Giáo Trình Tác Động Cột Sống

DAp da trtioc. Khi co thu nhuan mOi dUng thu thuat. Khong co phan loai. An tay vao, no trat tra trat treo va di da.ng. Vu6t gdn len hinh thai ding chAc. Co loai tat nAm ngang trail d6t[r]

LU'O'NG Y NGUYtN THAM TAN

TAC GIA

CAM NAN G

vE

PHOING PHAP TAC BONG COT SONG

BO 13(5C CUONG bien sown

QW.,N II

HA NO, THANG 6-2002

MUC LUC

Trang

1 Ngu6n goc va hi:6u qua caa phuang phap tac dOng cot song 5 - 12

Kinh clang len Thdy luong y Nguyen Thom Tan kinh mkt, DOng kinh gui ccic ban dOng man dux PPTDCS than rne'n!

Toan bo cutin scich nay la nhung kinh nghiem guy, bdu trong 53 nam hanh nghe mkt Thdy chting

to - Luang y Nguyen Thom Tan Thdy da day di va ccic ban clang mon tic nam 1979 can nam 2000 Cay dai thu cua phuong phap Tae clang cot sting da ra di "Ban tay nhung, ban tay yang cua Theiy" khong con na-a Thel y mat di, 'de lei cho gia dinh, ban be va deing mon chting ta n6i mat mat dau thuong that la vez han M6i khi chting to chat berth bang phuorzg phcip Tae clang cot song, ai ai cung nho den Thay, nh& Thdy phu ho cho co sac khoe de chug benh cuu Hinh dnh cua Thety, lbi day cua Theiy mai mai la ngon dutic soi during cho chting to di

The theo nguyen vong cua ccic ban d6ng mon, toi bien soon lei tai lieu _da hoc, de' cling cdc ban nghien cuu va tip clang, gop phan den dcip lei ng-uyen vong tha thiet cua Thtly la: "Phitong phcip Tcic dong cot song phai duoc phcit trien va hoan thien, trly thanh mat nen Y hoc cot song hien dai cua dan tac Viet Nam ta"

De ccic ban hieu biet them ve nhung viec Thdy da lam duoc, tai xin not rat so lupe ve ngu6n gtic cua phuong phcip va mat so' hieu qua cua phu-ong phcip ma toi da linh hoi duoc

I- NGUON GOC COA PHUONG PHAP TAC BONG COT SONG

Luong y NguAn Thom Tcin sinh nam 1915 6- xei Hoang Xd, huyen Thanh Thdy, tinh Phd Tho La they thtdc Bong y, Theiy rat coi trong nhung bai thtdic qu:y trong den gian Trong nhieu nam, Thdy de nhiL tam lac treo len ntii coo, rang sau tim kiern ccic loaf thulic quj, de chug benh

Nhung nam di tim thu6c, Thdy they ccic cu coo tudi hay dung vai tai, hodc 14 la ca y cho xdt len cot song rzgurii kenh Khi cat song co nhung vet d6, ccic cu clang bat hodc ld thu5c hay cua d6ng gia ra deip vao nhdrig vet d6, co khi dun soi thutic la de xong cho ngtthri.benh Chi co the ma khoi benh

Su viec tre'n lam Thdy suy nghi tai sao cot song lai chart clupc benh? Tai sao Bong - Tay y Ica khong chtia vac) cot sting? Stich Nai kinh ghi :"Tuj, song khong sri they, khong trong they nen khong the chaa duoc benh" COn Tay y chi churl dupe mot s5 rat it berth cua cot song Nhung khong chda dupc cdc benh not tang Phdi cheing day la mot khe ho ma Bong - Tay y chug di sau nghien cdu, ta nen nghien cdu then xem? Thdy nghi: "Tai sao cat song la mat thuc the, la mat hien tupng sinh ly Ma da la hien tuong sinh ly thi tat yeu phed CO hien tupng benh

Ter day, Thy b6 viec tim thu6c, quyet tam di sau ved cat sting Thdy da nghien ctiu ccic scich

ve co the hoc, scich Tay y, Bong y, chain cti-u, bain huyet v.v Khi Thdy ta Chd tich UBND xei , dcinh bong chuygn ki nga, dau lung, chart mai cheing kh6i mot Ong ban be bao cho The' la kh6i dau lung Ldn khac, Thdy ki kiet ly Uorrig thutic mai khong kh6i Lai nh& Ong ban be bao cho Benh khoi Thdy cang they ri-) cot song lien quan din benh tat Ldn lupt Theiy mua 9 con khi, mo tang con de xem cdu too cat song cua chting? Dec biet Thezy rat coi trong viec tim hieu cat sang cua nhi& rtgubi benh xem co nhung bien khcic thuOng Thdy ghi lei ccic hien tuprzg cua tang kenh,.d6i chie-u, so sdnh, phein tich, tong hop la.i tharih tang benh va tim ccich char/ benh tren cot song Theiy tim hieu nhung nguai mai chet xem cot song ra sao? B:enh dau tien tim chua la berth

CAM NANG VE PHUONG PHAP TAC DONG COT SONG 6 BOI DUC CUONG BIN SCAN

dau bung He trong gia dinh haft ho hang hay nguai trong Zang trong xei, he ai dau bung la Thay den khdm va da chart kh6i benh

Cho den nay, mat s6 nguai u¢n can nghi hog' c? CO phcii Thay da tim ra phuong phdp tdc Bong cot sing nay hay khong? CO the' do mat nguai nao do da day Thay? Mat ngubi coo hoc vein nhu- Thay lam gi co kha ruing nghien cau ra nhieu van de hoc baa n.hzr not dung caa phuong phdp? Hoac có nguai cho rang Thay xem sdch bcio phuong Tay cip dung? Su th4t khi nay nghien cart phuong phdp tcic clang cot song la trong thbi ky khcirzg chien do ii?t, lam gi co sdch bdo ma nghien curt 6 not than da lam gi c6 phuong tien de' hoc h6i

Den nam 2000, Thay da c6 hon 300 hoc tra Nhung chug có ai dong gap gi cho phuong phcip Chinh luong y Nguyjn Tham Thin da tit minh nghien curt, dzic ket lai va sting tao ra phuong phdp chart benh k3, die u nay NO khcfc Mn vai cdc tru:Png phdi khdc chCca benh & Viet Nam va tren the gio-i Tai cang nhir nhieu nguai da thdy: Thay Tcin rat thong minh, hoc dau nha d6 Truric rzgay di sa u vao cat song Thay da c6 nhieu sting tao Lam- duoc may gieo hat duoc tinh Phu Tho khen thuang Thay lai biet phan tich, tong h9p, chic nit kinh nghiem, vita lam, vita hoc Bac biet la do co quyet tam cao, da tim du9c benh, lai chaa duoc benh, neri'47uly kien tri, nha n mai, say sua, ngay dem que'n an, quen net tim cho du:pc ccich chart benh co hieu qua nit&

Thuc vay, xutit phat tit nhung kinh nghiem co truyen dan tpc va tren nhieu cot song cart rzgu&i benh, luong y Nguyen Tham Tdn da nhan thiic duoc nhung dac diem ceta he cot song lien quan den sinh ly va benh ly caa co the Bieu hien bang nhung bien•dPi tang va gicirn & tren dent gai sang va & ngogi vi do xay dung thanh phuong phdp chan va tri benh tren co s& xcic cl.inhsubien ceza he cot s6ng guy nap, chan docin benh va tdi lap sit can bang he cot s6ng bang cdc tha thuat clang pha n mem dau rzgon tay tdc clang tai trong diem tren he cot sang Sau do &in cao, dcip bat tren nhung diem da chaa Khang dung dung cu, khong duct thu6c truc tiep veto co- the

Cong trinh ceta luong y Nguyen Tham Tdn, la mat soytr-irz.h_da ' sa, o, khcic Mn uoi cdc truang phdi chart benh khcic Thay da c6 gan50c 0 bua-c chart tri ccic loci benh thupc cdc he trong

co the 54 de tai có the' lam luan thong khoa hoc, xcic dinh hieu quci cad phuong phdp Nai dung cilia phuong phdp tdc clang cat so-rig that la phong pha gem c6: Cdc nguyen tac, ccic tha thuat, cdc phuong thzic va cdc tu-th'e chart tri benh hoan

Thely da not &benh vien Vinh Phri: "Toi vo sit, va sdch Khong duoc thay nao day d3, khong co kinh nghiem gia truyen Khang duct vao sdch v& Tit tai tim tbi, nghien curt nhung kinh nghiem truyen dan tac va tren hang tram cot tong caa nguai benh ma sang tao thanh phuong phdp tdc clang Cat song" •

H - HISU QUA COA PHUONG PHAP

Rcit tiec la Thay khong c6 so ghi cam tzi6-ng can Twit-6i berth Chi xin neu mat so- rat it benh dien hinh, cheic chan can rat nhieu thieu sat clici vai hieu quci caaphu-ong phdp

Nam 1947, Thay bat dew chaa benh bang phuong phdp tdc clang cot song Vai 711177/ dart, chart benh trong gia dinh Benh nha n den cha-a rat clang, nhieu nguai kh6i berih Sau UBND xa HoangXd mbi Thely ra chaa benh & tram xci caa xei Cdc tinh den chug phcii co giei:y giai thieu caa Berth vien Huyen

Mat s6 can bp cao cap duoc Thay chaa kh6i benh da gap nen chart nhung berth nhein

ma benh vien Tay y da chaa, nhung khong kh6i de thanh tra y tinh ue kilm tra thi tot hcm

CAM NANG Alt PHUONG PHAP TAC DONG COT S6NG 7 NGUYEN TRAM TAN

They lay 5 benh nhan mac benh tim da china 6- ccic benh vien Tay y, nhung chua kh6i Co

nbaicoi suy tim, tim to, ngoai tam thu, so cang- dOng mach vanh, huye't cip cao, huye't cip thap, nhip

tim nhanh v.v SS benh nhan nay &u dupc cac benh vien xet nghiem chdu, chap day du They

chug 5 benh nhan nay khei hcin Ca 5 nguati da den ccic berth vien ca chieu chap lai, ccic kenh

vien da xdc nhan khong can kenh tim naa

Ban Thanh tra y tinh Vinh Phil den kdm tra do Ong trung ty y tinh lam tru6ng doan

Lac clau Thay dug ra 4 hi so ca day dii ccic xet nghiem Xem xong Ong truOng tru6-ng ban phdt

'Benh tim la kenh kho chart, &mg ngan tay china tren cot sang thi kh6i benh the nao dupc

Co the' ccic berth vien truck da dodn sai" Cuai cling, Thay duo ra benh an do chtnh Ong Thanh

tra nay khi con lam gieim do-c benh vien AIL khcim, ong cuai noi: "Co the lac do, Mi da kham

sal "

Tat qud, They dinh dem at ca tai lieu di' nghien cz-ru dot sach May thay nha co cu ba Bang

Thi Loan da khuyen gidi They They mai nguoi ngoai Thay nghi: "Da the to phai chug ccic benh

nhan ma ai cling bat Do la nhung kenh nhan cam, liet"

So' benh nhan cam, liet có lac thing tai hon 40 nguati Thdy di' china cam cho ba em gdi cda

ca Tang bi thu- Truing Chinh kh6i kenh MOt ba 6- Son Tcly co 2 con gcli cam de'n china Het gyo

ba ve lay ggo Ddn tong nha Thay, con gdi chay ra goi: "Mg oi" DOt ngOt qud, ba me vat di

Tinh tai, ba noi: "Nuoi con 18 nom nay, /an dela tieri chciu mai noi duoc"

Chu Ta Van Ly v huyen Vinh Lac tank Vinh Phil 1:4 liet, 2 than teo co lai Ter nho, chi nei

vi' le bang 2 ban tay di hoc phcii nho ccic ban thay nhau cOng Nam chd china kenh cid 13 tudi

They china 6 thcing Chd MI thing len, di lai binh thuang, Ve lang nguari lang no nzic ra don

ngua4 liet da di lai binh thuang Gia dinh lam 12 ma m c6, an merng Thciy lie Ai cling muicn

nhin thdy doi ban tay yang cdcz Thciy Den tuai nhap ngil, chzi Ly nang 60kg, nhap nga 3 nom,

tra lie lay vo sinh 3 chdu deu kh6e manh Chic Ly xin Thay duoc lam con nuoi

Bcic si Thily Linh o benh vien Hay nghi bi benh tam than phein liet Co lac a:4 chuang chay

ra ngoai pha, They china kh6i Bile si trey lai cong tic Val nom sau, bdc si Thdy Linh cho

biet di' có 3 de tai rzghien cdu khoa hoc, duoc hOi dOng khoa hoc cda berth vien khen thuang

Nam 1972, giac My bcfp phi dc liet khdp noi The ma có lac hon 200 nguari- den chug benh

