sawiradu waa muhiim

Dhaawac aan Shil ahayn (NAI) ee Carruurta

sawirka ogaanshaha carruurta el paso, tx.
  • Waxaa jira noocyo kala duwan oo xadgudubka carruurta ah. Xadgudubka jireed waxa uu u dhaxayn karaa dhaawacyo maqaarka ilaa dhaawacyo nidaamsan oo kala duwan oo saameeya lafaha iyo unugyada jilicsan. Sawirku waa muhiim waxaana laga yaabaa inuu tilmaamo calaamado qeexan oo ka digaya bixiyeyaasha caafimaadka iyo ku wargelinta adeegyada ilaalinta carruurta iyo hay'adaha fulinta sharciga xadgudubka jirka.
  • Dhallaanka: Ilmaha gilgilan waxaa laga yaabaa inay la yimaadaan calaamadaha CNS d/t jeexjeexa xididka isku xidhka aan qaan-gaarin iyo hematoma subdural kaas oo noqon kara dhimasho. Dhiig-baxa isha oo badanaa waa tilmaam. Madaxa CT waa muhiim.
  • Calamada Cas ee shucaaca shucaaca ee MSK:
  • 1) Fx laf weyn oo ku jirta ilmo aad u da'yar oo aan bukaan-socodka ahayn (0-12 mo)
  • 2) feeraha danbe Fx: dabiiciyan weligood ma dhicin shilalka d/t. Hababka ay u badan tahay: qabashada iyo tuujin ilmaha ama garaacid toos ah.
  • 3) Jajabyo badan oo leh heerar bogsiineed oo kala duwan, ie, lafo goynta oo muujinaya dhaawac jidheed oo soo noqnoqda.
  • 4) Metaphyseal geeska Fx aka baaldiga gacanta Fx, inta badan pathognomonic ee NAI ee carruurta. Waxay dhacdaa marka cidhifka ay saamaysay la qabto oo si xoog leh loo maroojiyo.
  • 5) Jabka laf-dhabarta ee lafaha dhaadheer ee ilmaha yar waa tusaale kale oo NAI ah.
  • Qodobbada kale ee muhiimka ah ee NAI. Taariikhda aan iswaafaqayn ee ay bixiyaan mas'uuliyiinta/daryeelayaasha. Ma jiraan wax caddaynaya cilladaha lafaha ku dhasha ama dheef-shiid kiimikaadka sida Osteogenesis Imperfecta ama Rickets/osteomalacia iwm.
  • NB Marka ay mas'uuliyiinta caruurtu sheegaan taariikh soo sheegta dhicitaanka iyo shilalka guriga, waxaa muhiim ah in la ogaado in inta badan shilalka/ku dhaca guriga ay aad u yar yihiin ama ay suurtogal tahay in ay sababaan lafo jaban oo waaweyn.
  • Ka warbixinta xadgudubka ilmaha ee Illinois:
  • www2.illinois.gov/dcfs/safekids/reporting/pages/index.aspx

Habka Sawirka ee MSK ee Dhakhaatiirta Carruurta

sawirka ogaanshaha carruurta el paso, tx.
  • Arthritis-ka dhallaanka ee idiopathic (JIA)-waxaa loo arkaa M/C cudur dabadheeraad ah oo caruurnimo. Clinical Dx: xanuunka kalagoysyada / bararka 6-usbuuc ama ka badan ee ilmaha <16-yo Noocyo kala duwan ayaa jira: Early Dx waa muhiim si looga hortago dhibaatooyinka dib u dhaca
  • Noocyada ugu caansan ee JIA:
  • 1) Cudurka Pauciarticular (40%) - m/c qaabka JIA. Gabdhaha ayaa halis weyn ku jira. Waxay u soo bandhigtaa sida arthritis-ka ee <4 kala goysyada: jilbaha, anqawyada, curcurka. xusulka. Noocani wuxuu muujinayaa xiriir sare oo leh ka-qaybgalka indhaha sida iridocyclitis (25%) oo laga yaabo inuu keeno indho la'aan. Shaybaadhka: RF-ve, ANA togan.
  • 2) Cudurka 'Polyarticular disease' (25%): RF-ve. Gabdhaha ayaa halis weyn ku jira. Waxay saamaysaa kalagoysyada yaryar iyo kuwa waaweyn inta badan waxay saameeyaan laf-dhabarka ilmo-galeenka
  • 3) Habka habaysan ee JIA (20%): inta badan waxa uu soo bandhigaa muuqaal habaysan oo ba'an sida qandho saraysa, arthralgias, myalgias, lymphadeno[pathy, hepatosplenomegaly, polyserositis (pericardial/pleural effusion). Muhiimka ah Dx waxa uu leeyahay sifada fican ee salmon pink finan ee cidhifyada iyo jirridda. Qaabka habaysan waxa uu leeyahay la'aan gaar ah oo ku lug lahaanshaha indhaha. Kala-goysyadu waxay caadi ahaan kabo lahayn nabaad-guur marka loo eego noocyada kale. Markaa burburin wadajir ah caadi ahaan lama arko

Sawirka gudaha JIA

sawirka ogaanshaha carruurta el paso, tx.
  • Xubinta wadajirka ah ee lafaha ka soo baxa korniinka xuubka patella ee carjawda/ nabaad guurka lafaha oo kor loo qaaday DJD
  • Faraha iyo lafaha dhaadheer ee hore ee xiritaanka jirka / addimada oo gaabisa
  • Rad DDx jilibka/canqowga: Hemophilic arthropathy Rx: DMARD.
  • Dhibaatooyinku waxay ku iman karaan burbur wadajir ah, dib u dhac korriin / addimo gaabin, indho la'aan, dhibaatooyin habaysan, naafo.

Inta badan Caadiga ah ee Xanuunka Ilmaha ee Neoplasms ee Lafaha

sawirka ogaanshaha carruurta el paso, tx.
  • Osteosarcoma (OSA) iyo Ewing's sarcoma (ES) waa 1 st iyo 2nd M / C asaasiga ah ee neoplasms lafaha malignantiga ah ee caruurnimada (ugu sarreeya 10-20 yo) Clinically: xanuunka lafaha, isbeddelka dhaqdhaqaaqa, metastasis hore gaar ahaan sambabada sambabada ayaa dhici karta. Saadaasha liidata
  • Ewing�s waxa laga yaabaa inuu la kulmo lafo xanuun, qandho iyo kor u kaca ESR/CRP oo la mid ah caabuqa. Dx hore oo leh sawir-qaadid iyo habayn ayaa muhiim ah.
  • Sawirka OSA & ES: raajada, oo ay ku xigto MRI, CT xabadka, PET/CT. Raajooyinka: OSA waxay saameyn kartaa lafo kasta laakiin inta badan waxay u jirtaa sida lafo gardarro ah oo samaynaysa neoplasms jilibka ah (50% xaaladood) gaar ahaan sida osteoid samaynta nabar gardarro ah oo metaphysis ah oo leh periostitis mala-awaal ah/qorraxda iyo saddexagalka Codman. Duulaanka unug jilicsan oo la calaamadiyey.
  • ES waxa laga yaabaa inay ku jirto usheeda dhexe oo ay muujiso faafitaanka unug jilicsan oo hore. MRI waa muhiim si loo muujiyo heerka lafaha iyo ST duulaanka, MRI looga baahan yahay qorsheynta qaliinka
  • OSA & ES Rx: Isku darka qalliinka, shucaaca, kiimiko. Farsamooyinka badbaadinta lugaha ayaa la sameeyaa xaaladaha qaarkood. Saadaasha liidata haddii la ogaado goor dambe.
sawirka ogaanshaha carruurta el paso, tx.
  • Sawirka Ewing's sarcoma
  • Kala-jeedin lafaha dhex mara
  • Duulaan hore iyo baladhan unug jilicsan
  • Dareen-celinta periosteal gardarrada leh oo leh jawaabta maqaarka basal (maqaarka basasha).
  • Saucerisation ee lafta kortikal (Falaarta orange)
  • Lesion caadi ahaan waa diaphyseal oo leh xoogaa dheeraad ah oo metaphyseal ah
  • Loo yaqaan buro unug wareeg ah oo ay weheliso Multiple Myeloma iyo Lymphoma

Xumad-xumada Carruurnimada Caadiga ah

sawirka ogaanshaha carruurta el paso, tx.
  • Neuroblastoma (NBL) M/C malignant ee dhallaannimada. Waxay ka soo jeedaan unugyada crest neural aka PNET burooyinka (tusaale, ganglia naxariista). Badankoodu waxay ku dhacaan carruurta <24-bilood. Qaarkood waxay muujinayaan saadaal wanaagsan laakiin> 50% kiisaska waxay qabaan cuduro horumarsan. 70-80% markay da'doodu tahay 18-bilood ama ka weyn waxay joogaan metastasis horumarsan. NBL waxaa laga yaabaa inuu ka soo baxo medulla adrenal, ganglia naxariista leh iyo meelo kale. Soo bandhiga sida cufnaanta caloosha, matag. > 50% waxay la timaadaa xanuunka lafaha d/t metastasis. Kiliinik ahaan: baadhis jidheed, shaybaadhka, sawirka: laabta iyo raajooyinka caloosha, CT caloosha iyo laabta ayaa muhiim u ah Dx. MRI ayaa laga yaabaa inay ku caawiso. NBL waxa laga yaabaa inay u soo baxdo madaxa oo ay dhex geliso tolidayada oo leh soo bandhigid sifada ah sida diastasis fayras ah.
  • Lymphoblastic Lymphoblastic Leukemia waa m/c xumaanta carruurnimada. Pathology: Unugyada leukemka ee dhuuxa lafta oo soo gala taasoo keenta lafo xanuun iyo beddelka unugyada kale ee dhuuxa caadiga ah anemia, trombocytopenia, neutropenia iyo dhibaatooyinka la xidhiidha. Unugyada leukemic waxaa laga yaabaa inay galaan goobo kale oo ay ku jiraan CNS, beeryarada, lafaha iyo gobollada kale. Dx: CBC, heerarka serum lactate dehydrogenase, Biyobsiga dhuuxa lafta waa furaha. Sawirka ayaa laga yaabaa inuu ku caawiyo laakiin muhiim maaha in la ogaado. Shucaaca, galitaanka leukemia ee lafta ayaa laga yaabaa inay caadi ahaan u muuqato sida xargaha shucaaca ee ku teedsan saxanka koritaanka physeal. Rx: kiimoterabiga iyo daaweynta dhibaatooyinka
sawirka ogaanshaha carruurta el paso, tx.
  • Medulloblastoma: M/C neoplasm CNS malignant ee carruurta
  • Inta badan waxay horumaraan ka hor 10-yo
  • Goobta M/C: cerebellum iyo fossa dambe
  • Taariikh ahaan waxay u taagan tahay buro nooca PNET ma aha glioma sidii markii hore loo maleeyay
  • MBL, iyo sidoo kale Ependymoma iyo CNS lymphoma, waxay u horseedi karaan inay hoos u dhigaan metastasis iyada oo loo marayo CSF ​​waxayna sidoo kale u taagan tahay mid gaar ah oo ka duwan burooyinka kale ee CNS waxay muujinayaan faafitaan barar ah oo ka baxsan CNS, m / c ilaa lafta
  • 50% ee MBL waxa laga yaabaa in si buuxda dib loo sixi karo
  • Haddii Dx iyo daawaynta bilaabmaan ka hor metastasis, badbaadada 5-sano waa 80%
  • Sawirku waa muhiim: CT scan ayaa la isticmaali karaa laakiin qaabka sawirka ee doorashada waa MRI kaas oo sidoo kale bixin doona qiimeyn aad u sarreeya oo dhan neuraxis ee metastasis.
  • MBL waxay caadi ahaan u muuqataa sida hypo, iso iyo boogaha hyperintense ee T1, T2 iyo FLAIR (sawirrada sare) haddii la barbardhigo unugyada maskaxda ee ku wareegsan. Badanaa ku cadaadi halbowlaha 4aad oo leh hydrocephalus xannibaad ah. Buradu waxay caadi ahaan muujisaa kobcinta isbarbardhigga ee T1+C gad (sawirka bidix ee hoose). Ku rid metastasis ka MBL oo leh T1+C oo kor u qaadaysa dhaawaca xadhigga

