1
00:00:01,154 --> 00:00:02,820
Video Stenford
Tibb Fakültəsindən

2
00:00:02,820 --> 00:00:04,990
həkim Mahadevan və Sal Xan

3
00:00:04,990 --> 00:00:06,240
tərəfindən

4
00:00:06,240 --> 00:00:07,240
hazırlanmışdır.

5
00:00:07,240 --> 00:00:09,290
Bu videoda onurğanın boyun şöbəsinin və

6
00:00:09,290 --> 00:00:11,570
boyun nahiyəsinin zədələnmələrindən
danışacağıq.

7
00:00:11,570 --> 00:00:15,014
Boyun yaralanmaları olan xəstələrə

8
00:00:15,014 --> 00:00:16,430
yanaşma prinsipindən və

9
00:00:16,430 --> 00:00:20,522
hava yolu açmaq lazım gəldikdə

10
00:00:20,522 --> 00:00:21,980
invaziv müdaxilələrin

11
00:00:21,980 --> 00:00:23,685
necə aparıldığından

12
00:00:23,685 --> 00:00:24,409
bəhs edəcəyik.

13
00:00:24,409 --> 00:00:25,134
Tənəffüs

14
00:00:25,349 --> 00:00:26,349
yollarında hansısa

15
00:00:26,565 --> 00:00:27,885
maneə olduqda

16
00:00:27,885 --> 00:00:29,047
müdaxilə edilməlidir.

17
00:00:29,047 --> 00:00:30,880
Çox hallarda tənəffüs yollarını

18
00:00:30,995 --> 00:00:31,995
bağlayan bu maneə

19
00:00:32,110 --> 00:00:34,500
dil olur. Maneə yarandıqda

20
00:00:34,500 --> 00:00:35,485
isə hava ağciyərlərə

21
00:00:35,485 --> 00:00:36,470
daxil ola bilmir,

22
00:00:36,470 --> 00:00:38,270
nəticədə,
ölüm baş verir.

23
00:00:38,270 --> 00:00:40,540
Huş itirildiyi zaman, dili
hərəkət etdirən

24
00:00:40,540 --> 00:00:42,180
əzələlər boşalır, dil udlağa

25
00:00:42,180 --> 00:00:45,220
tərəf istiqamətlənir. Nəticədə,

26
00:00:45,220 --> 00:00:46,470
tənəffüs yollarını

27
00:00:46,470 --> 00:00:50,630
bağlayır. Bu halda burundan
və ya ağızdan

28
00:00:50,630 --> 00:00:53,030
tənəffüs zamanı hava

29
00:00:53,030 --> 00:00:54,900
nəfəs borusuna, oradan da

30
00:00:54,900 --> 00:00:57,750
ağciyərlərə keçə bilmir.

31
00:00:57,750 --> 00:00:58,970
Yəni,

32
00:00:58,970 --> 00:00:59,970
insan huşunu itirib

33
00:00:59,970 --> 00:01:00,770
şəkildəki kimi

34
00:01:01,250 --> 00:01:02,710
yıxıldıqda tənəffüsü

35
00:01:02,710 --> 00:01:04,582
dayana, nəfəssiz

36
00:01:04,582 --> 00:01:05,582
qala bilər.

37
00:01:05,582 --> 00:01:07,040
Bu zaman o

38
00:01:07,040 --> 00:01:09,040
nəfəs almağa çalışsa da,

39
00:01:09,040 --> 00:01:11,331
ağciyərlərə kifayət qədər hava

40
00:01:11,331 --> 00:01:14,110
dola bilməyəcək. Burada

41
00:01:14,110 --> 00:01:14,960
ilk müdaxilə

42
00:01:14,960 --> 00:01:16,530
dilin yaratdığı maneəni

43
00:01:16,530 --> 00:01:17,920
aradan qaldırmaqdır.

44
00:01:17,920 --> 00:01:18,878
İlk iki şəkildə

45
00:01:18,878 --> 00:01:22,100
bunun təsvirini

46
00:01:22,100 --> 00:01:24,120
görürük. Birincidə

47
00:01:24,120 --> 00:01:28,107
başın geriyə, çənənin önə

48
00:01:28,107 --> 00:01:28,940
gətirildiyi

49
00:01:28,940 --> 00:01:32,980
vəziyyəti görürük. Xəstə
arxasıüstə yatır,

50
00:01:32,980 --> 00:01:35,510
müdaxilə edən şəxs isə
bir əlini onun alnına,

51
00:01:35,510 --> 00:01:36,732
digər əlini çənəsinə

52
00:01:36,732 --> 00:01:37,690
yerləşdirir. Başı

53
00:01:37,690 --> 00:01:40,300
arxaya, çənəni isə
çənə sümüyündən tutaraq önə

54
00:01:40,300 --> 00:01:42,630
çəkməklə dili tənəffüs
yollarından kənarlaşdırır.