Ho di lai lung tang Bo Cong an da cu 6 can bp gia lam berth nhan den kdm try: 6 thing chi nay

co kenh gi Thdy clkt chug khei Sau do mot so' thin tru6-ng BO cong an vi' gia dinh con chdu

den chug khOi nhieu benh, nen chinh ccic thd truOng BO da de nghi len co' Tong bi thu- Truing

Chinh, co thin tuangPhym Van Deng vi' Bp truOng b:6 y va Van Cdn mai Thay ve Ha NOi

chug berth

Ve Ha Noi, Thdy uao china berth 6 80 tu lenh Thong tin duoc 3 nom Nhieu benh nhan trung

cao don sic vi' quan sinduoc They chug kh6i benh

Ba An la vo mot thzi- trung BO Cong an bi suy tim, tim to, huye't lip cao, suy clOng vanh,

ngoai tam thu China khdp noi khorzg khOi Ba dinh nghi huu Lac They china ba mai la dyi uy

Chau kh6i kenh ba tiep tuc cong tic cho den khi nghi' him la doi td cong an Hien nay ba van

can sang

They-di'-chlia-cho-ca-di'i-tuang-Hoang-Veln-Thegy-nguyen-Tdng-th.am_muu_tru6-ng_qua rt_d:di

CAM NANG VP PHUGNG PHAP TAC DONG COT SONG 8 BUT DUC CUONG BIN SOAN

bi liet mot ccinh tay Chad 6 ccic benh vien Ha N:6i, khong kh6i phdi sang Cong hba dan chd Dac chart 6 thang cling khong kh6i Thei y chua kh6i benh Dcti tuong da ddnh bong ban duoc

Ong Nguyen Dar Thuan co chd tich HOi lien hiep Cong doan Viet Nam gieri thieu mot can bO cao cap Lien Xo sang giap ta thy dung Cung van h&c hau nghi Ong nay bi rapt melt da 17 nam

nay, khong nhdm Twit duoc Mat ca mQ chang chang ke cd liic bet° tuyet, lam rat rat melt, chua kheip noi 6 Lien XO khong khoi Ong cho biet: "Ne-u cu khong chua kh6i cho toi, thi vc toi se b6 toi Co Zan dang ngd, co thice day thdy mat toi ca- nu cha-ng chang, co ay gia: t minh khoc thet len" Thd y chua mot thi i gian ?vein Ong nhelm melt binh thubng

Thely chua benh cho ba Ciic, va co Thd Wang Pham Van D6ng Ba Ctic bi benh tam thein, ca ngay chi vuot do KJiong pluin biet duoc nguai than Dcti den tcio bon phdi chiu dau don, lan lOn tren givang rat kh6 s6 Theiy china cho ba dinh tinh tluin, khOi tao ban Ba da biet duoc ngubi than, cbn, biet hdt cd mot so bai ca h6i tru6c each mang Thd tiding Pham Van D6ng da mbi corn Thdy va mot tien sy y hoc Thd tuong rat ca ngai phuong phcip tdc clOng cOt song Thai tuong noi:

"Bcic da chua khoi benh cho nhieu can bp each mang, tac la Bdc da cau cdch mang" Ong tien

sy y hoc gop "Bac noi ro them nguyen nhan vi sao tac Bong cot song lai chart duoc benh" Thd tuong trci lbi ngay "Chang ta clang thing dien cho cdc nganh khoa hoc Den nay vein chua tim ra

Mn chat cda dien Nhung ta van clang dien rat tot Lac ra ve thzt ky rieng cda thd tiro-rig

"Chun bao gib- Thd tuong mai corn vet ru5i chuyen voi Bcic lau den the' "1 gib • 15 phut"

O khdch san Duang Thanh, Thdy chart benh nhein bi di tinh Tinh trang ta- Ong thocit ra lien tac, chi= noi nao chua duoc Benh nhein xanh sao, khong hoc hanh duoc Thdy chart kh6i Anh thy ra nutic ngoai hoc tap, c16 dat cao MOt chi phac vu khach san cia ngoai 20 tudi, bi benh dal m, chug nhie u noi khong kh6i CO khong ddm lay thong Tiuly chum kh6i benh Co lay ch6ng sinh con Thdy than kh6i benh huyet dp cao cho trung taring Nguyen Hung Phong, chinh riy quan khu I Da gdn 20 nam benh khong tai phcit Nam 1978 Thdy duoc ve berth vie:n Bach Mai lam nghien tali chuyen de, xcic minh hie:u qud tai khoa y hoc dan tOc Thdy nh:dn chua benh viem cOt sting dinh kherp do gido sic Deli-1g Van Trung chd nhiem khoa noi chez tri Viem cOt song dinh khop la benh nan y Ccic bdc si quen than voi thdy Be nghi Thdy nen chon Be tai khcfc Vi benh thy the- gioi da chiu, nen Thdy khong thanh tong thi con dau la su nghiep Nhung Thdy cam on va tin rang Thdy se chua kh6i Ket qud Thdy chart kh6i benh viem cOt song dinh khop dat ke-t qud tren 90% Thdy thanh tong tie-p trong Be do nghien cau benh viem thdn kinh tog dat tren 90%

Piety chart kh6i benh r6i loan than kinh thar vat cho gicio su- tien si Vu Tuyen Hoeing chd tich HO i lien hiep khoa hoc ky" thua: t da gel n 20 nam nay khong tai

Thdy lam de tai nghien cau chuyen Be voi Vie* n sinh ly hoa sinh do gicio su tien si Nguyen Teti Luang Vie n trizerng chi tri trong de tai "Phut hoi ngu6n sum me" Ket qud dat tren 90% Dieu dac biet la: khi vdt sari cda nhung ba me dii saa thi hang sesinh ly cda glucide la 7%, lipide la 1,5%

va protit la 0,5% Cbn saa cda cdc ba me thie-u sun cdc hang so sinh ly cleu cao hoac theip hon Nhung ba thieu sat dupe Thdy chum co saa r6i thi hang so sinh ly lai trb ve binh thuang Gicio sic Nguyen Teti Luang da lam mot bcio cao ket qud 25 trang gdi len ban Khoct gido Trung tong Bcfc si Nguyen Thi Hdi lac do da 42 tu6i, tru6ng phang y te- trub-ng can bO y to cda BO Y te, chda 6 Zan, cd 6 Mn thai deu bi che't luu Thdy chart cho ca 2 va ch6ng da co hien tuong suy sinh

CAM NANG Vt PHUONG PHAP TAC DONG COT SONG 9 NGUYEN THAM TAN

duc Chaa 6 thcing bcfc si Hdi thu thai Chart lien tuc den khi de Thdy ket hop v6i khoa sdn Bach Mai yet benh vien C de theo dOi ket qua Chciu Nguyen Ngoc Chau sinh ra rat thong minh

ua march kho6 Luc de chciu, ca khoa sdn toi them Ho rat ngac nhien vi khoa scin da tiem thuOc cho cdc ba me c6 thai chet luu Khi de ra ccic chciu nay deu bi khuyet tat Rieng chciu Ngpc Chau lac manh khoe binh thuOng, dang hoc tai nhac vien Ha NOi

MO1 benh nhan nam del hon 30 tudi bi lcet duong Duong vat bi that hart uao trong, khong lay duoc vo Thdy chug duong vat tr6 lac binh thuang, chic nay da lei); vp- sinh con

Ong Tien can b:o Phd thd tu6ng bi li.et duong dd lau Ong den yeu cdu thdy chaa Vi sau mot thcing Ong cu6i up: Thdy chuc kh6i, Ong sinh lien tiep hai chau trai

Thdy chap nhieu -truang hop vo chdng lay nhau hang chuc nam khong c6 con Chd Tam, dai dy phi ding va co va la gicio vien xinh xdn, nhung khong c6 con BS me chting bdt dai ziy phdi b6 va, cho rang co nay khong de duct Theiy churl khoi CO gicio da c6 hai chciu gai kh6e marsh Thdy chita kh6i berth suy tdy Thong thuong ca ba clang rruiu deu thieu hut Dong y chiu Tay y chi con duy nhat mot tech la tiep mau turri, nhung den chang mz.sc 71a0 co the khong, tiep thu dupc, benh nhan chet dau don uo tang Thdy dal yeu cau phcii ket hap voi Tay y cho tiep mau Gic chdu 6 benh vien Bach Mai va Vien nhi ra chap Thdy Nhieu chcizz 6 cac tinh ca 3 mien deu chaa kit& benh

mot die'n hinh la cu Nguyjn Thi Kiem 71.11771 nay hon 80 tudi 6- 70 Hang Chieu Ha NOi Kh.i

cu hon 60 thi bi benh suy tdy Vao benh vien Cuba lac d6 c6 9 ngubi suy tdy Rieng cu Kiem ra china Theiy, cu Kiem khOi benh gein 20 nam nay khong bi tdi phcit Can 8 rigu&i kia del vinh uien

ra di 6- berth vien Cuba

Chd Ta Vdn L5, 14 Het gioi thieu em ho la Trdn Van Tien, xei Yen Dong, huyen Vinh Lac, Vinh Phd bi suy tdy churl cdc not khong kh6i, Thdy da chap kh6i benh, chd Tien kh6e marsh, lay

uo c6 con Hon chuc nam nay benh khong tdi phcit

mot trung td quern dOi 6- Vinh Phd thocii hoa cat song co, tay Chan be liet, benh vien 103 hen

md, nhung phcii ch6, chd Ta Van L.9 o Vinh Lac gioi thre :u den Thdy Den nha phcii c6 nguiri diu Thdy chap 20 horn benh khoi Ong truing to den 103, ccic bcic si bdo vao md Ong ay May nhdy vung than tay tai ch6 H6i chaa ai? Chaa cu Tan Moi nguai der biet cu nen rat hoan ngenh

mot nu benh nhan ngoai 20 tucli 14 to bang nha ngubi c6 thai 4-5 thcing Cd nha lo so Benh vien Bach Mai mai Thdy den cuing chdn docin Bdc si khcim nhung khong they tim thai, khong ket titan dupe Thdy khcim va cho rang: "Day la benh chda girl, iOi se nhan chaa" Thdy chaa bung nh6 lei binh thuang

Thdy chica duct nhieu berth ung thu- Nhung thciy yeu cdu khong tuyen truyen Vi not ra sinh rdc rdi nen Thdy bcio: "Ch'ing ta c& chap, benh nhan-se tuyen tru.yen cho ta"

Chinh toi del gioi thi:eu co Ha Nhi tong nhan huu tr.( 6 so nha 307K1- tap thg in Tien BO bi ung thu- Amiddan Co ay chaa o benh uien Knhung khong not dupc, khong an duct ng6i cha chet nha Toi der due va chdng co chd ay den, Thdy chap benh der kh6i CO den benh vien kham khong can bi ung thu Amidan Nay co van can song hon chuc nam

Mot chciu 6 Thanh Hoa bi ung thu Arnidan clang chart 6- benh vien K Chau khong an duct, khong uong duct, khong not duce Bac, sa benh vien goi me clulu vao bid° cho beet la benh wen

CAM NANG VE PHIJONG PHAP TAC DONG COT SONG 10 BUT DUC CUGNG BIEN SOAK

khong con khci ruing chaa cho chau Bac phdi cho chdu ve ngay horn nay Neu khong di ngay thi chciu se Chet o doc dubng Me con so qud den nh& theiy Chita 12 ldn chciu lai binh thuang, khdm

o benh vien K khong thet'y ung thu Amidan nCca

Toi gi6i thieu rapt benh nhan có gitly nhap vien cda benh vien K de la: K vii ngay mai vao Thei y der chart kh6i benh CO Nguyen Thi Nhan hipri nay con song hon 10 nam kh6e rnanh, benh khong tai phdt, CO o rtgO Luang Sec A S6 nha 33 ph6 Qutic Tir Gidm

