A: Airway ( ng dn kh )

Kho st kh qun, ph qun gc tri & phi, ph qun trung gian.

B: Breathing ( H hp )
Kho st xem 2 phi c n u, so snh cc vng phi.
Kho st nhng ng, b ca mi phi.
Kho st 4 bng ( 4 silhouettes ).

C: Circulation ( Tun hon )

Kho st kch thc tim.
Kho st cc mch mu ln ( mch mu phi v ng mch ch )
Kho st trung tht v rn phi.

D: Disability ( Tn thng )
Kho st cc gy xng, c bit xng sn v ai vai ).

E: Everything else ( Nhng th cn li )

Kho st kh di c honh.
Kho st trn kh di da.
Kho st bng v.
Kho st d vt
A: Airway ( ng dn kh ): Kho st kh qun, ph qun gc tri & phi,
ph qun trung gian.
Kho st nh th no
Bt u t kh qun (1) t trn xung. Kh qun nn ng gia. N
chia i gc carina (2) thnh ph qun gc T (3) v ph qun gc P
(4).
bn T, ng dn kh kt thc ti ch chia i ca ph qun gc T, ni
m dn vo ph qun thy trn (5) v ph qun thy di (6).
bn P, ph qun gc P cho ra ph qun thy trn (7), tip tc i
xung di thnh ph qun trung gian (8). ng dn kh kt thc ti
ch chia i ca ph qun trung gian, ni m dn vo ph qun thy
gia (9), v ph qun thy di (10).

Cc ng dn kh phi.

Cn kho st nhng g:
Tracheal deviation ( Kh qun c lch khng ? ).
Carina angle ( Gc carina ).
V d: Nu bnh thng th ghi : kh qun trung tm .
Tracheal deviation
Kh qun c cn nhc l lch khi mt phn, bt k u dc theo chiu di
ca n, hon ton nm v bn phi hay bn tri so vi ng gia ( ng gia
nm trung tm ct sng c xc nh bng cc mm gai ).
Lu : Phi m bo phim khng b xoay, mt phim xoay s cho n tng l
kh qun lch trong khi thc t n nm trung tm.
Nu nh nghi ng kh qun lch, hy ngh n tm nguyn nhn.
1. Kh qun hng v pha tn thng ( tn thng ko kh qun ):
Xp phi.
Ct phi hoc ct thy phi.
Unilateral fibrosis ( x ha phi ngoi bin ? ).
Thiu sn phi.
2. Kh qun ra xa tn thng ( tn thng y kh qun ):
Trn khi mng phi p lc.
Trn dch mng phi ( ln ).
Khi trung tht.
Khi cnh kh qun.
Nhng nguyn nhn thng gp c in nghing, m.
Nhng bnh cnh khc nh ng c, trn kh mng phi khng p lc,.. c t
nh hng ln s lch kh qun.
V d:

Kh qun c t bng mu xanh dng hnh bn phi. C th thy khi tn

thng phi P v rn phi, vi kt qu l xp thy gia, ko kh qun lch
sang P.
Carina angle
Gc carina l gc gia ph qun gc T & P. Bnh thng gc ny khong 400-
1000. Mt s gia tng ca gc carina l du hiu bnh hc gin tip ca tim,
trung tht, phi, do nu gc carina ln hn 1000 cn tm bnh nguyn gy ra
vic ny.
Gc ny ln khi c mt th bn di n y hoc l mt ci g ko bn trn
2 ph qun gc T & P.

Mt gc carina rng c th ch ra:

Khi di gc carina ( K ph qun, thot v,)
Ln nh tri, tim ln hoc trn dch mng ngoi tim.
Xp thy trn phi T hoc P ( ko ph qun gc ln trn ).
V d

Gc carina ln hn 1000. Phim bn P kh qu, ph qun gc T & P c t mu

xanh.
B: Breathing ( H hp )
Kho st nh th no
Qui tc c bn l en=kh v trng=khng c kh. C 5 vic chnh cn
kho st.
1. Phi c n u hay khng ?
2. So snh cc vng phi: so snh nh, 1/3 trn,
gia, di 2 bn vi nhau.
3. Kho st cc ng b ca mi phi.
4. Kho st cc gc sn honh.
5. Kho st 4 bng
Bng tim bn phi. Mt bng tim bn phi ch ra vic
mt kh thy gia ( lin quan ti xp hay ng c ).
Bng tim bn tri. Mt bng tim bn tri ch ra mt kh thy li ( tng ng
vi thy gia ca phi tri ).
C honh bn P. Mt s r ca bng c honh ch ra mt kh thy di ( xp
hay ng c ) hoc c mt th g nm gia c honh v
C honh bn T. thy di ca phi ( v d nh dch ).

4 silhouettes c nh du trn phim bn P. Bng tim bn P mu (i), bng

tim bn T mu vng (ii), vm honh P mu tm (iii), vm honh T mu hng
(iv).
Cn kho st nhng g:
Phim XQ ngc khng ch ra nhiu bnh c trng nh vim phi, k ph
qun,..m ch c nhng du hiu ca bnh, ci m a ra chng c lin quan
n qu trnh c bn ca bnh. Nhng bnh v du hiu di y bn cn bit.
ng c/ bng m.
Kh ph qun .
Xp phi:
Xp thy trn P.
Xp thy gia.
Xp thy di P.
Xp thy trn T.
Xp thy di T.
Xp phi hon ton.
Ct phi.
Khi n c.
Tn thng a khi.
Tn thn dng hang.
X ha.
Trn kh mng phi.
Trn kh p lc.
Trn dch-trn kh mng phi.
Trn dch mng phi.
Ph phi.
Du hiu cnh di.
Cc ng Kerley.
V d: nu bnh thng: 2 phi n u v cc vng phi r.