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new file mode 100644
index 0000000000000000000000000000000000000000..5e70e4efffbf237396b538bb484fb32d52110454
--- /dev/null
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@@ -0,0 +1 @@
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تندرج تحت طلب مشطق كيف؟ الطلب على الخدمات الصحية هو طلب مشطق من الطلب على الصحة الطلب على الصحة بشكل عام وطلب نهائي طلب على الصحة بشكل عام وطلب نهائي لكن الطلب على الخدمات الصحية هو طلب مشطق", "tokens": [3794, 1863, 39648, 50113, 15040, 12399, 34105, 5551, 3794, 1211, 37746, 33962, 40448, 9307, 31767, 5016, 10632, 10874, 2304, 3615, 11296, 6055, 41260, 47341, 6055, 33753, 23032, 46152, 37893, 9566, 4587, 9122, 33911, 22807, 41950, 46152, 15844, 33962, 40448, 9307, 31767, 5016, 10632, 31439, 23032, 46152, 37893, 9566, 4587, 9154, 41950, 46152, 15844, 31767, 5016, 3660, 41950, 46152, 15844, 31767, 5016, 3660, 4724, 8592, 28820, 6225, 10943, 4032, 9566, 46152, 8717, 3224, 16373, 1829, 23032, 46152, 15844, 31767, 5016, 3660, 4724, 8592, 28820, 6225, 10943, 4032, 9566, 46152, 8717, 3224, 16373, 1829, 44381, 41950, 46152, 15844, 33962, 40448, 9307, 31767, 5016, 10632, 31439, 23032, 46152, 37893, 9566, 4587], "avg_logprob": -0.14313359380862034, "compression_ratio": 2.758169934640523, 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0.9910481770833334}, {"start": 1610.11, "end": 1611.19, "word": " الطلب", "probability": 0.89990234375}, {"start": 1611.19, "end": 1611.37, "word": " على", "probability": 0.93505859375}, {"start": 1611.37, "end": 1611.79, "word": " الصحة", "probability": 0.9822591145833334}, {"start": 1611.79, "end": 1612.13, "word": " بشكل", "probability": 0.9830729166666666}, {"start": 1612.13, "end": 1612.47, "word": " عام", "probability": 0.99853515625}, {"start": 1612.47, "end": 1612.83, "word": " وطلب", "probability": 0.8312174479166666}, {"start": 1612.83, "end": 1613.73, "word": " نهائي", "probability": 0.9893798828125}, {"start": 1613.73, "end": 1615.53, "word": " طلب", "probability": 0.883056640625}, {"start": 1615.53, "end": 1615.69, "word": " على", "probability": 0.9482421875}, {"start": 1615.69, "end": 1616.27, "word": " الصحة", "probability": 0.9947916666666666}, {"start": 1616.27, "end": 1617.49, "word": " بشكل", "probability": 0.974609375}, {"start": 1617.49, "end": 1617.81, "word": " عام", "probability": 0.998291015625}, {"start": 1617.81, "end": 1618.15, "word": " وطلب", "probability": 0.98291015625}, {"start": 1618.15, "end": 1618.31, "word": " نهائي", "probability": 0.9915771484375}, {"start": 1618.31, "end": 1618.47, "word": " لكن", "probability": 0.3154296875}, {"start": 1618.47, "end": 1618.77, "word": " الطلب", "probability": 0.97509765625}, {"start": 1618.77, "end": 1618.89, "word": " على", "probability": 0.93017578125}, {"start": 1618.89, "end": 1619.37, "word": " الخدمات", "probability": 0.9739583333333334}, {"start": 1619.37, "end": 1620.05, "word": " الصحية", "probability": 0.99560546875}, {"start": 1620.05, "end": 1620.97, "word": " هو", "probability": 0.970703125}, {"start": 1620.97, "end": 1621.35, "word": " طلب", "probability": 0.994384765625}, {"start": 1621.35, "end": 1622.27, "word": " مشطق", "probability": 0.9908854166666666}], "temperature": 1.0}, {"id": 60, "seek": 164242, "start": 1623.44, "end": 1642.42, "text": "يعني مثلا أذهب للطبيب هذا طلب مشتق شراء الدواء هذا طلب مشتق أخذ علاج هذا طلب مشتق طلب على الصحة هو طلب نهائي طلب على الخدمات الصحية", "tokens": [40228, 22653, 50113, 15040, 5551, 24192, 3555, 24976, 9566, 21292, 3555, 23758, 23032, 46152, 37893, 2655, 4587, 13412, 2288, 16606, 32748, 2407, 16606, 23758, 23032, 46152, 37893, 2655, 4587, 5551, 9778, 8848, 11203, 26108, 23758, 23032, 46152, 37893, 2655, 4587, 23032, 46152, 15844, 31767, 5016, 3660, 31439, 23032, 46152, 8717, 3224, 16373, 1829, 23032, 46152, 15844, 33962, 40448, 9307, 31767, 5016, 10632], "avg_logprob": -0.1411210364765591, "compression_ratio": 1.888, "no_speech_prob": 1.4960765838623047e-05, "words": [{"start": 1623.44, "end": 1623.84, "word": "يعني", "probability": 0.6029052734375}, {"start": 1623.84, "end": 1624.28, "word": " مثلا", "probability": 0.868896484375}, {"start": 1624.28, "end": 1625.48, "word": " أذهب", "probability": 0.8209635416666666}, {"start": 1625.48, "end": 1626.52, "word": " للطبيب", "probability": 0.98095703125}, {"start": 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الفرق أن الطلب على الصحة الإنسان يطلب أن يعيش صحيحا، سليما، معافا، هذا طلب نهائي لكن حتى يحدث له ذلك في حالة أنه لا سمع الله مرض، يريد أن يعمل طلب على خدمة الصحة طلب على الدواء، طلب على الذهاب للطبيب، طلب على الذهاب للصيدلية، هذا ما يسمونه طلب مشطق", "tokens": [3224, 2407, 23032, 46152, 37893, 9566, 4587, 9154, 27188, 2288, 4587, 14739, 41950, 46152, 15844, 31767, 5016, 3660, 33688, 1863, 3794, 7649, 7251, 9566, 46152, 14739, 37495, 1829, 8592, 20328, 5016, 1829, 5016, 995, 12399, 8608, 20292, 15042, 12399, 20449, 31845, 995, 12399, 23758, 23032, 46152, 8717, 3224, 16373, 1829, 44381, 11331, 49975, 7251, 24401, 12984, 46740, 29910, 23275, 8978, 11331, 6027, 3660, 14739, 3224, 20193, 8608, 2304, 3615, 21984, 3714, 43042, 12399, 7251, 16572, 3215, 14739, 7251, 25957, 1211, 23032, 46152, 15844, 16490, 40448, 3660, 31767, 5016, 3660, 23032, 46152, 15844, 32748, 2407, 16606, 12399, 23032, 46152, 15844, 32545, 11296, 3555, 24976, 9566, 21292, 3555, 12399, 23032, 46152, 15844, 32545, 11296, 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الصحة الطلب على الدواء طلب مشطق من الطلب النهائي على الصحة فالإنسان لا يطلب الدواء لأنه يحب الدواء", "tokens": [2304, 12984, 15040, 23032, 46152, 15844, 31767, 5016, 3660, 4032, 9566, 46152, 8717, 3224, 16373, 1829, 7251, 7435, 3555, 14739, 7251, 23557, 5172, 4587, 3224, 23032, 46152, 15844, 8608, 1211, 27884, 5551, 34740, 7578, 50113, 1211, 32748, 2407, 16606, 50113, 15040, 41950, 46152, 15844, 32748, 2407, 16606, 23032, 46152, 37893, 9566, 4587, 9154, 41950, 46152, 15844, 31767, 5016, 3660, 41950, 46152, 15844, 32748, 2407, 16606, 23032, 46152, 37893, 9566, 4587, 9154, 41950, 46152, 28239, 3224, 16373, 1829, 15844, 31767, 5016, 3660, 6156, 6027, 28814, 1863, 3794, 7649, 20193, 7251, 9566, 46152, 32748, 2407, 16606, 5296, 33456, 3224, 7251, 5016, 3555, 32748, 2407, 16606], "avg_logprob": -0.1479116572210422, "compression_ratio": 2.542483660130719, "no_speech_prob": 0.0001957416534423828, "words": [{"start": 1672.19, "end": 1672.69, "word": "مثلا", "probability": 0.87451171875}, 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2768.02, "end": 2768.76, "word": " ننتهي", "probability": 0.883544921875}, {"start": 2768.76, "end": 2768.94, "word": " من", "probability": 0.95654296875}, {"start": 2768.94, "end": 2769.2, "word": " هذه", "probability": 0.98681640625}, {"start": 2769.2, "end": 2769.92, "word": " المحاضرة", "probability": 0.9432373046875}, {"start": 2769.92, "end": 2771.82, "word": " إن", "probability": 0.9208984375}, {"start": 2771.82, "end": 2771.96, "word": " شاء", "probability": 0.98681640625}, {"start": 2771.96, "end": 2772.18, "word": " الله", "probability": 0.96826171875}, {"start": 2772.18, "end": 2772.7, "word": " يعني", "probability": 0.978271484375}], "temperature": 1.0}, {"id": 102, "seek": 280189, "start": 2773.35, "end": 2801.89, "text": "نكمل طبعاً وصلنا لنقطة تصنيف التكاليف في منشئات الخدمات الصحية ان شاء الله هذه النقطة و النقاط الأخرى نكملها في محاضرات لاحقة انتهينا اليوم من محاضرة رقم 14 ان شاء الله بنكمل جيجيه هذه في المحاضرة رقم 15 ختما أستودعكم الله", "tokens": [1863, 24793, 1211, 23032, 3555, 3615, 995, 14111, 4032, 36520, 8315, 5296, 1863, 47432, 3660, 6055, 9381, 22653, 5172, 16712, 4117, 6027, 33911, 8978, 9154, 8592, 19986, 9307, 33962, 40448, 9307, 31767, 5016, 10632, 16472, 13412, 16606, 21984, 29538, 28239, 47432, 3660, 4032, 28239, 4587, 41193, 16247, 34740, 7578, 8717, 24793, 1211, 11296, 8978, 3714, 5016, 46958, 2288, 9307, 20193, 5016, 28671, 16472, 47395, 1829, 8315, 45595, 20498, 9154, 3714, 5016, 46958, 25720, 12602, 4587, 2304, 3499, 16472, 13412, 16606, 21984, 44945, 24793, 1211, 10874, 1829, 7435, 1829, 3224, 29538, 8978, 9673, 5016, 46958, 25720, 12602, 4587, 2304, 2119, 16490, 39237, 995, 5551, 14851, 23328, 3615, 24793, 21984], "avg_logprob": -0.23451835463900084, "compression_ratio": 1.9900497512437811, "no_speech_prob": 6.920099258422852e-05, "words": [{"start": 2773.35, "end": 2774.29, "word": "نكمل", "probability": 0.7213541666666666}, {"start": 2774.29, "end": 2775.15, "word": " طبعاً", "probability": 0.69130859375}, {"start": 2775.15, "end": 2776.45, "word": " وصلنا", "probability": 0.67626953125}, {"start": 2776.45, "end": 2776.93, "word": " لنقطة", "probability": 0.74603271484375}, {"start": 2776.93, "end": 2777.33, "word": " تصنيف", "probability": 0.765380859375}, {"start": 2777.33, "end": 2777.93, "word": " التكاليف", "probability": 0.8785400390625}, {"start": 2777.93, "end": 2778.63, "word": " في", "probability": 0.56298828125}, {"start": 2778.63, "end": 2778.95, "word": " منشئات", "probability": 0.7139892578125}, {"start": 2778.95, "end": 2780.37, "word": " الخدمات", "probability": 0.927734375}, {"start": 2780.37, "end": 2781.63, "word": " الصحية", "probability": 0.9640299479166666}, {"start": 2781.63, "end": 2782.51, "word": " ان", "probability": 0.411376953125}, {"start": 2782.51, "end": 2782.69, "word": " شاء", "probability": 0.96142578125}, {"start": 2782.69, "end": 2782.81, "word": " الله", "probability": 0.95263671875}, {"start": 2782.81, "end": 2783.81, "word": " هذه", "probability": 0.93359375}, {"start": 2783.81, "end": 2784.89, "word": " النقطة", "probability": 0.9820963541666666}, {"start": 2784.89, "end": 2786.15, "word": " و", "probability": 0.59765625}, {"start": 2786.15, "end": 2786.67, "word": " النقاط", "probability": 0.8445638020833334}, {"start": 2786.67, "end": 2787.53, "word": " الأخرى", "probability": 0.9807942708333334}, {"start": 2787.53, "end": 2788.87, "word": " نكملها", "probability": 0.9229736328125}, {"start": 2788.87, "end": 2789.33, "word": " في", "probability": 0.96875}, {"start": 2789.33, "end": 2790.13, "word": " محاضرات", "probability": 0.86298828125}, {"start": 2790.13, "end": 2790.89, "word": " لاحقة", "probability": 0.8069661458333334}, {"start": 2790.89, "end": 2791.59, "word": " انتهينا", "probability": 0.688507080078125}, {"start": 2791.59, "end": 2791.75, "word": " اليوم", "probability": 0.955322265625}, {"start": 2791.75, "end": 2791.85, "word": " من", "probability": 0.87060546875}, {"start": 2791.85, "end": 2792.37, "word": " محاضرة", "probability": 0.9246826171875}, {"start": 2792.37, "end": 2793.19, "word": " رقم", "probability": 0.908203125}, {"start": 2793.19, "end": 2793.73, "word": " 14", "probability": 0.93017578125}, {"start": 2793.73, "end": 2794.83, "word": " ان", "probability": 0.791015625}, {"start": 2794.83, "end": 2794.97, "word": " شاء", "probability": 0.98388671875}, {"start": 2794.97, "end": 2795.03, "word": " الله", "probability": 0.9541015625}, {"start": 2795.03, "end": 2795.71, "word": " بنكمل", "probability": 0.9313151041666666}, {"start": 2795.71, "end": 2796.65, "word": " جيجيه", "probability": 0.5830078125}, {"start": 2796.65, "end": 2796.97, "word": " هذه", "probability": 0.865234375}, {"start": 2796.97, "end": 2797.69, "word": " في", "probability": 0.88427734375}, {"start": 2797.69, "end": 2798.25, "word": " المحاضرة", "probability": 0.92236328125}, {"start": 2798.25, "end": 2798.85, "word": " رقم", "probability": 0.9835611979166666}, {"start": 2798.85, "end": 2799.55, "word": " 15", "probability": 0.90380859375}, {"start": 2799.55, "end": 2801.01, "word": " ختما", "probability": 0.89306640625}, {"start": 2801.01, "end": 2801.65, "word": " أستودعكم", "probability": 0.72939453125}, {"start": 2801.65, "end": 2801.89, "word": " الله", "probability": 0.9443359375}], "temperature": 1.0}, {"id": 103, "seek": 280932, "start": 2802.46, "end": 2809.32, "text": "الذي لا تضيع وجائعه السلام عليكم ورحمة الله وبركاته", "tokens": [6027, 8848, 1829, 20193, 6055, 11242, 40228, 49610, 16373, 3615, 3224, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.12950720981909677, "compression_ratio": 1.1898734177215189, "no_speech_prob": 2.5391578674316406e-05, "words": [{"start": 2802.46, "end": 2802.96, "word": "الذي", "probability": 0.8916015625}, {"start": 2802.96, "end": 2803.18, "word": " لا", "probability": 0.82275390625}, {"start": 2803.18, "end": 2803.66, "word": " تضيع", "probability": 0.9915364583333334}, {"start": 2803.66, "end": 2804.48, "word": " وجائعه", "probability": 0.779541015625}, {"start": 2804.48, "end": 2805.4, "word": " السلام", "probability": 0.71875}, {"start": 2805.4, "end": 2806.3, "word": " عليكم", "probability": 0.97216796875}, {"start": 2806.3, "end": 2807.1, "word": " ورحمة", "probability": 0.9735107421875}, {"start": 2807.1, "end": 2807.6, "word": " الله", "probability": 0.9658203125}, {"start": 2807.6, "end": 2809.32, "word": " وبركاته", "probability": 0.90556640625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2810.287875, "duration_after_vad": 2749.0356249999886}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/Ml115FAWdV4_postprocess.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/Ml115FAWdV4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..bb577ec6d2fdc62ea6d6c2ee8d82448e8e7ec0d3
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/Ml115FAWdV4_postprocess.srt
@@ -0,0 +1,2456 @@
+1
+00:00:01,640 --> 00:00:04,560
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,560 --> 00:00:08,560
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:08,560 --> 00:00:16,040
+وعلى أهله وأصحابه والتابعين بإحسان إلى يوم الدين
+
+4
+00:00:16,040 --> 00:00:22,360
+طلاب الطلبات الأعزاء السلام عليكم ورحمة الله
+
+5
+00:00:22,360 --> 00:00:29,480
+وبركاته إن شاء الله سوف أتكلم اليوم في المحاضرة
+
+6
+00:00:29,480 --> 00:00:35,860
+المصورة رقمثمانية لمصادر اقتصاديات التعليم والصحة
+
+7
+00:00:35,860 --> 00:00:41,780
+عن الجزء الأول من الفصل الرابع والفصل الرابع
+
+8
+00:00:41,780 --> 00:00:48,360
+عنوانه تمويل التعليم ان شاء الله في هذا الفصل سوف
+
+9
+00:00:48,360 --> 00:00:54,760
+نتكلم عن عدة نقاط مقدمة أولا مفهوم تمويل التعليم
+
+10
+00:00:54,760 --> 00:01:01,160
+ثانيا مصادر تمويل التعليم ثالثا اتجاهاتتمويل
+
+11
+00:01:01,160 --> 00:01:07,900
+التعليم رابعا تجارب في مجال تمويل التعليم خامسا
+
+12
+00:01:07,900 --> 00:01:11,980
+تمويل التعليم في مسئولية الحكومة ومشاركة
+
+13
+00:01:11,980 --> 00:01:22,440
+المستفيدين سادسا تمويل التعليم في فلسطين طبعا نبدأ
+
+14
+00:01:22,440 --> 00:01:28,880
+في المقدمة أصبحت أزمة تمويل التعليم العالي من
+
+15
+00:01:28,880 --> 00:01:33,780
+الهموم المشتركةللكثير من الدول النامية والمتقدمة
+
+16
+00:01:33,780 --> 00:01:39,920
+على حد سواعي فتزايدت القيود على ميزانيات التعليم
+
+17
+00:01:39,920 --> 00:01:45,860
+العالي باستمرار بسبب تزايد في عجز المواجنة لكثير
+
+18
+00:01:45,860 --> 00:01:49,440
+من دول العالم فخضت بالتالي نسبة الانفاق على
+
+19
+00:01:49,440 --> 00:01:54,660
+التعليم العالي إلى الدخل القامي كما زادت حد الأزمة
+
+20
+00:01:54,660 --> 00:01:59,200
+في التمويل عندما أصبح العائد الماديالتعليم العالي
+
+21
+00:01:59,200 --> 00:02:03,800
+لا يمثل إلا نسبة ضئيلة مما يُستثمر فيه سيتوجه
+
+22
+00:02:03,800 --> 00:02:08,420
+الطلبة نحو تخصيصات تقليدية وبتعاديهم عن تخصيصات
+
+23
+00:02:08,420 --> 00:02:14,260
+نادرة فلم يعد باستطاعت خرجي الجامعات الحصول على
+
+24
+00:02:14,260 --> 00:02:18,540
+فرص عمل ملائمة على رغم تجارب الطلب على التعليم
+
+25
+00:02:18,540 --> 00:02:22,860
+العالي الذي لم يرافقه تطوير في البرامج المطروحة
+
+26
+00:02:22,860 --> 00:02:28,080
+وطرح برامج جديدةكما أن ضعف الرابط بين استراتيجيات
+
+27
+00:02:28,080 --> 00:02:32,560
+وسياسات وهداف التعليم العالي وحقوق الترمية لم يحقق
+
+28
+00:02:32,560 --> 00:02:36,960
+الموامر بين مخرجات الجامعة وسوق العمل كمًا وكيفًا
+
+29
+00:02:36,960 --> 00:02:40,580
+لتعظيم العائد الاجتماعي والاقتصادي للتعليم في
+
+30
+00:02:40,580 --> 00:02:43,480
+الدول النامية والأصل في المفاق على التعليم أن يكون
+
+31
+00:02:43,480 --> 00:02:47,840
+استثمارًا مرتبطًا بحاجات السوق من حيث نوعية
+
+32
+00:02:47,840 --> 00:02:53,060
+الخريجين ومدى ملائمة خصتتهم لسوق العمل وما يمكن أن
+
+33
+00:02:53,060 --> 00:02:57,430
+تقدمه الجامعاتمن خدمات وأبحاث واستشارات لقطاع
+
+34
+00:02:57,430 --> 00:03:03,130
+الأعمال مقابل عائد مزن يغطي تكفة إنتاج الخدمات
+
+35
+00:03:03,130 --> 00:03:09,270
+يعني التمويل أو بأجمع التمويل العالي أحب اللاحظ
+
+36
+00:03:09,270 --> 00:03:18,930
+أنه قد تمول للدولة أو الحكومة الجامعات لكن بعد ذلك
+
+37
+00:03:18,930 --> 00:03:25,440
+الطلبة يدخلون في تخصصات ليس لها طلبفي سوق العمل
+
+38
+00:03:25,440 --> 00:03:31,020
+وبالتالي لا يوجد هنا وظائف المناسبة أو كأن التمويل
+
+39
+00:03:31,020 --> 00:03:39,900
+هنا لم يؤدي الدور المطلوب منه بذلك طبعا على الدول
+
+40
+00:03:39,900 --> 00:03:46,180
+أن تضع سياسات و استخدامات الهدف منها عند التمويل
+
+41
+00:03:46,180 --> 00:03:53,000
+أن يذهب الطلاب التخصصات الجديدة التخصصات التقليدية
+
+42
+00:03:53,570 --> 00:04:00,070
+ممكن يذهبوا إلى التعليم الفني والتعليم المهني اللي
+
+43
+00:04:00,070 --> 00:04:08,610
+بيفيدهم في سوق العمل طبعاً المجتمعات تتغورها من
+
+44
+00:04:08,610 --> 00:04:12,950
+غير الزمن تتغورت من المجتمع الزراعي لمجتمع الصناعي
+
+45
+00:04:12,950 --> 00:04:19,570
+وأخيراً مجتمع المعرفة اليوم احنا يعني فقنا نغيط
+
+46
+00:04:19,570 --> 00:04:23,380
+القطاع الزراعي والقطاع الصناعيالأن صار المجتمع
+
+47
+00:04:23,380 --> 00:04:29,160
+مجتمع المعرفة يرى «فرانسيس بي كون» أن المعرفة قوة
+
+48
+00:04:29,160 --> 00:04:34,160
+ويرى الكاتب «ألفن دافلر» أن قوة المعرفة هي أكثر
+
+49
+00:04:34,160 --> 00:04:38,480
+أنواع القوة تأثيرها مفعلية وإيجابية فالمعرفة هي
+
+50
+00:04:38,480 --> 00:04:42,620
+أهم وسيلة لرفع وتحسين مستوى أنتجية القطاعات
+
+51
+00:04:42,620 --> 00:04:46,980
+المختلفة وزي زيادة ثروة المجتمع الاقتصادية يعني
+
+52
+00:04:46,980 --> 00:04:54,210
+عندما ازداد المعرفةفي كل الأمور وخاصة في الأمور
+
+53
+00:04:54,210 --> 00:05:00,670
+التقنية الحديثة اليوم في ثورة المعلومات أصبح
+
+54
+00:05:00,670 --> 00:05:05,930
+العالم كله قرية صغيرة لذلك مواكبة التطورات
+
+55
+00:05:05,930 --> 00:05:12,270
+المعاصرة والمعرفة بها ومعرفة التقنيات الحديثة
+
+56
+00:05:12,270 --> 00:05:17,730
+طبعاً هذه كلها بتأدي إلى القوة لأن المعرفة مرتبطة
+
+57
+00:05:17,730 --> 00:05:24,820
+بالإنسانوإذا تم بناء الإنسان بشكل صحيح وبشكل سليم
+
+58
+00:05:24,820 --> 00:05:30,100
+هذا سواء إلى حدوث التنمية الاقتصادية الحقيقية
+
+59
+00:05:30,100 --> 00:05:33,220
+طبعاً
+
+60
+00:05:33,220 --> 00:05:38,980
+أصبحت هناك تغيرات جوهرية في حياة الإنسان المعاصر
+
+61
+00:05:38,980 --> 00:05:43,500
+بحيث أصبح الاستثمار في مجال المعرفة من أهم مجالات
+
+62
+00:05:43,500 --> 00:05:48,710
+الاستثمار في رأس المال البشريومن أهم مصادر القوة
+
+63
+00:05:48,710 --> 00:05:54,290
+الاقتصادية مجتمع المعرفة يؤكد أن المعرفة قوة هو
+
+64
+00:05:54,290 --> 00:05:59,190
+مجتمع يقوم على أساس إنتاج المعارف ومن ثم فإن تميز
+
+65
+00:05:59,190 --> 00:06:03,650
+المجتمع وقدراته على المنافسة ومواجهة تحديات يعتمد
+
+66
+00:06:03,650 --> 00:06:09,250
+على إنتاج المعارف الأمر الذي يؤكد أن مجتمع اقتصاد
+
+67
+00:06:09,250 --> 00:06:12,910
+المعارف والبعت عنها هو استخدام التقنيات المعاصرة
+
+68
+00:06:13,490 --> 00:06:18,090
+كأدات تسيير الحصول على المعلومات لسه كافية وإنما
+
+69
+00:06:18,090 --> 00:06:23,450
+لابد من تجاوز ذلك إلى عملية إنتاج حقيقية للمعارف
+
+70
+00:06:23,450 --> 00:06:27,830
+يتم تسويقها بحيث تصبح مصدرها اقتصاديا يحمل في
+
+71
+00:06:27,830 --> 00:06:32,330
+ثانيات إمكانات القوة ويمهد التطور والتحسن والتقدم
+
+72
+00:06:32,330 --> 00:06:36,150
+على مستوى الأفراد والجماعات يعني موضوع المعرفة
+
+73
+00:06:36,150 --> 00:06:43,370
+أصلا هو موضوع مهم جداوبالتالي هذا العنصر البشري
+
+74
+00:06:43,370 --> 00:06:50,990
+لكي يحصل تطور حقيقي تطور اقتصادي وتطور علمي وتطور
+
+75
+00:06:50,990 --> 00:06:58,050
+تقني في المجتمع عليه أن ينم بكل ما هو جديد وينم
+
+76
+00:06:58,050 --> 00:07:03,630
+بكل ما هو معاصر حتى يستطيع أن يتقدم في كافة
+
+77
+00:07:03,630 --> 00:07:09,450
+المجالات الزراعية والصناعية والصحية والتعليمية
+
+78
+00:07:10,920 --> 00:07:15,380
+والسياحية وكل مجال الخدمات المختلفة وكل أنواع
+
+79
+00:07:15,380 --> 00:07:22,240
+الكنول والعلوم المختلفة طبعا إن التمويل المطلوب
+
+80
+00:07:22,240 --> 00:07:27,200
+لنظام التعليمي يكون ال investment product المجزر
+
+81
+00:07:27,200 --> 00:07:31,920
+أهم للإنفاق العام الذي يعدل تغيرا اقتصاديا حاسما
+
+82
+00:07:31,920 --> 00:07:36,540
+فدوتيح للإنفاق العام أن يلمو من محتملا أن تزداد
+
+83
+00:07:36,540 --> 00:07:40,300
+تداليف الأموال التي تنفق على التعليميعني دا
+
+84
+00:07:40,300 --> 00:07:44,320
+الإنفاق العام يعني إحنا بتوفر عندنا إيرادات عالية
+
+85
+00:07:44,320 --> 00:07:49,780
+يمكن أن نزيد الإنفاق وعندما توضع الموازنات توضع
+
+86
+00:07:49,780 --> 00:07:57,620
+موازنة للتعليم توضع موازنة للصحة توضع موازنة للجيش
+
+87
+00:07:57,620 --> 00:08:05,100
+توضع موازنة للخدمات المختلفة لذلك كل ما هذا
+
+88
+00:08:05,100 --> 00:08:12,220
+التمويل يزيد كل ما المجال للإنفاقعلى التعليم ممكن
+
+89
+00:08:12,220 --> 00:08:17,440
+يزيد وكل ما زاد مجال انفاق على التعليم كل ما هذا
+
+90
+00:08:17,440 --> 00:08:23,760
+أدى إلى زيادة المعرفة بشكل أكبر وأحداث تقدم في
+
+91
+00:08:23,760 --> 00:08:27,540
+كافة العلوم على كافة المستويات وفي المدرسة
+
+92
+00:08:27,540 --> 00:08:32,220
+التدائية و المدرسة الإعدادية و المدرسة التانوية ثم
+
+93
+00:08:32,220 --> 00:08:38,440
+التعليم العالي و الجامعة مفهوم تمويل التعليم
+
+94
+00:08:38,440 --> 00:08:42,810
+النقطة الأولىالتمويل في أبسط صورة يعني تعبئة في
+
+95
+00:08:42,810 --> 00:08:48,710
+الموارد النقدية وغير النقدية للما اللازمة والتخطيط
+
+96
+00:08:48,710 --> 00:08:52,350
+والإشراف على إدارتها بهدف القيام بمشروع معين
+
+97
+00:08:52,350 --> 00:08:58,250
+وإحفظها لإستمراريته وتطويره لتحقيق أهدافه الحالية
+
+98
+00:08:58,250 --> 00:09:05,270
+والمستقبلية بشكل أكثر كفائة وأكثر فاعلية كذلك يعني
+
+99
+00:09:05,270 --> 00:09:11,680
+هناك تعريفات متعددة للتعليمنذكر منها مثلا هنا أنه
+
+100
+00:09:11,680 --> 00:09:17,400
+إيجاد مصادر مالية قادرة على تغطية احتياجات
+
+101
+00:09:17,400 --> 00:09:21,780
+المنظمات التعليمية كافة حتى تتمكن من تحقيق أهدافها
+
+102
+00:09:21,780 --> 00:09:26,440
+ورسالتها التربوي والاقتصادية والعلمية والبحثية
+
+103
+00:09:26,440 --> 00:09:33,420
+والاجتماعية الآن يعني مصادر تمويل التعليم العالمي
+
+104
+00:09:33,420 --> 00:09:37,960
+ما هي المصادر اللي احنا ممكن من خلالهاالمولد
+
+105
+00:09:37,960 --> 00:09:43,160
+التعليم العالي أولا المصدر الأول والرئيسي الحكومات
+
+106
+00:09:43,160 --> 00:09:48,780
+طبعا الحكومات وضع يعني درجة في معظم دول العالم على
+
+107
+00:09:48,780 --> 00:09:54,240
+تحسيس اعتمادات مالية من مواجناتها للفقر التعليم
+
+108
+00:09:54,240 --> 00:09:59,220
+العالي وترتبط هذه الاعتمادات اقتباطا مباشرا بالدخل
+
+109
+00:09:59,220 --> 00:10:03,560
+القومي وميزانية الحكومةوتعدّل الأموال الناتجة عن
+
+110
+00:10:03,560 --> 00:10:07,760
+الدرائب العامة للمورد الأساسي للبيزانية في الحكومة
+
+111
+00:10:07,760 --> 00:10:12,640
+اللي ترصد من مخصصات التعليم العالمي وتؤكد دراسات
+
+112
+00:10:12,640 --> 00:10:15,900
+استقصائية في قامة بها المنظمات العالمية على عدد
+
+113
+00:10:15,900 --> 00:10:19,300
+كبير من دول العالم أن هناك أثلاث أشكال يأخذوا
+
+114
+00:10:19,300 --> 00:10:21,740
+تمويل التعليم العالمي عن طريق الدرائب العامة وهي
+
+115
+00:10:21,740 --> 00:10:26,360
+كيف التمويل يعني؟ أولا التمويل عن طريق الحكومة
+
+116
+00:10:26,360 --> 00:10:33,040
+المركزية لحكومة الدولة ككلمن التمويل عن طريق كل من
+
+117
+00:10:33,040 --> 00:10:35,980
+الحكومة المركزية وشركة المعالية الشركة المعالية هي
+
+118
+00:10:35,980 --> 00:10:42,680
+البلدية ويكون التمويل يعني من خلال الحكومة ثم
+
+119
+00:10:42,680 --> 00:10:48,940
+البلدية يعني في أي مثلا مدينة فيها بلدية ممكن تقوم
+
+120
+00:10:48,940 --> 00:10:53,680
+بالإنشاء جامعة تابعة لهذه المدينة وتموّل هذه
+
+121
+00:10:53,680 --> 00:10:57,360
+الجامعة أو قد يتم التمويل عن طريق الحكومة المركزية
+
+122
+00:10:57,360 --> 00:11:02,950
+التمويلعن طريق التعاون ما بين الحكومة المركزية
+
+123
+00:11:02,950 --> 00:11:11,530
+والسلطات المحلية طبعاً يمكن يصير
+
+124
+00:11:11,530 --> 00:11:17,270
+التمويل إما عن طريق الحكومة المركزية فقط أو عن
+
+125
+00:11:17,270 --> 00:11:21,930
+طريق السلطات المحلية يعني في نقطة ثانية السلطات
+
+126
+00:11:21,930 --> 00:11:26,270
+المحلية فقط أو في نقطة تالتة عن طريق التعاون ما
+
+127
+00:11:26,270 --> 00:11:27,730
+بين الحكومة المركزية والسلطات المحلية خلّالي عن
+
+128
+00:11:27,730 --> 00:11:32,640
+نقطة تانية هنانعتبرها عن طريق السلطات المحلية فقط
+
+129
+00:11:32,640 --> 00:11:35,860
+النقطة الأولى التمويل عن طريق الحكومة المركزية فقط
+
+130
+00:11:35,860 --> 00:11:39,420
+النقطة الثانية تمويل عن طريق السلطات المحلية فقط
+
+131
+00:11:39,420 --> 00:11:44,360
+أنا خطأ في اقتباع فقط ثلاثة
+
+132
+00:11:44,360 --> 00:11:48,180
+تمويل عن طريق التعاوض من السلطات المحلية البلدية
+
+133
+00:11:48,180 --> 00:11:54,540
+والحكومة المركزية أثناء
+
+134
+00:11:54,540 --> 00:11:58,020
+التمويل الممكن يتم عن طريق الطلابالطالب هو
+
+135
+00:11:58,020 --> 00:12:02,360
+المستفيد الأول من العملية التعليمية وهو من أهم
+
+136
+00:12:02,360 --> 00:12:06,420
+مصادر تمويل التعليم العالي الجامعي في عدد من دول
+
+137
+00:12:06,420 --> 00:12:12,040
+العالم خاصة الدول المتقدمة يعني الطالب هو المستفيد
+
+138
+00:12:12,040 --> 00:12:17,860
+وبالتالي الطالب يقوم بتمويل التعليم عن طريق مصادر
+
+139
+00:12:17,860 --> 00:12:22,080
+ففيما يلي عرض أهم بنود التي يمكن أن يكون الطالب من
+
+140
+00:12:22,080 --> 00:12:26,700
+خلالها مصدرا من مصادر مهمة لتمويل التعليم الجامعي
+
+141
+00:12:27,240 --> 00:12:32,740
+أول نقطة الرسوم الدراسية طبعا أسلوب الرسوم
+
+142
+00:12:32,740 --> 00:12:36,620
+الدراسية على أسلوب التمويل يعد نظام الرسوم
+
+143
+00:12:36,620 --> 00:12:39,360
+الدراسية أحد الأسليب المتبعة في تمويل التعليم
+
+144
+00:12:39,360 --> 00:12:43,660
+الجامعي وهو نظام تأخذ بيه معظم دول العالم المتقدم
+
+145
+00:12:43,660 --> 00:12:47,840
+و تتبنيقه بعض الدول النامية وأخذت فيها حديثا الدول
+
+146
+00:12:47,840 --> 00:12:52,240
+العربية اللي أنه يثير معارضة شديدة في معظم الدول
+
+147
+00:12:52,240 --> 00:12:58,500
+العربية التعود على مجانية التعليمويؤسس نظام الرسوم
+
+148
+00:12:58,500 --> 00:13:04,480
+الدراسية ويؤسس هذا النظام على أن يقوم الطالب أولي
+
+149
+00:13:04,480 --> 00:13:09,440
+الأمر بدفع رسوم دراسية مقابل التعليم لإتلقاه
+
+150
+00:13:09,440 --> 00:13:14,540
+توسيلة لإستعادة التكلفة المدعوعة للتعليم يعني أول
+
+151
+00:13:14,540 --> 00:13:20,440
+مصدر من مصادر الطلاب اللي هي الرسوم الدراسية من
+
+152
+00:13:20,440 --> 00:13:29,980
+قروض الطلاب ممكن أن الطالب يُعطى قرضقرد جامعي و
+
+153
+00:13:29,980 --> 00:13:37,760
+بعد أن يتخرج و يستلم العمل يقوم بتسجيل هذا القرض
+
+154
+00:13:37,760 --> 00:13:43,440
+طبعاً و هناك كفلات على هذه القرد و طبعاً القرد هذه
+
+155
+00:13:43,440 --> 00:13:48,680
+لها أنظمة كثيرة و يعني متعددة و متنوعة لكن من
+
+156
+00:13:48,680 --> 00:13:54,280
+أشهرها أن الطالب عند الدراسة يُعطى قرض من الجامعة
+
+157
+00:13:54,280 --> 00:13:56,520
+أو المؤسسة معينة
+
+158
+00:13:59,530 --> 00:14:04,330
+وتأخذ المؤسسة ضمانات على هذا الطالب لكي يقوم تزيد
+
+159
+00:14:04,330 --> 00:14:10,010
+قرض بعد التخرج وبعد أن يستلم العمل الرقم G هو
+
+160
+00:14:10,010 --> 00:14:14,890
+السندات الدراسية يُعدى ضمن السندات أحد مصادر تومول
+
+161
+00:14:14,890 --> 00:14:19,050
+التعليم الجامعي ما هو السند؟ السند عبارة عن كابون
+
+162
+00:14:19,050 --> 00:14:24,010
+يحدد قوة شراء الخدمة الخاصة هو شعب الطلاب وأولياء
+
+163
+00:14:24,010 --> 00:14:28,440
+الأمور على خيارلخدمة التعليمية التناسبة للسند لأنه
+
+164
+00:14:28,440 --> 00:14:34,980
+كأحد أنواع القروض لكن يتعلق مثلا بشراء الكتب أو
+
+165
+00:14:34,980 --> 00:14:43,200
+بدفع الرسوم أو بشراء أمور متعلقة بالطالب ويسهم
+
+166
+00:14:43,200 --> 00:14:46,700
+نظام السند ذات في إيجاد تجارب متنوعة وزي التنافس
+
+167
+00:14:46,700 --> 00:14:50,060
+بين مؤسسات التعليم العالي مما يزيد من تحميل مؤسسات
+
+168
+00:14:50,060 --> 00:14:54,470
+التعليمية لمسؤوليتها تجاه الطلابتبحث عن الشودة
+
+169
+00:14:54,470 --> 00:14:57,970
+والنوعية التي تجلب أكبر عدد من الكلاب الذين
+
+170
+00:14:57,970 --> 00:15:03,610
+يتقرؤونها تقلب الطبقات التعليمية يعني السندات هي
+
+171
+00:15:03,610 --> 00:15:11,670
+أحد أنواع القروض لأن القرض يسجل ضمن طبعا سند معين
+
+172
+00:15:11,670 --> 00:15:18,190
+يكون هناك دائم ومدير تلاتة
+
+173
+00:15:18,190 --> 00:15:21,590
+الجامعة نقول أن التمويل والتعليم يتم عن طريق
+
+174
+00:15:21,590 --> 00:15:27,850
+الحكومةأو عن طريق الطلاب أو عن طريق الجامعات نفسها
+
+175
+00:15:27,850 --> 00:15:32,390
+لكثير من الجامعات في دول العالم أخذت تبحث عن موارد
+
+176
+00:15:32,390 --> 00:15:37,530
+مالية خارج نظر الموازنة الحكومية بساعدة على تعزيز
+
+177
+00:15:37,530 --> 00:15:42,830
+موازنتها السنوية وتفعيل أدورها المطلقة وسمى هذا
+
+178
+00:15:42,830 --> 00:15:46,090
+النوع من التمويل التمويل الذاتي اللي بتعمل
+
+179
+00:15:46,090 --> 00:15:51,000
+الجامعات على توفيره عن طريق أشراطها المطلقةويقول
+
+180
+00:15:51,000 --> 00:15:54,660
+الجامعات حق التصرف في هذه الموارد المالية بما يخدم
+
+181
+00:15:54,660 --> 00:15:58,800
+مصلحتها للجامعات دون التقييد بقواعد الصرف المحددة
+
+182
+00:15:58,800 --> 00:16:08,700
+بقانون موازنة الحكومية طبعا هنا الجامعة نفسها ممكن
+
+183
+00:16:08,700 --> 00:16:15,060
+تعمل يعني بعض أوجه الأجهزة الاقتصادية شركات مثلا
+
+184
+00:16:15,060 --> 00:16:27,090
+محلات تجاريةمحطات للوقود أو للبنزين فنادق،
+
+185
+00:16:27,090 --> 00:16:34,230
+شركة سكنية، تأجير، نشاط اقتصادي وتقوم الجامعة من
+
+186
+00:16:34,230 --> 00:16:39,290
+خلال هذا نشاط اقتصادي تضع لجنة من خلال الجامعة
+
+187
+00:16:39,290 --> 00:16:46,890
+تشرف على هذا نشاط اقتصادي وهذه اللجنة تدر دخلا أو
+
+188
+00:16:46,890 --> 00:16:55,030
+تمويلاوهذا الترميل يتوجه لدعم الجامعة ودعم نشاطها
+
+189
+00:16:55,030 --> 00:17:01,830
+التعليمي يعني الهدف هنا أنه نعمل أنشطة اقتصادية
+
+190
+00:17:01,830 --> 00:17:08,790
+شركات أو مرسلات اقتصادية بهدف طبعا تحقيق الإيرادات
+
+191
+00:17:08,790 --> 00:17:14,750
+وتحقيق الأرباح لكتصب لصالح الجامعة وهذا الكلام مهم
+
+192
+00:17:14,750 --> 00:17:19,630
+جدا يعني يقول يمكن انتباعهخاصة عندنا في الجامعات
+
+193
+00:17:19,630 --> 00:17:25,250
+الفلسطينية في ظل الأزمات المالية في مجال هذه
+
+194
+00:17:25,250 --> 00:17:33,450
+الجامعات وانعدام الدعم الحكومي تقريبا ويتلكوا كثير
+
+195
+00:17:33,450 --> 00:17:41,450
+من الطلاب في دفع الرسوم الدراسية فممكن
+
+196
+00:17:41,450 --> 00:17:49,310
+الجامعات الفلسطينية تضع وتقومبأنشطة اقتصادية تساهم
+
+197
+00:17:49,310 --> 00:17:56,190
+وتعزز موازناتها السنة القادمة فهنا عندنا مثلا الـ
+
+198
+00:17:56,190 --> 00:18:00,090
+Europe الجامعة الإسلامية عندنا عز في الموازنة يزيد
+
+199
+00:18:00,090 --> 00:18:05,170
+عن خمسين مليون دولار كافي واطلاع هذا العز يظل طبعا
+
+200
+00:18:05,170 --> 00:18:10,230
+أوضاع اقتصادية صعبة وعدم قدر كثير من الطلاب على
+
+201
+00:18:10,230 --> 00:18:17,560
+دفع الرسوم وتقريبا انخفاض أو اعدام التمويلبشكل
+
+202
+00:18:17,560 --> 00:18:27,440
+كبير من قبل الحكومة أو من قبل الجهات المانحة يدنا
+
+203
+00:18:27,440 --> 00:18:35,880
+نقطة 4 التمويل الشعبي للجامعة احنا قلنا حكومة ثم
+
+204
+00:18:35,880 --> 00:18:41,460
+طلاب أو طلاب نفسهم ثم الجامعات نفسها تتموّل نفسها
+
+205
+00:18:41,460 --> 00:18:47,230
+بنفسها أربع تمويل شعبي للجامعاتوهذا ممكن يتم من
+
+206
+00:18:47,230 --> 00:18:52,330
+خلال مشاركات الشعبية عن طريق الإيباد والتبرعات من
+
+207
+00:18:52,330 --> 00:18:59,650
+يعني رجال الأعمال أو من الناس الأغنياء أو من أهل
+
+208
+00:18:59,650 --> 00:19:04,430
+الخير ممكن يتبرعوا لهذه الجامعات باسم تبوي شعبي
+
+209
+00:19:04,430 --> 00:19:11,950
+الأوقاف كمان ممكن تتبرع بما تملكهم من إقارات ومن
+
+210
+00:19:11,950 --> 00:19:17,910
+يعني أموالجمعيات الخرجين برضه ممكن تساهم في التبرع
+
+211
+00:19:17,910 --> 00:19:24,490
+للجامعات مثلا عن طريق مثلا دعم شهادات الخراجين أو
+
+212
+00:19:24,490 --> 00:19:32,130
+تحليل شهادات الخراجين في هذا التمويل الخارجي واقت
+
+213
+00:19:32,130 --> 00:19:38,130
+تمويل يعني ممكن يتم من عن طريق قروض ومعونات خارجية
+
+214
+00:19:38,130 --> 00:19:41,690
+في مؤسسة دولية كالبنك الدولي والسوق الأوروبي
+
+215
+00:19:41,690 --> 00:19:46,790
+المفتركةوالـ UNESCO هو المؤسسة المعظمة الدولية
+
+216
+00:19:46,790 --> 00:19:54,130
+متعلقة بالتعليم وقد يتم طبعا تقديم مساعدات أو مناح
+
+217
+00:19:54,130 --> 00:20:00,070
+وقد يتم كذلك تقديم قروض من خلال هذه المؤسسات
+
+218
+00:20:00,070 --> 00:20:04,770
+الدولية مع أننا نقض بعين الاعتبار أن هذه القروض
+
+219
+00:20:04,770 --> 00:20:11,050
+يجب أن لا تكون مسيسةأو هذا التمويل يجب أن لا يكون
+
+220
+00:20:11,050 --> 00:20:21,290
+مسيّس يعني ليس له ثمن سياسي وطبعاً مايكونش يعني له
+
+221
+00:20:21,290 --> 00:20:28,050
+أغراض تهدف إلى التأثير مثلا في المناهج التعليم أو
+
+222
+00:20:28,050 --> 00:20:31,050
+المادة اللي عملت بوعطان التولة إلى أكتر
+
+223
+00:20:35,770 --> 00:20:42,770
+عندنا نقطة ثالثة اتجاهات تمويل التعليم العالي يعني
+
+224
+00:20:42,770 --> 00:20:47,010
+في اتجاهات كيف نمول التعليم الاتجاه الأول اللي هو
+
+225
+00:20:47,010 --> 00:20:50,110
+بصمود تمويل التعليم للحكومة العامة انصار هذا
+
+226
+00:20:50,110 --> 00:20:56,650
+الاتجاه يعمل التعليم الجامعي حق له كل مواطن وان
+
+227
+00:20:56,650 --> 00:21:00,390
+المجانية تجسيد لهذا الحق يعني هؤلاء الناس من هدون
+
+228
+00:21:00,390 --> 00:21:05,890
+الحكومة هي فقط تمويل التعليم العاليوأن يقول
+
+229
+00:21:05,890 --> 00:21:13,110
+التعليم العالي الجامعي هو تعليم مجاني ويتم تحقيق
+
+230
+00:21:13,110 --> 00:21:16,710
+الديمقراطية في مجال التعليم وتكافأة الفرص
+
+231
+00:21:16,710 --> 00:21:21,970
+التعليمية وأن الألغاء المجانية سيخلق تمييزا طبقيا
+
+232
+00:21:21,970 --> 00:21:27,150
+أساسه الموقع الاقتصادي والاجتماعي من قرص التمييز
+
+233
+00:21:27,150 --> 00:21:30,790
+ويهدد فم المجتمع وعليه فالدولة مسئولة مسئولية
+
+234
+00:21:30,790 --> 00:21:35,530
+كاملة عن تمويل التعليم العالي وتوفيره للأبرادفي
+
+235
+00:21:35,530 --> 00:21:41,270
+المجتمع يعني بالاتجاه الأول بيقول إن الجامعات تجب
+
+236
+00:21:41,270 --> 00:21:46,350
+أن تموّل من الحكومة وأن يكون التعليم هو تعليم
+
+237
+00:21:46,350 --> 00:21:50,250
+الجامعة التجاه
+
+238
+00:21:50,250 --> 00:21:54,330
+الثاني التمويل الخاص يرى أساطر التجاه أن التعليم
+
+239
+00:21:54,330 --> 00:21:58,990
+الجامعي مشروع استثنائي فما تصرف عليه أموال في لابد
+
+240
+00:21:58,990 --> 00:22:03,970
+له من عائد ومدد التصاليفوعليه يجب أن ترفع الدولة
+
+241
+00:22:03,970 --> 00:22:07,450
+يدها عن التعليم الجامعي تصبح مسئولة القطاع الخاص
+
+242
+00:22:07,450 --> 00:22:11,730
+لتولد جواب إدارية ومالية لهذه الجامعة أقول لك إنه
+
+243
+00:22:11,730 --> 00:22:17,630
+طالب في الجامعة يدرس ودراسته هذه تمثل مشروع
+
+244
+00:22:17,630 --> 00:22:22,610
+إستثماري بعد أن يدرس هيتخرج ثم يبحث في صوف العمل
+
+245
+00:22:22,610 --> 00:22:28,050
+عن فرصة عمل أو عن قطيفة فأنا ليش أموّل هذا الطالب
+
+246
+00:22:28,050 --> 00:22:36,020
+أو أموّل نفسه بنفسه في لان الرسوموبالتالي بعد ذلك
+
+247
+00:22:36,020 --> 00:22:41,720
+يمارس النشاط الاقتصادي وحق الإيرادات التمويل الخاص
+
+248
+00:22:41,720 --> 00:22:46,660
+مقصود أنه تتصرف مع جامعات هي جامعات خاصة يموّلها
+
+249
+00:22:46,660 --> 00:22:52,280
+القطاع الخاص والقطاع الخاص هذا يأخذ رسوم من الطلاب
+
+250
+00:22:52,280 --> 00:22:57,680
+يغطي من خلاله نفقات الجامعة أدوات تجاه يعني موجود
+
+251
+00:22:57,680 --> 00:23:03,710
+في كثير من دول العالمالاتجاه الثالث هو بيسموه
+
+252
+00:23:03,710 --> 00:23:08,110
+التمويل المقتنع نظرا إلى كل من التمويل العام و
+
+253
+00:23:08,110 --> 00:23:11,730
+التمويل الخاص محاذيره و سلبياته يعني سواء أن
+
+254
+00:23:11,730 --> 00:23:16,750
+الحكومة تموّل فقط و تكون التعليم مجاني أو القطاع
+
+255
+00:23:16,750 --> 00:23:24,290
+الخاص يتموّل فقط و يتم طبعا جمع اللي هو يأخذ سبب
+
+256
+00:23:24,290 --> 00:23:29,990
+للطلاع يعني كل واحد له محاذيرهوالتلاف الجدد القائم
+
+257
+00:23:29,990 --> 00:23:34,310
+بين أصحاب الاتجاهين السابقين غير اتجاه ثالث ينحو
+
+258
+00:23:34,310 --> 00:23:39,130
+ملحق وسط من اتجاه السابق، يعني أنا اتجاه مجلس وسط
+
+259
+00:23:39,130 --> 00:23:43,450
+ونادي بالتمويل المختلط يؤسس سبب الاتجاه ويؤسس
+
+260
+00:23:43,450 --> 00:23:48,050
+الاتجاه على أنا تمويل التعليم لعالم مسئولية مشتركة
+
+261
+00:23:48,050 --> 00:23:53,210
+بين القطاعين العام والخاص يعني يكون التعليم مسؤول
+
+262
+00:23:53,210 --> 00:23:57,920
+عن المقومة وكمان القطاع التاصلويؤكد هذا الاتجاه حق
+
+263
+00:23:57,920 --> 00:24:02,520
+الفدء التعليمي شريط التوفيق بين حاجات الفدء وحاجات
+
+264
+00:24:02,520 --> 00:24:07,000
+المجتمع ويعد هذا الاتجاه هو الأكثر شيوعا على مستوى
+
+265
+00:24:07,000 --> 00:24:11,040
+العالم يعني في المعظم دول العالم التمويل يكون
+
+266
+00:24:11,040 --> 00:24:16,080
+تمويل مفتلط من قبل الحكومة ومن قبل طبعا القطاع
+
+267
+00:24:16,080 --> 00:24:20,200
+الخاص وربما في المستقبل يصبح هذا الاتجاه الأقوى
+
+268
+00:24:20,200 --> 00:24:23,840
+بين اتجاهات تمويل التعليم العالمي خاصة أنه يتغلب
+
+269
+00:24:23,840 --> 00:24:29,080
+على مشكلات التمويل الخاصحيث لا يترك الحبل على غيره
+
+270
+00:24:29,080 --> 00:24:33,220
+القطاع الخاص يتحكم في مجالات الأمور، المجتمع، حسب
+
+271
+00:24:33,220 --> 00:24:36,880
+سياسات القطاع الخاص، أنت تغلب المصدر الشخصية
+
+272
+00:24:36,880 --> 00:24:42,760
+والربع على غيره من الأمور، يعني يبدأ تكون توازن،
+
+273
+00:24:42,760 --> 00:24:49,520
+حكومة تمول، والقطاع الخاص يمول، ويجب أن ترفع يد
+
+274
+00:24:49,520 --> 00:24:53,240
+الحكومة عن التعليم العالي، حتى لو كان مشكلة غير
+
+275
+00:24:53,240 --> 00:24:59,650
+عامة،في فلسطين يعني هناك مجلس التعليم العالي
+
+276
+00:24:59,650 --> 00:25:03,550
+الفلسطيني يعني هو يعني يقدم هذا القضية اللي نتكلم
+
+277
+00:25:03,550 --> 00:25:06,590
+عنها ان شاء الله يمكن في المحاضرة العالية أو
+
+278
+00:25:06,590 --> 00:25:11,970
+المحاضرة القادمة نفس القصل هذا على أنه طبعا هيقوم
+
+279
+00:25:11,970 --> 00:25:16,900
+بالتمويل وأن كان التمويل الحين يكون محدودلكن هذا
+
+280
+00:25:16,900 --> 00:25:21,020
+المجلد التعليم العالي يمثل الحكومة الفلسطينية
+
+281
+00:25:21,020 --> 00:25:26,720
+طبعاً هو المجلد المسؤول عن وضع السياسات لهذه
+
+282
+00:25:26,720 --> 00:25:31,340
+الجامعات وعن تنظيم البرامج التعليمية البرامج
+
+283
+00:25:31,340 --> 00:25:36,920
+الأكاديمية إلى أخرها بعض
+
+284
+00:25:36,920 --> 00:25:39,960
+مجالات ترشيد الاستخدام داخل مؤسسات التعليم العالي
+
+285
+00:25:39,960 --> 00:25:44,000
+وبعض مصادر إغلاق فيها التنمية كيف احنا ممكن نرشد
+
+286
+00:25:44,420 --> 00:25:46,700
+للاستخدام، على الرغم من اجتياج مؤسسات التعليم
+
+287
+00:25:46,700 --> 00:25:51,040
+العالي للمزيد من التمويل لتقابل أزايد الأعداد
+
+288
+00:25:51,040 --> 00:25:55,100
+المقمولة من طلبات البحث العلمي فإنهم المهم اللي
+
+289
+00:25:55,100 --> 00:25:59,440
+عمل على الاستخدام الأمثل لكل الموارد المتاحة لدى
+
+290
+00:25:59,440 --> 00:26:05,300
+الجامعة طبعا ممكن نوصي في هذا الشأن بعض مشارات
+
+291
+00:26:05,300 --> 00:26:11,900
+مباشرة لترشيد الاستخدامكيف نرش الأسهلات داخل
+
+292
+00:26:11,900 --> 00:26:19,320
+مؤسساتنا وكيف نضيف مصادر أخرى للتمويل وخاصة في ظل
+
+293
+00:26:19,320 --> 00:26:25,940
+أزمات مالية بنعاني منها بشكل كامل أولا التشرير
+
+294
+00:26:25,940 --> 00:26:30,360
+الكامل للمعامل والورش بمدرجات حتة يكون خاصة على
+
+295
+00:26:30,360 --> 00:26:34,780
+كلية بعينها ولمّا يوضع عليها جدول زمني يتعاون في
+
+296
+00:26:34,780 --> 00:26:37,940
+بطاقين مندغون من كل كرة يعني لسه فيه، احنا ما
+
+297
+00:26:37,940 --> 00:26:41,170
+نتكلم عنه في الجامعةمثل الإسلامية ممكن نستفيد من
+
+298
+00:26:41,170 --> 00:26:47,550
+كل القاعات الدراسية أو من كل المعامل أو من كل
+
+299
+00:26:47,550 --> 00:26:54,010
+المورات ليس فقط لكلية معين إنما لكل الكليات بهدف
+
+300
+00:26:54,010 --> 00:27:00,090
+طبعا تعظيم المنفعة من هذه الأشياء الاشتراك في
+
+301
+00:27:00,090 --> 00:27:03,650
+الجامعيات العلمية والمهنية العالمية ومشارات
+
+302
+00:27:03,650 --> 00:27:06,730
+إلكترونية في الدوليات العلمية يما في من توثير
+
+303
+00:27:06,730 --> 00:27:11,450
+القلفة وتفاعل كبير من المجلاتالعلمية التلاتة عسل
+
+304
+00:27:11,450 --> 00:27:15,250
+اختيار مكان مؤسسة وتوفير الشروط التدرسية والترموية
+
+305
+00:27:15,250 --> 00:27:22,150
+المناسبة ومكان مؤسسة مناسب وإقاعاتها مناسبة
+
+306
+00:27:22,150 --> 00:27:27,250
+وحضائقها مناسبة إلى آخرية أربع دراسة ممكنية التنمج
+
+307
+00:27:27,250 --> 00:27:30,350
+من الوطن كانت من أحصان متلاظرة داخل الجامعة
+
+308
+00:27:30,350 --> 00:27:37,910
+الواحدة فممكن ندمج بين قسمين أو واحد بعض المصطلحات
+
+309
+00:27:39,260 --> 00:27:46,060
+على سبيل المثال في برنامج السياسة
+
+310
+00:27:46,060 --> 00:27:51,540
+والإعلام اللي عندنا في قسم الاقتصاد لدينا فيه بعض
+
+311
+00:27:51,540 --> 00:27:59,040
+المساواة متشابهة في نفس برنامج الإعلام في قسم الـ
+
+312
+00:27:59,040 --> 00:28:02,280
+A، في كلية الأدام، كلية الأدام فروحنا احنا
+
+313
+00:28:02,280 --> 00:28:07,060
+المساواات المشتركةاللي في الإعلام لأن البرنامج
+
+314
+00:28:07,060 --> 00:28:12,460
+اسمه الإعلام أعطينا نفس الرقم الموجودة في برنامج
+
+315
+00:28:12,460 --> 00:28:16,660
+الإعلام التابع لقسم الصحافة والإعلام في كلية
+
+316
+00:28:16,660 --> 00:28:22,780
+الإعداد وبيهدف طبعا تقليل التكلفة وتعظيم الإرادات
+
+317
+00:28:22,780 --> 00:28:26,640
+الحد من المطال المقنع في مؤسسات تعليم العالي كثير
+
+318
+00:28:26,640 --> 00:28:32,100
+من مؤسسات تعليم العالي فيها يعني ناس مشتغلوا وما
+
+319
+00:28:32,100 --> 00:28:38,010
+لهو مش لزوم وخاصةيعني في الموظفين الإداريين بشكل
+
+320
+00:28:38,010 --> 00:28:44,010
+كبير وهذا طبعا من أن نخد منه وفي الجامعة الإسلامية
+
+321
+00:28:44,010 --> 00:28:49,210
+حاولت الجامعة تخد منه عن طريق يعني الاتفاق مع بعض
