Semiologie - Seminar 4

7/23/2019 Semiologie - Seminar 4

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Semiologie Seminar 4

1) ADENOPATIA

2) MODIFICARI DE COLORATIE ( hiperpigmenarea)

A!enopaiile "#n mo!i$i%ari !e &ol#m ale ganglionilor lim$ai%i' anglionii

lim$ai%i "#n $ormai#ni relai& n#meroa"e(**+,**-organi"m). !e !imen"i#ni

&ariae. !e la 1+2 mm la 1+2 %m. lo%ali/ae "#per$i%ial "a# pro$#n! in oae

regi#nile %orp#l#i' l "#n $ormai#ni no!#lare repre/enae !e %or!oane

%el#lare in%on0#rae !e o %ap"#la !e "r#%#ra %on0#n%i&o+ela"i%a' Prin $#n%ie

prin%ipala "i "r#%#ra aparin "i"em#l#i %ir%#laor lim$ai%. $iin! aa"ae &a"elor

%ole%oare %are !#lea/a %ir%#laia &enoa"a' ( %ele mai mari &a"e lim$ai%e "e

&ar"a in &enele %a&e)

In %ea mai mare pare a lor. li%hi!ele era%el#lare "#n re/#lae $inale ale

a%i&iaii %el#lare'

Energia ne%e"ara %el#lelor ee repre/enaa !e gl#%o/a %are in #rma pro%e"elor

!a na"ere energiei 3 !ioi! !e %aron "i apa' Re"pe%i&#l li%hi! e"e prel#a !e

%apilarele lim$ai%e'

l a# %a prin%ipala $#n%ie reglarea $l##l#i li%hi!ian prin &a"ele lim$ai%e' Ale$#n%ii im#nologi%a 5 a"a "e epli%a lo%ali/area pre!ominana a gl in prea0ma

porilor !e inrare in organi"m "i re"pe%i& in 0#r#l oeganelor inerne'

R6PE IMPORTANTE la ni&el "#per$i%ial (#"or aor!aile) retro si

prearicular, subaxilari – "i#ai !e o pare "i !e ala a limii. %are lo%hea/a

re%erea in$e%iei %are %aile re"piraorii pro$#n!e. laterocervicali (amig!alia.

laringia. $legmon amig!alian). inghinali 5 marii !e &ol#m in %a/ !e "#$erine lani&el genial "a# erminal #rinar "a# !ige"i& + nepalpaili. poplitei.

Ei !e&in palpaili !#pa %e "i+a# eer%ia $#n%ia !e ariera in in%er%area !e a

limia epan"i#nea #nor pro%e"e a) inflamatorii 7 ) infectioase7 %)

neoplazice7

a) 89 A!enopaie generali/aa %are poae "a apara la !e##l "#$erinelora#oim#ne' In $#n%ie !e inin!ere poae $i a!enopaie locala 5 %an! e"e



in$lama #n "ing#r ganglion "a# #n "ing#r gr#p ganglionar. a!enopaie

regionala 5 %an! "#n a$e%ae oae gr#pele #nei regi#ni. sectoriala 5 %#

re$erire la %ele 4 "e%oare ale %orp#l#i $ormae prin iner"e%area %elor 2

plan#ri. a!enopaie generalizata 5 %an! %#prin!e mai m#le "e%oare "a#

%an! oae gr#pele ganglionare "#n a$e%ae'

) : 8 9 in$e%ii &irale "a# mi%roiene %are "e po lo%ali/a in &e%inaaea

porii !e inrare !e #n!e a# en!ina "a "e ein!a in re"#l organi"m#l#i

#n!e "e o&e"% !e ganglionii lim$ai%i'

Se a!#na. la ni&el#l ganglionilor lim$ai%i. le#%o%ie %are l#pa %# in$e%ia "i !e

a%eea. in imp. ganglionii "i#ai in prim#l ran! po ramane palpaili' Cele mai

$re%&ene in$e%ii &irale %are !eermina a!enopaie "#n pro!#"e !e

a!eno&ir#"#ri. a!i%a gr#p !e &ir#"#ri %# ropi"m penr# m#%oa"a %on0#n%i&al;.