Caabuqyada Caruurta ee Muhiimka ah

sawirka ogaanshaha carruurta el paso, tx.
  • Dhallaanka/ilmaha dhallaanka ah <1bilood: qandho>100.4 (38C) waxa laga yaabaa inay muujiso bakteeriyada iyo caabuqyada fayraska qaarkood. Strep B, Listeria, E. Coli waxay keeni kartaa sepsis, qoorgooye. Habka: raajada xabadka, daloolinta lumbar ee dhaqanka, dhaqanka dhiigga, CBC, baarista kaadida.
  • Carruurta yaryar, Hemophilus hargabka nooca B (HIB) wuxuu u horseedi karaa Epiglottitis oo naadir ah laakiin dhib daran. Tallaalka hadda jira wuxuu kaa caawinayaa dhimista tirada kiisaska Epiglottit iyo cudurrada kale ee la xiriira HIB.
  • Parainfluenza ama RSV Fayrasku wuxuu u horseedi karaa Croup ama Laryngotracheobronchitis ba'an.
  • Epiglottitis iyo Croup waa Dx caafimaad ahaan laakiin AP iyo luqunta jilicsan ee lateral raajada aad bay u caawinayaan
  • Epiglottis waxa ay muujisaa calaamad sifo ah �suulka oo la socota bararka epiglottis ee dhumucsan. Tani waxay noqon kartaa marin-haweedka degdega ah ee nafta halis gelinaya (bidix sare)
  • Croup waxaa laga yaabaa inay muujiso calaamad �Steeple ama dhalada khamri ah
  • Fayraska Syncytia ee neefsashada (RSV) iyo hargabku waxay u horseedi karaan oof-wareenka fayras ee suurtogalka ah oo leh dhibaatooyin nafta halis gelinaya ee difaaca difaaca jirka, aadka u yaryar iyo carruurta leh cudurrada wadajirka ah. CXR waa muhiim (bidix dhexe)
  • Streptococcal pharyngitis Infekshanka GABHS wuxuu u horseedi karaa dhibaatooyin degdeg ah ama dib u dhac ah (tusaale, qandhada Rheumatic)
  • Maqnaanshaha Peritonsillar (korka midig ee dhexe) waxaa laga yaabaa in ay dhacdo xaaladaha qaarkood oo ay adkaato iyada oo ay ku faafaan diyaarado jilicsan oo qoorta ah taas oo keeni karta in ay ku faafto meelaha hoose ee submandibular (Ludwig Angina) marka marinnada hawadu ay u baahan yihiin in la xakameeyo d/t saldhigga bararka carrabka
  • Horumarinta maqaarka retropharyngeal waxay u horseedi kartaa faafitaanka caabuqa iyada oo loo marayo fascia qoorta oo si xor ah ula xiriirta taasoo keentay necrotizing mediastinitis, Lemmier syndrome iyo duulaanka meelaha carotid (dhammaantood waa dhibaatooyin nafta halis gelin kara)
  • Grisel syndrome- (korka hoose ee bidix) Dhibaatooyin naadir ah oo ku dhaca qanjidhada qumanka/xanuunada afka ee gobolka oo ku fidi kara booska prevertebral taasoo horseedaysa seedaha C1-2 caajisnimo iyo xasillooni darro.
  • Caabuqyada kale ee muhiimka ah ee ku dhaca carruurta waa bakteeriyada caadiga ah (Pneumococcal) oof wareenka, caabuqa kaadi mareenka iyo Pyelonephritis ba'an (gaar ahaan gabdhaha) iyo Meningococcal Meningitis
sawirka ogaanshaha carruurta el paso, tx.
  • Cudurka dheef-shiid kiimikaadka ee carruurta
  • Rickets: loo arko osteomalacia oo aan qaan-gaarin. Aagga calcification ku meel gaadhka ah ee saxanka koritaanka epiphyseal ayaa si gaar ah u saameeya
  • Kiliinik ahaan waxa ay soo bandhigtaa dib u dhac korriin, rukuuc xag-jir ah, tusbax cuncun leh, laabta xamaam, feeraha niyad jabsan, cumaacadaha oo bararsan iyo barar, iyo anqawyada, qallooca madaxa
  • Pathology: Vit D iyo kalsiyum aan caadi ahayn ayaa ah sababta m/c. La'aanta qorraxda esp. Shakhsi madaw ah, dharka xaddidan iftiinka iftiinka, naasnuujinta dheeraadka ah ee gaarka ah, veganism, cillad la'aanta mindhicirka, dhaawaca kelyaha iyo kuwa kale
  • Sawirka: metaphysis-jilicsan aka buraashka metaphysis rinji leh oo dhalaalaya, balaadhinta saxanka korriinka, isgoysyada Costachondral bulbous sida tusary rachitic, rukunka xag jirka
  • Rx: daweeyo sababaha hoose, nafaqo-darrada saxda ah, iwm.

tixraacyada

Caloosha: Habka Sawirka ogaanshaha | El Paso, TX.

Caloosha: Habka Sawirka ogaanshaha | El Paso, TX.

 

  • Ogaanshaha cudurrada caloosha waxaa loo kala saari karaa:
  • Aan caadi ahayn ee xanuunka caloosha mareenka hunguriga (esophagus, caloosha, mindhicirka yar & weyn, iyo lifaaqa)
  • Aan caadi ahayn ee xubnaha dheefshiidka dheeriga ah (xanuunka cagaarshowga & xameetida)
  • Waxyaalaha aan caadiga ahayn ee genitourinary & xubnaha taranka
  • Aan caadi ahayn ee gidaarka caloosha iyo maraakiibta waaweyn
  • Bandhigan waxa uu ujeedadiisu tahay in ay bixiso fahamka guud ee aasaasiga ah sawirka ogaanshaha habka iyo maareynta bukaan-socodka ku habboon ee bukaannada qaba cudurrada ugu badan ee caloosha
  • Hababka sawirka ee la isticmaalo inta lagu jiro baaritaanka cabashooyinka caloosha:
  • AP caloosha (KUB) iyo CXR toosan
  • Sawirka CT-ga caloosha (oo leh isbarbardhiga afka iyo IV iyo w/o ka soo horjeeda)
  • Sare iyo Hoose GI Barium
  • Ultrasonography
  • MRI (inta badan loo isticmaalo sida Beerka MRI)
  • MRI enterography iyo enteroclysis
  • MRI malawadka
  • Endoscopic Retrograde Cholangiopancreatography (ERCP) - inta badan hepatobiliary iyo ductal pathology.
  • Sawirka Nukliyeerka

Maxaa U Dalbanaya Raajo Caloosha?

Sawirka ogaanshaha caloosha el paso tx.

 

  • Ku dar qiimaynta hordhaca ah ee gaasta mindhicirka meel degdeg ah. Tusaale ahaan, daraasad taban oo lagu sameeyay bukaanka ixtimaalka hooseeya ayaa laga yaabaa inay meesha ka saarto baahida CT ama hababka kale ee qallafsan.
  • Qiimaynta tuubooyinka shucaaca, xadhkaha, iyo shucaaca qalaad
  • Qiimaynta ka dib nidaamka gaaska bilaashka ah ee intraperitoneal/retroperitoneal
  • La socodka xadiga gaaska mindhicirka iyo xallinta qalliinka (adynamic) ileus
  • La socoshada marinka isbarbardhigga ee mindhicirka
  • Daraasadaha socdaalka xiidanka
  • La-socodka calculi kelyaha

 

Sawirka ogaanshaha caloosha el paso tx.

 

Maxaa lagu Ogyahay AP Caloosha: Supine vs. Toosan vs. Decubitus

  • Hawada Xorta ah (pneumoperitoneum)
  • Xididdada mindhicirka: Siddooyinku kala dillaacay: SBO vs LBO (3-6-9 xeer) SB-upper xadka-3-cm, LB-upper xadka-6-cm, Caecum-upper xadka-9-cm. Xusuusnow luminta haustra, fidinta qoraalka (joogitaanka) valvule conivente (plica semilunaris) gudaha SBO
  • SBO: ogow dhererka kala duwan ee heerarka dareeraha hawada ee jaranjarada filimka toosan, muuqaalka SBO
  • Ogow yaraanta gaaska dabada/malawadka (la daadgureeyay) gudaha SBO

 

Sawirka ogaanshaha caloosha el paso tx.

 

  • Sawirka CT-ga caloosha -qaabka doorashada inta lagu jiro baaritaanka cabashooyinka caloosha ee ba'an iyo kuwa daba-dheeraada gaar ahaan dadka waaweyn. Tusaale ahaan, malignantiga caloosha ayaa si guul leh loo baari karaa waxaana loo diyaarin karaa iyadoo la bixinayo macluumaadka caafimaad ee qorsheynta daryeelka
  • Ultrasound ee caloosha, kelyaha iyo miskaha Waxa la samayn karaa si ay u caawiso ogaanshaha cudurka appendicitis (tus. carruurta), ba'an & cudurada xididdada dhiigga ee dabadheeraad ah, cilladaha hepatobiliary, cudurada dhalmada iyo dumarka
  • Isticmaalka shucaaca ionizing (raajada iyo CT) waa in la yareeyo carruurta iyo kooxaha kale ee nugul.

 

Sawirka ogaanshaha caloosha el paso tx.