+
+322
+00:28:49,210 --> 00:28:54,950
+الموظفين للتقاعد المفكر وعطاهم بعض الإمتيازات وبعض
+
+323
+00:28:54,950 --> 00:29:00,810
+الحقوق وبالتالي تقليل بشكل كبير من الفطالة المقنعة
+
+324
+00:29:03,370 --> 00:29:09,110
+رابعاً تجارب في مجال تمويل التعليم يعني مثلا في
+
+325
+00:29:09,110 --> 00:29:11,730
+بريطانيا تمويل التعليم الجامعي في بريطانيا
+
+326
+00:29:11,730 --> 00:29:18,150
+الجامعات البريطانية هي مؤسسات مستقلة لكنها مدعومة
+
+327
+00:29:18,150 --> 00:29:24,150
+مالياً بشكل غير مباشر من قبل الحكومة ويتولى مجلس
+
+328
+00:29:24,150 --> 00:29:27,930
+تمويل التعليم العالي مهم التمويل التعليم الجامعي
+
+329
+00:29:27,930 --> 00:29:33,120
+وتقيم نوايته وجودهويتخذ تقرير هذه اللجنة للوائد
+
+330
+00:29:33,120 --> 00:29:36,780
+التعليم الجامعي أساساً عن الأموال التي تُعطى
+
+331
+00:29:36,780 --> 00:29:43,260
+للجامعات ويمول التعليم الجامعي في بريطانيا بطرق
+
+332
+00:29:43,260 --> 00:29:46,180
+متعددة منها التمييز من خلال السلطات التعليمية
+
+333
+00:29:46,180 --> 00:29:49,760
+المركزية والمحلية يعني طبعاً السلطات التعليمية
+
+334
+00:29:49,760 --> 00:29:53,080
+اللي هي الحكومة سواء الحكومة المركزية أو البلديات
+
+335
+00:29:53,080 --> 00:29:57,860
+وتحصير رسوم الطلاب على عصر رسومومنح قروض للطلاب
+
+336
+00:29:57,860 --> 00:30:00,020
+اللي درسونا على أساس التفرق الدراسي الجامعية
+
+337
+00:30:00,020 --> 00:30:04,080
+الأولى ويقوموا الطلاب بالتدريب في القروض خاصة في
+
+338
+00:30:04,080 --> 00:30:09,300
+سوق العمل يعني هنا مسم التعليم مفتلط الحكومة
+
+339
+00:30:09,300 --> 00:30:12,840
+الساهم فيه والقطاع الخاص بالساهم فيه وكذلك الطلاب
+
+340
+00:30:12,840 --> 00:30:18,700
+الساهم في هذا العمل تمول
+
+341
+00:30:18,700 --> 00:30:24,210
+التعليم الجامعة لولايات المتحدة الأمريكيةطبعاً منذ
+
+342
+00:30:24,210 --> 00:30:27,050
+أن بدأ التعليم في ولاية وطاعتنا المالكية ياخد
+
+343
+00:30:27,050 --> 00:30:30,510
+طبيعه أقصدي وتقطع منه التومي له علاقة على عدد
+
+344
+00:30:30,510 --> 00:30:34,510
+الأفراد في المقام الأولى وبشكل عام يموّل التعليم
+
+345
+00:30:34,510 --> 00:30:37,710
+الجامعي من خلال الحكومة الفيدرالية ومن ولايات
+
+346
+00:30:37,710 --> 00:30:43,310
+الأفراد يعني برضه تعليم مختلط يتموّل الولاية أو
+
+347
+00:30:43,310 --> 00:30:47,090
+حاكم الولاية أو سلطة المحلي المموّل كمان الأفراد
+
+348
+00:30:47,090 --> 00:30:50,070
+عن طريق الرسوم اللي اتفاعته اللي بيموّل هي تدفع
+
+349
+00:30:50,070 --> 00:30:53,210
+الحكومة الفيدراليةالنسبة للجامعات اللي بتنطبق
+
+350
+00:30:53,210 --> 00:30:57,330
+عليها الشروط والمعنية بتنفيذ البرامج المطلوبة كما
+
+351
+00:30:57,330 --> 00:31:01,550
+تسمو الولاية لتمويل الجامعات بها ثم يقوم أولياء
+
+352
+00:31:01,550 --> 00:31:04,410
+الأمور أو الطلاب بتفاجزهم من تقريباتهم التعليمية
+
+353
+00:31:04,410 --> 00:31:10,170
+أما الجامعات الخاصة بقامة جامعات أقومية أو يعني
+
+354
+00:31:10,170 --> 00:31:14,890
+ميئة للتعليم المختلط في جامعات خاصة بتبول من
+
+355
+00:31:14,890 --> 00:31:17,470
+الرسوم الدراسية أو من المساعدات الفедرالية أو
+
+356
+00:31:17,470 --> 00:31:24,790
+الأبحاث الممولةعلى أمريكا التنمول التعليم الجامعي
+
+357
+00:31:24,790 --> 00:31:28,670
+في كوريا الجنوبية تعتمد كوريا الجنوبية على أربع
+
+358
+00:31:28,670 --> 00:31:31,870
+مصادر أساسية لتنمول التعليم بها هي الحكومة
+
+359
+00:31:31,870 --> 00:31:40,210
+المركزية الحكومة المحلية وأولياء الأمور وبعض
+
+360
+00:31:40,210 --> 00:31:45,450
+الأمور الموقوفة للتعليم وعليه هناك عدة من المصادر
+
+361
+00:31:45,450 --> 00:31:48,730
+غير حكومية تتصم بشكل كبير في تنمول التعليم في
+
+362
+00:31:48,730 --> 00:31:52,860
+كورياالجنوبية كل الدول الجنوبية كانت طبعا من دول
+
+363
+00:31:52,860 --> 00:31:59,600
+النمور الأسيوية تمويل التعليم العالي في اليابان
+
+364
+00:31:59,600 --> 00:32:03,700
+يتم تمويل التعليم الإيامي في اليابان من خلال
+
+365
+00:32:03,700 --> 00:32:07,060
+المشاركة بين الحكومة القومية والحكومات الولايات
+
+366
+00:32:07,060 --> 00:32:13,200
+والبلدية برضه الحكومة المركزية بتموّل حكومة
+
+367
+00:32:13,200 --> 00:32:17,700
+الولاية أو البلدية بتموّل والقطاع الخاص أيضا بموّل
+
+368
+00:32:18,160 --> 00:32:23,440
+هذا بالإضافة إلى أموال تحصل في صورة دراية كما
+
+369
+00:32:23,440 --> 00:32:27,500
+تساهم المؤسسات والشركات اليابانية في تحمل جزء من
+
+370
+00:32:27,500 --> 00:32:31,860
+المناطقات التعليم لتقدم منها طلاب خاصة متميزين
+
+371
+00:32:31,860 --> 00:32:37,440
+منهم وتقدر يمنح شكل من أشكال القروض بعضها بفائدة و
+
+372
+00:32:37,440 --> 00:32:42,780
+بعضها دون فائدة و هذه الأخيرة تقدم لطلاب الجامعة
+
+373
+00:32:46,420 --> 00:32:49,960
+خامساً تمويل التعليم بين مسئولية الحكومة ومشاركة
+
+374
+00:32:49,960 --> 00:32:55,960
+المستفيدين هنا في سؤال ما ضرر مشاركة المستفيدين في
+
+375
+00:32:55,960 --> 00:33:00,660
+تمويل التعليم؟ مش نمو الطلاب يعني عادة مقضت كثير
+
+376
+00:33:00,660 --> 00:33:04,820
+من الحكومات على مقابلة قوة التعليم العالية نظرا
+
+377
+00:33:04,820 --> 00:33:09,860
+للنمو السكان المتزاين هذا ما يجعل المستفيد أو
+
+378
+00:33:09,860 --> 00:33:14,120
+الطالب يشارك في تمويل التعليم عن طريق الرسوم طبعا
+
+379
+00:33:14,120 --> 00:33:17,780
+الحكومة مش قادرة تتمويل التعليمالعالي، اعتذرًا
+
+380
+00:33:17,780 --> 00:33:22,480
+لنمو السكان المتزايد في من الدول اللامية وزيادة
+
+381
+00:33:22,480 --> 00:33:25,520
+طلب على التعليم في المعدلات القايدة بالمدارس
+
+382
+00:33:25,520 --> 00:33:29,940
+ورُجعة المدرس التماركي في جمهور دول التعليم هذا
+
+383
+00:33:29,940 --> 00:33:34,820
+سبب، كمان إدراكًا منها بعدم قدرة كثير من الحكومات
+
+384
+00:33:34,820 --> 00:33:37,800
+لمقابلة كلها في التعليم العالية قبل المنظمة
+
+385
+00:33:37,800 --> 00:33:40,520
+الدولية المهتمة بالتعليم التنازلات والدعوات
+
+386
+00:33:40,520 --> 00:33:45,100
+المنادي بحق مجلمات التعليم، بطلوا الناس ينادوابحق
+
+387
+00:33:45,100 --> 00:33:49,760
+مجاني التعليم لأن الحكومة مش قادرة تتمول وطبعاً من
+
+388
+00:33:49,760 --> 00:33:54,300
+ذلك يعني واحد نصد التفاقيت اللي هو المتحدة في عمق
+
+389
+00:33:54,300 --> 00:33:58,480
+الإنسان في عام 1948 على أن التعليم يجب أن يكون
+
+390
+00:33:58,480 --> 00:34:03,080
+مجانياً خاصة المراحل التدائية و المراحل الأساسية،
+
+391
+00:34:03,080 --> 00:34:06,400
+تمام؟
+
+392
+00:34:06,400 --> 00:34:09,640
+يعني
+
+393
+00:34:09,640 --> 00:34:12,960
+في البداية كانوا ينادوا أن يجب أن يكون التعليم
+
+394
+00:34:12,960 --> 00:34:15,750
+مجانيقاسم المراحل الدولية والمراحل الإعدادية
+
+395
+00:34:15,750 --> 00:34:20,890
+والمراحل الأساسية اثنين نصف اتفاقية حقوق الأطفال
+
+396
+00:34:20,890 --> 00:34:25,870
+عامة الـ53 ميلاد على أن الأطفال يجب أن يحصلوا على
+
+397
+00:34:25,870 --> 00:34:30,470
+خدمة التعليم ويجب أن تكون لزمية ومجانية على قانون
+
+398
+00:34:30,470 --> 00:34:35,290
+المراحل الدولية ثلاثة لم تنصف التفاقية العالمية
+
+399
+00:34:35,290 --> 00:34:39,770
+للتعليم للجامعة في جومتين أتفالاندية اتفالنة القرن
+
+400
+00:34:39,770 --> 00:34:45,800
+من دول النمور الأسويةعام 1998 على مجانية 1.5
+
+401
+00:34:45,800 --> 00:34:50,540
+مجانية للتعليم أربع ألمحة نقاش الدائرة المستديرة
+
+402
+00:34:50,540 --> 00:34:56,820
+البرنامج UNESCO عام 1998 لإمكانية فرض رسوم
+
+403
+00:34:56,820 --> 00:35:01,500
+الدراسية في تقديم الخدمة التعليمية في صمم تقرير
+
+404
+00:35:01,500 --> 00:35:07,040
+عبارات مثل التعليم المجاني التي تتحملها الحكومة
+
+405
+00:35:07,040 --> 00:35:12,680
+بمفادة غالبا ما يكون غير كافي في جودته لإيقافات
+
+406
+00:35:12,680 --> 00:35:16,160
+أكبرأو المستمع المحلي أو الدولة يعني التعليم
+
+407
+00:35:16,160 --> 00:35:20,920
+المجاني يتحمل الحكومة يكون كافي لأنه مش هيعطي جودة
+
+408
+00:35:20,920 --> 00:35:28,200
+عالية في التعليم الأطفال الأكثر حاجة لن يكون
+
+409
+00:35:28,200 --> 00:35:31,860
+بإمكانهم التأقلم مع المشروعات أو حتى متفع الرسوم
+
+410
+00:35:31,860 --> 00:35:35,580
+الدراسية يحتاجوا يكونوا بإمكان أطفال طبعا توسطة
+
+411
+00:35:35,580 --> 00:35:42,920
+وعلم في أطفال ممكنش يتعرفوا وفي أطفال طبعا أهلهم
+
+412
+00:35:42,920 --> 00:35:49,950
+أغنيةممكن أن يدفعوا هذه الأرشوف إذا هناك من ينادي
+
+413
+00:35:49,950 --> 00:35:54,970
+بعدم مجانيته التعليم العام بدل قاضي رسوم بغرض
+
+414
+00:35:54,970 --> 00:36:00,190
+تحقيق مستويات أعلى من الكفاءة والمساواة بفجة أن
+
+415
+00:36:00,190 --> 00:36:04,510
+واحدة من التعليم المجاني يلغي درجة التنافسيان هنا
+
+416
+00:36:04,510 --> 00:36:10,640
+صار ينادي شكل واضح بعدم مجانيت التعليم العاليوهو
+
+417
+00:36:10,640 --> 00:36:15,860
+الواجب أن يتمدى الفرسون عشان الحجاج واحد من
+
+418
+00:36:15,860 --> 00:36:18,200
+التعليم المجاني يضغط في وسط النفسية وبالتالي
+
+419
+00:36:18,200 --> 00:36:21,680
+الحافظ الانجازي في مؤسسات تعليمية سواء لدى العامين
+
+420
+00:36:21,680 --> 00:36:26,740
+أو الطلاب فالطلاب بس مايدفعش رسوم يعني بحس أنه خال
+
+421
+00:36:26,740 --> 00:36:33,320
+طرف، ممكن مايهتمش، لا ينجز، لا درس جيدا، مايحقش
+
+422
+00:36:33,320 --> 00:36:36,640
+معدل عالي، مايتفوقش، وبالتالي هتكون هذي بيبال عليه
+
+423
+00:36:36,640 --> 00:36:41,350
+مش علاج لفرصة عمال بعد ذلكأثناء التعليم المجاني
+
+424
+00:36:41,350 --> 00:36:45,610
+يستفيد منه بشكل أكبر طبقات المجتمع الأعلى دخلًا
+
+425
+00:36:45,610 --> 00:36:50,810
+التعليم المجاني لأن الطبقات الأعلى دخلًا مش هيدفع
+
+426
+00:36:50,810 --> 00:36:57,090
+رسوم وهو دخله عالي وهو هيتعلم بالبلاش وبالتالي هو
+
+427
+00:36:57,090 --> 00:37:01,150
+هيستفيد بشكل أكبر من الطبقات المقلية ممكن هو يخل
+
+428
+00:37:01,150 --> 00:37:06,290
+الطلاب يدفع رسوم لكن نعفي الطلاب القرار من هذا
+
+429
+00:37:06,290 --> 00:37:13,550
+الرسوميعني للناس اللي عندهم دخل قليل أو عائلتهم رب
+
+430
+00:37:13,550 --> 00:37:18,210
+الأسرة لا يعمل ممكن أن يُعفى من نفسهم لكن خلّي
+
+431
+00:37:18,210 --> 00:37:26,490
+الناس المقدرين أن يدفعوا هذه الرسوم الدعوة
+
+432
+00:37:26,490 --> 00:37:30,610
+المضربة لمجانية التعليم العام والقائمة على فشل
+
+433
+00:37:30,610 --> 00:37:36,250
+الكفاءة والمستوى قد تكون دقيقة لأسباب ما كان هناك
+
+434
+00:37:36,250 --> 00:37:41,900
+دعوة مضربةالمجال التعليم طبعاً هذه الدعوة يعني قد
+
+435
+00:37:41,900 --> 00:37:49,280
+لا تكون دقيقة ضد مجال التعليم لأسباب واحد النظم
+
+436
+00:37:49,280 --> 00:37:54,000
+التعليمية اللي تحصل اللي تحصل رسوم دراسية من
+
+437
+00:37:54,000 --> 00:37:57,940
+الطلاب قد تواجه صعوبات إدارية مكلفة يعني تقصير
+
+438
+00:37:57,940 --> 00:38:00,860
+الرسوم الدراسية تتطلب إدارة مالية لتقنعه من
+
+439
+00:38:00,860 --> 00:38:05,880
+التعقيد والبخامة تقصير الرسوم يجب إدارة وهذه قد
+
+440
+00:38:05,880 --> 00:38:11,100
+تكون يعنيفيها تعقيد أثنين أن ابناء الطبقات الفقيرة
+
+441
+00:38:11,100 --> 00:38:14,960
+يشكلون الشريح الأعظم في المجتمع ومحاولة تعوضهم
+
+442
+00:38:14,960 --> 00:38:19,820
+الرسوم الدراسية قد يكون مكلف أكثر من كونه مفيد إذا
+
+443
+00:38:19,820 --> 00:38:25,980
+هناك الناس يتفرسون أو يدعوتون ثلاثة أن سمعة الرسوم
+
+444
+00:38:25,980 --> 00:38:31,260
+الدراسية بحد ذاتها قد تكون منفرةلأبناء الثقافات
+
+445
+00:38:31,260 --> 00:38:34,900
+الفقيرة حتى وإن كانت مصحوبة من التعامل بيها
+
+446
+00:38:34,900 --> 00:38:38,320
+فالمسئول يقول تعالي تفع رسوم يكون هؤلاء الفقراء
+
+447
+00:38:38,320 --> 00:38:44,800
+مايبعتوش أبناءهم للدراسة لأنه مش حد داري يتفع رسوم
+
+448
+00:38:44,800 --> 00:38:47,740
+لأنه سمع أنه في رسوم وبالتالي ممكن حتى ابنهم
+
+449
+00:38:47,740 --> 00:38:51,680
+مايبعتوش للدراسة حتى لو الأخي بدي يعطاه منها أو
+
+450
+00:38:51,680 --> 00:38:55,980
+يعفى من الرسوم لأنه ورد في عقليه تقول في رسوم
+
+451
+00:38:55,980 --> 00:39:02,490
+ويكون عنده أحراجيعني في أنه يُخذ منحة أو يُعفر
+
+452
+00:39:02,490 --> 00:39:06,810
+للرسوم أربع، في التعليم الثانوي قد يكون توزيع
+
+453
+00:39:06,810 --> 00:39:10,350
+التلميذ بين الطلاقات الغنية والفقيرة أكثر توازنًا
+
+454
+00:39:10,350 --> 00:39:14,790
+وبالتالي يزداد درجة القبول الرسوم الدراسية، هذا
+
+455
+00:39:14,790 --> 00:39:18,430
+التعليم الثانوي خمسة، الرسوم الدراسية تعليم العام
+
+456
+00:39:18,430 --> 00:39:22,370
+قد تؤثر على تكافئة الفرص الإجتماعي للصالح في
+
+457
+00:39:22,370 --> 00:39:25,590
+البلد، بس يستطيع تقع رسوم سر يعلنه أننا نعلمش
+
+458
+00:39:25,590 --> 00:39:31,380
+البناتلأنه بيقول لك أنا بدرس أعلم و هذا الكلام
+
+459
+00:39:31,380 --> 00:39:34,720
+بيحصل في الجامعات هنا عندنا في فلسطين، في قطاع غزة
+
+460
+00:39:34,720 --> 00:39:39,160
+بعض الناس يعلمش ابنته في الجامعة لأنه مش قادر
+
+461
+00:39:39,160 --> 00:39:43,100
+يساعد على رسوم، لكن بعلم ابنه لأنه ابنه بيعتبر
+
+462
+00:39:43,100 --> 00:39:48,880
+يعني ممكن يلاقي فرصة عمل بعد التخرج يساعد فيها رب
+
+463
+00:39:48,880 --> 00:39:57,640
+الأسرة على مشاقات الحياةعقبات في طريق شاركة
+
+464
+00:39:57,640 --> 00:40:02,040
+المستفدين في تنموية التعليم العالي ما هي العقبات
+
+465
+00:40:02,040 --> 00:40:07,400
+اللي بتواجه أن الناس يدفع رسوم أو يشاركوا في
+
+466
+00:40:07,400 --> 00:40:10,700
+تنموية التعليم؟ واحد من العقبات، واحد من قوة
+
+467
+00:40:10,700 --> 00:40:14,400
+الطلاب وأولياء أمورهم وخلافهم المتفعين بالتعليم
+
+468
+00:40:14,400 --> 00:40:17,320
+العالي، خاصة في الجمهوري الإجتماعية، سواء تمويلها
+
+469
+00:40:17,320 --> 00:40:21,600
+مبادئ أو نادي، بأن التعليم الكام يحق لمن تقايل
+
+470
+00:40:21,600 --> 00:40:24,140
+قدراته التعليمية لإنه يلتحق بيه، كله كانت تعليم
+
+471
+00:40:24,140 --> 00:40:27,670
+الحق، ما هي الطلاب اللي يدفعوا رسوم؟أثنين العواقد
+
+472
+00:40:27,670 --> 00:40:31,010
+الخارجية المرتفعة بالتعليم العالي والكفيرة بالتغلب
+
+473
+00:40:31,010 --> 00:40:38,350
+جانب تعادل اجتماعي على الفردي ثلاثة
+
+474
+00:40:38,350 --> 00:40:43,390
+التخوض على إنسانيته وأكاديمية التعليم الجامعي من
+
+475
+00:40:43,390 --> 00:40:47,790
+قوة الصوت يعني ناحن الناس اللي هتطلب الرسول مثلا
+
+476
+00:40:47,790 --> 00:40:53,190
+في ناحية إنسانية حيث يرى لبعض أنه في ترك التعليم
+
+477
+00:40:53,190 --> 00:40:58,130
+العاليلتوجهه رغبات الطلاب وأرباب العمل انحضاراً به
+
+478
+00:40:58,130 --> 00:41:03,750
+نحو الانحطار الأكاديمي إذا خرست الطلاب يعني بدأوا
+
+479
+00:41:03,750 --> 00:41:09,830
+يدفعوا طبعاً رسولة ليؤكد البعض أن عدم مساواة
+
+480
+00:41:09,830 --> 00:41:14,150
+الناتجة عن تقريم التعليم العالي مجاناً واستأثار
+
+481
+00:41:14,150 --> 00:41:18,870
+أبناء الطبق الأغنى بالحظ الأوفر منه يمكن أن تحل،
+
+482
+00:41:18,870 --> 00:41:22,490
+يمكن كذلك كل أحنا بإصلاحات سياسية أو اقتصادية أو
+
+483
+00:41:22,490 --> 00:41:28,470
+اجتماعيةعلى مستوى أوسع من التعليم يعني ممكن نخلص
+
+484
+00:41:28,470 --> 00:41:35,870
+الطالب الغني يعني هو يستغرق ويبدهر يعني حل من قبل
+
+485
+00:41:35,870 --> 00:41:42,210
+الحكومة خمسة أن الواعد بتقديم مساعدات الطلاب أو
+
+486
+00:41:42,210 --> 00:41:45,670
+المؤسسات التعليمية في حال قرط الرسوم الدراسية قد
+
+487
+00:41:45,670 --> 00:41:51,910
+يكون بريطا علاميا وليس القزاما سياسيا يعنيإن احنا
+
+488
+00:41:51,910 --> 00:41:57,470
+قمنا بتقديم وعد بتقديم مساعدات للطلاب والمؤسسات
+
+489
+00:41:57,470 --> 00:42:02,270
+إذا تسارسوها، لقد يكون مستحيل إعلامية لكن على أرض
+
+490
+00:42:02,270 --> 00:42:07,830
+المواقع ماحدثش هساعد هؤلاء والطلاب ستة إن إدخال
+
+491
+00:42:07,830 --> 00:42:12,130
+سياسة المشاركة ربما أدل تهميش اتياجات التعليم
+
+492
+00:42:12,130 --> 00:42:16,190
+العالي من الموارد العامة حتى في حالة حاجة تيلف
+
+493
+00:42:16,190 --> 00:42:20,980
+بمقابل ما يقصص لبقية القطاعات الخدميةركونا إلى
+
+494
+00:42:20,980 --> 00:42:24,280
+مبدأ أن المؤسسات التعليم العالي قادر على أن تموّل
+
+495
+00:42:24,280 --> 00:42:27,780
+نفسها من الموارد الأهلية الأمر الذي لايتوفر لغيرها
+
+496
+00:42:27,780 --> 00:42:33,020
+مؤسسة الخدمات العامة سبعة ضعف نظر المعلومات
+
+497
+00:42:33,020 --> 00:42:38,840
+والاتصالات بما يضمن تنفيذ تعالي سياسة منح لسياسة
+
+498
+00:42:38,840 --> 00:42:43,540
+منح للأبناء غير القادرين أو تمويل التعليم من خلال
+
+499
+00:42:43,540 --> 00:42:48,160
+قوات تسدد على التخرج بأقصاد مناسبة، خاصة في الدول
+
+500
+00:42:48,160 --> 00:42:54,010
+العالمية التي تتفقدلبنية بريفية نظر معلومات تمكن
+
+501
+00:42:54,010 --> 00:42:57,210
+المتابعون من تقييم عدد قدرت الأداء على التمويل
+
+502
+00:42:57,210 --> 00:43:06,330
+اللي هو التعليم طبعاً في أن نتائج التمويل من قبل
+
+503
+00:43:06,330 --> 00:43:14,250
+الدولة أو المجتمع تشيل النتائج الإيجابية اللي احنا
+
+504
+00:43:14,250 --> 00:43:18,760
+لو مولنا التعليممن قبل الدولة أو المجتمع، في إنتاج
+
+505
+00:43:18,760 --> 00:43:22,420
+إيجابية، في إيجابيات، وفي طبعاً سلبيات، ما هو
+
+506
+00:43:22,420 --> 00:43:25,580
+الإيجابيات؟ لو أحنا كنتم بتعمل تنمية من قبل
+
+507
+00:43:25,580 --> 00:43:30,620
+الدولة، واحد تجيل العواقب المالية، تمام قدرات
+
+508
+00:43:30,620 --> 00:43:34,520
+الأفراد في التعلم، يعني زيادة الأفراد المتعلمين
+
+509
+00:43:34,520 --> 00:43:39,100
+واستخدارهم في التعليم، يعني ما أصلش يعني، كل بدي
+
+510
+00:43:39,100 --> 00:43:43,630
+أتعلم،وأكدوا أن هناك مجاني في التعليم هنا عندما
+
+511
+00:43:43,630 --> 00:43:47,830
+دولة تتموّل، تصبح التعليم مجاني وبالتالي، العوائق
+
+512
+00:43:47,830 --> 00:43:51,470
+المالية تنزل وبتستمر الأوراق، خاصة بغرب التعليم،
+
+513
+00:43:51,470 --> 00:43:55,770
+تستمر بالتعليم أتنين، أداة فاعلة في تعميم التعليم
+
+514
+00:43:55,770 --> 00:43:58,570
+مشمول لكل أوراق المجتمع، للمجتمع التعليمي، لرسول
+
+515
+00:43:58,570 --> 00:44:03,850
+التعليم لكل بتعلم، لأن أصبح التعليم مجانيثلاث يقفل
+
+516
+00:44:03,850 --> 00:44:06,950
+في تحقيق هدف المجتمع في إلزامية التعليم اللي احنا
+
+517
+00:44:06,950 --> 00:44:10,230
+نقول والله التعليم إلزامي، طب مش لازم اتفرجهم، طب
+
+518
+00:44:10,230 --> 00:44:13,210
+مش لازم اتفرجهم، تعالوا اتعلموا، اتعلموا بشكل
+
+519
+00:44:13,210 --> 00:44:19,190
+درسهم أربعة، تمكن الأفراد من إدارة إمكانيات
+
+520
+00:44:19,190 --> 00:44:23,530
+وقابليات علمية لاستمرار في التعليم، وتطوير مواهبهم
+
+521
+00:44:23,530 --> 00:44:29,640
+وقدرتهم، لأنهم مش دافعون، خمسةيضمن إن سيابية أفضل
+
+522
+00:44:29,640 --> 00:44:35,220
+للكوادر الماهرة لمختلف القطاعات إنشاءات اقتصادي
+
+523
+00:44:35,220 --> 00:44:40,100
+واجتماعي ويوفر إمكانية أفضل لتخطيط القوى العاملة
+
+524
+00:44:40,100 --> 00:44:46,080
+من المواهر العملية والنوعية ستة توفر ظروف أفضل
+
+525
+00:44:46,080 --> 00:44:50,740
+تقدم علمي والتكنيكي يمكن توفير قدات كافية من اطلاف
+
+526
+00:44:50,740 --> 00:44:56,280
+الخصائص هذا كله مزايا وإيجابيات للتعليم يعني لدمول
+
+527
+00:44:56,280 --> 00:45:03,370
+التعليممن قبل الدولة أو الحكومة في سلبيات لهذا
+
+528
+00:45:03,370 --> 00:45:08,530
+الأمر ان هو من قبل الدولة واحد ضعف او انعدام
+
+529
+00:45:08,530 --> 00:45:12,970
+الدوافع الاقتصادية ترورية رفع انتجية التعليم سواء
+
+530
+00:45:12,970 --> 00:45:15,990
+من جانب الطلاب أو من جانب المعلمين بصير الطالب
+
+531
+00:45:15,990 --> 00:45:20,130
+يعني أو مش كله اقتلاف يعني بعض الطلاب مش عندهم
+
+532
+00:45:20,130 --> 00:45:25,330
+دافع التعليم كانوا بيزفع رسوم التالي بيصير متكاسل
+
+533
+00:45:25,330 --> 00:45:31,840
+غير مشتهدلا يحقق معدن متفع وقد يرسل في الجامعة
+
+534
+00:45:31,840 --> 00:45:39,140
+وبالتالي ما يتخرجش .. ما يتخرج .. يتخرجش معدن طعيف
+
+535
+00:45:39,140 --> 00:45:42,740
+ما بيجيش فرصة عملية مناسبة احنا اللي هم الطلاب
+
+536
+00:45:42,740 --> 00:45:46,960
+بتدفع رسوم، بتدفع رسوم، ماتجيبوش علامات فكيف لو
+
+537
+00:45:46,960 --> 00:45:51,300
+الطالب لم يدفع رسوم، بتكون طبعا الأمور أسوأ؟
+
+538
+00:45:51,300 --> 00:45:54,830
+القضية دي عند كلام موجودة عند بعض الطلابالأثنين
+
+539
+00:45:54,830 --> 00:45:57,290
+يخلقوا من الأشكال المكافئة لتقابل زيادة في منتجيته
+
+540
+00:45:57,290 --> 00:46:00,890
+المعلم إذا نشعر المعلم بعدد قصولي على موارد مالية
+
+541
+00:46:00,890 --> 00:46:05,130
+ضارفية، ليس جهودية ضارفية، فقال منتجيته يخبر
+
+542
+00:46:05,130 --> 00:46:11,190
+المعلم إذا الطالب يدفع رسوم ويخلق زيادة عن عبوه
+
+543
+00:46:11,190 --> 00:46:16,790
+الدراسي، يحصل دخل
+
+544
+00:46:16,790 --> 00:46:23,170
+آخر لكن إذا كان التعليم مجاني، لن يحصل أي شيء جديد
+
+545
+00:46:23,750 --> 00:46:27,910
+الثالث جاذب لهدف التربوي هو رسوم والتصرف لأن
+
+546
+00:46:27,910 --> 00:46:32,630
+التعليم مجاني يحصل رسوم أكثر وتصرف أكتر، عدم
+
+547
+00:46:32,630 --> 00:46:36,370
+اهتمام أربع ضعف اهتمام الطلب والعملين في برصة على
+
+548
+00:46:36,370 --> 00:46:40,190
+مستخدمات التعليم، هذا كل نتائج سلبية لو كان
+
+549
+00:46:40,190 --> 00:46:44,970
+التعليم موّل من قبل الدولة وكان التعليم مجاني
+
+550
+00:46:44,970 --> 00:46:52,410
+بالنسبة للطلاب العلاج، ماهو علاج ذلك؟ عشان نوفق
+
+551
+00:46:52,410 --> 00:46:55,850
+أحناواحد تحميل الطالب بعض جوانب النفقات غير أساسية
+
+552
+00:46:55,850 --> 00:47:00,450
+كالكتب أو القرتصين الطالب يتحمل بعض جوانب غير
+
+553
+00:47:00,450 --> 00:47:03,790
+أساسية تحميل الطالب جزء من النفقات التعليمية في
+
+554
+00:47:03,790 --> 00:47:07,070
+حال عدم إجازة الطلبات التعليمية تحمل جزء من الرسوم
+
+555
+00:47:07,070 --> 00:47:11,410
+حجمان الطالب من حصول على ملاحقة عمالية بيوت إسكان
+
+556
+00:47:11,410 --> 00:47:19,900
+الطلبة عشان أسهلتحميل الطالب أجار نقلية لامتحانات
+
+557
+00:47:19,900 --> 00:47:23,620
+المواقف الثانية وثالث امتحان دور ثانى ودور ثالث
+
+558
+00:47:23,620 --> 00:47:29,820
+يتحمل طبعا عجر نقلي أو رسوم توفير فرص أفضل لمبدأين
+
+559
+00:47:29,820 --> 00:47:35,500
+في تطوير ممكنتهم المهنية والعامة
+
+560
+00:47:35,500 --> 00:47:40,700
+هذا كان اتكلم عن إنتاج التمويل من قبل اللي هو
+
+561
+00:47:40,700 --> 00:47:43,860
+الحكومات
+
+562
+00:47:44,530 --> 00:47:47,630
+أو إنتاج الإيجابية أو إنتاج السلبية أو الإيجابيات
+
+563
+00:47:47,630 --> 00:47:51,770
+والسلبيات إنتاج التمويل من قبل أفراد برضه فيه
+
+564
+00:47:51,770 --> 00:47:57,010
+إيجابيات وإلها سلبيات إذا الفرد تموّل أول
+
+565
+00:47:57,010 --> 00:48:00,270
+الإيجابيات إذا هو تموّل الفرد من نفسه لعمل فعال
+
+566
+00:48:00,270 --> 00:48:04,070
+رسوم هذا هي إيجابيات توفر الدوافع والحوافز
+
+567
+00:48:04,070 --> 00:48:08,370
+الاقتصادية في التعليم وما يترتب على ذلك من تقييم
+
+568
+00:48:08,370 --> 00:48:14,060
+حجم الإهدار الناتج عن رسوم أو تصادرلأن بصير عنده
+
+569
+00:48:14,060 --> 00:48:17,980
+حفظ يدفع رسوم يدّو وهذا أصبح بالنسبة للمشروع
+
+570
+00:48:17,980 --> 00:48:22,740
+استثماري زي التاجر المفتاح مثلًا supermarket أو
+
+571
+00:48:22,740 --> 00:48:28,260
+مصلحة اقتصادية أو شركة صغيرة أو محل تجارب يحرص إنه
+
+572
+00:48:28,260 --> 00:48:31,560
+ينجح فيه فالطالب اللي يدفع رسوم هذا بالنسبة ليه
+
+573
+00:48:31,560 --> 00:48:36,200
+يعتبر مشروع تعليمي استثماري وبالتالي يحصل متاج
+
+574
+00:48:36,200 --> 00:48:41,440
+أفضل لأنه باستخدام يعني أثنينأجعل الطالب أكثر
+
+575
+00:48:41,440 --> 00:48:44,760
+حرصًا على حسن استخدام المستخدمات التعليمية
+
+576
+00:48:44,760 --> 00:48:53,060
+وبفعالية أعلى يستفيد من كل الأشياء في الجامعة
+
+577
+00:48:53,060 --> 00:48:59,500
+يستفيد من المكتب، يستفيد من المعامل والمختبرات
+
+578
+00:48:59,500 --> 00:49:03,240
+يستفيد من كل شيء ممكن يستفيد منه بدمه ويدفعه بسرعة
+
+579
+00:49:03,240 --> 00:49:07,580
+ثالث، يجعل الطالب أكتر حرصًا على اختيار أفضل نوع
+
+580
+00:49:07,580 --> 00:49:10,780
+التعليمأتفق مع طموحاتهم أو مكانياتهم دم هو بدي
+
+581
+00:49:10,780 --> 00:49:14,880
+يدفع رسوم بختار التخصص المناسب بالنسبيله اللي ممكن
+
+582
+00:49:14,880 --> 00:49:19,460
+هو يلبّوي طموحاتهم أربعة تعتبر عاملها في رفقة
+
+583
+00:49:19,460 --> 00:49:23,000
+نموذج الطالب التعليمية ليحقق الاستفادة قصوة في
+
+584
+00:49:23,000 --> 00:49:26,280
+المعارف في الحياة العملية بقول حريص الطالب أنه
+
+585
+00:49:26,280 --> 00:49:31,740
+يحصل أفضل معدل تراكمي حتى طبعا يتخرج بمعدل عالي
+
+586
+00:49:31,740 --> 00:49:34,640
+يقدر ينافس في السوق في العالم، هذه إيجابيات
+
+587
+00:49:34,640 --> 00:49:40,360
+السلبيات أن التنمو من قبل الأفرادواحد، وضع عقبات
+
+588
+00:49:40,360 --> 00:49:42,140
+مادية أمام الناس لحصول الأفراد على التعليم
+
+589
+00:49:42,140 --> 00:49:44,380
+والاستمرار فيها، خاصة الناس الفقراء، يكون لها
+
+590
+00:49:44,380 --> 00:49:49,140
+عقبات مادية أمام الناس الفقراء، الناس يعني أصحاب
+
+591
+00:49:49,140 --> 00:49:54,200
+الدخول المحدودة. أثنين، تحرم عدد كبير من الفقراء
+
+592
+00:49:54,200 --> 00:49:57,760
+في المجتمع أن يتوفر عليهم كمهات عقلية وجسمية عن
+
+593
+00:49:57,760 --> 00:50:00,480
+التعليم أو الاستمرار فيهم، يكون عنده قدرة عقلية
+
+594
+00:50:00,480 --> 00:50:05,740
+وجسمية ومش قادر يستمر أو يدفع حصوله. ثلاثة، تعيق
+
+595
+00:50:05,740 --> 00:50:10,170
+إمكانية أو فير هو العاملةبالمهارات المطلوبة كمًا
+
+596
+00:50:10,170 --> 00:50:14,030
+ونوعًا، وذلك في عيط المحاصيل النهائية وإمكانية
+
+597
+00:50:14,030 --> 00:50:17,130
+تخطيط النشاط، سواء في مجال التوفيق أو العاملة أو
+
+598
+00:50:17,130 --> 00:50:22,250
+في مجال تخطيط التعليم لنفسه طبعًا، مدام هو يعني
+
+599
+00:50:22,250 --> 00:50:30,390
+بدي يدفع رسوم، مش جاد يدفع رسوم، فمش هيدخل لتخصص
+
+600
+00:50:30,390 --> 00:50:36,360
+المطلوبوبالتالي بتقل المخرجات
+
+601
+00:50:36,360 --> 00:50:39,580
+اللي بتخلّي الناس يطلعوا بالمهارات المطلوبة اللي
+
+602
+00:50:39,580 --> 00:50:46,620
+احنا بدنا يعني وبالتالي بيصير في ناس كتير بيحرموا
+
+603
+00:50:46,620 --> 00:50:50,140
+من التعليم لأنهم مش قادرين إن هم عندهم مهارة
+
+604
+00:50:50,140 --> 00:50:55,800
+وعندهم يعني عقل ذكي جدا لكن مش قادروا يتعلم أو مش
+
+605
+00:50:55,800 --> 00:51:00,060
+قادروا يدفع قصصهم وهذا بعوّق أن وجود كفاءات في
+
+606
+00:51:00,060 --> 00:51:04,480
+المجتمعأربعة، لاتوفر إمكانيات متكافة للمموجة من
+
+607
+00:51:04,480 --> 00:51:11,600
+عقول المعرفة التي احتجها المجتمع طبعاً يعني احنا
+
+608
+00:51:11,600 --> 00:51:17,020
+اتكلمنا عن خمس نقاط في الفصل النقطة السادسة
+
+609
+00:51:17,020 --> 00:51:22,280
+والأخيرة هي تنمو التعليم في فلسطين ان شاء الله سوف
+
+610
+00:51:22,280 --> 00:51:28,290
+نفرض لهاالمحاضرة المصورة قبل تسعة إن شاء الله
+
+611
+00:51:28,290 --> 00:51:31,490
+وتعتبر
+
+612
+00:51:31,490 --> 00:51:36,430
+جزء ثاني من الفصل الرابع اللي هو الفصل التمويل
+
+613
+00:51:36,430 --> 00:51:42,190
+للتعليم أخيرًا أسعدكم الله زردعوا دعاه السلام
+
+614
+00:51:42,190 --> 00:51:46,110
+عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XCUMXSitnus_postprocess.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XCUMXSitnus_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..69bd5c24bfdd8f960e07606364ef18fa8337061b
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XCUMXSitnus_postprocess.srt
@@ -0,0 +1,1728 @@
+1
+00:00:00,770 --> 00:00:03,810
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:03,810 --> 00:00:08,530
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:08,530 --> 00:00:14,910
+وعلى آله وأصحابه والتابعين بإحسان إلى يوم الدين
+
+4
+00:00:14,910 --> 00:00:22,290
+أما بعد طلاب طالبات الأعزاء السلام عليكم ورحمة
+
+5
+00:00:22,290 --> 00:00:28,850
+الله وبركاته بداية أدعو الله سبحانه وتعالى لكم
+
+6
+00:00:28,850 --> 00:00:35,740
+بالصحةوالعافية وأن نبعد الله سبحانه وتعالى عننا
+
+7
+00:00:35,740 --> 00:00:44,660
+وعنكم الوباء والبلاء وكافة الأصقام وكل
+
+8
+00:00:44,660 --> 00:00:51,700
+عام وانتم بألف خير بمناسبة الفصل الدراسي الأول
+
+9
+00:00:51,700 --> 00:01:00,550
+2020-2021 ان شاء الله سبحانه وتعالى سوف نبدأمن
+
+10
+00:01:00,550 --> 00:01:07,290
+اليوم بالمخادرة المصورة رقم واحد لمصافي اقتصاديات
+
+11
+00:01:07,290 --> 00:01:12,990
+التعليم والصحة ان شاء الله في هذه المخادرة سوف
+
+12
+00:01:12,990 --> 00:01:18,830
+نتكلم عن خطة المصاف فسوف نبدأ ان شاء الله بجزء من
+
+13
+00:01:18,830 --> 00:01:23,710
+الفصل الأول على أن نكمل الفصل الأول في مخادرة
+
+14
+00:01:23,710 --> 00:01:30,500
+لاحقة بإذن الله سبحانه وتعالى طبعا احناالخطة
+
+15
+00:01:30,500 --> 00:01:35,400
+الدراسية هتتقسم إن شاء الله سبحانه وتعالى إلى
+
+16
+00:01:35,400 --> 00:01:42,840
+قسمين رئيسيين عند القسم الأول يتعلق باقتصاديات
+
+17
+00:01:42,840 --> 00:01:48,680
+التعليم والقسم الثاني يتعلق
+
+18
+00:01:48,680 --> 00:01:55,400
+باقتصاديات الصحة بالنسبة لاقتصاديات التعليم طبعا
+
+19
+00:01:55,400 --> 00:02:03,780
+الوصف يتناولهذا المصاد بالوصف والتحليل في المفاهيم
+
+20
+00:02:03,780 --> 00:02:09,180
+والأسس النظرية اقتصاديات التعليم وكذلك الاقتصاديات
+
+21
+00:02:09,180 --> 00:02:14,380
+الصحة وتطبيقاتهم المختلفة فيما يتعلق اقتصادية
+
+22
+00:02:14,380 --> 00:02:20,740
+التعليم سوف يتم الحديث عن التعريف والأهمية
+
+23
+00:02:20,740 --> 00:02:25,700
+والخصائص والمجالات ودور التعليم في عملية التنمية
+
+24
+00:02:25,700 --> 00:02:30,160
+الاقتصاديةوالعلاقة بين التعليم والكسب وسوق العمل
+
+25
+00:02:30,160 --> 00:02:35,020
+وتكاليف التعليم والعائد من التعليم وتمويل التعليم
+
+26
+00:02:35,020 --> 00:02:39,580
+والعلاقة بين التقنية والتعليم وبعض قضايا اقتصادية
+
+27
+00:02:39,580 --> 00:02:45,380
+التعليم وتطبيقاتها في فلسطين أما اقتصادية الصحة
+
+28
+00:02:45,380 --> 00:02:51,100
+فيبحث إن شاء الله هذا المصاد في كيفية تطبيق أدوات
+
+29
+00:02:51,100 --> 00:02:55,020
+علم الاقتصاد على قضايا الرعاية الصحيةوتوضيح
+
+30
+00:02:55,020 --> 00:02:59,640
+جوانبها بحيث تصبح أكثر قابلية للتحليل أشياء تم
+
+31
+00:02:59,640 --> 00:03:03,440
+تناول سوق خدمات الرعاية الصحية الطلب والعرض
+
+32
+00:03:03,440 --> 00:03:09,360
+والتوازن والتدخل الحكومي في سوق الخدمات الصحية لأن
+
+33
+00:03:09,360 --> 00:03:14,720
+إعلاج الحكومة طبعاً لها دور مهم في الرعاية الصحية
+
+34
+00:03:14,720 --> 00:03:19,300
+كذلك الإنتاج والتكاليففي سوق الخدمات الصحية
+
+35
+00:03:19,300 --> 00:03:23,880
+ومعايير التقييم المالي والاقتصادي لسوق الخدمات
+
+36
+00:03:23,880 --> 00:03:29,140
+الصحية والقوة العاملة الصحية وأثر اقتصاديات
+
+37
+00:03:29,140 --> 00:03:33,360
+الخدمات الصحية على التنمية والحالة الصحية في الدول
+
+38
+00:03:33,360 --> 00:03:41,360
+العربية وفي فلسطينطبعا المساقطة يعني حوالي عشر
+
+39
+00:03:41,360 --> 00:03:45,740
+فصول تقريبا الفصول الأربع الأولى هي في اقتصادية
+
+40
+00:03:45,740 --> 00:03:49,960
+التعليم وفاق الفصول من الفصل الخامسة لفصل عشر فيه
+
+41
+00:03:49,960 --> 00:03:54,660
+اقتصاديات الفصل الأول اقتصادية التعليم التعريف
+
+42
+00:03:54,660 --> 00:03:58,980
+والاهامية الخصائص والمجالات الفصل الثاني العقد
+
+43
+00:03:58,980 --> 00:04:04,380
+للتعليم الفصل الثالث تكاليف التعليم الفصل الرابع
+
+44
+00:04:04,380 --> 00:04:08,530
+تمويل التعليمالفصل الخامس هنبدأ فيه طبعا من الفصل
+
+45
+00:04:08,530 --> 00:04:12,790
+الخامس كما قلنا باقتصادية الصحة الفصل الخامس مدخل
+
+46
+00:04:12,790 --> 00:04:18,210
+الاقتصاد الصحي الفصل السادس الصحة والحياة من وجه
+
+47
+00:04:18,210 --> 00:04:23,650
+تضارب اقتصادية الفصل السابع مواضيع ومفاهيم متنوعة
+
+48
+00:04:23,650 --> 00:04:29,490
+في اقتصاديات الصحة الفصل الثامن السلع الصحية ففشل
+
+49
+00:04:29,490 --> 00:04:34,580
+السوق العدالة وعقود التأمينالفصل التاسع معايير
+
+50
+00:04:34,580 --> 00:04:38,200
+التحليل المالي والاقتصادي في سوق الخدمات الصحية
+
+51
+00:04:38,200 --> 00:04:43,700
+والفصل عشر أثر أسهمات الصحية على التنمية إن شاء
+
+52
+00:04:43,700 --> 00:04:48,580
+الله نستطيع أن نغطي هذه حصول العشرة بإذن الله
+
+53
+00:04:48,580 --> 00:04:55,900
+سبحانه وتعالى المجال
+
+54
+00:04:55,900 --> 00:05:00,240
+التعليم المقصودة إيش احنا متوقع نحصل إن شاء الله
+
+55
+00:05:00,850 --> 00:05:06,790
+إيش ال output اللي هنحصلها بعد دراسة هذا المصدر
+
+56
+00:05:06,790 --> 00:05:11,170
+أول حاجة التعرف على طبيعة علم الاقتصاد والتعليم
+
+57
+00:05:11,170 --> 00:05:16,690
+وعلم اقتصادية الصحة ومجالات البحث لكل منهم خاصة أن
+
+58
+00:05:16,690 --> 00:05:20,870
+هذا المجال يعني هو مجال حديث عن اقتصاد التعليم
+
+59
+00:05:20,870 --> 00:05:24,810
+واقتصاد الصحة مجالات حديثة من مجالات الاقتصاد
+
+60
+00:05:24,810 --> 00:05:30,750
+اثنينالمحدد للطالب إمكانيات الاستفادة من اقتصاديات
+
+61
+00:05:30,750 --> 00:05:34,310
+التعليم واقتصاد الصحة في البلاد العربية بشكل عام
+
+62
+00:05:34,310 --> 00:05:38,670
+أو في فلسطين بشكل خاص، إيش احنا ممكن نستفيد في
+
+63
+00:05:38,670 --> 00:05:44,190
+فلسطين من هذه الاقتصاديات؟ تلاتة، إدراك الطالب دور
+
+64
+00:05:44,190 --> 00:05:46,610
+التعليم والرعاية الصحية في عملية التنمية
+
+65
+00:05:46,610 --> 00:05:51,890
+الاقتصادية وها طبعا أمر مهم جدا جدا جدالأن العقل
+
+66
+00:05:51,890 --> 00:05:57,630
+السليم في الجسم السليم وبالتالي كل ما كان عندنا
+
+67
+00:05:57,630 --> 00:06:02,810
+صحة أفضل كل ما كان هناك تنمية اقتصادية أفضل لأن في
+
+68
+00:06:02,810 --> 00:06:07,330
+مجال الإنسان فيه فرص العمل بشكل أفضل وكل ما كنا
+
+69
+00:06:07,330 --> 00:06:12,770
+متعلمين أكتر كل ما كنا نقدر نأثر في موضوع التنمية
+
+70
+00:06:12,770 --> 00:06:18,150
+على الأقل الإنسان بس يكون متعلمبكون لنفسه الحياة
+
+71
+00:06:18,150 --> 00:06:22,930
+الخاصة وبس يكون جسمه سليم يستطيع أن ينتج أكثر
+
+72
+00:06:22,930 --> 00:06:29,050
+ويبدع أكثر ويحقق تنمية اقتصادية أكثر تنمية خاصة به
+
+73
+00:06:29,050 --> 00:06:36,690
+وبأسرته وبعائلته ومن ثم بالمدينة اللي هو بتبع
+
+74
+00:06:36,690 --> 00:06:40,650
+إليها ثم الدولة اللي هو انتمي إليها
+
+75
+00:06:44,730 --> 00:06:48,310
+تمامًا من الأشياء الـ Output اللي بنحصلها إكساب
+
+76
+00:06:48,310 --> 00:06:51,850
+الطالب مفاهيم تجربة التعليم والعائد من التعليم
+
+77
+00:06:51,850 --> 00:06:57,210
+وتوميل التعليم خمسة إدراك الطالب كيفية تطبيق أدوات
+
+78
+00:06:57,210 --> 00:07:01,830
+علم الاقتصاد على قضايا الرعاية الصحية لأن هذه مادة
+
+79
+00:07:01,830 --> 00:07:09,330
+ممتعة ومادة جميلة ومادة تطبيقية يعني كل طالب إن
+
+80
+00:07:09,330 --> 00:07:13,510
+شاء الله وطالبة سوف يستفيد بكثرة كبيرةمن هذه
+
+81
+00:07:13,510 --> 00:07:17,530
+المادة وسوف يتم عرضها إن شاء الله بأسلوب سهل
+
+82
+00:07:17,530 --> 00:07:23,270
+وبأسلوب بسيط لأن أحنا في النهاية هدفنا أن نفهم مش
+
+83
+00:07:23,270 --> 00:07:27,610
+هدفنا أن نعقد الأمور إن شاء الله سبحانه وتعالى ست
+
+84
+00:07:27,610 --> 00:07:31,690
+تعرف الطالب على سوق الخدمات الصحية ودور الحكومة في
+
+85
+00:07:31,690 --> 00:07:35,430
+هذا المجلد نحن بنلاحظ اليوم مثلا في ظل أزمة Corona
+
+86
+00:07:35,430 --> 00:07:41,050
+اللي بنعاني منها في قطاع غزة بنلاحظ أن الحكومة
+
+87
+00:07:41,050 --> 00:07:47,390
+حقيقة يعنيلها دور فعال في هذا المجال وبالتالي، إن
+
+88
+00:07:47,390 --> 00:07:52,030
+شاء الله، نحن سنستعرض في هذا المسار دور حكومة ليس
+
+89
+00:07:52,030 --> 00:07:57,830
+في موضوع كورونا فقط بل في كل الأمور الصحية
+
+90
+00:07:57,830 --> 00:08:04,550
+المرتبطة بالأفراد وبالمجتمع كمان
+
+91
+00:08:04,550 --> 00:08:08,550
+من المخرجات المهمة جدا، والتي إن شاء الله هتنوّلها
+
+92
+00:08:08,550 --> 00:08:12,160
+في التطبيقربط ما يدرسه الطالب بواقع النظام
+
+93
+00:08:12,160 --> 00:08:15,860
+التعليمي والصحي الفلسطيني بهمن أعرف الواقع اللي
+
+94
+00:08:15,860 --> 00:08:21,280
+أنا بعيش فيه وأنا بستطيع أنه يعني مؤثر فيه وهو
+
+95
+00:08:21,280 --> 00:08:26,440
+يؤثر في أيضا من خلال تناول بعض الموضوعات التي
+
+96
+00:08:26,440 --> 00:08:30,040
+يعاني منها النظام التعليمي والصحي الفلسطيني مثلًا
+
+97
+00:08:30,040 --> 00:08:34,580
+في كثير من المشاكل اللي احنا بنعاني منها زهجة
+
+98
+00:08:34,580 --> 00:08:39,470
+العقول، بطالة السريجين، بنعاني من بطالبكبيرة جداً
+
+99
+00:08:39,470 --> 00:08:44,010
+في الخرجين، شو أسبابها، شو مشاكلها، كيف الحلول
+
+100
+00:08:44,010 --> 00:08:48,850
+إلها، خدمات الصحية والتعليمية وعلاقتها بالتنمية،
+
+101
+00:08:48,850 --> 00:08:52,970
+الكفاءة الإنتاجية لخدمات الصحية والتعليمية،
+
+102
+00:08:52,970 --> 00:08:56,550
+الجامعة المنتجة، وتأثيراتها الاقتصادية وكيفية حد
+
+103
+00:08:56,550 --> 00:09:02,030
+منها، وإن شاء الله، يعني هنكلف كل طالب وكل طالبة
+
+104
+00:09:02,030 --> 00:09:08,880
+بإعداد تقرير، بس هو يتعلق التقرير بموضوع التعليمأو
+
+105
+00:09:08,880 --> 00:09:15,200
+بموضوع الصحة وإن شاء الله بعد قليل أعطيك بعض
+
+106
+00:09:15,200 --> 00:09:18,760
+العنوين المهمة اللي احنا ممكن نفكر فيها هذا راح
+
+107
+00:09:18,760 --> 00:09:21,720
+يكون عالي 10 درجات يعني مثلا ممكن نتكلم عن هجرة
+
+108
+00:09:21,720 --> 00:09:25,840
+العقول نتكلم عن مطالب الخرجين عن الخدمات الصحية
+
+109
+00:09:25,840 --> 00:09:28,920
+والتعليمية وعلاقاتها بالتنمية في موضوع كتير إن شاء
+
+110
+00:09:28,920 --> 00:09:35,220
+الله بعد قلي سوف أستعرضها إن شاء الله لكم في انا
+
+111
+00:09:35,220 --> 00:09:41,470
+كتير مراجع هذا مراجع طبعاموجودة في مكتبة الجامعة
+
+112
+00:09:41,470 --> 00:09:46,250
+وموجودة على بواقع الانترنت يعني في مثلا مكتب
+
+113
+00:09:46,250 --> 00:09:50,310
+اقتصادية التعليم لفاروق عبد الفلاء في اقتصادية
+
+114
+00:09:50,310 --> 00:09:54,350
+الصحة لمهند أحمد علوش في اقتصادية التعليم لعبدالله
+
+115
+00:09:54,350 --> 00:09:59,650
+الرشدان اقتصادية الجودة والتعليمية لمجدي المهدي في
+
+116
+00:09:59,650 --> 00:10:03,050
+محاضرات في اقتصادية التعليم ويطور ماجستير الدكتور
+
+117
+00:10:03,050 --> 00:10:09,150
+عليان الحوليفي اقتصاد التعليم للوديع أدنان اقتصاد
+
+118
+00:10:09,150 --> 00:10:16,690
+الصحي لعوض إبراهيم وطبعاً في اقتصاد خدمات العيال
+
+119
+00:10:16,690 --> 00:10:22,010
+الصحية في دول النمية وأسرار التنمية للفاتر محمد
+
+120
+00:10:22,010 --> 00:10:25,630
+عثمان مختار ودور الاقتصاد في خدمات العيال الصحية
+
+121
+00:10:25,630 --> 00:10:31,150
+لمحمد حامد عبدالله يعني هذه كلها طبعاً يعني مراجع
+
+122
+00:10:31,150 --> 00:10:35,990
+احنا أشهر ما مطلوب منها المراجع اللي ذكرناهاقبل
+
+123
+00:10:35,990 --> 00:10:39,270
+قليل المخاضرات .. نحن أتمنى إن شاء الله في
+
+124
+00:10:39,270 --> 00:10:45,890
+المخاضرات عليها الـ slides بشكل كبير وعلى
+
+125
+00:10:45,890 --> 00:10:49,030
+المخاضرات المصورة إن شاء الله حتى إفتاح الجامعة
+
+126
+00:10:49,030 --> 00:10:53,190
+وعودتنا إلى مقاعد الدراسة سوف نبدأ من حيث أنتهينا
+
+127
+00:10:53,190 --> 00:11:00,070
+في مخاضرات الجامعة وطبعاً عندنا أحنا ال slides
+
+128
+00:11:00,070 --> 00:11:04,870
+كلها موجودةعلى الـ Model المنصة الأساسية والرئيسية
+
+129
+00:11:04,870 --> 00:11:09,830
+لمتابعتنا هي الـ Model ممكن فيه طبعا استفسارات من
+
+130
+00:11:09,830 --> 00:11:13,650
+خلال مجموعة الـ WhatsApp اللي احنا كونناها وحصل
+
+131
+00:11:13,650 --> 00:11:17,050
+التواصل أيضا من خلالها إن شاء الله لكن التواصل
+
+132
+00:11:17,050 --> 00:11:21,510
+الرسمي والأساسي هو من خلال الـ Model طبعا
+
+133
+00:11:21,510 --> 00:11:25,330
+الامتحانات يعني احنا في حالة العودة إلى الجامعة
+
+134
+00:11:25,330 --> 00:11:30,530
+حستين سياخدون محاضرات ومشارك على عشر درجات امتحان
+
+135
+00:11:30,530 --> 00:11:35,030
+عامة بفصل عليهاالـ 32 درجة حيكون عندنا بحث إجرائي
+
+136
+00:11:35,030 --> 00:11:42,110
+تطبيقي حول تطبيق
+
+137
+00:11:42,110 --> 00:11:44,830
+أقصاد التعليم وأقصاد الصحة في واقعة فلسطين مثلا
+
+138
+00:11:44,830 --> 00:11:48,750
+دراسة حالة عملية مثلا دراسة حالة مستشفى أو جامعة
+
+139
+00:11:48,750 --> 00:11:52,330
+أو مدرسة طبعا إحنا موجود عندنا على الـ model يعني
+
+140
+00:11:52,330 --> 00:12:01,410
+حقيقة موجود تقرير بوضح العنوين اللي إحناممكن نتحدث
+
+141
+00:12:01,410 --> 00:12:09,530
+فيها في هذا التقرير أو هذا البحث الإجرائي من بين
+
+142
+00:12:09,530 --> 00:12:16,050
+هذه العنوين طبعاً لو احنا لاحظنا يعني هذه العنوين
+
+143
+00:12:16,050 --> 00:12:21,050
+اللي احنا عندنا هذه بعض العنوين اللي احنا ممكن
+
+144
+00:12:21,050 --> 00:12:26,290
+نكتب فيها وهذه القائمة بالعنوين كلها موجودة على ال
+
+145
+00:12:26,290 --> 00:12:31,560
+model وبالتالي ممكن الطالبكل طالب يختار عنوان من
+
+146
+00:12:31,560 --> 00:12:34,880
+هذه العنوان يعني أنا على سبيل المثال أقرأ بعض
+
+147
+00:12:34,880 --> 00:12:39,780
+العنوان «هجرة العقول» و «أفاق أفاق و حلول» هذا
+
+148
+00:12:39,780 --> 00:12:44,360
+يعني التقرير، إحنا نتكلم عن تقرير وليس عن بحث
+
+149
+00:12:44,360 --> 00:12:49,520
+التقرير يكون طبعاً سهل وبسيط، في حدود مثلا عشر
+
+150
+00:12:49,520 --> 00:12:53,080
+صفحات ممكن نكتبه وطبعاً تبعتولنا إياه من خلال
+
+151
+00:12:53,080 --> 00:12:57,130
+الـModel وانا خلاص الله أعملأيقونة عندنا على الـ
+
+152
+00:12:57,130 --> 00:13:00,570
+Model الممكن أن نسلم التقارير من خلالها مثلًا،
+
+153
+00:13:00,570 --> 00:13:04,530
+نجلة العقول وأفاق وحلول قطارات الخريجين وأفاق
+
+154
+00:13:04,530 --> 00:13:09,670
+وحلول التعليم التقني رؤية مستقبلية التعليم المهني
+
+155
+00:13:09,670 --> 00:13:14,130
+رؤية مستقبلية الكفاءة الإنتاجية في التعليم التعليم
+
+156
+00:13:14,130 --> 00:13:18,310
+والتنمية البشرية التعليم وسوق العمل قطاع التعليم
+
+157
+00:13:18,310 --> 00:13:21,670
+في فلسطين ودوره في التنمية الاقتصادية كيفية وضع
+
+158
+00:13:21,670 --> 00:13:26,560
+خطط استراتيجية لمؤسسة تعليميةجامعة أو مدرسة وفق
+
+159
+00:13:26,560 --> 00:13:32,420
+الموضوع اقتصادية علم اقتصادية التعليم عشر حال
+
+160
+00:13:32,420 --> 00:13:36,000
+عملية عن مفاهيم ونظريات علم اقتصادية التعليم
+
+161
+00:13:36,000 --> 00:13:41,100
+وأسلوبه في المدرسة مصادر التوميم للمدرسة، عدد
+
+162
+00:13:41,100 --> 00:13:44,760
+مزاية المدرسة، تكلفة التعليم في المدرسة، عدد
+
+163
+00:13:44,760 --> 00:13:48,380
+التعليم في المدرسة، الكفاية الإنتاجية في المدرسة
+
+164
+00:13:48,730 --> 00:13:52,650
+رقم 11 القطاع الصحي في فلسطين ودوره في التنمية
+
+165
+00:13:52,650 --> 00:13:57,650
+الاقتصادية 12 المؤسسات الصحية في فلسطين زي مثلًا
+
+166
+00:13:57,650 --> 00:14:00,930
+نسبة الانفاق الصحي على من أجمع الانفاق العام عدد
+
+167
+00:14:00,930 --> 00:14:04,290
+المستشفيات عدد العيادات عدد إعادات خصوصية أو
+
+168
+00:14:04,290 --> 00:14:08,210
+عيادات حكومية أو خصوصية عدد السرة في المستشفيات
+
+169
+00:14:08,210 --> 00:14:13,670
+لكل مريض إلى آخرهم هذه يعني عنوين مهمة ممكن نختار
+
+170
+00:14:13,670 --> 00:14:18,060
+كل واحد منها 13 الحالة الصحية في فلسطينمقرر مع بعض
+
+171
+00:14:18,060 --> 00:14:21,700
+الدول العربية من حيث العمل المتوقع للحياة، معدلات
+
+172
+00:14:21,700 --> 00:14:25,580
+توفيات الأطفال دولة سن الخامسة، معدلات توفيات
+
+173
+00:14:25,580 --> 00:14:29,860
+الأطفال الرُدع، 14 اختلافات بين أسواق التنافسية
+
+174
+00:14:29,860 --> 00:14:33,500
+النموطية وسوق الرعاية الصحية، بس الفرق بين سوق
+
+175
+00:14:33,500 --> 00:14:38,100
+الرعاية الصحية والأسواق الأخرى، زي سوق البنزين، زي
+
+176
+00:14:38,100 --> 00:14:41,600
+سوق الملابس، زي سوق المواد الغذائية، شو الفرق؟ فيه
+
+177
+00:14:41,600 --> 00:14:46,730
+فرق جوهرية، يعني هذا بحث ممكن نعمل أو تقريرخمسة
+
+178
+00:14:46,730 --> 00:14:50,210
+عشر جودة الخدمات الصحية في مستوى القطاع الغزة ممكن
+
+179
+00:14:50,210 --> 00:14:54,110
+أن يكون حالة عاملية من الشفاء مثلا ستة على سوق
+
+180
+00:14:54,110 --> 00:14:59,150
+السيدلة في فلسطين في القطاع الغزة مشاكل وحلول
+
+181
+00:14:59,150 --> 00:15:02,050
+سبعتاشر دورة الاقتصاد في خدمات العيار الصحية