Ong Nguyen Van H6ng, nguyen truring phbng Tong hop Bp Giao thong Van tdi, di benh vien Hau Nghi khdm docin la ung thu trung that pho'i Duoc dieu tri, nhung benh cang ruing them Hei do, BO truOng Bp Y re- la Pham Song, lac do la Gicim d6c berth vien da not voi Ong H6ng: "Anh bi benh nay, nhung anh co tien sic benh gan nen khong Wong duoc rephamicine Vi very, benh vien khong c6 cdch gi giap anh Anh nen ye right tai nha thoi" Ong kiting that vong Ong da den nhb Thdy chaa, Thdy chaa khocirtg &fin 2 mint Di khdm ch5 ung thu- chi con 1 dam nh6, Ong H6ng duoc BO cho nghi o nha chaa benh.Dein clan ong kh6e ra Ong xin di lam

nem ngay Sau 'Ong xin di lam ca ngay cho can khi ve huu Ong con sting dupc 12 nam, benh ung

thu khong tdi phcit Ong der rruit vi mot berth khcfc

Tit 1981 cltn 1985 6- benh vien Bach Mai Thei y da chaa 847 benh nhan vai 23 loci berth thuOc ccic he tub.' n hoan, ho hap, tam than, nOi tiet, tieu hba, sinh duc, dau co ruing va cdc benh

ca xu-orzg khdp IC& quci'locti va khd tit 87% der/ 90%

Thdy vao trubng y hoc dan tOc, co truyen Tue TYn.h tic nam 1981 lam chd nhiem khoa tdc clOrzg cot song 1V7u1 tru&ng to chiic dupc 11 khoa hoc dao tao ve phuong phcip teic dOng cot song Rieng Bp Cling an da co nhieu y bdc si (3- cac trung tam y te tInh ve du Chat luting cac khoa deu dat loci khd va gi6i Cdc hoc vien deu say sun hoc tap Cuc y te" va Gidm d6c benh vien Y hpc dan tOc co truyen cda BO cong an da mbi Thay day 2 kh6a Tring ::Ong la 13 khoci co hon 300 hoc vien "Trong gia dinh Thdy da 5 lap co hon 40 hoc vien"

Trong thbi gian o trztong Thdy chaa duoc nhieu benh nhan

Theiy chaa cho ba vp Ong A-li-da-de bi thu- thzi nhat dai sic quern Lien XO Ba nartg 103 kg, di lai kho khan Thy chug, rat xuong 12 kg500 Ba con bi va he' hoach, có thai Thdy da dieu hber kinh nguy:et cho, nen dupc binh thubng

Thdy duoc mai sang chaa benh 6 Mcit-sco-va 2 Mn., c6 them ba cong sit cling di trong 3 thdng ChCta duoc 210 berth nhan Ket qua dat loci khd va tot 91,5% Co benh nhan liet duong, hai ch6ng cang chaa Horn sau, ha up- den chart da not ngay: "Bac si Viet Nam tuyet vbi, tuyet obi" MOt benh nhan Hang 82 kg Chart gidm dupe 17kg Vien than kinh trung uong Pi-go-r6p da

k'y 3 hop d6ng vOi Thdy, rnbi sang chCca berth Nhung vi có dao chinh phdi ngang

Xu6ng phim tai lieu trung uong quay mot cEdn phim tai lieu not ve Thdy Bang thug hanh chaa benh ale dai phdt thanh, truyen hinh, dai tieng not Viet Nam, Tieng not clem-khuya phdt

di nhieu bai tieng nu6c ngoai tuyen truyen 6 trong nuric va nuoc npai Cele bdo Nhetn d,a'n, Quern dOi nhan dan, Tien phong, Phu nu Ha NOi, Khoa hoc va doi song, Ha NO i mvi, Cong an nhan dan, bdo cong gido v.v da nhieu /an ca ngoi phuong phdp "Tcic dong cot song"

Tic lau, Thei y der có mong uoc: "Thu6c Nam ter có mot so bat thu6c hay, nhung khong CO phuong phcip chin benh, nen viec chein benh phdi nh& vao Dong y Toi muon lai cho dan tOc

CAM NANG Vg PHUONG PHAP TAC DONG COT SONG 11 NGUYEN TRAM TAN

ta mat phuong phdp chart bp.nh mai Co ca than va tri b:enh Nhung toi cling men chi la ngubi link chign Reit mong cdc nha khoa hoc clang dnh sang khoa hoc de' chring minh hi"eu guci va xay dung phuong phdp tdc dong cot s6ng tr6 thanh mat nenY hoc cot s6ng Vi."?t Nam hipi dai Ket hop hai nen y hoc Ring y ua Tay y, tao ra mat "chat mo-i", chaa tri cho nhei n dein ta ngay cang manh khoe de' bap ve va xei y dung dat nixie ta ngay cang phtin vinh va hanh phitc"

Chting toi rat mong cdc ban dOng mon va cdc nha khoa hoc hay di sau vao cot song hoan thi:en vaphcit trieln phuong phcip tae dOng cot s6ng dat dupe mong Lilac czia Theiy

Mong dpi cdc ban piling mon cling clang gop them dl silt/ chi-a tai lieu not ho nay cho dupe hoan chinh

BUT DUC CUONG

1<-em

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 13 - BO1 DUC CUCFNG BIEN SOAN

COT SONG

COT SONG CO 33 HOAC 34 DOT

7 DOT SONG CO

(KS, hi:eu la C chit cldu ciia ter Cervicalis)

Cl - D6t dei (Atlas) nang hep s9, hinh met vong trim, det Than dot khong re Lei rat rang, dam bao cho hep s9 quay chuydn de dang, khong có gai sau Cl

C2 - D6t truc (Axis), co hinh Ichuyen trim, phia tren va track Ichuyen nay 16i len met mom, goi la mau rang Idle (mom rang) C2 16i cao trei len Neu tren C2 khong co lop co' benh 1Y, khong ductc chita va.o, de sinh benh

C3 - BO' &Teri C2 cao hon bo' tren C3, thap hon C2

C4 - Bo' dithi C3 cao hon bo' tren C4, thap nhat trong cac d6t c6 Thap hon C3 C4 ra triteec nhieu nhat

C5 - &lei C4 cao bang bo' tren C5 Cao hon C4 Bo' clued C5 thap horn bOe tren C6 Day tay thay bo' cltrOi C5 hoi

C6 - Cao hon C5 Thap hon C7 a mom ngang C6 có met chi3 161 cao Do la I6i tren (Tubercule de Chassaignas)

C7 - d mom gai C7 cung co met 16i cao rat re cao trei hon ca cu Chassaignas G9i

CAM NANG Vt PHUCING ?HAP TAC DONG COT SONG

12 DOT SONG LUNG

(Kf, lieu la D, chit cidu ctia trr Dorsalis)

Cac dot song lung, do can tidp xuc voi cac dauxt/Ong sau, nen m8i d6t co 136n dien khop dd tidp giap xacmg sithn Cac to clOt deu tran Than d6t day, mom gai dai va thong sau Nen khi ta so thdy duOi gai cua mOt.d6t nao do thi n.gon tay ta da dat ngang tam cua d6t duoi r6i

D1 - Cao, nam dui! 16i chroi ciia C7 BO' tren Di cao horn bo-dithi C7 Bo'

Di cao horn be tren D2

D2 - Bc chthi D2 cao hon bo' tren D3

D3 - NAm tren cli/ong thong n6i 2 trong tren ciaa 2 xvong ha, thdp ho'n D2 va Inthng ra phia truce Bo' dithi D3 tha.'p horn hoc bang be tren D4

D4 - L6i cab Bo' &re:6 D4 cao horn be tren D5

D5-6-7-8-9 - 2 khe cac cl6t dgu bA.ng nhau D7 n.dm tren dvOng thang n6i 2 goc duai cua xixong ba

D10 - Loi cao

D11 - BO dithi D11 cao hornbctrenD12

D12 - dtthi D12 bang ho4c th6p horn be' tren Li

Tir D1 trc xu6ng, cot song lung c6 xu the cong ve phia sau D4 la didin thin nhdt nho cao len 'fir D8 tra di, cot song co hinh cong hx&t D10 la didm cao thix hai

CAM NANG VE PHUONG PHAP TAC DONG COT SONG BUT DUC CUONG BIEN SOAN

(Kfr hi"Ou la L, cha dSu cila ter Lombalis)

Cac ci6t s6ng thAt lung so vOi cac (1(31 s6ng lung khoe hon vi thong phai chiu toan be si.tc nang clia than tren gia tr9ng len no Cac mom gai ngAn, reng Ngang than d6t song to hcm., khong tie-p khoT) voi xuong soon nen cac mom ngang dai va nhen La d6t co hinh tam gia.c •

Li - BO' duoi Ll cao hon bO tren L2

L2 - Bo' duoi L2 cao hon bo tren L3 L2 nam tren &Tong thang not 2 dAu xuo'ng soon cut (ch6 eo lung that

L3 - + Nam : B6 clued L3 cao hon 1DO tren L4

+ Nu : bo duoi L3 b'a'ng be' tren L4

L4 - L4 nAm tren duong thAng not 2 b6 tren xucmg hong

+ Nam : Bo' duei L4 cao hcrn bo• tren L5 L4 dua ra phia tru&c

+ BO' cluoi L4 b&ng ba' tren L5

L5 - + Nam: Bo clued L5 tha-p hon b6 tren Si L4 - L5 dua ra phia truck nhiCSu

hon Sr tha'y be' duoi L5 lom hon be? tren

+ NIs : BO' dual L5 bAng be' tren Si L4-5 th.A.ng d6u

5 MIT SONG VUNG CUNG

(K.k hiOu la S, chi? da 0 ala ter Sacrilis)

Tir Si den 55 cot s6ng dua ra phia sau, thanh Hien tang.•Di.gm cao nha't la S5

• 9 :Viing cut

CAM NANG VE PHUONG PE-IAP TAC DONG COT SONG

INGUYtN TRAM TAN

5 DOT SONG GUT

(Kfl hiOu bAng cut van thing nguyen ter Coccyx)

Cac xuo'ng cut deu dita ra phia tni&c va cling thanh 1 lien tang

PHANVUNG COT SONG

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 17 - BUI DUC CUONG BIEN SOiNN

, DOT SONG LQ DOT SONG

*C1-2 // S1 -> 5 - CUT

- Day than kinh 10 - V data - Mat - Dong td co

lai - Tiet nuac bot - Chi tren - Darn r6i canh

tay - TT tang nhip tim - Mui - DOng mach chd

- Tim - Phi - Gan - Mat o Chi chrai - Ban chan

- - MOng - Gan Asin - Co quan sinh duc - Ti6t

niau - Tnrc trang - Co bop bang quang - Tian

liat tuyen - Co ti cung - Niau dao - Dam r6i ha

vi - Sigma - Td cung - Hau mOn

* C3 // L5

Tai TT tang nhip tim CUDC co lai Tim

Ph6i Gan Mat DOng mach chti *Chi chnii

-Ban chan - -Bang quang - Ti6t niau - Truc

trang

* C4 // L4

- Luari - TT tang nhip tim DOng mach chti

-Mang bao tim - Tim - Phi - Gan - Mat •Xtrcrng

banh the - Chi dtroi - Sinh cluc nam - Ong dAn

tinh

* C5 // L3

- DOng mach chti - Mang bao tim - Tim - Ph6i

- Gan - Mat - Co 2 dau - Phan xa gan - X quay

tay - Thanh quan - Khi quan Co' quan sinh

chic nu nam - cung - Bung trdng - Ngoc

hanh - Than - Bertholine - RI* non - Xtrong

banh the - Tic ch6 co bop bang quang - Tic ,co

b6p v niau dao

* C6 // L2

- Xtrong quay tay - Phan xa gan - Ban tay co

lai - KhuSiu tay - Co 2 dau - Mang bao tim -

Ng9c hanh - N quan s Co td cung - Than tir

cung - tit cung - bu6ng tning - RuOt non - Rut

gia - Bang quang - D R mac treo - Xtrong banh

the - Bertholine - Sigma

C7 // Ll - TCN C6 - D9

- Ban tay co lai - Canh tay dui ra - KhuSfu tay

- Mang bao tim - Tuy6n giap trang - Ti6t ntrot

bgt - Tuy6n m6 hoi - Hanh nhan - Dong td ma

to - Gan - Mat - Tuyen ntrot mat - Than ,4 Ha

nang Nggc hanh Tix cung Bu6ng trtrng

-Than td cung - N quan - RI* gia - RuOt thira

- Tuy - Dam r6i mac treo - Co' vtIng niau dao

* D1 // D12 - TCN C6.7 - D8.9

- Tim - Ph6i - Tam nhi - DM ngodi da - Tim

dap nhanh - DOng mach vanh - Tim trai -

efe-C:/

Tuy6n nuot mat - Tuy6n m6 hoi - Uco bap bang quang - Co' co bap yang niau dao - Chi trail - D6ng td ma to - BO' cong nh6 da day - Da day - Rut non - Rugt gia - RuOt thira - Gan -Mat - Tuy6n ntrOc b9t - Tuy Ng9c hanh - bu6ng trdng - Ong dan trdng - T>Y cung - Tian bat tuy6n - TT not tang du'iri co hoanh - ThuY

&Teti than tug, Da bung Dam r6i ducmg dung mach nh6 ph6i va nao - Than

-* D2 // D11 - TCN D7-8

Tim Tim trai Tam nhi tim dap nhanh Tuyen m6 hOi - DOng mach vanh - DOng mach nh6 ngoai da - DOng mach nho trong bung -Dong mach nh6 phi va nao - Phi - Khi quail

Co' chan long Chi trail DOng mach chd BO' cong nh6 da day - Tuy - Gan - RuOt non - RuOt thira o Bang quang - Ng9c hanh - Ong dan trdng - Niau dao - Dam r6i throng - Da bung

