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Chuẩ= ;n bị
Giải thích trước với BN
BN cởi bỏ áo, khoác &aac= ute;o khoác. Áo khoác có nút cài ở phía sau. Khi thăm khám chỉ bộc lộ phần ngực phía bên kh&aac= ute;m (trừ lúc quan sát cả hai vú)
Mang gant tay nếu vú có l̖= 3; loét hay có chảy dịch núm vú
Nếu thăm khám vú định kỳ, tốt nhất là hẹn = BN đến khám ngay sau khi sạ= ;ch kinh
------=_NextPart_01C79D14.09554B40 Content-Location: file:///C:/F1686902/KHAMVU-web_files/slide0045.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" KHÁM VÚ
Khi quan sát, cần bộc lộ cả hai vú
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C&aacut= e;c tư thế BN khi quan sát vú
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Khi quan sát hai vú, cần nghi nhận:
Kích thước của hai vú
Sự cân xứng của hai vú
Sự đối xứng của hai núm vú
Đ+= 2;ờng bờ của hai vú
= <= span style=3D'font-size:88%'>Một khối gồ lên hay một chỗ lõm xuố= ng trên bề mặ= ;t da
<= span style=3D'font-size:88%'>Một vùng da có màu sắc bất thường (tấy đỏ hay xạm đen)
= Một vùng da giống “da cam”
<= span style=3D'position:absolute;top:0%;left:4.5%;width:95.49%;height:100.0%'>Một chỗ lở loét
------=_NextPart_01C79D14.09554B40 Content-Location: file:///C:/F1686902/KHAMVU-web_files/slide0008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" KHÁM VÚ
Cần dành nhiều thời gian đ= 875; quan sát vú
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Đừng qu&eci= rc;n quan sát núm vú!
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Chảy dịch từ n&uacut= e;m vú (ghi nhận dịch trong, mũ, dịch như = sữa hay máu)
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M̖= 9;c đích của sờ nắn vú:
Phát hiện khối cộm (quan trọng nhất) trong mô tuyến vú
Phát hiện bất thường của núm vú
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Nguy&e= circ;n tắc sờ nắn vú
Phải sờ nắn mô vú trên một  “tấm đệm” chắc
Không bỏ sót b̐= 5;t kỳ vùng nào của mô tuyến vú
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T̐= 5;m đệm khi sờ nắn vú
Trong hầu hết các trường hợp, “tấm đệm” là c)= 7; ngực lớn được làm căng ra. BN nằm ngữa, có một gối mỏng kê dưới xương bả vai bên khám, cánh t= ay phía bên khám giơ lên trên đầu
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RRhUk3uVnvYy5O1qKKK0Mz//2T== ------=_NextPart_01C79D14.09554B40 Content-Location: file:///C:/F1686902/KHAMVU-web_files/slide0012.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" KHÁM VÚ
T̐= 5;m đệm khi sờ nắn vú
Tấm đệm có thể là lòng bàn tay nâng vú lên
Dành cho BN có vú= to và chảy xệ (BN ở tư thế ng̕= 1;i)
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Để không bỏ sót bất kỳ vùng nào của mô vú khi sờ n= 855;n
Di chuyển v= 883; trí khám theo một cách thức nhất định:
<= span class=3DB1B style=3D'position:absolute;left:-4.23%'>–Hì= ;nh nan quạt
<= span class=3DB1B style=3D'position:absolute;left:-4.23%'>–Hì= ;nh xoắn ốc
<= span class=3DB1B style=3D'position:absolute;left:-4.23%'>–Cá= ;c đường thẳng song song
Chú ý sờ nắn đuôi vú (đuôi vú có thể kéo dài đến hố nách)
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Không bỏ sót vùng nào khi sờ vú
= Có thể thực hiện theo hình xoắn ốc, nan quạt hay những đường song song
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K̘= 9; thuật sờ nắn mô vú
Dùng mặt múp các ngón tay 2,3,4 ép mô vú lên “tấm đệm” theo những vòng tròn nhỏ
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Ch&uac= ute; ý:
Nếu tấm đệm quá mỏng hay kém săn chắc, việc sờ nắn mô vú lên các xương sườn có thể tạo ra các “khối cộm giả tạo”
Cần phân biệt với các khối nằm dưới da với các khối cộm trong mô tuyến vú
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Khi phát hiện một khối cộm bên trong vú, cần ghi nhận:
Vị trí, kích thước
Số lượng
Khối cộm hiện diện ở một hay cả h= ai vú
Mật độ
Giới hạn&= #13;
Tính di động (di động tại chỗ và di động so với cơ ngO= 21;c lớn)
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