+
+182
+00:15:02,050 --> 00:15:07,330
+تمانتاشر العيادات الخصية في القطاع الغزة وآثار
+
+183
+00:15:07,330 --> 00:15:10,430
+اقتصادية مختلفة لها تسعتاشر دفع الحكومة في سوق
+
+184
+00:15:10,430 --> 00:15:15,940
+الخدمات الصحية في كمصر هي طبعا مواضيعطبعاً كل طالب
+
+185
+00:15:15,940 --> 00:15:19,400
+بيكتفي الموضوع ممنوع تكرار الموضوع يعني أنا بطلب
+
+186
+00:15:19,400 --> 00:15:22,980
+من كل طالب بعد مشهور المحاضرة هذه يبعثلي على
+
+187
+00:15:22,980 --> 00:15:27,820
+الواتس إيش هو الموضوع اللي هو بده يختاروك ويبعثلي
+
+188
+00:15:27,820 --> 00:15:30,780
+كمان على ال model إذا أراد إيش هو الموضوع طبعاً
+
+189
+00:15:30,780 --> 00:15:36,280
+إختيار طالب لموضوع مابنفعش طالب ثاني يختاره يعني
+
+190
+00:15:36,280 --> 00:15:40,720
+الأولوية الإختيار لطالب أو طالبة اللي بيختار
+
+191
+00:15:40,720 --> 00:15:46,100
+الموضوع يبعثلي في الموضوع اللي هوطبعا الموضوع اللي
+
+192
+00:15:46,100 --> 00:15:50,620
+بيختاره هو بندونه عندنا ممنوع يختاره كما قلنا واحد
+
+193
+00:15:50,620 --> 00:15:55,380
+تاني كمان يعني ممنوع كمان يشتركوا في موضوع واحد
+
+194
+00:15:55,380 --> 00:15:59,740
+المطلوب كل طالب أو كل طالبة يختار الموضوع اللي
+
+195
+00:15:59,740 --> 00:16:05,300
+نفسه الموضوع هذا يعني من حدود عشر صفحات تقريبا على
+
+196
+00:16:05,300 --> 00:16:09,420
+ال word ممكن تبعتولنا إياهأو إذا حبيتوا تحولوه إلى
+
+197
+00:16:09,420 --> 00:16:13,440
+bar point مافي عندى ان شاء الله أي مشكلة هذا حيكون
+
+198
+00:16:13,440 --> 00:16:19,480
+عليه عشر درجات وحيكون على امتحان النصفي تلاتين
+
+199
+00:16:19,480 --> 00:16:23,560
+درجة احنا ممكن الامتحان النصفي نقسمه لثلاث أجزاء
+
+200
+00:16:23,560 --> 00:16:27,420
+يعني كل جزء عليه عشر درجات عشر درجات عشر درجات
+
+201
+00:16:27,420 --> 00:16:32,030
+عبارة عن كمزات وطبعا هذا يعني حسب الوضعاللي ممكن
+
+202
+00:16:32,030 --> 00:16:35,530
+نصير في البلد إذا والله رجعنا إلى الجامعة وإن شاء
+
+203
+00:16:35,530 --> 00:16:40,150
+الله نرجعلها قريبًا هيكون فيها نمتحان نصفي في
+
+204
+00:16:40,150 --> 00:16:44,190
+اقتصادية التعليم إذا ما رجعلناش للجامعة لسبح الله
+
+205
+00:16:44,190 --> 00:16:47,990
+وظل الوضع يعني عبارة عن التعليم على البعد هنعتمد
+
+206
+00:16:47,990 --> 00:16:52,190
+على الكوزيات تالتة كوزيات إن شاء الله في اللي هو
+
+207
+00:16:52,190 --> 00:16:56,710
+اقتصاديات التعليم وبعد ذلك إن شاء الله بنطلق
+
+208
+00:16:56,710 --> 00:17:01,270
+لاقتصاديات الصحة ويعني هنتابع إن شاء الله مع بعضنا
+
+209
+00:17:01,590 --> 00:17:06,610
+البعض هذا الأمر إن شاء الله سبحانه وتعالى خلّيني
+
+210
+00:17:06,610 --> 00:17:14,070
+أنا يعني أبدأ معاكم قليلاً في الفصل الأول من طبعاً
+
+211
+00:17:14,070 --> 00:17:19,270
+المادة هو مكان طول كثير إن شاء الله عليكم طبعاً
+
+212
+00:17:19,270 --> 00:17:25,230
+الفصل الأول بتكلم عن اقتصاديات التعليم التعريف
+
+213
+00:17:25,230 --> 00:17:29,550
+والأهمية والخصائص والمجالات هنتكلم إن شاء الله في
+
+214
+00:17:29,550 --> 00:17:35,200
+الفصل هذافي البداية عن المقدمة ثم تعريف علم
+
+215
+00:17:35,200 --> 00:17:38,720
+اقتصادية التعليم وعلم اقتصاديات التعليم الأهمية
+
+216
+00:17:38,720 --> 00:17:43,440
+المبررات مجالات علم اقتصادية التعليم العامة وفي
+
+217
+00:17:43,440 --> 00:17:47,480
+المدرسة الخصائص العامة للدراسات الاقتصادية في
+
+218
+00:17:47,480 --> 00:17:50,860
+التعليم عبر طورها التاريخي اقتصادية التعليم في
+
+219
+00:17:50,860 --> 00:17:54,540
+الفكر الإنسان هي تقريبًا العناوين الأساسية اللي
+
+220
+00:17:54,540 --> 00:17:59,420
+أحنا نتكلم فيها في هذا الفصل لا شك أنه يعني في
+
+221
+00:17:59,980 --> 00:18:06,100
+علاقة وقيدة وعلاقة قوية بين التعليم والاقتصاد
+
+222
+00:18:06,100 --> 00:18:12,240
+فالإنسان المتعلم هو إنسان اقتصادي الإنسان المتعلم
+
+223
+00:18:12,240 --> 00:18:17,760
+هو إنسان منتج لا شك التعليم يسف في التلميح الإنسان
+
+224
+00:18:17,760 --> 00:18:27,300
+بس اتعلم تكبر معارفه يكبر فهمه تكبر الآفاق بالنسبة
+
+225
+00:18:27,300 --> 00:18:32,070
+لهالعنصر البشري مهم في التنمية يعني الاقتصاديين
+
+226
+00:18:32,070 --> 00:18:36,990
+قالوا إن الذي يسهم في التنمية رأس المال البشري
+
+227
+00:18:36,990 --> 00:18:42,670
+ويساهم في التنمية حوالي 70% من عملي التنمية ترجع
+
+228
+00:18:42,670 --> 00:18:48,470
+إلى العنصر البشري و 30% إلى رأس المال المادي لذلك
+
+229
+00:18:48,470 --> 00:18:52,190
+العنصر البشري المتعلم هو القاضي على التنمية دولة
+
+230
+00:18:52,190 --> 00:18:57,340
+زي ماليزيا كانت دولة فقيرة جداًعندما توفرت الإرادة
+
+231
+00:18:57,340 --> 00:19:02,100
+البشرية وتوفر العنصر البشري المتعلم والمتدرب
+
+232
+00:19:02,100 --> 00:19:07,900
+والمثقف والواعي صار في تنمية اقتصادية لذلك موضوع
+
+233
+00:19:07,900 --> 00:19:13,700
+التنمية هذا موضوع مهم جدا التعليم يرفع الإنتاجية
+
+234
+00:19:13,700 --> 00:19:17,620
+والاستثمار يحسن نوعية الحياة شعر في التغيير
+
+235
+00:19:17,620 --> 00:19:21,670
+التكنولوجييحسن توزيع الدخل وتكافؤ الفرص يسهم
+
+236
+00:19:21,670 --> 00:19:24,750
+بالتأثير في المهارات الإدراكية والطبوح الشخصي
+
+237
+00:19:24,750 --> 00:19:30,610
+والتنافس والإبداع والصحة لذلك كل مكان فيه تعليم
+
+238
+00:19:30,610 --> 00:19:37,290
+أفضل لاهتمام بنوعية التعليم، هذا مهم جدا التعليم
+
+239
+00:19:37,290 --> 00:19:41,630
+اللي احنا بنعلمه، هل هو تعليم مهني؟ هل هو تعليم
+
+240
+00:19:41,630 --> 00:19:48,080
+أكاديمي؟ هل هو تعليم يتعلق بالـبالصناعة؟ هل هو
+
+241
+00:19:48,080 --> 00:19:52,080
+تعليم متعلق بالتجارة؟ هل هو تعليم متعلق بالصحة؟ هل
+
+242
+00:19:52,080 --> 00:19:57,120
+هو تعليم متعلق بالأمور التقنية والفنية؟ هل هو
+
+243
+00:19:57,120 --> 00:20:01,200
+تعليم متعلق بالخدمة للاتصالات؟ التعليم أنواع
+
+244
+00:20:01,200 --> 00:20:06,180
+متعددة، لكن الشيء المهم جداً أن الإنسان المتعلم
+
+245
+00:20:06,180 --> 00:20:10,800
+يساهم في التنمية بشكل كبير والتعليم محتاج إلى
+
+246
+00:20:10,800 --> 00:20:13,980
+تدريب، أنا بدأ أتعلم، بدأ أتدرب، عشان الطالب
+
+247
+00:20:13,980 --> 00:20:19,220
+الأكاديمي في الجامعةمطلوب منه يتعلم ويأخذ دورات
+
+248
+00:20:19,220 --> 00:20:23,020
+تدريبية حتى إن شاء الله عندما يتخرج من الجامعة
+
+249
+00:20:23,020 --> 00:20:28,300
+يكون عنده قدرة على الإبداع بشكل أفضل وبشكل أحسن
+
+250
+00:20:28,300 --> 00:20:32,540
+طبعاً هذه المادة يعني المخاطرات في اقتصاد التعليم
+
+251
+00:20:32,540 --> 00:20:38,760
+مهمة لطلاب قسم الاقتصاد بشكل كبير جداً هنتكلم عن
+
+252
+00:20:38,760 --> 00:20:43,020
+عالم اقتصادية التعليم تعريفه، أهميته، مبرراته،
+
+253
+00:20:43,020 --> 00:20:46,970
+مجالاتهالخصاص العامة لدراسات الاقتصادية للتعليم
+
+254
+00:20:46,970 --> 00:20:50,550
+مكان تعلّم اقتصادية التعليم في الفكر الإنساني
+
+255
+00:20:50,550 --> 00:20:53,970
+والصلاحات والمفاهيم متعلقة بيه؟ في مجتمع التعليم
+
+256
+00:20:53,970 --> 00:20:58,270
+والتنمية؟ ماهية التنمية؟ إيش دور التعليم في النمو؟
+
+257
+00:20:58,270 --> 00:21:01,670
+الأهمية الاقتصادية والاجتماعية للتعليم؟ التعليم
+
+258
+00:21:01,670 --> 00:21:05,650
+ومسوق العمل؟ التنمية في فلسطين؟ درجات التنمية؟ دور
+
+259
+00:21:05,650 --> 00:21:09,420
+التعليم في تعزيز ثقافة المجتمع؟هتكلم عن عائد
+
+260
+00:21:09,420 --> 00:21:12,520
+الاقتصادي في التعليم، شوه مفهومه، شوه النظر
+
+261
+00:21:12,520 --> 00:21:16,540
+التحليلي للتعليم، منهجية تقدير العائد الاقتصادي في
+
+262
+00:21:16,540 --> 00:21:20,940
+التعليم، طرق قياس كيفية الاستفادة منه في فلسطين
+
+263
+00:21:20,940 --> 00:21:26,880
+هتكلم عن تكلفة التعليم، تعريف تكلفة التعليم، أسباب
+
+264
+00:21:26,880 --> 00:21:30,020
+ارتفاع تكلفة التعليم، أهداف دراسة تكلفة التعليم
+
+265
+00:21:30,020 --> 00:21:34,220
+وطرق قياسها، سبب تقفية تكلفة التعليمتمول التعليم
+
+266
+00:21:34,220 --> 00:21:38,900
+مفهوم تمول التعليم ومصادره واتجاهاته تجارب في
+
+267
+00:21:38,900 --> 00:21:42,320
+مجالات تمول التعليم وتمول التعليم العالي في
+
+268
+00:21:42,320 --> 00:21:45,660
+الدراسة هذه كلها إن شاء الله الأشياء اللي هنتكلم
+
+269
+00:21:45,660 --> 00:21:54,460
+عنها طبعا كما قلنا طلاب هيتدموا تقاريرفي موضوعات
+
+270
+00:21:54,460 --> 00:22:00,620
+كثيرة ومتنوعة كما سبق أن نتحدثنا قبل قليل زي مثلا،
+
+271
+00:22:00,620 --> 00:22:03,980
+أي عندنا التعليم والصحة، تغيير التعليم، تنمول
+
+272
+00:22:03,980 --> 00:22:08,060
+التعليم، هجرة العقول، بطاقة الخريجين، جامعة
+
+273
+00:22:08,060 --> 00:22:12,680
+المنتجة، اتكلمنا عن تقريبا 19 نقطة، نرجع إن شاء
+
+274
+00:22:12,680 --> 00:22:16,980
+الله التقرير اللي عرضناه في القطة، في المقدمة،
+
+275
+00:22:16,980 --> 00:22:22,300
+وممكن نكتب إن شاء الله في هذاالمجال طبعًا إصلاح
+
+276
+00:22:22,300 --> 00:22:25,880
+التعليم مشكلة صعبة لكنها ليست مستحيلة الدول
+
+277
+00:22:25,880 --> 00:22:31,400
+النامية بتعاني من مشكلة في التعليم سواء في تقدس
+
+278
+00:22:31,400 --> 00:22:37,560
+عدد الصفوف في عدم الكفاءة العالية للمعلمين هناك
+
+279
+00:22:37,560 --> 00:22:43,000
+معايير كثيرة طبعًا الدول وضعتها وخاصة في القرن
+
+280
+00:22:43,000 --> 00:22:46,500
+الواحد والعشرين زي معايير الجودة التغيرات
+
+281
+00:22:46,500 --> 00:22:50,820
+والتطورات التكنولوجيا المتسارعةمطلبات الحياة وسوق
+
+282
+00:22:50,820 --> 00:22:54,700
+العمل، انفتاح ومواجهة الغلاق الفكري، العوالم
+
+283
+00:22:54,700 --> 00:22:58,420
+الثقافية المسائلة والشفافية، هذه كلها الأشياء
+
+284
+00:22:58,420 --> 00:23:02,500
+طبعاً بحاجة لا وضع قطط ولا وضع استراتيجيات من
+
+285
+00:23:02,500 --> 00:23:05,580
+الجهات المسؤولة، والحكومة طبعاً وزارة التربية
+
+286
+00:23:05,580 --> 00:23:11,020
+والتعليم لها دور مهم في هذا المجال، أساتذ الجامعات
+
+287
+00:23:11,020 --> 00:23:16,510
+لهم دور مهم في هذا المجال، القطاع الخاص أيضاًيعني
+
+288
+00:23:16,510 --> 00:23:19,630
+له دور مهم في هذا المجال موضوع أصلحة التعليم هو
+
+289
+00:23:19,630 --> 00:23:27,510
+مهمة يعني شاملة مهمة يجب أن يتعاون فيها الجميع
+
+290
+00:23:27,510 --> 00:23:32,570
+الأسرة، الأب والأم في البيت يجب أن يتعاون المدرسة
+
+291
+00:23:32,570 --> 00:23:36,270
+يجب أن تتعاون المجتمع يجب أن يتعاون الجامعة وأساتذ
+
+292
+00:23:36,270 --> 00:23:38,270
+الجامعات يجب أن يتعاونوا كما وزارة التربية
+
+293
+00:23:38,270 --> 00:23:44,350
+والتعليم يجب أن تتعاون في هذا المجال طبعاً في
+
+294
+00:23:44,350 --> 00:23:50,780
+أمريكايعني تكلموا عن موضوع يعني إصلاح التعليم منذ
+
+295
+00:23:50,780 --> 00:23:56,000
+وقت طويل وزير التربية الأمريكي Terrell Bill شكل
+
+296
+00:23:56,000 --> 00:24:01,340
+لجنة بهذا الخصوص ولوها التقرير اللي عملوه إلى عدة
+
+297
+00:24:01,340 --> 00:24:06,740
+نقاط مهمة زي مثلا قالت التاريخ لا لن يرحم الكثير
+
+298
+00:24:06,740 --> 00:24:11,600
+من المتقاصين موضوع التعليم ماكنتوش تكاسم، بدوا
+
+299
+00:24:11,600 --> 00:24:15,890
+اهتمامتمتد نمط المنافسة الآن إلى ميدان الأفكار
+
+300
+00:24:15,890 --> 00:24:19,410
+ومشاريع البحثية العلمية هذا مجال المنافسة في مجال
+
+301
+00:24:19,410 --> 00:24:23,370
+الاقتصاد والتجارة كمان مجال البحث العلمي مجال مهم
+
+302
+00:24:23,370 --> 00:24:28,930
+الدول المتقدمة تنفق الأبحاث يعني مبالغ خيالية
+
+303
+00:24:28,930 --> 00:24:37,330
+ومبالغ عالية جداً وتعدلها موازنات تتطخمة وهي تستحق
+
+304
+00:24:37,330 --> 00:24:43,370
+حقيقة ذلكالخامات الجديدة للتجارة الدولية في الأمور
+
+305
+00:24:43,370 --> 00:24:46,890
+المرتبطة بشتت جانب المعرفة والتعلم والمعلومات
+
+306
+00:24:46,890 --> 00:24:50,330
+والذكاء لا تكتسب الأمة قوتها بامتلاكها آليات
+
+307
+00:24:50,330 --> 00:24:55,810
+الصناعة والتجارة وحدها وإنما ينبغي أن تسند وتسند
+
+308
+00:24:55,810 --> 00:25:02,270
+هذه الآليات قوة معنوية روحية وفكرية لكن أنا بتكلمه
+
+309
+00:25:02,270 --> 00:25:07,610
+الأمريكان عشانك احنا رجعنا إلى قرآننا رجعنا إلى
+
+310
+00:25:07,610 --> 00:25:11,770
+ديننا الإسلاميرجعنا إلى عقيدتنا الإسلامية مستمت
+
+311
+00:25:11,770 --> 00:25:16,150
+منها قوتنا ومن مستمت منها منعتنا تعلم القرآن
+
+312
+00:25:16,150 --> 00:25:20,150
+الكريم هو أساس العلم كلها لأن الإنسان اللي بتعلم
+
+313
+00:25:20,150 --> 00:25:24,170
+القرآن الكريم الله سبحانه وتعالى يمده بالقوة
+
+314
+00:25:24,170 --> 00:25:29,930
+وبالقدرة لتعلم أشياء كثيرة والتفوق في المجال اللي
+
+315
+00:25:29,930 --> 00:25:37,370
+هو يتخصص فيه التقرير الأمريكي أظهر قصور في بعض
+
+316
+00:25:37,370 --> 00:25:43,070
+الجوانبيعني مثلًا ممكن نلاحظ إنه قال لك إنه بالرغم
+
+317
+00:25:43,070 --> 00:25:46,890
+من أن فيه ثورة علمية حالية لكن فيه كثير من الناس
+
+318
+00:25:46,890 --> 00:25:50,190
+الأمريكان، ممكن نسميهم الأمريكان أميين من الناحية
+
+319
+00:25:50,190 --> 00:25:55,230
+العلمية والتكنولوجية كمان قال لك إنه فيه اللي هو
+
+320
+00:25:55,230 --> 00:26:00,210
+متسعة بين عدد محدود من العلماء والتكنولوجيين وبين
+
+321
+00:26:00,210 --> 00:26:03,330
+الجمهور والمواطنين اللي ما لهوش علم بقضايا
+
+322
+00:26:03,330 --> 00:26:07,610
+التكنولوجيا، ثورات تكنولوجيةكذلك أكد على مبادئ
+
+323
+00:26:07,610 --> 00:26:12,250
+القراءة والكتابة ومهارات الحساب أكد في النقطة
+
+324
+00:26:12,250 --> 00:26:14,310
+الرابعة على جوانب التكنولوجيا والمهارات المتعلقة
+
+325
+00:26:14,310 --> 00:26:20,890
+بالعمل وقال لك إنه المهارات التعليمية للجيل من
+
+326
+00:26:20,890 --> 00:26:24,670
+النجال لا تفوق، بل لا تساوي ولا تطلب من مهارات
+
+327
+00:26:24,670 --> 00:26:32,550
+أباهم يعني هذا قضية واضحة إنه يعني الجيل الحالي
+
+328
+00:26:32,550 --> 00:26:39,320
+يعني ينبغي ينبغيإنه يزيد في المهارات طبعًا عن
+
+329
+00:26:39,320 --> 00:26:46,760
+الجيل السابق مش يكون أقل منه الرئيس
+
+330
+00:26:46,760 --> 00:26:51,500
+الأمريكي George Bush سنة 1999 طرح استراتيجية
+
+331
+00:26:51,500 --> 00:26:55,900
+للتعليم ضمن مشروع القوم التحت شعار أمريكي عام اللي
+
+332
+00:26:55,900 --> 00:27:01,180
+في الوقت كلها طبعًا كان منذ زمن بعيدوبنبنى هذه
+
+333
+00:27:01,180 --> 00:27:04,220
+الستراتيجية قالك إنه العمل على تنمية استعداد
+
+334
+00:27:04,220 --> 00:27:07,780
+الأطفال المتجين للتعلم من دراسين باللسان يعني قالك
+
+335
+00:27:07,780 --> 00:27:14,700
+إنه لازم الكل يتعلم مايكون أحد متسرب من التعليم أن
+
+336
+00:27:14,700 --> 00:27:18,340
+يكمل 90% من الطلاب تعليمهم في المرحلة الثانوية أن
+
+337
+00:27:18,340 --> 00:27:22,000
+يتم انتقال الطلاب من المرحلة الأخرى على تأكيد من
+
+338
+00:27:22,000 --> 00:27:27,740
+طريق الاختبارات يعني ينتقل بعد ما يكون هو اجتاز
+
+339
+00:27:27,740 --> 00:27:31,900
+بنجاحمش بتكون ترفيع قالي ترفيع القالي هذا طبعا
+
+340
+00:27:31,900 --> 00:27:36,560
+مشكلة وفيه عدة علوم أساسية أتعلمها الطالب زي اللغة
+
+341
+00:27:36,560 --> 00:27:40,880
+الإنجليزية الرياضيات، العلوم، التاريخ، الجغرافيا
+
+342
+00:27:40,880 --> 00:27:47,920
+وهذا طبعا مهم جدا لأن من ممي ملكة التفكير والإفداع
+
+343
+00:27:47,920 --> 00:27:51,700
+عند الطالب ليه حد يقول والله الجغرافيا مش مهمة
+
+344
+00:27:51,700 --> 00:27:58,780
+والتاريخ مش مهم التاريخ يصنع الفكر ويصنع الحياةفهو
+
+345
+00:27:58,780 --> 00:28:02,160
+لا يقل أهمية عن اللغة الإنجليزية والرياضيات وانا
+
+346
+00:28:02,160 --> 00:28:06,220
+طبعا بالنسبة لنا هنضيف لها اللغة العربية لأنها
+
+347
+00:28:06,220 --> 00:28:09,580
+طبعا طاقة أمريكية هنضيف لها اللغة العربية والتربية
+
+348
+00:28:09,580 --> 00:28:15,160
+الإسلامية وهي طبعا مهمة تربية دينية مهمة جدا لأن
+
+349
+00:28:15,160 --> 00:28:21,060
+موضوع القيم مهم جدا في التعليم لا تعليم حقيقي بدون
+
+350
+00:28:21,060 --> 00:28:25,640
+قيم التعليم الحقيقي هو بغرس القيم وبغرس الأخلاق
+
+351
+00:28:25,640 --> 00:28:32,450
+الحميدة عند الطلابوعند الكلامين طبعاً كنا أمريكا،
+
+352
+00:28:32,450 --> 00:28:34,990
+لكن نحتاج للطلب الأمريكي المكان الأولى في العالم
+
+353
+00:28:34,990 --> 00:28:38,090
+في مادتهي العلوم والرياضيات نركز على مادة العلوم
+
+354
+00:28:38,090 --> 00:28:44,050
+والرياضيات واحنا بنركز كما قلت قبل قليل عندنا
+
+355
+00:28:44,050 --> 00:28:49,210
+كمسلمين على اللغة العربية والتربية الدينية وعلى
+
+356
+00:28:49,210 --> 00:28:53,510
+الرياضيات وكمان على اللغة الإنجليزية لأنها طبعا هي
+
+357
+00:28:53,510 --> 00:28:58,470
+لغة السوق في هذه الأيامعلى تماكر كل أمريكي من
+
+358
+00:28:58,470 --> 00:29:01,430
+المعرفة والمهارات اللي لازم يتنافسوا الاقتصادية،
+
+359
+00:29:01,430 --> 00:29:03,970
+لأنه في الآخر، يبدوا يمارسوا حياته الاقتصادية
+
+360
+00:29:03,970 --> 00:29:08,250
+كموظف، كعامل، وفي حالة هذا، يبدوا يكونوا عندهم
+
+361
+00:29:08,250 --> 00:29:12,610
+القدرة ويكونوا عندهم الاستعداد على المناقشة، أن
+
+362
+00:29:12,610 --> 00:29:16,670
+تقتزم كل مدرسة بتوفير البيئة الملائمة للتعليم،
+
+363
+00:29:16,670 --> 00:29:20,470
+تقضي على ظهر العنف وانتشار المخدرات بين الطلاب،
+
+364
+00:29:20,470 --> 00:29:23,490
+خاصة من هذه الأشياء اللي يعني للأسف موجودة في بلاد
+
+365
+00:29:23,490 --> 00:29:27,740
+الغرب وفي الولايات المتحدة الأمريكيةبشكل طبيعي
+
+366
+00:29:27,740 --> 00:29:31,060
+طبعاً الرؤوساء الأمريكان السابقين زي «كلونتون» و
+
+367
+00:29:31,060 --> 00:29:34,360
+«جورج بوش» في برامجهم الانتخابية كانوا دايماً
+
+368
+00:29:34,360 --> 00:29:38,900
+بركزوا على التدعية الانتخابية على موضوع التعليم
+
+369
+00:29:38,900 --> 00:29:43,720
+ويعني لابد أن القيام في ثورة في التعليم لأن
+
+370
+00:29:43,720 --> 00:29:50,660
+التعليم بخلنا أكثر ثراء و أكثر قدرة و أكثر يعني
+
+371
+00:29:51,030 --> 00:29:58,350
+قدرة على أن نعيش في المجتمع وأن نتقدم ونحقق ما
+
+372
+00:29:58,350 --> 00:30:04,670
+نريد في هذا المجتمع وقالوا طبعاً إن التعليم يعد
+
+373
+00:30:04,670 --> 00:30:09,130
+أكثر مجموعة انفتاح أو مفتاح للترقي إشلا من الوظائف
+
+374
+00:30:09,130 --> 00:30:14,470
+بل طبعاً هو جزء من النظام العالمي الاقتصادي الحديث
+
+375
+00:30:14,470 --> 00:30:19,570
+الحالي أو الجديدطبعاً الفكومة تفشل في تحقيق
+
+376
+00:30:19,570 --> 00:30:23,270
+استراتيجيتها القومية لما تعجز المدرسة عن تحقيق
+
+377
+00:30:23,270 --> 00:30:27,030
+الخطط والهداف التربوية المرسومة هي تكامل بين دور
+
+378
+00:30:27,030 --> 00:30:31,790
+المدرسة ودور الفكومة ينبغي أن يوركب ما يدفعه الناس
+
+379
+00:30:31,790 --> 00:30:36,950
+من الضرائب اهتماماً في التعليم وخاصة تعليم الأطفال
+
+380
+00:30:36,950 --> 00:30:41,590
+طبعاً لابد من تهيئة الأطفال للذهاب عن الذهاب إلى
+
+381
+00:30:41,590 --> 00:30:46,190
+المدرسة أن يكونوا مهيئين للتعليم ويتم التغلبعلى أي
+
+382
+00:30:46,190 --> 00:30:51,570
+عوائق تتعلق في هذا المجال وينبغي التفكير بطرق
+
+383
+00:30:51,570 --> 00:30:58,630
+مبتكرة لتجمع بين الوالدين والأطفال عن طريق الخطط
+
+384
+00:30:58,630 --> 00:31:02,290
+اللي هتسهم في إكسابهم المعارف بده طبعاً يكون
+
+385
+00:31:02,290 --> 00:31:09,390
+الوالدين في رعاية بأبناءهم وفي اهتمام بأبناءهم
+
+386
+00:31:09,390 --> 00:31:14,250
+وينبغي أن تتوافر لكل طفل فرصة للحصول على تعليم
+
+387
+00:31:14,250 --> 00:31:18,980
+عالي المستوىووضع معايير صارمة ونظم حزمة لاختبارات
+
+388
+00:31:18,980 --> 00:31:23,020
+قومية يعني كما قلنا موضوع الترفيع الآلي هذه حقيقة
+
+389
+00:31:23,020 --> 00:31:28,940
+مشكلة الأصل أن يكون طبعاً فيه معايير للنجاح
+
+390
+00:31:28,940 --> 00:31:34,640
+واهتمام بالطفل ما طبعاً يعني وضع حوافز لهؤلاء
+
+391
+00:31:34,640 --> 00:31:39,020
+الأطفال مايكونش التعليم عبارة عن عبء اللي هم لابد
+
+392
+00:31:39,020 --> 00:31:46,610
+من حصص للترفيه لابد من برامج للترفيهحجم المنهج ما
+
+393
+00:31:46,610 --> 00:31:54,510
+يكون حجم كبير جداً نحاول أن نبسط الفكرة للأولاد
+
+394
+00:31:54,510 --> 00:32:01,050
+والأطفال حتى تكون الأمور واضحة وبساطة مهمة في
+
+395
+00:32:01,050 --> 00:32:07,390
+التعليم الجامعي أنا لا أميل إلى تعقيد الأمور على
+
+396
+00:32:07,390 --> 00:32:13,070
+الطلاب الجامعيين حتى الجامعيين لأنه ما دخل اللينو
+
+397
+00:32:13,070 --> 00:32:18,460
+في شيءإلا زانة وما دخل العنف في شيء إلا شانة
+
+398
+00:32:18,460 --> 00:32:23,420
+فموضوع الـ Lean يعني حتى مع الطلاب وطبعا رسالة ..
+
+399
+00:32:23,420 --> 00:32:27,780
+رسالة لكم للطلاب والطالبات الأعزاء نقولكوا إن شاء
+
+400
+00:32:27,780 --> 00:32:31,580
+الله تعيشوا في المجتمع دائما تسهيل الأمور ..
+
+401
+00:32:31,580 --> 00:32:35,900
+الأمور تسهيل الأمور رحم الله عبده، رحم الله عبده
+
+402
+00:32:35,900 --> 00:32:40,020
+سمحنا إذا باع، سمحنا إذا اشترى، سمحنا إذا اخترى
+
+403
+00:32:40,020 --> 00:32:43,920
+السماح مهمة في كل حياتنا، في حياتنا الخاصةوفي
+
+404
+00:32:43,920 --> 00:32:53,600
+حياتنا العامة طبعاً بعض الحكماء زي حكماء «صين وانت
+
+405
+00:32:53,600 --> 00:33:00,090
+سو» أشار إلى أهمية الاستثمار في العنصر البشريوكما
+
+406
+00:33:00,090 --> 00:33:08,610
+قلنا قبل قليل الاستثمار في العصر البشري مهم جداً
+
+407
+00:33:08,610 --> 00:33:14,170
+وقال هذا الحكيم إن الحبوب بتزرع الإنسان مرة يحصدها
+
+408
+00:33:14,170 --> 00:33:18,890
+مرة فالشجرة التي يغلوسها الإنسان في فرق من إنه
+
+409
+00:33:18,890 --> 00:33:22,830
+نزرع قمح ينزرع مرة يحصل مرة لكن الشجرة التي
+
+410
+00:33:22,830 --> 00:33:25,910
+يغلوسها الإنسان ربما يقطفها عشرات مرة عشرات
+
+411
+00:33:25,910 --> 00:33:31,360
+الزيتون أكتر مرة مقطفهايمكن نقطفها احنا وابناءنا
+
+412
+00:33:31,360 --> 00:33:34,540
+وابناء أبناءنا زي ما قطفها أجدادنا، هي نفس الشجرة
+
+413
+00:33:34,540 --> 00:33:39,700
+هي شجرة زيتون بعيسية 800 سنة أما إذا علمنا الشعب،
+
+414
+00:33:39,700 --> 00:33:43,940
+فنقصده مائة مرة إذا علمنا الشعب أن الشعب سيكون
+
+415
+00:33:43,940 --> 00:33:47,920
+متعلم ومثقف ومبتدل استثمار في العصر البشري وهم فقف
+
+416
+00:33:47,920 --> 00:33:51,760
+لطورش وقال فإن التعليم له عوائد تعود على الفرد
+
+417
+00:33:51,760 --> 00:33:58,620
+والمجتمع عام يعني كل الكتاب القدامىتكلموا عن هذا
+
+418
+00:33:58,620 --> 00:34:05,780
+الأمر بشكل أو باخر فيه طبعاً عالم اقتصادي التعليم
+
+419
+00:34:05,780 --> 00:34:09,280
+هو ثمر للتفاعل بين علمين الاقتصاد والتربية يعني
+
+420
+00:34:09,280 --> 00:34:14,500
+فيه بناء تم بموضوع التربية حتى احنا الاقتصاديين
+
+421
+00:34:14,500 --> 00:34:18,900
+لأن الاقتصاد يتكلم عن أرقام وعن نظريات اقتصادية
+
+422
+00:34:18,900 --> 00:34:22,340
+لكن المفاهيم العلمية والمفاهيم التربية بدها تكون
+
+423
+00:34:22,340 --> 00:34:27,210
+موجودة وهذا لعله يعني من الأشياء المهمةالطلاب
+
+424
+00:34:27,210 --> 00:34:30,190
+والطالبات وانتم اليوم ان شاء الله مصورة رابع
+
+425
+00:34:30,190 --> 00:34:34,390
+لنفسكم اللي اتخرجوا وبالتالي هذا المصاد يكون رافع
+
+426
+00:34:34,390 --> 00:34:39,110
+ان شاء الله لكم في فهم كثير من الأمور وفهم كثير من
+
+427
+00:34:39,110 --> 00:34:44,170
+الأشياء يعني احنا انا وصلنا لتعريف اتصالات التعليم
+
+428
+00:34:44,170 --> 00:34:49,350
+ان شاء الله يعني بنقف عند هذه النقطة فانا بتحاول
+
+429
+00:34:49,350 --> 00:34:52,530
+اكون محاضراتنا مش طويلة محاضرة حوالي تقريبا نصف
+
+430
+00:34:52,530 --> 00:34:59,750
+ساعة الآن ان شاء اللهنلتقي بكم في المحاطة المصورة
+
+431
+00:34:59,750 --> 00:35:07,310
+رقم 2 نرجو منكم المتابعة والاهتمام بارك الله فيكم
+
+432
+00:35:07,310 --> 00:35:12,010
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_postprocess.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..8d594545cbe82625c645cb50c4ee6fefb1584077
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_postprocess.srt
@@ -0,0 +1,1980 @@
+1
+00:00:01,160 --> 00:00:03,720
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:03,720 --> 00:00:08,340
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:08,340 --> 00:00:13,660
+سيدنا محمد وعلى آله وأصحابه والتابعين بإحسان إلى
+
+4
+00:00:13,660 --> 00:00:19,700
+يوم الدين أما بعد الطلاب والطالبات الأعزاء السلام
+
+5
+00:00:19,700 --> 00:00:24,950
+عليكم ورحمة الله وبركاتهإن شاء الله نتكلم في
+
+6
+00:00:24,950 --> 00:00:30,510
+المقادرة المصورة رقم 7 لمصادر اقتصاديات التعليم
+
+7
+00:00:30,510 --> 00:00:37,770
+والصحة عن الفصل الثالث تكلفة التعليم إن شاء الله
+
+8
+00:00:37,770 --> 00:00:42,610
+في هذا الفصل سوف نتكلم عن تقريبا سبع نقاط أول
+
+9
+00:00:42,610 --> 00:00:47,830
+مقدمة ثم تعريف تكلفة التعليم ثم أسباب ارتفاع تكلفة
+
+10
+00:00:47,830 --> 00:00:52,390
+التعليمأهداف دراسة تكلفة التعليم وخلاصة التكلفة
+
+11
+00:00:52,390 --> 00:00:56,990
+التعليمية تقفية تكلفة التعليم بسبب تكلفة التعليم
+
+12
+00:00:56,990 --> 00:01:00,470
+هو نقطة السابقة الأمثلة التطبيقية حول تكلفة
+
+13
+00:01:00,470 --> 00:01:04,290
+التعليم وإن شاء الله الأمثلة التطبيقية هيكون واجب
+
+14
+00:01:04,290 --> 00:01:07,810
+إن شاء الله من هذه الأمثلة هيتم إرساله في الأيام
+
+15
+00:01:07,810 --> 00:01:12,770
+القادمة على المدل هنعطيكوا هذه الأمثلة المطلوب
+
+16
+00:01:12,770 --> 00:01:17,890
+طبعا خلها في البيتوإرسالها إن شاء الله على الموديل
+
+17
+00:01:17,890 --> 00:01:24,010
+وهذا هنوضحه إن شاء الله في آخر هذه المقاطرة طبعاً
+
+18
+00:01:24,010 --> 00:01:28,610
+في عبارات مهمة إن التعليم الجيد هو تعليم غالي
+
+19
+00:01:28,610 --> 00:01:35,110
+الثمن يعني إذا بدنا نتعلم كويس ممكن ندفع فلوس أكثر
+
+20
+00:01:35,110 --> 00:01:40,430
+فنحصل على تعليم أفضل يعني في تعليم الخاص وفي
+
+21
+00:01:40,430 --> 00:01:44,640
+التعليم العكومي أو التعليم العاموأن التعليم الرديق
+
+22
+00:01:44,640 --> 00:01:48,940
+هو التعليم الرخيص النقطة الثانية تعتبر تجارب
+
+23
+00:01:48,940 --> 00:01:52,640
+التعليم مؤشرًا واضحًا على نواعيد التعليم كل ما
+
+24
+00:01:52,640 --> 00:01:57,060
+ندفع تكلفة أعلى في التعليم هذا بتدل على جودة
+
+25
+00:01:57,060 --> 00:02:03,580
+التعليم وإن هو التعليم أفضل وأحسن طبعًا في المقدمة
+
+26
+00:02:03,580 --> 00:02:10,200
+يعني في صارت يعني خلاف كيف نحش بتجارب التعليم؟ هل
+
+27
+00:02:10,200 --> 00:02:15,950
+نحش بتجارب التعليمعلى أساس المدرسة أو الفصل أو
+
+28
+00:02:15,950 --> 00:02:22,370
+التلميذ طبعاً صار دراسي لكل يعني بند من هذه الدول
+
+29
+00:02:22,370 --> 00:02:27,150
+التلاتة و تم التواصل في النهاية أن التكلفة تحسب
+
+30
+00:02:27,150 --> 00:02:31,170
+على أساس التلميذ لأنه لو حسبنا أساس المدرسة أو
+
+31
+00:02:31,170 --> 00:02:36,750
+أساس الفصل هنلاحظ أنه فيه مشكلة يعني مثلا لو حسبنا
+
+32
+00:02:36,750 --> 00:02:41,510
+التعليم على أساس التكلفة على أساسالمدارس بالنسبة
+
+33
+00:02:41,510 --> 00:02:46,450
+لمدارس تختلف اختلافا كبيرا وتكاليفها توقف على
+
+34
+00:02:46,450 --> 00:02:51,050
+عوامل كثيرة مثل عدد مابها من قصول وعدد الطلاب
+
+35
+00:02:51,050 --> 00:02:56,510
+ومكان المدرسةوغير ذلك يعني في مناقش مدرسة جيدة وفي
+
+36
+00:02:56,510 --> 00:03:01,030
+مدرسة غير جيدة في مدرسة مبانيها حديثة وفي مدرسة
+
+37
+00:03:01,030 --> 00:03:10,850
+مبانيها غير حديثة في مدرسة فيها تهوية مناسبة وفي
+
+38
+00:03:10,850 --> 00:03:14,450
+مدرسة ليست فيها تهوية مناسبة كذلك هلاحظ أنه لو
+
+39
+00:03:14,450 --> 00:03:17,730
+نحسب التكلف على أساس الفصل هلاحظ أنه برضه في
+
+40
+00:03:17,730 --> 00:03:24,460
+صعوبات ليش؟ لأن ساعة الفصل تقد تختلفبين مدرسة و
+
+41
+00:03:24,460 --> 00:03:28,400
+مدرسة أخرى أو بين فصل و فصل آخر كمان العملية
+
+42
+00:03:28,400 --> 00:03:31,800
+التعليمية لاتتم في الفصل فقط إذا عملية التعليمية
+
+43
+00:03:31,800 --> 00:03:35,760
+بتتمش في الفصل فالاتجاهات الحديثة في التربية ترعوا
+
+44
+00:03:35,760 --> 00:03:39,000
+لإتمام جزء كبير من العملية التعليمية خارج الفصل
+
+45
+00:03:39,000 --> 00:03:42,320
+وعلى ذلك في حساب تجربة التعليمية العملية التعليمية
+
+46
+00:03:42,320 --> 00:03:46,660
+على أساس واحدة الفصل يهم المرافق الأخرى في المدرسة
+
+47
+00:03:46,660 --> 00:03:50,330
+يعني في عملية التعليمية بتتمش داخل الفصلبتتم داخل
+
+48
+00:03:50,330 --> 00:03:55,350
+الفصل و بتم ايضا خارجه الفصل مثل الملاعب مثل
+
+49
+00:03:55,350 --> 00:04:02,010
+الحدائق فجرات الرسم الهندسي إلى آخرين و هناك علوم
+
+50
+00:04:02,010 --> 00:04:05,530
+أخرى تتم دراسة مباشرة في الطبيعة أو في المعامل و
+
+51
+00:04:05,530 --> 00:04:10,030
+المختبرات أو عن طريق النشاط الفصل لا يعني مامنفعش
+
+52
+00:04:10,030 --> 00:04:14,410
+يكون هو اللي على اساس تحسب اللي هي التكلفة
+
+53
+00:04:14,410 --> 00:04:21,230
+وبالتالي التلميد هو يعني أكثروحدات دقة في حساب
+
+54
+00:04:21,230 --> 00:04:27,230
+تكلفة التعليم كما أن مراعاة اعتبارات الفروق
+
+55
+00:04:27,230 --> 00:04:31,730
+الفردية في التعليم يحكم إذابة الفصول ووحدات مستقلة
+
+56
+00:04:31,730 --> 00:04:35,410
+من التلاميذ وتحويلها إلى مجموعات من التلاميذ وكل
+
+57
+00:04:35,410 --> 00:04:39,130
+مجموعة متجنسة في مادة معينة تاخد رسالة من قشرة
+
+58
+00:04:39,130 --> 00:04:43,270
+متخصصة لهذه المادة كالتاريخ والجغرافيا والرياضيات
+
+59
+00:04:43,270 --> 00:04:48,190
+واللغة الإنجليزيةيعني من العرض السابق اتضح أن أفضل
+
+60
+00:04:48,190 --> 00:04:51,770
+طريقة لحساب تكلف التعليم هو حسابه على أساس تكلف
+
+61
+00:04:51,770 --> 00:04:56,010
+التلميذ لا على أساس تكلف الفصل أو المدرسة فالتلميذ
+
+62
+00:04:56,010 --> 00:05:00,150
+يكون أساسا أكثر ثابتا من الفصل أو المدرسة عند حساب
+
+63
+00:05:00,150 --> 00:05:07,210
+التكلفة تعريف تكلفة التعليم يعني التكلفة في اللغة
+
+64
+00:05:07,210 --> 00:05:11,930
+هي مفرد التكلفة وتعني المبلغ المدفوع أو المنفق على
+
+65
+00:05:11,930 --> 00:05:17,920
+إنتاج سلعة أو خدمة معينةالتكلفة قد تقدر بالمال وقد
+
+66
+00:05:17,920 --> 00:05:25,780
+تقدر بالجهد لأن جهده يعتبر تكلفة المال اللي يدفعه
+
+67
+00:05:25,780 --> 00:05:30,000
+يعتبر تكلفة بالمفهوم الاقتصادي التكلفة هي جميع
+
+68
+00:05:30,000 --> 00:05:35,320
+النفقات اللي تدفع المؤسسة يعني الشركة أو المدرسة
+
+69
+00:05:35,320 --> 00:05:40,580
+أو الجامعة بسموها التكلفة المحسبية أو تضحي بها في
+
+70
+00:05:40,580 --> 00:05:44,900
+الفرصة البديلة من أجل ضمان مساهم عناصر الإنتاجفي
+
+71
+00:05:44,900 --> 00:05:48,780
+العملية الإنتاجية وطبعاً احنا تكلمنا عن موضوع
+
+72
+00:05:48,780 --> 00:05:52,060
+التكلفة اللي بتوسع في مصارع الاقتصاد الجزي في
+
+73
+00:05:52,060 --> 00:05:56,240
+مصارع الاقتصاد الكلي وبالتالي هذا الأمر يعني صار
+
+74
+00:05:56,240 --> 00:05:59,820
+مفروض عنده وعنده الطلاب لكن احنا عملية تذكير سريع
+
+75
+00:05:59,820 --> 00:06:04,540
+ان شاء الله لهذا الأمر التكلفة التعليم هي مقياس
+
+76
+00:06:04,540 --> 00:06:09,340
+لمقدار الإنفاق النقدي وغير النقدي الذي يتم في سبيل
+
+77
+00:06:09,340 --> 00:06:14,460
+تحقيق منفعات محددة وبيتم طبعا على أساسالعملية
+
+78
+00:06:14,460 --> 00:06:17,760
+التعليمية أو بمجرد طرحية الاقتصادية التي تحملها
+
+79
+00:06:17,760 --> 00:06:21,720
+النظام التعليمي أو المؤسسة التعليمية مقابل حصولها
+
+80
+00:06:21,720 --> 00:06:25,180
+على خدمة أو منفعة ضرورية تبقى للمعايير المقررة
+
+81
+00:06:25,180 --> 00:06:32,840
+ويمكن قياسها في شكل وعداد نقلي فعالية التكلفة في
+
+82
+00:06:32,840 --> 00:06:37,320
+التعليم يُخص الفعالية التكلفة تقويم التكلفة بربط
+
+83
+00:06:37,320 --> 00:06:41,620
+النتائج أو المنافع المتحققة بتكاليفها التي يمكن
+
+84
+00:06:41,620 --> 00:06:45,700
+حصول عليهابغرض تحديد التكاليف التي يمكن أن تعطي
+
+85
+00:06:45,700 --> 00:06:51,880
+أفضل ندائج أو المنافع بأقل التكاليف أهم شغلة أن
+
+86
+00:06:51,880 --> 00:06:55,340
+نصل على أدنى تكلفة ممكنة يعني أنا عندى فيه total
+
+87
+00:06:55,340 --> 00:06:59,480
+cost تكلفة القليل وفيه ال average cost المتوسط
+
+88
+00:06:59,480 --> 00:07:04,200
+تكلفته الهدف أن نحقق أفراد الحجم الكبير حتى في
+
+89
+00:07:04,200 --> 00:07:08,860
+التعليم أفراد الحجم الكبير يعني يصير عندى أنا
+
+90
+00:07:08,860 --> 00:07:16,770
+تكلفة التلميدأقل ما يمكن أسباب
+
+91
+00:07:16,770 --> 00:07:20,590
+ارتفاع تكليف التعليم هناك مجموعة من الأسباب اللي
+
+92
+00:07:20,590 --> 00:07:25,330
+بتخلي تكليف التعليم مرتفع وهي زيادة عدد الطلاب
+
+93
+00:07:25,330 --> 00:07:29,150
+الرضو بالتعليم ومشاركة الطلبة يعني كل معدد الطلاب
+
+94
+00:07:29,150 --> 00:07:32,390
+بزيد سواء في المدارس أو في المعاهد أو في الكلية أو
+
+95
+00:07:32,390 --> 00:07:37,050
+في الجامعات لأسباب كثيرة اللي عدد الطلاب بزيد أول
+
+96
+00:07:37,050 --> 00:07:41,380
+حاجة ارتفاع معدد الموظف الشكانيالدول تبقى اللي
+
+97
+00:07:41,380 --> 00:07:46,460
+ملزمة ومجهدة التعليم على كله بخل فيه زيادة في
+
+98
+00:07:46,460 --> 00:07:50,900
+أعداد الطلبة مما يترتب عليه ارتفاع في التكلفة
+
+99
+00:07:50,900 --> 00:07:56,160
+مخصوصا بالتكلفة لل total cost أو التكلفة الكلية
+
+100
+00:07:56,160 --> 00:08:00,980
+طول سنوات الدراسة القدر كبير من السكان والتزايد
+
+101
+00:08:00,980 --> 00:08:04,880
+التوجه نحو التنوع التعليم الأكثر تكلفة اليوم النصر
+
+102
+00:08:04,880 --> 00:08:11,960
+يدوروا على التعليم الخاص يعنيقدر يفعل شوم أغلى أو
+
+103
+00:08:11,960 --> 00:08:18,480
+تكلفة أعلى عشان يحطط نوعين من التعليم أفضل ثلاثة
+
+104
+00:08:18,480 --> 00:08:22,220
+الاحتمال متزايد بتحسين نوعية التعليم وتجود مخرجاته
+
+105
+00:08:22,220 --> 00:08:27,140
+كما قلنا اليوم صاروا الكل يعني بيدور على أنه يحسن
+
+106
+00:08:27,140 --> 00:08:31,580
+التعليم وجود مخرجاته لأنه في تنافس في سوق العمل
+
+107
+00:08:33,940 --> 00:08:36,220
+كمان من الأسباب اللي اتفتت بالتعليم هي الحاجة
+
+108
+00:08:36,220 --> 00:08:40,100
+المتزايدة لتغيير مواصفات الأبنية المدرسية يعني
+
+109
+00:08:40,100 --> 00:08:44,920
+لازم هذا الأبنية تتحدث إما لعدم صلاحية الأبنية
+
+110
+00:08:44,920 --> 00:08:49,680
+القديمة وتأثرت جديدها لقيام بالوظائف الجديدة أو
+
+111
+00:08:49,680 --> 00:08:53,300
+لصيالتها الدائمة أو لتجديد الأساس والمعدات اللاجئة
+
+112
+00:08:53,300 --> 00:08:56,980
+طبعاً إذا بدنا نجد احنا الأبنية أو علماء الأبنية
+
+113
+00:08:56,980 --> 00:09:01,060
+الجديدة هنفكب أيضا بجديد المتكلمة خمس التزايد
+
+114
+00:09:01,060 --> 00:09:04,540
+والتوجه نحو الاستخدام المكثفاقتقالية التعليم
+
+115
+00:09:04,540 --> 00:09:10,240
+والتعلم استخدام قصاد التعلم الحديثة تقنيات
+
+116
+00:09:10,240 --> 00:09:12,980
+المعاصرة في العملية التدريبية هذا كله يزيد من
+
+117
+00:09:12,980 --> 00:09:17,240
+تقنية التعليم ستة ارتفاع معادلة وضخم هو ارتفاع
+
+118
+00:09:17,240 --> 00:09:20,500
+مستوى العالم الأسعار ومانجم عنها من ارتفاع الأسعار
+
+119
+00:09:20,500 --> 00:09:23,560
+وارتفاع التقن الشرائية اللي عمناها المحل وهذا
+
+120
+00:09:23,560 --> 00:09:29,220
+يخلّي برضه التقنية تزيد زيادة مستمرة رقم سبعة في
+
+121
+00:09:29,220 --> 00:09:32,670
+المرتبات وأجور العاملين في قطاع التعليموغيرها من
+
+122
+00:09:32,670 --> 00:09:36,310
+أوجه الصرف الأخرى الجارية منها والأصمليين طبعاً
+
+123
+00:09:36,310 --> 00:09:40,650
+يعني فيه زيادة متفعة في الإنفاق على التعليم ومن
+
+124
+00:09:40,650 --> 00:09:47,770
+بينه أجور المعامل المعينين أهداف دراسة تكلفة
+
+125
+00:09:47,770 --> 00:09:52,790
+التعليم لماذا ندرس تكلفة التعليم؟ لأنه فيه ارتفاع
+
+126
+00:09:52,790 --> 00:09:57,330
+في التكلفة ارتفاع التكلفةفرض على المخططين وصناع
+
+127
+00:09:57,330 --> 00:10:00,550
+القرار الاقتصادي والتربوي وغيرين من الباحثين
+
+128
+00:10:00,550 --> 00:10:04,790
+والمهتمين دراسة تكلفة التعليم المستوين لكل نظام
+
+129
+00:10:04,790 --> 00:10:09,650
+التعليم أو جزء مؤسسة التعليم الواحدة شوه أهداف هذه
+
+130
+00:10:09,650 --> 00:10:15,250
+الدراسة أولا تبصر دراسة التكلفة صناع القرار
+
+131
+00:10:15,250 --> 00:10:19,470
+بالتكلفة الإجمالية للمدرسة هم تحتجم مطالبات مالية
+
+132
+00:10:19,470 --> 00:10:23,230
+لعيشتتها ومشروعاتها وممكنياتها ممكنة تنفيذها في
+
+133
+00:10:23,230 --> 00:10:28,500
+ضوء المطالبات الماليةورجع التكلفة طبعاً بتوضح هذه
+
+134
+00:10:28,500 --> 00:10:34,060
+التكلفة كأول هدف لصناعة القرار لدرجة التكلفة
+
+135
+00:10:34,060 --> 00:10:40,020
+الإجمالية للمدرسة وليس لتكلفة الوحدة في المدرسة
+
+136
+00:10:40,020 --> 00:10:44,160
+اثنين إيجاد نوع من التوازن بين مخصصات التعليم غير
+
+137
+00:10:44,160 --> 00:10:48,420
+من النفقات المخصة لقطعات اقتصاد أخرى بصورة تبرز
+
+138
+00:10:48,420 --> 00:10:52,360
+مدرسة حاجة التعليم لزيادة مخصصاته من مجالين عامة
+
+139
+00:10:52,360 --> 00:10:58,390
+لدور من نتج المحل الإجماليبنعمل توازن بين مخصصات
+
+140
+00:10:58,390 --> 00:11:02,350
+انفاق على التعليم ومخصصات انفاق على الأمور الأخرى
+
+141
+00:11:02,350 --> 00:11:07,330
+سواء سلاسل غذائية، سواء ملابس، سواء خدمات الصحة
+
+142
+00:11:07,330 --> 00:11:13,450
+إلى آخرين ثلاثة، المقوف على الكم الذي يُنفق على
+
+143
+00:11:13,450 --> 00:11:17,170
+قطاع التعليم بصورة ممكن وحقيقين بمعرفة الأموال
+
+144
+00:11:17,170 --> 00:11:22,070
+المنفقة في قطاع التعليم، الموارد الحقيقية الموظفة
+
+145
+00:11:22,070 --> 00:11:26,080
+فيهتعرض فدائل مختلفة التي ترفع كفاءة قطاع التعليم
+
+146
+00:11:26,080 --> 00:11:29,740
+وتحقيق أهداف المجتمع وحصل أعداء المالية الجديدة
+
+147
+00:11:29,740 --> 00:11:34,280
+أربعة من بين الأهداف أيضًا دراسة تقدير التكلفة
+
+148
+00:11:34,280 --> 00:11:38,360
+تفيد في اكتشاف الإمكانيات المالية المطلوبة بدء من
+
+149
+00:11:38,360 --> 00:11:42,140
+تحديد وتصنيف وقياس تكلفة المدخلات توقف على
+
+150
+00:11:42,140 --> 00:11:45,480
+الإمكانيات المالية المتاحة ومرورا بتقدير تكلفة
+
+151
+00:11:45,480 --> 00:11:50,690
+تنفيذ مشروع أو برنامج أو تحسينهخامس اكتشاف نمطية
+
+152
+00:11:50,690 --> 00:11:54,150
+سلوك التكلفة اللي وقوف على مدى استغلال أو سوق
+
+153
+00:11:54,150 --> 00:11:58,290
+استغلال متخلات في العملية التعليمية وتعييم وأشرات
+
+154
+00:11:58,290 --> 00:12:02,290
+معينة يمكن الاستغلال منها على مدى استغلال الموارد
+
+155
+00:12:02,290 --> 00:12:08,350
+ستة بيان مدى تأثير تكلفة العاملين في المدرسة على
+
+156
+00:12:08,350 --> 00:12:10,990
+وحدة التكلفة وتأثر التكلفة في الشياسة التعليمية
+
+157
+00:12:10,990 --> 00:12:15,690
+مثلًا نشوف تكلفة العاملين شتده على الوحدة الواحدة
+
+158
+00:12:15,690 --> 00:12:19,970
+للتكلفةوتأثر بالسياسة للتعليمين مثل حجم الفصل
+
+159
+00:12:19,970 --> 00:12:24,370
+الجديد، حجم المدرسة، رجع العاملين فيها، سبعة من من
+
+160
+00:12:24,370 --> 00:12:27,510
+الأهداف أيضًا، الكشف عن كفاءة إنتاجية التعليم أو
+
+161
+00:12:27,510 --> 00:12:31,150
+المدرسة، وضوء العائدات أو المنافع التي تفيد الشخص
+
+162
+00:12:31,150 --> 00:12:36,810
+أو المجتمع مقارنة من النفقات، مقارنة بين النفقات
+
+163
+00:12:36,810 --> 00:12:40,130
+والإيرادات المستقبلية، لإنشاء مشغول كفاية
+
+164
+00:12:40,130 --> 00:12:45,660
+الإنتاجية8- توزيع نفقات قطاع التعليم بصورة عادلة
+
+165
+00:12:45,660 --> 00:12:49,300
+على مضم التعليم ومراحله ومؤسساته وعلى أوجه
+
+166
+00:12:49,300 --> 00:12:53,580
+الاستخدامات والمختلفة أوطن لو لولا المفترض 9-
+
+167
+00:12:53,580 --> 00:12:58,060
+التأكد من حسن استغلال أجهزة التعليم والمؤسسات
+
+168
+00:12:58,060 --> 00:13:03,360
+التعليمية لمواردها المتاحة المخصصة لها، بدنا نشوف
+
+169
+00:13:03,360 --> 00:13:08,420
+يعني مدى الحسن استغلال هذه الموارد اللي تابعة
+
+170
+00:13:08,420 --> 00:13:13,560
+للتعليم 10-بساعد تقليف التعليم على تقدير مفاد
+
+171
+00:13:13,560 --> 00:13:16,820
+التعليم في دور اختيار المدائل المناسبة للتقليف
+
+172
+00:13:16,820 --> 00:13:23,280
+والعائد وما داشر التنبؤ بتكاليف التعليم المستقبلية
+
+173
+00:13:23,280 --> 00:13:27,420
+يفيد في البحث عن مصادر تمويل إضافية ترتقل إيديه
+
+174
+00:13:27,420 --> 00:13:31,840
+للتعليم مدى ما أنا بتشير لبند التفليف في المستقبل
+
+175
+00:13:31,840 --> 00:13:37,140
+دا نفر عن مصادر تمويل بتشير لعملية التعليم في
+
+176
+00:13:37,140 --> 00:13:41,490
+النقطة الرابعة، عناصر التقليفاتالتعليمية طبعا
+
+177
+00:13:41,490 --> 00:13:45,910
+التكلفة التعليمية هناك تكلفة جارية أو بتشغيلية أو
+
+178
+00:13:45,910 --> 00:13:49,190
+دورية و هناك طبعا تكلفة في النقطة اللي بعدها اللي
+
+179
+00:13:49,190 --> 00:13:54,210
+هي الرأسمانية التكلفة الدورية كل منفق على التعيب
+
+180
+00:13:54,210 --> 00:14:01,190
+من أجور ومرتبات العاملين كمعلمين ومداريين مثلا
+
+181
+00:14:01,190 --> 00:14:04,790
+مصاريف الكهربا والماء والنضاليات وهذه كلها بسموها
+
+182
+00:14:04,790 --> 00:14:09,170
+مصاريفدورية قد تكون دورية مباشرة قد تكون غير
+
+183
+00:14:09,170 --> 00:14:13,310
+مباشرة قد تكون مصطفات خدمات إجتماعية للتلاميذ
+
+184
+00:14:13,310 --> 00:14:17,010
+والطلاب طبعاً في علم التكلفة الرأس مالية أو
+
+185
+00:14:17,010 --> 00:14:21,270
+الإنتاجية أو بيسموها الاسف مالي وتشمل تكليف شراع
+
+186
+00:14:21,270 --> 00:14:25,690
+الأرض وتشجيد المباني وشراع التجهيزات ووسائل النقل
+
+187
+00:14:25,690 --> 00:14:29,530
+وغيرها من الأمور التي يتم استفادة منها على مدى
+
+188
+00:14:29,530 --> 00:14:34,100
+أطول السنة مالية ومعقدة ينهي عن تكليف اسف ماليةعند
+
+189
+00:14:34,100 --> 00:14:38,700
+تكاليف تشغيلهم و هذا بشمل المدارس وبشمل الشركات
+
+190
+00:14:38,700 --> 00:14:43,380
+والمصادر النقطة الخامسة تخفيف تكلفة التعليم كيف
+
+191
+00:14:43,380 --> 00:14:49,860
+نخفظ تكلفة التعليم؟ طبعاً ارتفاع تكلفة التعليم إلى
+
+192
+00:14:49,860 --> 00:14:52,480
+أسواق كثيرة كما قلنا قبل قليل من بين النمول
+
+193
+00:14:52,480 --> 00:14:57,720
+السكاني أي واحد من بين أسواق ارتفاع تكلف التعليم
+
+194
+00:14:57,720 --> 00:15:02,260
+إزدياد الطلب على مستويات أعلى من التعليم إلى ترافض
+
+195
+00:15:02,260 --> 00:15:07,820
+الحكومات والدولبتقديم فرصة تعليمية متكافة لجميع
+
+196
+00:15:07,820 --> 00:15:13,720
+أفراد الشعب هذه طبعاً يعني من الأسباب اللي بتخليك
+
+197
+00:15:13,720 --> 00:15:18,140
+يرتفع تقليد التعليم الان ما هي الإجراءات اللي
+
+198
+00:15:18,140 --> 00:15:22,040
+الدول اتبعتها لتقليد تقليد التعليم إجراءات اللي تم
+
+199
+00:15:22,040 --> 00:15:26,920
+اتباعها لتقليد التقليد على نوعين من الإجراءات في
+
+200
+00:15:26,920 --> 00:15:31,140
+عندنا إجراءات مباشرة لخفض تقليد التعليم في عندنا
+
+201
+00:15:31,140 --> 00:15:34,370
+إجراءات غير مباشرةالزيارات المباشرة او واحد زيادة
+
+202
+00:15:34,370 --> 00:15:38,850
+كثافة الفصل تخصب كثافة الفصل متوسط عدد طلاب الفصل
+
+203
+00:15:38,850 --> 00:15:42,150
+لمرحلة معينة ويكون استخلاصها من خلال المعادلة
+
+204
+00:15:42,150 --> 00:15:44,670
+التانية عدد بيجيب كثافة الفصل كثافة الفصل في مرحلة
+
+205
+00:15:44,670 --> 00:15:48,330
+معينة سواء عدد طلاب مسجلين في المرحلة أو عدد
+
+206
+00:15:48,330 --> 00:15:52,870
+الفصول في المرحلة يعني ومن المعلوم أن كثافة الفصل
+
+207
+00:15:52,870 --> 00:15:57,010
+المتلة يجب أن تتجاوز 25 طالب الفصل يعني الأصل
+
+208
+00:15:57,010 --> 00:16:02,650
+الفصل يكون في حد أقصى 25 طالبوإن هذه الكثافة تختلف
+
+209
+00:16:02,650 --> 00:16:06,330
+بدرجات متفاوضة وفقًا لنوع التعليم أو المستوار
+
+210
+00:16:06,330 --> 00:16:09,610
+فالدرجة العزل الميزانيات التعليم في بعض الدول
+
+211
+00:16:09,610 --> 00:16:13,550
+تضطرت الجهات المسؤولة عن التعليم لرفع كتابة الفصل
+
+212
+00:16:13,550 --> 00:16:18,890
+لضعف خمسين طالب في الفصل الواحد أو أكثر يعني تقدش
+
+213
+00:16:18,890 --> 00:16:23,110
+في الفصل في طلاب لو أنا بدأ أخلق التكلفة بدأ أرفع
+
+214
+00:16:23,110 --> 00:16:26,250
+الكثافة بدأ أخلق طلاب يزيدوا في الفصل عند مثلًا في
+
+215
+00:16:26,250 --> 00:16:33,470
+قطاع غزة بسبب طبعًا الفقروبسبب نقص الموارد وقلة
+
+216
+00:16:33,470 --> 00:16:38,530
+الإمكانيات الكثافة الفصل عالية سواء في مدارس
+
+217
+00:16:38,530 --> 00:16:43,850
+الوكالة أو مدارس الحكومة الكثافة عالية جدا تخلّف
+
+218
+00:16:43,850 --> 00:16:48,910
+في الفصل 55 طالب أو يزيد عن 55 وهذا بتقلل التكلفة
+
+219
+00:16:48,910 --> 00:16:54,690
+لأن طبعا الدكتورات الأعلى من الطلاب تحتاج لمدرسين
