SU38260A1 - Device for comparative auscultation - Google Patents

Description

The proposed device, which is two phonepdoscopes (auscultatory), connected by rubber tubes with headphones for using the resonating properties of the auricle and equipped with a special switching mechanism, aims to facilitate the comparison of the results of listening to two different places on the patient's body and makes it possible to perform listening in different combinations at the same time both, phonendoscopes or each separately. Phonendoscopes can also be equipped with special devices for percussion and for applying the necessary marks at the place of study with a pencil.

In FIG. 1 shows a schematic view of the entire device; FIG. 2-phonendoscope (graduate) in a vertical section; FIG. 3 - view of the lower stationary part of the phonendoscope from above (left half) and below (right half); FIG. 4 - horizontal section of the switch disk; FIG. 5 is a view of the upper stationary part of the stethoscope from below (left half) and from above (half right); FIG. 6-10 - different positions of the rotary disk and combinations achieved by the switch; fig; 11 -19 - the same parts in the same sections of the second version of the device and the switching scheme; FIG. 20-vertical section of a phonendoscope with a percussion hammer; FIG. 21 - the same, top view; FIG. 22 is another version of the phonendoscope with a percutor in a vertical section; FIG. 23 is a simplified version of a device with cavities for clamping tubes; FIG. 24 - the same, in a horizontal section;

(107)

fng 25 - 26 - the same, using an eccentric in vertical and horizontal sections; FIG. 27 is a variant of the device, consisting of mutually rotating parts and a disk, external view; FIG. 28 - the same option, bottom view; FIG. 29 - the same, in a vertical section; FIG. 30 - the same, top view; FIG. 31 is a variation of the instrument using a lever for driving a striker; FIG. 32-form naup: nicknames.

The proposed device for comparative auscultation consists of two open (without membranes) phonendoscopes I and II (Fig. 1), equipped with switching mechanisms, and two pairs of rubber tubes — straight a, a- (Fig. I) and intersecting b, bi, the upper ends of the headphones entering with, s; these latter are pressed against the ears by a metal spring d, d, which is put on the head and adjustable in length by clamps e, e.

Each phonendoscope is equipped with a switching mechanism, the structure of which can be made quite diverse. In the first embodiment, the phonendoscope (Fig. 2) consists of three metal parts that are fitted tightly to each other: 1) the lower fixed part, 2) the middle rotary dial-switch and 3) the upper fixed part into which the tips of the rubber tubes fit tightly. The lower stationary part of the phonendoscope (Fig. 2) has a cylindrical shape and is provided with a cavity at the bottom — resonator a, outlined along a spherical surface. From this transducer, two cylindrical channels 1 to 2 (Fig. 2 lead to a common annular recess 1, b (Fig. 2 and 3 are also cylindrical. The center of the lower part does not have a vertical cylindrical section), Chao-iieuHbiM The inner thread for the center bolt g (Fig. 2) connecting all three parts of the phonendoscope is one whole. The switching disk g (Figs 2, 4) also has a flat cylindrical shape with a circle,: a hole in the center a, (Fig. 4); on its circumference there are three holes with a c, d to e cylindrical shape (of the same diameter), allowing for connecting the sound-free space of the annular undercut of the lower non-moving part with the channels of the upper fixed part, or, conversely, complete:) stitching this connection by inserting the intermediate integral part of the disc. On one side of the disc is the side handle / (Fig. 4), allowing you to set the disk with the help of a finger at the right angle and perform any desired switching, and the pointer located on the opposite side of the disk allows you to find the position using the appropriate icons ate, upper:; fixed part (fig. 2 and 5) it has a cylindrical shape and is supplied with a cylindrical sleeve, which protrudes erectly downward (k. Fig. 5), resting on the lower fixed part; in the center of this part, without cutting, the cylindrical opening passes the middle connecting bolt g (Fig. 2). Along the side of the M1 there are two slightly conical holes np (Fig. 6), into which the metal tips of the rubber tubes S and (Fig. 2L) are tightly attached. At the periphery there are signs for the pointer. The switching mechanism of phonendoscopes allows the patient to listen, keeping both the phonendoscope is stationary and is achieved using a switching mechanism of a wide variety of combinations for auscultation, explained in Figures 6-10. In all these figures, various positions of the rotary dial of the switch for the right and left phonend are shown The upper and lower stationary parts of phonendoscopes in all cases are located with their channels exactly opposite each other, with the centers of the channels in all cases located on the horizontal line. Thus, in these schematic figures, the coincidence of the openings of the switch disk with the horizontal corresponds to the opening of the channels, and the coincidence of a solid MSCT disk with a horizontal signifies the closure of the connection between the channels. For example, in Fig. 8 in the left phonendoscope, the lexical nanal is open, a; .., and the right is closed; in fig. 9 . the left canal of the phonendoscope is open, and the right is closed, etc. With each figure, the combinations achieved by switching are shown schematically. L and B in all figures means the left and right ear; I and II - left and right phonendoscopes; solid lines indicate tubes through which sound passes, and dotted lines are tubes closed by a switch and not working. The second variant of the device (Fig. 11-19 differs from the first, mainly by the switch device consisting of two sectors 6, b, (Fig. 13), mounted on the middle bolt g, around which they are turned using external handles /, /. Outstanding lateral protrusions c, c (Fig. 13) 1-: the very fixed part on which the switch sectors are located serves as supports fixing the extreme positions of the latter. When positioned, handle against channel I ;; -; the upper and lower parts (figs. 12 and 14) of the channels open, and when the sides are oblique Your pedals are closed. G. Sectors b, o freely rotate relative to each other, overlapping each other by the thickness of the notch, as shown in Fig. And in section, and in Fig. 13 - in plan. Each device can be equipped with an additional percussion device that allows the patient to be tapped out, listening to the result through phonendoscopes. This device can be carried out either directly with the doctor’s finger, or with any push levers or buttons or other mechanism. In its simplest form, such a percussion machine consists of a solid, vertically located, best in the center of the phonendoscope, a massive column M (Fig. 20 and 21), equipped with a ring for lifting it with a finger. In order for such a hammer to be fixed, if desired, in an inactive upper position, the stethoscope is provided with a clamping screw on the side. In this position, the auscidator can be used as such without using percussion. To delineate the boundaries of the organs under study, the percussion hammer can be provided with a soft pencil centrally located in it, the cocky will fall down when pressed with a sals on the percussion head or when turning the screw, makes a mark on the body of the patient at the point being examined. The described hammer can be adapted to turn off phonendoscope (auscultator), for what: o hammer 8 (fig. 22), in its usual position during listening to a large person under the action of the spring 6, pressing the button 5 provided on it, sleep wives central passage, outwards otkryvayuschims two pairs of side windows arranged so that the sound at the raised upward malleus passes from chamber 1 to 3 kana.ay through its lower window. When the hammer is lowered by pressing a finger on the keyboard, the sound from chamber 1 goes into channel 3 through the internal channel of the hammer, the entrance to the lower window and the exit through the upper window. Finally, if both windows do not come against the throat channel, the latter are closed and the sound is not carried out into the ear, i.e. the instructor is turned off. Inside the hammer 8 is placed a movable recording device, for example, a pencil 9, attached to the barrel 5 and under the action of the pin 6, which, pressing on the clamp 5, sweeps the pencil until the extension 11 of the latter holds it. In this way, when you need to polish with a pencil, you just need to press and press 5 to failure, and pencil 9 will come up with a hammer. The malleus is fixed in its similar positions (upper, middle, and lower) with the help of the locking bolt. latch if other well-known.

