Auscultation of children of younger and older age: the main features of the methodology
In the early stages of auscultation of children performed a natural medical "apparatus" - the organ of hearing. The doctor applied his ear to the actual area of the child being examined.
With the development of technology, this method of auscultation of children is considered unacceptable because of its unaesthetic and uninformative nature.
Relevance of the
method In modern pediatric outpatient clinics, as well as in inpatient facilities, auscultation of children is defined as a universal diagnostic method necessary for the detection of cardiac, intestinal, pulmonary and respiratory anomalies.
The main diseases of
Among all the cardiovascular anomalies revealed by the auscultation of children, it should be noted:
- Congenital heart diseases, also referred to as the triad of Fallot.
- Perkardit.
- Myocarditis( as well as other inflammatory pathologies of both the near-cardiac zone and the "motor" itself).
- Hypertrophy of the myocardium.
- Sclerotic abnormality.
- Endocarditis.
Other pathologies
Abnormal conditions that can be diagnosed by auscultation are many. Most often the specialist reveals the presence of:
- pneumonia;
- bronchitis;
- pulmonary emphysema;
- pulmonary tuberculosis;
- of the "silent" lung.
Intestinal anomalies diagnosed by this method are characterized by the fact that the organ is stopped. This stops specific peristaltic noise.
Cardiovascular pathology
Auscultation of the heart in children gives the specialist information regarding:
- Cardiac rhythm.
- heart rate "engine" of the researched.
- Presence of air bubbles in the heart chambers.
- Cardiac output.
If there are air bubbles in the body chambers, the specialist will hear a specific sound similar to the engine or mill wheel noise.
There are five common shocks that are relevant for auscultation of the heart in children:
- apical strike zone;
- zone of the second intercostal space( the edge of the sternum on the right side);
- zone of the second intercostal space on the left side of the sternum;
- zone of the xiphoid process;
- zone of the third-fourth rib on the left side of the sternum( determined by the Botkin point).
How preschool children
are researched For the auscultation of children the specialist is "armed" with a stethoscope equipped with a delicate pad. The first stage of the research is heating the equipment in such a way that its temperature coincides with the temperature of the baby's skin.
The doctor conducting the study should behave according to the age characteristics of the young client.
If the researcher is not yet five or six years old, the doctor may resort to a game, the main condition of which is the child's fulfillment of all the wishes of the elder. This method is relevant in the event that the child is frightened or prejudices against people in white coats. Investigating the actual organs of the young patient in a play form, the specialist "kills two birds with one stone": he gets the necessary information and acts for preventive purposes.
Important nuances of
It should be borne in mind that very small children under the age of twelve months are well received with exhalation and inhalation. In the future, the specialist has the opportunity to detect bronchitis at an early stage.
Auscultation of the heart in children also has its differences. When an infant is examined, strong attenuation of both tones is often observed. The causes of this anomaly have not yet been identified. Sometimes there are functional sound phenomena.
Over time, these noises disappear on their own.
This method of investigation allows to reveal not only the presence of a pathological condition, but also the degree of its progression. It is important to remember that the results obtained by auscultation of children should be confirmed by other methods.
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