55
00:01:42,630 --> 00:01:45,120
Nəticədə, hava ağciyərlərə

56
00:01:45,120 --> 00:01:47,900
daxil ola bilir.

57
00:01:47,900 --> 00:01:48,620
Qeyd edim ki,

58
00:01:48,620 --> 00:01:50,410
gördüyünüz bu şəkillər

59
00:01:50,410 --> 00:01:51,730
real xəstələrdən alınaraq

60
00:01:51,730 --> 00:01:52,650
illustrasiyaya

61
00:01:52,650 --> 00:01:53,665
çevrilmişdir.

62
00:01:53,665 --> 00:01:55,210
Mövzumuza

63
00:01:55,210 --> 00:01:56,550
geri

64
00:01:56,550 --> 00:01:58,520
qayıdaq.

65
00:01:58,520 --> 00:01:59,730
Əvvəldə

66
00:01:59,730 --> 00:02:01,410
danışdıqlarımıza

67
00:02:01,410 --> 00:02:02,740
əlavə

68
00:02:02,740 --> 00:02:04,950
edək ki,

69
00:02:04,950 --> 00:02:06,105
xəstədə

70
00:02:06,105 --> 00:02:08,585
onurğa sütununun

71
00:02:08,585 --> 00:02:12,200
yaralanması

72
00:02:12,200 --> 00:02:13,250
baş verərsə,

73
00:02:13,250 --> 00:02:14,083
boynu hərəkətə

74
00:02:14,083 --> 00:02:15,370
gətirmək və ya

75
00:02:15,370 --> 00:02:17,286
başı arxaya çəkmək

76
00:02:17,286 --> 00:02:21,290
zədələnməyə gətirib
çıxara bilər.

77
00:02:21,290 --> 00:02:24,400
Xəstənin boynu
döndərilsə və ya boyun

78
00:02:24,400 --> 00:02:26,360
nahiyəsinə təzyiq
göstərilsə, sümüklər

79
00:02:26,360 --> 00:02:29,250
yerdəyişmə edə bilər
və bu da daha ciddi zədələnmələrə

80
00:02:29,250 --> 00:02:31,570
səbəb ola bilər. Buna görə də
onurğanın boyun

81
00:02:31,570 --> 00:02:33,540
nahiyəsinin yaralanmaları zamanı
bu

82
00:02:33,540 --> 00:02:34,590
üsuldan istifadə

83
00:02:34,590 --> 00:02:36,642
olunmur.

84
00:02:36,642 --> 00:02:37,850
Sağ

85
00:02:37,850 --> 00:02:38,940
tərəfdəki

86
00:02:38,940 --> 00:02:41,320
metoda

87
00:02:41,610 --> 00:02:43,170
üstünlük verilir.

88
00:02:43,170 --> 00:02:44,792
Bu üsulda boyun nahiyəsinə daha az

89
00:02:44,792 --> 00:02:45,750
təzyiq göstərilir.

90
00:02:46,290 --> 00:02:47,357
Bu zaman

91
00:02:47,357 --> 00:02:48,357
sümüklərin

92
00:02:48,357 --> 00:02:49,690
yerdəyişmə

93
00:02:49,690 --> 00:02:52,309
ehtimalı

94
00:02:52,309 --> 00:02:53,309
daha az olur.

95
00:02:53,309 --> 00:02:54,600
Sağdakı

96
00:02:54,600 --> 00:02:55,866
şəkilə baxaq.

97
00:02:56,450 --> 00:02:58,480
Burada boyun yaralanması olan

98
00:02:58,480 --> 00:03:00,239
xəstədə çənəni itələmə

99
00:03:00,239 --> 00:03:02,030
manevri ilə dil tənəffüs

100
00:03:02,030 --> 00:03:04,113
yollarından uzaqlaşdırılır.