The more simplified form of the exhausted device consists of one whole cylindrical body, in its lower part 4 (Fig. 23) a syabnial hollow resonator, and in the upper part - a vertical stand with two external lateral depressions 5 (Fig. 23 and 24). On both sides of this stand there are two holes allowing the st rubber tubes to pass through the whole body of the auscultator to the lower resonator. The lower ends of the rubber tubes are fitted onto the metal nipples T (Figs. 23 and 25), which tightly enter the channels and fix the ends of the tubes, in place. Alternating or simultaneous switching off of the tubes is carried out by simply pressing with fingers on the tubes in the lateral depressions of the vertical column. If desired, an auxiliary eccentric 3 (FIGS. 23 and 26) can be arranged in the upper part of the rack to alternately turn off the tubes by squeezing them. Along the axis. The instructor (phonendoscope), as in other constructive variants, has a percussion drummer J (ph. 23 and 25), which in its upper and lower parts passes through the body of the instructor and serves as an axis of rotation for the switching eccentric.

In the switch shown in FIG. 23, for switching off each willow of two tubes of the phonendoscope, there are cylindrical knots n and p located perpendicular to these tubes and held in the open state by flat springs p.

In the next version of the device (Fig. 27-30), its lower part 1 (Fig. 27) is equipped with three holes 12 located on a plane at an angle of 9CG (Fig. 28 and 29), with external knurling along the rim 2 (Fig. 27 ) to rotate the bottom of the axle and set it to the desired position. Above it is located the upper part of the auscultator 3 (Fig. 27), through which two metal pipes, tightly connected to it, connected cylindrical nozzle 15 and the middle metal sleeve 5 (Fig. 29), are also tightly seated therein. Between the lower and upper parts of the instructor freely rotates on the axis (relative to the same metal sleeve 5) tightly fitting switching disk 4 (Fig. 29) with two diametrically arranged holes 7 (Fig. 30), which is brought to the desired position using the output outside the handle 6 (Fig. 27 and 30).

The handle 6 of the disk is positioned so that when it is moved to the extreme right position, as shown in FIG. 27, the channels of the nozzles 15 opened, and when installed in the extreme left position, they were closed. Along the axis of the instructor, there is a percussion drummer (hammer) 8 (Fig. 27), freely passing through the metal inner sleeve 5 and secured in any height position with the fastening kit 14 (Fig. 27). This shock is supplied with a BHjTTpH pencil 9 (Fig. 29), located along the entire axis and going down when pressing the head of the drummer from above.