 

Sawirka Baadhista Cudurrada Waaweyn ee Hab-dhiska dheef-shiid kiimikaadka

  • 1) Xanuunada hunguriga ku dhaca
  • 2) Kansarka caloosha
  • 3) Gluten Sensitive Enteropathy
  • 4) Cudurka caloosha oo bararsan
  • 5) adenocarcinoma ductal ganaca
  • 6) kansarka mindhicirka
  • 7) Cudurka loo yaqaan 'appendicitis' oo daran
  • 8) Mindhicirrada yaryar oo xidhma
  • 9) Volvulus

Xanuunada hunguriga

  • Achalasia (achalasia aasaasiga ah): fashilka hunguriga habaysan ee peristalsis d/t nasinta daciifka ah ee hunguriga hoose ee hunguriga (LOS) oo leh fidinta hunguriga iyo joogsiga cuntada. Xannibaadda hunguriga fog (badanaa ay sababto buro) ayaa loo yaqaan "achalasia labaad" ama "pseudoachalasia." Peristalsis ee qaybta muruqa siman ee hunguriga waxaa laga yaabaa inay lumiso sababtoo ah cillad aan caadi ahayn ee Auerbach plexus (mas'uul ka ah nasashada muruqa siman) . Vagus neurons sidoo kale waa la saameeyaa
  • Asaasiga ah: 30 -70s, M: F siman
  • Cudurka Chagas (Trypanosoma Cruzi infection) oo leh burburinta neerfaha Myenteric plexus neurons ee nidaamka GI (megacolon & hunguriga)
  • Hase yeeshee, wadnuhu waa xubinta ay saamaysay M/C
  • Caafimaad ahaan: Dysphagia ee adkaha iyo dareeraha labadaba, marka la barbardhigo dysphagia adkaha kaliya xaaladaha kansarka hunguriga. Xabad xanuun iyo dib u gurasho. M/C Kansarka unugyada squamous hunguriga dhexe ee ku dhawaad ​​5% sababtoo ah cuncun joogto ah oo xuubka xabkaha ah oo joogsiga cuntada iyo dheecaanka. Oof wareenka hamiga ayaa laga yaabaa inuu kobco. Candida esophagitis
  • Sawirka: �Shimbir-beak� oo ku taal liqidda barium GI sare, hunguriga oo furfuran, luminta peristalsis. Baaritaanka endoscopic waa muhiim.
  • Rx: adag. Calcium channel blockers (short-term) .Balaadhinta sambabada, oo wax ku ool u ah 85% bukaanada qaba 3 -5% khatarta dhiigbaxa / daloolka. Cirbadeynta sunta botulinum waxay socotaa kaliya qiyaastii. 12 bilood daaweyn kasta. Waxa laga yaabaa inay nabarto xuubka hoose ee xuubka hoose ee u horseedaya khatarta sii kordheysa ee daloolinta inta lagu jiro myotomy xiga. Myotomy qalliin (Heller myotomy)
  • 10-30% bukaanada ayaa ku dhaca reflux gastroesophageal (GERD)

 

Sawirka ogaanshaha caloosha el paso tx.

 

  • Presbyesophagus: loo isticmaalo in lagu qeexo muujinta shaqada mootada ee hooseysa ee hunguriga gabowga> 80-yo Sababo la xiriira kala-goynta arc reflex oo hoos u dhac ku yimid dareenka kala-baxa iyo isbeddelka peristalsis.
  • Bukaan-socodka ayaa laga yaabaa inay ka cawdaan dysphagia ama xanuunka laabta, laakiin intooda badan waa asymptomatic
  • Diffous/Distal spasm hunguriga (DES) waa cillad dhaqdhaqaaqa hunguriga oo laga yaabo inay u muuqato sida burjileec ama hunguriga tusbaxa ee liqidda barium.
  • 2% xanuunka laabta ee aan wadnaha ahayn
  • Manometry waa baaritaanka ogaanshaha heerka dahabka ah.
Sawirka ogaanshaha caloosha el paso tx.

 

  • Zenker diverticulum (ZD) kiishka pharyngeal
  • Soo bixidda heerka hypopharynx, oo u dhow xuubka hunguriga sare, oo loo yaqaan qallafsanaanta Killian ama saddexagalka Killian
  • Bukaanku waa 60-80 yo waxayna la joogaan dysphagia, regurgitation, halitosis, dareenka globus
  • Waxaa laga yaabaa inay ku adkaato hamiga iyo cilladaha sambabada
  • Bukaan-socodka waxaa laga yaabaa inay urursadaan daawooyinka
  • ZD- waa pseudodiverticulum ama pulsion diverticulum oo ka timaadda herniation of submucosa iyada oo loo sii marayo dehiscence Killian, samaynta kiish halkaasoo cuntada iyo waxyaabaha kale ay ku urursan karaan.
Sawirka ogaanshaha caloosha el paso tx.

 

  • Mallory-Weiss syndrome Waxa loola jeedaa jeexjeexyada xuubka iyo xuubka hoose ee xuubka dhuunta hunguriga ee hunguriga fog ee la xidhiidha dib u soo kabashada/ matagga rabshadaha leh iyo odoroska waxyaabaha caloosha ku jira ee ka dhanka ah hunguriga hoose. Khatar gaar ah ayay ku jiraan khamriga. Kiisaska la socda hematemesis aan xanuun lahayn. Daawaynta caadi ahaan waa taageero.
  • Dx: sawirku door yar ayuu ka ciyaaraa, laakiin isbarbardhigga hunguriga ayaa laga yaabaa inuu muujiyo jeexjeexyo xuubka xuubka ah oo ay ka buuxaan isbarbardhig (sawirka midig ee hoose). Baaritaanka CT-ga ayaa laga yaabaa inuu ku caawiyo in laga saaro sababaha kale ee dhiigbaxa GI sare
Sawirka ogaanshaha caloosha el paso tx.

 

  • Boerhaave syndrome: dilaaca hunguriga ka dib matag xoog leh
  • Soo bandhigid: M>F, matag, laab xanuun, mediastinitis, septic mediastinum, pneumomediastinum, pneumothorax pleural effusion
  • Waagii hore, waxay ahayd mid aan kala go' lahayn oo dhimasho ah
  • Farsamooyinka waxaa ka mid ah in si xoog leh looga saaro maaddooyinka caloosha ku jira gaar ahaan cuntooyinka aan dheefshiidka lahayn marka hungurigu si xoog ah ula qabsado glottis xiran iyadoo 90% uu ka dhaco derbiga dambe ee bidix.
Sawirka ogaanshaha caloosha el paso tx.

 

  • Hiatus hernias (HH): herniation ee waxa ku jira caloosha iyada oo loo marayo hiatus hunguriga hunguriga ee diaphragm galay daloolka thoracic.
  • Bukaanno badan oo qaba HH ​​waa asymptomatic, waana helitaan shil ah. Si kastaba ha ahaatee, calamadaha waxaa ka mid noqon kara xanuunka epigastric/xabadka, qanjidhada ka dib, lallabo iyo matag
  • Mararka qaarkood HH waxaa loo arkaa inay la mid tahay cudurka gastro-oesophageal reflux disease (GORD), laakiin waxaa jira xidhiidh xumo u dhaxaysa labada xaaladood!
  • 2-nooc: hiatus hernia silbanaya 90% & rolling (paraoesophageal) hernia 10%. Midda dambe ayaa laga yaabaa inay ceejiso taasoo keenta ischemia iyo dhibaatooyin.
Sawirka ogaanshaha caloosha el paso tx.

 

  • Cudurka Esophageal Leiomyoma waa M/C neoplasm hunguriga benign. Badanaa way weyn tahay laakiin weli ma xannibayso. Burooyinka xiniinyaha mindhicirku (GIST) ayaa ah kuwa ugu yar hunguriga. Waa in laga soocaa kansarka Esophageal.
  • Sawirka: ka soo horjeeda hunguriga, liqidda barium GI sare, CT scan. Gastroesophagoscopy waa habka Dx ee doorashada.

Sawirka ogaanshaha caloosha el paso tx.

  • Kansarka hunguriga ee hunguriga: lagu soo bandhigo kororka dysphagia, marka hore ilaa adkaha iyo u gudubka dareeraha leh xannibaadda xaalado aad u horumarsan
  • <1% dhammaan kansarrada iyo 4-10% dhammaan cudurrada GI. Waxaa jira isu-soo-bax la aqoonsan yahay oo leh nooca unugga-squamous-ka ee ay sababto sigaarka iyo khamriga. Barrett hunguriga iyo adenocarcinoma
  • M: F 4:1. Shakhsiyaadka madow ayaa aad uga nugul shaqsiyaadka cad 2:1. Saadaasha liidata!
  • Liqidda barium waxay noqon kartaa mid xasaasi u ah aqoonsiga cufka hunguriga. Gastroesophagoscopy (endoscopy) ayaa xaqiijinaysa ogaanshaha iyada oo la adeegsanayo biopsy unugyada
  • Guud ahaan xumaanta ugu badan waa kansarka fundal gastric 2ndary oo soo duulay hunguriga fog
  • Unugga squamous waxaa sida caadiga ah laga helaa hunguriga dhexe, Adenocarcinoma ee gobolka fog
Sawirka ogaanshaha caloosha el paso tx.
  • Kansarka caloosha: malignant aasaasiga ah ee epithelium gastric. Naadirka ka hor da'da 40. Da'da dhexe ee cudurka ogaanshaha gudaha Mareykanka waa 70 sano ragga iyo 74 sano haweenka. Japan, South Korea, Chile, iyo wadamada bariga Yurub waxay leeyihiin mid ka mid ah heerarka ugu sarreeya ee kansarka caloosha ee adduunka. Heerarka kansarka caloosha ayaa hoos u dhacaya adduunka oo dhan. Kansarka gastric waa sababaha 5aad ee dhimashada kansarka la xiriira. Ururka qaba caabuqa Helicobacter pylori 60-80%, laakiin kaliya 2% dadka qaba H. Pyloris ayaa ku dhaca kansarka caloosha. 8-10% waxay leeyihiin qayb qoys oo la dhaxlo.
  • Lymphoma gastric wuxuu sidoo kale ku xiran yahay caabuqa H. Pyloris. Burada unugga Stromal ee xiidmaha mindhicirka ama GIST waa neoplasm kale oo saameeya caloosha
  • Caafimaad ahaan: Ma jiraan wax calaamado ah marka ay tahay mid kore oo suurtagal ah in la daweyn karo. Ilaa 50% bukaanada ayaa laga yaabaa inay qabaan cabashooyin GI oo aan gaar ahayn. Bukaannada ayaa laga yaabaa inay la kulmaan anorexia iyo miisaan lumis (95%) iyo sidoo kale calool xanuun aan caddayn. Lalabbo, matag, iyo dheregsanaanta hore ee d/t xannibaadda ayaa laga yaabaa inay ku dhacdo burooyin waaweyn ama nabarro gudaha ah oo wax u dhimaya kala-baxa caloosha.
  • Saadaasha: Inta badan kansarka caloosha ayaa la ogaadaa goor dambe waxaana laga yaabaa inay muujiso duulaan maxalli ah oo leh adenopathy gobolka, beerka, iyo faafidda mesenteric. Heerka badbaadada 5-sano oo ah 20% ama ka yar. Japan iyo S. Kuuriya, barnaamijyada baadhista hore waxay kordhiyeen badbaadada ilaa 60%
  • sawirka: Barium GI sare ee daraasadda, CT scanning. Baaritaanka endoscopic waa habka doorashada ee cudurka. Sawirada, kansarka caloosha waxa uu u muuqan karaa sida exophytic (polypoid) cuf ama nooca fungative, boog ama faleebo/nooca fidsan (Linitis Plastica). Baaritaanka CT-ga ayaa muhiim u ah in la qiimeeyo soo galitaanka maxalliga ah (nodes, mesentery, beerka, iwm.)
Sawirka ogaanshaha caloosha el paso tx.
  • Cudurka Celiac aka sprue non-tropical aka Gluten-sensitive enteropathy: Unugyada T-guud ee dhexdhexaadinta difaaca jirka ee daba-dheeraaday ee uu sababay dhaawaca xuubabka taasoo keentay luminta villi ee mindhicirka yar ee u dhow iyo malabsorption-ka caloosha (ie, sprue). Waxaa lagu tixgaliyaa xaaladaha qaarkood ee dhiig yaraanta birta ee sabab aan la go'aamin. Waxay ku badan yihiin dadka Caucasians (1 200kiiba) laakiin naadir ku ah Aasiya iyo shakhsiyaadka madowga ah. Laba meelood: koox yar oo carruurnimada hore ah. Caadi ahaan 3aad iyo 4aad ee nolosha.
  • Caafimaad ahaan: Calool xanuunka waa calaamadda m / c, cilladda nafaqooyinka / fitamiinada: IDA iyo saxarada guaiac-positive, shuban, calool-istaag, steatorrhea, miisaan lumis, osteoporosis / osteomalacia, dermatitis herpetiformis. Kordhinta xidhiidhka la leh T-cell lymfoma, korodhka xidhiidhka leh kansarka unugyada hunguriga, SBO
  • Dx: endoscopy-ga sare ee GI oo leh biopsies badan oo duodenal ah ayaa loo arkaa a heerka ogaanshaha cudurada baruurta. Histology waxay daaha ka qaadaysaa dhex galka T-unugga iyo lymphoplasmacytosis, Villi atrophy, Crypts hyperplasia, Submucosa, iyo Serosa waa la badbaadiyay. Rx: baabi'inta alaabooyinka ku jira gluten-ka
  • Sawirka: Looma baahna Dx laakiin Barium liqa fluoroscopy: atrophy xuubka iyo baabi'inta laalaabka xuubka (xaalad sare oo keliya). Kala-baxa SB waa helitaanka ugu caansan. Nodularity of duodenum (bubbly duodenum). Dib u noqoshada jejunal iyo laalaabka xuubka ileal:
  • �Jejunumku waa u ekaa ileum, ileumku wuxuu u eg yahay jejunum, duodenumkuna wuxuu u eg yahay cadaab.
Sawirka ogaanshaha caloosha el paso tx.