101
00:03:04,113 --> 00:03:06,080
Bu zaman

102
00:03:06,080 --> 00:03:08,190
çənə bucağı

103
00:03:08,190 --> 00:03:12,680
dörd barmaqla

104
00:03:12,680 --> 00:03:14,990
90 dərəcə bucaq altında

105
00:03:14,990 --> 00:03:17,790
tutularaq

106
00:03:17,790 --> 00:03:19,860
yuxarı

107
00:03:19,860 --> 00:03:22,880
çəkilir. Baş barmaqlarla

108
00:03:22,880 --> 00:03:25,350
çənə önə itələnir.

109
00:03:25,350 --> 00:03:27,974
Bu, birinci şəkildəki üsula

110
00:03:27,974 --> 00:03:28,790
oxşayır, ancaq

111
00:03:28,790 --> 00:03:29,720
birincidən fərqli

112
00:03:29,720 --> 00:03:31,178
olaraq, burada boyuna təzyiq

113
00:03:31,178 --> 00:03:32,352
göstərilmir. Beləliklə,

114
00:03:32,352 --> 00:03:34,310
çənəni hərəkətə gətirdikdə,
dil də önə

115
00:03:34,310 --> 00:03:35,030
çəkilir və

116
00:03:35,030 --> 00:03:36,130
tənəffüs
yollarında olan

117
00:03:36,130 --> 00:03:37,921
maneə aradan qalxır.

118
00:03:37,921 --> 00:03:39,890
Bu üsul travma keçirmiş

119
00:03:39,890 --> 00:03:41,830
xəstələrdə tətbiq edilir.

120
00:03:41,830 --> 00:03:46,460
Daha aydın olması üçün,
rentgen görüntülərinə

121
00:03:46,460 --> 00:03:48,865
nəzər salaq.

122
00:03:48,865 --> 00:03:51,850
Eyni pasiyenti görürük.

123
00:03:51,850 --> 00:03:55,530
Birinci rentgendə onurğa sütunun
görünüşü normaya

124
00:03:55,530 --> 00:03:58,140
tam uyğundur. Uyğunluğa
nəzər salsaq,

125
00:03:58,140 --> 00:03:59,470
bu, fəqərə cisimlərinin

126
00:03:59,470 --> 00:04:00,360
ön,

127
00:04:00,360 --> 00:04:02,318
bu isə

128
00:04:02,318 --> 00:04:05,850
arxa xəttidir. Daha sonra

129
00:04:05,850 --> 00:04:08,370
onurğa-səfhə xətti və
tin çıxıntılarını birləşdirən

130
00:04:08,370 --> 00:04:13,590
xətti görürük. Hər biri
normal görünür.