+
+220
+00:16:54,690 --> 00:17:02,250
+أقل تحتاج لفصول أقل وهكذاكمان من بين الأشياء اللي
+
+221
+00:17:02,250 --> 00:17:08,610
+بنخلّي احنا نتقلل من اللي هو التكلفة استخدام
+
+222
+00:17:08,610 --> 00:17:12,430
+المبنى المدرسي لأكثر من دورة ولا دورة إن الوضع
+
+223
+00:17:12,430 --> 00:17:15,790
+الطبيعي للتعليم ينفذ التلاميذ في مدارسهم لفترة
+
+224
+00:17:15,790 --> 00:17:21,090
+كامة مدارس بتاع الطلبة كرسة كافية للدراسة ومارسة
+
+225
+00:17:21,090 --> 00:17:24,590
+لنشاط اللاصف فيه ولكن تضطر بعض الدول لشغل مبنى
+
+226
+00:17:24,590 --> 00:17:27,570
+دورتين أو ثلاث دورتين زي اللي عندنا في قطاع غزة
+
+227
+00:17:28,020 --> 00:17:31,900
+ونلاحظ إن المبنى المدرسي والمدرسة فيه دورة صلاحية
+
+228
+00:17:31,900 --> 00:17:36,100
+وفيه دورة مسائلة وفيه الآن تفكير عند الجهات
+
+229
+00:17:36,100 --> 00:17:43,060
+المسؤولة إنه تعمل طبعاً ثلاث دورات في الفصل طبعاً
+
+230
+00:17:43,060 --> 00:17:48,500
+هذا كلام كانت تفكير قبل يعني جائحة Corona لكن يعني
+
+231
+00:17:48,500 --> 00:17:53,740
+قد الجائحة جائحة خلت فيه تغيير في الأمور لأن
+
+232
+00:17:53,740 --> 00:17:59,030
+الطلاب اضطروا للجلوس في بيوتهمكمان من بين الأشياء
+
+233
+00:17:59,030 --> 00:18:01,770
+اللي بتخلي في تخسيس التكلفة للتعليم زيادة نساء
+
+234
+00:18:01,770 --> 00:18:05,830
+المدرس ويقصد بيها أن الساعات المقارنة بدرسها وده
+
+235
+00:18:05,830 --> 00:18:12,130
+مثلا يعطي مثلا عشرين حصة يعطي تلاتين حصة فهذا بيقل
+
+236
+00:18:12,130 --> 00:18:17,330
+من التكلفة لأن المدرس بغض راتب وبس يزيد نسابه بقل
+
+237
+00:18:17,330 --> 00:18:21,270
+عدد المدرس اللي احنا محتاجينه أربع استخدام كفاءات
+
+238
+00:18:21,270 --> 00:18:26,690
+علمية ومتدنية كمان خمس التوسع في إنشاء قصود المدرس
+
+239
+00:18:26,690 --> 00:18:32,080
+القائمةأو مدرسة قايمة ستة تخلي عن برام برنامج
+
+240
+00:18:32,080 --> 00:18:36,960
+النشاط بالمدارس والتخضير المدرسية زمان كانوا في
+
+241
+00:18:36,960 --> 00:18:41,860
+وقت الغوث يجيبوا واجبات وطعام اليوم بطنوا استخدام
+
+242
+00:18:41,860 --> 00:18:46,860
+الكتاب المدرسي لأكثر من تلميذ يعني يمكن يكفي تلميذ
+
+243
+00:18:46,860 --> 00:18:50,020
+بس يخلص الفصل السنة الدراسية بيسلموا وبيسلموه
+
+244
+00:18:50,020 --> 00:18:54,400
+لتلميذ اللي بعدهم تصييم المباني المدرسية وتنقذها
+
+245
+00:18:54,400 --> 00:18:57,630
+لاهتمام باستخدام أساليب التعليم عن بواسطةالتعليم
+
+246
+00:18:57,630 --> 00:19:01,630
+على البعد لو أجدناه وإحنا هنا في الجامعة الإسلامية
+
+247
+00:19:01,630 --> 00:19:06,870
+متبقينه الآن هذا التعليم صح أنه أجاب بسبب جائحة
+
+248
+00:19:06,870 --> 00:19:10,970
+كورونا لكن كما يقول البعض على ضارة نافعة التعليم
+
+249
+00:19:10,970 --> 00:19:15,770
+على البعد بقل التكلفة لأنه بزيد عدة ساعات المدرسة
+
+250
+00:19:15,770 --> 00:19:21,330
+المدرسة التكلفة التشغيلية من إشغال القاعات
+
+251
+00:19:21,330 --> 00:19:25,770
+الدراسية من كهرباء من تليفونات في بطنة الجامعة
+
+252
+00:19:25,770 --> 00:19:30,950
+تتفاحةالمدرس إن صعبه زاد لأن الشعوبة ممكن تصبح
+
+253
+00:19:30,950 --> 00:19:35,430
+شعوبتين أو الشعوبتين تصبح شعوبة لأن التعليم على
+
+254
+00:19:35,430 --> 00:19:38,430
+البُعد بتنمي بشكل يعني وبالتالي الجامعة تنفر على
+
+255
+00:19:38,430 --> 00:19:43,770
+حالها نفقات عالية ولكن التعليم على البُعد اليوم في
+
+256
+00:19:43,770 --> 00:19:47,430
+جامعات في العالم يعتبر أسلوب تدريسي والجامعة
+
+257
+00:19:47,430 --> 00:19:52,610
+الإسلامية اليوم بتفكر تفكير جدي أنها يعني حتى
+
+258
+00:19:53,650 --> 00:19:57,270
+التعليم العالي الفلسطيني يفكر إنه يفتح برامج محددة
+
+259
+00:19:57,270 --> 00:20:01,370
+للتعليم على البعد يتعلم فيها طلبة من داخل فلسطين
+
+260
+00:20:01,370 --> 00:20:04,750
+أو من خارج فلسطين عشرة انقاص سنوات من سلسلة
+
+261
+00:20:04,750 --> 00:20:08,890
+التعليم كل هذه الأسباب بتكلّفي تخفية في تكلفات
+
+262
+00:20:08,890 --> 00:20:14,390
+اللي هو التعليم هذه بيشوفوا إجراءات اللي حكينا
+
+263
+00:20:14,390 --> 00:20:18,590
+عنها قبل قليل إجراءات مباشرة لتخفية التكلفة في
+
+264
+00:20:18,590 --> 00:20:22,870
+عندنا إجراءات غير مباشرة لتقليل أو تخفف طلبة
+
+265
+00:20:22,870 --> 00:20:27,540
+التعليممن بين واحد تقليل معدلات التسرب التسرب من
+
+266
+00:20:27,540 --> 00:20:33,120
+المدرسة طبعاً هذا مشكلة بتعانينا كثير من الدول
+
+267
+00:20:33,120 --> 00:20:37,420
+خاصة الدول اللامية في بعض البلاد نسمة التسرب تزيد
+
+268
+00:20:37,420 --> 00:20:45,460
+على 20% خاصة في المراحل الابتدائية في المراحل
+
+269
+00:20:45,460 --> 00:20:49,880
+التالية تصل إلى 5% أو 10% التلميذ المتسرب هو
+
+270
+00:20:49,880 --> 00:20:54,530
+التلميذ الذي لا يكمن دراسته حتى نهايةعلى مرحلة
+
+271
+00:20:54,530 --> 00:20:58,570
+التعليم يبقى ناجح فذلك فإن ما يُصرف عليه يدخل في
+
+272
+00:20:58,570 --> 00:21:05,370
+باب الفاقر يصرف عليه بالأخير الصرف فالإنفاق عليه
+
+273
+00:21:05,370 --> 00:21:09,590
+هذا هو الفاقر بتعلم سنة كام يبقى مش مصرف أو الهدف
+
+274
+00:21:09,590 --> 00:21:15,130
+للتعليم وكلفة السنوات الدراسية اللي صرفت عليه تحمل
+
+275
+00:21:15,130 --> 00:21:18,390
+على كلفة هؤلاء اللي أكملوا المرحلة يبقى ناجحة يعني
+
+276
+00:21:18,390 --> 00:21:22,670
+هو نفع التكلفة هو مش ناجح وبالتالي التكلفة هذه
+
+277
+00:21:22,670 --> 00:21:26,780
+العاليةبتزيد من تكلفة التعليم فإذا تقلل التسرب
+
+278
+00:21:26,780 --> 00:21:32,300
+بتقل التكلفة التعليمية اثنين خفض نسبة الرسوم
+
+279
+00:21:32,300 --> 00:21:37,720
+الرسوم مع التسرب يدخل في باب الهدر بالتعليم ده كأن
+
+280
+00:21:37,720 --> 00:21:42,420
+التلميذ اللي يعيد صفه يضاعف كلف التعليم في صف الصف
+
+281
+00:21:42,420 --> 00:21:48,420
+يعيد جديد يشكل تكلفة إضافة إلى ذلك فإن الرسوم
+
+282
+00:21:48,420 --> 00:21:52,820
+يعتبر من أهم أسباب التسرب إذا أول شغل مشروعات غير
+
+283
+00:21:52,820 --> 00:22:01,400
+مباشرةتقريباً معدل التصرف عشان نقلل تقليل التعليم
+
+284
+00:22:01,400 --> 00:22:07,660
+ونخفض نسبة الرسوم ونرفع كفاءة المعلمدالك أن تحسين
+
+285
+00:22:07,660 --> 00:22:10,600
+نوعية المعلم يؤدي بالضرورة إلى تحسين نوعية التعليم
+
+286
+00:22:10,600 --> 00:22:14,420
+المقدمة ويحدث من عامل الهدف من تصرف ورسولة أربع
+
+287
+00:22:14,420 --> 00:22:17,680
+تطوير المناهج وأسلوب التدريس، خمس تطوير نظم
+
+288
+00:22:17,680 --> 00:22:22,040
+التقويم والانتحار، ستة رشيد مواقع المدارس، سبع قمم
+
+289
+00:22:22,040 --> 00:22:25,500
+وجامعات المدارس، والتوسع في المدارس، ثلاثة فاصلة،
+
+290
+00:22:25,500 --> 00:22:31,600
+كل هذه تمثل السبع أسباب، اللي هو إجراءات غير
+
+291
+00:22:31,600 --> 00:22:38,310
+مباشرة لتقليل تكلفات التعليمحساب تكلفة الطالب نحنا
+
+292
+00:22:38,310 --> 00:22:44,850
+الآن عندنا بعض القوانين
+
+293
+00:22:44,850 --> 00:22:48,350
+هذه القوانين هستخدمها ان شاء الله في حل بعض
+
+294
+00:22:48,350 --> 00:22:53,990
+الأمثلة لأن أنت قول هقرأها ان شاء الله لكن ان شاء
+
+295
+00:22:53,990 --> 00:22:56,950
+الله في نهاية الشبط أو في نهاية الفصل أكون مجموعة
+
+296
+00:22:56,950 --> 00:23:00,130
+أمثلة مطلوب حلها أربعة أمثلة مثلا واحد اتنين اتنين
+
+297
+00:23:00,130 --> 00:23:04,220
+اتنين اربعة باستخدام هذه القوانينأنا مش هحل
+
+298
+00:23:04,220 --> 00:23:09,740
+الأمثلة لأنها واجب على الطالب ان شاء الله يبعتلنا
+
+299
+00:23:09,740 --> 00:23:13,020
+إياه من خلال الموضوع إذا نحن نتكلم عن قوانين
+
+300
+00:23:13,020 --> 00:23:17,040
+يستخدمها الطالب ويستخدمها الطالب التعليمية السنوية
+
+301
+00:23:17,040 --> 00:23:21,000
+من المصاليف الجارية ويتم الفصول عليها من خلال قسم
+
+302
+00:23:21,000 --> 00:23:24,540
+التكلفة الجارية للبرنامج والكلية أو القسم للعدد
+
+303
+00:23:24,540 --> 00:23:26,880
+الطلبة المستفيدين من البرنامج والقسم
+
+304
+00:23:29,770 --> 00:23:32,750
+التعليمية السنوية من المصادر التدثميرية على نحو
+
+305
+00:23:32,750 --> 00:23:36,290
+التعليم واحد تكفة الطالب التعليمية السنوية من
+
+306
+00:23:36,290 --> 00:23:40,350
+استهلاك السنة والأبنية يشاوي اجمال تكفة الأبنية ضد
+
+307
+00:23:40,350 --> 00:23:43,910
+نسبة استهلاك السنة والأبنية على عدد الطلبة
+
+308
+00:23:43,910 --> 00:23:47,070
+المساعدين الأبنية معرفة نسبة استهلاك من السنة
+
+309
+00:23:47,070 --> 00:23:51,670
+والأبنية هي 2% هذه طبعا نسب استهلاك ستكون ثابتة
+
+310
+00:23:51,670 --> 00:23:56,330
+لكل أمثلة نسب استهلاك ستكون ثابتة لأن هذه مقدرة من
+
+311
+00:23:56,330 --> 00:24:00,220
+قبل اللي همهي أهل الاقتصاد و أهل الاقتصادي نسبة
+
+312
+00:24:00,220 --> 00:24:03,520
+السلاك الأجزة والأبناء هي 2% ومن بعد طبعا التسهيل
+
+313
+00:24:03,520 --> 00:24:08,480
+والتفشير اثنين تكلفة الطالب التعليمية السنوية من
+
+314
+00:24:08,480 --> 00:24:11,840
+السلاك السنوي الأجزة والأسات ومعدات والألات تساوي
+
+315
+00:24:11,840 --> 00:24:15,520
+إجمال تكلفة الأجزة والأسات ومعدات والألات تار نسبة
+
+316
+00:24:15,520 --> 00:24:18,480
+السلاك السنوي الأجزة والأسات على عدد الطلب
+
+317
+00:24:18,480 --> 00:24:21,980
+المستفيدين من الأجزة والأسات ومعدات والألات مع
+
+318
+00:24:21,980 --> 00:24:24,920
+العلم أن نسبة السلاك السنوي الأجزة والأسات ومعدات
+
+319
+00:24:24,920 --> 00:24:30,770
+والألات هي 10% برضه هذا النسبة هتكونثابتة تلاتة
+
+320
+00:24:30,770 --> 00:24:34,030
+تكلفة الطالب التعليمية السنوية من استخدام السنوية
+
+321
+00:24:34,030 --> 00:24:38,150
+للسيارات يساوي أجمال تكلفة السيارات ضعف نسبة
+
+322
+00:24:38,150 --> 00:24:41,390
+استخدام السنوية للسيارات على عدد طلب المستخدمين من
+
+323
+00:24:41,390 --> 00:24:45,690
+السيارات مع أن علم نسبة استخدام السيارات هي 15%
+
+324
+00:24:45,690 --> 00:24:48,850
+برضه هذه نسبة ثابتة أربع تكلفة الطالب التعليمية
+
+325
+00:24:48,850 --> 00:24:52,110
+السنوية من استخدام السنوية للكتب يساوي أجمال تكلفة
+
+326
+00:24:52,110 --> 00:24:55,050
+الكتب ضعف نسبة استخدام السنوية للكتب على عدد طلب
+
+327
+00:24:55,050 --> 00:24:57,780
+المستخدمين من الكتبوالنسبة للسلاك يساوي الكتب
+
+328
+00:24:57,780 --> 00:25:01,040
+بساوي 10% هذه كل القوانين اللي هتتم استخدامها ان
+
+329
+00:25:01,040 --> 00:25:06,620
+شاء الله في حل الأمثلة بعد قليل خمسة ترزط طالب
+
+330
+00:25:06,620 --> 00:25:11,440
+تعليمية من نفقات الإدارة المركزية ويتم الحصول
+
+331
+00:25:11,440 --> 00:25:14,320
+عليها من خلال قسمة الميزانية الخاصة الإدارة
+
+332
+00:25:14,320 --> 00:25:17,620
+المركزية في السنة نون على عدد الطلاب المستفدين من
+
+333
+00:25:17,620 --> 00:25:21,290
+الإدارة المركزية ستةتأخذ الطالب التعليمية من
+
+334
+00:25:21,290 --> 00:25:24,170
+المصروف الجايب ويتم الحصول عليها من خلال قسمة
+
+335
+00:25:24,170 --> 00:25:27,950
+نجموع المشاهدات الرقمية بالاستيبانات المتعلقة
+
+336
+00:25:27,950 --> 00:25:31,050
+بالمصروف الجايب لكل تخصص على عدد استجابات التي
+
+337
+00:25:31,050 --> 00:25:35,630
+فرغت لكل تخصص سبعة تأخذ الطالب التعليمية من الفرصة
+
+338
+00:25:35,630 --> 00:25:39,470
+الضائعة بالساوي متوسط الراتب الشهر للخريج العامل
+
+339
+00:25:39,470 --> 00:25:45,110
+من المرحلة السابقة تاريخ 1212 هذه عبارة عن تأخذ
+
+340
+00:25:45,110 --> 00:25:47,590
+الفرصة اللي كان ضائعة في السنة الأولى أما في السنة
+
+341
+00:25:47,590 --> 00:25:52,800
+التانيةفيضاف إليها فيضاف إلى قيمة الراتب متوسط
+
+342
+00:25:52,800 --> 00:25:57,620
+الزيادة السنوية ثمانية تكلفة الطالب السنوية الكلية
+
+343
+00:25:57,620 --> 00:26:01,060
+سواء تكلفة الطالب العامة غير مباشرة أو غير مباشرة
+
+344
+00:26:01,060 --> 00:26:05,180
+أو تكلفة الطالب الخاصة مباشرة أو غير مباشرة طبعا
+
+345
+00:26:05,180 --> 00:26:10,020
+بين جسين ناقص ما يخص الطالب الواحد من إيرادات
+
+346
+00:26:10,020 --> 00:26:15,060
+المؤسسة الموجودة تسعة تكلفة الطالب السنوية العامة
+
+347
+00:26:23,430 --> 00:26:27,810
+10 تكلفة الطالب السنوية الخاصة سواء تكلفة الطالب
+
+348
+00:26:27,810 --> 00:26:31,330
+الخاصة المباشرة بين قُسايم تكلفة الطالب بالرسوم
+
+349
+00:26:31,330 --> 00:26:36,950
+الدراسية زائد تكلفة الطالب المصروف الجيد طبعا من
+
+350
+00:26:36,950 --> 00:26:40,250
+سكر القوس زائد تكلفة الطالب الخاصة غير مباشرة في
+
+351
+00:26:40,250 --> 00:26:45,690
+تكتف قصة الضايع 11لحساب متوسط العوائد الاقتصادية
+
+352
+00:26:45,690 --> 00:26:50,650
+لخريج العامل من التخص معين نعمل خطوات تالية ألف
+
+353
+00:26:50,650 --> 00:26:55,230
+العوائد في السنة الأولى لخريج العامل كل تخصص يساوي
+
+354
+00:26:55,230 --> 00:26:59,630
+متوسط الراتب الشهري الأولي لخريج متوسط الراتب
+
+355
+00:26:59,630 --> 00:27:03,030
+الشهري الأولي لخريج من المرحلة السابقة لبن جوسين
+
+356
+00:27:03,030 --> 00:27:07,470
+ضرب لبن جوسين مرت واتناشر شهر بسبب التعطل والأشهر
+
+357
+00:27:07,470 --> 00:27:12,170
+بالتخصص سبعة سنة سنة سنة سنة سنة سنة سنة سنة سنة
+
+358
+00:27:17,140 --> 00:27:20,860
+العواقد في السنة الثانية اللي الخريج بعمل كل حص
+
+359
+00:27:20,860 --> 00:27:24,100
+يساوي من بسيمة متوسطة الراتب الشهر الأول للخريج
+
+360
+00:27:24,100 --> 00:27:26,660
+بالمتوسطة الراتب الشهر الأول اللي تميله من السنة
+
+361
+00:27:26,660 --> 00:27:30,420
+الرحلة السابقة زائد متوسطة السادة السنوية للخريج
+
+362
+00:27:30,420 --> 00:27:37,270
+second course طرد 12 شهر لعدد أشهر السنةالآن
+
+363
+00:27:37,270 --> 00:27:40,010
+الأمثلة اللي أخدناها كلها إن شاء الله هنستخدمها في
+
+364
+00:27:40,010 --> 00:27:44,150
+اللي هو الأمثلة اللي كمان شوية هنوضحها لكم إن شاء
+
+365
+00:27:44,150 --> 00:27:47,810
+الله تعالى حساب التكلفة العائلية كيف لسه التكلفة
+
+366
+00:27:47,810 --> 00:27:51,350
+العائلية؟ تزايد في العقود الأخيرة تحمل عائلات
+
+367
+00:27:51,350 --> 00:27:55,570
+نفقات تعليم أبناء، تدفع الفلوس ولسه يأمر بعد
+
+368
+00:27:55,570 --> 00:27:58,250
+انتشار المدارس الخاصة وتحسب التكلفة العائلية
+
+369
+00:27:58,250 --> 00:28:02,390
+لأجهزة الصرف المختلفة في سنة محددة سواء كانت مدرسة
+
+370
+00:28:02,390 --> 00:28:06,900
+حكومية أو خاصة وذلك من حيثالشيء التكلفة هذه واحد
+
+371
+00:28:06,900 --> 00:28:10,340
+المبالغ التي صرفت على تعليم التلميذ خلال سنة
+
+372
+00:28:10,340 --> 00:28:16,700
+دراسية واحدة وذلك لشراء الملابس المدرسية والرياضية
+
+373
+00:28:16,700 --> 00:28:21,140
+والشط المدرسي والكراسات المدرسية وواجور النقل
+
+374
+00:28:21,140 --> 00:28:25,820
+وخلافها اثنين الرسوم الدراسية لتسلمة المدرسة ثلاثة
+
+375
+00:28:25,820 --> 00:28:30,820
+قيمة الكتب الدراسية ومستلزمات نشر الدراسية أربع
+
+376
+00:28:30,820 --> 00:28:35,230
+المصاريف اليوميةويمكن هنا أخذ متوسطات الإنفاق على
+
+377
+00:28:35,230 --> 00:28:39,450
+مجموعة من التلميذ في السنة معينة حيث يمكن تقدير
+
+378
+00:28:39,450 --> 00:28:46,190
+التكلم الكلمي لتحمل عيلته أو أسرته التكاليف العامة
+
+379
+00:28:46,190 --> 00:28:50,390
+هي تكاليف مباشرة ومن بينها تكاليف الجارية اللي
+
+380
+00:28:50,390 --> 00:28:53,990
+حكينا عنها قبل قليل تشمل رواتب العاملين في الكلية
+
+381
+00:28:53,990 --> 00:28:59,230
+احنا تكلمنا عن الكلية طبعا أو مدرسة يعني مدرسة
+
+382
+00:28:59,230 --> 00:29:03,090
+جامعة ما هي مشكلةالمعلمين الإداريين المستخدمين
+
+383
+00:29:03,090 --> 00:29:07,030
+المجموعة نفغات الكلية أو المدرسة بتشمل الماء
+
+384
+00:29:07,030 --> 00:29:10,330
+الكهرباء الهاتف الانترنت اللوازم في الورش اللوازم
+
+385
+00:29:10,330 --> 00:29:13,490
+الرياضية الصيانة اللوازم التنظيف الإعلانات هذا
+
+386
+00:29:13,490 --> 00:29:17,310
+كلها بيسموها تكاليف تشغيلية فيه تكليف رأس مالية
+
+387
+00:29:17,310 --> 00:29:21,290
+اللي أحنا حكينا عنها قبل قليل زي السلك السامي
+
+388
+00:29:21,290 --> 00:29:25,640
+للأمنيةفي حالة استأجار المباني هتتم اضافة إيجارات
+
+389
+00:29:25,640 --> 00:29:29,320
+لمبني أمنية والمرفقات بدلاً من حساب السلاك السلاك
+
+390
+00:29:29,320 --> 00:29:33,020
+السنوي الأمنية كانت المبنى ملك للمدرسة كان مستأجر
+
+391
+00:29:33,020 --> 00:29:36,020
+طبعاً من حساب الإيجارات السلاك السنوي للسيارات،
+
+392
+00:29:36,020 --> 00:29:38,660
+السلاك السنوي للأثاث والمعدات، وهذا كله قبل قليل
+
+393
+00:29:38,660 --> 00:29:41,640
+وخلال القوانين واضحناه السلاك السنوي للكتب
+
+394
+00:29:41,640 --> 00:29:45,840
+المكتبية يتفادع على رأس المال ويشبر قيم المكاني
+
+395
+00:29:45,840 --> 00:29:49,440
+الأرض لتجهيزات الكتب السياسية والضرائبالتكلفة غير
+
+396
+00:29:49,440 --> 00:29:52,660
+مباشرة تصيب الكلية من الإدارة المركزية بإجمال
+
+397
+00:29:52,660 --> 00:29:55,560
+التكليف العامة مباشرة أو غير مباشرة لردد الكلية من
+
+398
+00:29:55,560 --> 00:29:59,900
+إنتاج الكلية والطلبة إن وصلت في أقل فيه عندنا
+
+399
+00:29:59,900 --> 00:30:03,800
+نموذج استخدام تحديد مصروف الجامعة أو رسوم دراسية
+
+400
+00:30:03,800 --> 00:30:07,480
+الطالب يعني اسم الكلية، تخصص موقع الكلية، طبعا
+
+401
+00:30:07,480 --> 00:30:10,360
+عنده متخصص عدد الساعات المعتمدة ومتفجرة، لأول ولا
+
+402
+00:30:10,360 --> 00:30:15,280
+فتخصص أول مثلا عندك عشرين ساعة رسوم الساعة
+
+403
+00:30:15,280 --> 00:30:20,550
+المعتمدة للتخصصعنده طلع هنا مثلا الرسوم برضه عشرين
+
+404
+00:30:20,550 --> 00:30:32,130
+دينار فانا اقول مثلا لو احنا قلنا هنا يعني اقول
+
+405
+00:30:32,130 --> 00:30:40,750
+هنا عشرين ساعة مثلا و
+
+406
+00:30:40,750 --> 00:30:43,910
+هنا قلنا ضرب فصل أول مثلا عشرين
+
+407
+00:30:49,570 --> 00:30:56,330
+عشرين دينار رجوع من الساعة مثلا نطلع
+
+408
+00:30:56,330 --> 00:31:03,430
+إلى المجموع مثلا هنا نطلع 400 دينار
+
+409
+00:31:11,370 --> 00:31:14,290
+في الفاصلة الثانية ممكن نحسبها بسعة أقل أو أكثر
+
+410
+00:31:14,290 --> 00:31:21,310
+بنفس الطريقة التي حسبناها بهذا الشكل هذا نموذج
+
+411
+00:31:21,310 --> 00:31:27,050
+موجود في نموذج ثاني مثلا ثمن الكتب في الشهر قداش
+
+412
+00:31:27,050 --> 00:31:30,730
+وفي الفاصلة قداش ثمن كتب المواد التعليمية ومواصلة
+
+413
+00:31:30,730 --> 00:31:33,670
+التسلسل التنموذج الأسرة ومشاريع التخرج هذا كله
+
+414
+00:31:33,670 --> 00:31:38,390
+نماذج قد تتغير قد تعتمد كل مدرسة على نموذج معين في
+
+415
+00:31:38,390 --> 00:31:44,120
+حساب التكلفةومافيها مشكلة على الأطلاع أخيراً هذه
+
+416
+00:31:44,120 --> 00:31:47,100
+الأمثلة العملية هذه الأمثلة العملية هي مثال واحد
+
+417
+00:31:47,100 --> 00:31:50,240
+مثال اثنين مثال اثنين مثال اربع هذا ان شاء الله
+
+418
+00:31:50,240 --> 00:31:56,460
+انا اتقلكم من خلال ال model ومطلوب حلها و تسليم
+
+419
+00:31:56,460 --> 00:32:02,800
+الحل لنا بشكل يعني يدو الطالب مطلوب انه يكتب و
+
+420
+00:32:02,800 --> 00:32:08,670
+يبعت يعني يكتب خط ايدهوميصور اللي .. اللي كتب وفق
+
+421
+00:32:08,670 --> 00:32:11,750
+إيده ويبقى عادة اللي هي من قبله الموديل عشان يكون
+
+422
+00:32:11,750 --> 00:32:15,770
+يشتغل ان شاء الله أو يحيط مثال واحد اتحقق طال
+
+423
+00:32:15,770 --> 00:32:19,410
+البرنامج الدولو متوسط تخصص منظم معلومات جغرافية في
+
+424
+00:32:19,410 --> 00:32:21,690
+كلية العلم المهنية والتطبيقية في الجامعة الاسلامية
+
+425
+00:32:21,690 --> 00:32:24,570
+بعد اعلانته أن متوسط الراتب الشهري لخروج التنوية
+
+426
+00:32:24,570 --> 00:32:27,610
+العامة 200 دينار ومتوسط لزيادة السنوية 10 دينار
+
+427
+00:32:27,610 --> 00:32:30,690
+بقى متوسط راتب الشهر لخروج نظم معلومات جغرافية من
+
+428
+00:32:30,690 --> 00:32:34,290
+تلقاء 90 دينار متوسط لزيادة السنوية 15 دينار
+
+429
+00:32:35,630 --> 00:32:38,910
+المقلوب واحد أوجد تجربة الفرصة المدينة الضائعة أن
+
+430
+00:32:38,910 --> 00:32:42,730
+أوجد العوائد الاقتصادية تتطلب خلال سنتين من تخرجتي
+
+431
+00:32:42,730 --> 00:32:47,190
+إذا أنت انتصرت بفضالة تخصصت من معلمات عالمية هذا
+
+432
+00:32:47,190 --> 00:32:51,210
+مثال لو انت دفقت القوانين هتحلوا القوانين اللي
+
+433
+00:32:51,210 --> 00:32:56,910
+احنا ذكرناها قبل قليل مثال اثنين نفس القضية طبعا
+
+434
+00:32:56,910 --> 00:33:02,210
+مثال واحد مختلف عن مثال اثنيناستحق طالب ببرنامج
+
+435
+00:33:02,210 --> 00:33:05,210
+اللوم المتوسط تخصص طبقات متعددة بالقليلية في علوم
+
+436
+00:33:05,210 --> 00:33:07,890
+المهنية وطبقية بالجامعة الإسلامية في أرزا ثم الطب
+
+437
+00:33:07,890 --> 00:33:11,550
+واحد اجترخ الطالب السنوي العامة انت بتوصل بديلة
+
+438
+00:33:11,550 --> 00:33:14,830
+ضائعة في ثلاث سنة دراساته تلت العواد الاقتصادية
+
+439
+00:33:14,830 --> 00:33:17,610
+للطالب في ثلاث سنتين من التخرجه إذا انت متوسط
+
+440
+00:33:17,610 --> 00:33:21,230
+ببطالة تخصص اللوم المتوسطة بتعدد ست شهور ففي غضب
+
+441
+00:33:21,230 --> 00:33:24,150
+توفر معلومات التالية اجترخ الطالب العامة السنوية
+
+442
+00:33:24,150 --> 00:33:27,390
+مباشرة ب 100 دينارطبعاً نحن ناسم ناسم الاستهلاك
+
+443
+00:33:27,390 --> 00:33:32,810
+إجمال التكنولوجيا الأولية للكلية تساوي 6.3 مليون
+
+444
+00:33:32,810 --> 00:33:37,030
+دينار إجمال التكنولوجيا للأجهزة والإبطالات
+
+445
+00:33:37,030 --> 00:33:40,010
+والممدنات بالكلية 100 ألف دينار إجمال التكنولوجيا
+
+446
+00:33:40,010 --> 00:33:42,730
+للإبطالات والممدنات بالكلية 20 ألف دينار إجمال
+
+447
+00:33:42,730 --> 00:33:45,970
+التكنولوجيا للكتب بالكلية 10 ألف دينار إتفاليف
+
+448
+00:33:45,970 --> 00:33:48,950
+الطرف المباشر 50 دينار إتفاصل الفترة بالشهر
+
+449
+00:33:48,950 --> 00:33:53,810
+لقانوني التنوي العامة 150 دينارومتوسط نسية السنوية
+
+450
+00:33:53,810 --> 00:33:58,850
+يخلص دنانير ومتوسط راتب الشهر يخلص دنانير ومتوسط
+
+451
+00:33:58,850 --> 00:34:03,130
+راتب
+
+452
+00:34:03,130 --> 00:34:05,710
+الشهر يخلص دنانير ومتوسط راتب الشهر يخلص دنانير
+
+453
+00:34:05,710 --> 00:34:08,010
+ومتوسط راتب الشهر يخلص دنانير ومتوسط راتب الشهر
+
+454
+00:34:08,010 --> 00:34:08,230
+دنانير ومتوسط راتب الشهر يخلص دنانير ومتوسط راتب
+
+455
+00:34:08,230 --> 00:34:11,940
+الشهر يخلص دنانير ومتوسط راتب الشهر يخلبنفس
+
+456
+00:34:11,940 --> 00:34:14,860
+الطريقة، هي نقرأ على سريع اتحاق طالب ببرنامج اللغة
+
+457
+00:34:14,860 --> 00:34:17,020
+المتوسط، خاص بحسوب الكليك العلمي و البيانات
+
+458
+00:34:17,020 --> 00:34:19,800
+التجاربية الجامعية السعودية، فعلمت أن ألف الواصل
+
+459
+00:34:19,800 --> 00:34:22,700
+الرابط الشهري للدراسة التنوية العامة، 220 دماغ،
+
+460
+00:34:22,700 --> 00:34:26,260
+نفس الطريقة مثل الثلاث سنة جاية مثل الأول، بس
+
+461
+00:34:26,260 --> 00:34:29,360
+الأقان تختلف، برضه مضطب حلومتواصل الجادة السنوية
+
+462
+00:34:29,360 --> 00:34:32,280
+عشان تنانير، بقى متواصل في زيادة بشار لقرنز الحسوب
+
+463
+00:34:32,280 --> 00:34:35,200
+تقريبا 70 دينار، متواصل في الجادة 120 دينار،
+
+464
+00:34:35,200 --> 00:34:37,240
+المطلوب يجيب تفكير في هذه الفرصة البديلة أو
+
+465
+00:34:37,240 --> 00:34:40,340
+الضائعة، في مجال عوادة اقتصادية للطالب 3 سنة تانية
+
+466
+00:34:40,340 --> 00:34:43,580
+من تحرجه، إذا علمت متواصل بطالب متخصص منه متحصول
+
+467
+00:34:43,580 --> 00:34:50,780
+سبع شهورة مثال أربعة، زي مثل رقم 2، برضه مطلوب حله
+
+468
+00:34:51,170 --> 00:34:54,030
+اتحق طالب ببرنامج دبلوم متحسن تخص محاسب قلوب
+
+469
+00:34:54,030 --> 00:34:57,530
+العلوم المهنية وتطبيقية بغزة المظلوم احسن ميالي
+
+470
+00:34:57,530 --> 00:35:00,550
+تكرر تلقى الطالب السنوية العامة تاخد فرصة لضايع
+
+471
+00:35:00,550 --> 00:35:04,050
+عائلة فرصته العواد الاقتصادي لطالب دراسة التامن
+
+472
+00:35:04,050 --> 00:35:07,910
+تخرجي إلى انت المتواصل بطالب تخصص دبلوم محاسب أربع
+
+473
+00:35:07,910 --> 00:35:12,830
+شهور لك لغل توفر المعلومات التالية تلقى الطالب
+
+474
+00:35:12,830 --> 00:35:16,270
+العامة سنوية مباشرة 200 دينار اجمال تقفة الأبناء
+
+475
+00:35:16,270 --> 00:35:20,270
+للقلية خمس مليون دينار
+
+476
+00:35:22,050 --> 00:35:25,050
+إجمال تدفت الأجر والأتاد والمعداد بالكلية 200 ألف
+
+477
+00:35:25,050 --> 00:35:28,090
+دينار إجمال تدفت السيارات بالكلية 30 ألف دينار
+
+478
+00:35:28,090 --> 00:35:31,990
+إجمال تدفت الكتب بالكلية 20 ألف دينار تقريبا تدفت
+
+479
+00:35:31,990 --> 00:35:35,430
+الانبشار 100 دينار تواصل تقريبا تقريبا تقريبا
+
+480
+00:35:35,430 --> 00:35:42,530
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+481
+00:35:42,530 --> 00:35:43,150
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+482
+00:35:43,150 --> 00:35:48,190
+تقريبا تقريب
+
+483
+00:35:49,870 --> 00:35:54,250
+المطلوب حلها نبعتلكم أي أمتع موجود عندكم تجربة
+
+484
+00:35:54,250 --> 00:35:59,950
+للسيدات تطبع المطلوب حلها ورسالها عبر الموديل بعد
+
+485
+00:35:59,950 --> 00:36:05,870
+أن تنتهي مدة الحل ووقت محدد سيكون عليه درجات على
+
+486
+00:36:05,870 --> 00:36:10,870
+حال يكون عليه درجات لأن هذا يعتبر واجب يمكن أن
+
+487
+00:36:10,870 --> 00:36:15,750
+يكون عليه خمس درجات تقريبا للأسلحة هذه وبالتالي
+
+488
+00:36:15,750 --> 00:36:19,830
+المطلوب حلهابعد ان شاء الله ما ينتهي وقت الحل لما
+
+489
+00:36:19,830 --> 00:36:25,030
+تلقوا إجابة صحيحة عبر الموديل بنرسل لكم الإجابات
+
+490
+00:36:25,030 --> 00:36:30,790
+الصحيحة طبعا احنا بذلك نكون انتهينا من المقادرة
+
+491
+00:36:30,790 --> 00:36:36,750
+المصورة رقم 7 أرجو منكم أبناء الطلاب والطالبات
+
+492
+00:36:36,750 --> 00:36:41,750
+المتابعة الحديثة وأرجو حل هذا المواجب طبعا نبدأ
+
+493
+00:36:41,750 --> 00:36:47,330
+حله بعد نرسله خلال اليومين عبر الموديل
+
+494
+00:36:50,630 --> 00:36:55,730
+والنجاح وفي الختام استودعكم الله الذي يستطيع وداعه
+
+495
+00:36:55,730 --> 00:37:00,110
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_raw.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a9e3e378bb5971920a36dade6ec8322cf67c3ba3
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/XrjxJlMMj5g_raw.srt
@@ -0,0 +1,2000 @@
+1
+00:00:01,160 --> 00:00:03,720
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:03,720 --> 00:00:08,340
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:08,340 --> 00:00:13,660
+سيدنا محمد وعلى آله وأصحابه والتابعين بإحسان إلى
+
+4
+00:00:13,660 --> 00:00:19,700
+يوم الدين أما بعد الطلاب والطالبات الأعزاء السلام
+
+5
+00:00:19,700 --> 00:00:24,950
+عليكم ورحمة الله وبركاتهإن شاء الله نتكلم في
+
+6
+00:00:24,950 --> 00:00:30,510
+المقادرة المصورة رقم 7 لمصادر اقتصاديات التعليم
+
+7
+00:00:30,510 --> 00:00:37,770
+والصحة عن الفصل الثالث تكلفة التعليم إن شاء الله
+
+8
+00:00:37,770 --> 00:00:42,610
+في هذا الفصل سوف نتكلم عن تقريبا سبع نقاط أول
+
+9
+00:00:42,610 --> 00:00:47,830
+مقدمة ثم تعريف تكلفة التعليم ثم أسباب ارتفاع تكلفة
+
+10
+00:00:47,830 --> 00:00:52,390
+التعليمأهداف دراسة تكلفة التعليم وخلاصة التكلفة
+
+11
+00:00:52,390 --> 00:00:56,990
+التعليمية تقفية تكلفة التعليم بسبب تكلفة التعليم
+
+12
+00:00:56,990 --> 00:01:00,470
+هو نقطة السابقة الأمثلة التطبيقية حول تكلفة
+
+13
+00:01:00,470 --> 00:01:04,290
+التعليم وإن شاء الله الأمثلة التطبيقية هيكون واجب
+
+14
+00:01:04,290 --> 00:01:07,810
+إن شاء الله من هذه الأمثلة هيتم إرساله في الأيام
+
+15
+00:01:07,810 --> 00:01:12,770
+القادمة على المدل هنعطيكوا هذه الأمثلة المطلوب
+
+16
+00:01:12,770 --> 00:01:17,890
+طبعا خلها في البيتوإرسالها إن شاء الله على الموديل
+
+17
+00:01:17,890 --> 00:01:24,010
+وهذا هنوضحه إن شاء الله في آخر هذه المقاطرة طبعاً
+
+18
+00:01:24,010 --> 00:01:28,610
+في عبارات مهمة إن التعليم الجيد هو تعليم غالي
+
+19
+00:01:28,610 --> 00:01:35,110
+الثمن يعني إذا بدنا نتعلم كويس ممكن ندفع فلوس أكثر
+
+20
+00:01:35,110 --> 00:01:40,430
+فنحصل على تعليم أفضل يعني في تعليم الخاص وفي
+
+21
+00:01:40,430 --> 00:01:44,640
+التعليم العكومي أو التعليم العاموأن التعليم الرديق
+
+22
+00:01:44,640 --> 00:01:48,940
+هو التعليم الرخيص النقطة الثانية تعتبر تجارب
+
+23
+00:01:48,940 --> 00:01:52,640
+التعليم مؤشرًا واضحًا على نواعيد التعليم كل ما
+
+24
+00:01:52,640 --> 00:01:57,060
+ندفع تكلفة أعلى في التعليم هذا بتدل على جودة
+
+25
+00:01:57,060 --> 00:02:03,580
+التعليم وإن هو التعليم أفضل وأحسن طبعًا في المقدمة
+
+26
+00:02:03,580 --> 00:02:10,200
+يعني في صارت يعني خلاف كيف نحش بتجارب التعليم؟ هل
+
+27
+00:02:10,200 --> 00:02:15,950
+نحش بتجارب التعليمعلى أساس المدرسة أو الفصل أو
+
+28
+00:02:15,950 --> 00:02:22,370
+التلميذ طبعاً صار دراسي لكل يعني بند من هذه الدول
+
+29
+00:02:22,370 --> 00:02:27,150
+التلاتة و تم التواصل في النهاية أن التكلفة تحسب
+
+30
+00:02:27,150 --> 00:02:31,170
+على أساس التلميذ لأنه لو حسبنا أساس المدرسة أو
+
+31
+00:02:31,170 --> 00:02:36,750
+أساس الفصل هنلاحظ أنه فيه مشكلة يعني مثلا لو حسبنا
+
+32
+00:02:36,750 --> 00:02:41,510
+التعليم على أساس التكلفة على أساسالمدارس بالنسبة
+
+33
+00:02:41,510 --> 00:02:46,450
+لمدارس تختلف اختلافا كبيرا وتكاليفها توقف على
+
+34
+00:02:46,450 --> 00:02:51,050
+عوامل كثيرة مثل عدد مابها من قصول وعدد الطلاب
+
+35
+00:02:51,050 --> 00:02:56,510
+ومكان المدرسةوغير ذلك يعني في مناقش مدرسة جيدة وفي
+
+36
+00:02:56,510 --> 00:03:01,030
+مدرسة غير جيدة في مدرسة مبانيها حديثة وفي مدرسة
+
+37
+00:03:01,030 --> 00:03:10,850
+مبانيها غير حديثة في مدرسة فيها تهوية مناسبة وفي
+
+38
+00:03:10,850 --> 00:03:14,450
+مدرسة ليست فيها تهوية مناسبة كذلك هلاحظ أنه لو
+
+39
+00:03:14,450 --> 00:03:17,730
+نحسب التكلف على أساس الفصل هلاحظ أنه برضه في
+
+40
+00:03:17,730 --> 00:03:24,460
+صعوبات ليش؟ لأن ساعة الفصل تقد تختلفبين مدرسة و
+
+41
+00:03:24,460 --> 00:03:28,400
+مدرسة أخرى أو بين فصل و فصل آخر كمان العملية
+
+42
+00:03:28,400 --> 00:03:31,800
+التعليمية لاتتم في الفصل فقط إذا عملية التعليمية
+
+43
+00:03:31,800 --> 00:03:35,760
+بتتمش في الفصل فالاتجاهات الحديثة في التربية ترعوا
+
+44
+00:03:35,760 --> 00:03:39,000
+لإتمام جزء كبير من العملية التعليمية خارج الفصل
+
+45
+00:03:39,000 --> 00:03:42,320
+وعلى ذلك في حساب تجربة التعليمية العملية التعليمية
+
+46
+00:03:42,320 --> 00:03:46,660
+على أساس واحدة الفصل يهم المرافق الأخرى في المدرسة
+
+47
+00:03:46,660 --> 00:03:50,330
+يعني في عملية التعليمية بتتمش داخل الفصلبتتم داخل
+
+48
+00:03:50,330 --> 00:03:55,350
+الفصل و بتم ايضا خارجه الفصل مثل الملاعب مثل
+
+49
+00:03:55,350 --> 00:04:02,010
+الحدائق فجرات الرسم الهندسي إلى آخرين و هناك علوم
+
+50
+00:04:02,010 --> 00:04:05,530
+أخرى تتم دراسة مباشرة في الطبيعة أو في المعامل و
+
+51
+00:04:05,530 --> 00:04:10,030
+المختبرات أو عن طريق النشاط الفصل لا يعني مامنفعش
+
+52
+00:04:10,030 --> 00:04:14,410
+يكون هو اللي على اساس تحسب اللي هي التكلفة
+
+53
+00:04:14,410 --> 00:04:21,230
+وبالتالي التلميد هو يعني أكثروحدات دقة في حساب
+
+54
+00:04:21,230 --> 00:04:27,230
+تكلفة التعليم كما أن مراعاة اعتبارات الفروق
+
+55
+00:04:27,230 --> 00:04:31,730
+الفردية في التعليم يحكم إذابة الفصول ووحدات مستقلة
+
+56
+00:04:31,730 --> 00:04:35,410
+من التلاميذ وتحويلها إلى مجموعات من التلاميذ وكل
+
+57
+00:04:35,410 --> 00:04:39,130
+مجموعة متجنسة في مادة معينة تاخد رسالة من قشرة
+
+58
+00:04:39,130 --> 00:04:43,270
+متخصصة لهذه المادة كالتاريخ والجغرافيا والرياضيات
+
+59
+00:04:43,270 --> 00:04:48,190
+واللغة الإنجليزيةيعني من العرض السابق اتضح أن أفضل
+
+60
+00:04:48,190 --> 00:04:51,770
+طريقة لحساب تكلف التعليم هو حسابه على أساس تكلف
+
+61
+00:04:51,770 --> 00:04:56,010
+التلميذ لا على أساس تكلف الفصل أو المدرسة فالتلميذ
+
+62
+00:04:56,010 --> 00:05:00,150
+يكون أساسا أكثر ثابتا من الفصل أو المدرسة عند حساب
+
+63
+00:05:00,150 --> 00:05:07,210
+التكلفة تعريف تكلفة التعليم يعني التكلفة في اللغة
+
+64
+00:05:07,210 --> 00:05:11,930
+هي مفرد التكلفة وتعني المبلغ المدفوع أو المنفق على
+
+65
+00:05:11,930 --> 00:05:17,920
+إنتاج سلعة أو خدمة معينةالتكلفة قد تقدر بالمال وقد
+
+66
+00:05:17,920 --> 00:05:25,780
+تقدر بالجهد لأن جهده يعتبر تكلفة المال اللي يدفعه
+
+67
+00:05:25,780 --> 00:05:30,000
+يعتبر تكلفة بالمفهوم الاقتصادي التكلفة هي جميع
+
+68
+00:05:30,000 --> 00:05:35,320
+النفقات اللي تدفع المؤسسة يعني الشركة أو المدرسة
+
+69
+00:05:35,320 --> 00:05:40,580
+أو الجامعة بسموها التكلفة المحسبية أو تضحي بها في
+
+70
+00:05:40,580 --> 00:05:44,900
+الفرصة البديلة من أجل ضمان مساهم عناصر الإنتاجفي
+
+71
+00:05:44,900 --> 00:05:48,780
+العملية الإنتاجية وطبعاً احنا تكلمنا عن موضوع
+
+72
+00:05:48,780 --> 00:05:52,060
+التكلفة اللي بتوسع في مصارع الاقتصاد الجزي في
+
+73
+00:05:52,060 --> 00:05:56,240
+مصارع الاقتصاد الكلي وبالتالي هذا الأمر يعني صار
+
+74
+00:05:56,240 --> 00:05:59,820
+مفروض عنده وعنده الطلاب لكن احنا عملية تذكير سريع
+
+75
+00:05:59,820 --> 00:06:04,540
+ان شاء الله لهذا الأمر التكلفة التعليم هي مقياس
+
+76
+00:06:04,540 --> 00:06:09,340
+لمقدار الإنفاق النقدي وغير النقدي الذي يتم في سبيل
+
+77
+00:06:09,340 --> 00:06:14,460
+تحقيق منفعات محددة وبيتم طبعا على أساسالعملية
+
+78
+00:06:14,460 --> 00:06:17,760
+التعليمية أو بمجرد طرحية الاقتصادية التي تحملها
+
+79
+00:06:17,760 --> 00:06:21,720
+النظام التعليمي أو المؤسسة التعليمية مقابل حصولها
+
+80
+00:06:21,720 --> 00:06:25,180
+على خدمة أو منفعة ضرورية تبقى للمعايير المقررة
+
+81
+00:06:25,180 --> 00:06:32,840
+ويمكن قياسها في شكل وعداد نقلي فعالية التكلفة في
+
+82
+00:06:32,840 --> 00:06:37,320
+التعليم يُخص الفعالية التكلفة تقويم التكلفة بربط
+
+83
+00:06:37,320 --> 00:06:41,620
+النتائج أو المنافع المتحققة بتكاليفها التي يمكن
+
+84
+00:06:41,620 --> 00:06:45,700
+حصول عليهابغرض تحديد التكاليف التي يمكن أن تعطي
+
+85
+00:06:45,700 --> 00:06:51,880
+أفضل ندائج أو المنافع بأقل التكاليف أهم شغلة أن
+
+86
+00:06:51,880 --> 00:06:55,340
+نصل على أدنى تكلفة ممكنة يعني أنا عندى فيه total
+
+87
+00:06:55,340 --> 00:06:59,480
+cost تكلفة القليل وفيه ال average cost المتوسط
+
+88
+00:06:59,480 --> 00:07:04,200
+تكلفته الهدف أن نحقق أفراد الحجم الكبير حتى في
+
+89
+00:07:04,200 --> 00:07:08,860
+التعليم أفراد الحجم الكبير يعني يصير عندى أنا
+
+90
+00:07:08,860 --> 00:07:16,770
+تكلفة التلميدأقل ما يمكن أسباب
+
+91
+00:07:16,770 --> 00:07:20,590
+ارتفاع تكليف التعليم هناك مجموعة من الأسباب اللي
+
+92
+00:07:20,590 --> 00:07:25,330
+بتخلي تكليف التعليم مرتفع وهي زيادة عدد الطلاب
+
+93
+00:07:25,330 --> 00:07:29,150
+الرضو بالتعليم ومشاركة الطلبة يعني كل معدد الطلاب
+
+94
+00:07:29,150 --> 00:07:32,390
+بزيد سواء في المدارس أو في المعاهد أو في الكلية أو
+
+95
+00:07:32,390 --> 00:07:37,050
+في الجامعات لأسباب كثيرة اللي عدد الطلاب بزيد أول
+
+96
+00:07:37,050 --> 00:07:41,380
+حاجة ارتفاع معدد الموظف الشكانيالدول تبقى اللي
+
+97
+00:07:41,380 --> 00:07:46,460
+ملزمة ومجهدة التعليم على كله بخل فيه زيادة في
+
+98
+00:07:46,460 --> 00:07:50,900
+أعداد الطلبة مما يترتب عليه ارتفاع في التكلفة
+
+99
+00:07:50,900 --> 00:07:56,160
+مخصوصا بالتكلفة لل total cost أو التكلفة الكلية
+
+100
+00:07:56,160 --> 00:08:00,980
+طول سنوات الدراسة القدر كبير من السكان والتزايد
+
+101
+00:08:00,980 --> 00:08:04,880
+التوجه نحو التنوع التعليم الأكثر تكلفة اليوم النصر
+
+102
+00:08:04,880 --> 00:08:11,960
+يدوروا على التعليم الخاص يعنيقدر يفعل شوم أغلى أو
+
+103
+00:08:11,960 --> 00:08:18,480
+تكلفة أعلى عشان يحطط نوعين من التعليم أفضل ثلاثة
+
+104
+00:08:18,480 --> 00:08:22,220
+الاحتمال متزايد بتحسين نوعية التعليم وتجود مخرجاته
+
+105
+00:08:22,220 --> 00:08:27,140
+كما قلنا اليوم صاروا الكل يعني بيدور على أنه يحسن
+
+106
+00:08:27,140 --> 00:08:31,580
+التعليم وجود مخرجاته لأنه في تنافس في سوق العمل
+
+107
+00:08:33,940 --> 00:08:36,220
+كمان من الأسباب اللي اتفتت بالتعليم هي الحاجة
+
+108
+00:08:36,220 --> 00:08:40,100
+المتزايدة لتغيير مواصفات الأبنية المدرسية يعني
+
+109
+00:08:40,100 --> 00:08:44,920
+لازم هذا الأبنية تتحدث إما لعدم صلاحية الأبنية
+
+110
+00:08:44,920 --> 00:08:49,680
+القديمة وتأثرت جديدها لقيام بالوظائف الجديدة أو
+
+111
+00:08:49,680 --> 00:08:53,300
+لصيالتها الدائمة أو لتجديد الأساس والمعدات اللاجئة
+
+112
+00:08:53,300 --> 00:08:56,980
+طبعاً إذا بدنا نجد احنا الأبنية أو علماء الأبنية
+
+113
+00:08:56,980 --> 00:09:01,060
+الجديدة هنفكب أيضا بجديد المتكلمة خمس التزايد
+
+114
+00:09:01,060 --> 00:09:04,540
+والتوجه نحو الاستخدام المكثفاقتقالية التعليم
+
+115
+00:09:04,540 --> 00:09:10,240
+والتعلم استخدام قصاد التعلم الحديثة تقنيات
+
+116
+00:09:10,240 --> 00:09:12,980
+المعاصرة في العملية التدريبية هذا كله يزيد من
+
+117
+00:09:12,980 --> 00:09:17,240
+تقنية التعليم ستة ارتفاع معادلة وضخم هو ارتفاع
+
+118
+00:09:17,240 --> 00:09:20,500
+مستوى العالم الأسعار ومانجم عنها من ارتفاع الأسعار
+
+119
+00:09:20,500 --> 00:09:23,560
+وارتفاع التقن الشرائية اللي عمناها المحل وهذا
+
+120
+00:09:23,560 --> 00:09:29,220
+يخلّي برضه التقنية تزيد زيادة مستمرة رقم سبعة في
+
+121
+00:09:29,220 --> 00:09:32,670
+المرتبات وأجور العاملين في قطاع التعليموغيرها من
+
+122
+00:09:32,670 --> 00:09:36,310
+أوجه الصرف الأخرى الجارية منها والأصمليين طبعاً
+
+123
+00:09:36,310 --> 00:09:40,650
+يعني فيه زيادة متفعة في الإنفاق على التعليم ومن
+
+124
+00:09:40,650 --> 00:09:47,770
+بينه أجور المعامل المعينين أهداف دراسة تكلفة
+
+125
+00:09:47,770 --> 00:09:52,790
+التعليم لماذا ندرس تكلفة التعليم؟ لأنه فيه ارتفاع
+
+126
+00:09:52,790 --> 00:09:57,330
+في التكلفة ارتفاع التكلفةفرض على المخططين وصناع
+
+127
+00:09:57,330 --> 00:10:00,550
+القرار الاقتصادي والتربوي وغيرين من الباحثين
+
+128
+00:10:00,550 --> 00:10:04,790
+والمهتمين دراسة تكلفة التعليم المستوين لكل نظام
+
+129
+00:10:04,790 --> 00:10:09,650
+التعليم أو جزء مؤسسة التعليم الواحدة شوه أهداف هذه
+
+130
+00:10:09,650 --> 00:10:15,250
+الدراسة أولا تبصر دراسة التكلفة صناع القرار
+
+131
+00:10:15,250 --> 00:10:19,470
+بالتكلفة الإجمالية للمدرسة هم تحتجم مطالبات مالية
+
+132
+00:10:19,470 --> 00:10:23,230
+لعيشتتها ومشروعاتها وممكنياتها ممكنة تنفيذها في
+
+133
+00:10:23,230 --> 00:10:28,500
+ضوء المطالبات الماليةورجع التكلفة طبعاً بتوضح هذه
+
+134
+00:10:28,500 --> 00:10:34,060
+التكلفة كأول هدف لصناعة القرار لدرجة التكلفة
+
+135
+00:10:34,060 --> 00:10:40,020
+الإجمالية للمدرسة وليس لتكلفة الوحدة في المدرسة
+
+136
+00:10:40,020 --> 00:10:44,160
+اثنين إيجاد نوع من التوازن بين مخصصات التعليم غير
+
+137
+00:10:44,160 --> 00:10:48,420
+من النفقات المخصة لقطعات اقتصاد أخرى بصورة تبرز
+
+138
+00:10:48,420 --> 00:10:52,360
+مدرسة حاجة التعليم لزيادة مخصصاته من مجالين عامة
+
+139
+00:10:52,360 --> 00:10:58,390
+لدور من نتج المحل الإجماليبنعمل توازن بين مخصصات
+
+140
+00:10:58,390 --> 00:11:02,350
+انفاق على التعليم ومخصصات انفاق على الأمور الأخرى
+
+141
+00:11:02,350 --> 00:11:07,330
+سواء سلاسل غذائية، سواء ملابس، سواء خدمات الصحة
+
+142
+00:11:07,330 --> 00:11:13,450
+إلى آخرين ثلاثة، المقوف على الكم الذي يُنفق على
+
+143
+00:11:13,450 --> 00:11:17,170
+قطاع التعليم بصورة ممكن وحقيقين بمعرفة الأموال
+
+144
+00:11:17,170 --> 00:11:22,070
+المنفقة في قطاع التعليم، الموارد الحقيقية الموظفة
+
+145
+00:11:22,070 --> 00:11:26,080
+فيهتعرض فدائل مختلفة التي ترفع كفاءة قطاع التعليم
+
+146
+00:11:26,080 --> 00:11:29,740
+وتحقيق أهداف المجتمع وحصل أعداء المالية الجديدة
+
+147
+00:11:29,740 --> 00:11:34,280
+أربعة من بين الأهداف أيضًا دراسة تقدير التكلفة
+
+148
+00:11:34,280 --> 00:11:38,360
+تفيد في اكتشاف الإمكانيات المالية المطلوبة بدء من
+
+149
+00:11:38,360 --> 00:11:42,140
+تحديد وتصنيف وقياس تكلفة المدخلات توقف على
+
+150
+00:11:42,140 --> 00:11:45,480
+الإمكانيات المالية المتاحة ومرورا بتقدير تكلفة
+
+151
+00:11:45,480 --> 00:11:50,690
+تنفيذ مشروع أو برنامج أو تحسينهخامس اكتشاف نمطية
+
+152
+00:11:50,690 --> 00:11:54,150
+سلوك التكلفة اللي وقوف على مدى استغلال أو سوق
+
+153
+00:11:54,150 --> 00:11:58,290
+استغلال متخلات في العملية التعليمية وتعييم وأشرات
+
+154
+00:11:58,290 --> 00:12:02,290
+معينة يمكن الاستغلال منها على مدى استغلال الموارد
+
+155
+00:12:02,290 --> 00:12:08,350
+ستة بيان مدى تأثير تكلفة العاملين في المدرسة على
+
+156
+00:12:08,350 --> 00:12:10,990
+وحدة التكلفة وتأثر التكلفة في الشياسة التعليمية
+
+157
+00:12:10,990 --> 00:12:15,690
+مثلًا نشوف تكلفة العاملين شتده على الوحدة الواحدة
+
+158
+00:12:15,690 --> 00:12:19,970
+للتكلفةوتأثر بالسياسة للتعليمين مثل حجم الفصل
+
+159
+00:12:19,970 --> 00:12:24,370
+الجديد، حجم المدرسة، رجع العاملين فيها، سبعة من من
+
+160
+00:12:24,370 --> 00:12:27,510
+الأهداف أيضًا، الكشف عن كفاءة إنتاجية التعليم أو
+
+161
+00:12:27,510 --> 00:12:31,150
+المدرسة، وضوء العائدات أو المنافع التي تفيد الشخص
+
+162
+00:12:31,150 --> 00:12:36,810
+أو المجتمع مقارنة من النفقات، مقارنة بين النفقات
+
+163
+00:12:36,810 --> 00:12:40,130
+والإيرادات المستقبلية، لإنشاء مشغول كفاية
+
+164
+00:12:40,130 --> 00:12:45,660
+الإنتاجية8- توزيع نفقات قطاع التعليم بصورة عادلة
+
+165
+00:12:45,660 --> 00:12:49,300
+على مضم التعليم ومراحله ومؤسساته وعلى أوجه
+
+166
+00:12:49,300 --> 00:12:53,580
+الاستخدامات والمختلفة أوطن لو لولا المفترض 9-
+
+167
+00:12:53,580 --> 00:12:58,060
+التأكد من حسن استغلال أجهزة التعليم والمؤسسات
+
+168
+00:12:58,060 --> 00:13:03,360
+التعليمية لمواردها المتاحة المخصصة لها، بدنا نشوف
+
+169
+00:13:03,360 --> 00:13:08,420
+يعني مدى الحسن استغلال هذه الموارد اللي تابعة
+
+170
+00:13:08,420 --> 00:13:13,560
+للتعليم 10-بساعد تقليف التعليم على تقدير مفاد
+
+171
+00:13:13,560 --> 00:13:16,820
+التعليم في دور اختيار المدائل المناسبة للتقليف
+
+172
+00:13:16,820 --> 00:13:23,280
+والعائد وما داشر التنبؤ بتكاليف التعليم المستقبلية
+
+173
+00:13:23,280 --> 00:13:27,420
+يفيد في البحث عن مصادر تمويل إضافية ترتقل إيديه
+
+174
+00:13:27,420 --> 00:13:31,840
+للتعليم مدى ما أنا بتشير لبند التفليف في المستقبل
+
+175
+00:13:31,840 --> 00:13:37,140
+دا نفر عن مصادر تمويل بتشير لعملية التعليم في
+
+176
+00:13:37,140 --> 00:13:41,490
+النقطة الرابعة، عناصر التقليفاتالتعليمية طبعا
+
+177
+00:13:41,490 --> 00:13:45,910
+التكلفة التعليمية هناك تكلفة جارية أو بتشغيلية أو
+
+178
+00:13:45,910 --> 00:13:49,190
+دورية و هناك طبعا تكلفة في النقطة اللي بعدها اللي
+
+179
+00:13:49,190 --> 00:13:54,210
+هي الرأسمانية التكلفة الدورية كل منفق على التعيب
+
+180
+00:13:54,210 --> 00:14:01,190
+من أجور ومرتبات العاملين كمعلمين ومداريين مثلا
+
+181
+00:14:01,190 --> 00:14:04,790
+مصاريف الكهربا والماء والنضاليات وهذه كلها بسموها
+
+182
+00:14:04,790 --> 00:14:09,170
+مصاريفدورية قد تكون دورية مباشرة قد تكون غير
+
+183
+00:14:09,170 --> 00:14:13,310
+مباشرة قد تكون مصطفات خدمات إجتماعية للتلاميذ
+
+184
+00:14:13,310 --> 00:14:17,010
+والطلاب طبعاً في علم التكلفة الرأس مالية أو
+
+185
+00:14:17,010 --> 00:14:21,270
+الإنتاجية أو بيسموها الاسف مالي وتشمل تكليف شراع
+
+186
+00:14:21,270 --> 00:14:25,690
+الأرض وتشجيد المباني وشراع التجهيزات ووسائل النقل
+
+187
+00:14:25,690 --> 00:14:29,530
+وغيرها من الأمور التي يتم استفادة منها على مدى
+
+188
+00:14:29,530 --> 00:14:34,100
+أطول السنة مالية ومعقدة ينهي عن تكليف اسف ماليةعند
+
+189
+00:14:34,100 --> 00:14:38,700
+تكاليف تشغيلهم و هذا بشمل المدارس وبشمل الشركات
+
+190
+00:14:38,700 --> 00:14:43,380
+والمصادر النقطة الخامسة تخفيف تكلفة التعليم كيف
+
+191
+00:14:43,380 --> 00:14:49,860
+نخفظ تكلفة التعليم؟ طبعاً ارتفاع تكلفة التعليم إلى
+
+192
+00:14:49,860 --> 00:14:52,480
+أسواق كثيرة كما قلنا قبل قليل من بين النمول
+
+193
+00:14:52,480 --> 00:14:57,720
+السكاني أي واحد من بين أسواق ارتفاع تكلف التعليم
+
+194
+00:14:57,720 --> 00:15:02,260
+إزدياد الطلب على مستويات أعلى من التعليم إلى ترافض
+
+195
+00:15:02,260 --> 00:15:07,820
+الحكومات والدولبتقديم فرصة تعليمية متكافة لجميع
+
+196
+00:15:07,820 --> 00:15:13,720
+أفراد الشعب هذه طبعاً يعني من الأسباب اللي بتخليك