Cudurrada mindhicirka bararsan: Cudurka Crohn (CD) & Colitis Ulcerative (UC)

  • CD: Caabuqa difaaca jirka ee joogtada ah oo saameeya qayb kasta oo ka mid ah mareenka GI ee afka ilaa dabada laakiin bilawga inta badan waxay ku lug leedahay ileumka terminal. Soo bandhigida M/C: calool xanuun/maroojin iyo shuban. Jidka: samaynta granulomata oo ka duwan UC waa transmural, oo suurtogal ah in ay keento adag. Meelaha uu caabuqu saameeyay caadi ahaan waa barar
  • Dhibaatooyinku aad bay u badan yihiin: nafaqo-xumada/fitamiinnada oo xumaada (anemia, osteoporosis, dib u dhac korriinka carruurta, u nuglaanshiyaha GI malignant, calool-istaaga, samaynta fistula, caloosha dheeraadka ah: uveitis, arthritis, AS, erythema nodosum iyo kuwa kale. 10-20% waxaa laga yaabaa inuu u baahdo qaliin caloosha ah 10-sano ka dib CD sida caadiga ah adkeynta, fistilization, BO.
  • Dx: bukaan-socod, CBC, CMP, CRP, ESR, serological tests: DDx of IBD: anti-Saccharomyces cerevisiae antibodies (ASCA), perinuclear antineutrophil cytoplasmic antibody (p-ANCA) histologically ama serum. Tijaabada Calprotectin ee saxarada waxay caawisaa DDx IBS waxayna qiimeeyaan jawaabta daawaynta, dhaqdhaqaaqa/soo noqoshada cudurka.
  • Dx doorashada: endoscopic, ileoscopy, iyo biopsies badan ayaa muujin kara isbeddellada endoscopic iyo histological. Fiidiyowga kaabsulka endoscopy (VCE), Imaging ayaa laga yaabaa inay caawiso Dx ee dhibaatooyinka. Rx: dawooyinka difaaca jirka, dawo kaabista, cunto, probiotics, hawlwadeen. Ma jirto dawo laakiin ujeedadu waa in la dhaliyo cafiska, la xakameeyo calaamadaha lagana hortago/daaweeyo dhibaatooyinka
  • Sawirka Dx: KUB ilaa DDx SBO, Barium enema (hal iyo laba jeer is barbar dhig), mindhicir yar ayaa raacaya. Natiijooyinka: nabarrada ka booda, nabarrada aphthous/qoto dheer, mareenka fistula/mareenka sanka, Calaamadda xadhkaha, dufanka gurguurta ee la riixay ee LB, muuqaalka dhagaxa dhagaxa ka sameysan ee d/t fissures/ boogaha riixaya xuubka, CT scan oo leh afka iyo isbarbardhigga IV.
Sawirka ogaanshaha caloosha el paso tx.
  • Sawir laga soo qaaday bukaanka Crohn kaas oo mindhicir yar laga soo gooyay xannibaado.
  • (A) Sawirka CT wuxuu muujinayaa barar aan gaar ahayn halka
  • (B) MRE ee isla aagga ayaa muujinaya adkeyn fibrostenotic ah
Sawirka ogaanshaha caloosha el paso tx.
  • UC: si gaar ah waxay ku lug leedahay oo kaliya xiidanka laakiin ileitis dhabar-wash ayaa laga yaabaa inuu kobco. Bilawga caadi ahaan waa 15-40s waxayna aad ugu badan tahay ragga, laakiin bilawga da'da 50 ka dib waa caadi. In badan oo ka mid ah Waqooyiga Ameerika iyo Yurub (hygiene hypothesis). Etiology: Isku-dhafka deegaanka, hidda-socodka iyo isbeddellada microbiome-ga ee mindhicirka ayaa ku lug leh. Sigaar cabista iyo appendectomy hore waxay u muuqdaan inay muujinayaan xiriir xun oo ay la leeyihiin UC, si ka duwan CD-ga loo tixgeliyey qaar ka mid ah arrimaha khatarta ah.
  • Astaamaha Caafimaadka: Dhiigbaxa malawadka (caadi ah), shuban, dheecaan malawadka, tenesmus (mararka qaarkood), xanuunka caloosha hoose iyo fuuqbax daran oo ka yimaada dheecaanka malawadka (xaalad daran, gaar ahaan dadka waayeelka ah), colitis fulminant iyo megacolon sun ah ayaa noqon kara uurjiif laakiin waa dhibaatooyin naadir ah. . Pathology: Ma jiro granulomata. Boogaha waxay saameeyaan xuubka xuubka iyo xuubka hoose. Pseudopolyps waxay u taagan tahay sida xabkaha la badbaadiyey ee sarreeya.
  • Nidaamka bilawga ah wuxuu had iyo jeer saameeyaa malawadka wuxuuna ahaanayaa cudur maxalli ah (proctitis) gudaha (25%). 30% fiditaanka cudur ee u dhow ayaa dhici karta. UC waxaa laga yaabaa inay u soo bandhigto dhinaca bidix (55%) iyo pancolitis (10%). Kiisaska badankoodu waa kuwa fudud ilaa dhexdhexaad
  • Dx: colonoscopy oo leh ileoscopy oo leh cadaymo badan ayaa xaqiijinaya Dx. Shaybaarada: CBC, CRP, ESR, Calprotectin Fecal, Dhibaatooyinka: dhiig-yarida, megacolon sunta ah, kansarka mindhicirka, cudurada mindhicirka ka baxsan: arthritis, uveitis, AS, Pyoderma gangrenosum, sclerosing cholangitis aasaasiga ah. Rx: 5-aminosalicylic acid afka ama daawaynta malawadka, corticosteroids, daawooyinka immunomodulatory, colectomy waa daawo.
  • Sawirka: looma baahna Dx laakiin barium enema waxay muujin kartaa boogaha, suulka daabacaadda, xaaladaha horumarsan waayida hastra iyo cidhiidhiga xiidanka soo saara xiidanka-lead-ka. kiisaska. CT ayaa laga yaabaa inay ka caawiso Dx ee dhibaatooyinka. Sawirka filimka caadiga ah wuxuu muujinayaa xiidanka-tuubada-lead-ka iyo sacroiliitis sida Enteropathic arthritis (AS)
Sawirka ogaanshaha caloosha el paso tx.
  • kansarka mindhicirka (CRC) m/c Kansarka marinka GI-ga iyo 2-aad ee malignant-ka ugu badan ee dadka waaweyn. Dx: endoscopy iyo biopsy. CT waa hababka inta badan loo isticmaalo diyaarinta. Dib-u-soo-celinta qalliinka ayaa laga yaabaa inay dawo noqoto inkasta oo heerka badbaadada shanta sano uu yahay 40-50% iyadoo ku xiran habaynta. Qodobbada khatarta ah: fiber yar iyo dufan badan iyo cunto borotiinka xoolaha, buurnaanta (gaar ahaan ragga), colitis raaga. Adenoma xiniinyaha (polyps). Qoyska adenomatous polyposis syndromes (Gardener syndrome) iyo Lynch syndrome sida polyposis aan qoyska ahayn.
  • Caafimaad ahaan: bilawga dhagarta leh ee caadooyinka mindhicirka oo bedelay, dhiig cusub ama melena, dhiig yaraanta birta oo ka timaada luminta dhiiga joogtada ah ee sixirka gaar ahaan burooyinka dhinaca midig. Calool-xidhka, xiidmaha, dhiig-baxa culus iyo cudurrada dheef-shiid kiimikaadka gaar ahaan Beerka ayaa laga yaabaa inay bilow u noqdaan. Jidka: 98% waa adenocarcinomas, waxay ka soo jeedaan adenomas colonic (polyps neoplastic) oo hore u jiray oo leh isbeddel xun. Heerka badbaadada shanta sano waa 40-50%, iyadoo marxaladda hawlgalka ay tahay qodobka keliya ee ugu muhiimsan ee saameeya saadaasha. Burooyinka M/C rectosigmoid (55%),
  • NB Qaar ka mid ah adenocarcinomas esp. noocyada mucinous sida caadiga ah soo bandhigay habsaameen oo badiyaa sido saadaal liidata ay sabab u tahay soo bandhigid daahday iyo dheecaanka xabka iyo faafitaan gudaha/ fog
  • Imaging: Barium enema waa dareenka burooyinka> 1 cm, hal ka duwanaansho: 77-94%, kala duwanaansho labajibaaran: 82-98%. Colonoscopy waa habka doorashada ee ka hortagga, ogaanshaha, iyo aqoonsiga kansarka mindhicirka. Iskaanka CT-ga isbarbardhigga ah ayaa loo isticmaalaa dejinta iyo qiimaynta saadaasha ee metts.
  • Baadhitaanka: colonoscopy-ga: ragga 50 yo-10-sano haddii ay caadi tahay, 5-sano haddii polypectomy, FOB, qaraabo darajada 1aad ee CA bilaabay ilaa 40 yo
Sawirka ogaanshaha caloosha el paso tx.