131
00:04:13,590 --> 00:04:16,616


132
00:04:16,616 --> 00:04:17,490


133
00:04:17,490 --> 00:04:18,698


134
00:04:18,698 --> 00:04:19,850


135
00:04:19,850 --> 00:04:21,850


136
00:04:21,850 --> 00:04:24,160


137
00:04:24,160 --> 00:04:27,210


138
00:04:27,210 --> 00:04:28,710


139
00:04:28,710 --> 00:04:33,770


140
00:04:33,770 --> 00:04:35,650


141
00:04:35,650 --> 00:04:38,730


142
00:04:38,730 --> 00:04:40,444


143
00:04:40,444 --> 00:04:41,110


144
00:04:41,110 --> 00:04:43,230


145
00:04:43,230 --> 00:04:45,155


146
00:04:45,155 --> 00:04:49,320


147
00:04:49,320 --> 00:04:51,399


148
00:04:51,399 --> 00:04:53,190


149
00:04:53,190 --> 00:04:53,610


150
00:04:53,610 --> 00:04:53,900


151
00:04:53,900 --> 00:04:54,858


152
00:04:54,858 --> 00:04:56,960


153
00:04:56,960 --> 00:04:58,565


154
00:04:58,565 --> 00:04:59,231


155
00:04:59,231 --> 00:05:00,210


156
00:05:00,210 --> 00:05:01,750


157
00:05:01,750 --> 00:05:05,770


158
00:05:05,770 --> 00:05:08,632


159
00:05:08,632 --> 00:05:09,340


160
00:05:09,340 --> 00:05:10,890


161
00:05:10,890 --> 00:05:13,431


162
00:05:13,431 --> 00:05:15,200


163
00:05:15,200 --> 00:05:16,890


164
00:05:16,890 --> 00:05:17,848


165
00:05:17,848 --> 00:05:20,110


166
00:05:20,110 --> 00:05:23,099


167
00:05:23,099 --> 00:05:23,890


168
00:05:23,890 --> 00:05:25,140


169
00:05:25,140 --> 00:05:25,390


170
00:05:25,390 --> 00:05:27,010


171
00:05:27,010 --> 00:05:29,960


172
00:05:29,960 --> 00:05:32,905


173
00:05:32,905 --> 00:05:34,780


174
00:05:34,780 --> 00:05:35,613


175
00:05:35,613 --> 00:05:38,510


176
00:05:38,510 --> 00:05:41,470


177
00:05:41,470 --> 00:05:44,040


178
00:05:44,040 --> 00:05:46,880


179
00:05:46,880 --> 00:05:47,890


180
00:05:47,890 --> 00:05:50,990


181
00:05:50,990 --> 00:05:53,150


182
00:05:53,150 --> 00:05:56,480


183
00:05:56,480 --> 00:05:58,795


184
00:05:58,795 --> 00:06:00,107


185
00:06:00,107 --> 00:06:00,690


186
00:06:00,690 --> 00:06:01,490


187
00:06:01,490 --> 00:06:02,240


188
00:06:02,240 --> 00:06:05,400


189
00:06:05,400 --> 00:06:07,400


190
00:06:07,400 --> 00:06:09,400


191
00:06:09,400 --> 00:06:11,760


192
00:06:11,760 --> 00:06:14,400


193
00:06:14,400 --> 00:06:17,950


194
00:06:17,950 --> 00:06:22,210


195
00:06:22,210 --> 00:06:24,090


196
00:06:24,090 --> 00:06:26,500


197
00:06:26,500 --> 00:06:28,030


198
00:06:28,030 --> 00:06:29,530


199
00:06:29,530 --> 00:06:31,140


200
00:06:31,140 --> 00:06:33,397


201
00:06:33,397 --> 00:06:34,980


202
00:06:34,980 --> 00:06:39,680


203
00:06:39,680 --> 00:06:41,530


204
00:06:41,530 --> 00:06:44,520


205
00:06:44,520 --> 00:06:47,760


206
00:06:47,760 --> 00:06:49,710


207
00:06:49,710 --> 00:06:50,740


208
00:06:50,740 --> 00:06:52,240


209
00:06:52,240 --> 00:06:54,180


210
00:06:54,180 --> 00:06:55,850


211
00:06:55,850 --> 00:06:57,160


212
00:06:57,160 --> 00:06:58,659


213
00:06:58,659 --> 00:07:03,570


214
00:07:03,570 --> 00:07:06,885


215
00:07:06,885 --> 00:07:10,410


216
00:07:10,410 --> 00:07:13,030


217
00:07:13,030 --> 00:07:16,140


218
00:07:16,140 --> 00:07:17,420


219
00:07:17,420 --> 00:07:18,200


220
00:07:18,200 --> 00:07:19,050


221
00:07:19,050 --> 00:07:20,508


222
00:07:20,508 --> 00:07:22,610


223
00:07:22,610 --> 00:07:24,040


224
00:07:24,040 --> 00:07:25,220


225
00:07:25,220 --> 00:07:25,580


226
00:07:25,580 --> 00:07:26,750


227
00:07:26,750 --> 00:07:28,030


228
00:07:28,030 --> 00:07:29,571


229
00:07:29,571 --> 00:07:32,519


230
00:07:32,519 --> 00:07:33,810


231
00:07:33,810 --> 00:07:34,470


232
00:07:34,470 --> 00:07:34,770


233
00:07:34,770 --> 00:07:35,978