A new form of the device named is characterized in that for tight pressing of the auscultatory 1 (Fig. 21) to the patient's body serves a bed 44 with a handle connected to the ascultory to communicate the same to the percussion

4S bracelets are fastened to the shock of the 4 side movements, covered by the forked end of the lever 46, mounted rockingly on the axis 47 reinforced in the frame 44. A spring 48 acts on the free end of the lever. ii the bed 44 44 are arranged besides channel 49 and 50, inside which, along the main line, two rods 51 and 52 move, provided at the lower ends with push rods 53,54, acting on the free part of the rubber tubes 5 that are located in the lateral cavities of the accelerator.

At the position of the rods, retained by springs 55 and 56, indicated in the drawing, the listening occurs only with one right ear, since the left bending tube 5 with the device 52, 54 and 56 is turned off; but if you press on the rod 52 with a finger, shifting it in from, then the sound is heard by both fingers. When pressing down both rods 51 and 52, listening is done by the left ear alone.

The latter form of the proposed device, however, modifies the headphone device (Fig. 32) held on the researcher's head by means of a flexible spring 3, on which a flexible sound tube 4 is fastened, connecting the internal cavities of both forests, formed by the three channels 5, at the intersection point of which there is a triple shut-off valve 6, outside fitted with valve 2, turning which, we have the opportunity to obtain all the combinations we need, i.e. to listen to one ear, then the other, right ay kulyator, then left, then both together.

The combination of the valves in the auscultators and the valves in the headphones makes it easier to set up the device, as well as its use, since the valves in the auscultators can always be open and the work is reduced only to closing them. The installation of switches in the disciples is more than stationary and does not require frequent changes.

A separate sound resonator having the shape of a round spherical cavity can be arranged in headphones.

For better sound conductivity, flexible auditory tubes are subjected to internal treatment of walls with cover (oil on rubber-based paint) or other similar varnishes and compositions that make the walls smooth, which contributes to a significant increase in hearing due to the resonating properties of a polished smooth wall in contrast to the commonly used rubber tubes rough surface, which muffles the sound.

The subject matter of the invention.

1, Apparatus for comparative auscultation. consisting of two phonendoscopes (auscultators) each equipped with two branch pipes with flexible tubes attached to them, characterized in that the phonendoscopes are equipped with g switching disks or sectors and allowing the rearrangement of the latter to attach the tubes in any combination, for which each pair of tubes a bn ai & i from one phonendoscope leads to hearing aids for both hearing ears, and each pair of corresponding a & 1 tubes and ujfe from both backgrounds2ndpsko :: OB

attached to the hearing aid for one of the ears of the listener.

2. With the device of switching disks or sectors specified in item 1 of the device, equipped with a handle / or other similar device that allows switching of the tubes without moving the endoscopes on the patient's body. .

3. At the device specified in clause 1, use as hearing instruments, to which tubes from background endoscopes are attached, headphones with which are held on the head in the usual way with the help of an elastic spring rf.

4. When specified in paragraph 1 of the device use in. one or both of the phonendoscopes of a vertically arranged percussion hammer M, either actuated directly by the doctor’s finger, or by means of some transmitting lever or the like, and fixed in the inactive upper

 position with a clamping screw located perpendicular to the malleus (Fig. 20, 21).

5. Form O3: acted in item 1 of the device, characterized in that for turning off each of the tubes or both tubes of each phonendoscope together serves either a vertical stand of the phonendoscope equipped with hollows 5 (Fig. 22, 23) for clamping rubber tubes 1 or an auxiliary eccentric 3 (Fig. 24 and 25), or located perpendicularly to the tubes of the cork, under the action of a spring holding them in the open state (Fig. 22 and 23),

6.When the percussion hammer specified in paragraph 4, use a pencil placed on its axis, which is pushed outward when pressing its head to produce a mark at a precisely defined test point on the patient's gel.

7. The form of execution of the device indicated in claim 1, characterized in that for closing and opening of one of two tubes or both tubes instead of each of a pair of phonendoscopes, the latter consist of two mutually rotating 90 ° parts 1 and 3 and a turntable 4 between them, of which the lower part 1 is provided with three openings J2 (fng. 27) located on a plane at an angle of 90 °, and a disk 4 with two openings 7 diametrically located (Fig. 29).

8. The form of implementation of the above in PA. 1 - 4 devices, from. It is intended that the lever 46, hinged on the frame 44, connected to the instructor (phonendoscope) 1 (Fig. 31), is used to actuate the hammer 4.

9. The form of implementation of the above in paragraphs. 1, 2, 5, 7 and 8 devices, characterized in that for switching off the rubber tubes, the bed 44 is provided with channels 49 and 50 with rods 51 and 52 moving inside them, terminating at the end of the push-in pins 53 and 54 (Fig. 31) .

10. The form of implementation of the above in the square. 1-if device, characterized in that there are three channels 5 inside the headphones, at the point of intersection of which there is a 6-way valve 6, outside fitted with valve 2 of the device's settings for listening to ausculators (phonendoscopes) in one or another combination.