 

Sawirka ogaanshaha caloosha el paso tx.
  • Kansarka ganaca: ductal epithelial adenocarcinoma (90%), saadaal aad u liidata oo leh dhimasho sare. 3aad M/C kansarka caloosha. Colon waa #1, caloosha #2. Kansarka ganaca ayaa 22% ka ah dhammaan dhimashada dhimashada ay sabab u tahay xumaanta caloosha iyo mindhicirka, iyo 5% dhammaan dhimashada kansarka. 80% kiisaska 60+. Sigaar cabista sigaarku waa khatarta ugu xooggan deegaanka, cunno qani ku ah dufanka xoolaha iyo borotiinka. Cayilka. Taariikhda qoyska. M/C laga helay madaxa iyo habka aan la aqbalin.
  • Dx: Iskaanka CT waa muhiim. Duullaanka Halbowlaha Mesenteric Sare (SMA) wuxuu muujinayaa cudur aan la daweyn karin. 90% adenocarcinomas pancreatic waa wax aan lagu sifeynin Dx. Bukaanjiifka badankoodu waxay ku dhintaan 1 sano gudahood Dx. Caafimaad ahaan: cagaarshow aan xanuun lahayn, abd. Xanuun, Xameetida Courvoisier: cagaarshow aan xanuun lahayn iyo xameeti oo weyn, Trousseau's syndrome: trombophlebitis migratory, cudurka macaanka ee cusub ee Mellitus, heer gobol iyo fogaan metastasis.
  • CT Dx: cufnaanta ganaca oo leh falcelin desmoplastic xoog leh, kobcin liidata, iyo hoos u dhac yar marka loo eego qanjirka caadiga ah ee ku xiga, duulaanka SMA.
Sawirka ogaanshaha caloosha el paso tx.
  • Cudurka loo yaqaan 'appendicitis': Xaalad aad u badan oo ku jirta dhaqanka guud ee shucaaca waana sababta ugu weyn ee qalliinka caloosha ee bukaanka da'da yar
  • CT waa habka ugu xasaasisan ee lagu ogaado xanuunka loo yaqaan 'appendicitis'
  • Ultrasound waa in lagu shaqaaleeyaa bukaanada yaryar iyo carruurta
  • KUB Radiographs waa in aanay wax door ah ka ciyaarin ogaanshaha xanuunka appendicitis
  • Sawirka, xanuunka 'appendicitis' wuxuu muujinayaa lifaaqa bararsan oo leh darbi dhumucdiisuna, balaadhinta, iyo baruurta xuubka xuubka. Natiijooyinka la midka ah ee dhumucda derbiga iyo ballaarinta ayaa lagu xusay Maraykanka. Calaamadda bartilmaameedka ee caadiga ah waxay ku taal dhidibka gaaban ee booska baaritaanka Maraykanka.
  • Haddii lifaaqa uu yahay retro-caecal marka loo eego US waxa laga yaabaa inay ku guul darreysato inay bixiso Dx sax ah iyo iskaanka CT ayaa loo baahan karaa
  • Rx: qalliin si looga fogaado dhibaatooyinka
Sawirka ogaanshaha caloosha el paso tx.
  • Xannibaadaha mindhicirka (SBO) -80% dhammaan xannibaadda mindhicirka ee farsamada; 20% soo hartay waxay ka dhalataa xannibaadda weyn ee mindhicirka. Waxay leedahay heerka dhimashada 5.5%
  • M/C sababa: Hx kasta oo qalliin hore oo caloosha ah iyo dhejisyo
  • Soo bandhigida qadiimiga waa calool-istaagga, kordhinta kala-baxa caloosha oo leh lallabbo iyo matag
  • Sawir-qaadista ayaa 50% keliya u nugul SBO
  • CT waxay muujin doontaa sababta SBO 80% kiisaska
  • Waxaa jira shuruudo doorsooma oo loogu talagalay xannibaadda mindhicirka yar ee ugu badan, laakiin 3.5 cm waa qiyaas muxaafid ah oo ah mindhicirka dillaacsan.
  • On Abd x-ray: supine vs. toosan. Mindhicir dilaacay, fidsan valvulae conivente (laalaabka xuubka), beddelka heerarka dareeraha hawo � sallaanka.
  • Rx: qalliin sida � caloosha ba'an
Sawirka ogaanshaha caloosha el paso tx.
  • Volvulus-m/c ee Sigmoid colon esp. waayeelka. Sababta ugu weyn: calool-istaagga dabadheeraad ah oo leh sigmoid-ka-soo-baxa oo ku leexanaya sigmoid mesocolon. Waxay u horseedaa calool istaag weyn (LBO). Sababaha kale ee caadiga ah: burada mindhicirka. Sigmoid vs. Caecum volvulus
  • Kiliinik ahaan: calaamadaha LBO ee calool-istaagga, calool-xanuun, xanuun, lallabbo, iyo matag. Bilawga waxa uu noqon karaa mid degdeg ah ama ba'an
  • Shucaac ahaan: luminta haustra ee LB, kala duwanaanta LB (> 6-cm), calaamadda digirta qaxwada
  • FG: Xeerka suulka ee mindhicirka fidsan waa inuu ahaadaa 3-6-9 halka 3-cm SB, 6-cm LB & 9-cm Coecum
  • Rx: qalliin sida � caloosha ba'an.�
Sawirka ogaanshaha caloosha el paso tx.

tixraacyada

 

Cudurada Habka Laabta ee Sawirka ogaanshaha

Cudurada Habka Laabta ee Sawirka ogaanshaha

Anatomy Core

  • U fiirso jiilka tracheal-bronchial geed, lobes, qaybaha, iyo jeexjeexyada. Ogsoonow lobule sambabada sare (1.5-2-cm) -cutubka shaqada aasaasiga ah ee sambabada ee lagu arkay HRCT. U fiirso qaab dhismeedka muhiimka ah ee meelaha alveolar-ka ah ee leh isgaarsiintu inta u dhaxaysa (daloolada Kohn & kanaalka Lambert) taas oo u oggolaanaysa in hawadu dhaqaaqdo isla habkana u oggolaanaya dareeraha dheecaanka ama transudative inuu ku faafo sambabada oo uu joogsado meesha dillaacsan. U fiirso anatomy ee sambabada: parietal oo ah qayb ka mid ah xuubka endothoracic iyo visceral ee sameeya cidhifka sambabada � meel bannaan oo u dhaxaysa.

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Mediastinum: waxaa ku hareeraysan sambabada iyo sambabada. Waxay dejisaa dhismayaal waaweyn oo ka kooban qanjidhada qanjidhada badan (eeg jaantuska muujinaya qanjidhada dhexe iyo ka-qaybgalkooda Lymphoma

 

Sawirka ogaanshaha laabta el paso tx.

 

Habka Guud ee Baarista Cabashooyinka Laabta

  • Baaritaanka shucaaca (X-ray CXR); tallaabo 1 aad u fiican. Qiimaha jaban, soo-gaadhista shucaaca hooseeya, qiimaynta cabashooyinka caafimaad ee badan
  • Sawirka CT: CT laabta, CT-xalinta sare (HRCT)
  • Habka pathology-ga laabta:
  • Qaxarka
  • Caabuqa
  • Neoplasms
  • Bararka xiiq-dheerta
  • Emphysema Pulmonary
  • Xiriiriyaha
  • Cudurka xuubka
  • Mediastinum

PA & CXR dambe

Sawirka ogaanshaha laabta el paso tx.

 

  • Aragtiyo dheeri ah ayaa la isticmaali karaa:
  • Aragtida Lordotic: waxay ka caawisaa in la qiimeeyo gobollada apical
  • Decubitus wuxuu u fiirsadaa midig iyo bidix: waxay ka caawisaa qiimaynta dheecaanka malabyarowga, pneumothorax iyo cudurrada kale

 

Sawirka ogaanshaha laabta el paso tx.

 

Sawirka ogaanshaha laabta el paso tx.

 

  • CXR PA ee caadiga ah & aragtida dambe. Hubi soo-gaadhis wanaagsan: saxanadaha T-laf-dhabarta iyo weelasha wadnaha dhex mara ayaa lagu arki karaa aragtida PA. Tiri 9-10 feeraha dambe ee midig si aad u xaqiijiso dadaal dhiirigelin ku filan. Bilow sahan dhammaystiran adigoo isticmaalaya habkan: Ma jiraan dhaawacyo badan oo sambabada ah A-caloosha/diaphragm, darbiga T-thorax, M-mediastinum, L-sanbabada si gaar ah, sambabada-labadaba. Samee qaab raadin wanaagsan

 

Sawirka ogaanshaha laabta el paso tx.

 

  • 1) Cudurka hawada hawada ee loo yaqaan alveolar lung disease? Buuxinta alveoli ee sambabada, acini iyo ka dibna labka oo dhan oo leh dareere ama walax kasta oo ka kooban (dhiig, malax, biyo, walxo borotiin ah ama xitaa unugyo) Radiographically: lobar ama qaybinta qaybinta, nodules hawada hawada ayaa laga yaabaa in la xuso, u janjeera in ay coalesce, hawada. bronchograms iyo calaamad silhouette ayaa jooga. Qaybinta (balanbaalista) lagu xusay (CHF). Si degdeg ah isu beddela muddo, ie, korodh ama hoos u dhac (maalmo)
  • 2) Cudurka interstitial: dhexgalka sambabada interstitium (alveoli septum, parenchyma sambabada, darbiyada maraakiibta, iwm) tusaale ahaan fayrasyada, bakteeriyada yaryar, protozoans. Sidoo kale galitaanka unugyada sida unugyada bararka/malignantiga ah (tusaale, lymphocytes) Waxaa loo soo bandhigay xoojinta interstitium sambabada oo leh qaab reticular, nodular, isku dhafan oo reticulonodular ah. Sababo kala duwan: barar cudurada korontadaCudurka sambabada fibrosing, cudurada sambabada shaqada, caabuqa fayras/mycoplasma, TB, sarcoidosis lymphoma/leukemia iyo kuwo kale oo badan.

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Aqoonsiga qaababka kala duwan ee cudurrada sambabada ayaa kaa caawin kara DDx. Curo vs. Isku-dubarid (bidix). U fiirso qaababka kala duwan ee cudurrada sambabada: cudurka hawada sida isku-darka lobar ee tilmaamaya oof-wareen, isku-ururinta fidsan ee tilmaamaysa bararka sambabada. Atelectasis (burburka iyo luminta mugga). Noocyada interstitial ee cudurada sambabada: reticular, nodular ama isku dhafan. SPN vs. Isku-dubarid fara badan (nodules) waxay u badan tahay inay matalaan metts infiltrates vs. septic infiltrates.

 

Sawirka ogaanshaha laabta el paso tx.

 

  • A = intraparenchymal
  • B = pleural
  • C = extrapleura
  • Aqoonso goobta muhiimka ah ee nabarrada laabta

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Calaamadaha muhiimka ah: Calaamadda silhouette: ka caawinta meelaynta iyo DDx. Tusaale: Sawirka hoose ee bidix: shucaaca sambabada midig, xagee ku yaalaa? Sax MM sababtoo ah xudduudaha wadnaha saxda ah ee ku dheggan labka dhexe ee midig lama arko (silhouetted) Hawada bronchograms: hawo ka kooban boronkiito/bronchioles oo ay ku wareegsan yihiin dareere

 

Sawirka ogaanshaha laabta el paso tx.

 

Chest Trauma

  • Pneumothorax (PTX): hawo (gaas) ee bannaanka xuubka. Sababo badan. Dhibaatooyinka:
  • PTX kacsanaan: korodhka joogtada ah ee hawada booska xuubka xuubka kaas oo si degdeg ah u cadaadiya mediastinum iyo sambabada si degdeg ah u yareeya soo noqoshada xididada wadnaha. Waxay noqon kartaa dhimasho haddii aan si degdeg ah loo daweyn
  • Spontaneous PTX: asaasiga ah (30-40) gaar ahaan ragga dhaadheer, dhuuban Sababaha dheeraadka ah: Marfans syndrome, EDS, Homocystinuria, a - 1-antitrypsin deficiency. Secondary: pts ka weyn oo qaba cudurka parenchymal: neoplasms, abscess, emphysema , fibrosis sambabada iyo malabka, catamenial PTX d/t endometriosis iyo kuwa kale.
  • pneumothorax naxdin leh: jeexjeexa sambabada, dhaawacyada aan fiicneyn, iatrogenic (tuubooyinka laabta, iwm.) acupuncture, iwm.
  • CXR: note visceral pleural line aka sambabada geesta. Maqnaanshaha unugyada sambabada/mareenada sambabada ee ka baxsan xariiqda xuubka xuubka aragga. Pneumothorax qarsoon waa la seegi karaa. Marka la eego booska toosan, hawo ayaa kor u kacda iyo PTX waa in la raadiyaa meesha ugu sareysa.
  • Jabka feeraha: v.common. Taxanaha feeraha ama fayraska (tusaale, mets, MM) Taxanaha feeraha x - fallaadho faa'iido badan ma leh sababtoo ah CXR iyo/ama iskaanka CT ayaa aad uga muhimsan in la qiimeeyo PTX ka dib (bidix bidix) dillaacsanaanta sambabada iyo waddo kale oo weyn.