* D3 // D10 - TCN Dl-D7

Tim Tim trai Tam nhi Tim dap nhanh Tuyen m6 hoi - DOng mach vanh - DOng mach nho ngoai da - DOng mach nh6 trong bung - dOng mach nh6 ph& va nao - Ph6i - Khi quan -

-Ca chan long - Chi tren - dOng mach chu - Da day - Tuy6n day da day - cong nh6 da day -

Ta trang - Mang ruOt - RuOt non - RuOt gia - Vi toan - gan - Mat - Tuy - Than - Tuyen thuong than r Ngo c hanh - Than ter cung - Bung trdng - Tian hat tuy6n - Dam r6i ducmg

* D5 // D8 - TCN D3-D5

- Tim - Tim trai - DOng mach chd - Da day - Tuy6n day da day - Bo' cong nh6 da day - Ta trang - Thuc quan - Gan - Mat - Mang runt - Ph& - Ph6 quail - Khi quan - Tuyen vu - Ruat non - RuOt gia - Lach - Tuy - RuOt thira thai throng - Darn r6i throng

-CAM NANG Vi PHUONG PHAP TAC DONG COT 96NG - 18 - NGUYEN THAN' TAN

BA DIEM KHOP BAN LE

3 dam nay lien quan nhieu CQ CNNT va

benh chung, anh hub-ng ion den sac khok,

benh tat chzia at 3 diem nay, nang cao

sac kho, tri dupe nhigu berth tat

I VUNG C1.2

Day la ch6 n6i tidp hanh tug' va cat sang, la

throng day thong tin chinh CO day TK 10 TW

pho giao cam, CQ ngoai tigt Wing dau c6 hop

so co nhieu khap thong vai nhau nap Thai

throng lien quan Mat, Khap xuong tran lien

Tian Vung chdrn

T" - Wing dau - Vung ca truck tim - Wing c6

phai - Wing c6 phai den D3.5 - Wing &rad *c

phai Wing vai phai Wing gi*a lung D7

-Vung tru&c ran

• Cl

1 Trieu c.hting: - Liet cirng t* chi - Liet day

than kinh 7 Chan tay run ray Ciing c6

-Mao m6m - Mgt tieng - Mat khOng nham

&lac - Hay ch6ng mat - Nga bat tinh - Cam

mao Vung gay lanh HAT Dau vai gay

-Dau dau phia sau - Cha:m to bi - Say song,

say xe - Di lao phia truac - DOng kinh - Mat

lanh nhu bin - Tai die/c, tai u - Mgt ngu keo

dai - Ngu qua nhieu - Tim dap cham

2 Chirc nang : Wing dau d6ng tik co lai

-Dam r6i canh tay - Day than kinh 10 -

Tuyen nuac b9t - Than kinh pho giao cam

THUdNG TREN VUNG C1.2:

1 Tr9ng didm yang C1.2 khdc cac wing khac khong o ch6 co cOm ma trong diem nhiing ch6 x9 teo mong, day an vao dgy BN that' dau Trong,,,didm,n'arnr:tr6n n6n,s9, tren

2 C1.2 bd thi co' thang 1 ben cang, 1 ben chUng, teo nhuac Chda D4:ben rktufil

3 2 co thang deu chung la cam diec bai'm sinh, khong sO thgy C1.2 Clii2pLluas=c

4 Gifra gay n6i len 1 b6 co' cdng to bang chiec

thanh &rang sang trau, tir tren vUng chdm xuang C7 C -41

so:issaixJ1:19,bat.ngu,an,.4ua„acti,carlay,AKe.9 n4Lkat

5 C1.2 lech sang 1 ben, bao gia co' thang, CUDC, h6 cham cling co cam v6 ben lech QInla,C6E-ma-136.41-goai-GlIDG

6 Chan: Ding 2 nein tay cila 2 tay ay t* sat goc ham sat mang tai xoay i tren trai chi6u vao vao gitla tren yang cham tren nen s9

Dau dau kinh nien Tim loan nhip nhanh

- Dau nda dau - Dau dau bu6n non - TKSN

- Tri nhar giam - Teo co - Cam diec - Cam diec bam sinh - Tieing not thO - Noi ngong -

TO lueri TO c*ng lir6i Mat nhu co bui Loan thi - Mat ma - Mat 16i - Sup mi - MAt mat phan xa - Dan don, ngay nga - M6 hai tay - dong kinh - Cam mao - Choang yang nhu -say song, say xe - Suy sinh duc nam -Liet duong - Di mang hoat tinh - Giap h6p khong xugt tinh -.Lanh cam - Nix thus' dich khO Kinh nguyet khong &du - It sua Ett&u c6 - N6i hach c6 - Lung; gay cdng dau

-"1-1qH171VG Frittcr—TtfcritG—MkT—B- re teu-h-cTa-keni - Kliap

• C2

1 Trieu chi= : Dau Tau kinh nien - Dau vai

gay - Meo m6m - Mui chay ntrac trong - Mat

may co giat - Tac mai - Dau to - Luai

day - Ltrai qua dai - Luoi co rut - Ho - Mgt

tieng - Noi ngong - Cam ba.'m sinh

2 Chirc nang : Mat - Mui - Khi quan - TK

hoanh cach Tim Gan Ph6i Mat Tuy

-clang mach chU - Rut non

• Chan to vUng C1.2

- Cl co gai sau - Gai sau C2 cao hon Cl va C3

- Tim hien Wang mat d6i xdng gifia phai

trai tren, ditai 6' thang va co' g6i dau

Dung phuo'ng thtic chuyen to th6 c6 cui

ngiYa nghieng phai, nghieng trai de' xac Binh

lop ca va cl6t song benh 1Y

• C7

1 Trieu chLing: HAC - Benh liet - Liet nia

CAM NANGVE PHLJONG PHAP TAC DONG COT SONG - 19 - BCTI DUC CUONG BIEN SOAN con - Phe khi thong - U phe quan - Run tay

- U tai

2 Chirc nang : Tuyen giap Tuyen can gidp

-Tuyen nuarc bot - -Tuyen nuot mat - Chi tren

- d6ng td ma to - Ban tay co lai - Ban tay,

khuYu dui ra - Co Muyle - Mang bao tim

3 Nhiet do : Vung nguc T Viing gida lung

-Than kinh not 661

III YONG L5-S1

1 Benh chung : - Cdc benh throng runt - Tre di tuft - Tdo bon - R6i loan tieu hod - Sa truc trang - Sa da con - Dau that lung - Dau mat

ca chan - dau quanh khop vai - DaU dau goi

- Nuo'c dai d6 - Viem bang quang - Viem than - Liet duong - Bai liet - Lam thoa than

• D1

1 Triezi chzing: HAC thodng me - Tam

than kinh - Toan than co cUng - Dau dam

kinh nien - Mat ng-ii keo dai.- Sq gio lzia - So'

dnh sang - Sq not d6ng nquai - Su tieng deng

- Lao dao mu6n nga - Ch6ng mat - Su vat

quay cu6ng - H6i chi:mg tien Binh - may

giat - Mat hoa trang, den, yang - B6c nong

len mat D6ng kinh 2 TKSN - Ngti ma dc

m6ng - Than sac bac nlitrqc - Xay sa:m mat

may Bai liet town than Liet ntla nguoi

-Liet chi tren - Teo co - Chan tay co giat - Tay

run - Buon c6 - Mat 161 - Thdp khop - Liet

throng Dim6ng host tinh Tieng not the

-Cam sot - U tai - Co gdy co giat - S6t ret con

- Cam barn sinh - Dau h9ng - Xdu da - Hen

xuyren - Ngoai tam thu - KhOng có m6 hOi

2 Chzic nang: Tim Chi tren TK giao cam

-Deng mach nh6 ngoai da co that lai - Lam

ner d6ng mach vanh - Lam tuyen m6 h6i bai

tiet -Cacohbaonp - c

manh

cci long -Uct:o _u do bopb*, cinquang

ma to - Lam Muyle co lai - Lam chay nuot

mat - tuye'n mang tai - Lam tim dap nhanh

manh - than kinh clan toi tam nhi trai va

phai - Lop ngoai lam tim dap nhanh

3 Nhiet do: Wing nguc trai Wing c6 phai

-Vung gift lung

• Chan tri viing C7-D1:

1 Can cir dd chan benh \Tung C7-D1 la he co' xa

cdng Ur 2 ca vai vao d6t song phai china tin

co vai 1*;9;P-s]!!E•vi=e, " "_

C7-D1-D3 - 1-3,D.11.16.m.mem 2-ca vai

2 Neu C7-D1 lOm phai chda vao D8 dd nang

3 C7-D1 16i lech, sau khi lam merrucu,.2 vai

sAtcOt_sting se nen.rung.2 ngontay.tren

chinh

minh

2 Nhiet do : - V that lung phia sau - V that

lung phai - V bung duoi - V cha.'m

• Si

1 Barth chzing: Bai liet - Liet chi &Teti - Te

chan Teo co' bap chd.n Dau khoeo chan Chan to bi - Chu6t rut bAp chan - Liet throng

Tdo bon Dai dam Lung dau cap, nhoi

- Kinh nguyet khOng ddu - Sa truc trang -

2 Chu nand-: L5-S1 hay thodi hod lien quan

den: Bang quang Tiet nieu Truc trang Phan xa gan

-• Chan tri yang L5-S1

1 Chan: BN dtIng thAng buong chung 2 tay va gan co' de' xem

a.) Cu thArig lung den ca chung có mat can bang khOng?

Vung hOng - that lung teo nhuruc hay xa f-P-i'cdng hoac thanh hinh cdi xeng lam hAn xu6ng hay dap len 1 lop cu day thoai hod hoA.c voi hod, d6t song bien d6i ra sao?

2 Dung phuong thdc chuydn tu the: cai ngda, nghieng phai, nghieng trai de xem lop co* va d6t song vung L5-S1 day corn hay teo nhtrqc, 16i, lam, *h

3 Khi chgn, BN nam xoai tren gitrang dd chan tri cho (16 clang hon

4 V.I.:jig c.a shung.: teo nhuoc phai china tinigr neins9,,tren vdng,cham - Ca chungteoben nao, chita ben do

5 Viing cy chung va L5-S1 teo plwqc,.thanh hinh cai, xeng phai chda co' thang.lung yang D7.8.9.1() tr.& xu6ng t*ngod.i _ , vao trong, theo thu tu 3 lop cu

6 Wing hOng plui 1 lap co day phai nen tinh

7 Vung L fro' xu6ng phai chcra lap ca ngoai tren (tau gai song

(

NGUYi'N TH 4M TAN

- 20 -

CAM NANG V.E PHUONG PHAP TAC ONG COT SONG

9 VONG A TREN Ht COT SONG

1 Veiny cci trot) d.1

A C1-C2-C3 Wang Ong chi2c ncing.thein

1 TK pito gitio cdm Wang Ong uoi chz2c

ruing n6i tang

- Wing dau; - Dam r6i canh tay

- Dong ta co Tigt nuesc bot

jvi - Than kinh je- vi; - Dai trang

1 2 TK hparzh ccich Wang zing voi chOc nzing

n5i tyng

- DOng mach chil; Tim

'My tang; - RuOt non

B Tiel doqn TK phcin xg C4 C7 c5ng

tzaing Ong vai chile ncing tqng

'1 TK hoanh cach Wang t2ng chOc nang

n5i tyng

- Tim; - Ph6i; - quan

- Gan; - mat; - Tny tang

- RuOt non; - DOng mach chia

2 TK giao Wang Ong CN n5i tang

- Tuye'n Tut& b9t; - Tuygn nuoc mat

- DOng ma to

3 Phcin xct gem Wang Ong vat ua'n d5ng

- Ban tay co lai

3 Wing lung tren d3

Thong ling cac he tuan hoan - HO 1-4.p lien quan de'n CNTK va nOi tang

A D1 13.3 tUdng itn.g voi CN thdn hinh

- acing mach nhi5 ngoai da

- Cd chan long

- Cd muy-le (d8ng tif ma to)