+
+197
+00:15:13,720 --> 00:15:18,140
+يرتفع تقليد التعليم الان ما هي الإجراءات اللي
+
+198
+00:15:18,140 --> 00:15:22,040
+الدول اتبعتها لتقليد تقليد التعليم إجراءات اللي تم
+
+199
+00:15:22,040 --> 00:15:26,920
+اتباعها لتقليد التقليد على نوعين من الإجراءات في
+
+200
+00:15:26,920 --> 00:15:31,140
+عندنا إجراءات مباشرة لخفض تقليد التعليم في عندنا
+
+201
+00:15:31,140 --> 00:15:34,370
+إجراءات غير مباشرةالزيارات المباشرة او واحد زيادة
+
+202
+00:15:34,370 --> 00:15:38,850
+كثافة الفصل تخصب كثافة الفصل متوسط عدد طلاب الفصل
+
+203
+00:15:38,850 --> 00:15:42,150
+لمرحلة معينة ويكون استخلاصها من خلال المعادلة
+
+204
+00:15:42,150 --> 00:15:44,670
+التانية عدد بيجيب كثافة الفصل كثافة الفصل في مرحلة
+
+205
+00:15:44,670 --> 00:15:48,330
+معينة سواء عدد طلاب مسجلين في المرحلة أو عدد
+
+206
+00:15:48,330 --> 00:15:52,870
+الفصول في المرحلة يعني ومن المعلوم أن كثافة الفصل
+
+207
+00:15:52,870 --> 00:15:57,010
+المتلة يجب أن تتجاوز 25 طالب الفصل يعني الأصل
+
+208
+00:15:57,010 --> 00:16:02,650
+الفصل يكون في حد أقصى 25 طالبوإن هذه الكثافة تختلف
+
+209
+00:16:02,650 --> 00:16:06,330
+بدرجات متفاوضة وفقًا لنوع التعليم أو المستوار
+
+210
+00:16:06,330 --> 00:16:09,610
+فالدرجة العزل الميزانيات التعليم في بعض الدول
+
+211
+00:16:09,610 --> 00:16:13,550
+تضطرت الجهات المسؤولة عن التعليم لرفع كتابة الفصل
+
+212
+00:16:13,550 --> 00:16:18,890
+لضعف خمسين طالب في الفصل الواحد أو أكثر يعني تقدش
+
+213
+00:16:18,890 --> 00:16:23,110
+في الفصل في طلاب لو أنا بدأ أخلق التكلفة بدأ أرفع
+
+214
+00:16:23,110 --> 00:16:26,250
+الكثافة بدأ أخلق طلاب يزيدوا في الفصل عند مثلًا في
+
+215
+00:16:26,250 --> 00:16:33,470
+قطاع غزة بسبب طبعًا الفقروبسبب نقص الموارد وقلة
+
+216
+00:16:33,470 --> 00:16:38,530
+الإمكانيات الكثافة الفصل عالية سواء في مدارس
+
+217
+00:16:38,530 --> 00:16:43,850
+الوكالة أو مدارس الحكومة الكثافة عالية جدا تخلّف
+
+218
+00:16:43,850 --> 00:16:48,910
+في الفصل 55 طالب أو يزيد عن 55 وهذا بتقلل التكلفة
+
+219
+00:16:48,910 --> 00:16:54,690
+لأن طبعا الدكتورات الأعلى من الطلاب تحتاج لمدرسين
+
+220
+00:16:54,690 --> 00:17:02,250
+أقل تحتاج لفصول أقل وهكذاكمان من بين الأشياء اللي
+
+221
+00:17:02,250 --> 00:17:08,610
+بنخلّي احنا نتقلل من اللي هو التكلفة استخدام
+
+222
+00:17:08,610 --> 00:17:12,430
+المبنى المدرسي لأكثر من دورة ولا دورة إن الوضع
+
+223
+00:17:12,430 --> 00:17:15,790
+الطبيعي للتعليم ينفذ التلاميذ في مدارسهم لفترة
+
+224
+00:17:15,790 --> 00:17:21,090
+كامة مدارس بتاع الطلبة كرسة كافية للدراسة ومارسة
+
+225
+00:17:21,090 --> 00:17:24,590
+لنشاط اللاصف فيه ولكن تضطر بعض الدول لشغل مبنى
+
+226
+00:17:24,590 --> 00:17:27,570
+دورتين أو ثلاث دورتين زي اللي عندنا في قطاع غزة
+
+227
+00:17:28,020 --> 00:17:31,900
+ونلاحظ إن المبنى المدرسي والمدرسة فيه دورة صلاحية
+
+228
+00:17:31,900 --> 00:17:36,100
+وفيه دورة مسائلة وفيه الآن تفكير عند الجهات
+
+229
+00:17:36,100 --> 00:17:43,060
+المسؤولة إنه تعمل طبعاً ثلاث دورات في الفصل طبعاً
+
+230
+00:17:43,060 --> 00:17:48,500
+هذا كلام كانت تفكير قبل يعني جائحة Corona لكن يعني
+
+231
+00:17:48,500 --> 00:17:53,740
+قد الجائحة جائحة خلت فيه تغيير في الأمور لأن
+
+232
+00:17:53,740 --> 00:17:59,030
+الطلاب اضطروا للجلوس في بيوتهمكمان من بين الأشياء
+
+233
+00:17:59,030 --> 00:18:01,770
+اللي بتخلي في تخسيس التكلفة للتعليم زيادة نساء
+
+234
+00:18:01,770 --> 00:18:05,830
+المدرس ويقصد بيها أن الساعات المقارنة بدرسها وده
+
+235
+00:18:05,830 --> 00:18:12,130
+مثلا يعطي مثلا عشرين حصة يعطي تلاتين حصة فهذا بيقل
+
+236
+00:18:12,130 --> 00:18:17,330
+من التكلفة لأن المدرس بغض راتب وبس يزيد نسابه بقل
+
+237
+00:18:17,330 --> 00:18:21,270
+عدد المدرس اللي احنا محتاجينه أربع استخدام كفاءات
+
+238
+00:18:21,270 --> 00:18:26,690
+علمية ومتدنية كمان خمس التوسع في إنشاء قصود المدرس
+
+239
+00:18:26,690 --> 00:18:32,080
+القائمةأو مدرسة قايمة ستة تخلي عن برام برنامج
+
+240
+00:18:32,080 --> 00:18:36,960
+النشاط بالمدارس والتخضير المدرسية زمان كانوا في
+
+241
+00:18:36,960 --> 00:18:41,860
+وقت الغوث يجيبوا واجبات وطعام اليوم بطنوا استخدام
+
+242
+00:18:41,860 --> 00:18:46,860
+الكتاب المدرسي لأكثر من تلميذ يعني يمكن يكفي تلميذ
+
+243
+00:18:46,860 --> 00:18:50,020
+بس يخلص الفصل السنة الدراسية بيسلموا وبيسلموه
+
+244
+00:18:50,020 --> 00:18:54,400
+لتلميذ اللي بعدهم تصييم المباني المدرسية وتنقذها
+
+245
+00:18:54,400 --> 00:18:57,630
+لاهتمام باستخدام أساليب التعليم عن بواسطةالتعليم
+
+246
+00:18:57,630 --> 00:19:01,630
+على البعد لو أجدناه وإحنا هنا في الجامعة الإسلامية
+
+247
+00:19:01,630 --> 00:19:06,870
+متبقينه الآن هذا التعليم صح أنه أجاب بسبب جائحة
+
+248
+00:19:06,870 --> 00:19:10,970
+كورونا لكن كما يقول البعض على ضارة نافعة التعليم
+
+249
+00:19:10,970 --> 00:19:15,770
+على البعد بقل التكلفة لأنه بزيد عدة ساعات المدرسة
+
+250
+00:19:15,770 --> 00:19:21,330
+المدرسة التكلفة التشغيلية من إشغال القاعات
+
+251
+00:19:21,330 --> 00:19:25,770
+الدراسية من كهرباء من تليفونات في بطنة الجامعة
+
+252
+00:19:25,770 --> 00:19:30,950
+تتفاحةالمدرس إن صعبه زاد لأن الشعوبة ممكن تصبح
+
+253
+00:19:30,950 --> 00:19:35,430
+شعوبتين أو الشعوبتين تصبح شعوبة لأن التعليم على
+
+254
+00:19:35,430 --> 00:19:38,430
+البُعد بتنمي بشكل يعني وبالتالي الجامعة تنفر على
+
+255
+00:19:38,430 --> 00:19:43,770
+حالها نفقات عالية ولكن التعليم على البُعد اليوم في
+
+256
+00:19:43,770 --> 00:19:47,430
+جامعات في العالم يعتبر أسلوب تدريسي والجامعة
+
+257
+00:19:47,430 --> 00:19:52,610
+الإسلامية اليوم بتفكر تفكير جدي أنها يعني حتى
+
+258
+00:19:53,650 --> 00:19:57,270
+التعليم العالي الفلسطيني يفكر إنه يفتح برامج محددة
+
+259
+00:19:57,270 --> 00:20:01,370
+للتعليم على البعد يتعلم فيها طلبة من داخل فلسطين
+
+260
+00:20:01,370 --> 00:20:04,750
+أو من خارج فلسطين عشرة انقاص سنوات من سلسلة
+
+261
+00:20:04,750 --> 00:20:08,890
+التعليم كل هذه الأسباب بتكلّفي تخفية في تكلفات
+
+262
+00:20:08,890 --> 00:20:14,390
+اللي هو التعليم هذه بيشوفوا إجراءات اللي حكينا
+
+263
+00:20:14,390 --> 00:20:18,590
+عنها قبل قليل إجراءات مباشرة لتخفية التكلفة في
+
+264
+00:20:18,590 --> 00:20:22,870
+عندنا إجراءات غير مباشرة لتقليل أو تخفف طلبة
+
+265
+00:20:22,870 --> 00:20:27,540
+التعليممن بين واحد تقليل معدلات التسرب التسرب من
+
+266
+00:20:27,540 --> 00:20:33,120
+المدرسة طبعاً هذا مشكلة بتعانينا كثير من الدول
+
+267
+00:20:33,120 --> 00:20:37,420
+خاصة الدول اللامية في بعض البلاد نسمة التسرب تزيد
+
+268
+00:20:37,420 --> 00:20:45,460
+على 20% خاصة في المراحل الابتدائية في المراحل
+
+269
+00:20:45,460 --> 00:20:49,880
+التالية تصل إلى 5% أو 10% التلميذ المتسرب هو
+
+270
+00:20:49,880 --> 00:20:54,530
+التلميذ الذي لا يكمن دراسته حتى نهايةعلى مرحلة
+
+271
+00:20:54,530 --> 00:20:58,570
+التعليم يبقى ناجح فذلك فإن ما يُصرف عليه يدخل في
+
+272
+00:20:58,570 --> 00:21:05,370
+باب الفاقر يصرف عليه بالأخير الصرف فالإنفاق عليه
+
+273
+00:21:05,370 --> 00:21:09,590
+هذا هو الفاقر بتعلم سنة كام يبقى مش مصرف أو الهدف
+
+274
+00:21:09,590 --> 00:21:15,130
+للتعليم وكلفة السنوات الدراسية اللي صرفت عليه تحمل
+
+275
+00:21:15,130 --> 00:21:18,390
+على كلفة هؤلاء اللي أكملوا المرحلة يبقى ناجحة يعني
+
+276
+00:21:18,390 --> 00:21:22,670
+هو نفع التكلفة هو مش ناجح وبالتالي التكلفة هذه
+
+277
+00:21:22,670 --> 00:21:26,780
+العاليةبتزيد من تكلفة التعليم فإذا تقلل التسرب
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+278
+00:21:26,780 --> 00:21:32,300
+بتقل التكلفة التعليمية اثنين خفض نسبة الرسوم
+
+279
+00:21:32,300 --> 00:21:37,720
+الرسوم مع التسرب يدخل في باب الهدر بالتعليم ده كأن
+
+280
+00:21:37,720 --> 00:21:42,420
+التلميذ اللي يعيد صفه يضاعف كلف التعليم في صف الصف
+
+281
+00:21:42,420 --> 00:21:48,420
+يعيد جديد يشكل تكلفة إضافة إلى ذلك فإن الرسوم
+
+282
+00:21:48,420 --> 00:21:52,820
+يعتبر من أهم أسباب التسرب إذا أول شغل مشروعات غير
+
+283
+00:21:52,820 --> 00:22:01,400
+مباشرةتقريباً معدل التصرف عشان نقلل تقليل التعليم
+
+284
+00:22:01,400 --> 00:22:07,660
+ونخفض نسبة الرسوم ونرفع كفاءة المعلمدالك أن تحسين
+
+285
+00:22:07,660 --> 00:22:10,600
+نوعية المعلم يؤدي بالضرورة إلى تحسين نوعية التعليم
+
+286
+00:22:10,600 --> 00:22:14,420
+المقدمة ويحدث من عامل الهدف من تصرف ورسولة أربع
+
+287
+00:22:14,420 --> 00:22:17,680
+تطوير المناهج وأسلوب التدريس، خمس تطوير نظم
+
+288
+00:22:17,680 --> 00:22:22,040
+التقويم والانتحار، ستة رشيد مواقع المدارس، سبع قمم
+
+289
+00:22:22,040 --> 00:22:25,500
+وجامعات المدارس، والتوسع في المدارس، ثلاثة فاصلة،
+
+290
+00:22:25,500 --> 00:22:31,600
+كل هذه تمثل السبع أسباب، اللي هو إجراءات غير
+
+291
+00:22:31,600 --> 00:22:38,310
+مباشرة لتقليل تكلفات التعليمحساب تكلفة الطالب نحنا
+
+292
+00:22:38,310 --> 00:22:44,850
+الآن عندنا بعض القوانين
+
+293
+00:22:44,850 --> 00:22:48,350
+هذه القوانين هستخدمها ان شاء الله في حل بعض
+
+294
+00:22:48,350 --> 00:22:53,990
+الأمثلة لأن أنت قول هقرأها ان شاء الله لكن ان شاء
+
+295
+00:22:53,990 --> 00:22:56,950
+الله في نهاية الشبط أو في نهاية الفصل أكون مجموعة
+
+296
+00:22:56,950 --> 00:23:00,130
+أمثلة مطلوب حلها أربعة أمثلة مثلا واحد اتنين اتنين
+
+297
+00:23:00,130 --> 00:23:04,220
+اتنين اربعة باستخدام هذه القوانينأنا مش هحل
+
+298
+00:23:04,220 --> 00:23:09,740
+الأمثلة لأنها واجب على الطالب ان شاء الله يبعتلنا
+
+299
+00:23:09,740 --> 00:23:13,020
+إياه من خلال الموضوع إذا نحن نتكلم عن قوانين
+
+300
+00:23:13,020 --> 00:23:17,040
+يستخدمها الطالب ويستخدمها الطالب التعليمية السنوية
+
+301
+00:23:17,040 --> 00:23:21,000
+من المصاليف الجارية ويتم الفصول عليها من خلال قسم
+
+302
+00:23:21,000 --> 00:23:24,540
+التكلفة الجارية للبرنامج والكلية أو القسم للعدد
+
+303
+00:23:24,540 --> 00:23:26,880
+الطلبة المستفيدين من البرنامج والقسم
+
+304
+00:23:29,770 --> 00:23:32,750
+التعليمية السنوية من المصادر التدثميرية على نحو
+
+305
+00:23:32,750 --> 00:23:36,290
+التعليم واحد تكفة الطالب التعليمية السنوية من
+
+306
+00:23:36,290 --> 00:23:40,350
+استهلاك السنة والأبنية يشاوي اجمال تكفة الأبنية ضد
+
+307
+00:23:40,350 --> 00:23:43,910
+نسبة استهلاك السنة والأبنية على عدد الطلبة
+
+308
+00:23:43,910 --> 00:23:47,070
+المساعدين الأبنية معرفة نسبة استهلاك من السنة
+
+309
+00:23:47,070 --> 00:23:51,670
+والأبنية هي 2% هذه طبعا نسب استهلاك ستكون ثابتة
+
+310
+00:23:51,670 --> 00:23:56,330
+لكل أمثلة نسب استهلاك ستكون ثابتة لأن هذه مقدرة من
+
+311
+00:23:56,330 --> 00:24:00,220
+قبل اللي همهي أهل الاقتصاد و أهل الاقتصادي نسبة
+
+312
+00:24:00,220 --> 00:24:03,520
+السلاك الأجزة والأبناء هي 2% ومن بعد طبعا التسهيل
+
+313
+00:24:03,520 --> 00:24:08,480
+والتفشير اثنين تكلفة الطالب التعليمية السنوية من
+
+314
+00:24:08,480 --> 00:24:11,840
+السلاك السنوي الأجزة والأسات ومعدات والألات تساوي
+
+315
+00:24:11,840 --> 00:24:15,520
+إجمال تكلفة الأجزة والأسات ومعدات والألات تار نسبة
+
+316
+00:24:15,520 --> 00:24:18,480
+السلاك السنوي الأجزة والأسات على عدد الطلب
+
+317
+00:24:18,480 --> 00:24:21,980
+المستفيدين من الأجزة والأسات ومعدات والألات مع
+
+318
+00:24:21,980 --> 00:24:24,920
+العلم أن نسبة السلاك السنوي الأجزة والأسات ومعدات
+
+319
+00:24:24,920 --> 00:24:30,770
+والألات هي 10% برضه هذا النسبة هتكونثابتة تلاتة
+
+320
+00:24:30,770 --> 00:24:34,030
+تكلفة الطالب التعليمية السنوية من استخدام السنوية
+
+321
+00:24:34,030 --> 00:24:38,150
+للسيارات يساوي أجمال تكلفة السيارات ضعف نسبة
+
+322
+00:24:38,150 --> 00:24:41,390
+استخدام السنوية للسيارات على عدد طلب المستخدمين من
+
+323
+00:24:41,390 --> 00:24:45,690
+السيارات مع أن علم نسبة استخدام السيارات هي 15%
+
+324
+00:24:45,690 --> 00:24:48,850
+برضه هذه نسبة ثابتة أربع تكلفة الطالب التعليمية
+
+325
+00:24:48,850 --> 00:24:52,110
+السنوية من استخدام السنوية للكتب يساوي أجمال تكلفة
+
+326
+00:24:52,110 --> 00:24:55,050
+الكتب ضعف نسبة استخدام السنوية للكتب على عدد طلب
+
+327
+00:24:55,050 --> 00:24:57,780
+المستخدمين من الكتبوالنسبة للسلاك يساوي الكتب
+
+328
+00:24:57,780 --> 00:25:01,040
+بساوي 10% هذه كل القوانين اللي هتتم استخدامها ان
+
+329
+00:25:01,040 --> 00:25:06,620
+شاء الله في حل الأمثلة بعد قليل خمسة ترزط طالب
+
+330
+00:25:06,620 --> 00:25:11,440
+تعليمية من نفقات الإدارة المركزية ويتم الحصول
+
+331
+00:25:11,440 --> 00:25:14,320
+عليها من خلال قسمة الميزانية الخاصة الإدارة
+
+332
+00:25:14,320 --> 00:25:17,620
+المركزية في السنة نون على عدد الطلاب المستفدين من
+
+333
+00:25:17,620 --> 00:25:21,290
+الإدارة المركزية ستةتأخذ الطالب التعليمية من
+
+334
+00:25:21,290 --> 00:25:24,170
+المصروف الجايب ويتم الحصول عليها من خلال قسمة
+
+335
+00:25:24,170 --> 00:25:27,950
+نجموع المشاهدات الرقمية بالاستيبانات المتعلقة
+
+336
+00:25:27,950 --> 00:25:31,050
+بالمصروف الجايب لكل تخصص على عدد استجابات التي
+
+337
+00:25:31,050 --> 00:25:35,630
+فرغت لكل تخصص سبعة تأخذ الطالب التعليمية من الفرصة
+
+338
+00:25:35,630 --> 00:25:39,470
+الضائعة بالساوي متوسط الراتب الشهر للخريج العامل
+
+339
+00:25:39,470 --> 00:25:45,110
+من المرحلة السابقة تاريخ 1212 هذه عبارة عن تأخذ
+
+340
+00:25:45,110 --> 00:25:47,590
+الفرصة اللي كان ضائعة في السنة الأولى أما في السنة
+
+341
+00:25:47,590 --> 00:25:52,800
+التانيةفيضاف إليها فيضاف إلى قيمة الراتب متوسط
+
+342
+00:25:52,800 --> 00:25:57,620
+الزيادة السنوية ثمانية تكلفة الطالب السنوية الكلية
+
+343
+00:25:57,620 --> 00:26:01,060
+سواء تكلفة الطالب العامة غير مباشرة أو غير مباشرة
+
+344
+00:26:01,060 --> 00:26:05,180
+أو تكلفة الطالب الخاصة مباشرة أو غير مباشرة طبعا
+
+345
+00:26:05,180 --> 00:26:10,020
+بين جسين ناقص ما يخص الطالب الواحد من إيرادات
+
+346
+00:26:10,020 --> 00:26:15,060
+المؤسسة الموجودة تسعة تكلفة الطالب السنوية العامة
+
+347
+00:26:23,430 --> 00:26:27,810
+10 تكلفة الطالب السنوية الخاصة سواء تكلفة الطالب
+
+348
+00:26:27,810 --> 00:26:31,330
+الخاصة المباشرة بين قُسايم تكلفة الطالب بالرسوم
+
+349
+00:26:31,330 --> 00:26:36,950
+الدراسية زائد تكلفة الطالب المصروف الجيد طبعا من
+
+350
+00:26:36,950 --> 00:26:40,250
+سكر القوس زائد تكلفة الطالب الخاصة غير مباشرة في
+
+351
+00:26:40,250 --> 00:26:45,690
+تكتف قصة الضايع 11لحساب متوسط العوائد الاقتصادية
+
+352
+00:26:45,690 --> 00:26:50,650
+لخريج العامل من التخص معين نعمل خطوات تالية ألف
+
+353
+00:26:50,650 --> 00:26:55,230
+العوائد في السنة الأولى لخريج العامل كل تخصص يساوي
+
+354
+00:26:55,230 --> 00:26:59,630
+متوسط الراتب الشهري الأولي لخريج متوسط الراتب
+
+355
+00:26:59,630 --> 00:27:03,030
+الشهري الأولي لخريج من المرحلة السابقة لبن جوسين
+
+356
+00:27:03,030 --> 00:27:07,470
+ضرب لبن جوسين مرت واتناشر شهر بسبب التعطل والأشهر
+
+357
+00:27:07,470 --> 00:27:12,170
+بالتخصص سبعة سنة سنة سنة سنة سنة سنة سنة سنة سنة
+
+358
+00:27:12,170 --> 00:27:12,170
+سنة سنة سنة سنة سنة سنة سنة سنة سنة سنة سنة سنة
+
+359
+00:27:12,170 --> 00:27:12,170
+سنة سنة سنة
+
+360
+00:27:17,140 --> 00:27:20,860
+العواقد في السنة الثانية اللي الخريج بعمل كل حص
+
+361
+00:27:20,860 --> 00:27:24,100
+يساوي من بسيمة متوسطة الراتب الشهر الأول للخريج
+
+362
+00:27:24,100 --> 00:27:26,660
+بالمتوسطة الراتب الشهر الأول اللي تميله من السنة
+
+363
+00:27:26,660 --> 00:27:30,420
+الرحلة السابقة زائد متوسطة السادة السنوية للخريج
+
+364
+00:27:30,420 --> 00:27:37,270
+second course طرد 12 شهر لعدد أشهر السنةالآن
+
+365
+00:27:37,270 --> 00:27:40,010
+الأمثلة اللي أخدناها كلها إن شاء الله هنستخدمها في
+
+366
+00:27:40,010 --> 00:27:44,150
+اللي هو الأمثلة اللي كمان شوية هنوضحها لكم إن شاء
+
+367
+00:27:44,150 --> 00:27:47,810
+الله تعالى حساب التكلفة العائلية كيف لسه التكلفة
+
+368
+00:27:47,810 --> 00:27:51,350
+العائلية؟ تزايد في العقود الأخيرة تحمل عائلات
+
+369
+00:27:51,350 --> 00:27:55,570
+نفقات تعليم أبناء، تدفع الفلوس ولسه يأمر بعد
+
+370
+00:27:55,570 --> 00:27:58,250
+انتشار المدارس الخاصة وتحسب التكلفة العائلية
+
+371
+00:27:58,250 --> 00:28:02,390
+لأجهزة الصرف المختلفة في سنة محددة سواء كانت مدرسة
+
+372
+00:28:02,390 --> 00:28:06,900
+حكومية أو خاصة وذلك من حيثالشيء التكلفة هذه واحد
+
+373
+00:28:06,900 --> 00:28:10,340
+المبالغ التي صرفت على تعليم التلميذ خلال سنة
+
+374
+00:28:10,340 --> 00:28:16,700
+دراسية واحدة وذلك لشراء الملابس المدرسية والرياضية
+
+375
+00:28:16,700 --> 00:28:21,140
+والشط المدرسي والكراسات المدرسية وواجور النقل
+
+376
+00:28:21,140 --> 00:28:25,820
+وخلافها اثنين الرسوم الدراسية لتسلمة المدرسة ثلاثة
+
+377
+00:28:25,820 --> 00:28:30,820
+قيمة الكتب الدراسية ومستلزمات نشر الدراسية أربع
+
+378
+00:28:30,820 --> 00:28:35,230
+المصاريف اليوميةويمكن هنا أخذ متوسطات الإنفاق على
+
+379
+00:28:35,230 --> 00:28:39,450
+مجموعة من التلميذ في السنة معينة حيث يمكن تقدير
+
+380
+00:28:39,450 --> 00:28:46,190
+التكلم الكلمي لتحمل عيلته أو أسرته التكاليف العامة
+
+381
+00:28:46,190 --> 00:28:50,390
+هي تكاليف مباشرة ومن بينها تكاليف الجارية اللي
+
+382
+00:28:50,390 --> 00:28:53,990
+حكينا عنها قبل قليل تشمل رواتب العاملين في الكلية
+
+383
+00:28:53,990 --> 00:28:59,230
+احنا تكلمنا عن الكلية طبعا أو مدرسة يعني مدرسة
+
+384
+00:28:59,230 --> 00:29:03,090
+جامعة ما هي مشكلةالمعلمين الإداريين المستخدمين
+
+385
+00:29:03,090 --> 00:29:07,030
+المجموعة نفغات الكلية أو المدرسة بتشمل الماء
+
+386
+00:29:07,030 --> 00:29:10,330
+الكهرباء الهاتف الانترنت اللوازم في الورش اللوازم
+
+387
+00:29:10,330 --> 00:29:13,490
+الرياضية الصيانة اللوازم التنظيف الإعلانات هذا
+
+388
+00:29:13,490 --> 00:29:17,310
+كلها بيسموها تكاليف تشغيلية فيه تكليف رأس مالية
+
+389
+00:29:17,310 --> 00:29:21,290
+اللي أحنا حكينا عنها قبل قليل زي السلك السامي
+
+390
+00:29:21,290 --> 00:29:25,640
+للأمنيةفي حالة استأجار المباني هتتم اضافة إيجارات
+
+391
+00:29:25,640 --> 00:29:29,320
+لمبني أمنية والمرفقات بدلاً من حساب السلاك السلاك
+
+392
+00:29:29,320 --> 00:29:33,020
+السنوي الأمنية كانت المبنى ملك للمدرسة كان مستأجر
+
+393
+00:29:33,020 --> 00:29:36,020
+طبعاً من حساب الإيجارات السلاك السنوي للسيارات،
+
+394
+00:29:36,020 --> 00:29:38,660
+السلاك السنوي للأثاث والمعدات، وهذا كله قبل قليل
+
+395
+00:29:38,660 --> 00:29:41,640
+وخلال القوانين واضحناه السلاك السنوي للكتب
+
+396
+00:29:41,640 --> 00:29:45,840
+المكتبية يتفادع على رأس المال ويشبر قيم المكاني
+
+397
+00:29:45,840 --> 00:29:49,440
+الأرض لتجهيزات الكتب السياسية والضرائبالتكلفة غير
+
+398
+00:29:49,440 --> 00:29:52,660
+مباشرة تصيب الكلية من الإدارة المركزية بإجمال
+
+399
+00:29:52,660 --> 00:29:55,560
+التكليف العامة مباشرة أو غير مباشرة لردد الكلية من
+
+400
+00:29:55,560 --> 00:29:59,900
+إنتاج الكلية والطلبة إن وصلت في أقل فيه عندنا
+
+401
+00:29:59,900 --> 00:30:03,800
+نموذج استخدام تحديد مصروف الجامعة أو رسوم دراسية
+
+402
+00:30:03,800 --> 00:30:07,480
+الطالب يعني اسم الكلية، تخصص موقع الكلية، طبعا
+
+403
+00:30:07,480 --> 00:30:10,360
+عنده متخصص عدد الساعات المعتمدة ومتفجرة، لأول ولا
+
+404
+00:30:10,360 --> 00:30:15,280
+فتخصص أول مثلا عندك عشرين ساعة رسوم الساعة
+
+405
+00:30:15,280 --> 00:30:20,550
+المعتمدة للتخصصعنده طلع هنا مثلا الرسوم برضه عشرين
+
+406
+00:30:20,550 --> 00:30:32,130
+دينار فانا اقول مثلا لو احنا قلنا هنا يعني اقول
+
+407
+00:30:32,130 --> 00:30:40,750
+هنا عشرين ساعة مثلا و
+
+408
+00:30:40,750 --> 00:30:43,910
+هنا قلنا ضرب فصل أول مثلا عشرين
+
+409
+00:30:49,570 --> 00:30:56,330
+عشرين دينار رجوع من الساعة مثلا نطلع
+
+410
+00:30:56,330 --> 00:31:03,430
+إلى المجموع مثلا هنا نطلع 400 دينار
+
+411
+00:31:11,370 --> 00:31:14,290
+في الفاصلة الثانية ممكن نحسبها بسعة أقل أو أكثر
+
+412
+00:31:14,290 --> 00:31:21,310
+بنفس الطريقة التي حسبناها بهذا الشكل هذا نموذج
+
+413
+00:31:21,310 --> 00:31:27,050
+موجود في نموذج ثاني مثلا ثمن الكتب في الشهر قداش
+
+414
+00:31:27,050 --> 00:31:30,730
+وفي الفاصلة قداش ثمن كتب المواد التعليمية ومواصلة
+
+415
+00:31:30,730 --> 00:31:33,670
+التسلسل التنموذج الأسرة ومشاريع التخرج هذا كله
+
+416
+00:31:33,670 --> 00:31:38,390
+نماذج قد تتغير قد تعتمد كل مدرسة على نموذج معين في
+
+417
+00:31:38,390 --> 00:31:44,120
+حساب التكلفةومافيها مشكلة على الأطلاع أخيراً هذه
+
+418
+00:31:44,120 --> 00:31:47,100
+الأمثلة العملية هذه الأمثلة العملية هي مثال واحد
+
+419
+00:31:47,100 --> 00:31:50,240
+مثال اثنين مثال اثنين مثال اربع هذا ان شاء الله
+
+420
+00:31:50,240 --> 00:31:56,460
+انا اتقلكم من خلال ال model ومطلوب حلها و تسليم
+
+421
+00:31:56,460 --> 00:32:02,800
+الحل لنا بشكل يعني يدو الطالب مطلوب انه يكتب و
+
+422
+00:32:02,800 --> 00:32:08,670
+يبعت يعني يكتب خط ايدهوميصور اللي .. اللي كتب وفق
+
+423
+00:32:08,670 --> 00:32:11,750
+إيده ويبقى عادة اللي هي من قبله الموديل عشان يكون
+
+424
+00:32:11,750 --> 00:32:15,770
+يشتغل ان شاء الله أو يحيط مثال واحد اتحقق طال
+
+425
+00:32:15,770 --> 00:32:19,410
+البرنامج الدولو متوسط تخصص منظم معلومات جغرافية في
+
+426
+00:32:19,410 --> 00:32:21,690
+كلية العلم المهنية والتطبيقية في الجامعة الاسلامية
+
+427
+00:32:21,690 --> 00:32:24,570
+بعد اعلانته أن متوسط الراتب الشهري لخروج التنوية
+
+428
+00:32:24,570 --> 00:32:27,610
+العامة 200 دينار ومتوسط لزيادة السنوية 10 دينار
+
+429
+00:32:27,610 --> 00:32:30,690
+بقى متوسط راتب الشهر لخروج نظم معلومات جغرافية من
+
+430
+00:32:30,690 --> 00:32:34,290
+تلقاء 90 دينار متوسط لزيادة السنوية 15 دينار
+
+431
+00:32:35,630 --> 00:32:38,910
+المقلوب واحد أوجد تجربة الفرصة المدينة الضائعة أن
+
+432
+00:32:38,910 --> 00:32:42,730
+أوجد العوائد الاقتصادية تتطلب خلال سنتين من تخرجتي
+
+433
+00:32:42,730 --> 00:32:47,190
+إذا أنت انتصرت بفضالة تخصصت من معلمات عالمية هذا
+
+434
+00:32:47,190 --> 00:32:51,210
+مثال لو انت دفقت القوانين هتحلوا القوانين اللي
+
+435
+00:32:51,210 --> 00:32:56,910
+احنا ذكرناها قبل قليل مثال اثنين نفس القضية طبعا
+
+436
+00:32:56,910 --> 00:33:02,210
+مثال واحد مختلف عن مثال اثنيناستحق طالب ببرنامج
+
+437
+00:33:02,210 --> 00:33:05,210
+اللوم المتوسط تخصص طبقات متعددة بالقليلية في علوم
+
+438
+00:33:05,210 --> 00:33:07,890
+المهنية وطبقية بالجامعة الإسلامية في أرزا ثم الطب
+
+439
+00:33:07,890 --> 00:33:11,550
+واحد اجترخ الطالب السنوي العامة انت بتوصل بديلة
+
+440
+00:33:11,550 --> 00:33:14,830
+ضائعة في ثلاث سنة دراساته تلت العواد الاقتصادية
+
+441
+00:33:14,830 --> 00:33:17,610
+للطالب في ثلاث سنتين من التخرجه إذا انت متوسط
+
+442
+00:33:17,610 --> 00:33:21,230
+ببطالة تخصص اللوم المتوسطة بتعدد ست شهور ففي غضب
+
+443
+00:33:21,230 --> 00:33:24,150
+توفر معلومات التالية اجترخ الطالب العامة السنوية
+
+444
+00:33:24,150 --> 00:33:27,390
+مباشرة ب 100 دينارطبعاً نحن ناسم ناسم الاستهلاك
+
+445
+00:33:27,390 --> 00:33:32,810
+إجمال التكنولوجيا الأولية للكلية تساوي 6.3 مليون
+
+446
+00:33:32,810 --> 00:33:37,030
+دينار إجمال التكنولوجيا للأجهزة والإبطالات
+
+447
+00:33:37,030 --> 00:33:40,010
+والممدنات بالكلية 100 ألف دينار إجمال التكنولوجيا
+
+448
+00:33:40,010 --> 00:33:42,730
+للإبطالات والممدنات بالكلية 20 ألف دينار إجمال
+
+449
+00:33:42,730 --> 00:33:45,970
+التكنولوجيا للكتب بالكلية 10 ألف دينار إتفاليف
+
+450
+00:33:45,970 --> 00:33:48,950
+الطرف المباشر 50 دينار إتفاصل الفترة بالشهر
+
+451
+00:33:48,950 --> 00:33:53,810
+لقانوني التنوي العامة 150 دينارومتوسط نسية السنوية
+
+452
+00:33:53,810 --> 00:33:58,850
+يخلص دنانير ومتوسط راتب الشهر يخلص دنانير ومتوسط
+
+453
+00:33:58,850 --> 00:34:03,130
+راتب
+
+454
+00:34:03,130 --> 00:34:05,710
+الشهر يخلص دنانير ومتوسط راتب الشهر يخلص دنانير
+
+455
+00:34:05,710 --> 00:34:08,010
+ومتوسط راتب الشهر يخلص دنانير ومتوسط راتب الشهر
+
+456
+00:34:08,010 --> 00:34:08,010
+يخلص دنانير ومتوسط راتب الشهر يخلص دنانير ومتوسط
+
+457
+00:34:08,010 --> 00:34:08,010
+راتب الشهر يخلص دنانير ومتوسط راتب الشهر يخلص
+
+458
+00:34:08,010 --> 00:34:08,230
+دنانير ومتوسط راتب الشهر يخلص دنانير ومتوسط راتب
+
+459
+00:34:08,230 --> 00:34:11,940
+الشهر يخلص دنانير ومتوسط راتب الشهر يخلبنفس
+
+460
+00:34:11,940 --> 00:34:14,860
+الطريقة، هي نقرأ على سريع اتحاق طالب ببرنامج اللغة
+
+461
+00:34:14,860 --> 00:34:17,020
+المتوسط، خاص بحسوب الكليك العلمي و البيانات
+
+462
+00:34:17,020 --> 00:34:19,800
+التجاربية الجامعية السعودية، فعلمت أن ألف الواصل
+
+463
+00:34:19,800 --> 00:34:22,700
+الرابط الشهري للدراسة التنوية العامة، 220 دماغ،
+
+464
+00:34:22,700 --> 00:34:26,260
+نفس الطريقة مثل الثلاث سنة جاية مثل الأول، بس
+
+465
+00:34:26,260 --> 00:34:29,360
+الأقان تختلف، برضه مضطب حلومتواصل الجادة السنوية
+
+466
+00:34:29,360 --> 00:34:32,280
+عشان تنانير، بقى متواصل في زيادة بشار لقرنز الحسوب
+
+467
+00:34:32,280 --> 00:34:35,200
+تقريبا 70 دينار، متواصل في الجادة 120 دينار،
+
+468
+00:34:35,200 --> 00:34:37,240
+المطلوب يجيب تفكير في هذه الفرصة البديلة أو
+
+469
+00:34:37,240 --> 00:34:40,340
+الضائعة، في مجال عوادة اقتصادية للطالب 3 سنة تانية
+
+470
+00:34:40,340 --> 00:34:43,580
+من تحرجه، إذا علمت متواصل بطالب متخصص منه متحصول
+
+471
+00:34:43,580 --> 00:34:50,780
+سبع شهورة مثال أربعة، زي مثل رقم 2، برضه مطلوب حله
+
+472
+00:34:51,170 --> 00:34:54,030
+اتحق طالب ببرنامج دبلوم متحسن تخص محاسب قلوب
+
+473
+00:34:54,030 --> 00:34:57,530
+العلوم المهنية وتطبيقية بغزة المظلوم احسن ميالي
+
+474
+00:34:57,530 --> 00:35:00,550
+تكرر تلقى الطالب السنوية العامة تاخد فرصة لضايع
+
+475
+00:35:00,550 --> 00:35:04,050
+عائلة فرصته العواد الاقتصادي لطالب دراسة التامن
+
+476
+00:35:04,050 --> 00:35:07,910
+تخرجي إلى انت المتواصل بطالب تخصص دبلوم محاسب أربع
+
+477
+00:35:07,910 --> 00:35:12,830
+شهور لك لغل توفر المعلومات التالية تلقى الطالب
+
+478
+00:35:12,830 --> 00:35:16,270
+العامة سنوية مباشرة 200 دينار اجمال تقفة الأبناء
+
+479
+00:35:16,270 --> 00:35:20,270
+للقلية خمس مليون دينار
+
+480
+00:35:22,050 --> 00:35:25,050
+إجمال تدفت الأجر والأتاد والمعداد بالكلية 200 ألف
+
+481
+00:35:25,050 --> 00:35:28,090
+دينار إجمال تدفت السيارات بالكلية 30 ألف دينار
+
+482
+00:35:28,090 --> 00:35:31,990
+إجمال تدفت الكتب بالكلية 20 ألف دينار تقريبا تدفت
+
+483
+00:35:31,990 --> 00:35:35,430
+الانبشار 100 دينار تواصل تقريبا تقريبا تقريبا
+
+484
+00:35:35,430 --> 00:35:42,530
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+485
+00:35:42,530 --> 00:35:43,150
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+486
+00:35:43,150 --> 00:35:43,150
+تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا تقريبا
+
+487
+00:35:43,150 --> 00:35:48,190
+تقريبا تقريب
+
+488
+00:35:49,870 --> 00:35:54,250
+المطلوب حلها نبعتلكم أي أمتع موجود عندكم تجربة
+
+489
+00:35:54,250 --> 00:35:59,950
+للسيدات تطبع المطلوب حلها ورسالها عبر الموديل بعد
+
+490
+00:35:59,950 --> 00:36:05,870
+أن تنتهي مدة الحل ووقت محدد سيكون عليه درجات على
+
+491
+00:36:05,870 --> 00:36:10,870
+حال يكون عليه درجات لأن هذا يعتبر واجب يمكن أن
+
+492
+00:36:10,870 --> 00:36:15,750
+يكون عليه خمس درجات تقريبا للأسلحة هذه وبالتالي
+
+493
+00:36:15,750 --> 00:36:19,830
+المطلوب حلهابعد ان شاء الله ما ينتهي وقت الحل لما
+
+494
+00:36:19,830 --> 00:36:25,030
+تلقوا إجابة صحيحة عبر الموديل بنرسل لكم الإجابات
+
+495
+00:36:25,030 --> 00:36:30,790
+الصحيحة طبعا احنا بذلك نكون انتهينا من المقادرة
+
+496
+00:36:30,790 --> 00:36:36,750
+المصورة رقم 7 أرجو منكم أبناء الطلاب والطالبات
+
+497
+00:36:36,750 --> 00:36:41,750
+المتابعة الحديثة وأرجو حل هذا المواجب طبعا نبدأ
+
+498
+00:36:41,750 --> 00:36:47,330
+حله بعد نرسله خلال اليومين عبر الموديل
+
+499
+00:36:50,630 --> 00:36:55,730
+والنجاح وفي الختام استودعكم الله الذي يستطيع وداعه
+
+500
+00:36:55,730 --> 00:37:00,110
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/_MCBo6CSmSU_postprocess.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/_MCBo6CSmSU_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..73803110955d63992389d0ff37ad341e965b6e49
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/_MCBo6CSmSU_postprocess.srt
@@ -0,0 +1,1452 @@
+1
+00:00:01,550 --> 00:00:04,750
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,750 --> 00:00:10,130
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:10,130 --> 00:00:16,770
+سيدنا محمد وعلى آله وأصحابه والتابعين بإحسان إلى
+
+4
+00:00:16,770 --> 00:00:22,650
+يوم الدين أما بعد الطلاب والطالبات الأعزاء
+
+5
+00:00:22,650 --> 00:00:28,850
+المسجلين لمساق اقتصادية التعليم والصحة السلام
+
+6
+00:00:28,850 --> 00:00:36,690
+عليكمورحمة الله وبركاته المحاضرة المصورة رقم 6 ان
+
+7
+00:00:36,690 --> 00:00:42,550
+شاء الله في هذه المحاضرة سوف نستعرض الجزء الثاني
+
+8
+00:00:42,550 --> 00:00:49,170
+من الفصل الثاني وهو العائد من التعليم اتكلمنا احنا
+
+9
+00:00:49,170 --> 00:00:54,990
+في المحاضرة الماضية عن الجزء الأول من العائد على
+
+10
+00:00:54,990 --> 00:01:00,240
+التعليم وان شاء الله في هذه المحاضرةمكمل الجزء
+
+11
+00:01:00,240 --> 00:01:07,680
+الثاني والأخير ان شاء الله من الفصل الثاني قياس
+
+12
+00:01:07,680 --> 00:01:12,820
+العائد الاقتصادي من التعليم طبعا يمكن أن نقيص
+
+13
+00:01:12,820 --> 00:01:19,220
+العائد من خلال طبعا عدة طرق سأفرضها ان شاء الله
+
+14
+00:01:19,220 --> 00:01:26,140
+بعد قليل لكن بشكل عام نقول ان بواسطة حساب التكلفة
+
+15
+00:01:26,140 --> 00:01:31,410
+والعائدعن طريق العينة المقطعية المستعرضة ويستخرج
+
+16
+00:01:31,410 --> 00:01:36,050
+منها دخول الأفراد لمختلف المستويات للعمر تبقى
+
+17
+00:01:36,050 --> 00:01:40,990
+لمستوى التعليمي للأفراد بذلك تحصل على مستوى داخل
+
+18
+00:01:40,990 --> 00:01:45,450
+الفرد لمستويات التعليمية المختلفة بالأعمار
+
+19
+00:01:45,450 --> 00:01:51,710
+المتعاقبة طبعا هذه الطريقة أبرزت ما يلي طريقة
+
+20
+00:01:51,710 --> 00:01:57,400
+التكلفة والعائد واحديرتبط دخل الفرد ارتباطاً
+
+21
+00:01:57,400 --> 00:02:02,380
+عالياً بمستوى التعليم كلما زاد درجة التعليم زاد
+
+22
+00:02:02,380 --> 00:02:07,480
+دخل، فتكون علاقة تفضية بين مستوى التعليم وبين
+
+23
+00:02:07,480 --> 00:02:14,420
+الدخل أثنين يرتبط الدخل أو يزيد الدخل ويبلغ أعلى
+
+24
+00:02:14,420 --> 00:02:22,380
+مستوى له في متوسط العمر يعني في الأربعينيات من
+
+25
+00:02:22,380 --> 00:02:27,270
+أربعين إلى خمسين سنةيصل إلى أعلى مستوى له ثم يثبت
+
+26
+00:02:27,270 --> 00:02:34,010
+وأحيانا تناقص حتى بلغ سن التقاعد تلاتة دخول أفراد
+
+27
+00:02:34,010 --> 00:02:39,610
+في دوية التعليم العالي مرتفع جدا بالنسبة لمن أهم
+
+28
+00:02:39,610 --> 00:02:45,130
+أقل تعليما يعني اللي معاهم شهادات دكتوراه يعني
+
+29
+00:02:45,130 --> 00:02:50,570
+بشكل عام يكون دخولهم أعلىوكل مرتقة في مراتب
+
+30
+00:02:50,570 --> 00:02:56,450
+الدكتوراه من مثلًا أستاذ مساعد إلى أستاذ مشارك إلى
+
+31
+00:02:56,450 --> 00:03:01,670
+professor بزيادة طبعًا الدخل وهذا أمر طبيعي لأن
+
+32
+00:03:01,670 --> 00:03:08,030
+حجم الجهود اللي بدلوا حجم ليس سهل أربعة يبلغ الدخل
+
+33
+00:03:08,030 --> 00:03:12,810
+أعلى مستوى له بالنسبة لذوي التعليم العالي في سن
+
+34
+00:03:12,810 --> 00:03:20,050
+متأخرةوأحيانًا يستمر الارتفاع حتى سن التقاعد وقد
+
+35
+00:03:20,050 --> 00:03:25,510
+يزيد عن ذلك هدف
+
+36
+00:03:25,510 --> 00:03:31,550
+قياس عائد التعليم هناك عدة أهداف واحد بيان مدى
+
+37
+00:03:31,550 --> 00:03:35,410
+مؤسسة التعليم في التنمية الاقتصادية ليش أنا
+
+38
+00:03:35,410 --> 00:03:40,070
+ماابقاش العائد؟ الأهداف أول حاجة عشان نشوف كده ليش
+
+39
+00:03:40,070 --> 00:03:44,710
+التعليم متشاهد في التنمية الاقتصاديةيمدّل مخطط
+
+40
+00:03:44,710 --> 00:03:49,270
+اقتصادي أو التربوي بمعلومات أساسية مفيدة عن
+
+41
+00:03:49,270 --> 00:03:53,790
+الروابط التي تربط التعليم بسوق العمل وهي نقطة
+
+42
+00:03:53,790 --> 00:03:59,810
+المهمة تلاتة، جودة بتكلفة التعليم بمرحل مختلفة
+
+43
+00:03:59,810 --> 00:04:04,770
+وتوازن العرض مع الطلبة دام على بقية العائد، إذن
+
+44
+00:04:04,770 --> 00:04:11,210
+بتتكلم عن التكلفة أربعة، يساعد بالقيام بإحداث
+
+45
+00:04:11,210 --> 00:04:14,610
+مقارناتمختلف بين العائد الاقتصادي من التعليم
+
+46
+00:04:14,610 --> 00:04:19,290
+والمشروعات الاستثمارية الأخرى بدا نقارن العائد
+
+47
+00:04:19,290 --> 00:04:23,310
+التعليمي مع عائد المشاريع الأخرى خامسة يحدد
+
+48
+00:04:23,310 --> 00:04:26,830
+المرحلة التعليمية والبرامج التعليمية الأشده
+
+49
+00:04:26,830 --> 00:04:30,890
+للاستثمار فيها ستة يوجه العلاقة بين الانفاق على
+
+50
+00:04:30,890 --> 00:04:34,950
+التعليم العالي بسوق العمل وسياسة الأجور في الدولة
+
+51
+00:04:34,950 --> 00:04:40,210
+سبعة يفيد المخطط في توزيع الاستثمار في المجال
+
+52
+00:04:40,210 --> 00:04:45,160
+بالعائد المرتفععادى يقترح طرقا بزيادة كفاءة
+
+53
+00:04:45,160 --> 00:04:49,980
+التعليم بزيادة العائد أو بتخفيض التكلمة يعني بنفحص
+
+54
+00:04:49,980 --> 00:04:57,160
+تلف التعليم بنقارنها بالدخول لقوة العاملة المتعلمة
+
+55
+00:04:57,160 --> 00:05:01,540
+صعوبات
+
+56
+00:05:01,540 --> 00:05:11,500
+العائد في التعليم طبعا هناك صعوبات يعني تتقنف
+
+57
+00:05:12,200 --> 00:05:18,180
+بسبب العائد في التعليم من بين هذه الصعوبات واحد
+
+58
+00:05:18,180 --> 00:05:23,320
+صعوبة مقارنة التكلفة بالعائد بسبب صعوبة تحديد
+
+59
+00:05:23,320 --> 00:05:28,140
+الأهداف التعليمية بدقة بصورة معايير تقييس الأداء
+
+60
+00:05:28,140 --> 00:05:31,700
+عشان أقارن التكلفة بالعائد بدأ أنا أحط معايير
+
+61
+00:05:31,700 --> 00:05:36,380
+تقييس الأداء عشان نعرف يعني هل هذه اللي مثلا
+
+62
+00:05:36,380 --> 00:05:40,340
+تكلفتها كذا كان عائدها مناسب ولا كان عائدها قليل
+
+63
+00:05:40,340 --> 00:05:45,390
+أو كانعيدها غير مناسب ثم إن العائدات في التعليم
+
+64
+00:05:45,390 --> 00:05:49,530
+تأخذ أشكال مختلفة من الاقتصادي وغير الاقتصادي
+
+65
+00:05:49,530 --> 00:05:53,810
+ومنها العائدات على مستوى الشخص المتعلم وأتكلم
+
+66
+00:05:53,810 --> 00:06:00,330
+سابقا عنه لأن العائدات قد تكون عائدات اقتصادية وقد
+
+67
+00:06:00,330 --> 00:06:06,150
+تكون عائدات غير اقتصادية يعني في النواحي
+
+68
+00:06:06,150 --> 00:06:10,310
+الاجتماعية وما يتعلق بيها واخر على مستوى المجتمع
+
+69
+00:06:11,770 --> 00:06:14,970
+وإذا كان بالإمكان قِحساب العائدات الاقتصادية في
+
+70
+00:06:14,970 --> 00:06:19,610
+صورة عائد صافي متوقع من انفاق على التعليم فإنه
+
+71
+00:06:19,610 --> 00:06:24,970
+يصعب قياس العائدات غير اقتصادية بل وتعريفها بتلقى
+
+72
+00:06:24,970 --> 00:06:30,510
+نين من الصعوبات صعوب التحديد أنواع النفقات
+
+73
+00:06:30,510 --> 00:06:34,550
+المستثمرة في التعليم ومصادرها وما إذا كانت هذه
+
+74
+00:06:34,550 --> 00:06:39,610
+النفقات استثمارية أو نفقات استثمارية وما إذا كانت
+
+75
+00:06:39,610 --> 00:06:45,050
+هذه النفقات مالية نقدةأو مادية أخرى وطبعاً خلقت
+
+76
+00:06:45,050 --> 00:06:50,830
+صعوبة في تثمينها بتقع تلاتة صعوبة قياس عوامل
+
+77
+00:06:50,830 --> 00:06:55,510
+الإنتاج في التعليم إذن الإنتاجية في التعليم تعتمد
+
+78
+00:06:55,510 --> 00:06:59,930
+على مؤشرات كثيرة يصعب القياس الكام لأشياء غير
+
+79
+00:06:59,930 --> 00:07:04,750
+مادية كما يصعب قياس فعالية وإنتاجية عامل المعلمين
+
+80
+00:07:04,750 --> 00:07:10,440
+والتلاميذ في استعليمية لأنه طبعا يعنييعني قد تكون
+
+81
+00:07:10,440 --> 00:07:18,980
+مؤشرات القياس يعني غير تقيقة بشكل كامر أربعة،
+
+82
+00:07:18,980 --> 00:07:23,260
+صعوبة التعبير الكام عن وحدة الناتج بالتعليم كيف أن
+
+83
+00:07:23,260 --> 00:07:31,000
+نعبر بشكل رقمي عن ما هو أفضل في سوء التعليم كما
+
+84
+00:07:31,000 --> 00:07:35,200
+يحدث في تصنيف السلع والخدمات فضلاً عن صعوبة تحديد
+
+85
+00:07:35,200 --> 00:07:40,610
+القيمة النقودية للناتج للتعليملا يعمل لبيع ناتجه
+
+86
+00:07:40,610 --> 00:07:47,010
+بأسعار السوق خمسة، صعوبة قياس أثر التعليم على
+
+87
+00:07:47,010 --> 00:07:52,110
+إنتاجية العمل يعني هل التعليم بديزيد الإنتاجية؟ إذ
+
+88
+00:07:52,110 --> 00:07:56,970
+قد ترجع كفاية عنصر العمل والإنتاجية لعوم أخرى غير
+
+89
+00:07:56,970 --> 00:08:01,710
+التعليم، القدرة الشخصية أو أثر الأسرة أو أثر
+
+90
+00:08:01,710 --> 00:08:08,510
+الإعلام إلا وعلى صعوبة عزل أثر التعليموحده وقياسيه
+
+91
+00:08:08,510 --> 00:08:13,530
+من بين العلاوات الغير مادية المؤثرة في الإنتاج
+
+92
+00:08:13,530 --> 00:08:18,730
+طبعاً الإنتاجية زادت هل زيادة هذا راجع للتعليم؟ قد
+
+93
+00:08:18,730 --> 00:08:24,290
+يقول ذلك صحيحاً لكنها قد ترجع إلى عوامل أخرى، إلى
+
+94
+00:08:24,290 --> 00:08:31,050
+عوامل شخصية، إلى أثر الأسرة، أثر الإعلام، أثر
+
+95
+00:08:31,050 --> 00:08:34,590
+الاهتمام والتدريب عند الشخص، لأن في فرق من التعليم
+
+96
+00:08:34,590 --> 00:08:41,540
+وبين التدريب6 تأخر ظهور عائد اقتصادي من الانفاق
+
+97
+00:08:41,540 --> 00:08:46,700
+على التعليم نظرا لموجود فترة زمنية طويلة في
+
+98
+00:08:46,700 --> 00:08:50,800
+الانفاق على التعليم وبين الحصول على عائد منه،
+
+99
+00:08:50,800 --> 00:08:55,600
+والذي قد تستغلق بين 10 إلى 15 سنة أو أكثر يعني إن
+
+100
+00:08:55,600 --> 00:09:01,620
+شخص بتعلم مدة طويلة، خلال 6 سنوات اتدائي، 3 سنوات
+
+101
+00:09:01,620 --> 00:09:07,910
+اعدادي، 3 سنوات تانوي، 16 سنةمع 4 سنوات على الأقل
+
+102
+00:09:07,910 --> 00:09:17,770
+جامعة هي طبعا نتكلم هنا عن 16 سنة 6 و 6 12 و 4 16
+
+103
+00:09:17,770 --> 00:09:23,550
+سنة 16 سنة عشان يبدأ الإنسان يتعلم 16 سنة عشان
+
+104
+00:09:23,550 --> 00:09:28,990
+يبدأ يدردخل أو يلاقي وظيفة حقق من ورائها عائد
+
+105
+00:09:29,310 --> 00:09:33,090
+المادية وها طبعا وقضوا من الصعوبات مش يعني مشروع
+
+106
+00:09:33,090 --> 00:09:37,570
+هذا عمره سنة أو سنتين أو شهر أو شهرين هذا مشروع
+
+107
+00:09:37,570 --> 00:09:42,070
+التعليم مشروع طويل لأبد وإنسان أحيانًا قد يخلص
+
+108
+00:09:42,070 --> 00:09:45,650
+كمان أربع سنين جامعة ثم أدرس ماجستير ويدرس دكتوراه
+
+109
+00:09:45,650 --> 00:09:48,050
+يعني كمان ماجستير تالت سنين ودكتوراه أربع سنين
+
+110
+00:09:48,050 --> 00:09:52,110
+كمان سبع سنين سبعة وست عشر سنة يعني ما يقارن من
+
+111
+00:09:52,110 --> 00:09:59,600
+تلاتين وعشرين سنة بده تعليم سبعةالهمال الواضع في
+
+112
+00:09:59,600 --> 00:10:02,580
+قياس العادات الاجتماعية والسياسية والثقافية
+
+113
+00:10:02,580 --> 00:10:06,380
+والحضارية من التعليم نظرًا لشحالة قياسها بوحدات
+
+114
+00:10:06,380 --> 00:10:13,000
+نقلية ومادية لأن التعليم يعني بيكفّي أنه بيعطي
+
+115
+00:10:13,000 --> 00:10:19,400
+الإنسان قيمة وبيعطيه احترام وبيعطيه مكانة اجتماعية
+
+116
+00:10:19,400 --> 00:10:23,920
+مرموقة لك لعظم أية أول آية في القرآن الكريم اقرأ
+
+117
+00:10:23,920 --> 00:10:29,180
+اقرأ باسم ربك الذي خلقالذين علموا القلم علم
+
+118
+00:10:29,180 --> 00:10:35,180
+الإنسان ما لم يعلم يعني التعليم هنا طبعا مهم وأول
+
+119
+00:10:35,180 --> 00:10:41,760
+آية في القرآن الكريم نزلت في موضوع التعليم ثم
+
+120
+00:10:41,760 --> 00:10:45,480
+نتجاه الدراسات والبحوث بقياس دور العلم والبحث
+
+121
+00:10:45,480 --> 00:10:50,560
+العلمي في زيادة إنتاجية العمل عرف أنه كل ما كان في
+
+122
+00:10:50,560 --> 00:10:56,400
+تعلم أكثر وفي علم أكثر وفي أبحاث أكثرإنتجة العمل
+
+123
+00:10:56,400 --> 00:11:03,160
+لكن كثير من الأجهزة يعني اتجاهل دور العمل لكن
+
+124
+00:11:03,160 --> 00:11:06,600
+بالرغم من الصعوبات السابقة لم تملعوا قياس عدد
+
+125
+00:11:06,600 --> 00:11:09,900
+التعليم على الأقل في الجوانب التي يمكن أخسابها
+
+126
+00:11:09,900 --> 00:11:14,100
+والتواصل إلى أسليب تتفادى الكثير من الصعوبات وتسعى
+
+127
+00:11:14,100 --> 00:11:18,360
+للدراسة دراسات أخرى إلى قياس عدد التعليم الأخرى عن
+
+128
+00:11:18,360 --> 00:11:24,440
+طريق ممشّرات PFD مشكلات قياس عقل التعليم هناك عدة
+
+129
+00:11:24,440 --> 00:11:28,860
+مشكلاتتعلق بقياس عدد التعليم واحد استغلال رأس
+
+130
+00:11:28,860 --> 00:11:33,100
+المال في التعليم بناء المدارس مثلا لينتج عنه إنتاج
+
+131
+00:11:33,100 --> 00:11:37,500
+وكنتسويك فإن احنا مثلا بننا مدرسة مش إنتاج
+
+132
+00:11:37,500 --> 00:11:42,340
+وكنتسويكها ويصعب قياس حسابه حساب عائده المالي
+
+133
+00:11:42,340 --> 00:11:46,200
+class-money-social-card عند مقارنته بالمشاريع
+
+134
+00:11:46,200 --> 00:11:52,000
+الأخرى المدرسة تبدو كأنها يعني مؤسسة خدماتية مش
+
+135
+00:11:52,000 --> 00:11:58,840
+مؤسسة تدروا دخلهاتنين، الاقتصاد على حالات العرض
+
+136
+00:11:58,840 --> 00:12:03,260
+والطلب الحاضر والماضي والاستناد اليها في تحديد
+
+137
+00:12:03,260 --> 00:12:07,900
+التحتيجات المستقبلية تلاتة، يهم القياس الفوائد
+
+138
+00:12:07,900 --> 00:12:13,720
+الاقتصادية غير المباشرة من التعليم أربعة، مشكلة
+
+139
+00:12:13,720 --> 00:12:17,440
+جمع الحقائق والبيانات المطلوبة ودقتها في الدول
+
+140
+00:12:17,440 --> 00:12:22,160
+النامية مثل دخول الأطرادنفقات كل مرحلة تعليمية
+
+141
+00:12:22,160 --> 00:12:27,280
+مصروفات المدرسية المناخ الدراسية إهناء السوق العمل
+
+142
+00:12:27,280 --> 00:12:34,360
+وترصد طريقة الدخل كل هذه الأشياء طبعا يعني ممكن
+
+143
+00:12:34,360 --> 00:12:41,660
+تتم عدم حسابها بدقة مما يؤثر في قياس عائد التعليم
+
+144
+00:12:41,660 --> 00:12:47,400
+طرق وأساليب قياس عائد الاقتصاد في التعليم «Yellow
+
+145
+00:12:47,400 --> 00:12:51,220
+Charts»إنه يمكن قياس عقد التعليم من ناحيتين
+
+146
+00:12:51,220 --> 00:12:56,680
+المباشرة وغير مباشرة قلك مثلا إقامة حديقة وسط
+
+147
+00:12:56,680 --> 00:13:02,720
+منطقة السكنية إذا فتحت هذه الحديقة للناس نظير أجر
+
+148
+00:13:02,720 --> 00:13:09,380
+معين أو نظير سوق معين فإن الدخل لهذه الحديقة الدخل
+
+149
+00:13:09,380 --> 00:13:12,900
+اللي يتحكم في الحديقة يمثل عقد مباشر من الناحية
+
+150
+00:13:12,900 --> 00:13:18,750
+الاقتصادية لكن هناك عقد اقتصاديغير مباشر يتمثل
+
+151
+00:13:18,750 --> 00:13:24,230
+فيما يتاح في المنطقة من هواء ومن شمس منظر للشجر
+
+152
+00:13:24,230 --> 00:13:29,470
+ومنظر للخضر وكاد كل منافع اقتصادية يمكن قياسها لكن
+
+153
+00:13:29,470 --> 00:13:36,730
+بصعوبة وهذا هو شأن التعليم يعني التعليم قياسه تأتم
+
+154
+00:13:36,730 --> 00:13:42,310
+بسهولة وبالرغم من ذلك نقول هنا أن هناك أربع طرق
+
+155
+00:13:42,310 --> 00:13:50,060
+لقياس العائد الاقتصادي للتعليم وهذه الطرق هيواحد،
+
+156
+00:13:50,060 --> 00:13:56,400
+حساب العائد عن طريق زيادة الدخل الفردي كل ما الدخل
+
+157
+00:13:56,400 --> 00:14:00,780
+الفردي بزيد طبعا العائد هنا بزيد يعني في علاقة
+
+158
+00:14:00,780 --> 00:14:06,780
+فرضية بين زيادة الدخل الفردي وزيادة العائد فعند
+
+159
+00:14:06,780 --> 00:14:13,240
+زيادة الدخل الفردي على يعني مستوى الفرد معناه أنه
+
+160
+00:14:13,240 --> 00:14:17,040
+هيزيد عن مستوى العائلةمعناه هي زيادة على مستوى
+
+161
+00:14:17,040 --> 00:14:23,840
+المجتمع ثم على مستوى الدولة ككلها طبعاً أن تقوم
+
+162
+00:14:23,840 --> 00:14:30,840
+العلماء لهذه الطريقة على مقارنة بين أرباح الأفراد
+
+163
+00:14:30,840 --> 00:14:36,880
+وبين مستوهم التعليمي يعني بين دخل الفرق ومستوى
+
+164
+00:14:36,880 --> 00:14:40,740
+التعليم والفكرة هنا أن التعليم يرفع مستوى التأهيل
+
+165
+00:14:40,740 --> 00:14:46,190
+عند العامل مما يستبع سيادة إنتجيتهكل ما فيه تعليم
+
+166
+00:14:46,190 --> 00:14:51,190
+أعلى كل ما فيه تأهيل أعلى وكل ما فيه تأهيل أعلى
+
+167
+00:14:51,190 --> 00:14:56,430
+فيه إنتاجية أعلى وهذه تؤدي بدورها إلى رفع مستوى
+
+168
+00:14:56,430 --> 00:15:01,410