 

Sawirka ogaanshaha laabta el paso tx.

 

Caabuqa

  • Oof wareenka: bakteeriyada vs. fayraska ama fangas ama ku jira martida difaaca difaaca (tusaale, Cryptococcus in HIV/AIDS) TB sambabada

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Oof-wareen: beesha-helay vs. cusbitaal-helay. Bakteeriyada oof wareenka caadiga ah ama Lobar (aan ahayn qayb ka mid ah) oof wareenka oo wata walax suuf ah oo buuxinaysa alveoli kuna faafta dhammaan lobeska. M/C noolaha Streptococcus oof wareenka ama pneumococcus
  • Kuwo kale: (Staph, Pseudomonas, Klebsiella esp. ee khamriga leh oo u horseedi kara necroSIS/gangrene sambabada) Mycoplasma (20-30s) aka sambabada socodka, iwm.
  • Kiliinik ahaan: qufac wax soo saar leh, qandho, laabta xanuunka pleuritic mararka qaarkood hemoptysis.
  • CXR: madhnaanshiyaha hawada isku-darka ah oo ku kooban dhammaan laabka. Bronchograms hawada. Calaamadda silhouette waxay caawisaa goobta.
  • Viral: Hargabka, VZV, HSV, EBV, RSV, iwm. waxay soo bandhigtaa sida cudur sambabada interstitial oo noqon kara laba geesood. Waxaa laga yaabaa inay u horseeddo tanaasul xagga neefsiga ah
  • Oof wareenka aan caadiga ahayn iyo Fungal Pneumonia: Mycoplasma, cudurka Legionnaire, iyo qaar ka mid ah fungal/Cryptococcus pneumonia ayaa laga yaabaa inay la socdaan cudur sambabada interstitial.
  • Nabarka sambabada: ururinta caabuqa ee walxaha purulent ee sambabada oo inta badan necrotizes. Waxa laga yaabaa inay u horseeddo dhibaatooyin xagga sambabada iyo hab-dhiska oo weyn/nafta halis gelisa.
  • On CXR ama CT: ururin wareeg ah oo leh xuduudo dhumuc weyn leh iyo necrosis dhexe oo ka kooban heerka dareeraha hawada. DDx oo ka yimaadda empyema oo qalloocisa sambabada iyo xuubka xuubka
  • Rx: antibiyootik, antifungal, wakiilada fayraska.
  • Oof wareenka wuxuu u baahan yahay in lagu daba galo ku celcelinta CXR si loo hubiyo xallinta dhamaystiran
  • La'aanta hagaajinta shucaaca ee oof-wareenka waxay u taagan tahay difaaca oo hoos u dhacay, iska caabbinta antibiyootiga, kansarka sanbabada hoose ama arrimo kale oo murugsan.

Qaaxada sambabada

Sawirka ogaanshaha laabta el paso tx.

 

  • Caabuqa guud ee aduunka (wadamada aduunka 3aad). 1 ka mid ah 3dii qof ee adduunka oo dhan waxaa saameeya TB. Qaaxada waxaa keena Mycobacterium TB ama Mycobacterium Bovis. Bacillus intracellular. Macrophage ayaa door muhiim ah ka ciyaara.
  • Qaaxada sambabada aasaasiga ah & TB-da aasaasiga ah kadib. Waxay u baahan tahay soo-gaadhis soo noqnoqda iyadoo la neefsanayo. Inta badan ciidamada difaaca jirka, caabuqa firfircooni ma horumaro
  • Qaaxadu waxay soo bandhigtaa sida 1) oo uu nadiifiyo qofka martida loo yahay, 2) oo lagu cadaadiyo Caabuqa Qaaxada Daahsoon (LTBI) 3) wuxuu keenaa cudur firfircoon oo TB. Bukaanka qaba LTBI ma fidiyaan TB.
  • Sawirka: CXR, HRCT. Qaaxada aasaasiga ah: isku-darka hawada sambabada (60%) laf-dhabarta hoose, lymphadenopathy (95% - hilar & paratracheal), xuubka xuubka (10%). Faafitaanka Qaaxada aasaasiga ah waxay u badan tahay inay ku dhacaan kuwa difaaca jirran iyo carruurta.
  • TB-da Milliary: faafinta dhibka sambabada iyo habdhiska oo keeni karta dhimasho
  • Infekshanka dib-u-dhaqaajinta dugsiga hoose (sare) ama dib-u-kicinta: Inta badan Apices iyo qaybaha dambe ee nabarrada sare) PO2 sare, 40% - nabarada cavitating, barar ama cudur hawada isku dhafan, fibrocalcific. Tilmaamaha qarsoon: calcifications nodal.
  • Dx: Bacilli acid-degdega ah (AFB) smear iyo dhaqanka (xaakada). Seerology HIV ee dhammaan bukaannada qaba tiibayda iyo heerka HIV aan la garanayn
  • Rx: 4-daawoyinka: isoniazid, rifampin, pyrazinamide, iyo midkood ethambutol ama streptomycin.

Neoplasms sambabada (kansar sambabada aasaasiga ah vs. metastasis sambabada)

  • Kansarka sambabada: m/c kansarka ragga iyo 6-aad ee kansarka ugu badan ee haweenka. Xiriir adag oo la leh neefsashada kansarka. Kiliinik ahaan: hel goor dambe, taas oo ku xidhan meesha burodu taal. Pathology (noocyada): Unugyada yaryar (SCC) vs. Kansarka unugyada aan yareyn
  • Unug yar: (20%) waxay ka soo baxaan unugyada neuroendocrine aka Kultchitsky, sidaas awgeed waxaa laga yaabaa inay qariyaan walxo bayooloji ahaan firfircoon oo soo bandhigaya xanuunka 'paraneoplastic syndrome'. Caadi ahaan waxay ku taal badhtamaha (95%) ee ama u dhow sagxadda dhexe/labarka bronchus. Badankoodu waxay muujinayaan saadaal xumo oo aan la sixin karin.
  • Unug aan yareyn: adenocarcinoma sambabada (40%) (M/C kansarka sanbabada), M/C ee haweenka iyo kuwa aan sigaarka cabbin. Kuwo kale: Unug-squamous-ka (waxaa laga yaabaa inay la socdaan nabar cakiran), unug weyn iyo qaar kale
  • Filim cad (CXR): dhaawac cusub ama weynaaday, mediastinum balaartay oo soo jeedinaysa ka qayb qaadashada qanjidhada xuubka, dheecaanka xuubka, atelectasis, iyo xoojinta. SPN-waxaa laga yaabaa inay u taagan tahay kansarka sanbabada ee suurtagalka ah gaar ahaan haddii ay ka kooban tahay xudduudaha aan joogtada ahayn, weelasha quudinta, darbiga qaro weyn, ee sambabada sare. Nodules sambabada oo badan ayaa laga yaabaa inay matalaan metastasis.
  • Habka ugu Fiican: HRCT oo ka duwan.
  • Neoplasms laabta kale: Lymphoma waa v. ku badan laabta gaar ahaan qoraalada naasaha dhex dhexaadinta iyo gudaha.
  • Guud ahaan M/C neoplasms sambabada waa metastasis. Burooyinka qaarkood waxay muujinayaan u-hortaag sare oo loogu talagalay sambabada sambabada, tusaale ahaan, Melanoma, laakiin kansar kasta wuxuu u soo bixi karaa sambabada. Meesha qaar ayaa loo yaqaan �Cannonball� metastasis
  • Rx: shucaac, kiimoterabi, dib u soo celin

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Bararka sambabada: erey guud ayaa qeexaya ururinta dareeraha aan caadiga ahayn ee ka baxsan dhismayaasha xididada. Si balaadhan loogu qaybiyey Cardiogenic (tusaale, CHF, mitral regurgitation) iyo non-cardiogenic oo leh sababo badan (tusaale, dareere xad dhaaf ah, shubid ka dib, sababaha neerfaha, ARDS, qarqashada/xiirid u dhow, qiyaasta heroin-ka, iyo kuwa kale)
  • Sababaha: korodhka cadaadiska Hydrostatic vs. hoos u dhaca cadaadiska oncotic.
  • Sawirka: CXR iyo CT: 2-nooc daadka dhexmara iyo Alveolar. Soo bandhigida sawirku waxay kuxirantahay marxaladaha
  • Gudaha CHF: Marxaladda 1: Dib-u-qaybinta socodka xididdada dhiigga (10-18-mm Hg) ee loo aqoonsaday sida �cephalization� ee xididdada sambabada. Marxaladda 2: bararka interstitial (18-25-mm Hg) bararka interstitial: xuubka xuubka, khadadka Kerley (lymphatics oo dareere ka buuxo) khadadka A, B, C. Marxaladda 3: bararka alveolar: cudurka hawada sare: isugaynta balastar ee ka dhalanaysa cudur hawada hawada kala firdhisan: bararka bararka, hawada bronchograms
  • Rx: 3 yoolalka ugu muhiimsan: O2 hore si loo ilaaliyo O2 90% saturation
  • Xiga: (1) hoos u dhigista soo noqoshada xididada sambabada (hoos u dhigista hore), (2) hoos u dhigista iska caabbinta xididdada dhiigga (yaraynta ka dib), iyo (3) taageerada inotropic. Daawo sababaha hoose (tusaale, CHF)

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Atelectasis sambabada: balaadhinta aan dhamaystirnayn ee parenchyma sambabada. Erayga "sambabada dumay" waxa caadiyan loo hayaa marka sambabada oo dhami ay dunto
  • 1).
  • 2) Atelectasis Passive (nasasho) waxay dhacdaa marka xiriirka ka dhexeeya xuubka parietal iyo visceral pleura uu xumaado (xuubka pleural effusion & pneumothorax)
  • 3) Atelectasis Compressive waxay ku dhacdaa natiijadu tahay nabar kasta oo meel bannaan oo dhuunta ku jira oo cadaadis saaraya sambabada oo ku qasbaya hawada alveoli
  • 4) Cicatricial atelectasis: waxay ku dhacdaa natiijada nabarrada ama fibrosis ee yareeya fidinta sambabada sida cudurada granulomatous, necrotizing oof-wareen, iyo fibrosis shucaaca.
  • 5) Atelectasis sambabada xabagta waxay ka timaadaa yaraanta dusha sare iyo burburka alveolar
  • 6) Plate-like ama discoid oo badanaa soo baxa ka dib marka la suuxiyo guud
  • 7) Tilmaamaha sawirka: sambabada oo burburay, guuritaanka sambabada sanbabada, leexashada mediastinum, kor u kaca diaphragm, sicir-bararka sambabada ku dhow

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Mediastinum: pathology waxaa loo qaybin karaa kuwa keena cufnaanta xad-dhaafka ah ama kuwa keena cudurrada faafa ee ku lug leh mediastinum. Intaa waxaa dheer, hawadu waxay la socon kartaa mediastinum ee pneumomediastinum. Aqoonta anatomy mediastinal waxay caawisaa Dx.
  • Baaxadaha dhexe ee hore: thyroid, thymus, teratoma/ burooyinka unugyada jeermiska, lymphoma, lymphadenopathy, kor u kaca aneurysms aortic
  • Baaxadaha dhexe ee dhexe: lymphadenopathy, xididdada dhiigga, nabarrada bronki, iwm.
  • Baaxadaha dhexe ee dhexe: burooyinka neurogenic, aneurysms aortic aneurysms, cufnaanta hunguriga, cufnaanta laf dhabarta, adenopathy silsilad aortic

 

Sawirka ogaanshaha laabta el paso tx.