- DOng mach nha, MO tang

- DOng mach OA va nao

b Lam njt ra

- DOng mach vanh tim

c Lam Oc che'co b6p bang quang

- Co bop mach

- Co yang nien dao

d Lam bai tiet tuye'n nu'orc byt - tuye'n nctdc mast - tuye'n md hoi

d Lam mach nhanh

- Nhip dap ciaa tim

Mang Ong val cciin gide da ang

- TK tim trai da'n toi tam nhi

- Hach hanh nhan

- Khuyu tay dual ra

CAM NANG VE PHUONG PHAPTAC DONG COT SONG - 21 - Bf.n DOC CUONG BIEN SWAN

- Khi quan

Turing TK the' dich

- Tim trai

Ddng y

- Tim - phi - khi quan - chi tren

4 Wing dual luhg tren A4

4 d6t ta D4 -4 D7 Wring ang voi he tuan

hoan - ha hap - tieu hod lien quan CNTK va

not tang

A D4 D7 tuang zing vai than hinh

- TK giao cam - TK tug/ sang

TK the dich - Cam giac

- }Jong y

B Tiei down TK D4 —) D7 Wring Ong vai

CN not tang

.1 TK giao cdm Wring Ong vai CN nOi tang

- Tim dap nhanh, manh

- Tuyen day da day

- Bai thai dudng

- Mang runt tren

2 TK tay song Wang Ong not CN nOi tang

- Tim - Dang mach chi

- Phi - Khi quan

- Thitc quan - De day

- Gan - Tui mat

3 Turing Ong vOi TK the dich

- Tim trai - Ba cong nha da day

- Phe quan - Dam rai during

4 Turing On.g vai cam gicic da 964

- Ph6'i - Da day

- Gan - Tai mat

- Tvy tang - La lath

5 Dong y

- Tim - Chi trail - Ph6i - Khi quan

- Phe quan - Da day - TA trang

- Gan

5 Wing lung gic-ra A5

G6m.5 cl6t tit D8 > D12

Chia ra hai phan: Phan tren va phan dual

Ph/in tren tit D8 - D9

Turing Ling vdi he tieu hoa va lien quan

Wong ring \Teri chic nang than kinh va not

tang

A D8, D9 lien quan Wang Ong CN

than kinh

- TK giao cam - TK by sting

- TK the dich - Cam giac da s6ng

- Dam r6i than kinh

Thing y: Giap tich, du huyet

B Chile ndng than hinh thuOc D8, 9 tuang Ong CN not tang

1 TK giao cdm Wang Ong vai not tang

- Tuyen day da day - Bai thai throng

- Mang runt trail duai

2 TK tay song Wang Ong vai not tang

- Gan - Tai mat - Tidy tang - Ruat non

- Ruat gia - Nieu quan

3 TK the' dich wane Ong voi not tang

- Ruat thaa

4 Ccim gidc da song

- Gan - Tui mat - Da day - Tvy tang

- Ruat non - Ruat gia

5 Dcim roi than kinh

- Dam r6i throng

6 Bong y

- Da day - TA trang - Tuy tang - Gan phai

- Lich trai - Tai mat

6 Wing lung dual: z16

Turing Cing vai he tieu hoa va than sinh duc, phan xa va lien quan Wring ring vdi CN not tang

A D10, 11, 12 tuang Ong vai CN not tang

- TK giao cam - TK tuy s6ng - Tk the dich

- Dam rea than kinh - Cam giac da son

- Phan xa da - DOng y: Giap tic Du huyet

1 TK giao cdm Wang Ong vai CN not tang

Tuy6n day da day - Bui thai ducing - Dang mach nha: ph6i, nao - mang runt tren (Altai - Thay thai dozing

2 TK tUy song Wang Ong (Jai CN not tang

- Tvy tang - RA* non

- Ruat gia - Bang quang, ngoc hanh, bu6ng trang, tai bung, than

3 TK the' dich Wang Ling CN not tang

- ROA thira, tuyen clay da day - Ba cong to,

da day vi toan - than - bang quang

4 Ccim gicic da song

- Ruat thira - nieu dao - bang tritng

- Then - ng9c hanh - tien liet tuye-n

- Than ti cung - Ruat non - Ruat gia - 6ng dan trang

5 Dcim rdi than hinh

CAM NANG VE PHUONG PHAP TAC BONG COT.S6NG NGUYN THAN( TAN

- Dam r6i doing

6 Bong y

Tuy tang Tuyen thuong than Than

-Ruet non - -Ruet gia - Ta trang - Mat

7 Phan xa da

- Da bung

7 Wing th5t lung 47

5 d6t tit Ll, 2, 3, 4, 5 ttidng ling vdi he -Lieu

hoa, than, sinh duc, 66'1 nieu, phan xa lien

quan vdi cac CN than kinh va CN nei tang

A Li L5 lien quan tucing Ong vdi CN

than hinh

- TK giao cam - TK tay song - Tk thd dich

- Dam roi TK - Cam giac da Ong - Phan xa

gan

- Phan xa da - Dong y: Giap tich, du huyet

B Tiet doan TK Li L5 Wang Ong veil

CN n *c5i tang

1 TK giao cdm tu'cing Ong udi CN ndi tang

- Lrc the co bop: + Rut non;

+ Da day

- the co bop:

+ Bang quang

+ Mach

+ Cd vOng nieu dao

+ Bui mang ruet + Bin thai doing

2 TK to}, song Wang Ong udi CN ndi tang

- Dai trang - Xich ma - Than - Bang quang

- Nieu quan - Ng9c hanh - Bung tritng -

Tii cung

3 TK the 'dich tu'ang Ong udi CN n5i tang

- Tit cung - Bang tritng - Sinh duc

- Ong dan tinh - Sinh duc nam - Bang

quang

- Tiet nieu Truc trang

4 Dam roi TK thdrig Ong udi CN n5i tang

- Darn r6i mac treo dudi

- Darn roi mac treo

5 Cdm g,idc da song Wang z2ng vdi CN ndi tang

- Tuyen Bertholin - Dai trang - Xich ma

- Ruet thita - Than - Nieu quan

- Than tit cung - Co tit cung

6 Phdn xa gan CN ndi tang

- Xttong banh che

7 Phdn xa do, tu'ang r?ng udi CN ndi tang

- Ha nang (btu dal)

- Ban chan

8 Bong y: Gidp tich - Du huyet - Hue hhanh

- Ruet non - RuOt gia - Truc trang - Th4n

- Cd quan sinh chic - Chi dual

- Bang quang - Gan - Mat - Tuy

8 Wing hong d8

5 ct6t tit SI den S5

Turing ling vdi than sinh duc, 661 nieu, tn,tc trang, phan xa lien quan vdi CNTK va nei tang

A Si S5 Wang Ong vdi CN ndi tang

- TK giao cam - TK chau

- TK thd dich - Dam roi TK

- Phan xan gan - Phan xa da

- Cam giac da song - Deng y

B Tiet doan than hinh di Si -> S5 tu'ung Ong udi CN ndi tang

1 TK giao cdm Wang Ong yeti CN ndi tang

- Co bop bang quang

2 TK chdu thdng rTeng vat CN ndi tang

- Xich ma - Bang quang - Co tit cung

- Nieu dao

3 TK the dch Wang Ong vdi CN ndi tang

- Bang quang - Truc trang - Tiet nieu

4 Dam roi TK Wang Ong ()di CN n5i tang

-Darn roi ha

5 Pluin xa gan tu'ang zing vdi CN ndi tang

- Gan Asin

6 Phdn xa da song udi CN ndi tang

- Ban chan - Cd rang - Hatt men

7 Coin gicic da song tu'ang Ong udi CN NT

- True trang - Bang quang - Nieu dao - Co tit cung - Tien het tuyen

8 Bong y: Gicip tich - du huyet - Hue hhanh

- Chi dual - Cd quan sinh duc - Bang quang

- Truc trang

cyt d9

- H4u mon

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 23 - BO DUC CUONG BIEN SOAN

MOI LIEN WAN GIU'A COT SONG R6I LOAN CHIC NANG

ROl LOAN TRONG VUNG TAM GIAC CO

1 Trung tam tang nhip tim x x x I Tim phOi, tuytn vu x x x

2 DOng mach chi, phOi, khi quan x x 2 Tam that, bUi thai duong x x x

3 Gan, mat, tuy, runt non x x 3 Tim trai, DM chi x x

7 Chi tren darn racanh tay x 7 Tim clap nhanh, chi tren x

_

8 CO quan t If& bot x 8 Gan, mat, da day, to trang x x x x

9 Tai, la, tuytn vu, runt gia x 9 BO cong nhO da day .r.xx x

11 CO UDC co lai, tay co lai x 11 Trung tam Crc cht ti -tu trang x x x

13 Trung tam not tangaitgico hoanh x x

1 Trung tam tang nhip tim x

3 Gan, DM chit, DM phO:i, khi guar' x x

6 Thanh quin, thuc quAn, runt non x

7 Gan mat x x x 1 Gan, mat, da day, to trang x x x x x

9 Tuyen 1e, tuye'vbcot 1"-c-"-'i*-' e'-e-f- x 3 Trung tam irc the tieu trang x x x x x

10 Khuj, tay dui ra, ban tay co x x 4 Dai trang, dam rOi throng x x x x x

11 DOng tir itti to, ban tay du8i ra x 5 Ruc:it tht:ra x x x x

12 Gan co nhi tau -3 kv, x x 6 Mang byng x x x x

TAM GIAC III DI D2 D3 9 Trung tam nOi tang cluoi co hoanh x x x

3 Tuytn rna Fled, co than long x x 12 Bo cong Ion da day x x x

5 Tim, tim trai, tarn nhi x x x 14 Tien liet tuytn, than N x

6 Tim dap nhanh, manh x x x

12 Trung tam diu khien clic tang trung•that x 21 Dam rOi that lung

NGUYiN THAN' TAN

- 24 -

CAM NANG lit PHUONG PHAP TAC ONG COT SONG

ROI LOAN TRONG VUNG TAM GIAC CO

2 Dam riSi mac treo, nieu quan x x 4 Truc trang, dam rai ha vi x x

7 Trung tam at che al-L.;T-1-i-e." x

Jj cre,r

6 Bang quang, ngoc hanh x x x

7 Dai trang, dal trang Sigma x x

8 Rut thira, truc trang x

I Gan Asin, mOng, ban chin x

• - ,,,,

10 Than, buong trung • x x x

2 Truc trang, bang quang x x x x 77: 44,,,, r.tt• e ,, ,

/.I Nan - 0660rigle, eiaLtriazNing x x

4 Chi duai, tie( nieu x

14 Trung tam phOng tinh

_ x 5 Dam riSi ha vi x x x x

15 Tuyeln Bertholin >c (

6 Da.m rtii thAt lung x x X

16 Tic che co bOp mach x

17 Trung tam ifc che co bOp bang quang x 7 Trung tam cu'ang cif, c6 tit cung &D x CZ

I8 Trung tam itc the co *co yang nieu dao x x

8 Trung tam thao phan x x

19 Trung tam Crc che: co bop da day x x

9 Hail mon, nieu quan x

20 Trung tam tic che co bOp truc trang x

21 Trung tam irc che co bop dal trang x 10 Trung tam tieu tien x x

22 Xuong banh che, root non x

I I Nieu dao, dal trang Sigma x x x

12 Co co hop bang quang x x x x

24 Trung tam irc che co bop miing bung x

13 Tien lief tuyen 04.,b ,1)

„Ls_

1.Sinh due nam, Ong din tinh x

-27Xtrarrg-birrrh-c-h-e, dam re)) dtfong x

CAM NANG VE PHUONG PHAP TAC DONG COT SONG BOI DUC CUONG BIEN SOAN

VI TRI TRONG DIEM

Co quan not tang Nh* clCi D6t song

Lop co' Vi tri 115'1:, co' , Ngoai GiUa Trong Ranh

song

BN

RS

BT CTL

3 Mang bao tim Co trai C4-5-6-7 N

4 Tam nhi phai Lung tren D1-2-3 N

6E•

t

Co' quan not tang Nhi'4 do, Dot song

Lop co' , Vi tri o'p co' Ngoai Gifta Trong Ranh

song

BN

RS

BT CTL

14 Thanh quan Co phai C5 G

18 Thyc quan Mo dc C6 G T Khong 2

co diem lien quan

12 - Khong co lap lien quan BnRs

- Tat ca deu barn vao D7

CAM NANO VE PHUCING PHAP TAC DONG COT SONG -27- BI JI DUC CUONG BIEN SOAN

Co' quan nOi tang Nhigt coo D6t song

Lop co Vi tri lop co' Ngoai Ghia Trong Ranh

song

BN

RS

BT CTL

H6 chau phai Dia phuong

D2-8-9 D11-L1

!.`/ Rs

L4-5 - Si S2-3-4

42 Than That lung D10-12

Ll L2-3

NGUYLN THAM TAN

- 28 -

OW NANG VC PHUCJNG PHAP TAC DONG COT SONG

Co quan nOi tang Nhigt dO D6t song

Lop co' Vi tri 16rp co Ngoai Gifia Trong Ranh

song

BN

RS

BT CTL

43 Tit nigu That lung

va tru&c

Rs

co' thang lai)

T,

Lai - mast

Cham

54 D6ng tir ma to Dia phuong C7 N Bel ngoai (Mat • diu

55 D6ng tir co lai Dia phuong Cl

D12-L1-2-3-4-5 S2-3-4 N Et& trong

58 Day than kinh

10

Co tren Cl cha'm

CAM NANG Vh PHUONG PHAP TAC DONG COT SONG - 29 - BUI DUC COOING Br :EN SOAN

IJIEU NM :ET

9 T°' that lung tru'oc va sau: - S4

10 T" that lung phai va sau: - L3 -

20 T°+ vtang hmg tren va viing than: - D7 -

25 Di6u hoa than nhi4 sau khi chita xong: - Wing S

NGUYEN THAN TAN CAM NANG \it PHUONG PHAP TAC DONG COT SONG - 30 -

- D8.9

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 31 - BUI DUC CUONG BIEN SOAN