$aringial; i e"##l lim$ai%'ș ț

E Monon#%leo/a in$e%ioa"a : 8 9 oala "ar##l#i 5 pro!#"a !e &ir#"#l

E<STEIN+<ARR. in %a/#l %areia a!enopaia e"e generali/aa. !ar "e remie

!#pa 2+= "apamani 5 !oar %a p#ne !iagno"i% !i$erenia %# ale oli mai gra&e'

In$e%iile a%eriene "e in"oe"% !e a!enopaie lo%ali/aa in 0#r#l porii !e inrare

a in$e%iei in organi"m'

%) : 8 9 neopla/ii 8 %an%ere

Deermina. in $#n%ie !e ip#l %an%er#l#i. mai m#le $el#ri !e a!enopaii' 6nele

$orme a# a!enopaie generali/aa !e la !e#. mani$e"aa prin mo!i$i%area

%el#lelor hemao$ormaoare !in ma!#&a oa"elor 5 e le#%emie' Alele a# !e#

lo%al (#morile) "i "e ein! pe !e+o pare prin %re"erea #morii "i pe !e ala

pare. prin pro%e" mea"ai% : 8 9 re/#la #mori "e%#n!are in ori%e /ona irigaa

%apilar'

In %a/ !e neopla/ii. a!enopaia are rol aa !iagno"i% %a "i progno"i%'

STADIALI>AREA T6MORILOR MALINE IN F6NCTIE DE ADENOPATII

Sa!i#l :: * 99 al #nei #mori e"e "a!i# IN SIT6. in %are #mora e"e

impo"iil !e i!eni$i%a !aoria lip"ei mo!i$i%arilor'

Sa!i#l :: 1 99 repre/ina #mora !e mi%i !imen"i#ni (1mm+1%m) %are "+a

!e/&ola in inerior#l #n#i organ. $ara a+i !epa"i limiele'



Sa!i#l :: 2 99 #mora primara n# a !epa"i limiele organ#l#i. !ar a# apar#

a!enopaii lo%ale'

Sa!i#l :: = 99 a!enopaiile "+a# ein" $ara a !epa"i "e%or#l'

Sa!i#l :: 4 99 A) + #mora a prin" 0#maae !e %orp !e a%eea"i pare a plan#l#i

me!io+ran"&er"al 5 <) 5 generai/aa. in %are apar mea"a/e a !i"ana $ara a mai

re"pe%a &re#n "e%or'

CARACTERE PALPATORII AE ADENOPATIILOR S6PERFICIALE

In a!enopaia in$lamaorie-in$e%ioa"a ganglionii "#n moi "a# remieni.

"en"iili "i moili $aa !e "ra#rile "#pra "i "#ia%ene'

In a!enopaiile neopla/i%e. %on"i"ena e"e !#ra. lemnoa"a. ganglionii "#nne!#rero"i' T#mora a penera %ap"#a ganglionilor "i a a0#n" "a "e in$ilre/e in

e"## !in 0#r ($ia+a!eren)'

FORMATI6NI PIMENTARE TE6MENTARE

La ni&el#l eg#men#l#i po ei"a mo!i$i%ari !e %oloraie !aorae aglomerarii

in gro"imea eg#men#l#i. a #nor $ormai#ni n#mie melano%ie. %are !a# na"ere

pigmen#l#i melani%'

Melano%iele "#n "im#lae #"or. #n %el#le $oare a%i&e'

?iperpigmenarea 8 %oloraia mai in%hi"a a eg#men#l#i 8 in"eamna o %aniae

mai mare !e pigmen melani% a%#m#la in eg#mene "i !eermina an#mie

%ara%ere ra"iale'

Pigmen#l melani% poae lip"i oal 8 alini"m 8 oala alino"ilor' Alini"m#l

e"e #n !e$e% ran"mi" genei%'

In a$ara !e %olori#l #ni$orm a eg#men#l#i. mai in%hi" "a# mai !e"%hi". mai po aparea $ormai#ni pigmenare a) %on"i#ionale 5 ) %# %ara%er $amilial "a#

in!i&i!#al'

a) Formai#ni %on"i#ionale areole mamare. linia ala'

) Formai#ni %# %ara%er $amilial "a# in!i&i!#al pi"r#i. e$eli!e. pee !in

na"ere. al#nie. ne&i pigmenari'

Ne&ii pigmenari "im#lai ina!e%&a. a$lai in /one !e ra%i#ne. iriaie. pre"i#ne

8 9 po !egenera malign' Tre#ie in&e"igai !in in l#ni !e %are me!i%#l!ermaolog'



Can! #n ne& i"i mo!i$i%a %#loarea. a"pe%#l. el re#ie eirpa'

In %a/# melanoamelor. "r#%#ra "e n#me"e meanom malign "i poae !eermina

mea"a/a la !i"ana. %eea %e impli%a $ap#l %a o!aa apar#e. $ormai#nile

"e%#n!are e&ol#ea/a in!epen!en !e %ea primara'

Documents

Semiologie - Seminar 4