 

  • Emphysema sambabada: luminta unug laastikada caadiga ah/laastikada sambabada oo burburay xididada iyo septum alveolar / interstitium.
  • Burburka parenchyma sambabada sababtoo ah barar dabadheeraad ah. Burburinta elastin-ku-dhex-dhexaadineed. Qabashada hawada/ balaadhinta hawada, sicir-bararka, dhiig-karka sambabada, iyo isbeddellada kale. Clinical: dyspnea horumarsan, aan laga noqon karin. Waqtiga mugga dhicitaanka qasabka ah ee 1 ilbiriqsi (FEV1) uu hoos ugu dhacay 50% bukaanku waa neefsanayaa marka uu dadaal yar sameeyo wuxuuna la qabsado qaab nololeedka.
  • COPD waa sababta saddexaad ee ugu badan ee dhimashada adduunka. Waxay saamaysaa 1.4% dadka waaweyn ee Maraykanka. M:F = 1: 0.9. Pts 45 jir iyo ka weyn
  • Sababaha: Sigaarka iyo a-1-Antitrypsin yaraanta (oo loo qaybiyo centrilobular (sigaar) iyo panacinar.
  • Sawirka; calaamadaha sicir-bararka, hawo-ku-qabsiga, bulla, dhiig-karka sambabada.

 

Sawirka ogaanshaha laabta el paso tx.

 

Dhaawaca Madaxa iyo Hababka kale ee Sawirka Pathology Intra-Cranial Pathology

Dhaawaca Madaxa iyo Hababka kale ee Sawirka Pathology Intra-Cranial Pathology

Dhaawaca Madaxa: Jabka madaxa

Sawirka dhaawacyada madaxa el paso tx.
  • XOGTA DHAAWACA MADAXA: Caan ka ah HABKA DHAAWACYADA MADAXDA. FX FX AYAA BADAN U FIICAN ARRIMAHA KALE EE DHISAN: Dhiig-baxa-CARANIAL-KA DHEX-DHEXEEYA, Dhaawaca Maskaxda ee Xidhan iyo Dhibaatooyin kale oo Halis ah
  • X-rays-yada dhafoorka ayaa ah kuwa duugoobay marka la qiimeeyo dhaawaca madaxa. CT SCANNING W/O CONTRAST waa tillaabada ugu horeysa ee ugu muhimsan ee qiimaynta madax xun TRAUMA. MRI HASA IYADOO FIIRO GAAR AH SI AY U SOO BANDHIGTO JABAN MADAXDA , OO AAN SI CAR AH LOO ISTICMAALIN DX bilow ah oo madax ba'an TRAUMA.
  • FX SKULL waxa loo aqoonsaday inay yihiin FXS OF SKULL VAULT, SALDHIGA AQOONTA IYO Qalfoofka Wajiga Mid Kasta Oo La Xiriira Sifooyin Gaar Ah Iyo Caawinta Saadaasha Dhibaatooyinka
  • LINEAR SKULL FX: SKULL VAULT. M/C FX. Scanning CT waa furaha lagu qiimeeyo dhiigbaxa halbowlaha ah
  • X-RAY DDX: SUTURES VS. LINEAR SKULL FX. FX waa ka khafiifsan yahay, madaw
  • RX: HADDII UUSAN DHIIG INDHAQAAL AH AAN LA DAAWAYN. DARYEELKA NUURSURIGA HADDII UU DHIIG KA GO'DO CT Scanning
Sawirka dhaawacyada madaxa el paso tx.
  • FX AQOONSI NUUQA: 75% ayaa ku jira khasnadda. WUXUU DHICI KARAA. U fiirsaday FX FURAN. Kiisaska badankoodu waxay u baahan yihiin Neefta-neurosurgicalle-ka-soo-baxa Khaasatan NAFKA Niyad-jabsan > 1-CM. DHIBAATOOYINKA: Dhaawaca xididdada dhiigga/HEMATAMAS, Pneumocephalus, meningitis, TBI, CSF LEAK, Maskaxda Herniation IWM.
  • Sawirka: CT SCANNING W/O CONTRAST
Sawirka dhaawacyada madaxa el paso tx.
  • BASILAR SKULL FX: WUXUU DHICI KARAA. INTA BADAN OO ay weheliso dhaawacyada kale ee ugu waaweyn ee madaxa ee VAULT IYO FACIALSKELETON, BADAN oo leh TBI iyo dhiigbaxa MAJORINTRACRANIAL Inta badan waxa ay u dhacdaa sida �MADAX MADAXA SAAMAYNTA IYO Kacsanaanta Makaanikada ee ay soo maraan lafaha ku meel gaarka ah ee loo maro Sphenoid iyo Saldhigga kale ee lafaha madaxa. Kliinikada: INDHAHA RACCOON, CALAAMADAHA BATTEL, CSFRHINO/OTORRHEA.

Jabka wajiga

Sawirka dhaawacyada madaxa el paso tx.
  • LAfaha sanka FX: 45%. X-rays 80% xasaasi ah, oo ay ku xigto CT INCOMPLEX DHAAWACYADA.
  • ORBITAL AFKA FX: DHAAWAC DHAAWAC AH D/T SAAMEYNTA CAALAMKA IYO/AMA LAFAHA AF-AFKA. FX EE Dabaqa ORBITAL EE INTOMAXILLARY SINUS VS. Darbiga Dhexdhexaadka ah ee ETHMOID SINUS. DHIBAATOOYINKA: DAWLADAHA DHEX-DHEXEEYA M, FAT PROLAPSEORBITAL, FURSAD JACAYL, dhiigbax iyo dhaawac neerfaha indhaha. RX: Walaacaha dhaawaca GLOBE waa muhiim, guud ahaan waxaa loola dhaqmaa si taxadar leh haddii aysan jirin dhibaatooyin
Sawirka dhaawacyada madaxa el paso tx.
  • TRIPOD FX: 2ND M/C FACIAL FX#NASASALKA KA DIB (40% MIDFACEFX) 3-DALBEED FX-ZYGOMATICARCH, HABKA ORBITAL LAFAHA ZYGOMATIC Scanning CT aad ayay u xog badan tahay raajada
  • LEFORT FX: XAFLADA XANUUNKA AH MAR WALBA WAXAY KU lug leedahay Taarikada PTERYGOID, SUURTAGGA KALA SOOCAYNTA DHEXDHEXDEEDA IYO NIDAAMKA ALVEOLAR EE ILKAHA LAGU SOO SAARO MADAXDA. WALWLAD: MADHIGAHA HAWADA, HEMOSTASIS, DHAAWACYADA NERVES. Scanning CT ayaa loo baahan yahay. HALISTA SUURTAGALKA AH EE BASILAR SKULL FX
Sawirka dhaawacyada madaxa el paso tx.
  • PING-PONG FX:GAAR AHAAN CARUURTA. FX D/T FOCALDEPRESSION OO AAN DHAMEYSIN: KEYDKA CIIDANKA, SHAQO ADAG IWM. FOCALTRABECULAR MICROFRACTURIING KA BIXIYADA Niyad-jabka U eg APING-PONG. DX inta badan waxa loo daaweeyaa sidii ciladaha xudunta u ah �Niyad-jabka CAADIGAN NEUROLOGICALY FOG. CT ayaa laga yaabaa inay ku caawiso haddii laga shakiyo dhaawaca maskaxda. RX: U fiirsasho VS. qaliin ISKU-KAAABKA ISKU-KAAABKA ayaa la soo sheegay
Sawirka dhaawacyada madaxa el paso tx.
  • CYSTKA LEPTOMININGEAL (GARAWING SKULL FX) - WAA jeex jeexan oo weyn oo ka soo baxa ku xiga ENCEPHALOMALACIA
  • MA ahan CYST, laakiin waa Kordhinta THEENCEPHALAMALACIA oo lagu arkay dhowr bilood oo dhaawac ah oo hore ula soo baxay Herniation ee meninges iyo ADJACENTBRAIN oo leh muuqaalo CSF ​​ah. CT ayaa ugu Fiican ATDX Cudurkan. WAXAY TILMAAMAY: XOGTA KORAYSA IYO ENCEPHALOMALACIA OO KU HORSEEDA INAY AHAYN LESION FOCALHYPOATTENUating.
  • Kliinikada: balaadhinta KALVARIAL, XANUUN, CALAAMADAHA NUUROLOJIGA AH/XANUUNKA. RX: LA tashiga Neerfaha ayaa loo baahan yahay
  • DDX: Unugyada GALINTA/METS/XANUUNKA KALE EE NEOPLASSINTO, tusaale, infekshanka IWM.
Sawirka dhaawacyada madaxa el paso tx.
  • FXS MANDIBULAR: GUUD Si Suurtagal Ah Ayaa Loo Tixgaliyay FX FURAN D/T INTRA-ORALEXTENSION. 40% FOCAL FOCAL PRESSIONAL IN UU GAARAAN NOQDO. SAAMAYN toos ah (Weerarka) M/C farsamoyaqaanka
  • XANUUNKA XANUUNKA FX D/T LAfaha neoplasms, caabuqa IWM. IATROGENIC INTA LAGU SAMEEYO ILKAHA
  • Sawirka: raajada MANDIBLE, PANOREX, CT Scanning ESP. Kiisaska URURKA/Dhaawaca madaxa
  • DHIBAATOOYINKA: JOOJINTA HAWDADA HAWADA, HEMOSTASIS waa tixgalin weyn, waxyeello loo geysto MANDIBULAR N, Osteomyelitis/cellulites iyo Suurtagalnimada ku faafidda sagxada AFKA LAMA DAYAC KARO D/T HEERARKA DHIMATADA SARE.
  • RX: Conservative VS. SHAQAYSI