M6I LIEN QUAN TU'gNG trNG DOT SONG Vol BENH CHU^NG

CI

I CHT:TC NANG

1 Nao /thong binh thuiing

- DS: Lech, 16i, co day

- Teo: V cham co corn

- T': v dinh dau

Cam giac: dau v trong diem - cham

2 Day 10 - TKphe vi roi loan

- DS: Don lech, 16i, co mOng

- TC: V.cham co mong

- Te*: V dau sau

Cam giac T.diam + v.cham

3 Day TK 7 hhong binh thueing

- DS: lech, lom, curing, xo

- TC: V cham xo

- T°': V thai dUong

- Cg: T diem + v cham

4 Dam rdi ccinh tay hhong binh thuemg

- DS: Don lech, 16i, co day

- TC: V.cham co day

- v.cham

-Cg: T.diem - v.cham

5 Tuyeh nuac bot hhong binh thueing

DS: Don lech, 16i, co day

- TC: V cham co day - T° v.cham

- Cg: T diem + v.cham phia lech

6 Nhip tim hhong binh thuang

- DS: lien lech 16i co day

a Nhip tim rdi loan

- DS: L'6i phai hoac trai

- TC: Lop co citng day, co thanh dai det Ci v

cham

- T°' v.cham + v lung tren

- Cg: Tren diem co day nhgt

b Ching trang

Wing sau dau dau, to bi Trong dau am u, kh6ng tap trung suy nghi Thuang nghe thgy tigng not o trong tai nhu tigng go, reo reo, hoac thuang thi thao, the bai, the gi8u, trach mac Khi lam vies hay nghi ngai dau xugt hien Khi narn ngu xugt hien nhieu hon

Trong diem = Cl

2 Huyei ap thap (dau u.gciy)

a Hien Wang roc loan

- DS: Lech 16i, co day phai hoac trai

3 Co long ter (dau dclu)

- DS: Lech, co day phai hoac trai

- TC: V.cham phia lech co Om

- v.gay, v.dau ben lech

- Cg: T.diem + v.chS.m

Dan dau hen lech

Luc rrat, and nhieu dau tang tang

Trong di4m: Cl

4 Benh Pcic Kin-son (dau deiu)

- DS: Lien 15m det doc

- TC: nhieu soi det tit co len cham

- ca yang dau

- Cam giac: v cham va trung diem

- V.sau nao nang va bi dau Dau nhieu dau tang lao vd phia truoc va tay tang run

Trong diem = Cl

5 Mat lanh (do con huyei ap theip)

Mat lanh nhu bun do con huygt ap ha va ret, mach gip va

Trong diem = Cl

6 Ca' cUng (do berth viern cot song dinh hhdp)

- DS: lien lech, curing, cimg mang

- TC: v.cham., ben lech xo

- T°': C1 + v.dau

CAM NANG VE PHUONG PHAPTAC DONG COT SONG - 32 - NGUYEN THAM TAN

- Cg: Dau 6 phia gai song lech + v.chd.m

Chitc nang yang c6 (Mu bi han chd, quay,

ng6a, nghieng datt kho

7 Budn non (do say song, say xe)

- DS: den lech, 16i, co day

-TC: v.chdm co day phia dOt song lech

- T': V.chdm

- Cg: T di6m, v.chem phia lech

- Ua nhidu nu& dai va chong mat

8 Budn non (do TK thyc vat RL)

- DS: Den lech 16i, co ming

- TC: V chdm co mang ben lech

- v.chdm

- Cg: T.diem + v.chdm

- Wing trait lanh va nhidu m6 hoi, se gio Ua

nu& dai Ch6ng mat

Trong diem: Cl

9 Tai diec, tai

- DS: Lech 16i, clang, day

- TC: v.cham thanh dai det

- T°÷: v.cham + lung tren

- Cg: Dau v.cham + t.di6rn

Trong tai loon co tidng u, am, i, co ltic nhu

didc ban

Trong diem: Cl

III Cl VOl NHIEU DOT SONG ROI LOAN

TU'ONG 'ONG Vol BE: NH ClIfiNG

- Thueng ha chi ddtt bi co ding Cam giac

giam, chfic nang van clang han chd Tao bon

Trong di6m: Cl, C4

12 Mcit nhd m hhOng kin

(do liet day than kinh s6 7)

- TC: v.chdm T" v.chdm T°- ben mat liet

- Cg: T.diem + v.chdm

- Mat ben lech nharn khong kin kd ca khi ng6 Hay chay nu& mat

13 Chem tay run 14 t bdt

(do benh Pac Kin Seri)

- DS: Cl - C3 - C5: 16m, det, doc

- TC: Xe v.chem, T' v.chdrn

Cg: T.di6m - v.chdm

- Mdt chinh xac - not chain

Di lao phia truck - Tay run lat bat

Trong diem: Cl, C3, C5

14 Ccim mao

- DS: Cl, 2, 6 + Li rl - Lien lech, co day

- TC: v.chdin co day T": v.dau, c6, gay, lung Cg: T.diem + v.chdm

- Nhidu trang chiing khong binh thuang

15 Ngzi qua nhie.0

(Do huydt ap thap)

- DS: Cl, 2- D6 - L3 r6i loan: Lien lech, mang

- TC: Co v.chem, T° tha/p 6 v.chdrn

- Cg: T.diem + v.chd.m

- Cd the binh thuang Thinh thoang co ltic

bi dart tiic 6 \rang chdm khi co cdn huydt ap ha Trong diem: Cl, C2, C6 - L3

16 Nga bdt tinh va truy tim mach

- DS: Cl, 2, 3, 4 - D6 - L3 r6i loan

Lien lech, 16i, co day TC: v.chdm corn

- T thip toan than Cg: Td+ v.cham

- Va m6 hoi Ngat xiu

Trong diem: CI, C2, C3, C4 - D6 - L3

17 Tim Op yeic

- DS: Cl, 2, 3, 4 roi loan Lien lech co mang

- TC: Xd v.chdm v.tran, c6 trai, ng-uc trai

- Cg: T.di6m

- H6i hop Nang Pang nguc Met mai

Trong di6m: Cl, C2, C3, C4

18 Mat nga heo dai (TK SN)

- C1,6 - D1, 7, 8, 9, 10 reit loan - Lien lech, det doc

- Xd v.chSrn - Dau: T.diem - v.chdm

- T°' v.dau, long tren

- Dau dart kinh nien Tri nho giarn Tao bon Trong di6m: Cl, C6 - D7, 8, 9, 10

- DS: Cl, C6 rai loan, lech lom, xe cling 19 Dau co va ccinh tay

CAM NANG Vh PHUONG PHAP TAC HONG COT SONG - 33 - BUI DUC CUONG BIEN SOAN

- Cl, 6, 7 rl - Lien 16i mgm dAy

- c6 gay - Dau: T.diern + c6

- H6i hop, tlic ngig trai

Nhigu m6 h6i - dau lung

Trong diem: Cl, C6, C7

20 Dau dau, nhtic mat

(do tuyen yen r6i loan) (C2)

- Cl, 2, 7 - D1, 2 roi loan: lien 16i, co day

- V.chem co day Dau t.diern va v.chem

- dAtt, c6, gay, lung tram

- Vang dd.0 dau va na.ng, bi bi kho chiu

Khong danh gia dude khu vuc dau titc

MAt nhuc luon Chay nuac mat Thi 114c

giam Mat ma - da xam xit Met 16i )(yang tren

do

- Dung len ng6i xu6ng bi co giat, dau di'eng

trong c/A.u Tao bon

Trong diem: Cl, C2, C7 6 - DI - D2

21 Nhau me; h6i Sy gio do cam

- C1 - D7 r6i loan

- Lech co dAy - V.chem co

Dau: T.diern v.chem - v.c6, gay

Truac 1)1 dau &du d>r dOi den not khong the

buck ra ngoai duoc Sau ngay dau dAu thi

dAu va mat va m6 hoi Lan lain so gio

Trong diem: Cl - D7

1.C1, 2:

Dau day thAn kinh 10, than kinh 7 Dau

yang daiu, mat D6rig tit co lai Tiet nuoc bot

Chi tren Dam r6i canh tay: Truy tim.Trang

nhip tim Mui - Ding mayih chii Tim - ph6i -

gan - mat

2 Cl- Truy tim mach (do TK giao cam

chiem uu the)- Phai chua TK pho giao cam

C1)

3 Cl - T°' v.dAu

- Dau dAu bu6n non Dau dAu phia sau

4 Cl + goc ham sat hhoe tai

- Kho nuac bot - it nitric bot

5 Cl, 2: Tit TK Rho giao cam

6 Cl, 2 lom

- Chaa vao ch8 lom giita ba )(Laing so voi C2

bang cach clua ngon tay lan ngang vao khe nay

cho den khi cd 6 khe day len

7 Ca co loi song trei u giaa hai cc/ thang

- Chula vao ch8 lom giaa xudng s9 vdi C2, dua ngon tay lan ngang, song chinh C2 //C7

8 Gidi toci ca co a be( xacing che ru

- Ha van 2 la

9 Gicii toa cd co (3: hai ben ho'cha: u ua D6

Ngoai tam thu (2 nhip mat 1 nhip) cluaa cham, gilt ddu t6c do

10 Gicti toci co etc don chum trcii

- Ligt naa nguai, tay phai co, lam copoidng don trai

- Bong gan ban chan

13 Cl, 2 1&hphdi co corn - C7, D1 tech trai

- Song chinh Cl, 2 // C7-D1

14 Gicii toa veing chcl'm ua D3

- Cd thang c6 trai lap

15 CT - Si, 2, 3 cling ccing

- R6i loan thAn kinh thuc vat

16 Chita ccic dot song

- Sau khi chaa xong cac d6t song c6 phai chila tiep D9

1 Mai /thong birth thzteing

DS: Don lech 16i, co clay Co co Cl

v.dau - Dau: T.diem v.chem

C2 ciing vdi nhigu d6t taring itng vdi chiic nang:

1 Trung tam tang nhip tim

- Cl, 2,3, 4: C2 ben lech co day

- V.chem co cam Dau: v.chem ben lech

1

CAM NANG Vt PHUONG PHAP TAC DONG COT SONG - 34 - • NGUYiN THAM TAN

- thap bran than

Tx-91-1g Cl, 2, 3, 4

2 Dang mach chu hhong binh thziang

- C2, 3, 4, 5: C2 lien loch, 16i

- TC: Ngang CI a yang ch6.m Dau: Tdie'm v.ch6m

- To*: v.c6, vai - nguc trai

3 Tim hhong binh thdang

- C2, 3, 4, 5 - D1, 2, 3, 4, 5,6

- C2 lien 16i co day Cd ngang CI + v.chSrn khong binh thuang - T°+ v.nguc trai Dau T.digm v.ch6m

4 PIA hhong binh thu'ang

- C2, 3, 4,5 - DI, 5, 6 C2 lien loch, lom, nhac

- Xd ngang Cl + v.chSrn - Dau Tdie'rn v.ch6m

- T°' v.ngiic trai

5 Mat hhong binh thu'eing

- C2, 3, 4, 5 - D4 - D11 - 12

- C2 lien lOch, nhac, m9ng

- Cd ngang Cl - v.ch6m khong binh thuiing

- T°1* v.vai phai - dau: Tdie'm +v.ch6m

6 Gan khong binh thu'O'ng

- C2, 3, 4, 5 - D4, 10, 12 - Ll

C2 lien loch co mang Cd ngang CI -v.ch6m

Dau: Tdie'm T' vai phai + ha Klan phai

II C2 ROI LOAN TU'CiNG LANG VOI BENH CHONG

1 Litai co giat dcly

- DS: Donl6i, co, mang

- Cd ngang Cl +v.chgm khong binh thuang

Dau T.diem +v.ch6m T°4 c6, vai trai Cam die"c 136m sinh

3 Lanh yang gdy do huytt ap tha:p

9c (6-rig-t:u day p-hia ti a'

- Cd ngang C2 + v.cham khOng binh thuang

- Dau: Td + v.ch6m

- Dau tac v.gay - met mai

Trong diem: C2

4 Mai chety nitric trong do cam lanh

- DS: Lien loch lom, xd

- Cd ngang Cl + v.ch6m khong binh thuang

- Dau: Tdie'm +v.cha'm

- Te+: c6phai, lung, dau

Cam mao, hat hdi, so mai

Trong Cl, C2

5 Mdt, mai may gist

(Do liOt day than kinh)