+الفن وأشارت دراسات Walsh إلى أن القيمة المالية
+
+169
+00:15:01,410 --> 00:15:05,430
+التي يحصل عليها الفرد نتيجة هذه التربية تتجاوز
+
+170
+00:15:05,430 --> 00:15:09,890
+بجميع الأحوال النفقات التي تنفق عليها دراسات
+
+171
+00:15:09,890 --> 00:15:14,210
+Walsh, Nobel, Glick, Picard وWoodstocker كلها
+
+172
+00:15:14,210 --> 00:15:19,610
+بتدلة علىثالث الاعتراضات
+
+173
+00:15:19,610 --> 00:15:24,930
+واحد تعارض عقد التعليم من ناحية الفرد والمجتمع فيه
+
+174
+00:15:24,930 --> 00:15:28,490
+فرق بينهم ثاني اختلاف العقد الفردي من المجتمع إلى
+
+175
+00:15:28,490 --> 00:15:34,990
+آخر ثلاثة من حسب نسبة الفقر فاللي هو المجتمع فقير
+
+176
+00:15:34,990 --> 00:15:40,650
+أو غير فقير ثلاثة إن مقدار ما يأخذه الفرد من الدخل
+
+177
+00:15:40,650 --> 00:15:45,970
+ليهدل بالضرورة على قيمة عملهسبب ارتباط تلك بوضع
+
+178
+00:15:45,970 --> 00:15:50,410
+الأصول الاجتماعي ورغم كانتها قعوة اجتماعية أخرى
+
+179
+00:15:50,410 --> 00:15:55,610
+كالمحسوبية مش شرط إنه كل ما زاد دخل الفدع زاد
+
+180
+00:15:55,610 --> 00:16:01,090
+إنتاجيته أو زاد قيمة عمله طبعاً في علاقات أخرى
+
+181
+00:16:01,090 --> 00:16:07,270
+يعني ممكن أسنان يتعين في مكان مش مناسب له في رشوة
+
+182
+00:16:07,270 --> 00:16:11,810
+في محسوبية إلى آخرها العقل غير مباشر على الفدع
+
+183
+00:16:13,380 --> 00:16:16,720
+كاحترام العمل في الإنتاج تقبل التغيير الثقافي
+
+184
+00:16:16,720 --> 00:16:23,280
+والدعوة له تنمية الابتكار والطموح للفرد، خبرات
+
+185
+00:16:23,280 --> 00:16:27,380
+تربوية، مفاهيم ومهارات اجتماعية والتجاهات وأذواق
+
+186
+00:16:27,380 --> 00:16:31,540
+الأفراد يعني التعليم فيه عائد مباشر، عائد المادة
+
+187
+00:16:31,540 --> 00:16:37,300
+اللي هو الدخل، فيه عائد غير مباشر اللي هو الثقافة،
+
+188
+00:16:37,300 --> 00:16:42,960
+الابتكار، الطموحالخبراء، الخبرات، المفاهيم،
+
+189
+00:16:42,960 --> 00:16:49,500
+الأضواب والهدف تؤثر تأثير بسموه اللي هو غير مباشر
+
+190
+00:16:49,500 --> 00:16:54,220
+طريقة ثانية لكياسة التعليم هي طريقة الترابط وتعني
+
+191
+00:16:54,220 --> 00:16:57,060
+إيش هو طريقة الترابط؟ بينا نربط بين إيش وإيش لو
+
+192
+00:16:57,060 --> 00:17:01,020
+كياس الترابط القائم بين نشاط التعليمي وبين مستوى
+
+193
+00:17:01,020 --> 00:17:06,040
+نشاط الاقتصادي بينا نشوف مدى الترابط بين نشاط
+
+194
+00:17:06,040 --> 00:17:11,890
+التعليمي ونشاط الاقتصادي وقولوا أساليبمن أساليبه
+
+195
+00:17:11,890 --> 00:17:17,270
+المقارنة بين البلدان المختلفة في وقت سابق واكتشاف
+
+196
+00:17:17,270 --> 00:17:21,430
+الترابط السابق بين نمو التربية ونمو الدخل القومي
+
+197
+00:17:21,430 --> 00:17:26,610
+وقد أجريت أبحاث تعلق بالترابط بين معدلات انتساب
+
+198
+00:17:26,610 --> 00:17:32,190
+إلى المدرسة وبين الدخل القومي الفارق ووجود ترابطا
+
+199
+00:17:32,190 --> 00:17:37,130
+إيجابيا بينهما فرغم التفاين القائم بين البلدان
+
+200
+00:17:37,130 --> 00:17:41,570
+وهناك أسلوب الترابط عبر الزمنويعني قياس الترابط
+
+201
+00:17:41,570 --> 00:17:46,030
+بين التربية وبين الداخل القومي داخل بلد معين عبر
+
+202
+00:17:46,030 --> 00:17:50,690
+فترات زمنية مختلفة كدراسة «الشولز» وردقاس خلالها
+
+203
+00:17:50,690 --> 00:17:54,230
+الترابط بين التربية وبين الداخل القومي في أمريكا
+
+204
+00:17:54,230 --> 00:17:59,250
+في الفترة الفتس عمية في 1956 يعني الآن المقصودة
+
+205
+00:17:59,250 --> 00:18:05,330
+بالطريقة باختصار شديد هي قياس الترابط بين التعليم
+
+206
+00:18:05,330 --> 00:18:12,790
+وبين الدخلبين التعليم وبين النشاط الاقتصادي بين
+
+207
+00:18:12,790 --> 00:18:17,750
+التعليم وبين مبارزة العمل والعمال الفكرية أو
+
+208
+00:18:17,750 --> 00:18:23,650
+الجدوية أو المهنية إلى آخرين الطريقة الثانية طريقة
+
+209
+00:18:23,650 --> 00:18:29,610
+البواب لمعرفة أسام التعليم بجهة الدخل القومي اللي
+
+210
+00:18:29,610 --> 00:18:35,510
+هو العمل وبها
+
+211
+00:18:35,510 --> 00:18:41,030
+يتم تقديرزيادة الإجمالية في الإنتاج القومي لبلد من
+
+212
+00:18:41,030 --> 00:18:45,810
+البلدان إلى الحقب من الزمن مبينة دور العوامل
+
+213
+00:18:45,810 --> 00:18:51,790
+المحددة قابلة القياسي بتلك الزيادة منتهي للقول بأن
+
+214
+00:18:51,790 --> 00:18:56,930
+ما تبقى يرجع إلى بعض عوامل غير محددة وتجمع هذه
+
+215
+00:18:56,930 --> 00:19:00,710
+الأبحار على أن التعليم وتقدم المعرفة من هم هذه
+
+216
+00:19:00,710 --> 00:19:06,490
+العوامل غير محددة وأشار عدد الباحثين إلىعلى نسبة
+
+217
+00:19:06,490 --> 00:19:10,690
+الزيادة في الداخل القومي العام التي يمكن أرجعها
+
+218
+00:19:10,690 --> 00:19:14,770
+إلى ما أنفقة من رأس مال والعمل في ذلك الفترة
+
+219
+00:19:14,770 --> 00:19:19,130
+الزمنية معينة ثم اعتبار البواقي نتيجة تحسينات
+
+220
+00:19:19,130 --> 00:19:22,710
+اتطرأت على قوة العاملة من حيث كيف نساوي التعليم
+
+221
+00:19:22,710 --> 00:19:27,110
+العامل المتبقي في البواقي هذه بأثر على التعليم
+
+222
+00:19:27,110 --> 00:19:35,040
+يعني في عامل أساسي بأثر على اللي هو الإنتاجيةعلى
+
+223
+00:19:35,040 --> 00:19:42,340
+التقدم وفي عوامل اسموها البواقي طبعا العامل
+
+224
+00:19:42,340 --> 00:19:47,620
+المتباقي تضمن خلاص التعليم والتدريب والتنظيم
+
+225
+00:19:47,620 --> 00:19:51,940
+التكنولوجي ويمكن أن نفسر عامل المتباقي بأنه عبارة
+
+226
+00:19:51,940 --> 00:19:57,680
+عن أقصاديات الحجم نعرف كل ما زاد حجم الشركة يقل
+
+227
+00:19:57,680 --> 00:20:01,720
+متوسط التكنولوجيا ال average cost قلوهذا معناه إنه
+
+228
+00:20:01,720 --> 00:20:07,140
+بزيد طبعاً إذا باع سعر معين بزيد أرباحه بشكل كبير
+
+229
+00:20:07,140 --> 00:20:11,840
+جداً فاقتصادية الحجم معناها إنه كل ما زاد حجم
+
+230
+00:20:11,840 --> 00:20:16,980
+الشركة وحجم المؤسسة كل ما الـ Average Cost قلت
+
+231
+00:20:16,980 --> 00:20:20,480
+معناه إنه بالإمكان تخفيف الأسعار وتحقيق أرباح
+
+232
+00:20:20,480 --> 00:20:24,820
+عالية فالحقيقة المنافسة في السوق إذا العام
+
+233
+00:20:24,820 --> 00:20:29,070
+المتبقيةالتي هي التعليم، التدريب، التنظيم،
+
+234
+00:20:29,070 --> 00:20:32,870
+التكنولوجيا وقد يكون اقتصاد الحجم أو التحسن في
+
+235
+00:20:32,870 --> 00:20:37,310
+نوعية الموارد البشرية، وكلها بالسبب في الإنتاج
+
+236
+00:20:37,310 --> 00:20:40,570
+أربعة،
+
+237
+00:20:40,570 --> 00:20:53,070
+طريقة حساب التكلفة والعائد طريقة
+
+238
+00:20:53,070 --> 00:20:57,270
+حساب التكلفة والعائد الاقتصادييُقصد بحساب التكلف
+
+239
+00:20:57,270 --> 00:21:01,670
+والعائد مقارنة تكلفة المشروع الاستثماري بالعائد
+
+240
+00:21:01,670 --> 00:21:06,990
+المنتظر منه بقاس تحديد مدى فائدته كالذي يعمل راس
+
+241
+00:21:06,990 --> 00:21:12,130
+الجنوة واختيار استثمار رأس المال في مشروع ما ألاو
+
+242
+00:21:12,130 --> 00:21:15,970
+التضحية بالمال في الوقت الحاضر من أجل طبعا فوائد
+
+243
+00:21:15,970 --> 00:21:20,310
+مستقبلية أو عائد لهذا المال المستثمر على شكل
+
+244
+00:21:20,310 --> 00:21:24,570
+ومستويات أعلى في الدخل أو الإنتاج إذا المفهوم
+
+245
+00:21:24,570 --> 00:21:30,300
+التكلف والعائدمعنى هذا؟ يعني مقارنة مشروع استثماري
+
+246
+00:21:30,300 --> 00:21:35,280
+بالعقد المنتظر بقصة تحديد مدى خيرته نقارن من
+
+247
+00:21:35,280 --> 00:21:41,100
+التكلفة الحالية سواء كانت تكلفة استثمارية أو تكلفة
+
+248
+00:21:41,100 --> 00:21:46,760
+جارية بين عقد متوقع يتحققوا خلال سنوات التشغيل لأن
+
+249
+00:21:46,760 --> 00:21:53,720
+التكلفة جزء منها يعني يتم انفاقه ذات التأسيس يسمى
+
+250
+00:21:53,720 --> 00:21:57,630
+التكلفة الاستثماريةالجزء الثاني بتتم انفاق وخاصة
+
+251
+00:21:57,630 --> 00:22:02,790
+بتشغيل اسمه تكليف جاري أو تكليف تشغيل من حدد
+
+252
+00:22:02,790 --> 00:22:06,710
+العلاقة هنا بين حدد التكلفة وبين العائد المتوقع
+
+253
+00:22:06,710 --> 00:22:10,130
+والمنتظر كمان تحديد العلاقة بين انفاق على مشاريع
+
+254
+00:22:10,130 --> 00:22:13,930
+الاستثمار والعائد المنتظر منها يعتبر عملية هامة
+
+255
+00:22:13,930 --> 00:22:18,510
+جدا تلقى أشدنا لتوجيه الموارد المالية على أسس
+
+256
+00:22:18,510 --> 00:22:24,290
+سليمة يمكن مقارنة الاستثمار في التعليم بأنواع
+
+257
+00:22:24,290 --> 00:22:29,080
+الاستثمارات الأخرىأي أنواع الاستثمار أكثر أسهمًا
+
+258
+00:22:29,080 --> 00:22:34,480
+في النمو الاقتصادي؟ أي أنواع الاستثمار أكثر أسهمًا
+
+259
+00:22:34,480 --> 00:22:37,720
+في النمو الاقتصادي؟ هو الاستثمار في رأس المال
+
+260
+00:22:37,720 --> 00:22:42,160
+البشري أو نبعًا هو بيسأل سؤال أي استثمار أكثر
+
+261
+00:22:42,160 --> 00:22:45,100
+أسهمًا؟ هل استثمار في رأس المال البشري؟ أم في رأس
+
+262
+00:22:45,100 --> 00:22:50,720
+المال المادي؟ هل كل أنواع التعليم ومراحله تتساوى
+
+263
+00:22:50,720 --> 00:22:54,930
+من حيث معدل عائد منها؟وما بدأ أسهال التعليم في
+
+264
+00:22:54,930 --> 00:22:58,510
+زيادة دخل القوم والفرق وما علاقة التعليم بالنمول
+
+265
+00:22:58,510 --> 00:23:04,250
+التصريحي كل ما سبق وذكرناه يدور حوله محمو الرئيس
+
+266
+00:23:04,250 --> 00:23:10,730
+وهو لغب الإستثمار في التعليم والعائد منه في إعتبار
+
+267
+00:23:10,730 --> 00:23:15,090
+التعليم عملية استثمارية لها عائد لممكن قياسه بدون
+
+268
+00:23:15,090 --> 00:23:17,930
+أن أقارن بين الاستثمار في التعليم وبين العائد
+
+269
+00:23:17,930 --> 00:23:19,210
+المتوقع
+
+270
+00:23:21,110 --> 00:23:25,570
+أسلوب تحليل التكلفة التعليمية عندنا أسلوب التحليل
+
+271
+00:23:25,570 --> 00:23:31,710
+الشامل متناول هذا الأسلوب تحليل وضع التعليم
+
+272
+00:23:31,710 --> 00:23:36,190
+بالنسبة للاقتصاد القومي مقارنة التعليم بالداخل
+
+273
+00:23:36,190 --> 00:23:40,790
+القومي أو بالميزانية العامة للبلاد ويوفد هذا
+
+274
+00:23:40,790 --> 00:23:44,610
+الأسلوب في عمل دراسات المقارنة بين الدول المختلفة
+
+275
+00:23:44,610 --> 00:23:49,680
+اتنينستوب التحليل التفصيلي للتكاليف القليلة وحسب
+
+276
+00:23:49,680 --> 00:23:53,960
+التكلفة وحسب نوع التعليم هل هو تعليم عام أو تعليم
+
+277
+00:23:53,960 --> 00:23:58,660
+خاص ومراحلين هي حساب تكلفة التلميذ في مراحل
+
+278
+00:23:58,660 --> 00:24:01,780
+التعليم الإجتماعية الإعدادية الثانوية فغالب من
+
+279
+00:24:01,780 --> 00:24:07,560
+انفاق على أي دراسة هي دراسة تكلفة مباشرة للتعليم
+
+280
+00:24:07,560 --> 00:24:14,840
+والتكلفة المباشرة والتكلفة الاجتماعية يعني
+
+281
+00:24:14,840 --> 00:24:22,850
+في حساب تكلفةالتكلفة التعليم كيف نحسبها؟
+
+282
+00:24:22,850 --> 00:24:28,190
+التكلفة التعليم يُقصد بها المصروفات الجارية على
+
+283
+00:24:28,190 --> 00:24:34,170
+التعليم لأغراض تحديد الانفاق والعائد بالنسبة
+
+284
+00:24:34,170 --> 00:24:37,870
+لمشروع السهماري هذه التكلفة اسمها التكلفة
+
+285
+00:24:37,870 --> 00:24:39,050
+المحاسبية
+
+286
+00:24:41,200 --> 00:24:44,860
+التكلفة الكلية الفعلية المشروع التشمل قيمة كل
+
+287
+00:24:44,860 --> 00:24:50,360
+الموارد التي يستنفذها المشروع المصروفات المالية
+
+288
+00:24:50,360 --> 00:24:56,000
+للاستثمار التعليمي تمثل مرتبات المدرسين إيجار
+
+289
+00:24:56,000 --> 00:25:01,960
+المباني ثمن التجهيزات أدوات المكتبية المواد الأخرى
+
+290
+00:25:01,960 --> 00:25:08,400
+الخدمات بتكلفة الفرصة الضائعة أو البديلة كمان نقطة
+
+291
+00:25:08,400 --> 00:25:12,280
+أخرى هي عرقفة حساب التكلفة التعليميأنا معدّل
+
+292
+00:25:12,280 --> 00:25:16,440
+العائد من أي مشروع استثماري هو سعر الفائدة التي
+
+293
+00:25:16,440 --> 00:25:21,620
+توازن بين السعر الحالي العائد المنتظر وبين القيمة
+
+294
+00:25:21,620 --> 00:25:25,820
+الفعلية الإجمالية للتكلفة أي أنا معدّل العائد هو
+
+295
+00:25:25,820 --> 00:25:31,060
+السعر الفائدة الذي يتساوى عندها قيمة التكلفة مع
+
+296
+00:25:31,060 --> 00:25:38,120
+قيمة العائد فائدة معدّل العائد هو المفاضلة بين
+
+297
+00:25:38,120 --> 00:25:44,910
+المشاريع الاستثماريةوأولى الاستثمار الذي يحقق أكبر
+
+298
+00:25:44,910 --> 00:25:48,790
+عائد ذلك البيانات المطلوبة لحساب معدل عائد على
+
+299
+00:25:48,790 --> 00:25:53,490
+التعليم في هذه البيانات سلسلة معدل عائد منها دخول
+
+300
+00:25:53,490 --> 00:26:01,150
+الأفراد، مستوى التعليمي، النوع، الوظيفة، الطبقة،
+
+301
+00:26:01,150 --> 00:26:04,090
+ندسة صفراء التعليم في كل مرحلة، تقضية القيم
+
+302
+00:26:04,090 --> 00:26:08,670
+الأصملي للتعليم، المباني والتجهيزات، المعدات، هذه
+
+303
+00:26:08,670 --> 00:26:12,320
+كلها بيانات مطلوبةعشان نحسب معدّى العائد على
+
+304
+00:26:12,320 --> 00:26:17,920
+التعليم تبقى نقول إن معدّى العائد من مشروع ليس له
+
+305
+00:26:17,920 --> 00:26:24,540
+معنى يعني معدّى العائد المتحقق من أي مشروع ليس له
+
+306
+00:26:24,540 --> 00:26:28,180
+معنى ما لم يُقارن بعمل عائد من مشروع استثمارية
+
+307
+00:26:28,180 --> 00:26:34,080
+أخرى يعني نشوف العائد ونقارن ما لم يُقارن، نقارن
+
+308
+00:26:34,080 --> 00:26:37,620
+وآن طبعا نشوف الدراسات الجدوة الاقتصادية عشان نشوف
+
+309
+00:26:37,620 --> 00:26:38,740
+المشروع ناجح أو لم نناجح
+
+310
+00:26:41,560 --> 00:26:47,180
+بالبشريع اللي يشبه بيه من حيث اللي هو رأس المال من
+
+311
+00:26:47,180 --> 00:26:52,060
+حيث الحجم و بنشوف الله إذا كان بيحقق نفسي العائد
+
+312
+00:26:52,060 --> 00:26:57,360
+أو أعلى منه يكون هو مشروع ناجح إذا بيحقق أقل منه
+
+313
+00:26:57,360 --> 00:27:03,060
+يكون مشروع غير ناجح نتائج قياس معدل العائد على
+
+314
+00:27:03,060 --> 00:27:08,720
+التعليم في الدول العربية طبعا هناك نتائجتتضح من
+
+315
+00:27:08,720 --> 00:27:12,940
+هذه النتائج رشات متعلقة في قياس معدن العائد على
+
+316
+00:27:12,940 --> 00:27:17,000
+التعليق الدول العربية أن هذه الدول تفرز ألمواطن
+
+317
+00:27:17,000 --> 00:27:22,400
+مغايرة للمواطن الدولية التي تم استنباطها من قصد
+
+318
+00:27:22,400 --> 00:27:26,280
+الدول الانتاج في هذا المجال فالتمثل النتائج فيه ما
+
+319
+00:27:26,280 --> 00:27:32,060
+يليه يعني فيه طبعا تفاوت بين الدول العربية والدول
+
+320
+00:27:32,060 --> 00:27:37,310
+الأخرى من حيث ما يليهواحد تدني معدل عائد للتعليم
+
+321
+00:27:37,310 --> 00:27:40,910
+في الدول العربية مقارنة بالمتوسط على مستوى العالم
+
+322
+00:27:40,910 --> 00:27:48,230
+يعني مقارنة بين 7.3% و 10.0% مقابل 9.7% و 10.0%
+
+323
+00:27:48,230 --> 00:27:53,150
+اتنين اتجاه معدل عائد على التعليم في عينة الدول
+
+324
+00:27:53,150 --> 00:27:58,430
+العربية نحو الارتفاع فاع ارتفاع مستويات الدخل سجلت
+
+325
+00:27:58,430 --> 00:28:05,570
+كلمة الكويت داعش 10.4% سنة العمال 10.3%وإنما سجلت
+
+326
+00:28:05,570 --> 00:28:12,710
+اليمن 1.8 من 10% ثلاثة
+
+327
+00:28:12,710 --> 00:28:18,430
+تدني معدل عائد على التعليم الإبتدائي في الدول
+
+328
+00:28:18,430 --> 00:28:23,150
+العربية مقارنة متوسطة على مستوى العالم أربعة تدني
+
+329
+00:28:23,150 --> 00:28:26,790
+معدل عائد على التعليم الثانوي في الدول العربية
+
+330
+00:28:26,790 --> 00:28:31,360
+مقارنة متوسطة على مستوى العالمخمس تدني معدل عائد
+
+331
+00:28:31,360 --> 00:28:34,520
+على التعليم الجامعي دول عربية مقارنة متواصلة على
+
+332
+00:28:34,520 --> 00:28:39,660
+مستوى العالم ستة اتجاه معدل عائد على مستوى التعليم
+
+333
+00:28:39,660 --> 00:28:43,780
+في الدول العربية نحو الارتفاع مع ارتفاع مستويات
+
+334
+00:28:43,780 --> 00:28:49,080
+التعليم كيفية الاستفادة من حساب التكلفة والعائد في
+
+335
+00:28:49,080 --> 00:28:54,460
+فلسطين؟ واحد يوجه حساب التكلفة والعائد المخططين
+
+336
+00:28:54,460 --> 00:28:58,300
+يوجه حساب التكلفة والعائد المخططين إلى اتجاه
+
+337
+00:28:58,300 --> 00:29:01,910
+الاستثمارفي أي نوع من نوع التعليم بل في أي مرحلة
+
+338
+00:29:01,910 --> 00:29:07,530
+تعليمية يكون الاستثمار فيها إذن إحنا من خلال طبعا
+
+339
+00:29:07,530 --> 00:29:13,670
+المخططين بوجهونا كيف نستثمر في أنواع التعليم
+
+340
+00:29:13,670 --> 00:29:19,950
+المختلفة وما هو النوع الأكتر فعالية اثنين يوجه
+
+341
+00:29:19,950 --> 00:29:25,330
+حساب التكلفة والعائد الأنظار بالعلاقة بالانفاق على
+
+342
+00:29:25,330 --> 00:29:29,270
+تعليم فئات القوة البشريةعالية المستوى وبين سوق
+
+343
+00:29:29,270 --> 00:29:33,190
+العمل والذي أثر تغيير نظام المرتبات والأجور على
+
+344
+00:29:33,190 --> 00:29:39,170
+الطلبة للتعليم تلاتة يوجه حساب التكلفة والتعليم
+
+345
+00:29:39,170 --> 00:29:44,130
+توزيع أفضل من الموارد المالية لانواع التعليم وليها
+
+346
+00:29:44,130 --> 00:29:48,210
+المعدل المرتفع للعائد أربعة تقترح حساب التكلفة
+
+347
+00:29:48,210 --> 00:29:53,510
+والعائد طرقًا لزيادة كفاءة التعليم بزيادة العائد
+
+348
+00:29:53,510 --> 00:29:59,010
+أو تخفيف التكلفة خمسةيساعد حساب التكلفة والعائد في
+
+349
+00:29:59,010 --> 00:30:04,690
+فحص تكلفة التعليم ومقارنتها الزيادة في دخول القوة
+
+350
+00:30:04,690 --> 00:30:12,190
+العاملة المتعلمة بالطرق هذه نشوف كيف نستفيد من
+
+351
+00:30:12,190 --> 00:30:20,490
+حساب التكلفة والعائد على مستوى فلسطين بل على مستوى
+
+352
+00:30:20,490 --> 00:30:26,880
+العالم التقليدي طبعا إلى هناننتهي هذه المقادرة
+
+353
+00:30:26,880 --> 00:30:34,720
+المصورة طبعاً إن شاء الله بذلك نكون انتهينا من
+
+354
+00:30:34,720 --> 00:30:39,600
+الفصل الثاني في المادة إن شاء الله يعني في
+
+355
+00:30:39,600 --> 00:30:46,220
+المقادرة القادمة نلتقي في الفصل الثالث إن شاء الله
+
+356
+00:30:46,220 --> 00:30:49,720
+سبحانه وتعالى طبعا
+
+357
+00:30:52,650 --> 00:30:59,090
+إن شاء الله يعني نواصل الحديث في هذا المصاح
+
+358
+00:30:59,090 --> 00:31:03,410
+اتكلمنا احنا في الفصل الأول عن بعض التعليفات الفصل
+
+359
+00:31:03,410 --> 00:31:08,150
+الثانو هو اللي خالي عنه كلمنا عن العائد من التعليم
+
+360
+00:31:08,150 --> 00:31:15,110
+إن شاء الله الفصل التالت والرابع نتكلم عن اللي هو
+
+361
+00:31:15,110 --> 00:31:19,870
+تكلفة التعليم وعن تمويل التعليم إلى أن نلتقي أبناء
+
+362
+00:31:19,870 --> 00:31:23,970
+طلاب وطالباتفي المحاضرة القادمة استودعكم الله
+
+363
+00:31:23,970 --> 00:31:29,810
+ونبدأ وادعاه السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/cAFyw61dlD8.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/cAFyw61dlD8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..62029d1d172df2503d5490b1bd7b40c2067c5cbc
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/cAFyw61dlD8.srt
@@ -0,0 +1,1356 @@
+
+1
+00:00:01,180 --> 00:00:04,000
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,000 --> 00:00:08,480
+الرحيم الحمد لله والصلاة والسلام على رسول الله
+
+3
+00:00:08,480 --> 00:00:14,860
+سيدنا محمد وعلى آله وأصحابه والتابعين بإحسان إلى
+
+4
+00:00:14,860 --> 00:00:20,080
+يوم الدين الطلاب والطالبات الأعزاء السلام عليكم
+
+5
+00:00:20,080 --> 00:00:25,660
+ورحمة الله وبركاته إن شاء الله نبدأ اليوم في
+
+6
+00:00:25,660 --> 00:00:31,340
+المحاضرة المصورة رقم اثنين لمصادر اقتصادية التعليم
+
+7
+00:00:31,340 --> 00:00:36,860
+والصحة إن شاء الله في هذه المحاضرة سوف نتابع الفصل
+
+8
+00:00:36,860 --> 00:00:42,460
+الأول اقتصادية التعليم التعريف والأهمية والخصائص
+
+9
+00:00:42,460 --> 00:00:47,940
+والمجالات إحنا اتكلمنا في المحاضرة الماضية عن
+
+10
+00:00:47,940 --> 00:00:59,500
+مقدمة في اقتصادية التعليم واتكلمنا عن دور العنصر
+
+11
+00:00:59,500 --> 00:01:06,960
+البشري المتعلم في تحقيق التنمية الاقتصادية وقلنا
+
+12
+00:01:06,960 --> 00:01:15,060
+أن العنصر البشري يقع على عاتقه 70% من عملية
+
+13
+00:01:15,060 --> 00:01:23,100
+التنمية الاقتصادية أما عنصر رأس المال المادي يقع
+
+14
+00:01:23,100 --> 00:01:29,040
+على عاتقه 30% فقط من عملية التنمية الاقتصادية وهذا
+
+15
+00:01:29,040 --> 00:01:34,780
+يعني إذا توافر لدينا العنصر البشري المتعلم
+
+16
+00:01:34,780 --> 00:01:40,660
+والمتدرب والواعي يستطيع هذا العنصر البشري
+
+17
+00:01:40,660 --> 00:01:46,620
+بالإمكانيات المادية القليلة أن يحقق الكثير من
+
+18
+00:01:46,620 --> 00:01:52,280
+المعجزات ويستطيع أن يحقق الكثير من عملية التنمية
+
+19
+00:01:52,670 --> 00:01:57,790
+والتقدم والرفاهية الاقتصادية وهناك كثير من الدول
+
+20
+00:01:57,790 --> 00:02:04,570
+التي كانت فقيرة جداً استطاعت من خلال العنصر البشري
+
+21
+00:02:04,570 --> 00:02:12,300
+أن تتقدم بشكل كبير جداً وعلى سبيل المثال دول النمور
+
+22
+00:02:12,300 --> 00:02:19,280
+الآسيوية زي ماليزيا وزي سنغافورة وزي تايوان وكثير
+
+23
+00:02:19,280 --> 00:02:24,460
+من الدول وزي كوريا الجنوبية وكثير من الدول في هذا
+
+24
+00:02:24,460 --> 00:02:29,380
+المجال إن شاء الله في هذه المحاضرة سوف نبدأ بتعريف
+
+25
+00:02:29,380 --> 00:02:35,570
+اقتصاديات التعليم حقيقة هناك الكثير من التعريفات
+
+26
+00:02:35,570 --> 00:02:40,690
+المختلفة لاقتصاديات التعليم سوف نستعرض إن شاء الله
+
+27
+00:02:40,690 --> 00:02:47,970
+بعض منها قابوس ووبستر يقولان بأن اقتصاد التعليم هي
+
+28
+00:02:47,970 --> 00:02:55,130
+عملية تدريب وتنمية المعرفة والمهارة والفكر والخلق
+
+29
+00:02:55,130 --> 00:03:00,170
+وخصوصاً عن طريق التربية الرسمية وأيضاً هناك تعريف
+
+30
+00:03:00,170 --> 00:03:05,810
+آخر بأنه ذلك العلم الذي يدرس كيفية اختيار المجتمع
+
+31
+00:03:05,810 --> 00:03:10,710
+وأفراده للموارد الإنتاجية المتاحة واستخدامها في
+
+32
+00:03:10,710 --> 00:03:15,770
+القيام بمختلف أنواع التعليم والتدريب وتنمية
+
+33
+00:03:15,770 --> 00:03:21,390
+المعرفة والمهارات والقدرات العقلية والشخصية خلال
+
+34
+00:03:21,390 --> 00:03:26,110
+فترة زمنية محددة وتوزيعها لاستفادة منها في الحاضر
+
+35
+00:03:26,110 --> 00:03:32,270
+والمستقبل وهناك تعريف آخر يقول أن اقتصاد التعليم هي
+
+36
+00:03:32,270 --> 00:03:36,290
+العلم الذي ينظر إلى العملية التعليمية من الزاوية
+
+37
+00:03:36,290 --> 00:03:44,710
+الاقتصادية أيضاً تعريف آخر عرفه قاموس التربية بأنه
+
+38
+00:03:44,710 --> 00:03:51,030
+دراسة اقتصاديات الموارد البشرية والتربية المخططة في
+
+39
+00:03:51,030 --> 00:03:55,390
+ضوء الأهداف الاقتصادية وتحليل القيمة الاقتصادية
+
+40
+00:03:55,390 --> 00:04:00,930
+للعملية التربوية من حيث التكلفة والعائد الاقتصادي
+
+41
+00:04:00,930 --> 00:04:08,050
+التعليم تسهم أولاً بعملية إنتاج التربية والتعليم
+
+42
+00:04:08,050 --> 00:04:12,970
+وتوزيع التعليم ثانياً بين الجماعات والأفراد
+
+43
+00:04:12,970 --> 00:04:18,820
+المتنافسين وثالثاً بالقضايا المتعلقة بمقدار ما ينبغي
+
+44
+00:04:18,820 --> 00:04:23,360
+أن ينفقه المجتمع أو أي فرد فيه على الأنشطة التعليمية
+
+45
+00:04:23,360 --> 00:04:27,540
+وما هي أنماط الأنشطة التعليمية التي ينبغي أن
+
+46
+00:04:27,540 --> 00:04:32,820
+يختارها ومن أمثلتها مثلاً عملية
+
+47
+00:04:32,820 --> 00:04:36,820
+إنتاج التعليم، توزيع التعليم بين الأفراد والجماعات
+
+48
+00:04:36,820 --> 00:04:42,340
+المتنافسة، كمية الأموال التي يجب أن ينفقها المجتمع
+
+49
+00:04:42,340 --> 00:04:46,460
+أو أي من أفراده على الأنشطة التربوية، وأي أنواع من
+
+50
+00:04:46,460 --> 00:04:51,380
+الأنشطة يجب اختيارها لكن إحنا ممكن نقول كملخص
+
+51
+00:04:51,380 --> 00:04:56,480
+للتعريفات السابقة علم اقتصاد التعليم هو علم يبحث
+
+52
+00:04:56,480 --> 00:05:02,460
+أمثل الطرق لاستخدام الموارد التعليمية مالياً
+
+53
+00:05:02,460 --> 00:05:08,260
+وبشرياً وتكنولوجياً وزمنياً من أجل تكوين البشر
+
+54
+00:05:08,260 --> 00:05:16,000
+بالتربية والتدريب عقلاً وعلماً ومهارةً وخلقاً
+
+55
+00:05:16,000 --> 00:05:22,620
+وذوقاً ووجداناً وصحةً وعلاقةً في المجتمعات التي
+
+56
+00:05:22,620 --> 00:05:28,400
+يعيشون فيها حاضراً ومستقبلاً، ومن أجل أحسن توزيع
+
+57
+00:05:28,400 --> 00:05:34,160
+ممكن لهذا التكوين، إذن، صحيح التعليم يهتم كما قلنا
+
+58
+00:05:34,160 --> 00:05:41,140
+بالعنصر البشري المتعلم والمتدرب لأن هذا العنصر سوف
+
+59
+00:05:41,140 --> 00:05:48,440
+يسهم في تنمية المجتمع والدولة بشكل كبير جداً طبعاً،
+
+60
+00:05:48,440 --> 00:05:52,820
+لماذا ما فيش تعريف أو ما هي أسباب عدم وجود تعريف
+
+61
+00:05:52,820 --> 00:05:57,940
+جامع في اقتصاد التعليم؟ طبعاً، الأسباب كثيرة، منها
+
+62
+00:05:57,940 --> 00:06:03,780
+اختلاف وجهات النظر والتخصصات من حيث تركيز البعض
+
+63
+00:06:03,780 --> 00:06:06,920
+على مواضيع محددة، ما في قرار كثير في هذا المجال
+
+64
+00:06:06,920 --> 00:06:13,360
+ثانياً، الاختلاف حول أسس هذا العلم، هل أصل اقتصاد
+
+65
+00:06:13,360 --> 00:06:18,380
+التعليم هي الاقتصاد أم التربية؟ لكن الحقيقة يعني إن
+
+66
+00:06:18,380 --> 00:06:21,960
+العلمان
+
+67
+00:06:21,960 --> 00:06:28,980
+والمجالان يتحدان مع بعضهما البعض في تكوين اقتصادية
+
+68
+00:06:28,980 --> 00:06:34,880
+التعليم، التربية لها دور والاقتصاد له دور في تكوين
+
+69
+00:06:34,880 --> 00:06:41,960
+هذا العلم، ثالثاً، حدث علم اقتصاديات التعليم الآن في
+
+70
+00:06:41,960 --> 00:06:49,790
+نقطة أخرى، يعني ما هي أهمية علم اقتصاد التعليم؟ ما هي
+
+71
+00:06:49,790 --> 00:06:56,610
+الأسباب؟ وما هي المبررات التي تجعل هذا العلم مهماً؟
+
+72
+00:06:56,610 --> 00:07:02,670
+ما هي الأسباب والمبررات التي يستمد علم اقتصاد
+
+73
+00:07:02,670 --> 00:07:07,830
+التعليم منها أهميته؟ هناك الكثير من المبررات
+
+74
+00:07:07,830 --> 00:07:12,730
+والأسباب اللي بتخلي هذا العلم مهماً جداً، من بين هذه
+
+75
+00:07:12,730 --> 00:07:17,170
+الأسباب، أولاً، تزايد نفقات التعليم بسبب ارتفاع
+
+76
+00:07:17,170 --> 00:07:22,930
+الأسعار العالمية، طبعاً اليوم التعليم مكلف حتى يعني
+
+77
+00:07:22,930 --> 00:07:27,070
+في كثير من الدول، التعليم الابتدائي، التعليم
+
+78
+00:07:27,070 --> 00:07:31,750
+الإعدادي، التعليم الثانوي، وطبعاً التعليم الجامعي كله
+
+79
+00:07:31,750 --> 00:07:36,830
+بيحتاج إلى طبعاً نفقات، وبالتالي مدام فيه إنفاق إذا
+
+80
+00:07:36,830 --> 00:07:41,390
+فيه أهمية، وكثير من الناس يعني يرسلوا أولادهم
+
+81
+00:07:41,390 --> 00:07:45,800
+وأبناءهم إلى التعليم الخاص، والتعليم تكلفته بتكون
+
+82
+00:07:45,800 --> 00:07:51,260
+أعلى بكثير، وبالتالي كل ما إحنا بندفع تكلفة أعلى
+
+83
+00:07:51,260 --> 00:07:58,500
+يعني فيه أهمية لهذا العلم، ثانياً،
+
+84
+00:07:58,500 --> 00:08:05,960
+التعليم أصبح هو عملية استثمارية زي أي عملية أخرى
+
+85
+00:08:05,960 --> 00:08:10,380
+كما نستثمر في رأس المال المادي نستثمر في العنصر
+
+86
+00:08:10,380 --> 00:08:16,100
+البشري، زمان كانوا يقولوا أن عملية الإنفاق على
+
+87
+00:08:16,100 --> 00:08:22,600
+التعليم هي عملية إنفاق استهلاكي لكن اليوم النظرية
+
+88
+00:08:22,600 --> 00:08:26,960
+الاقتصادية اختلفت وقالت إن الإنفاق على التعليم هو
+
+89
+00:08:26,960 --> 00:08:32,760
+إنفاق استثماري لأن هذا الإنسان المتعلم نتوقع أنه
+
+90
+00:08:32,760 --> 00:08:39,760
+بعد ما ينتهي من تعليمه يحقق عائداً اقتصادياً، يعمل في
+
+91
+00:08:39,760 --> 00:08:46,550
+شركة، في مؤسسة، في قطاع صحي، في قطاع تعليمي، في قطاع
+
+92
+00:08:46,550 --> 00:08:51,630
+سياحي، في قطاع حكومي، في مؤسسات، في بنوك ويحقق
+
+93
+00:08:51,630 --> 00:08:57,110
+عوائد، طبعاً العوائد سواء لنفسه أو للمجتمع، ثالثاً،
+
+94
+00:08:57,110 --> 00:08:59,670
+تساعد الطلب الاجتماعي على مختلف أنواع التعليم
+
+95
+00:08:59,670 --> 00:09:06,710
+والتدريب، اليوم هناك ناس يطلبون التعليم يعني
+
+96
+00:09:06,710 --> 00:09:11,150
+بتلاقي الأب والأم مجرد أن ابنه يصبح عمره ست سنوات
+
+97
+00:09:11,150 --> 00:09:16,030
+حتى أربع سنوات، ويُسجلّه في تعليم رياض الأطفال ويهتم
+
+98
+00:09:16,030 --> 00:09:20,490
+بذلك ويدفع الأموال لذلك، في طلب يعني أصلاً نسبة
+
+99
+00:09:20,490 --> 00:09:24,730
+الأمية في كثير من دول العالم كانت تصل إلى الصفر
+
+100
+00:09:24,730 --> 00:09:29,250
+كانت طبعاً بعض الدول النامية لازالت يعني نسبة الأمية
+
+101
+00:09:29,250 --> 00:09:35,250
+عالية لكن في معظم دول العالم اليوم أصبحت نسبة
+
+102
+00:09:35,250 --> 00:09:39,470
+الأمية محدودة، إحنا في قطاع غزة مثلاً تكاد تصل نسبة
+
+103
+00:09:39,470 --> 00:09:44,750
+الأمية اليوم إلى الصفر لأن الناس حريصين على
+
+104
+00:09:44,750 --> 00:09:49,750
+التعليم، على تعليم أبنائهم، وحتى إن اضطروا أن يدفعوا
+
+105
+00:09:49,750 --> 00:09:54,510
+الأموال الباهظة، طب بتلاقي الإنسان يعني وضعه المادي
+
+106
+00:09:54,510 --> 00:10:00,870
+صعب جداً، عنده ابن متفوق في دراسته، طب لأنه هو مهتم
+
+107
+00:10:00,870 --> 00:10:08,870
+بالتعليم ومهتم بهذا الجانب، رابعاً،
+
+108
+00:10:08,870 --> 00:10:13,090
+التنمية وسوق العمل، التنمية بحاجة إلى الناس المتعلمين
+
+109
+00:10:13,090 --> 00:10:17,470
+إلى الناس المثقفين خاصة في الدول النامية وهذه نقطة أيضاً
+
+110
+00:10:17,470 --> 00:10:22,050
+مهمة، خامساً، عزيزي، نربط النظام التعليمي ومؤسساته
+
+111
+00:10:22,050 --> 00:10:26,790
+بالنظام الاقتصادي وبجهود التنمية على أسس معروفة
+
+112
+00:10:26,790 --> 00:10:32,550
+ومفهومة، طبعاً لازم يكون هناك أسس للتعليم وهناك أسس
+
+113
+00:10:32,550 --> 00:10:40,290
+للتنمية ومن ثم بدنا نربط بين هذين الجانبين حتى يصبح
+
+114
+00:10:40,290 --> 00:10:43,530
+التعليم أكثر قدرة على الاستجابة لمطالب التنمية
+
+115
+00:10:43,530 --> 00:10:47,790
+وتحدياتها الحالية والمستقبلية، يجب أن يكون التعليم
+
+116
+00:10:47,790 --> 00:10:54,090
+نرفع كفاءته ويواكب سوق العمل، يعني في عيب اسمه
+
+117
+00:10:54,090 --> 00:10:58,490
+البطالة الهيكلية، البطالة الهيكلية هي خريجون غير
+
+118
+00:10:58,490 --> 00:11:01,790
+مناسبين لسوق العمل، هو الأصل هذه البطالة نقدر
+
+119
+00:11:01,790 --> 00:11:07,310
+عليها إن نعلم الناس حسب ما يريده سوق العمل، مش شرط
+
+120
+00:11:07,310 --> 00:11:12,230
+يكون التعليم تعليماً أكاديمياً، قد يكون تعليماً مهنياً، قد
+
+121
+00:11:12,230 --> 00:11:20,830
+يكون تعليماً فنياً لكن بدنا نراعي سوق العمل، النقطة
+
+122
+00:11:20,830 --> 00:11:25,670
+السادسة، يمكن يمكن نحصل مدخلات التعليم ونُقَيّمها
+
+123
+00:11:25,670 --> 00:11:30,790
+ونتثمنها مادياً، وتحديد العمليات والأنشطة الداخلية
+
+124
+00:11:30,790 --> 00:11:35,870
+بناءً على كلفتها والوقت والجهد المبذول لإنجازها، ومن
+
+125
+00:11:35,870 --> 00:11:40,250
+ثم الوقوف على حجم النفقات المُستثمرة في التعليم
+
+126
+00:11:40,250 --> 00:11:47,270
+وطبعاً كله في النهاية يقود إلى ربط التكلفة بالعائد
+
+127
+00:11:47,270 --> 00:11:54,110
+أو ربط التكلفة بعملية الاستثمار نفسه، سابعاً، يمكن علم
+
+128
+00:11:54,110 --> 00:11:58,630
+اقتصاد التعليم يُساعد الحكومة والمسؤولين عن التعليم من
+
+129
+00:11:58,630 --> 00:12:03,410
+توزيع مخصصات التعليم السنوية والموارد الأخرى على
+
+130
+00:12:03,410 --> 00:12:06,870
+أروقة التعليم المختلفة، وعلى وجه الخصوص الاستخدامات
+
+131
+00:12:06,870 --> 00:12:12,230
+المختلفة تبعاً لأهميتها، والتدقيق في أساليب الصرف
+
+132
+00:12:12,230 --> 00:12:17,150
+وطبعاً، طبعاً بيستدعي أن الحكومة تضع الموازنات
+
+133
+00:12:17,150 --> 00:12:21,970
+المختلفة لكل مراحل التعليم، سواء التعليم الابتدائي
+
+134
+00:12:22,410 --> 00:12:26,010
+أو التعليم الإعدادي أو التعليم الثانوي أو التعليم
+
+135
+00:12:26,010 --> 00:12:30,730
+الجامعي، ثامناً،
+
+136
+00:12:30,730 --> 00:12:35,110
+ظهور نظم تعليمية بمناهج متخصصة وبمضامين وأساليب
+
+137
+00:12:35,110 --> 00:12:40,610
+متطورة مما يستدعي التسلح بالنظرة الاقتصادية لتطوير
+
+138
+00:12:40,610 --> 00:12:47,910
+أكثر ملاءمة وأعلاقة حتى نحقق أقل تكلفة وأكثر مردود
+
+139
+00:12:47,910 --> 00:12:54,720
+ومنفعـة، تاسعاً، وجود مشكلات مُركّبة ومعقدة في النظم
+
+140
+00:12:54,720 --> 00:12:58,220
+التعليمية المعاصرة هو ما يفرض استخدام منطق
+
+141
+00:12:58,220 --> 00:13:02,300
+الاقتصاد، لا بد أن يدخل الاقتصاد في التعليم، مدام أنا
+
+142
+00:13:02,300 --> 00:13:07,640
+بدفع أموالاً، وتكاليف، ونفقات، وجهد بشري، إذا لازم
+
+143
+00:13:07,640 --> 00:13:13,360
+نقلل التكلفة ونعظم العائد بأكبر قدر ممكن،
+
+144
+00:13:15,250 --> 00:13:18,530
+عاشراً، أصبح التعليم والتدريب المُقدم في المدارس
+
+145
+00:13:18,530 --> 00:13:23,830
+التعليمية مصدراً للحصول على المهارة والمعرفة اللازمة
+
+146
+00:13:23,830 --> 00:13:28,710
+للعمل والعيش في المجتمعات المعاصرة والتفاعل معها
+
+147
+00:13:28,710 --> 00:13:33,270
+مما يفرض توزيع الدارسين على مختلف التخصصات، كما قلنا
+
+148
+00:13:33,270 --> 00:13:38,170
+بدنا نراعي سوق العمل وبدنا نرفع كفاءة التعليم
+
+149
+00:13:38,170 --> 00:13:42,870
+وقدرة التعليم على تنمية المهارات، ولنُنوّع في هذه المهارات
+
+150
+00:13:43,230 --> 00:13:47,690
+مش شرط أن إحنا مثلاً في كلية التربية نحط عشرات الآلاف
+
+151
+00:13:47,690 --> 00:13:53,110
+من الناس في كلية التربية، لأ، القضية دي تنويع، ويجب أن
+
+152
+00:13:53,110 --> 00:13:58,790
+نبحث عن التعليم المهني والتعليم الفني والتعليم
+
+153
+00:13:58,790 --> 00:14:04,090
+الخدماتي، مش لازم إحنا نكون أكاديميين في هذا المجال
+
+154
+00:14:04,090 --> 00:14:10,050
+ولازم نُشرك الجميع في عملية التعليم والوظيفة التعليمية
+
+155
+00:14:10,050 --> 00:14:16,860
+تُوفيق اجتماعي يحقق أفضل النتائج، 11
+
+156
+00:14:16,860 --> 00:14:23,180
+وهي نقطة مهمة، يُعد التعليم مصدراً رئيسياً للمشاركة في
+
+157
+00:14:23,180 --> 00:14:27,860
+الدخل القومي والفردي، مما يفرض الحصول على كل مواطن
+
+158
+00:14:27,860 --> 00:14:31,240
+على فرص تعليمية ملائمة من أجل تحسين قوّات
+
+159
+00:14:31,240 --> 00:14:35,040
+التنافسية، الحصول على عمل، ورفع قوة الإنتاجية، لأن
+
+160
+00:14:35,040 --> 00:14:40,400
+هذا المتعلم في النهاية يصبح إنساناً منتجاً يحصل على
+
+161
+00:14:40,400 --> 00:14:46,050
+دخل، الدخل الفردي مجموع مع بعضه البعض لكل أفراد
+
+162
+00:14:46,050 --> 00:14:51,230
+المجتمع بيعطينا الدخل القومي، الدخل القومي يمثل
+
+163
+00:14:51,230 --> 00:14:55,490
+القيمة النقدية أو السوقية لجميع السلع والخدمات
+
+164
+00:14:55,490 --> 00:15:00,570
+المنتجة في المجتمع، وبالتالي كل الأفراد يُسهمون في
+
+165
+00:15:00,570 --> 00:15:06,670
+تحقيق الدخل القومي، الإنسان المتعلم يُفترض يحقق دخل
+
+166
+00:15:06,670 --> 00:15:13,750
+أفضل وأحسن من الإنسان غير المتعلم، يُسهم في توضيح
+
+167
+00:15:13,750 --> 00:15:18,590
+عدد من المفاهيم والحقائق والممارسات الاقتصادية في
+
+168
+00:15:18,590 --> 00:15:22,950
+ميدان العمل التربوي، وفي ترسيخ الأساليب الاقتصادية
+
+169
+00:15:22,950 --> 00:15:27,570
+المستخدمة في المؤسسات الإنتاجية، وكذا متابعة
+
+170
+00:15:27,570 --> 00:15:31,270
+النظريات والمفاهيم والأساليب الجديدة في علم
+
+171
+00:15:31,270 --> 00:15:34,790
+الاقتصاد وتطبيقها على العمل التربوي، مثلاً، دا
+
+172
+00:15:34,790 --> 00:15:39,830
+مؤسساتنا، إحنا اليوم مثلاً بنلاحظ مثلاً جامعاتنا
+
+173
+00:15:39,830 --> 00:15:45,270
+المحلية، والجامعة الإسلامية مثلاً بتعاني من أزمات
+
+174
+00:15:45,270 --> 00:15:50,970
+مالية، طبعاً يعني يُفترض أن
+
+223
+00:19:59,750 --> 00:20:04,330
+التعليم ونظرية التنمية الاقتصادية والاجتماعية، أما
+
+224
+00:20:04,330 --> 00:20:08,030
+التعليم كما قلنا ونقول وسوف نبقى نتكلم عليه
+
+225
+00:20:08,030 --> 00:20:13,750
+الموضوع حتى نهاية المادة. التعليم له علاقة بالتنمية
+
+226
+00:20:13,750 --> 00:20:17,510
+الاقتصادية. كلما فيه تعليم أكثر، نساهم في عمل
+
+227
+00:20:17,510 --> 00:20:21,910
+موضوع التنمية بشكل أكبر.  بعضهم يقول التعليم
+
+228
+00:20:21,910 --> 00:20:27,950
+والإنفاق عليه، وكل هذا مهم. أما الآن،  لازم نحدد مصادر الإنفاق
+
+229
+00:20:28,530 --> 00:20:32,750
+على تقسيط، تمويل التعليم، تقسيط الإنفاق على التعليم،
+
+230
+00:20:32,750 --> 00:20:38,070
+ونخصص، كما قلنا قبل قليل، موازنات عالية من أجل الإنفاق
+
+231
+00:20:38,070 --> 00:20:41,490
+على التعليم، ونوازن بين التكلفة والعائد.  زي ما فيه
+
+232
+00:20:41,490 --> 00:20:44,830
+تكلفة للتعليم، اللي هو التعليم عملية استثمارية،
+
+233
+00:20:44,830 --> 00:20:50,470
+كما قلت، وبالتالي عملية استثمارية فيها جدوى
+
+234
+00:20:50,470 --> 00:20:54,830
+اقتصادية. الإنسان عندما يتلقى تخصيصًا معينًا، أنت طالب
+
+235
+00:20:54,830 --> 00:20:58,480
+جامعي، تحب أن تتلقى تخصيصًا اقتصاديًا، فتُعمل جدوى اقتصادية
+
+236
+00:20:58,480 --> 00:21:02,340
+على هذا التخصيص، المجدي بالنسبة للفرد، ولغيره.
+
+237
+00:21:02,340 --> 00:21:07,420
+المجدي، وعم ندخل كلية الطب، تُعمل جدوى اقتصادية في
+
+238
+00:21:07,420 --> 00:21:12,100
+مقارنة النفقة والعائد في النهاية. ففي الأخير، ما تدرس
+
+239
+00:21:12,100 --> 00:21:19,540
+كلية الطب ثم يلاقي حاله يسافر على الرصيف، مش يلاقي
+
+240
+00:21:19,540 --> 00:21:27,080
+يعني سوق عمل يستوعبه. مثلما هذا مهم،  بنوازن بين
+
+241
+00:21:27,080 --> 00:21:33,740
+التكلفة والعائد، الاستثمار في التعليم، كما قلنا،
+
+242
+00:21:33,740 --> 00:21:39,160
+التعليم هو عملية استثمارية، وبالتالي لازم نقيس
+
+243
+00:21:39,160 --> 00:21:44,460
+العائد. نحلل الإنفاق على التعليم، سواء كانت طبيعته
+
+244
+00:21:44,460 --> 00:21:47,320
+استثمارية أو استهلاكية. لكن أنا بقول، يوم التعليم
+
+245
+00:21:47,320 --> 00:21:54,180
+بطبيعته أصبح تعليمًا، أو أصبح هو استثمارًا. وهذه
+
+246
+00:21:54,180 --> 00:21:57,940
+الكلام بنكرره عدة مرات. الإنفاق على التعليم هو إنفاق
+
+247
+00:21:57,940 --> 00:22:02,780
+استثماري، وليس إنفاقًا استهلاكيًا. أنت اليوم تدرس في
+
+248
+00:22:02,780 --> 00:22:08,560
+الجامعة أربع سنوات، باسم اقتصاد. أنت بتتوقع إنك بعد
+
+249
+00:22:08,560 --> 00:22:14,500
+تخلص من الجامعة، تلاقي عمل، سواء فرصة عمل حكومية أو
+
+250
+00:22:14,500 --> 00:22:19,700
+فرصة عمل في القطاع الخاص، أو حتى تُكوّن لنفسك أنت
+
+251
+00:22:19,700 --> 00:22:24,680
+عملًا حرًا، لأنه بتعليمك وبواعِثك. وأنا طبعًا أميل دائمًا
+
+252
+00:22:25,120 --> 00:22:29,420
+إلى أن الخريج يحاول، خاصة في كلية الاقتصاد، العلم
+
+253
+00:22:29,420 --> 00:22:35,820
+الإداري وفي قسم الاتصال بشكل خاص، يعني يذهب إلى العمل
+
+254
+00:22:35,820 --> 00:22:42,560
+الحر. فالعمل الحر يُدرّ له دخلًا وأرباحًا أعلى بكثير من
+
+255
+00:22:42,560 --> 00:22:47,840
+الوظيفة الحكومية. فالوظيفة الحكومية هي أضيق باب، أو باب
+
+256
+00:22:47,840 --> 00:22:52,780
+الرزق، بسبب قلة القدرة على الإبداع في هذا الجانب. أربعة،
+
+257
+00:22:52,780 --> 00:22:56,440
+القيم الاقتصادية للتعليم، ومدى مساهمته في زيادة
+
+258
+00:22:56,440 --> 00:23:01,500
+الدخل، وهي طبعًا نقطة مهمة، سواء الدخل القومي أو
+
+259
+00:23:01,500 --> 00:23:07,240
+الدخل الفردي. خمسة، الكفاية الإنتاجية في التعليم،
+
+260
+00:23:07,240 --> 00:23:12,420
+سواء الكفاية الداخلية أو الخارجية، بمستوياتها الكمّية
+
+261
+00:23:12,420 --> 00:23:17,720
+وكيفيّة وطرائق حسابها، وكذا بخرجات التعليم، أو الكفاية
+
+262
+00:23:17,720 --> 00:23:21,180
+الإنتاجية في التعليم. نريد أن نشوف التعليم، ما هي
+
+263
+00:23:21,180 --> 00:23:27,490
+الكفاية؟ ماذا سيحقق لي هذا التعليم؟ ما قدرة هذا
+
+264
+00:23:27,490 --> 00:23:31,730
+التعليم على تحقيق مطالب التنمية الاقتصادية؟ ما قدرة
+
+265
+00:23:31,730 --> 00:23:37,570
+هذا التعليم على أني أنا أُبني نفسي كإنسان، وأُكوّن
+
+266
+00:23:37,570 --> 00:23:41,630
+نفسي كإنسان، وأستطيع أن أحقق حياة محترمة كإنسان،
+
+267
+00:23:41,630 --> 00:23:47,890
+وهو مهم جدًا أيضًا. مفاهيم اقتصادية التعليم، مؤسسة
+
+268
+00:23:47,890 --> 00:23:51,150
+اقتصادية التعليم والتنمية. طبعًا في عندنا كثير من
+
+269
+00:23:51,150 --> 00:23:56,750
+النموذجات الرياضية والأساليب الإحصائية اللي نستخدمها
+
+270
+00:23:56,750 --> 00:24:02,110
+في عملية التقويم والقياس. وهذه كلها طبعًا مهمة في
+
+271
+00:24:02,110 --> 00:24:08,630
+العملية التعليمية، وبتخلي الإنسان عنده شخصية مش
+
+272
+00:24:08,630 --> 00:24:15,690
+شخصية نمطية، مش شخصية تقليدية، شخصية مبدعة. المطلوب
+
+273
+00:24:15,690 --> 00:24:19,450
+التعليم يُوصِلنا إلى قدرة على الإبداع، مش أنا في مادة
+
+274
+00:24:19,450 --> 00:24:23,690
+بدي أحفظها وأجيب فيها امتحان وخلاص. لأ، أنا بدي
+
+275
+00:24:23,690 --> 00:24:29,070
+المادة هذه تُسقِل مني شخصًا آخر، عنده قدرة على التفكير،
+
+276
+00:24:29,070 --> 00:24:34,150
+عنده قدرة على التحليل، عنده قدرة على الفهم، ويساعد
+
+277
+00:24:34,150 --> 00:24:40,010
+...ويساعده ذلك في تنمية نفسه، وبناء فرص أفضل له في
+
+278
+00:24:40,010 --> 00:24:44,150
+الحياة. سبعة، مساهمة التعليم في التنمية البشرية
+
+279
+00:24:44,150 --> 00:24:49,770
+المستدامة، وتنمية رأس المال البشري، طبعًا وهي أيضًا
+
+280
+00:24:50,940 --> 00:24:55,360
+مهمة. لقطاع التعليم، حتى في دليل التنمية البشرية
+
+281
+00:24:55,360 --> 00:25:02,440
+اللي عمله الـ UNDP، يعني بيخلّي اللي هو بند
+
+282
+00:25:02,440 --> 00:25:06,140
+التعليم أحد مُركّبات دليل التنمية البشرية، دليل
+
+283
+00:25:06,140 --> 00:25:09,660
+التنمية البشرية اللي تمّ تقويمه من قبل برنامج
+
+284
+00:25:09,660 --> 00:25:13,260
+الولايات المتحدة الإنمائي. من أهم مكونات هذا الدليل،
+
+285
+00:25:13,260 --> 00:25:17,920
+عنصر التعليم، رصد التعليم، سواء التعليم يتعلق بمحو
+
+286
+00:25:17,920 --> 00:25:22,060
+الأمية، أو يتعلق بعدد سنوات التعليم، وعدد سنوات
+
+287
+00:25:22,060 --> 00:25:29,060
+القيد في المدارس والجامعات. ثمانية، تطوير نظم تعليم
+
+288
+00:25:29,060 --> 00:25:34,300
+وتعلّم جديدة، ببرامج متعددة.  إحنا ما بنطوّر نظم التعليم،
+
+289
+00:25:34,300 --> 00:25:38,720
+إحنا اليوم مثلًا في الجامعة، لما صار عندنا أزمة
+
+290
+00:25:38,720 --> 00:25:43,760
+كورونا،  لم نَتَقاعس، صار التعليم عن بُعد. هذه المحاضرات
+
+291
+00:25:43,760 --> 00:25:51,940
+اللي بنعملها للطلاب وللطالبات، هي تغلب على مشكلة، ما
+
+292
+00:25:51,940 --> 00:25:56,280
+هو الأفضل؟ ما هو الأحسن؟ أن تُغلق الجامعة أبوابها،
+
+293
+00:25:56,280 --> 00:26:01,040
+تتجمد في مكانها؟ أم أن تتواصل مع الطلاب عن طريق
+
+294
+00:26:01,040 --> 00:26:05,100
+التعليم عن بُعد؟ وبالتالي، صحيح التعليم الوجهي
+
+295
+00:26:05,100 --> 00:26:10,940
+أفضل وأحسن، لكن علم إدارة التعليم بيقول إننا بدنا
+
+296
+00:26:10,940 --> 00:26:16,010
+نُخلق بدائل، إذا صار عندنا أزمات معينة، صار عندنا ظروف
+
+297
+00:26:16,010 --> 00:26:18,830
+معينة. وحقيقةً، يعني موضوع التعليم عن بُعد اليوم، في
+
+298
+00:26:18,830 --> 00:26:23,510
+جامعات في العالم كله، تُعطي برامج ماجستير وبرامج
+
+299
+00:26:23,510 --> 00:26:28,750
+دكتوراه، تعليم عن بُعد. هذا مهم، وإحنا ممكن نطوّره حتى
+
+300
+00:26:28,750 --> 00:26:32,330
+في ظل ظروف عادية. بس في بعض المساقات، ندرسها عن
+
+301
+00:26:32,330 --> 00:26:36,470
+البُعد، مش كل المساقات تكون وجهية. وبالتالي، يعني
+
+302
+00:26:36,470 --> 00:26:40,590
+الطلاب والطالبات الأعزاء، يجب عليكم أن تتفهموا هذا
+
+303
+00:26:40,590 --> 00:26:45,350
+الأسلوب، وتتعاونوا معه، وتطوّروا أنفسكم مع هذه
+
+304
+00:26:45,350 --> 00:26:51,110
+الطريقة، ومع هذا الأسلوب. تسعة، البدائل والأولويات
+
+305
+00:26:51,110 --> 00:26:57,110
+الاقتصادية: تعليم الكبار، نعلم الكبار، محو الأمية،
+
+306
+00:26:57,110 --> 00:27:01,170
+التعليم المفتوح، زي ما تعمل عند بعض الجامعات،
+
+307
+00:27:01,170 --> 00:27:05,610
+الجامعة القدس المفتوحة، جامعة الأمة، تعمل التعليم
+
+308
+00:27:05,610 --> 00:27:12,680
+مفتوحًا لناس مثلًا مشغولين، لناس عاملين، الناس عندهم
+
+309
+00:27:12,680 --> 00:27:17,960
+أعباء مثلًا أسرية عالية، يعني ممكن يكون التعليم
+
+310
+00:27:17,960 --> 00:27:22,000
+مفتوحًا، على كلام ما موجود الآن. وبالتالي، قصاد التعليم،
+
+311
+00:27:22,000 --> 00:27:26,960
+الفئات الأشد فقرًا، الناس المهمّشين، الناس اللي
+
+312
+00:27:26,960 --> 00:27:32,560
+ماعندهمش دخل اليوم. كل الناس يجب أن يتعلموا، ويجب
+
+313
+00:27:32,560 --> 00:27:37,390
+أن نقوم هنا بدورنا في هذا المجال. والقطاع الخاص
+
+314
+00:27:37,390 --> 00:27:41,950
+أيضًا له دور في هذا المجال، والمؤسسات الخيرية، والـ
+
+315
+00:27:41,950 --> 00:27:48,230
+NGOs اللي لهم دور في هذا المجال. كل تعاون، على سبيل
+
+316
+00:27:48,230 --> 00:27:57,070
+أن لا يبقى أحد أميًا. وكمان اليوم، الأمية لم تصبح
+
+317
+00:27:57,070 --> 00:28:01,430
+أمية القراءة والكتابة، أصبحت أمية التكنولوجيا. هل
+
+318
+00:28:01,430 --> 00:28:05,170
+تَعرف التكنولوجيا؟ هل تعرف الحاسوب؟ هل تعرف
+
+319
+00:28:05,170 --> 00:28:09,230
+الإنترنت؟ هل تعرف التعليم عن بُعد؟ إذا لم تَعرف،
+
+320
+00:28:09,230 --> 00:28:13,710
+صراحةً، أن أنت أميّ، فهذه الأولويات بدها تكون واضحة.