Dhiigbaxa Intracranial oo Ba'an

Sawirka dhaawacyada madaxa el paso tx.
  • EPI AKA EXTRADURAL: EDH CT Scanning waa furaha DX: waxay soo bandhigaysaa sida �LENTIFORM� ie BICONVEX COLLECTION OF CUTE (HYPERDENSE) DHIIG AAN AAN ISKU DHACAYN OO KA CAAWINAYA DDX OF HIMATOMA SUBDURAL. Kliinikada: HA, LUCID EPISODE BILOWGII IYO HORUMARAY SAACADAHA YAR GUDOOD O/ADUUNKA FIICAN HADDII SI DEGDEG AH LOOGU SOO BARO.
  • SUBDURAL HEMATOMA (SDH): KUURKA XIDIGAHA DURA GUDAHA IYO ARACHNOIDKA. Waxa laga yaabaa inay si gaar ah u saamayso ciyaalka aadka u yar iyo waayeelka iyo da' walba (MVA, Falls IWM) waxa laga yaabaa inay ku soo kordho DX waxa laga yaabaa in uu dib u dhigo oo uu ka sii daro saadaasha aadka u sarreeya. Dhaawaca madaxa waayeel waxa laga yaabaa inuu yar yahay ama aan dib loo soo celin. HOR U ARAGTIDA CT-du waa muhiim. Waxay soo bandhigaysaa sidii ururin qaabaysan oo ka gudbi kara suutures laakiin ay ku joogsato dib-u-eegis joogto ah. KA duwanaansho ku saabsan CT D/T HARAABOOYIN KALA DUWAN EE DHIIGGA: CUTE, SUBACUTE, IYO CHRONIC. WAXAY SAMEYN kartaa ururin dabadheeraad ah - CYSTICHYGROMA. Kliinikada: Soo bandhigid KALA DUWAN, 45-60% Joogta ah oo leh XAALADA CNS ee aadka u Niyad jabsan, sinnaan la'aanta ardada. BADAN OO LAGU JIRO MASKAXDA UGU HORREEYA, KA DIBNA MUUQAAL FIICAN KA HOR INTAAN SI AAD U DARDAARNIN. 30% kiisas ah bukaanada dhaawaca maskaxda ee dilaaga ah ayaa helay SDH. RX: Neefta Neefta ee Degdega ah.
Sawirka dhaawacyada madaxa el paso tx.
  • Dhiig-baxa SUBARACHNOID (SAH): DHIIGGA MEESHA SUB-ARACHNOID-KA INTAAS KA DHACDAY DHIBAATOOYINKA DHIBAATADA AMA AAN DHIIG-NIINKA AH: BERRY ANEURYSMS KU GEERIYOOYINKA WILLIS.SAH 3% dhufaannada, 5% garaaca wadnaha wadnaha. Madax xanuun PT WUXUU BURBUR KARAA AMA MA SOO CELIN KARO MIYIR. PATHOGY: DHIIG BADBAADIN INSA SPACE 1) SUPRASELLAR CISTERN OO KORDHINTA DHEX-DHEXAYSA, 2) PERIMESENCEPHALIC, 3) CISTERNS BASAL. DHIIGA U SOO BAXAY SA SPACE CADAADIN HOOSOOMEED OO KEENA KORDHINTA CAALAMKA EE CADAADADA INDHAQAALAHA, ISCHEMIA CAALAMIGA AH OO UGU DARSAN VASOSPASM IYO ISBEDELKA KALE.
  • DX: sawirid: CT AQOONSIGA DEGDEGGA AH W/O CONTRAST, CT ANGIOGRAPHY waxa laga yaabaa inay caawiso in la xukumo 99% ee SAH. LUMBAR PUNCURE WAXAY KA CAAWIN kartaa soo jeedinta dib u dhacday. KADIB DX
  • MUUQAALAHA MUUQAALKA AH: DHIIGGA CUNTADA AH waa dhiigkarka CT. Waxaa laga helay unugyo kala duwan: PERIMESENCEPHALIC, SUPRASELLA, BASAL, ventricles,
  • RX. XANUUNKA NUURSURIGA IYO HORUMAR KALE.

CNS Neoplasms: Beign vs. Malignant

Sawirka dhaawacyada madaxa el paso tx.
  • Burooyinka Maskaxda Waxay ka dhigan tahay 2% DHAMMAAN KANSARKA. Seddex meelood hal meel waa xummad, kuwaas oo nabarada Maskaxda ee Metastatic yihiin kuwa ugu badan.
  • Kliinikada oo joogta ah oo leh cillado aan caadi ahayn, ICP oo kordhay, Dhiig-baxa INTRACEREBRAL IWM. FAMILIALSYNDROMES: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 waxay kordhiyaan khatarta. CARUURTA: M/C Astrocytomas, EPENDYMOMAS, PNETNEOPLASMS (tusaale MEDULLOBLASTOMA) IWM. DX: OO KU SALAYSAN CIDDA KALA SOOCAYNTA.
  • Dadka waaweyn: M/C BENIGN NEOPLASM: MENINGIOMA. M/C HOOSE: GLIOBLASTOMA MULTIFORME (GBM) GAAR AHAAN KA TIRSAN SABABABA, MELANOMA, IYO NAASAHA. KUWA KALE: CNS LYMPHOMA
  • SAWIRRADA WAA MUHIIM: CALAAMADAHA ugu horraysa waxay u soo ban dhigi karaan suuxdin, calamadaha ICP HA. WAXAA LAGU QIIMEEYAY CT IYO MRI OO LAGU SAMEEYO IV GADOLInium.
  • GO'aaminta sawirka: INTRA-AXIAL VS. AXIALNEOPLASMS EXTRA-AXIAL. WAXAY KULA KULMEYSAA INUU KA BOGO GARABKA MASKAXDA AASAAmiga ah
  • XUSUUSIN AXIAL CT SLICE OF MeningiOMA oo leh kobcinta AVIDContrast.
  • AXIAL MRI OO KU SAABSAN TAXANAHA FULSE EE FILAIRKA AYAA SOO BANDHIGAY NEOPLASM BAAR AH IYO BARRUURTA CYTOTOXIC EE MASKAXDA SIFAACA FASALKA IV GLIOMA (GBM) OO leh BAROOSIN AAD U FIICAN. KOR SAWIRKA MIDIG FOG: AXIAL MRI FLAIR: BRAIN METASTASIS KAANKA NAASAHA. MELANOMA waa caadi METASTASIZESTO maskaxda (eeg shaybaarka tubbada) MRI AYAA NOQON KARAA D/T calaamad sare oo T1 ah iyo kor u qaadida isbarbardhigga.
  • RX: Neefsiyaha, Shucaaca, Kaneecada, Farsamooyinka Ka-hortagga Cudurrada ayaa soo baxaya

Bararka CNS Pathology

Sawirka dhaawacyada madaxa el paso tx.

Caabuqyada CNS

  • BACTERIAL
  • MYCOBACTERIAL
  • FUNGAL
  • VIRAL
  • PASITIC
Waa maxay sababta Chiropractors ay u isticmaalaan raajada Aalad lagu ogaanayo daawaynta

Waa maxay sababta Chiropractors ay u isticmaalaan raajada Aalad lagu ogaanayo daawaynta

Inta badan bixiyeyaasha daryeelka caafimaadka ayaa isticmaala raajada sida qalab lagu ogaanayo si loogu daweeyo cabashooyinka bukaanka ee kala duwan, oo ay ku jiraan lafopractors. Waxay ka caawin karaan takhaatiirta inay ogaadaan meesha dhibaatada ama haddii ay jiraan wax kale oo socda. Raajooyinka ayaa sidoo kale caawin kara lafopractors go'aaminta habka ugu wanaagsan ee daaweynta. Si aan wax badan u fahamno, aan si dhow u eegno waxay yihiin iyo sida loogu isticmaalo inta badan xafiisyada xanuunka loo yaqaan 'chiropractic offices'.

Waa maxay raajadu?

Raajo waa nooc aad u xoog badan oo ah shucaaca korantada oo la mid ah hirarka raadiyaha, shucaaca ultraviolet, microwaves, ama iftiin muuqda oo loo isticmaalo in lagu eego halabuurka gudaha ee qof ama shay. Ilaysku waxa uu diirada saarayaa qayb gaar ah oo ka mid ah jidhka qofka, sida dhabarka, waxa ay soo saartaa sawirka dhijitaalka ah qalfoofka qaab dhismeedka.

Dhuxulku si sahal ah ayuu u dhex maraa maqaarka iyo unugyo kale oo jilicsan�laakin ma awoodo in uu maro lafaha iyo ilkaha. Unug jilicsan oo cufan, sida xubnaha, seedaha, iyo murqaha, ayaa muuqan doona Meelaha sida mindhicirka ama sambabada ayaa ka muuqda filimka sida madow.

Isticmaalka raajada xanuunka loo yaqaan 'chiropractic ray'

Raajooyinka lafdhabarta ayaa bixiya macluumaad muhiim ah oo saameyn kara sida lafopractor u doorto inuu daweeyo bukaanka. Xaaladaha qaarkood, daryeelka xanuunka loo yaqaan 'chiropractic care' ama wax-ka-qabashada laf-dhabarka ayaa laga yaabaa inaysan ahayn koorsada ficilka ku habboon wakhtigaas, bukaan-socodka waxaa laga yaabaa in lagu bilaabo daaweyn kale oo ka duwan.

Waqtiyada kale, waxay tusi kartaa lafopractor sida ugu wanaagsan ee loo sii wado daaweynta bukaanka. Marka la soo koobo, bukaanadu waxay heli karaan daryeel ka sii wanaagsan, oo si fiican u wareegsan oo si fiican u fududayn kara bogsiintooda iyo maaraynta xanuunka.

Qaar ka mid ah faa'iidooyinka raajo xanuunka loo yaqaan 'chiropractic ray' waxaa ka mid ah:

  • Aqoonso xaalad ama calaamad, sida buro laf dhabarta ama nabar �taasoo bixinaysa sabab caafimaad oo ah in aan daryeel gaar ah la samayn.
  • Hel macluumaadka biomechanical ee muhiimka ah oo kaa caawin kara hagidda daaweynta.
  • Si aad ula socoto oo aad u ilaaliso diiwaanka habsocodka xumaanta bukaanka.
  • Caawinta aqoonsiga cilladaha laf dhabarta iyo kala-goysyada kuwaas oo saameyn kara daaweynta.
  • Waxay u ogolaataa bukaanada inay si fiican u fahmaan xaaladdooda iyo qorshahooda daawaynta, taasoo u ogolaanaysa inay qaataan lahaanshaha nidaamka oo ay aad uga qayb qaataan daawaynta iyo bogsashadooda.
raajada sida qalab lagu ogaanayo el paso tx.

Muxuu lafopractor ka eegayaa filimka raajada?

Marka a lafopractor waxay raajo ka qaadaan bukaanka, waxay wax ka raadinayaan meelo badan oo gaar ah. Waxa ugu horreeya ee ay hubiyaan waa inay hubiyaan inaysan jirin kala-bax, jab, kansar, caabuq, burooyin, ama xaalado kale oo khatar ah.

Kadibna waxay raadiyaan dhererka saxanka iyo calaamadaha kale ee xumaanshaha saxanka, cufnaanta lafaha, lafaha lafaha, meelaha xubnaha ah, iyo toosinta. Tani waxay u oggolaaneysaa inay aqoonsadaan xaaladaha sida scoliosis iyo xaaladaha kale ee u baahan kara qaabab gaar ah oo daaweyn ah.

Dhakhaatiir badan oo loo yaqaan 'chiropractors' ayaa doorbidaya in bukaanku uu ku jiro booska miisaanka marka uu qaadanayo raajo laf dhabarta. Tani way ka duwan tahay inta badan xarumaha caafimaadka ee bukaanku jiifo.

Faa'iidada raajada miisaanka sida qalab lagu ogaanayo waa in ay ogolaato cabbirka, tusaale ahaan, yaraanta dhererka lugaha, scoliosis, iyo cidhiidhinta booska wadajirka ah. Waxay sidoo kale muujin kartaa in lafaha qaarkood, sida tibia iyo fibula, ay kala soocaan taas oo noqon karta calaamad jeexan ama dhibaatada wadajirka ah. Raajo aan miisaan lahayn ma bixin karto aragti isku mid ah, iyo tilmaamaha muhiimka ah ee xaalada bukaanka waa la lumin karaa.

Daawaynta Xanuunka Garabka