- DS: LOch, lomidn xo, cuing

- V.chgm xv15au Tdigm +v.chS.m

- T' ngang C1 + V.chSm

- Cita), nu6c mat

- Mat bi may luon - aNH CHI:rNG CO LIEN QUANDfN C2

1 Ho cam cam

- C2, 3 - L3 - Lien loch, co

- Ngang yang chSm co khong binh thuang

- Dau T.diem +v.cham + T** yang dau

- S6 mai

Trong digm: C2, C3 - L3

2 Die-c beim sinh

C2 - L2 - C2 loch 16i, co day

Cd v.cha'm thanh dai dOt

T°.* v.ch6rn +v.lung teen

Dau: Tdie'm Trong tai nhii c6 u

- T' v.ch6m, lung tren, \fling cung

- Cam giac bi phu giam

Trong C1 - C2 - C6 - DI

COChcin tri yang CI, 2 bien doi

- ChSn: C1 c6 gai sau Gai sau C2 cao hdn

CI va C3

- Tim hiOn Wong mat doi xang giaa, phai, trai, tren, duoi a cd thang va co g6i dau Dung

2

CAM NANG VE PHUONG PHAP TAC DONG COT SONG

phildng thfic chuyen tat the: c6

nghieng phai, nghieng trai de' xac dinh lop co

va d6t song benh

- Tri ithang hien Wang mat binh

thuang Cl, 2:

1 Trong diem viing C1, 2 khac cac vOng

khac hay co cQm Trong diem a nhiing ch6 xo

teo mang, day, an vao dgy BN they dau

Trong diem nam tren nen so, tren v.cham,

tren cd thang

BOI DOC COOING BIEN SOAN

8 C2 - V.cham rdi loan

- Day ba dudi C2 lien quan chic nang van

9 C2 có bigh clo'i chila

Neu C2 binh thuOng, khong duoc ch2a chi chfia C2 co bian dai

10 C2 15m - D5 15i = cam

£1* ), C2 len ti/ goc ham len

11 C2, C3 - L3 - v.dau - - that icing

- 35 -

2 C1,2 bian d6i thi cd thang mot ben tang, - Ho - cam cum

mot ben chlang, teo nhuoc Chita D4 ben nhuoc

3 Hai cd thang d6u chUng la cam diet ba:m

sinh, khong so tidy C1, 2 Chila ba truck co

-iic dOn chum du'oi goc mang tai

4 Gifla gay n6i len mot bO co cling to lAng

chi& dila, thanh &tang song trau, tit tren

v.cham xu6ng C7 Chita hai tay hai bo teo'cUa

soi nay if ch6 bat nguen cue soi cd nay tren nen

Sc

5 C1, 2 lech sang mot ben, bao giO co thang

cd tic don chum, h6 cham cung co cQm ve ben

lech, chUa C6 phai va IDO ngoai cd Uc dOn chum

6 Chan: Dung hai ngon tay.cila hai tay day

tit sat gOc ham sat mang tay, xoay tran trai

chien vao giva tren v.cham, tren nen so Giai

toe bang 6 hc.lc 4 ngon cUa hai tay tren ch6 teo

nhttoc ma BN they dau

7 Cl, 2 16i lech, song chinh bang hai ngOn

tay de len nhau de' rung, sau se vi chinh

1 Chita 2 ben ngoai cd thang, dua sau vao

dot song, sau bi len

2 Chita bo tren C3 an \lit dau C3 xu6ng sat

bo du6i C2, day C2 len

5 C2, 3, 4, 5

- Tuyan not tie't - Tuyen tuy

6 C2 15i - C6 lom

- Chita tit dau 1)6 trail C7 xu6ng sat ba cluoi

C6, day bi (bSy) C6 len

7 C2, 3 co corn

- D4

C3

I NHIt T DO

a Nhiet do, da tiro'ng ling vai not tang

- Vang ngVc trai; - Truck r6n

- Vang co phai; - Vang ch"a'm

- Vang giita lung

- Vang vu phai

b T'''+ da tu'dng ling vi i die phu'cing Than the + tit chi

II CHUC NANG

a Chao nang rei loan Wong ling viii mot d6t song C3

1 Chiic nang tai hhong binh thztang

* HiOL tu'ang 4nh13;

D6t song va fiat cd benh ly Tug, thuQc vao nguyen nhan gay benh va benh cu the cUa tai ma hien tuong benh ly cUa d6t song va tiet co bieu hien len bang cac hinh thai khac nhau tudng ling v6i benh co the Chi tiat ghi ci phan 3 benh

- T' yang co +

- Dau T.diem + co co day

b C3 cang vO'i nhieu dot song khac r6i loan

1 Than hinh hocinh ccich rdi loan

C3, 4, 5 roi loan T" ha soon hai ben Dau: Tdiem + ha soon

2 Trung tarn tang nhip tim hhong binh

th ud/1g

3 D5ng mach chez hhong binh thitang

CAI NANG VE PHUONG PHAP TAC BONG COT SONG - 36 - NGUYEN TRAM TAN

4 Pheii - 5 - Gan - 6 - Mat hhong binh

thdang

7 La lcich /thong birth thaang

C3 - Dll rol loan

DS + TC nhu phan 1 phan 2

gitia lung - Dau:

III BENH CHUNG

a Benh chiing Wong Ting vdi dot song C3

1 Nong ca yang deiu

DS: Don, lei, co day

- dia phuong va v.dau

- Dau: Tdiem va dia phuong

- Cam giac giam

- Lien quan tOi nao (16m teo)

- D6t C3 sinh lY la d6t 16m

Trong diem: C3

4 Gai ret

- DS: Lech mOng - ngang Cl + v.cham

nhuoc T" v lung tren - Dau: Tdiem

Co the suy nhuoc

Trong diem: C3

5 Chong meet

- DS: Don 16i co mong - v h6cliSm co

- T° v.trai Dow T.digm

Bi choang khi quay c6 nhanh, ke ca khi

- C3 lei lech co day V.cldm co day

- T" vai phai: mat R6n + mO dc •

- ThAt lung - Cam giac: Tdiem + v.che'm

- C3 loi lech, COng, day Ngang C3 co cOm

- Dau: Tdiem, lop co co T" v.dau + mO ac Thi 19c giam

- C3 lech lom xd TC: Teo nhudc v.chSm

- T" nguc trai + vu phal

- Cg: Tdiem co diem c/62i dOng:

- Phu - met mOi

Trong diem: C3, C4, D2, D3, D4, D9, L3

6 TM ngein hot

- C3, 4, 5 - DV

- C3 16i Lech co day

- TC: Ngang C1 va v.chSrn co day T'÷ ma ac

- C3 lom lech xd TC ngang C1 + v.cha'm xd

- v.dau, lung tren, cd

- Cam giac: T.dijm +

- N4ng 16ng nvc

Trong digm: C3 - C4 - DI

8 Than hinh suy n.hugc

- C3, 4, 5, 6, 7 - D1, 7, 8, 9, 10, 11 - Ll

- C3: Lech mOng xd

- C3, 7 - DI - Ll, S2, 3

OW NANG VE PHLIONG PHAP TAC DONG COT SONG - 37 - BOI DUC CUONG BIEN SOAN

- v.dau lung tren that lung, giaa lung

- Dau: T.diem, cac diem d6i deng

- Dau dau - mat ngia Tri nho giam

Trong diem: C3, 4, 5, 6, 7 - -D7, D8, D9, D10

1.1 Chruc ruing

- Tai - trung tarn t - nhip tim Cd lac don

chum co lai - Tim - ph6i - Gan - mat - Ong

mach chit

2 C2 - dia phicong - Than hinh

Chan tay co cap

3 C3 - u dau -v.cham

- NOng yang dau

4 C3 - Tu* town than - That Zang trdi

- NguOi benh ngoi thang, ngOa co Thay

thu6c dSy tit sau ra trade 0 bat cladi C3 18i

Tim sdi xd ben trai Chaa d6i dOng 3 diem

Ben trai - C3 - Ben phai chila cling mot lac 3

di6m 3 tti th6 thang lung Ben trai ly tam

-Ben phii htiong tam C3 gifia day tit sau ra

trade

C4

I NHIT DO DA

a Viing da nhiet toting ifng vol not tang

- V nguc trai T°4; - V (Judi vu phi T'

- V co phai T"; - V vai phai

- V giOa lung T"; - V trade r6n

b Vang da nhiet dia phudng Cac khu vac nong 0 than minh 0 tit chi Chu 9: mang saan

II CHI-IC NANG

A Chic nang r6i loan tu'dng utng vdi 1 dot s6ng va C4 r6i loan

1 Lttai hhong binh thitang

a Hqn tztdng qnh ly

DS va ti6t cd benh 19 nhu da ghi u phan 2 chilc nang 0 C2 Tu9 thudc vao nguyen nhan gay benh va benh cu the cila ivai ma hien Wong benh 19 va lop co biL hien len bang cac hinh thai khac nhau tutting ling voi benh cu the, chi ti6t ghi 0 phan 3 benh

+ T' v.c6 gay

+ Dau: T.diem va co quan cua benh

B Chic nang r6i loan tddng iing vo'i C4 va nhiesu DS khfic

- Than hinh horinh cdch r61 loan

Hien Wong benh 19 xem d C3 phan chic nang

- T.tam tang nhip tim r6i loan

- D8ng mach chi khong binh thuOng

- Tim khong binh thu0ng

- Phi khong binh thadng

- Gan khong binh thuaing

- Mat khong binh thadng

- La lath khong binh thudng (xem C3 phan chic nang)

- Mang bao tim hhong binh thiteing

Dau: T digm + v.cham

III BENH CHLING

A Dot s6ng C4 ro'i loan -Wong itng yeti cac benh:

1 Mci't cam gicic tocin than

a HiOn tucmg 4nh

Xem 0 phan Cl phan chits nang

6,,M NANG Vt PHUONG PHAPTAC DONG COT SONG - 38 - NGUYEN THAM TAN

- C4 1oi, co, day

- TC: Ngang C3 khong binh thuang

- v dau + dia phudng

- Dau: T.die'rn, v.chSm, dia phudng

b Trgng thong

- Di lai kilo khan

2 Chan tay to bi

a Hien tilting benh ly;: C4 lam xd

- TC C1, 2 + v.chSm.khong binh thuang

- Dau: T.die'm

b Trcing chang:

- Nguai cham chap

3 Dau ttic vang-rno dc

a DS lien Lech co day

- TC: C1-2 chgm khong binh thUang

- T": v giva lung

- Dau: T.didm - mang suan

b Kern rdi loan tieu hod

B C4 ciang nhieu dot khac rol loan bldng

if ng vori cac benh chi:1'11g

1 Viern hang

a C4, 5 - D4 r6i loan

- C4 16i, lech, co day

- TC: C2, 3 - v.cha'm rol loan

- c6' phai, nguc trai

- Dan: T.diem +

b Thuang n6ng is yang lung teen

2 Dau mang so'o'n

a C4, D8, D10 ral loan

- C4 lech co day

- TC: Cl + v.cha'm

- T" v clan, ha wan Dau T.diem + co

b CO cam giac thuang xuyen dau d viing

ben suan

3 Cc/ the' suy nhuvc

a C4, D5, 7, 8, 9 r6i loan

- C4 lech co mang TC: Nhan Cl +

- T" v.dalt, giaa lung va thk lung

- Dau: T.diem + h6chSm

b Cd the bac nhudc

Lam RL chac nang than, not -661, than kinh

b Liet mem + RL tieu hoa

5 Rd'i loan tieu hod

a C4 - D10 - 12 - L4, 5 - S4

- C4 lech co day

- TC: Cl -2 + cham T" giita lung, ha scion, r6n, chSm

- Dau: Tdie'm - chSrn - tcd blY

b Nguai luon hap nong

OC4 - ch0c ming

Luai - trung tam tang nhip tim Dong mach chia - Mang bao tim - Tim - Ph6i - Gan - Mat

2 C4:

Cai nut ciia cam giac va van clOng

Neu cam giac hoac van &Ong han che, den phai chlIa vao C4 N6 gay co ding, lam nhip tim cham

3 C4 bid tren corn len, rech phcii

Nhin su vat quay cuemg Chong mat

9 C4 ldi gyn len bet tren corn len

Ngoai tam thu - lam tang hoac lam giim nhip tim

10 C4, C5, C6

Than kinh ngoai lai ga.'n voi TK phe vi

11 C4

Co ac don chum bi co Dung 4 ngon chaa

co ac clan chum, con 2 nem cai dat chua Dl

Cs

I NHIET DO DA 4,-c r) /- -( -va-'7

a 7' da tu'dng (mg udi marritang

- V nguc trai T"; - T" v vai phai

v giva lung

- T° v co p al;

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 39 - BUT DOC CUCYNG BIEN SOAN