+
+321
+00:28:13,710 --> 00:28:19,730
+عشرة، البدائل والأولويات لوضع خطة استراتيجية لمؤسسة
+
+322
+00:28:19,730 --> 00:28:24,730
+تعليمية، أو نوع تعليمي، أو نظام تعليمي، لمحافظة، أو
+
+323
+00:28:24,730 --> 00:28:30,230
+لكل. طبعًا، يعني أي شغل يعني في التعليم، أو في أي مجال
+
+324
+00:28:30,230 --> 00:28:38,200
+يعني اقتصادي، يحتاج إلى خطة. الجامعة الإسلامية تحتاج
+
+325
+00:28:38,200 --> 00:28:44,320
+إلى خطة عشان تقدر تحل أزمتها المالية، وتستمر في
+
+326
+00:28:44,320 --> 00:28:49,020
+التعليم. الحكومة، أي وزارة، وزارة التربية والتعليم،
+
+327
+00:28:49,020 --> 00:28:52,820
+بتضع خطة، وزارة الصحة بتضع خطة، وزارة الاقتصاد
+
+328
+00:28:52,820 --> 00:28:59,260
+بتضع خطة، الشركات الخاصة، الأفراد، حتى أنت في بيتك،
+
+329
+00:28:59,260 --> 00:29:04,680
+في حاجة بيسموها اقتصاد منزلي. كيف تقدر اقتصادك في
+
+330
+00:29:04,680 --> 00:29:10,210
+البيت؟ في ظل مثلًا رواتب محدودة، في ظل أوضاع اقتصادية
+
+331
+00:29:10,210 --> 00:29:16,630
+صعبة، في ظل أعباء مالية عالية، فنبدأ ندير الاقتصاد
+
+332
+00:29:16,630 --> 00:29:22,330
+المنزلي. الاقتصاد هو كملح الطعام. والاقتصاد ماذا
+
+333
+00:29:22,330 --> 00:29:26,410
+يعني؟ إنه فيه في الموارد ندرة. كيف أنا بستخدم
+
+334
+00:29:26,410 --> 00:29:32,470
+الموارد النادرة في تحقيق، وفي إشباع، أفضل بداية في
+
+335
+00:29:32,470 --> 00:29:37,500
+تحقيق أفضل العوائد. لأن الاقتصاد معناه الندرة. في
+
+336
+00:29:37,500 --> 00:29:41,480
+سؤال مهم، هل الاقتصاد هو علم الندرة؟ أم علم
+
+337
+00:29:41,480 --> 00:29:46,900
+الوفرة؟ أو لو وفرة، لو في وفرة، مافي مشكلة. دخلك
+
+338
+00:29:46,900 --> 00:29:52,640
+محدود، رزقك محدود، إمكانياتك المادية محدودة، كيف
+
+339
+00:29:52,640 --> 00:29:58,040
+تستخدم هذه الإمكانيات المحدودة لتحقيق أفضل بداية؟
+
+340
+00:29:58,040 --> 00:30:02,620
+ولو كان عندك بدايات كثيرة، كيف ترتب أولوياتك؟ هذه
+
+341
+00:30:02,620 --> 00:30:09,120
+نقطة مهمة، الترتيب، الأولويات، ونبدأ بالأكثر أهمية ثم
+
+342
+00:30:09,120 --> 00:30:11,940
+الأقل أهمية. وإن ما ندخل، عندنا مفهوم، نبحث عن فرصة
+
+343
+00:30:11,940 --> 00:30:16,860
+بديلة، في المجلد، نختار أفضل البدائل، ونؤجّل، أو نُطْحِي
+
+344
+00:30:16,860 --> 00:30:23,240
+البدائل الأخرى، ونؤجّلها إلى مراحل قادمة. 11، العائد
+
+345
+00:30:23,240 --> 00:30:26,420
+المنتظر، والفوائد عليه من الإنفاق الاستثماري في
+
+346
+00:30:26,420 --> 00:30:30,180
+التعليم، ومقارنة ذلك بالعوائد المنتظرة من
+
+347
+00:30:30,180 --> 00:30:33,470
+الاستثمارات الأخرى، مثل المتعلق برأس المال البشري، أو
+
+348
+00:30:33,470 --> 00:30:38,550
+برأس المال المادي. الاستثمار
+
+349
+00:30:38,550 --> 00:30:43,890
+هي نقطة مهمة، في وقت الطلبة، والمعلمين، والإداريين،
+
+350
+00:30:43,890 --> 00:30:50,470
+والمباني، والتجهيزات، والمعامل، والمختبرات، التقنيات
+
+351
+00:30:50,470 --> 00:30:54,130
+التعليمية. هذا مهم، إنّي أستثمر، هذه المباني، يعني
+
+352
+00:30:54,130 --> 00:31:00,470
+ما أضعش مثلًا في قاعة كبيرة، خمسة، كلها على الكبيرة،
+
+353
+00:31:00,470 --> 00:31:06,910
+بتاعت، طبعًا، مثلًا، مراوح، بدها إضاءة، بدها أجهزة أكبر،
+
+354
+00:31:06,910 --> 00:31:13,630
+خمس سنوات، وأتحف فيه قاعة صغيرة. كمان بدنا نعرف، على
+
+355
+00:31:13,630 --> 00:31:17,630
+تقنية التكلفة، يعني مالفعّش مثلًا، موظف، دكتور، في
+
+356
+00:31:17,630 --> 00:31:21,650
+الجامعة، يكون قاعد في مكتبه، يطلع من المكتب، يغيب
+
+357
+00:31:21,650 --> 00:31:24,470
+ساعة أو ساعتين أو ثلاث ساعات، أو يروح ييجي ثاني يوم.
+
+358
+00:31:24,470 --> 00:31:31,490
+فيه جهاز كمبيوتر، بيطفيه، فيه عندة إضاءة، بده يطفها،
+
+359
+00:31:31,940 --> 00:31:36,820
+بتحافظ على إمكانيات المؤسسة. كما هو في بيته، زي ما
+
+360
+00:31:36,820 --> 00:31:43,400
+يطلع من غرفته بيطفئ النار. كمان في الجامعة، تكون بهذا
+
+361
+00:31:43,400 --> 00:31:48,280
+الشكل. إذا نحرص على هذه التجهيزات، وهذه التقنيات،
+
+362
+00:31:48,280 --> 00:31:54,080
+نستفيد منها، ونستثمرها إلى أبعد حد. ثلاث عشرة، دراسة
+
+363
+00:31:54,080 --> 00:31:59,010
+علماء في هذا التعليم، ما يقدمونه من نظريات وأفكار،
+
+364
+00:31:59,010 --> 00:32:02,670
+ومفاهيم. ونشوف إيش الناس كتبت في هذا المجال،
+
+365
+00:32:02,670 --> 00:32:07,170
+ماذا تكلم الناس في اقتصاديات التعليم؟ البحوث اللي
+
+366
+00:32:07,170 --> 00:32:15,630
+تقدّمت في هذا المجال. طبعًا فيه مدارس، في مجالات يعني،
+
+367
+00:32:15,630 --> 00:32:19,270
+فيه ناس بيقولوا، كتبنا في المجال اللي حكيناه قبل قليل،
+
+368
+00:32:19,270 --> 00:32:24,150
+ثلاثة عشر مجالًا. هذول بشكل عام، مجالات اقتصاد التعليم بشكل،
+
+369
+00:32:24,150 --> 00:32:32,030
+عام. لكن لو اتكلمنا عن المدرسة، أو عن الجامعة يعني،
+
+370
+00:32:32,030 --> 00:32:36,630
+كقطع خاص، طب ما فيه هناك مجالات كثيرة، مفاهيم،
+
+371
+00:32:36,630 --> 00:32:41,950
+ونظريات عن إدارة التعليم، كيف نقدر نطبقها في المدرسة؟
+
+372
+00:32:41,950 --> 00:32:46,930
+المهم، مصادر التمويل. المدرسة، أنا عندي مدرسة خاصة، أو
+
+373
+00:32:46,930 --> 00:32:53,090
+جامعة، كيف بتموّل؟ كيف بيتحقق التمويل اللي بيضمن
+
+374
+00:32:53,090 --> 00:32:57,990
+استمرارية العمل في هذه المدرسة؟ إعداد ميزانية المدرسة،
+
+375
+00:32:57,990 --> 00:33:01,770
+أو الموازنة.
+
+376
+00:33:01,770 --> 00:33:07,230
+الإنفاق على المدرسة، حجمًا ونوعًا واتجاهًا، مستوى إذا
+
+377
+00:33:07,230 --> 00:33:11,090
+كنا نتكلم عن مدرسة أو عن جامعة، أو عن أي مؤسسة
+
+378
+00:33:11,090 --> 00:33:15,910
+تعليمية. اتكلم في التعليم في المدرسة، التكاليف يعني،
+
+379
+00:33:15,910 --> 00:33:20,670
+زي الرسوم، الطلاب عندنا في الجامعة، مثلًا، عالية،
+
+380
+00:33:20,670 --> 00:33:26,000
+عالية، ليش؟ إحنا مثلًا اليوم مثلًا في الماجستير، تمّ
+
+381
+00:33:26,000 --> 00:33:29,440
+تقفيد رسوم الماجستير، لأنه في منافسة. الجامعة
+
+382
+00:33:29,440 --> 00:33:33,320
+الإسلامية خفّضت رسوم كلية الاقتصاد والإدارة من 85
+
+383
+00:33:33,320 --> 00:33:38,440
+دينارًا إلى 50 دينارًا، لمدّة التقفيد، لأننا عندنا منافسة.
+
+384
+00:33:38,440 --> 00:33:42,340
+عدد التعليم في المدرسة، الكفاءة والإنتاجية في
+
+385
+00:33:42,340 --> 00:33:47,200
+المدرسة، الهدر التربوي في المدرسة. هذه كل مجالات نحن
+
+386
+00:33:47,200 --> 00:33:52,140
+نتكلم عنها. ولو نتكلم عن المدرسة، أو عن حتى الجامعة،
+
+387
+00:33:57,650 --> 00:34:01,870
+أساليب، وصف
\ No newline at end of file
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/mxEiQo3RuGA_raw.srt b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/mxEiQo3RuGA_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..96c1db62bf8c0f8a5dfdf87d69432de881dfc100
--- /dev/null
+++ b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/mxEiQo3RuGA_raw.srt
@@ -0,0 +1,2104 @@
+1
+00:00:01,330 --> 00:00:04,050
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,050 --> 00:00:07,970
+الرحيم الحمد لله الصلاة والسلام على رسول الله
+
+3
+00:00:07,970 --> 00:00:14,070
+سيدنا محمد وعلى آله وأصحابه والتابعين بالإحسان إلى
+
+4
+00:00:14,070 --> 00:00:19,890
+يوم الدين الطلاب والطالبات الأعزاء السلام عليكم
+
+5
+00:00:19,890 --> 00:00:24,790
+ورحمة الله وبركاته نلتقي إن شاء الله في المحاضرة
+
+6
+00:00:24,790 --> 00:00:31,730
+المصورة رقم 15 لمصافي اقتصاديات التعليم والصحةإن
+
+7
+00:00:31,730 --> 00:00:36,330
+شاء الله سنتحدث في هذه المحاضرة على جزء ثاني من
+
+8
+00:00:36,330 --> 00:00:42,250
+فصل السابع وهو بعنوان مواضيع ومفاهيم متنوعة في
+
+9
+00:00:42,250 --> 00:00:47,770
+اقتصاديات الصحة سنتحدث إن شاء الله في هذه المحاضرة
+
+10
+00:00:47,770 --> 00:00:52,190
+عن عدة نقاط نبدأ بتصنيف التكاليف من شئات الخدمات
+
+11
+00:00:52,190 --> 00:00:56,970
+الصحية إلى التكاليف الثابتة والتكاليف المتغيرة
+
+12
+00:00:56,970 --> 00:01:04,860
+والتكاليف الكلية ونلاحظإن هذا التصنيف يحص قطاع
+
+13
+00:01:04,860 --> 00:01:11,420
+الخدمات الصفرية ويحص كافة الشركات وكافة المؤسسات
+
+14
+00:01:11,420 --> 00:01:16,180
+الاقتصادية المختلفة التكاليف الثابتة لـ Total
+
+15
+00:01:16,180 --> 00:01:23,320
+Fixed Cost TFC هو التكاليف التي تدفع لعناص الإنتاج
+
+16
+00:01:23,320 --> 00:01:27,660
+الثابتة وبالتالي فهي التغير مع تغير الكمية المنتجة
+
+17
+00:01:28,200 --> 00:01:33,960
+أي أنها مستقلة عن حجم الإنتاج، فهي ثابتة سواء أنتج
+
+18
+00:01:33,960 --> 00:01:39,680
+المنشأة خمس تلاف أو خمس محدد أو حتى وقفت كلياً عن
+
+19
+00:01:39,680 --> 00:01:46,140
+الإنتاج من أمثلتها في قطاع الصحة، إيجار وعيادةأو
+
+20
+00:01:46,140 --> 00:01:50,500
+المستشفى الخاص أقصر التأمين الصحي سنة الأدوات
+
+21
+00:01:50,500 --> 00:01:55,220
+الصحية السلاك المباني والآلات الصحية فهذه كلها
+
+22
+00:01:55,220 --> 00:02:00,180
+تمثل تكاليف ثابتة فالشركة بتدفعها أو المؤسسة أو
+
+23
+00:02:00,180 --> 00:02:06,920
+المستشفى سواء أنتج أو أغلق فهو بتدفع جزء من
+
+24
+00:02:06,920 --> 00:02:11,680
+التكاليف الثابتة تكاليف متغيرة لـ Total Variable
+
+25
+00:02:11,680 --> 00:02:17,850
+Cost طبعا هي التكاليف التي تتغيرحسب الكمية المنتجة
+
+26
+00:02:17,850 --> 00:02:21,730
+إذا كانت الكمية المنتجة تساوي صفرا فإن التكاليف
+
+27
+00:02:21,730 --> 00:02:27,690
+المتغيرة تساوي صفرا وكل ما زادت كمية الإنتاج كل ما
+
+28
+00:02:27,690 --> 00:02:33,190
+زادت التكاليف المتغيرة وبالتالي فإن منحنة التكاليف
+
+29
+00:02:33,190 --> 00:02:39,330
+المتغيرة اتجه دائما من أسفل إلى أعلى وإلى اليمين
+
+30
+00:02:39,330 --> 00:02:44,050
+ويدخل ضمن هذه التكاليف المتغيرة تكاليف خلاص
+
+31
+00:02:44,050 --> 00:02:48,090
+الإنتاج المتغيرةالداخلة في العملية الإنتاجية مثلًا
+
+32
+00:02:48,090 --> 00:02:53,250
+مثل أجور الأطباء وأجور الممرضين وقيمة المواد الخام
+
+33
+00:02:53,250 --> 00:02:57,910
+واقتكاليف الوقود ونفقات النقل في خدمات الصحية
+
+34
+00:02:57,910 --> 00:03:02,110
+وغيرها هذا كلها مرتبطة بالإنتاج إذا كان الإنتاج
+
+35
+00:03:02,110 --> 00:03:09,270
+بسوء صفر فهي بسوء صفر وكل ما بزيد حجم الإنتاج بزيد
+
+36
+00:03:09,270 --> 00:03:11,310
+تكليف المتقيمة
+
+37
+00:03:13,640 --> 00:03:21,560
+التكاليف الكلية الى total cost تكاليف
+
+38
+00:03:21,560 --> 00:03:27,460
+التكاليف التابع التكاليف المتغيرة تكاليف تكاليف
+
+39
+00:03:27,460 --> 00:03:30,040
+التكاليف متغيرة تكاليف تكاليف تكاليف تكاليف تكاليف
+
+40
+00:03:30,040 --> 00:03:38,280
+تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف
+
+41
+00:03:38,280 --> 00:03:38,480
+تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف
+
+42
+00:03:38,480 --> 00:03:38,480
+تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف
+
+43
+00:03:38,480 --> 00:03:38,480
+تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف
+
+44
+00:03:38,480 --> 00:03:38,480
+تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف تكاليف
+
+45
+00:03:38,480 --> 00:03:40,960
+تكاليف تكاليف تكاليف تكاليف تكوتزييد كلما زاد كمية
+
+46
+00:03:40,960 --> 00:03:45,120
+الإنتاج فزاد تكاليف متغيرة وبالتالي فإن منحنى
+
+47
+00:03:45,120 --> 00:03:48,700
+التكاليف المبالي كلية يأخذ نفس شكل منحنى التكاليف
+
+48
+00:03:48,700 --> 00:03:54,280
+المتغيرة ولكنه يرتفع عنه إلى أعلى بمقدار التكاليف
+
+49
+00:03:54,280 --> 00:04:00,600
+الثابتة الآن لو أحنا شفنا الرسم البياني هذا طبعا
+
+50
+00:04:00,600 --> 00:04:03,960
+هيعنى على المحور رفض كمية كمية المنتج فيه على
+
+51
+00:04:03,960 --> 00:04:07,450
+المحور الرأسي التكاليفسواء التكاليف الكلية أو
+
+52
+00:04:07,450 --> 00:04:12,310
+الثابتة أو متغيرة تكاليف TFC و تكاليف TVC و TVC
+
+53
+00:04:12,310 --> 00:04:18,490
+تلاحظ أنه من حين تكاليف TFC و التكاليف الثابتة أخد
+
+54
+00:04:18,490 --> 00:04:22,450
+شكل خط فوقي بمجرد أنه تكاليف ثابت تكلف هنا مثلا
+
+55
+00:04:22,450 --> 00:04:28,370
+بالسوء 60 دينار سواء كان كمية المنتجة بصوفة صفر أو
+
+56
+00:04:28,370 --> 00:04:33,610
+بالسوء ألف أو ألفين فهو طبعاتبقى التكليف ثابتة
+
+57
+00:04:33,610 --> 00:04:37,870
+يعني سؤال المؤسسة أغلقت أم انتجتها التكلفة الثابتة
+
+58
+00:04:37,870 --> 00:04:44,190
+هي أسمها ثابتة تأخذ شكل خط مستقيم وفقي موازن
+
+59
+00:04:44,190 --> 00:04:49,550
+المحور اللفقي تكليف المتغيرة تبدأ من الصفر عندما
+
+60
+00:04:49,550 --> 00:04:53,850
+كل إنتاج يسوى الصفر فيسوى الصفر كل ما الإنتاج
+
+61
+00:04:53,850 --> 00:04:58,550
+بزيدي بزيه طبعا في البداية بزيه زيادة بطيهة كما
+
+62
+00:04:58,550 --> 00:05:05,530
+شايفين يجيب الخطثم بيصير زيادة سريعة تكاليف الكلية
+
+63
+00:05:05,530 --> 00:05:10,630
+تبتفع عن التكاليف المتغيرة بمقدار التكاليف الثابتة
+
+64
+00:05:10,630 --> 00:05:14,390
+يعني من الصفر لستين هنا هي مقدار التكاليف الثابتة
+
+65
+00:05:14,390 --> 00:05:21,110
+لأن ال TC بيسوي مجموع التكاليف المتغيرة والثابتة
+
+66
+00:05:21,420 --> 00:05:27,700
+لكن لو قلنا مثلا الـ Tvc سوى الـ Tc فقصة Tfc
+
+67
+00:05:27,700 --> 00:05:31,800
+فالفرق بينهم هو مقدار التفريق ثابت لكن طبعا
+
+68
+00:05:31,800 --> 00:05:36,040
+باللحظة أنه بيأخذ نفس الشكل في البداية بزيادة
+
+69
+00:05:36,040 --> 00:05:43,060
+بسيطة ثم زيادة سريعة يعني تقريبا بشكل يعني موازي
+
+70
+00:05:43,060 --> 00:05:49,480
+للـ Tc بشكل تقريبا موازي للـ Tvc
+
+71
+00:05:53,050 --> 00:05:58,050
+طبعاً عندنا كمان نوع رابع تكاليف شبه المتغيرة هي
+
+72
+00:05:58,050 --> 00:06:02,930
+تكاليف وهي طبعاً مهم جداً هي تكاليف تجمع بين عصراء
+
+73
+00:06:02,930 --> 00:06:06,550
+الثابت والتغير يعني هي جزء من الثابت وجزء من
+
+74
+00:06:06,550 --> 00:06:11,050
+التغير هي تختلف من اختلاف في سوء الإنتاج ولكن
+
+75
+00:06:11,050 --> 00:06:15,790
+بصورة ولكن ليس بصورة مستمرة مثلا لغاية مثال مهم
+
+76
+00:06:15,790 --> 00:06:23,290
+نحتاج إلى ممرض واحد للعيد من واحد إلى عشر مرضىولكن
+
+77
+00:06:23,290 --> 00:06:27,130
+إذا أصبحوا 11 مريض فتحتاج إلى 2 من الممرضين حتى 20
+
+78
+00:06:27,130 --> 00:06:32,130
+يعني من 1 إلى 10 فنأخذ ممرض 1 لكن لو صار المرض 11
+
+79
+00:06:32,130 --> 00:06:39,450
+فنأخذ 2 ممرض حتى 20 مريض فإذا أصبح قدر المرض 21
+
+80
+00:06:39,450 --> 00:06:46,310
+فتحتاج إلى 3 ممرضين حتى 30 إذا أصبحوا 31 فتحتاج
+
+81
+00:06:46,310 --> 00:06:53,390
+إلى 4 ممرضين حتى 40 و1 مثال آخربوب اكسجين تغطي خمس
+
+82
+00:06:53,390 --> 00:06:59,170
+عمليات ولكن ست عمليات تحتاج إلى البوب آخر مثلا حتى
+
+83
+00:06:59,170 --> 00:07:03,970
+عشر عمليات عند احتاجه يجب أن يكون البوب ثالث الشكل
+
+84
+00:07:03,970 --> 00:07:14,370
+البياني رقم تلاتة يوضح التكاليف شبه المتغير هذه
+
+85
+00:07:14,370 --> 00:07:17,730
+اللي لاحظ معانا هذه التكاليف شبه المتغير
+
+86
+00:07:21,470 --> 00:07:25,670
+على المحور الرأسي
+
+87
+00:07:25,670 --> 00:07:30,510
+يوجد عدد المرضين على المحور الأفقي يوجد عدد
+
+88
+00:07:30,510 --> 00:07:33,650
+المرضين على المحور الأفقي يوجد عدد المرضين على
+
+89
+00:07:33,650 --> 00:07:35,690
+المحور الأفقي يوجد عدد المرضين على المحور الأفقي
+
+90
+00:07:35,690 --> 00:07:35,790
+يوجد عدد المرضين على المحور الأفقي يوجد عدد
+
+91
+00:07:35,790 --> 00:07:36,810
+المرضين على المحور الأفقي يوجد عدد المرضين على
+
+92
+00:07:36,810 --> 00:07:38,090
+المحور الأفقي يوجد عدد المرضين على المحور الأفقي
+
+93
+00:07:38,090 --> 00:07:39,910
+يوجد عدد المرضين على المحور الأفقي يوجد عدد
+
+94
+00:07:39,910 --> 00:07:42,250
+المرضين على المحور الأفقي يوجد عدد المرضين على
+
+95
+00:07:42,250 --> 00:07:43,610
+المحور الأفقي يوجد عدد المرضين على المحور الأفقي
+
+96
+00:07:43,610 --> 00:07:47,330
+يوجد عدد المرضين على المحور الأفقي يوجد عدد الم
+
+97
+00:07:48,850 --> 00:07:59,310
+بنحتاج ممرض واحد إذا صاروا 11 منحتاج ل 2 ممرض من
+
+98
+00:07:59,310 --> 00:08:10,290
+11 لعند 20 يعني لعندي 22 ممرض إذا صاروا 21 بدنا 3
+
+99
+00:08:10,290 --> 00:08:14,860
+مرضي حتى 30فأحنا بنلاحظ أنه تكلف شبة ثابت، هذه
+
+100
+00:08:14,860 --> 00:08:19,320
+الجزر هنا ثابت، هذا ثابت، مع إيش صار إيش تغيير،
+
+101
+00:08:19,320 --> 00:08:22,960
+يعني أنا صارت تغيير، فأنا بصير ثابت، مع إيش بصير
+
+102
+00:08:22,960 --> 00:08:28,480
+تغيير، مع إيش بصير إيش ثابت، فهي طبعا تكلف شبة
+
+103
+00:08:28,480 --> 00:08:34,860
+المتغيرة، لأن أنا مثلا لو جبت مريض واحد إلى عشر
+
+104
+00:08:34,860 --> 00:08:41,250
+مرضى، بدنا ممرض واحد كما قلنا، هنا في ثباتمن واحد
+
+105
+00:08:41,250 --> 00:08:45,530
+لعشرة ممرض، لكن لو صار 11 مريض، يجب أن يكون هناك
+
+106
+00:08:45,530 --> 00:08:52,530
+اثنين ممرض، فتغير من 11 إلى 20، هناك ثبات، من 11
+
+107
+00:08:52,530 --> 00:09:00,850
+مريض إلى 20 مريض، فهناك ثبات في عدد الممرضين، مع
+
+108
+00:09:00,850 --> 00:09:07,430
+تغير في عدد المرضى، 11، 12، 13، 14، 15 مريض إلى
+
+109
+00:09:07,430 --> 00:09:13,350
+20،بس ممرضين في ثبات في المرضين في تغير في المرضى
+
+110
+00:09:13,350 --> 00:09:17,650
+لعند عشرين بناخد اثنين ممرضين لكن لو صار واحد
+
+111
+00:09:17,650 --> 00:09:21,470
+وعشرين عشان تغير في الممرضين من واحد وعشرين
+
+112
+00:09:21,470 --> 00:09:27,230
+لتلاتين بناخد ثلاث مرضين فصار ثبات في المرضى وتغير
+
+113
+00:09:27,230 --> 00:09:31,710
+في المرضين ثم من عند واحد وعشرين لواحد وتلاتين
+
+114
+00:09:31,710 --> 00:09:37,050
+مريض لعند اربعين مريض بدنا اربع مرضين فهكذا تسموها
+
+115
+00:09:37,050 --> 00:09:43,320
+الشبه متغيرفي تكاليف أخرى هي التكاليف الاقتصادية
+
+116
+00:09:43,320 --> 00:09:48,360
+فهو التكاليف المحاسبية الفرصة البديلة وايه طبعا
+
+117
+00:09:48,360 --> 00:09:53,280
+سرقة التكاليف كلها لأننا أخدناها بالتفصيل في مادة
+
+118
+00:09:53,280 --> 00:09:57,780
+تبادل الاقتصاد الجزي والاقتصاد التحليلي التكاليف
+
+119
+00:09:57,780 --> 00:10:02,640
+حسب الأجل هناك التكاليف الأجل القصير وتكاليف الأجل
+
+120
+00:10:02,640 --> 00:10:07,040
+الطويل وفي عندنا أيضا أنواع أخرى التكاليف الغارقة
+
+121
+00:10:07,040 --> 00:10:14,650
+والتكاليف المباشرة وغيرالمباشرة تكليف الاقتصادية
+
+122
+00:10:14,650 --> 00:10:19,470
+الـ Economic Cost ويبقى التكليف المحاسبية تعتبر
+
+123
+00:10:19,470 --> 00:10:22,730
+التكليف الضمنية لتمثل تكلف الفرصة البديلة تكلف
+
+124
+00:10:22,730 --> 00:10:29,310
+الضمنية تمثل تكلف الفرصة البديلة أو بمعنى آخر
+
+125
+00:10:29,310 --> 00:10:33,470
+لتكلف الاقتصادية طبعا هي المبالغ التي تدفعها
+
+126
+00:10:33,470 --> 00:10:40,460
+المؤسسة أو تضحي بها من أجلضمّا مساهمة عناصر
+
+127
+00:10:40,460 --> 00:10:45,360
+الإنتاج المختلفة في العملية الإنتاجية والتكاريف
+
+128
+00:10:45,360 --> 00:10:50,580
+الاقتصادية قد تكون صريحة عندما تكون صريحة يعني
+
+129
+00:10:50,580 --> 00:10:57,860
+محسبية عندما تكون عناصر الإنتاج غير مملوكة للمؤسسة
+
+130
+00:10:57,860 --> 00:11:03,180
+وقد تكون ضمنية وضمنية الإتكارف الفرصة البديلةعندما
+
+131
+00:11:03,180 --> 00:11:08,900
+تكون عناصر إنتاج مملوكة لمؤسسة وفي هذه الحالة تحسب
+
+132
+00:11:08,900 --> 00:11:15,020
+التكليف على أساس تكليف الفرصة المدينة طبعاً
+
+133
+00:11:15,020 --> 00:11:19,740
+انفصل كل نقطة على حدا تكليف المحاسبية الـ
+
+134
+00:11:19,740 --> 00:11:26,280
+Accounting Cost هو التكليف الصريحة الـ Explicit
+
+135
+00:11:26,280 --> 00:11:31,140
+Cost وهي عبارة عن الـ Value التي تدفعها المؤسسةأو
+
+136
+00:11:31,140 --> 00:11:36,380
+المنشأة صراحة مقابل خدمات خناص الإنتاج مثل اكثور
+
+137
+00:11:36,380 --> 00:11:41,080
+ومرتبات لأطباء ولممرضين مصاريف الصيانة أثناء
+
+138
+00:11:41,080 --> 00:11:45,780
+المستشفيات ثمن المواد الخام مستخدمة مثلا في عملية
+
+139
+00:11:45,780 --> 00:11:50,320
+الجراحية وإلى آخرى مصاريف الكهرباء والمياه وجور
+
+140
+00:11:50,320 --> 00:11:54,290
+النقل والإعلان ومصطفات أخرىمثل التأمين والضرائب
+
+141
+00:11:54,290 --> 00:11:58,970
+إلى آخرها، وهذه تدفع بشكل صريح، تدفعها المؤسسة
+
+142
+00:11:58,970 --> 00:12:04,530
+بشكل سهل، مثلما تكاليف المحاسبية التكاليف الضمنية،
+
+143
+00:12:04,530 --> 00:12:07,910
+مثلما تكاليف الفرصة البديلة هي عبارة عن تكاليف
+
+144
+00:12:07,910 --> 00:12:11,530
+التي لا تدفعها المؤسسة الصراحة، هو الخدمات علاص
+
+145
+00:12:11,530 --> 00:12:16,190
+الإنتاج، ولكنها تضحي بها مقابل استخدام علاص
+
+146
+00:12:16,190 --> 00:12:19,070
+الإنتاج الممنوكة للمؤسسة
+
+147
+00:12:21,370 --> 00:12:28,690
+الان مثال على هذا الكلام مثلا
+
+148
+00:12:28,690 --> 00:12:35,130
+لو قلنا عيادة خصوصية تمتلك مستودع وتقوم باستخدامه
+
+149
+00:12:35,130 --> 00:12:40,190
+في تخزين الدواء في هذه الحالة فهذا المستودع ملك
+
+150
+00:12:40,190 --> 00:12:45,610
+العيادة أو صاحب العيادة في هذه الحالة لن تدفع
+
+151
+00:12:45,610 --> 00:12:51,710
+العيادة أي أجراء أو إيجار لهذا المستودعلأنه ملك
+
+152
+00:12:51,710 --> 00:12:58,470
+لها ولكنها تتحمل تكلفة مثل بالتضحية بالإيجار الذي
+
+153
+00:12:58,470 --> 00:13:02,850
+كان يمكن الفصول عليه لو لم تستخدمه وقامت بتأجيره
+
+154
+00:13:02,850 --> 00:13:08,690
+وهذا ما يُعرف بتكلفة الفرصة البديلة مثال آخر لو
+
+155
+00:13:08,690 --> 00:13:13,030
+عملت زوجة صاحب العيادة وأولاده في هذه العيادة
+
+156
+00:13:13,030 --> 00:13:17,660
+تكلفة الفرصة البديلة بالنسبة لهمبمقدار الأجر الذي
+
+157
+00:13:17,660 --> 00:13:23,280
+كان يمكن تحصل عليه لو عمله في مؤسسة أخرى و كذلك
+
+158
+00:13:23,280 --> 00:13:26,740
+صاحب العيادة نفسه اللي هو الطبيب لو عمل خارج
+
+159
+00:13:26,740 --> 00:13:32,440
+العيادة الخاصة به فإنه يحصل على عائد أو أجر و هنا
+
+160
+00:13:32,440 --> 00:13:36,920
+نجد أن مقدار الأجر الذي يمكن أن يحصل عليه هذا
+
+161
+00:13:36,920 --> 00:13:40,700
+الإنسان و هذا الطبيب لو عمل خارج العيادة فاعتبر
+
+162
+00:13:40,700 --> 00:13:46,430
+تكلفة ضمنية وحسب التحليل الصادرإذا لم تكن العيادة
+
+163
+00:13:46,430 --> 00:13:50,750
+تمتلك مستودع وإذا لم يكن لصاحب العيادة وزوجتي
+
+164
+00:13:50,750 --> 00:13:55,250
+وأولاده عمل بديل فهذه الفرصة البديلة في هذه الحالة
+
+165
+00:13:55,250 --> 00:14:00,650
+الساوية يعني أنا بدي أحسب تقاليف العيادة تقاليف
+
+166
+00:14:00,650 --> 00:14:06,470
+اللي هي المحاسبية اللي تم طبعا دفعها زي مثلا إذا
+
+167
+00:14:06,470 --> 00:14:13,920
+شغل عمال مثلا إذا مثلا دفع مصالح كهربا ومياهالذي
+
+168
+00:14:13,920 --> 00:14:17,400
+دفع طريقه وانت ماتت كله بحسبه فليه فى الفرصة
+
+169
+00:14:17,400 --> 00:14:22,100
+البديلة فى إيش هو ضحى مثلا كان عنده مستودع بأجره
+
+170
+00:14:22,100 --> 00:14:27,220
+لكن المستودع قدر بأجره أوقف تأجيره واستخدمه
+
+171
+00:14:27,220 --> 00:14:32,400
+للعيادة مستودع الأدوية أدوة العيادة فالآن الأجر
+
+172
+00:14:32,400 --> 00:14:39,240
+اللى كان يقضوه وليه ضحى فيهيحسب طبعا ضمن تكلف مرصى
+
+173
+00:14:39,240 --> 00:14:44,660
+المدينة مثلا كان هو نفسه طبيب مثلا بشتغل في مستشفى
+
+174
+00:14:44,660 --> 00:14:50,580
+أو بشتغل في مؤسسة حكومية لكنه ضحى بعمله واتفرج
+
+175
+00:14:50,580 --> 00:14:53,900
+لعيادة الخصوصية فالراتب اللي كان ياخده مقابل عمله
+
+176
+00:14:53,900 --> 00:14:58,580
+السابق يحسبه ضمن تكلف مرصى المدينة للعيادة
+
+177
+00:14:58,580 --> 00:15:02,160
+الخصوصية كمان لو زوجته وأولاده كانوا يعملوا في
+
+178
+00:15:02,160 --> 00:15:06,280
+مكان آخروتركوا عملهم الآخر وضحفوا في وسائل يشتغلوا
+
+179
+00:15:06,280 --> 00:15:10,120
+معاه برضه إيجار إيجارهم اللي كانوا يقضوه في العمل
+
+180
+00:15:10,120 --> 00:15:14,600
+السابق اللي وضحفوا فيه لما تتكلمت فرصة مدينة في
+
+181
+00:15:14,600 --> 00:15:18,420
+المحاصلة عشان تكون العيادة خصية رمحانة لازم تغطي
+
+182
+00:15:18,420 --> 00:15:25,600
+تكاليف المحاسبية تغطي الفرصة المدينة اتحقق هنا ربح
+
+183
+00:15:25,600 --> 00:15:33,110
+اقتصادي لكنها لو لم تغطيالتكاليف المحاسبية التي هي
+
+184
+00:15:33,110 --> 00:15:39,330
+الفرصة البديلة فإنها لن تحقق ربح اقتصادي إذا أعطى
+
+185
+00:15:39,330 --> 00:15:45,470
+التكاليف المحاسبية فقط تحقق ربح محاسبي أو بيسموه
+
+186
+00:15:45,470 --> 00:15:51,610
+الربح العادي يعني بمعنى أنه لم يأخذ بعين اعتبار
+
+187
+00:15:51,610 --> 00:15:56,050
+تكاليف الفرصة البديلة اللي هو ضحكت عليه، لكن الأصل
+
+188
+00:15:56,050 --> 00:16:02,200
+أنه يأخذ بعين اعتبارتكليف الفرصة البديلة طبعا هو
+
+189
+00:16:02,200 --> 00:16:08,360
+لو حقق ربح محاسبي أو ربح عادي بيكون و كأنه هو يعني
+
+190
+00:16:08,360 --> 00:16:15,520
+غطى التكليف المحاسبية اللي هو دفعها وبالتالي
+
+191
+00:16:15,520 --> 00:16:22,680
+استطاع أن يحقق يعني ربح بالنسبة لهذه الإيادة لكنه
+
+192
+00:16:22,680 --> 00:16:25,840
+أهمل في الحالة هذه التكلفة الفرصة البديلة بالرغم
+
+193
+00:16:25,840 --> 00:16:28,180
+من أهميتها الشديدة
+
+194
+00:16:30,610 --> 00:16:35,930
+التكاليف الغارقة هي تكاليف لا يمكن استردادها نتيجة
+
+195
+00:16:35,930 --> 00:16:40,990
+نقارات اتخذها المدرس يدفعها مقدس استرداد أو هي
+
+196
+00:16:40,990 --> 00:16:44,790
+تكاليف تُصرف ولا يمكن استردادها في حالة خسارة أو
+
+197
+00:16:44,790 --> 00:16:49,630
+غيارة مثلا المستأجر الذي يقوم بصيانة الشبكة
+
+198
+00:16:49,630 --> 00:16:54,490
+السكنية على عاتق الشخص بعد ذلك لا يتم تجديب عقد
+
+199
+00:16:54,490 --> 00:16:58,230
+الإيجار وطالما دفع المستاجر من تكاليف الصيانة لا
+
+200
+00:16:58,230 --> 00:17:05,100
+يمكن استردادهوخلصت أحيانا مثلا يعني أتعاب المحامين
+
+201
+00:17:05,100 --> 00:17:10,700
+اللي بيتم دفعها لأنها لا يمكن استردادها سواء
+
+202
+00:17:10,700 --> 00:17:15,760
+المشروع نجح ولا ما نجحش الترخيص اللازمة لا يمكن
+
+203
+00:17:15,760 --> 00:17:21,500
+استردادها فهذا بيسموه طبعا تكاليف غارقة التكاليف
+
+204
+00:17:21,500 --> 00:17:26,420
+المباشر هي عبارة عن تكاليف ترتبط اتباط مباشر
+
+205
+00:17:26,420 --> 00:17:32,010
+بالإنتاج زي تكاليف الأطباءتكاليف التمرير، الدواء،
+
+206
+00:17:32,010 --> 00:17:36,910
+التنويب، عملية جراحية إلها ارتباط بنفس العمل الصحي
+
+207
+00:17:36,910 --> 00:17:40,990
+الإنتاجي تكاليف غير مباشرة هي عبارة عن تكاليف
+
+208
+00:17:40,990 --> 00:17:45,450
+ترتبط إرتباط غير مباشر للإنتاج مثل الإضاءة، سيانة
+
+209
+00:17:45,450 --> 00:17:50,110
+مرافق المستشفى كمكاتب الإدارة والحمامات إلى أخرين
+
+210
+00:17:50,110 --> 00:17:56,090
+فبسبب تكاليف غير مباشرة تكلفة متوسطة والحدية لل
+
+211
+00:17:56,090 --> 00:18:00,530
+average and marginal costsالإضافة إلى تكاليف
+
+212
+00:18:00,530 --> 00:18:05,090
+الكلية يتم لأقتصاريون ورجال الأعمال أيضًا تكاليف
+
+213
+00:18:05,090 --> 00:18:10,870
+الوحدة الواحدة أي نصيب كل وحدة من التكاليف ثابتة
+
+214
+00:18:10,870 --> 00:18:14,110
+لمتغير الكلية أشاركها المميز لدينا بين عدة ألواع
+
+215
+00:18:14,110 --> 00:18:17,450
+في المتوسطات نقول تكاليف الكلية، نقول تكاليف
+
+216
+00:18:17,450 --> 00:18:23,080
+المتوسطةعند المتواصل التكاليفي الثابت اللي هو الـ
+
+217
+00:18:23,080 --> 00:18:27,880
+AFC Average Fixed Cost بيساوي التكاليفي الثابت على
+
+218
+00:18:27,880 --> 00:18:33,860
+كمية الانتاج يعني AFC بيساوي TFC على كمية الانتاج
+
+219
+00:18:33,950 --> 00:18:38,430
+ملمضت علينا الاقتصاد الدوسي وكما قلنا ما ينطبق على
+
+220
+00:18:38,430 --> 00:18:45,450
+مؤسسات اقتصادية المختلفة ينطبق على المؤسسات الصحية
+
+221
+00:18:45,450 --> 00:18:49,610
+خاصة مثل هذا مؤسسات اقتصادي احنا طبعا احنا بنعرف
+
+222
+00:18:49,610 --> 00:18:58,110
+انه الجمال الناتج المحلي بساوي القطاع الصناعي زي
+
+223
+00:18:58,110 --> 00:19:01,530
+هذا القطاع الزراعي زي هذا القطاع الخدماتي والقطاع
+
+224
+00:19:01,530 --> 00:19:06,510
+الخدماتيهو أكبر هذه القطاعات، يعني يشكل 70% من حجم
+
+225
+00:19:06,510 --> 00:19:10,670
+إجمال الناتج المحلي وجزء مهم من القطاع الخدماتي
+
+226
+00:19:10,670 --> 00:19:15,830
+اللي هو قطاع الصحة فقطاع الصحة يعتبر قطاع اقتصادي،
+
+227
+00:19:15,830 --> 00:19:22,470
+عشانك ما ينطبق من تكاليف في القطاعات الاقتصادي
+
+228
+00:19:22,470 --> 00:19:27,580
+الصناعية والزراعيةينطبق أيضًا في قطاع الخدمات بما
+
+229
+00:19:27,580 --> 00:19:31,800
+فيه طبعًا قطاع الصحة وقطاع التعليم وقطاع السياحة
+
+230
+00:19:31,800 --> 00:19:37,000
+وقطاع الإتصالات والمواصلات وقطاع التكنولوجيا إلى
+
+231
+00:19:37,000 --> 00:19:42,820
+آخرين مدرسة التكاريف المتغيرة اللي هو الـAVC
+
+232
+00:19:42,820 --> 00:19:46,120
+Average Variable Cost بساوي المدرسة التكاريف
+
+233
+00:19:46,120 --> 00:19:48,140
+المتغيرة بساوي التكاريف المتغيرة على كمية الإنتاج
+
+234
+00:19:48,140 --> 00:19:55,620
+الـAVC بساوي TVC على EQمتواصل التكاليف الكلية ATC
+
+235
+00:19:55,620 --> 00:20:00,660
+هو average total cost متواصل التكاليف الكلية على
+
+236
+00:20:00,660 --> 00:20:07,580
+كمية الإنتاج ATC بيساوي TC على EQ ATC بيساوي AFC
+
+237
+00:20:07,580 --> 00:20:11,600
+زي AVC
+
+238
+00:20:11,600 --> 00:20:18,940
+متواصل التكاليف الكلية متواصل التكاليف المتغير
+
+239
+00:20:23,960 --> 00:20:29,940
+تكليف الحدية الـ MC Marginal Cost هي مقدار التغيير
+
+240
+00:20:29,940 --> 00:20:33,340
+في التكليف الكلية الناجم عن نزيات الإنتاج في واحدة
+
+241
+00:20:33,340 --> 00:20:38,400
+واحدة تكليف الحدية بسوء تقليف طرف التكلفة الكلية
+
+242
+00:20:38,400 --> 00:20:43,200
+على التغيير في كمية المنتجة الـ MC تسوء الـ ATC
+
+243
+00:20:43,200 --> 00:20:49,040
+على EQ الملحونات
+
+244
+00:20:49,040 --> 00:20:55,490
+التكليف يعني هذا هي موجودة كلهاهذا منحنى الـ MC
+
+245
+00:20:55,490 --> 00:20:58,710
+ومنحنى
+
+246
+00:20:58,710 --> 00:21:09,850
+ال AVC ومنحنى ال ATC ومنحنى ال AFC طبعا باللحظة أن
+
+247
+00:21:09,850 --> 00:21:17,930
+منحنى ال AVC يشغل كحرف U في البداية بزيد تقطع
+
+248
+00:21:17,930 --> 00:21:23,060
+منحنى ال MC عندنا نقطة A نقطة الأغلاقفي لحد الفصل
+
+249
+00:21:23,060 --> 00:21:29,740
+بالإنتاج والإغلاق واتكلمنا عن هذا الشكل أيضًا في
+
+250
+00:21:29,740 --> 00:21:37,540
+الفصل السادس من المادة ووضّحنا مادة عن نقطة
+
+251
+00:21:37,540 --> 00:21:42,760
+الإغلاق بالتفصيل فإحنا ممكن عشان ناخد تفاصيل كاملة
+
+252
+00:21:42,760 --> 00:21:48,700
+نرجع للفصل السادس والمحاضرات المتعلقة به هلاحظ أنه
+
+253
+00:21:48,700 --> 00:21:55,070
+طبعًا أنه نقطة Aهي أدنى نقطة في الـ AVC وهي طبعاً
+
+254
+00:21:55,070 --> 00:22:01,390
+بتمثل نقطة الإغلاق نقطة تقاطب الحناء اللي هو الـ
+
+255
+00:22:01,390 --> 00:22:08,490
+ATC مع الـMC عند النقطة بتمثل نقطة التعدم طبعاً أو
+
+256
+00:22:08,490 --> 00:22:13,430
+احتمال تواجن كما قلنا واتكلمنا عنها يعني عند
+
+257
+00:22:13,430 --> 00:22:18,790
+النقطة A في احتمال اللي هو تقييم نقطة الإغلاق إلى
+
+258
+00:22:18,790 --> 00:22:22,230
+حد فاصل من إنتاج الإغلاقلو صار تواجن بين A وB،
+
+259
+00:22:22,230 --> 00:22:26,310
+بيصير عندي أقل فصارة اقتصادية ممكنة لو صار تواجن
+
+260
+00:22:26,310 --> 00:22:29,470
+عند النقطة B، بيحقق طبعا ربح عادي و تربح اقتصادي
+
+261
+00:22:29,470 --> 00:22:32,690
+بسبع صفر لو حقن التواجن عند أعلى من النقطة B،
+
+262
+00:22:32,690 --> 00:22:35,830
+بيصير عندي ربح اقتصادي وهذا برضه اللي اتكلمنا عن
+
+263
+00:22:35,830 --> 00:22:40,190
+التواجن، اتكلمنا عنها بالتفصيل في الفصل السادس من
+
+264
+00:22:40,190 --> 00:22:44,910
+هذا المثل عندنا
+
+265
+00:22:44,910 --> 00:22:51,980
+أيضا نقطة أخرى يعني في اقتصاد الرزقىوممكن نطبقها
+
+266
+00:22:51,980 --> 00:23:04,180
+على قطاع الصحة في منحنيات الناتج المتساوي وكيف
+
+267
+00:23:04,180 --> 00:23:08,980
+نستخدمها في سوق الخدمات الصحية طبعا هنتكلم في
+
+268
+00:23:08,980 --> 00:23:14,680
+الفيلم هذه عن تعريف منحنيات الناتج المتساويعن
+
+269
+00:23:14,680 --> 00:23:18,620
+خصائص مجهد الناتج المتساوي عن خط التقن المتساوية
+
+270
+00:23:18,620 --> 00:23:23,420
+عن تواجن المنتج باستخدام مجهد متساوي عن خط توشع
+
+271
+00:23:23,420 --> 00:23:29,340
+المنشأ أو المستشفى وإن شاء الله في المحاضرة هذه
+
+272
+00:23:29,340 --> 00:23:37,400
+سأتكلم عن مجهد الناتج المتساوي وخصائصها وبنكمل في
+
+273
+00:23:37,400 --> 00:23:41,820
+المحاضرة القادمة إن شاء اللهالنقطة التلاتة الأخرى
+
+274
+00:23:41,820 --> 00:23:46,380
+هي خطة تقنية متساوية وتوازن المنتج باستخدام منحنات
+
+275
+00:23:46,380 --> 00:23:52,640
+النجم متساوي وخط توسع المنتج ان شاء الله تعريف
+
+276
+00:23:52,640 --> 00:23:56,720
+منحنات النجم متساوي منحنات النجم متساوي هو المنحنة
+
+277
+00:23:56,720 --> 00:24:01,660
+التي يوضح المجموعات المختلفة من عناصر الإنتاج التي
+
+278
+00:24:01,660 --> 00:24:06,400
+تعطي المنتج نفس كمية إنتاج وفكرة منحنات النجم
+
+279
+00:24:06,400 --> 00:24:12,980
+متساوي مبنيةعلى نفس فكرة منحنيات السواق مع وجود
+
+280
+00:24:12,980 --> 00:24:17,960
+خلاف جوهري بين منحنيات نفس المتساوي ومنحنيات
+
+281
+00:24:17,960 --> 00:24:22,800
+السواق منحنيات السواق تمثل مستوى إشباع معين
+
+282
+00:24:22,800 --> 00:24:28,960
+للمستهلك ولكنها لا تبين كمية ذلك الإشباع فذلك لعدم
+
+283
+00:24:28,960 --> 00:24:34,360
+أن كانت قياس المنفعة وحقق إشباع معين لكن الإشباع
+
+284
+00:24:34,360 --> 00:24:39,460
+مش معين جدش كميةه لأن المنفعة هي شعور نفسيغير قبل
+
+285
+00:24:39,460 --> 00:24:44,520
+القياس الكمية المنحوية الناتج المتساوية فيتمثل
+
+286
+00:24:44,520 --> 00:24:51,380
+كميات الإنتاج الممكنة مقاسة بوحدات قياس مثل الطول،
+
+287
+00:24:51,380 --> 00:24:55,060
+الليتر، العدد، إلى آخرين المنحوية المتساوية يتمثل
+
+288
+00:24:55,060 --> 00:25:00,000
+كمية إنتاج ويمكن قياسها كميات المنفعة يمكن قياسها
+
+289
+00:25:00,000 --> 00:25:04,120
+كمية منفعة
+
+290
+00:25:04,740 --> 00:25:10,060
+المنفعة شيء داكل، متعلق، شيء نفسه، شعور نفسه، أساس
+
+291
+00:25:10,060 --> 00:25:16,280
+نفسه، يعني لا أستطيع أن أقلبت في موضوع المنفعة،
+
+292
+00:25:16,280 --> 00:25:20,820
+أقسم أتناوله ثلاث حبات تفاح، لا أستطيع أن أقلص
+
+293
+00:25:20,820 --> 00:25:24,060
+المنفعة اللي متحصلها كل واحد منهم، أفرد واحد مثلا
+
+294
+00:25:24,060 --> 00:25:28,180
+استفاد منهم أكتر من الثانوية، واحد ماكانش مفطر أو
+
+295
+00:25:28,180 --> 00:25:32,950
+متغضي وأكلهم، واحد كان متغضي وأجي أكلهم،المنفع
+
+296
+00:25:32,950 --> 00:25:39,070
+هتختلف لكن كياس المنفع صعب وبالتالي يمكن أن بقارة
+
+297
+00:25:39,070 --> 00:25:42,950
+كميات الإنتاج التي تمثلها منحطة متساوي قياسيا وليس
+
+298
+00:25:42,950 --> 00:25:49,110
+تركبيا، بمقياسها كمية فقط، كما هو الحال في منحنية
+
+299
+00:25:49,110 --> 00:25:57,830
+السواب ملحظة
+
+300
+00:25:57,830 --> 00:26:01,940
+أخرت تعلق بمنحنة نادر متساويحيث يتم رسم هذا
+
+301
+00:26:01,940 --> 00:26:08,200
+الملحنة في ظل الفرض أن كل علاصة الإنتاج متغيرة حيث
+
+302
+00:26:08,200 --> 00:26:11,940
+أنه يمكن إحلال الممرض أو الحكيم مثل الطبيب أو
+
+303
+00:26:11,940 --> 00:26:15,500
+العكسر وهذا يعني أن الحديث هو عن الأجل الطويل،
+
+304
+00:26:15,500 --> 00:26:19,860
+بدأت كل علاصة الإنتاج متغيرة إذا نتكلم عن الأجل
+
+305
+00:26:19,860 --> 00:26:25,160
+الطويل، أي أن ملحن ناتج متساوي يحص الأجل الطويل،
+
+306
+00:26:25,160 --> 00:26:28,100
+ليس الأجل القصيروبالتالي تُكتب دلوقتي الإنتاج
+
+307
+00:26:28,100 --> 00:26:31,840
+كميالي Quantity of production اللي يبقى U بالساوي
+
+308
+00:26:31,840 --> 00:26:37,200
+Function of Nurses and Doctors يعني كمية الإنتاج
+
+309
+00:26:37,200 --> 00:26:41,940
+من يعني مثلا هتكون كمية الإنتاج متعبرة عن عدد اللي
+
+310
+00:26:41,940 --> 00:26:47,440
+هو المرضى المعالجين عدد المرضى المعالجين بالساوي
+
+311
+00:26:47,440 --> 00:26:51,980
+طبعا هي أدلة في عدد اللي هو الممرضين ال nurses
+
+312
+00:26:51,980 --> 00:27:07,570
+وعدد الأطباء اللي هو doctorsبنوضح المجموعات
+
+313
+00:27:07,570 --> 00:27:12,430
+المختلفة من المرضين والاطباء لعلاج عدد معين من
+
+314
+00:27:12,430 --> 00:27:20,550
+المرضى طبعا هنا عندنا مجموعات A وB وC وD وE عندنا
+
+315
+00:27:20,550 --> 00:27:25,200
+هنا كمية الإنتاج P1 بساوي 1000تعبر على عدد المرضى
+
+316
+00:27:25,200 --> 00:27:30,020
+المعالجين الـ Q2 بيسوأ 2500 تعبر على عدد المرضى
+
+317
+00:27:30,020 --> 00:27:33,820
+المعالجين يعني هنا عدد يعني بالمعنى الكمية الـ Q2
+
+318
+00:27:33,820 --> 00:27:42,720
+بيسوأ 2500 مريض معالج الـ Q3 بيسوأ 4500 يعني 4500
+
+319
+00:27:42,720 --> 00:27:48,000
+مريض معالج عند الموردين في المجموعة اللي بنستخدم
+
+320
+00:27:48,000 --> 00:27:55,740
+عند Q1 هنرسم منحنةسواء من Q2 من خنا تاني أو من Q3
+
+321
+00:27:55,740 --> 00:28:02,860
+من خنا تالت عند Q1 هي مجموعات مختلفة نستخدم مثلا
+
+322
+00:28:02,860 --> 00:28:09,220
+ممرض واحد من 16 طبيب لعلاج ألف مريض في المجموعة 2
+
+323
+00:28:09,220 --> 00:28:18,220
+يوجد 3 ممرضين و 8 أطباء لعلاج ألف مريض في المجموعة
+
+324
+00:28:18,220 --> 00:28:26,480
+C يوجد 5 ممرضينواربع طباء في علاج اللي هو ألف مريض
+
+325
+00:28:26,480 --> 00:28:31,820
+فانا بنلاحظ أنه كل ما أنا بزيد في عدد المرضى بقل
+
+326
+00:28:31,820 --> 00:28:37,620
+في عدد الأطباء أو بمعنى آخر بقل في عدد الأطباء و
+
+327
+00:28:37,620 --> 00:28:43,720
+بحل محلهم ممرضين كل ما عدد الأطباء بقل 16 إلى 8
+
+328
+00:28:43,720 --> 00:28:52,430
+طبعا احنا ضفنا هنا اثنين من الممرضين مدانهممن
+
+329
+00:28:52,430 --> 00:29:00,470
+ثماني لأربع أطباء دفن محلهم أثنين برضه مرضى فكانت
+
+330
+00:29:00,470 --> 00:29:04,610
+كل ما أنا ضحيت بأطباء بضيت محلهم مرضى، هذا بيسموه
+
+331
+00:29:04,610 --> 00:29:10,990
+معدل الإحلال، معدل الحديد الإحلال الفن، معدل
+
+332
+00:29:10,990 --> 00:29:15,310
+الحديد الإحلال الفن عند الفئة الـQ و الفئة الـ500،
+
+333
+00:29:15,310 --> 00:29:18,850
+رشة المعدد أكبر من المرضى و الأطباءيعني مثلا في
+
+334
+00:29:18,850 --> 00:29:22,310
+المجموع يحصل استخدام 3 مرضين و 16 طبيب في المجموع
+
+335
+00:29:22,310 --> 00:29:27,190
+B يحصل استخدام 4 مرضين و 12 طبيب فطبعا لو قررت بين
+
+336
+00:29:27,190 --> 00:29:34,230
+B عندما أنا عالج ألف مريض هنحصل استخدام 3 مرضين و
+
+337
+00:29:34,230 --> 00:29:40,410
+7 أطباء لكن في الـ B العلاج الفرق المسميت مريض
+
+338
+00:29:40,410 --> 00:29:51,280
+هستخدم 4 مرضين و 12 طبيب و طبعاQ3 لـ 4500 مريض
+
+339
+00:29:51,280 --> 00:29:56,860
+معالج سنستخدم في المجموعة بـ 6 ممرضين و 14 طبيب
+
+340
+00:29:56,860 --> 00:30:05,580
+لعلاج 4500 مريض لو رسمنا هذا الجدول نقصر على 3
+
+341
+00:30:05,580 --> 00:30:12,800
+ملحانيات للـ Nuts متساومة هذه
+
+342
+00:30:12,800 --> 00:30:16,160
+الملحانة
+
+343
+00:30:24,890 --> 00:30:30,910
+بنفس الكمية او نفس المرة يعني احنا ال Q واحد اذا
+
+344
+00:30:30,910 --> 00:30:35,670
+رجعنا للجدول نرسمه
+
+345
+00:30:35,670 --> 00:30:41,510
+من خلال ال A B C D E اي واحد ستة عشر ثلاثة تمانية
+
+346
+00:30:41,510 --> 00:30:42,790
+خمسة اربعة
+
+347
+00:30:45,800 --> 00:30:49,380
+يعني لو جينا هنا، هنقول هنا واحد، واشق إلى آخرين
+
+348
+00:30:49,380 --> 00:30:54,600
+إذا إحنا هذا ملحانة ناتج متساوي، بنلاحظ إنه كل
+
+349
+00:30:54,600 --> 00:30:58,480
+ملحانة ناتج متساوي يمثل كمية متساوية ومستوى ثابت
+
+350
+00:30:58,480 --> 00:31:02,440
+من الإنتاج، يعني إنه يمثل كل مجموعات من عنصرين
+
+351
+00:31:02,440 --> 00:31:08,520
+الأنود دي لعنصر الأطباء، ستعطي نفس الكمية من
+
+352
+00:31:08,520 --> 00:31:13,810
+الإنتاجوالشكل الرقم خمسة وكذلك المحدث المتساوي لا
+
+353
+00:31:13,810 --> 00:31:19,510
+تمثل مجتمعات إنتاج أكبر أي عندنا P1 بيعالج ألف
+
+354
+00:31:19,510 --> 00:31:24,870
+طبيب مجموعات يعني P1 تمثل مجموعات من المرضين إلى
+
+355
+00:31:24,870 --> 00:31:32,200
+طباء لعلاج ألف مريض وP2 تمثل مجموعات أكبرمن
+
+356
+00:31:32,200 --> 00:31:38,840
+الموردين لطباء علاج 2500 مريض الـ Q3 مثل الأجمعات
+
+357
+00:31:38,840 --> 00:31:45,300
+أكبر وأكبر من الموردين للطباء لعلاج 4500 مريض
+
+358
+00:31:45,300 --> 00:31:49,180
+خصائص
+
+359
+00:31:49,180 --> 00:31:52,380
+منحنيات النفس المتساوي واحد تتمتع من خلال النفس
+
+360
+00:31:52,380 --> 00:31:57,040
+المتساوي بنفس الخصائص اللي تتمتع بها منحنيات
+
+361
+00:31:57,040 --> 00:32:02,820
+السواق وهذه الخصائص تتمثل فيما يلي واحدالمنحنات
+
+362
+00:32:02,820 --> 00:32:10,100
+نفس متساوي لا تتقاطع لأنه يترتب على تقاطعها نتائج
+
+363
+00:32:10,100 --> 00:32:15,000
+غير منطقية حيث أن تقاطعها يعني أن المنحنة الأعلى
+
+364
+00:32:15,000 --> 00:32:21,500
+يعطي نفس الإنتاج للمنحنة الأسفل منه وهذا يتصوره
+
+365
+00:32:21,500 --> 00:32:25,740
+عقلا كما هو وضح في الشكل البياني رقم 6 يعني مثلا
+
+366
+00:32:25,740 --> 00:32:28,740
+لو قررنا أن هناك تقاطع
+
+367
+00:32:31,360 --> 00:32:39,740
+اللي هو U1 بعالج 400 مريض U2
+
+368
+00:32:39,740 --> 00:32:46,880
+بعالج 500 مريض الان وين المشكلة؟ المشكلة في
+
+369
+00:32:46,880 --> 00:32:57,680
+التقاطع لو قلنا والله أنه مثلا النقطة مثلا C سوى
+
+370
+00:32:57,680 --> 00:33:00,460
+النقطة B على نفس المنحنة
+
+371
+00:33:05,090 --> 00:33:10,570
+والنقطة A تساوي النقطة B لأنها على نفس الملحنة الـ
+
+372
+00:33:10,570 --> 00:33:17,190
+quick main إذا مدام الـ A تساوي الـ B و الـ C
+
+373
+00:33:17,190 --> 00:33:21,050
+تساوي الـ B لأن كل واحد منهم على نفس الملحنة إذا
+
+374
+00:33:21,050 --> 00:33:27,150
+الـ C تساوي الـ A و هذا كله أفضل لأن عند النقطة C
+
+375
+00:33:27,150 --> 00:33:35,310
+نعالج400 مريض عند نقطة ابل عارف 500 مريض اذا الـ C
+
+376
+00:33:35,310 --> 00:33:39,710
+لا تساوي ايه؟ التقاطع هو السبب انها تشغل منطقيا
+
+377
+00:33:39,710 --> 00:33:45,870
+وبالتالي مافيش مجال للتقاطع بين اللي هو من خاتم
+
+378
+00:33:45,870 --> 00:33:49,370