234
00:07:35,978 --> 00:07:36,960


235
00:07:36,960 --> 00:07:39,050


236
00:07:39,050 --> 00:07:40,900


237
00:07:40,900 --> 00:07:42,680


238
00:07:42,680 --> 00:07:45,260


239
00:07:45,260 --> 00:07:47,430


240
00:07:47,430 --> 00:07:49,440


241
00:07:49,440 --> 00:07:52,975


242
00:07:52,975 --> 00:07:54,077


243
00:07:54,077 --> 00:07:55,410


244
00:07:55,410 --> 00:07:56,670


245
00:07:56,670 --> 00:07:58,950


246
00:07:58,950 --> 00:08:01,460


247
00:08:01,460 --> 00:08:03,827


248
00:08:03,827 --> 00:08:04,660


249
00:08:04,660 --> 00:08:07,140


250
00:08:07,140 --> 00:08:08,651


251
00:08:08,651 --> 00:08:09,150


252
00:08:09,150 --> 00:08:11,502


253
00:08:11,502 --> 00:08:12,960


254
00:08:12,960 --> 00:08:18,164


255
00:08:18,164 --> 00:08:18,830


256
00:08:18,830 --> 00:08:20,496


257
00:08:23,250 --> 00:08:24,465


258
00:08:24,465 --> 00:08:26,710


259
00:08:26,710 --> 00:08:29,700


260
00:08:29,700 --> 00:08:32,836


261
00:08:32,836 --> 00:08:33,502


262
00:08:33,502 --> 00:08:36,320


263
00:08:36,320 --> 00:08:38,470


264
00:08:38,470 --> 00:08:41,092


265
00:08:41,092 --> 00:08:42,050


266
00:08:42,050 --> 00:08:43,140


267
00:08:43,140 --> 00:08:45,310


268
00:08:45,310 --> 00:08:47,309


269
00:08:47,309 --> 00:08:49,844


270
00:08:49,844 --> 00:08:51,260


271
00:08:51,260 --> 00:08:52,190


272
00:08:52,190 --> 00:08:52,550


273
00:08:52,550 --> 00:08:54,260


274
00:08:54,260 --> 00:08:56,480


275
00:08:56,480 --> 00:08:56,850


276
00:08:56,850 --> 00:08:57,220


277
00:08:57,220 --> 00:08:58,280


278
00:08:58,280 --> 00:08:59,280


279
00:08:59,280 --> 00:09:01,930


280
00:09:01,930 --> 00:09:05,450


281
00:09:05,450 --> 00:09:08,740


282
00:09:08,740 --> 00:09:10,027


283
00:09:10,027 --> 00:09:11,610


284
00:09:11,610 --> 00:09:13,860


285
00:09:13,860 --> 00:09:16,490


286
00:09:16,490 --> 00:09:19,680


287
00:09:19,680 --> 00:09:22,220


288
00:09:22,220 --> 00:09:22,935


289
00:09:22,935 --> 00:09:24,495


290
00:09:24,495 --> 00:09:26,562


291
00:09:26,562 --> 00:09:27,770


292
00:09:27,770 --> 00:09:28,070


293
00:09:28,070 --> 00:09:28,370


294
00:09:28,370 --> 00:09:30,990


295
00:09:30,990 --> 00:09:33,394


296
00:09:33,394 --> 00:09:34,810


297
00:09:34,810 --> 00:09:36,226


298
00:09:36,226 --> 00:09:39,155


299
00:09:39,155 --> 00:09:39,825


300
00:09:39,825 --> 00:09:40,560


301
00:09:40,560 --> 00:09:42,459


302
00:09:42,459 --> 00:09:44,500


303
00:09:44,500 --> 00:09:46,030


304
00:09:46,030 --> 00:09:47,460


305
00:09:47,460 --> 00:09:50,100


306
00:09:50,100 --> 00:09:52,260


307
00:09:52,260 --> 00:09:53,960


308
00:09:53,960 --> 00:09:55,810


309
00:09:55,810 --> 00:09:56,570


310
00:09:56,570 --> 00:09:57,030


311
00:09:57,030 --> 00:09:57,290


312
00:09:57,290 --> 00:09:57,500


313
00:09:57,500 --> 00:09:59,350


314
00:09:59,350 --> 00:10:00,934


315
00:10:00,934 --> 00:10:01,599


316
00:10:01,599 --> 00:10:03,040


317
00:10:03,040 --> 00:10:03,320


318
00:10:03,320 --> 00:10:03,930


319
00:10:03,930 --> 00:10:04,888


320
00:10:06,471 --> 00:10:08,220


321
00:10:08,220 --> 00:10:09,595


322
00:10:09,595 --> 00:10:12,590


323
00:10:12,590 --> 00:10:14,090


324
00:10:14,090 --> 00:10:17,350


325
00:10:17,350 --> 00:10:20,090


326
00:10:20,090 --> 00:10:22,630


327
00:10:22,630 --> 00:10:24,590


328
00:10:24,590 --> 00:10:26,530


329
00:10:26,530 --> 00:10:29,160


330
00:10:29,160 --> 00:10:31,100


331
00:10:31,100 --> 00:10:31,600


332
00:10:31,600 --> 00:10:31,850


333
00:10:31,850 --> 00:10:32,680


334
00:10:32,680 --> 00:10:33,763


335
00:10:33,763 --> 00:10:34,970


336
00:10:34,970 --> 00:10:36,650