- T' duoi vti phai; - T' v truck r6n

b T da c4a phu'ang Wong zing

Lien quan nhiau den chi tren

II CHUC NANG

A Chitc nang RL ttidng Ling viii C5

1 Tay co le'n

- DS: Tiel co tu9 thu5c cac nguyen nhan gay

benh cu the ma chting bieu hien len tudng ling

vai CS va TC chi tiel ghi a phan benh 19

- T°+ v nguc trai + DF

- Cgiac: Dau tai Tdiem + DF 11) - C 5.-

2 Thanh quern

- DS +TC nhu da ghi a tren

- T": v.c6 phai - Cgiac: T.diem

B Chitc nang r6i loan tticing ling C5 va

nhieu dot song khan

- Mang bao tim; D5rig mach chil.; Tim;

Ph6i; Gan; Mat; Kh1 quan; C5; Co hai dau

- C5, 6 la On; C5176 la xlicing quay tay

1

- DS va TC a miasj 6„8, 9, 10 tren tug thu5c

$ benh co the va biL hien

- T': Da DF: v c6 phai

- Cam giac: Tdiem + cd vai

III B '*NH CHI:rNG

1 Ho that thanh

C5: 16i, co day; TC: •ngang C4 khiing binh

thtiang; T': v.c6 phai; Cgiac: Tdiem + TC benh

19 Trang chiing: ca hong dau II) , ,- )

2 Hay buo'n non

- C5 16i, lech co day

- TC: ngang C4 khong binh thuang

- T": DF + v.dau

- Cam giac: Tdiem + h6 cham

- T.chitng: nOng 8 lung tren

3 Ti(ng not rigrcit doan

- C5 lech, co mOng

- TCo: ngang C4 khong binh thuang

- 'I': v.c6 phai

- Cgiac: Tdiem

- T clang: Tie'p xiic cham

4 TiEng not hhong r5

C5: Lech, co day

TC: Ngang C4 khong binh thuang

T°.: V.c6 phai

Cgiac: Tdiem

TchUng: CO cam giac ming v.dau

5 Nong Laing gay

Hien Wong benh 19:

- C5 16i, lech, co m*Ong

- TC: ngang C4 khong binh thuOng

- Cgiac: Tdiem + cd vai

TC: Canh tay cam giac gia.m

B C5 clang vari nhi6u DS khac RL tudng ifng vOi cac benh chitng

1 Cao huye't cip

Hien tudng benh 19:

'1 ;1 - C5, 6, 7 - D1, 2, 3, 10 - Li, 2, 3

- C5 16i, lech, co mOng

- TC ngang C4 khong binh thuang

- Cgiac: Tdiem + tie't co benh 19 va cac diem d6i d5ng, chu ye'u co vai

- T": Lung tren, c6 gay, ha suan, that lung, dam, mat, c6

-TO: Nang ng tri tae

2 Dau nhz2c ccinh tay

Hien tudng benh 19:

1-47/ - C5 - D2, 3, 4 r61 loan

- C5 lech xo

- TC: ngang C4 khong binh thtthng

- T': DF

- Cam giac: Tdigrn + diem d6i dong

TC: Khong van dOng ding dau

63) C5

D5ng mach chu - Mang bao tim - Tim - Ph6i - Gan - Mat - Co hai dau - Phan xa gan )(wing quay tay - Thanh quail - Khi quan

4 C5 4.ch phcii

- Tang huye't ap

5 C5 hhong binh thu'ang

- Nhin sit vat quay cu6ng N1-Am mat 10, van thay nha ci:/a quay len

6 C5 - C7

- D5ng mach canh trong

CAM NANG Vi PHUONG PHAPTAC DONG COT SONG - 40 - NGUYEN TT-LAM TAN

C5, 6, 7 - DI, 2, 3 rat quan trong song

letu

Lien quan chilc nang van dOng chi tren, co

tay, ngon tay, khuS'iti tay co dui - Ben nao han

the chtaa ben 5:y - Tuyen giap trang Nguai

mirth man - Gid can bang cn the

- V.ctAtt, c6, gay - lttng tren

II CHUG NANG

A - C6 Wong Ting vdi chitc nang - kh5ng có

B - C6 vdi cac d6t song khac ro'i loan

tuking Ting vdi cac chlic nang

- Mang bao tim (nhtt a C4)

- Co hai d6.0 (nhtt a C5)

- Gan (nhu C5)

- Xttong quay tay (C5)

• - C6, 7 ban tay co lai

- C6, 7 khuY'u tay

III BENH CHtING

A C6 r6i loan tong iing vdi benh chiing

I Dau nht2c /Mop vai

Hien Wong benh 19:

- C6 Wch co day

- TC ngang C5 khong binh thuang

- df

- Cg: Tdie'm + di4m dot d6ng

TC: Dau khi van &Ong

2 Bitdu ce

Hien tttong b'Oh 1S/:

- C6 lei l'ech, co day

- TC ngang C5 khong binh thttang

T": co phai + df

- Cg: Tdiem + cd vai

TC: Hay h6i h6p

3 Ban chan lanh budt

HiO Wong b'Oh 1St:

- 161, lech co mong

- TC ngang C5 khc3ng binh thttang

- v.d; d6.u

- Cam giac: T.di4m

TC: Cd the suy nhunc hoac bai het

4 Ho get

Hien Wong benh 19:

- C6 lech mem 'Ming

- TC ngang C5 khong binh tIniang

- T' co phai + lung tren

2 Tam than binh

HiOn Wong bOh 1St:

TO - C6, 7 - D8 - L4

- C6 16i, *h, co along

- TC: C4, 5 - D5, D12 khong binh thttang:

- Cgiac: Tdi6m + Trigt co

- v.nguc trai, v.lung, th6t lung

TC: tinh th6.n khong binh thuang

3 Tri Whet giam

Hien tuung benh 19:

- C6, 7 - L4 r6i loan

- C6 lech co mOng

- TC ngang C5, 6, D12 khong binh thlthng

- T' ng-uc trai + that lung

- Cam giac: Tdi4m + Tco lo•O.h 1Sr

TC: Ti6p xtic cham

5 Cd Ray citng dau

Hien Wong benh 19:

CAM NANG VE PHUONG PHAP TAC DONG COT SONG - 41 - BUI DUC CUCING BIEN SOAN

- C6 - Ll - D11 r6i loan

- C6 lech co day

- TC ngang C6, D9 r6i loan

- T" vai phai + mO ac

- Cgiac: Tdie'm + Teo Wong Ung

TC: Van Ong khdp c6 han ch6

6 Mcit loan thi

Hien Wong benh 19:

- C6, 7 roi loan

- C6: lot tech, co mang

- TC: ngang C5, 6 khong binh thuang

- T": v.dau

- Cam giac: Tdidm + Tcd benh 19

TC: dau dau - nang dau

- Cgiac: Tdie'm + Ted benh 19

TC: ThuCing xuyen dau dau

8 Suy Binh due nam

Hien tuOng benh 19:

- C6, 7 - IA roi loan

It - C6 tech 16i co day

es - TC: C5 - Dll khong binh thithrig

- T": vai phai, mo ac

- Cgiac: Tdie'm + Ted b19

TC: Lien quan chlac nang da day, gan, mat

9 Vzing iron nong

Hien Wong benh 19:

- C6, 8 - D11 khong binh thuang

- C6: lech co mong

- TC: Vai phai + df

- Cgiac: Tdie'm, Tc b19

TC: Lien quan chic nang mat

10 Nhie'u Ind h6i bcin tay

Hien Wong benh 19:

- C6, 7 khong binh thuOng

- C6 16i, lech co rm1ng

- TC: ngang C5, 6 khOng binh thtaing

- T": ngoc trai, lung tren RL

- Cg: Tdidm + Ted benh 19

TO: Tudng itng voi tam bao

12 Tie'ng not tho

Hien Wong benh 19:

- C6,7 - D1 khong binh thuang

- C6: lech co day

- TC: ngang C5, 6 r6i loan

- T": v lung tren

- Cgiac: Tdidm + TC benh 1Y

TC: Lien quan d6n chOc nang ho h6.p + Wan hoan

13 Lip chi tren

Hien Wong benh 19:

- C6, D10 kh8ng binh thuang

- C6: 16i co day

- TC: ngay C5 - 7 khong binh thuong

- T': yang lung tren

- Cgiac: Tdie'm + TC benh 19

TC: Lien quan chic nang 118 hap + Tuan hoan

14 Thocii hod dot song etc

Cd the binh thttang 8 c6 nhiau hach,

cd ifc don chum co, chfia cac hach cd thang co

•

1i

Tac dOng that nhc nhang 6 lop c ngoai C6

Song chinh bng 3 ngon tay 6 136 ilcd itc don chum, chi va ngon tay vao, kh8ng c/Sy

8 C6 - L2

- Thodi hoa d6t song di'

9 C6, 7 - Dl, 2 16i, c6 lap ca mein phii len

II CHIYC NANG

A C7 RL Wang ling vOri cac chiic nang

1 Tuydn ntidc bot roi loan

HiO Wong benh 1Sr:

- C7 lom loch co mang

- TC: ngang C5-6 roi loan

- h6 chgm

- Cgiac: Tdie'm + Tc benh 15r

TC: mat thang bang

2 Tuydn nu'ac mat

Hien Wong benh 1Y:

- C7 16i mdm day

- TC: ngang Cl, 2 khong binh thuang

- T":

- Cgiac: Tdie'm + Tcd benh 15/

TC: chay mi6c mat, co Om

3 Tuyin gicip trang roi loan

Hien Wong benh 1.Sr

- C7 16i loch, co day

- TC ngang C5, 6 + cd vai

- T°4: v.a.0 + lung tren

- Cg: Tdiem + co vai

TC: Hay h6i hOp

4 Hach hanh nhan

Hien Wong benh 1Sr:

- C7 16i, co day

- TC ngang C5, 6; cd lac don chum

- v c6 gay

- Cgiac: Tdie'rn + tcd hdnh 1Y

TC: Cd itc don chum Co lai

5 D6ng tot ma to

Hien Wong benh 1Y:

P - Cl 16i loch mdm day

- TC ngang C5, 6 + cd itc don chum

- T°': v.dau

- Cgiac: Tdidm + Tcd RL

TC: Thuang phai nhfu hai mat lai de' nhin

6 Tay duji ra dau

Hien Wong benh

- C7: Lech do day

- TC ngang C7 + co vai RL

- T°+: df

- Cgiac: Tdie'm + Tcd 4nh IY

B C7 vEli cac d6t khac RL tddng iing vdi cac chlic nang RL

* Tuyen me; h6i

Hien Wong benh

- C7, DI, 2 RL

- Cl 16i loch, co day

- TC ngang C7 + h6 cham RL

- v lung tren

- Cgiac: Tdidm + Tcd r6i loan

TC: cac RL vd TK thuc vat

* Mang bao tim

* Khqu tay Nhu a C4

* Ban tay co lai

CAM NANG Vt PHUONG PHAP TAC DONG COT SONG - 43 - BUT DOC CUONG BIEN SOAN

- Cgiac: Td + tcd rel loan

TC thin kinh (nao)

2 Melt mat phdn x9

Hien Wong benh 19:

- C7 lech 16i, co day

- TC ngang C7 + co vai co cem

- T" v dau

- Cg: Tdie'm + Tcd rol loan

3 Mat nhu có bui

Hien Wong benh 19:

- C7 lech mem mang

Hien Wong benh 19:

- C7 lam lech co mang

Hien Wong benh 19:

- C7 16i lech co day

- TC ngang C7 + cd vai co

- T" v dau - di gay

- Cg: Tdigni + tcd r6i loan

TC: ngay nge

6 Nu thz1y dich Itho rcio

Hien tudng benh 19:

7 Nam giao h9p khong xuat tinh

Hien Wong benh 19:

- C7 16i lech co day

TC ngang C7 + cd vai co cOm

- T': v.that lung

- Td + co vai

TC: Meng tinh co chu k9

8 Hai chid n lanh

Hien tudng benh- 19:

TC: Lien quan chirc nang than

B C7 vai nhiu dOt khac tu'dng iing vai nhiu benh chiing

1 Dau deiu buOn non

Hien tudng benh 19:

- C7 + 01 rei loan (xem a 01)

2 KhOp hang moi

Hien Wong benh 19:

- C7 - Dli r6i loan

-C7 lech co mang

- TC ngang C7 + co vai r6i loan

- T" v vai phai + df

- Cg: Tdigm + tcd benh 19

TC: co nhang r6i loan ves mat va than kinh

3 Mi melt nhiu dip tai

Hien Wog benh 19:

- C7 - D1 r6i loan

- C7 16i lech co mang

- TC ngang C5 -6- 7, cd vai corn xd

- dau, c6, gay nong

- TC ngang co vai co corn

- T0+ nguc trai, c6' phai, lung tree

- Cg: Td + tcd benh 19