+الرسول لازم تتسم كما هو موجود في هذا الشكل مافيش
+
+379
+00:33:49,370 --> 00:33:56,320
+تقاطع تقاطع معناه ان هناك نتائج غير منطقيةالخاصية
+
+380
+00:33:56,320 --> 00:33:59,380
+الثانية هي إذا حدر من أعلى إلى أسفل باتجاه اليمين
+
+381
+00:33:59,380 --> 00:34:03,720
+كما نرى من اليمين الثاني لازم توضيح العلاقة
+
+382
+00:34:03,720 --> 00:34:07,900
+العكسية بين استخدام الموردين والأطباء حيث كل ما
+
+383
+00:34:07,900 --> 00:34:10,780
+زادت الوحوزات المستخدمة من الموردين كل ما قدت
+
+384
+00:34:10,780 --> 00:34:14,520
+وحوزات مستخدمة من الأطباء المحافظة على نفسه يشبع
+
+385
+00:34:14,520 --> 00:34:20,420
+إذا زدنا عدد الموردين، نقل عدد الأطباء كما رأينا
+
+386
+00:34:20,420 --> 00:34:22,840
+هنا، ورجعنا للجدول
+
+387
+00:34:26,700 --> 00:34:31,300
+كل مزاد استخدام ممرضين سواء عند كمية Q1 أو Q2 أو
+
+388
+00:34:31,300 --> 00:34:37,180
+Q3 يعني في Q3 مثلا عند المجموع A خمس ممرضين و18
+
+389
+00:34:37,180 --> 00:34:45,960
+طالبين في المجموع B ضحينا باربع طباء وضفنا محل
+
+390
+00:34:45,960 --> 00:34:55,440
+ممرض واحد في المجموع C ضحينا باربع طباء كمان وضفنا
+
+391
+00:34:56,080 --> 00:35:00,360
+من المعرضين وهكذا لأن أنا بحل اشي ما هالاشي وانا
+
+392
+00:35:00,360 --> 00:35:09,300
+بسموه معدل الحدي للإحلال الفني معدل الحدي للإحلال
+
+393
+00:35:09,300 --> 00:35:16,860
+الفني اللي هو بسموه ال MRTS Marginal Rate of
+
+394
+00:35:16,860 --> 00:35:21,060
+Technical Specificationهو يقيس عدلة الطباء الذي
+
+395
+00:35:21,060 --> 00:35:26,220
+يجب تضحيا بهم حتى يوصلوا للسيشفة تشغيل ممرض ضافي
+
+396
+00:35:26,220 --> 00:35:29,680
+وذلك مع المحافظة على نفسه القوية الممتازة عدلة
+
+397
+00:35:29,680 --> 00:35:32,640
+المرضى الذي يمكن علاجته
+
+398
+00:35:36,040 --> 00:35:39,680
+ثلاثة يكون الحال نزل متساوي محددا بالنسبة لوقت
+
+399
+00:35:39,680 --> 00:35:43,440
+الأصلي كما رأينا في الشكل البياني كان محدد باتجاه
+
+400
+00:35:43,440 --> 00:35:48,800
+الوقت الأصلي وذلك ليعكس تناقص المعدل الحدى للإحلال
+
+401
+00:35:48,800 --> 00:35:55,040
+الفني اللي هو الـMRDS وذلك يعني أنه إذا أراد
+
+402
+00:35:55,040 --> 00:35:59,920
+المستشفى تشغيل مرض إضافي فلابد أن يضحي بوحدة
+
+403
+00:35:59,920 --> 00:36:01,000
+متناقصة من الأطباء
+
+404
+00:36:04,590 --> 00:36:11,370
+طبعاً تحدّبه نقطة نسيانة الأصل يعكس تناقص المعدل
+
+405
+00:36:11,370 --> 00:36:20,050
+الحدّي للإحلال هاي راحتين هنا هاي عندنا أساس منها
+
+406
+00:36:20,050 --> 00:36:26,850
+منهانة واحد هاي عنا مجموعات A, B, C, D, E هاي ال
+
+407
+00:36:26,850 --> 00:36:31,580
+nurses و الدكتورات المرضية طبعاً المجموعة Aوشغلنا
+
+408
+00:36:31,580 --> 00:36:38,700
+ممرض واحد و16 طبيب لعلاج الف مريض الـ MRTS،
+
+409
+00:36:38,700 --> 00:36:41,120
+المواضع الحديث الإجتماعي الفنى بين الـ Nurses
+
+410
+00:36:41,120 --> 00:36:44,100
+والدكتورين، هنا قرأت وشرت لأنه هو المجموعة
+
+411
+00:36:44,100 --> 00:36:52,480
+المجموعة التانية ضحينا 8 أطباء وشغلنا معاهم من
+
+412
+00:36:52,480 --> 00:36:59,230
+ممرضين فكان عند الـ MRTS بساوي سالب 4كيف جبنا ال
+
+413
+00:36:59,230 --> 00:37:06,190
+MRTS سواء دكتور دلتا دي ع دلتا انا ثمانية ناقص ستة
+
+414
+00:37:06,190 --> 00:37:09,970
+عشر ع تلاتة ناقص واحد بيطلع هنا سالب واحد سالب
+
+415
+00:37:09,970 --> 00:37:16,150
+اربعة سالب اربعة لان ثمانية ناقص ستة عشر سواء سالب
+
+416
+00:37:16,150 --> 00:37:20,450
+ثمانية ع تلاتة ناقص اتنين بيسوء اتنين سالب ثمانية
+
+417
+00:37:20,450 --> 00:37:24,430
+على اتنين بيسوء سالب اربعة هذا بيسمونه معدل يعني
+
+418
+00:37:24,430 --> 00:37:32,230
+احنا ضحينا باربع قطب باءمقابل تشريب ممرض واحد 8
+
+419
+00:37:32,230 --> 00:37:37,070
+أقل بقى مقابل مرضين 4 مقابل مرض واحد بعدها الشيء
+
+420
+00:37:37,070 --> 00:37:43,290
+اللي بعدها هنقول 4 ناقص 8 على 8 ناقص 3 يطلع سالب 2
+
+421
+00:37:43,290 --> 00:37:49,670
+اللي بعدها 2 ناقص 4 على 7 ناقص 5 يطلع سالب 1 عشان
+
+422
+00:37:49,670 --> 00:37:54,470
+1 ناقص 2 على 9 ناقص 7 يطلع سالب نصف الإشارة
+
+423
+00:37:54,470 --> 00:37:58,400
+السالبة هنالأنه في علاقة عكسية لأن كل سالب أربع
+
+424
+00:37:58,400 --> 00:38:04,200
+أقل من صفر السالب هنا ليس لها أي مقوم أو ودورية
+
+425
+00:38:04,200 --> 00:38:08,620
+إنما هي تعكس العلاقة العكسية بين تشغيل وموردين
+
+426
+00:38:08,620 --> 00:38:16,720
+وتشغيل الطبع كل ما ضحينا بعض المعالم وطباع شغلنا
+
+427
+00:38:16,720 --> 00:38:20,380
+محلهم مع بعض المعالم الموردين فالعلاقة عكسية نضحي
+
+428
+00:38:20,380 --> 00:38:21,480
+ونشغل
+
+429
+00:38:25,090 --> 00:38:30,230
+هنا التحذب وهنا الرصل وهنا المعدل الحدي اللي احنا
+
+430
+00:38:30,230 --> 00:38:39,410
+يعني هنا نضحينا في البداية نبتدأ هنا طبعا من 16 ل
+
+431
+00:38:39,410 --> 00:38:47,210
+8 نضحينا سبع أطباء مقابل شغلنا اثنين ممرضين
+
+432
+00:38:50,000 --> 00:38:54,400
+فلاحظ معايا إنه هنا ثمانية مقابلتين يعني كل أربع
+
+433
+00:38:54,400 --> 00:39:01,120
+مقابلهم واحد فزي شبه حين النقطة اللي بعدها باربع
+
+434
+00:39:01,120 --> 00:39:07,300
+أقدام شغلنا معاهم نين مرة دولة لحظة المسافر اللي
+
+435
+00:39:07,300 --> 00:39:14,040
+هنا من ستاشر تثمانية مسافة كبيرة المسافر بين هنا
+
+436
+00:39:14,040 --> 00:39:18,100
+المتقطع هذا بين ثمان لأربع أصغر منها شويةثم
+
+437
+00:39:18,100 --> 00:39:23,500
+المسافة بين أربعة أثنين أصغر ثم من أثنين لواحد
+
+438
+00:39:23,500 --> 00:39:27,500
+أصغر هذا متأكش الميلي اللي هو الميلي المتناقص
+
+439
+00:39:27,500 --> 00:39:32,660
+الميلي المتناقص والتناقص اللي هنا اللي صار في
+
+440
+00:39:32,660 --> 00:39:35,260
+الميلي أو في المعادل الحددي للإحلال في المعادل
+
+441
+00:39:35,260 --> 00:39:38,180
+الحددي للإحلال الفني يمثل الميلي يمثل اللي هو
+
+442
+00:39:38,180 --> 00:39:43,300
+delta D ع delta M هذا يمثل الميلي التناقص اللي في
+
+443
+00:39:43,300 --> 00:39:47,250
+الميلي هنا هي طبعا فيها المتطرفية كبيرةمقابل اثنين
+
+444
+00:39:47,250 --> 00:39:54,470
+عشان ضحينا هنا ب 8 مقابل 2 عشان ضحينا بعدد اقل من
+
+445
+00:39:54,470 --> 00:40:07,270
+4 مقابل 2 عشان ضحينا ب 1 مقابل 2 تمام؟ اذا ضحينا
+
+446
+00:40:07,270 --> 00:40:13,470
+هنا ب 2 مقابل 2 عشان ب 1 مقابل 2 فالمشافات هنا
+
+447
+00:40:13,470 --> 00:40:18,800
+كانت بداية مشافة كبيرةثم مسافة قليل من 16 إلى 8 ثم
+
+448
+00:40:18,800 --> 00:40:25,740
+مسافة أصغر من 8 إلى 4 ثم مسافة أصغر من 4 إلى 2 ثم
+
+449
+00:40:25,740 --> 00:40:30,660
+مسافة أصغر من 2 إلى 1 هذه المسافات اللي بتصغر شوي
+
+450
+00:40:30,660 --> 00:40:33,200
+شوي تعكس اللي هو ال mainly وهذا اللي بتخلي
+
+451
+00:40:33,200 --> 00:40:40,000
+الملحانة محدة باتجاه نقطة الأصل معدل إحلال الحدي
+
+452
+00:40:40,000 --> 00:40:47,180
+الفنى العصر أنحل دي تتغير في عدد المحداتD أتغير في
+
+453
+00:40:47,180 --> 00:40:51,540
+عدد وحدات من N يعني التغير في عدد الأطباء أتغير في
+
+454
+00:40:51,540 --> 00:40:57,300
+عدد المرضين يعني اللي يكون لنا ال M R T S اللي هو
+
+455
+00:40:57,300 --> 00:41:01,640
+partner-state technical solicitation بين ال nurses
+
+456
+00:41:01,640 --> 00:41:08,660
+و ال doctors فهو Delta D على Delta N طبعا
+
+457
+00:41:08,660 --> 00:41:12,060
+يلاحظ من إحلال الجدول رقم 3 و الرسم البياني رقم 7
+
+458
+00:41:12,060 --> 00:41:15,200
+أن المعدل الإحلال الحدي الفنيالمرضين والطباء
+
+459
+00:41:15,200 --> 00:41:19,040
+يتناقص عن الكمية التي يجب تتحكم بها أو الاستغناء
+
+460
+00:41:19,040 --> 00:41:22,380
+عنها من الطباء مقابل تشغيل واحدة أرافية المرضين
+
+461
+00:41:22,380 --> 00:41:27,020
+وتتناقص مع بقاء كمية الإنتاج ثابتة اللي هي الكلام
+
+462
+00:41:27,020 --> 00:41:30,020
+اللي حكيناه واضحناه قبل قليل بالشكل وتعرف هذه
+
+463
+00:41:30,020 --> 00:41:34,580
+الظاهرة ليست تناقص معدل الحد
+
+464
+00:41:34,580 --> 00:41:38,520
+الفني ويمكن تفسير ذلك من خلال استخدام الميلاد من
+
+465
+00:41:38,520 --> 00:41:42,560
+الحد المرضين ولطباء وكلمة زادت كمية استخدام
+
+466
+00:41:42,560 --> 00:41:46,010
+الميلاد المرضين اللي هو الأناللي ما تقل الناتج
+
+467
+00:41:46,010 --> 00:41:50,350
+الحددي للمرض، كل ما تزيد الكمية المستخدمة من
+
+468
+00:41:50,350 --> 00:41:53,930
+التمريد، بقل الناتج الحددي للمرض، إذا الناتج
+
+469
+00:41:53,930 --> 00:41:57,970
+الحددي بقل، بتقل كفاءة التمريد، أنا كل ما جيبت مرض
+
+470
+00:41:57,970 --> 00:42:03,710
+زيادة، بكون كفاءته أقل من المرض اللي جابناه، لأن
+
+471
+00:42:03,710 --> 00:42:08,130
+أنا في البداية بشغل المرضين أكثر كفاءة، الناتج
+
+472
+00:42:08,130 --> 00:42:12,110
+الحددي له بقل، الانتاجه بقل، وكفاءته كمان بقلوكل
+
+473
+00:42:12,110 --> 00:42:15,910
+ما قلت الكمية المستخدمة من الأطباء لوديه كل ما
+
+474
+00:42:15,910 --> 00:42:24,650
+زادت، كل ما زادت، نزل حد الأطباء كل ما كمية
+
+475
+00:42:24,650 --> 00:42:29,210
+الأطباء بتقل، زي ما موضع علينا في الجدول كل ما نزل
+
+476
+00:42:29,210 --> 00:42:31,930
+حد الأطباء بزيد، وإذا نزل حد الأطباء بزيد، بزيد
+
+477
+00:42:31,930 --> 00:42:38,370
+كفاءة الأطباء عشان أحنا لاحظنا أننا كنا نضحي بعض
+
+478
+00:42:38,370 --> 00:42:41,530
+الكثير من الأطباءعلى إتبار أن العدد الأقل يكون
+
+479
+00:42:41,530 --> 00:42:44,490
+كفاته أعلى، فما مش مشكلة لو كان الطبيب واحد يسكن
+
+480
+00:42:44,490 --> 00:42:51,270
+معاه عشر موردين أو ست موردين، فما في مشكلة، وهذا
+
+481
+00:42:51,270 --> 00:42:55,210
+يعني وجود علاقة طردية لناس يحددوا الطبيب، إذا
+
+482
+00:42:55,210 --> 00:43:00,620
+الناس يحددوا الطبيب بزيد، بزيد طبعا كفائةبالتالي
+
+483
+00:43:00,620 --> 00:43:05,300
+فإن عدد الأطباء اللازم لإعلان وحدة مرض محللة سيقل
+
+484
+00:43:05,300 --> 00:43:09,560
+إذا كانت منشأة أو مستشفى المحافظة على نفس مستوى
+
+485
+00:43:09,560 --> 00:43:13,980
+الإنتاج حيث أن مستوى الإنتاج ثابت مثلنا الصابت عند
+
+486
+00:43:13,980 --> 00:43:19,400
+ألف مريض يتم علاجه، فالانتقال من المجموعة إلى أخرى
+
+487
+00:43:19,560 --> 00:43:22,340
+هو عبارة عن انتقال من نقطة إلى أخر على نفسه من حال
+
+488
+00:43:22,340 --> 00:43:26,580
+الناس متساوي وبالتالي فإن معدل الانحلال الحد الفني
+
+489
+00:43:26,580 --> 00:43:30,660
+للعصرية التمريد اللي هو ال nurses وطباء ال doctors
+
+490
+00:43:30,660 --> 00:43:35,100
+يمثل في الحقيقة mail من حال الناس متساوي تقولنا
+
+491
+00:43:35,100 --> 00:43:39,620
+هذا يمثل ال mail ال MRTS يمثل ال mail اللي هو
+
+492
+00:43:39,620 --> 00:43:43,600
+delta D على delta N وهذا يعني ان الانتقال من
+
+493
+00:43:43,600 --> 00:43:51,450
+النقطة Aالنقطة B هي نفس المتساوي بأربع أطباء مقابل
+
+494
+00:43:51,450 --> 00:43:55,770
+تشغيل واحدة إضافية للممرضين رحنا بثمانية مقابل
+
+495
+00:43:55,770 --> 00:43:59,490
+اتنين رحنا باربع مقابل واحد هي أن معدل الإحلال
+
+496
+00:43:59,490 --> 00:44:06,450
+الحدي بين الممرضين و بين الأطباء هي عدد ساوي أربع
+
+497
+00:44:06,450 --> 00:44:11,050
+طبعا هنا بالسالب عشان هنا علاقة عكسية
+
+498
+00:44:13,660 --> 00:44:21,480
+ما يجب أن يكون المعادل الحددي للإحلال الفني بمقدار
+
+499
+00:44:21,480 --> 00:44:28,140
+تغير في D على مقدار تغير في N يعني slope of ice
+
+500
+00:44:28,140 --> 00:44:37,420
+point مرتس between nurses and doctors يساوي delta
+
+501
+00:44:37,420 --> 00:44:42,740
+D على delta Nوالواحد أخيرًا المعدل الإحلالي لحد
+
+502
+00:44:42,740 --> 00:44:47,780
+الفن فينا ال N وD هو عبارة عن النسبة بين ناتج الحد
+
+503
+00:44:47,780 --> 00:44:58,040
+دي لهم كيف؟ فانا عند ال MRTS مستوى ال MPN اللي هو
+
+504
+00:44:58,040 --> 00:45:05,120
+الناتج الحد دي للتمريد على ال MPD الناتج الحد دي
+
+505
+00:45:05,120 --> 00:45:13,750
+للأطباءويمكن إثبات أن الـMRTS between nurses and
+
+506
+00:45:13,750 --> 00:45:20,410
+doctors بيساوي MBN على MBD حيث أن المعروف أن
+
+507
+00:45:20,410 --> 00:45:30,710
+الـMRTS ND بيساوي ΔD على ΔN وكذلك فإن MBD بيساوي
+
+508
+00:45:30,710 --> 00:45:38,930
+ΔQ على ΔDو ال MPN بيساوي Delta Q على Delta N إيش
+
+509
+00:45:38,930 --> 00:45:44,050
+هذا الكلام المعنى؟ إذا النتيجة أن ال MPN على ال
+
+510
+00:45:44,050 --> 00:45:50,490
+MBT بيساوي Delta Q على Delta N تقسيم Delta Q على
+
+511
+00:45:50,490 --> 00:45:54,750
+Delta D حول القسمة إلى ضربة هقول Delta Q على Delta
+
+512
+00:45:54,750 --> 00:45:59,870
+N ضرب دلتا
+
+513
+00:45:59,870 --> 00:46:05,400
+D على Delta Qبتروح Delta Q مع Delta Q، بيصير عندي
+
+514
+00:46:05,400 --> 00:46:10,840
+الـ Mpn على Mpd بيسوي Delta D على Delta N وهذا
+
+515
+00:46:10,840 --> 00:46:13,480
+يسوي الـMRDS
+
+516
+00:46:17,740 --> 00:46:24,340
+الـ MRTS بيساوي Delta D على Delta N بيساوي NPN على
+
+517
+00:46:24,340 --> 00:46:30,140
+NPD بيساوي slope of isoquant يعني بيساوي اللي هو
+
+518
+00:46:30,140 --> 00:46:38,340
+ميل من حالة المياتج المتساوية طبعا احنا أخدنا
+
+519
+00:46:38,340 --> 00:46:46,500
+المقادرة الحالية كل أنواع التكاليف اللي بتخص القطع
+
+520
+00:46:46,500 --> 00:46:53,200
+الصحيواتكلمنا عن منحنى الناتج المتساوي وأخذنا عليه
+
+521
+00:46:53,200 --> 00:46:58,680
+المثال من القطاع الصحي طبعا إن شاء الله موضوع خط
+
+522
+00:46:58,680 --> 00:47:05,060
+التكلف متساوية والتوازن باستخدام استوازن في سوق
+
+523
+00:47:05,060 --> 00:47:11,720
+القطاع الصحي هذا إن شاء الله اتحدث عنه في المحاضرة
+
+524
+00:47:11,720 --> 00:47:17,820
+القادمة بإذن الله سبحانه وتعالىالى هنا تنتهي هذه
+
+525
+00:47:17,820 --> 00:47:23,560
+المقادرة أستغفر الله الذين لا تضيعوا ودائعه السلام
+
+526
+00:47:23,560 --> 00:47:27,860
+عليكم ورحمة الله وبركته
+
diff --git a/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/xbux-gcPRBw_raw.json b/PL9fwy3NUQKwZ4g7oJAH1_xVPxFf0yWH40/xbux-gcPRBw_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..21799de6f77a3bcb7c7fb020f3c81f2c65a8baa7
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المحاضرة المصورة رقم ستة ندعوكم أبناء الأطلال والطالبات لمزيد من الدراسة والاجتهاد لأن احنا ان شاء الله قريبا هنعلن انكوا عن quiz رقم واحد", "tokens": [27842, 16712, 3615, 20292, 2304, 27188, 36520, 6024, 104, 7649, 1829, 39896, 30544, 10874, 11622, 38207, 9957, 37495, 22653, 10874, 11622, 38207, 16247, 12610, 13672, 1829, 1975, 8315, 34105, 9154, 3224, 10874, 11622, 38207, 38637, 6027, 12984, 16472, 13412, 16606, 21984, 8032, 1863, 3615, 9566, 1829, 24793, 9673, 5016, 46958, 25720, 9673, 9381, 13063, 3660, 12602, 4587, 2304, 8608, 2655, 3660, 8717, 3215, 3615, 2407, 24793, 5551, 3555, 1863, 16606, 16247, 9566, 1211, 6027, 16070, 9566, 6027, 3555, 9307, 32767, 11622, 25708, 9154, 32748, 23557, 3794, 3660, 16070, 26108, 2655, 11296, 3215, 5296, 33456, 1975, 5016, 8315, 16472, 13412, 16606, 21984, 12174, 16572, 3555, 995, 8032, 1863, 30241, 1863, 16472, 4117, 14407, 18871, 15450, 12602, 4587, 2304, 36764, 24401], "avg_logprob": -0.22734374937911828, "compression_ratio": 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e464f968c7f30c455b9844d686dcee1263eafe90
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8.srt
@@ -0,0 +1,2007 @@
+1
+00:00:01,080 --> 00:00:03,520
+أَعوذُ بِاللهِ مِنَ الشَّيْطَانِ الرَّجِيمِ بِسْمِ اللهِ الرَّحْمَنِ
+
+2
+00:00:03,520 --> 00:00:07,380
+الرَّحِيمِ. خلينا نكمل طبعًا اللي هو وصلنا في المحاضرة
+
+3
+00:00:07,380 --> 00:00:11,380
+السابقة لعند اللي هو الـ skill اللي هو number two
+
+4
+00:00:11,380 --> 00:00:14,760
+اللي هو palpation بس عشان نتذكر احنا بنتكلم في الـ
+
+5
+00:00:14,760 --> 00:00:18,480
+skills اللي هي اللي بنعمل فيها بداية الـ physical
+
+6
+00:00:18,480 --> 00:00:22,560
+examination، وبعدين بالـ inspection، وبعدين هنشتغل
+
+7
+00:00:22,560 --> 00:00:25,440
+على الـ palpation، وبعدين هيكون percussion، وبعدين
+
+8
+00:00:25,440 --> 00:00:28,300
+auscultation، واحنا قولنا اللي في الـ inspection
+
+9
+00:00:28,300 --> 00:00:32,870
+دايمًا نستخدم إيه؟ يجب نتذكرها. دي الشريحة ابن الذكر
+
+10
+00:00:32,870 --> 00:00:36,230
+إيش أهم شيء؟ إنه بستخدم جالس، عامل أنا الـ vision والـ
+
+11
+00:00:36,230 --> 00:00:39,250
+smell، وبعدين روحت إيش؟ ووقفت على يمين المريض، وبعدين
+
+12
+00:00:39,250 --> 00:00:44,510
+بعدين وصلت لـ palpation. الـ palpation بيقول لي touch
+
+13
+00:00:44,510 --> 00:00:48,790
+feel with hands to determine. يعني أنا بمسك إيديا
+
+14
+00:00:48,790 --> 00:00:53,850
+إذا ملاحظين الصورة اللي هنا هي مقصودة إنه أنا
+
+15
+00:00:53,850 --> 00:00:57,990
+بستخدم راحة اليد وراحة الأصابع، يعني الإيد من
+
+16
+00:00:57,990 --> 00:01:02,160
+قدام. إلا في حالة واحدة اللي قدامي، هقول لكم ليش
+
+17
+00:01:02,160 --> 00:01:05,780
+بنستخدم اللي هو، لأ، عكس الإيد، يعني ظهر الإيد، ظهر
+
+18
+00:01:05,780 --> 00:01:10,300
+الإيد. من الآن بقول لكم هي بتستخدم لقياس حرارة
+
+19
+00:01:10,300 --> 00:01:16,320
+الإنسان. يعني معرفة عامة، سخن ولا مش سخن. يعني مثلًا
+
+20
+00:01:16,320 --> 00:01:20,320
+ما بينفع الواحد براحة اليد يحط إيده، يعني بهذا الكف
+
+21
+00:01:20,320 --> 00:01:25,500
+ما هيك يحط إيده على جبهة المريض. لأ، الصح إنه يجيب
+
+22
+00:01:25,500 --> 00:01:30,500
+إيده بالجهة الثانية. ليه؟ عشان الإيد مفتوحة فيها
+
+23
+00:01:30,500 --> 00:01:34,380
+soft tissue، وفيها يعني بتتكلموا blood supply كثير
+
+24
+00:01:34,380 --> 00:01:37,400
+وبتكلموا فيه كمان fatty tissue. لكن لو جبناها
+
+25
+00:01:37,400 --> 00:01:41,280
+عظمها، بتلاقي دغري skin، وفيه اللي هو nerve endings
+
+26
+00:01:41,280 --> 00:01:46,420
+مباشرة، بيقدر يسير إحساس، ويقدر يعطي إن هو المريض
+
+27
+00:01:46,420 --> 00:01:50,020
+الأمام سخن أو لا. طيب، بقولي الـ texture، واحنا
+
+28
+00:01:50,020 --> 00:01:53,880
+قولنا الـ texture إنه بستخدم إيش؟ الـ finger tips
+
+29
+00:01:53,880 --> 00:01:57,520
+يعني أطراف الأصابع، واحنا قولنا ليش؟ إنه بضغط
+
+30
+00:01:57,520 --> 00:02:02,340
+بطرفين الأصبع، زي بضغط الإبهام مثلًا، والسبابة، والوسطى
+
+31
+00:02:02,340 --> 00:02:06,600
+مع بعض. ممكن إيش؟ أعص شوية عشان أحس إيش فيه تحت الجلد
+
+32
+00:02:07,100 --> 00:02:09,620
+لما أنا أضغط على الجلد زي ما قلنا، زي واحد بيجيب و
+
+33
+00:02:09,620 --> 00:02:12,620
+بيقول لي في كيس دهني، في ورم، أو أي شيء بحاول أنا
+
+34
+00:02:12,620 --> 00:02:17,160
+أضغط عليه، وأحسّه. هذا اسمه الـ texture. أما أنا لما
+
+35
+00:02:17,160 --> 00:02:21,680
+أمسك ظهر اليد، اللي هو ممكن شفتوها في سنة أولى
+
+36
+00:02:21,680 --> 00:02:26,340
+حكينا لكم عنها، إنه اليد من ظهرها، يعني بجافها من
+
+37
+00:02:26,340 --> 00:02:30,840
+فوق، لو مسكنها وحاولنا نشد الجلد، ثم رخينا الجلد
+
+38
+00:02:30,840 --> 00:02:35,220
+وفي، أنا حاطط صورة اللي قدام، هتشوفها. هذا اسمه tear
+
+39
+00:02:35,220 --> 00:02:39,170
+guard. إيش اسمه؟ tear guard. الآن الـ temperature، uses
+
+40
+00:02:39,170 --> 00:02:41,490
+إيه؟ هي زي ما قلتها، بتشوف الـ temperature بس نستخدم
+
+41
+00:02:41,490 --> 00:02:45,710
+الـ back and front، زي ما حكينا. الـ moisture، بتشوف الـ
+
+42
+00:02:45,710 --> 00:02:52,490
+رطوبة، رطوبة الجسم، فيه عرق، فيه تصبب، فيه solution، في أي
+
+43
+00:02:52,490 --> 00:02:56,270
+شيء. لـ percussion أو حجم من هذا القبيل. الـ organ location
+
+44
+00:02:56,270 --> 00:03:01,790
+and size. بتشوف إيش الأعضاء كده موجودة، كده حجمها
+
+45
+00:03:02,430 --> 00:03:06,690
+يعني زي إنك تحس لا قدر الله وجود ورم، أو تحس تشوف
+
+46
+00:03:06,690 --> 00:03:11,790
+المعدة كيف شكلها، منطقة الـ liver كيف، وهكذا. show
+
+47
+00:03:11,790 --> 00:03:15,610
+and symmetric. إيش يعني slow... sorry، slow and
+
+48
+00:03:15,610 --> 00:03:20,270
+systematic. خليك عامل بطيء شوية شوية، وبشكل منتظم، و
+
+49
+00:03:20,270 --> 00:03:23,330
+دائمًا استخدم الـ palpation. هذا مهم، من الـ light للـ
+
+50
+00:03:23,330 --> 00:03:27,270
+deep. يعني عمرك ما تعص كثير على جسم الإنسان. لما نقول
+
+51
+00:03:27,270 --> 00:03:32,130
+light، يعني ليش؟ الضغط بخفة. لما نقول deep، الضغط بعمق.
+
+52
+00:03:32,130 --> 00:03:38,210
+لما نقول بخفة، يعني جداش بتكون؟ سنتي اتنين ماشي، لكن
+
+53
+00:03:38,210 --> 00:03:42,490
+في بعض الحالات لما نكون deep، ممكن يصل لستة وسبعة
+
+54
+00:03:42,490 --> 00:03:45,690
+سنتي. يعني بتكلم على تلاتة انش. ليه؟ خاصة في حالات
+
+55
+00:03:45,690 --> 00:03:49,610
+لما بدي أتأكد، زي في حالات الـ appendicitis، أو في
+
+56
+00:03:49,610 --> 00:03:54,210
+حالات لما بدي أشوف إذا بقدر أحس الـ gall bladder، إذا
+
+57
+00:03:54,210 --> 00:03:58,890
+اللي هو الحويصلة المرارية. اللي أنا بعيدها شوية. الـ
+
+58
+00:03:58,890 --> 00:04:01,110
+light palpation نستخدمه في إيه؟ في الـ tenderness
+
+59
+00:04:01,110 --> 00:04:04,390
+في المناطق اللي فيها ألم. الـ deep palpation بيستخدم
+
+60
+00:04:04,390 --> 00:04:07,150
+دائمًا لما نكون في abdominal organs زي ما احنا
+
+61
+00:04:07,150 --> 00:04:10,430
+قولنا، من الحس، أو في لا قدر الله masses أطلعوا
+
+62
+00:04:10,430 --> 00:04:13,590
+كيف المنظر اللي احنا قدامه فيه light palpation
+
+63
+00:04:13,590 --> 00:04:17,610
+الطبيب عامله، حاطط إيده زي ما أنتم ملاحظينه
+
+64
+00:04:17,610 --> 00:04:21,580
+مواقف هنا على اليمين، الإيد اللي مستخدمها إيده طبعًا
+
+65
+00:04:21,580 --> 00:04:25,240
+ما فيش فيها أظافر، وهذا كثير لازم نفهمه، لأن كثير
+
+66
+00:04:25,240 --> 00:04:29,940
+مرات بتصير إشكالية، بعض الطبيبات بالذات بتخليها
+
+67
+00:04:29,940 --> 00:04:33,380
+أظافرها طويلة، أو أظافرها ما بعرف، ومرات تلاقي أطباء كمان
+
+68
+00:04:33,380 --> 00:04:38,280
+فبيجي بضغط، بيتوجع المريض مباشرة، فبيفكر إنه فيه ألم
+
+69
+00:04:38,280 --> 00:04:41,620
+في هذا المكان، هو ما تألمش من أي problem، وإنما
+
+70
+00:04:41,620 --> 00:04:47,040
+تألم من الأظافر تبع الطبيب. لاحظين كيف اتديب، و
+
+71
+00:04:47,040 --> 00:04:50,330
+لاحظين كيف الـ light الآن هيديب. شوف كيف إذا بتطلع
+
+72
+00:04:50,330 --> 00:04:53,350
+معايا. مع الضغط، حتى هي الخيار اللي مبين، ضغط
+
+73
+00:04:53,350 --> 00:04:56,690
+أصابعه لجوة، خاصة في منطقة الـ McBurney's point، أو
+
+74
+00:04:56,690 --> 00:05:00,250
+بنتكلم الـ right، هي الـ lower quadrant، اللي هي منطقة
+
+75
+00:05:00,250 --> 00:05:03,650
+الـ appendix site. أما هنا لاحظوا إنه كان حاطط إيده
+
+76
+00:05:03,650 --> 00:05:07,390
+مفتوحة. هنا مضغوطة شوية، خاصة في المناطق اللي إيش
+
+77
+00:05:07,390 --> 00:05:11,560
+إذا بدك تعمل deep assessment. principles for
+
+78
+00:05:11,560 --> 00:05:15,900
+accurate palpation. شو المبدأ والأساسيات عشان يكون
+
+79
+00:05:15,900 --> 00:05:19,160
+عندنا الـ palpation دقيق جدًا. أول حاجة، الـ examiner
+
+80
+00:05:19,160 --> 00:05:22,880
+fingers حكينا عنها، لازم يكونش معلوم short. طيب، use
+
+81
+00:05:22,880 --> 00:05:25,860
+the sensitive part. حكينا عنها، استخدم إيش؟ منطقة
+
+82
+00:05:25,860 --> 00:05:30,220
+الحساسة من أصابعك. ما تستخدم من اللي هو ظهر الأصابع.
+
+83
+00:05:30,220 --> 00:05:33,800
+ابدأ بالـ light palpation، وبعدين خش على وين؟ على الـ
+
+84
+00:05:33,800 --> 00:05:37,100
+deep palpation. حكيناها. start with a light then
+
+85
+00:05:37,100 --> 00:05:40,160
+deep palpation. لاحظين إن احنا كلام بعيد بعضه. Tender
+
+86
+00:05:40,160 --> 00:05:42,600
+area، إشمالها، المنطقة اللي فيها ألم، إيش بيقولوا؟
+
+87
+00:05:42,600 --> 00:05:46,020
+palpated last. يعني في الآخر بنحاول نعمل assessment
+
+88
+00:05:46,020 --> 00:05:50,820
+حاضر. client must relax during palpation. لازم
+
+89
+00:05:50,820 --> 00:05:55,060
+المريض يكون مرتاح أثناء الـ palpation. خلي الـ client
+
+90
+00:05:55,060 --> 00:05:58,360
+دائمًا إيش؟ هنا ياخد دائمًا deep breath. الإنسان
+
+91
+00:05:58,360 --> 00:06:03,180
+الطبيعي، لما بنقوله خذ نفس عميق، ويلا طلعوا شوية
+
+92
+00:06:03,180 --> 00:06:06,540
+شوية. مجرد ما الإنسان ياخد نفس عميق ويطلع شوية شوية
+
+93
+00:06:06,540 --> 00:06:10,650
+إيش بيصير عنده؟ بقول لها enhance muscle relaxation.
+
+94
+00:06:10,650 --> 00:06:15,510
+بتلاقي عضلات بطنه بترتخي، عضلات جسمه بترتخي، بيصير
+
+95
+00:06:15,510 --> 00:06:19,950
+الإمكانية إنه نعمل palpation بشكل دقيق وصحيح. لكن
+
+96
+00:06:19,950 --> 00:06:24,330
+لو كان شادد، يعني تخيلوا معايا لو البطن عضلتها شادة
+
+97
+00:06:24,330 --> 00:06:27,490
+وأنا حاطط إيدي على البطن، لقيت عضلة شادة، إيش
+
+98
+00:06:27,490 --> 00:06:31,710
+هأقول؟ هأقول there is إيش؟ acute abdomen. كلمة acute
+
+99
+00:06:31,710 --> 00:06:34,990
+abdomen، أو severe abdominal pain، أو مثلًا abdominal
+
+100
+00:06:34,990 --> 00:06:39,290
+rigidity. يعني معناته في مشكلة. فأنا ما بأستعجلش الحكم، و
+
+101
+00:06:39,290 --> 00:06:42,370
+إنما بأطلب من المريض إنه يكون soft and relaxed
+
+102
+00:06:42,370 --> 00:06:47,210
+during deep respiration, inspiration and expiration.
+
+103
+00:06:47,210 --> 00:06:52,150
+طيب، بقول هنا depressed area. المنطقة اللي بدك تضغط
+
+104
+00:06:52,150 --> 00:06:56,350
+عليها must be approximately 2 cm. يعني لو بدنا نعمل
+
+105
+00:06:56,760 --> 00:06:59,880
+لو بدنا نعمل في الـ light touch، ما نضغطش كثير. حاول
+
+106
+00:06:59,880 --> 00:07:03,220
+نضغط قداش؟ يعني لو بدنا نضغط ما نضغطش إلا 2 cm، إلا
+
+107
+00:07:03,220 --> 00:07:06,620
+في بعض الحالات لما بدنا نديب شيء ثاني. assist
+
+108
+00:07:06,620 --> 00:07:09,580
+teargar. رجع نقولها كلمة teargar. الـ teargar شو هو؟
+
+109
+00:07:09,580 --> 00:07:15,040
+بيقول لي slightly، يعني بشكل خفيف. grasping، تشد الـ
+
+110
+00:07:15,040 --> 00:07:21,360
+body part with fingertips. أنت شد الجلد تبع المريض
+
+111
+00:07:21,360 --> 00:07:29,160
+بأطراف أصابعك، وأفضل شيء إنك تمسكه بالإبهام وبإيه؟
+
+112
+00:07:29,160 --> 00:07:32,720
+بإصبع السبابة. بالإبهام وإصبع السبابة. كل واحد فينا
+
+113
+00:07:32,720 --> 00:07:37,500
+بيقدر يعمله نفسه. بيمسك ظهر الإيد اليسرى، وبروح
+
+114
+00:07:37,500 --> 00:07:40,720
+بأصابع اللي هو الإبهام والسبابة بتاعة الإيد اليمنى
+
+115
+00:07:40,720 --> 00:07:46,660
+وبمسك ظهر الإيد اليسرى، وبشدّه. بشد الجلد، ثم برخيّه.
+
+116
+00:07:46,660 --> 00:07:50,300
+الآن، إذا رجع مباشرة الجلد بنقول إيش هنا؟ بنقول
+
+117
+00:07:50,300 --> 00:07:55,450
+elastic skin. لما بنقول كلمة elastic skin، يعني الجلد
+
+118
+00:07:55,450 --> 00:07:59,830
+كويس، وبرجع طبيعي. لما ما يرجعش الجلد بنسميه
+
+119
+00:07:59,830 --> 00:08:03,170
+inelastic. إيش الفرق بين elastic و inelastic؟ و
+
+120
+00:08:03,170 --> 00:08:07,510
+بيمكانكم تشوفوا حتى بعض المقاطع على الفيديو
+
+121
+00:08:07,510 --> 00:08:11,410
+بتشدها، بتحكينا عن هذا الكلام في اليوتيوب. هذا بيعني
+
+122
+00:08:11,410 --> 00:08:17,190
+إن inelastic، أما dehydration، أو some problems. يعني
+
+123
+00:08:17,190 --> 00:08:21,910
+وللأسف، قد يكون إنه في low fluid in the body. ما فيش
+
+124
+00:08:21,910 --> 00:08:26,740
+سوائل، أو aging process، يعني مع كبر السن، زاي العجائز.
+
+125
+00:08:26,740 --> 00:08:33,220
+الـ percussion. الـ percussion زي بتلاحظوا معايا، هي
+
+126
+00:08:33,220 --> 00:08:38,460
+المريض جالس شوية، وظهر ظهره وهي الطبيب. لاحظين
+
+127
+00:08:38,460 --> 00:08:42,500
+معايا. كثير من الناس، ويمكن أنا حزين أقول لكم اللي
+
+128
+00:08:42,500 --> 00:08:46,140
+على الأطباء كمان. كثير منهم بيخطئوا، بيصير عندهم
+
+129
+00:08:46,140 --> 00:08:49,920
+بيعملوا صح، بيعملوا percussion، بس incorrect. يعني
+
+130
+00:08:49,920 --> 00:08:56,360
+ما بيكونش دقيق. لما نكون correct، ها يكون يعني true
+
+131
+00:08:56,360 --> 00:09:00,260
+percussion. لا نستخدم إلا إصبعين. أخليكم معايا. لا
+
+132
+00:09:00,260 --> 00:09:03,700
+نستخدم إلا إيه؟ إصبعين. هالجيتها، هذي الـ E اليسرى، و
+
+133
+00:09:03,700 --> 00:09:08,240
+هذي الـ A، اليوم فوق اليمنى. الآن الـ E اليسرى، بناخد
+
+134
+00:09:08,240 --> 00:09:13,800
+الـ middle finger of the left hand، and middle
+
+135
+00:09:13,800 --> 00:09:19,250
+finger of the right hand. هنا بنحط الـ A. أخليكم
+
+136
+00:09:19,250 --> 00:09:24,450
+معايا. هنا بنحط إيه؟ الإصبع تبع اليد اليسرى على
+
+137
+00:09:24,450 --> 00:09:29,750
+جلد المريض مباشرة، جسم المريض، ويطرق. أه، هذا
+
+138
+00:09:29,750 --> 00:09:34,410
+المكان الثاني، يطرق بالإصبع تبع الإيد اليمنى فوق
+
+139
+00:09:34,410 --> 00:09:38,270
+الـ distal phalanges. إيش عن distal phalanges؟ آخر
+
+140
+00:09:38,270 --> 00:09:41,670
+الآن. أطلعوا كيف؟ جمع phalanges، اللي هو phalanges
+
+141
+00:09:41,670 --> 00:09:45,070
+إيش هالـ phalanges؟ اللي هو... بنتكلم على فقرات
+
+142
+00:09:45,070 --> 00:09:50,950
+الأصبع نفسه. كل إصبع فينا فيه three phalanges، فيه
+
+143
+00:09:50,950 --> 00:09:55,230
+تلاتة. فيه الـ... اللي هو أول حاجة، وفيه اللي هو الـ
+
+144
+00:09:55,230 --> 00:09:59,450
+الوسط، وفيه الأخيرة اللي هي الطرفية. الطرفية بنسميها
+
+145
+00:09:59,450 --> 00:10:07,670
+distal. فأنا بدي لما نضغط بإصبعنا الأيسر على الجسم، و
+
+146
+00:10:07,670 --> 00:10:12,370
+يجي إصبعنا الأيمن يضغط فوقه، يضغط على... بس على
+
+147
+00:10:12,370 --> 00:10:17,110
+آخر phalanges. عشان ما بديش يضرب على أي مكان، بدي يضرب
+
+148
+00:10:17,110 --> 00:10:20,550
+على منطقة الـ joint، لأن منطقة الـ joint هو اللي
+
+149
+00:10:20,550 --> 00:10:23,930
+بيعمل إياه الصوت. وإن شاء الله إذا ربنا قدر قعدنا
+
+150
+00:10:23,930 --> 00:10:27,350
+إن شاء الله للجامعة، همثل أمامكم عمليًا، وهتكون
+
+151
+00:10:27,350 --> 00:10:30,570
+أمور واضحة. والآن لو فتحنا أي مقطع على اليوتيوب
+
+152
+00:10:30,570 --> 00:10:37,300
+هيريحنا، أو ما يكون في أي مشكلة. طيب، إذا بتلاحظوا الـ
+
+153
+00:10:37,300 --> 00:10:39,780
+percussion اللي بقول لي هنا، بقول لي tapping body
+
+154
+00:10:39,780 --> 00:10:43,000
+parts. إيش يعني tapping؟ يعني كأنك بتنقرها، كأنك
+
+155
+00:10:43,000 --> 00:10:48,880
+بتعمل هذا الصوت. بتنقر إيش؟ على الجسم. تؤسس إيه؟ عشان
+
+156
+00:10:48,880 --> 00:10:52,740
+تشوف هل في tenderness، تشوف الـ size، تشوف الـ
+
+157
+00:10:52,740 --> 00:10:58,040
+location، تشوف الـ density، الكثافة. يعني هل كثيف كثير
+
+158
+00:10:58,040 --> 00:11:03,280
+هذا التجمع اللي حسيته، أو الورم؟ ولا قليل؟ في direct
+
+159
+00:11:03,280 --> 00:11:07,620
+وفي indirect. الـ direct percussion بستخدم إيش هنا؟
+
+160
+00:11:07,620 --> 00:11:11,740
+إما إصبع أو إثنين. one or two fingers. زي إيه؟ إزاي؟
+
+161
+00:11:11,740 --> 00:11:14,440
+في حالة الـ sinuses، زي واحد بيقول لك أنا عنده صداع،
+
+162
+00:11:14,440 --> 00:11:18,940
+باجي أنا بطرق على جبهته من الأمام طرقة بسيطة، و
+
+163
+00:11:18,940 --> 00:11:22,540
+بقول له إيه؟ حاسس أنت فيه، عندك ألم ولا لأ؟ الطرق
+
+164
+00:11:22,540 --> 00:11:26,820
+البسيط هذا، بتدلل إنه في عنده ألم ولا لأ. إذا عنده
+
+165
+00:11:26,820 --> 00:11:29,920
+ألم، بقول في عنده sinusitis. طبعًا هذا اسمه direct.
+
+166
+00:11:29,920 --> 00:11:34,420
+لما نقول indirect، لأ، اللي هو هذا الـ indirect هو
+
+167
+00:11:34,420 --> 00:11:38,130
+هذا. بس إيش نشرحهم؟ خلينا نشرحهم إنه بستخدم الـ
+
+168
+00:11:38,130 --> 00:11:42,590
+middle finger، إصبعي اللي في النص، of
+
+223
+00:15:02,730 --> 00:15:06,170
+لفوق أما الـ cardiac sphincter اللي بيبقى على فوق بدايته
+
+224
+00:15:06,170 --> 00:15:09,190
+اللي بيسموه الـ cardiac sphincter اللي هو بدايته
+
+225
+00:15:09,190 --> 00:15:13,610
+جاية شوية على الوسط يعني قريبة شوية من وسط الصدر
+
+226
+00:15:13,610 --> 00:15:18,990
+الدل.. إيش هذا الدل؟ الصوت اللي بيسموه القاتم صوت
+
+227
+00:15:18,990 --> 00:15:22,810
+غليظ زي إيش صوت الـ liver و الـ spleen لو حد سأله إن
+
+228
+00:15:22,810 --> 00:15:26,170
+الـ liver على جبالي المعدة على اليمين وبيأخد له شوية
+
+229
+00:15:26,170 --> 00:15:30,890
+حيز طب وين الـ spleen؟ بنذكركم على شمال تحت الـ stomach؟
+
+230
+00:15:30,890 --> 00:15:35,990
+تحت شوية من اللي هو الـ stomach تحت اللي هو المعدة
+
+231
+00:15:35,990 --> 00:15:41,040
+الصوت المسطح اللي هو إيش بقوله يعني no air
+
+232
+00:15:41,040 --> 00:15:44,760
+يعني ما فيه لا هوا ولا فيه solution طب هي إيش زي
+
+233
+00:15:44,760 --> 00:15:48,980
+إيش بقوله زي الـ thigh muscles زي عضلة الفخد زي الـ
+
+234
+00:15:48,980 --> 00:15:54,180
+bone العظم زي الـ tumor لا قدر الله إن فيه tumor
+
+235
+00:15:54,180 --> 00:15:58,300
+وعمليه solid يعني جامد فلما بضغط عليه اسمه إيش
+
+236
+00:15:58,300 --> 00:16:02,440
+أنا flat زي ما نضغط على اللوح المسطح أو نضغط على
+
+237
+00:16:02,440 --> 00:16:09,160
+الحيط اسمه flat طيب الـ stethoscope طبعا أنا هذه أجهزة
+
+238
+00:16:09,160 --> 00:16:12,700
+بستخدموها للسماع خاصة مش إحنا وفي بعضهم بيستخدموها
+
+239
+00:16:12,700 --> 00:16:17,810
+جديد كمان في عمليات الـ ultrasound اللي هو لما بدنا
+
+240
+00:16:17,810 --> 00:16:20,750
+نعمله خاصة للـ pediatric الأطفال إحنا اللي بيعنينا
+
+241
+00:16:20,750 --> 00:16:25,010
+السماعة هذه لكن السماعة اللي أنا بقصدها مش السماعة
+
+242
+00:16:25,010 --> 00:16:28,030
+العادية اللي بين إيديكم أنا بتكلم على الـ medical
+
+243
+00:16:28,030 --> 00:16:31,650
+stethoscope الـ medical stethoscope اللي هي رأسين و
+
+244
+00:16:31,650 --> 00:16:34,870
+أكيد منكم كتير اللي جرب حاجة من حد يسمع إن أنا
+
+245
+00:16:34,870 --> 00:16:38,730
+بحكي هيتذكرها فيه حاجة اسمها بالـ diaphragm إيش يعني
+
+246
+00:16:38,730 --> 00:16:42,190
+بالـ diaphragm يعني لحفتين حفة كبيرة زي اللي موجودة
+
+247
+00:16:42,190 --> 00:16:45,070
+عندكم اللي هي المسطح الدائرية اللي موجودة في
+
+248
+00:16:45,070 --> 00:16:49,300
+السماعة اللي معاكم، والتانية هي الصغيرة
+
+249
+00:16:49,300 --> 00:16:53,540
+جدا اللي بيستخدموها لما بدهم يسمعوا أصوات دقات
+
+250
+00:16:53,540 --> 00:17:00,000
+القلب وأصوات حركات القلب خاصة في الأطفال طيب الآن
+
+251
+00:17:00,000 --> 00:17:03,220
+الـ stethoscope إذا بنتكلم على السماعة الآن إيش
+
+252
+00:17:03,220 --> 00:17:07,200
+بيقول لي هذه السماعة اللي أنا حكيتها هذا الطرف اسمه
+
+253
+00:17:07,200 --> 00:17:12,660
+bell side وهذا الواسع اسمه diaphragm أنا بذكركم
+
+254
+00:17:12,660 --> 00:17:17,950
+ياريت الكل لما بقول diaphragm الـ G لا تلفظ الـ G
+
+255
+00:17:17,950 --> 00:17:22,410
+silent diaphragm مش diaphragm نوع يبقى معناه
+
+256
+00:17:22,410 --> 00:17:24,830
+diaphragm وهذا اللي اللي أنا بدي أستخدمه بالـ
+
+257
+00:17:24,830 --> 00:17:30,370
+assessment تستخدمه هو هذه السماعة هذه السماعة
+
+258
+00:17:30,370 --> 00:17:34,490
+اسمها إيه اسمها medical stethoscope طبعا ممكن إحنا
+
+259
+00:17:34,490 --> 00:17:38,050
+نستخدم سماعة تانية لكن إن وجدت هذه هي الأفضل في الـ
+
+260
+00:17:38,050 --> 00:17:43,850
+assessment طيب طيب ليش أنا بقى أستخدم الـ
+
+261
+00:17:43,850 --> 00:17:48,370
+auscultation بستخدم auscultation كمان مرة listening
+
+262
+00:17:48,370 --> 00:17:52,390
+to body sounds يعني بده أشوف أصوات اللي هو الجسم،
+
+263
+00:17:52,390 --> 00:17:55,430
+بده أشوف الـ movement of air، حركة الهواء زي في الـ
+
+264
+00:17:55,430 --> 00:17:59,210
+lungs، بده أشوف الـ blood flow زي حكاية الـ heart،
+
+265
+00:17:59,210 --> 00:18:02,730
+بده أشوف الـ fluid، الـ gas movement زي في الـ bowels
+
+266
+00:18:02,730 --> 00:18:06,650
+اللي هو يعني الأمعاء، remember دائما the sound
+
+267
+00:18:06,650 --> 00:18:11,190
+changes، دائما بتتذكر ده فيه أصوات متغيرة في الجسم
+
+268
+00:18:11,190 --> 00:18:17,180
+الإنسان عشان أنت تقدر تعرفها طيب خلينا نكمل how to
+
+269
+00:18:17,180 --> 00:18:20,140
+begin كيف أنا أبدأ بيقول لي الـ positions دائما الـ
+
+270
+00:18:20,140 --> 00:18:22,640
+positions اللي إحنا حكينا صورهم في الأول بس
+
+271
+00:18:22,640 --> 00:18:26,020
+بنذكركم هنا بيقول لي دائما أستخدم الـ position
+
+272
+00:18:26,020 --> 00:18:30,280
+المناسب لما أنت تتعامل يعني ممكن يكون شوية قاعد
+
+273
+00:18:30,280 --> 00:18:33,780
+ممكن يكون شوية نايم على جنبه بس على بطنه لأ ما بينفعش
+
+274
+00:18:33,780 --> 00:18:36,260
+و recumbent مش هينفع زي ما إحنا هنقوله لأنه بيثني
+
+275
+00:18:36,260 --> 00:18:41,560
+العضلات البطن طيب بيقول أستخدم هنا يعني ما تستخدم
+
+276
+00:18:41,560 --> 00:18:46,100
+يعني بيجي بعض الناس بيقول أتجاسر هستخدم اللي هو الـ
+
+277
+00:18:46,100 --> 00:18:49,660
+stethoscope طبعا هذه الـ..السطر هذا كله يقصد هنا
+
+278
+00:18:49,660 --> 00:18:52,940
+إنه بيقول longer the tube more sound has to travel
+
+279
+00:18:52,940 --> 00:18:57,580
+إحنا مش شرط يعني نستخدم يعني طويل جدا إحنا السماعة
+
+280
+00:18:57,580 --> 00:19:01,740
+اللي معناها تقريبا يمكن طول الـ..الطول يمكن
+
+281
+00:19:01,740 --> 00:19:05,380
+أربعين، خمسين سم حتى ما بتوصلش خمسين سم، أربعين
+
+282
+00:19:05,380 --> 00:19:09,160
+سم تقريبا ما بين اللي هو رأس السماعة وما بين
+
+283
+00:19:09,160 --> 00:19:13,820
+أنا بدي أبدأ أسمع له استخدمنا أطول مش كويس يعني مش
+
+284
+00:19:13,820 --> 00:19:16,200
+..مش معقول واحد يكون بيستخدم له يعني زي مترين
+
+285
+00:19:16,200 --> 00:19:19,640
+عشان يسمع فهو يعني كأنه بيقولنا نستخدم السماعة
+
+286
+00:19:19,640 --> 00:19:23,420
+الطبيعية hold the diaphragm firmly إيش يعني الـ diaphragm
+
+287
+00:19:23,420 --> 00:19:26,820
+إحنا قلنا هي الـ diaphragm عشان أنا قلت كم مرة هي
+
+288
+00:19:26,820 --> 00:19:30,540
+الـ diaphragm هيهم طبعا إيش بيقول لي امسك الـ diaphragm
+
+289
+00:19:30,540 --> 00:19:34,740
+إيش بيقول لي امسك الـ diaphragm against يعني حطها على
+
+290
+00:19:34,740 --> 00:19:38,200
+إيش على skin of the..of the client against the
+
+291
+00:19:38,200 --> 00:19:43,620
+client's skin يعني اضغطها مباشرة بدون إيش هنا ها not
+
+292
+00:19:43,620 --> 00:19:48,020
+through clothing إيش يعني مش من خلال الملابس ليه؟
+
+293
+00:19:48,020 --> 00:19:51,760
+عشان ما يصيرش الصوت يتخربط أما الـ..الـ..الـ
+
+294
+00:19:51,760 --> 00:19:55,280
+لما تستخدم الـ bell اللي هو الجزء الصغير..الجزء
+
+295
+00:19:55,280 --> 00:19:58,800
+الصغير من السماعة ما تضغطش كتير لأن لما تضغط..
+
+296
+00:19:58,800 --> 00:20:01,640
+تضغط كتير كأنك ممكن تزعج المريض لأنه أنت تتخيل
+
+297
+00:20:01,640 --> 00:20:04,800
+معاه، الآن الـ diaphragm واسع لما نضغط عليه بيضغط
+
+298
+00:20:04,800 --> 00:20:08,140
+..ما نزلش كتير في جسم الإنسان أما لما نستخدم الصغير
+
+299
+00:20:08,140 --> 00:20:10,740
+اللي هو الطرف الصغير بتلاقي الإنسان اللي هو
+
+300
+00:20:10,740 --> 00:20:13,800
+السماعة دخلت جوه شوية عشان إيه؟ عشان ما نضغط كتير
+
+301
+00:20:13,800 --> 00:20:20,700
+listen خلي إيديك تكون دافيات شوية عشان ما يبرُدش خاصة
+
+302
+00:20:20,700 --> 00:20:24,980
+في الأطفال بعدين اسمع كويس وحاول تركز في إيه؟ في
+
+303
+00:20:24,980 --> 00:20:29,000
+الأصوات olfaction لو حدثنا عن olfaction هو
+
+304
+00:20:29,000 --> 00:20:32,580
+another skill يعني حاجة تانية بس كويسة ومهمة و
+
+305
+00:20:32,580 --> 00:20:36,360
+بدنا إياها بتلزمنا في إيش يا أستاذ؟ بتلزمنا إن
+
+306
+00:20:36,360 --> 00:20:41,500
+ممكن يكون في بعض الروايح تطلع من المريض يبتعمل شغلات
+
+307
+00:20:41,500 --> 00:20:45,560
+خطيرة زي كيف الـ body odors ما بقولك تعال شم المريض
+
+308
+00:20:45,560 --> 00:20:48,260
+أو إيه كيف كإنك تشم إيده ورجليه، no no no مش هذا
+
+309
+00:20:48,260 --> 00:20:53,200
+اللي قصد، بيطلع بعض الأشياء اللي بتعمل عنده بعض
+
+310
+00:20:53,200 --> 00:20:58,580
+الأشياء اللي بتعمل عنده ريحة معينة وهذه الريحة ممكن
+
+311
+00:20:58,580 --> 00:21:03,380
+شوية تدل إن فيه مشكلة زي حاجة الآن هقولك هي
+
+312
+00:21:03,380 --> 00:21:07,140
+اسمها diabetic ketoacidosis مثلا diabetic
+
+313
+00:21:07,140 --> 00:21:10,500
+ketoacidosis زي إيش اللي هو حرقة السكر اللي بيصير
+
+314
+00:21:10,500 --> 00:21:17,220
+عند بعض المرضى اللي عندهم سكر هأقول لكم كيف خلينا
+
+315
+00:21:17,220 --> 00:21:20,440
+نقول الآن smelling بيقول لي بدك تشم عشان إذا فيه
+
+316
+00:21:20,440 --> 00:21:26,220
+abnormalities إذا فيه أي أشياء غير طبيعية غير طبيعية
+
+317
+00:21:26,220 --> 00:21:31,180
+ممكن تحددها عن طريق الشم فلو مريض السكر هذا مريض
+
+318
+00:21:31,180 --> 00:21:37,460
+السكر الآن فيه مشكلة عنده حرقة السكر حرقة السكر
+
+319
+00:21:37,460 --> 00:21:41,680
+لما حرقة السكر صار عنده بدل ما يستخدم الآن الـ
+
+320
+00:21:41,680 --> 00:21:45,650
+glucose و الـ carbohydrate صار يستخدم جسمه الفات
+
+321
+00:21:45,650 --> 00:21:49,310
+صار حمضية في الدم وإنتوا عارفين بيصير كل gram
+
+322
+00:21:49,310 --> 00:21:52,430
+يطلع تسعة kilo calorie في الفات فهنا بيسموه حمضية
+
+323
+00:21:52,430 --> 00:21:57,810
+في الدم فكيف بنعرفها فقط من ريحة نفس المريض بيبقى
+
+324
+00:21:57,810 --> 00:22:03,350
+نفسه ريحته زي التفاح أكرمني الله المعفن زي الريحة
+
+325
+00:22:03,350 --> 00:22:08,490
+التفاح المخمر يعني زي اللي متروك لوقت كبير وصار له
+
+326
+00:22:08,490 --> 00:22:12,430
+ريحة سيئة هذه الريحة بتدلنا إن إيش إن حد صار
+
+327
+00:22:12,430 --> 00:22:15,490
+عنده diabetic ketoacidosis ولو ما شميناش هذه الريحة
+
+328
+00:22:15,490 --> 00:22:19,410
+مش هنقدر نتأكد إلا من فحصات تانية assessment بيقول لي
+
+329
+00:22:19,410 --> 00:22:23,190
+of characteristic odors كيف طب لإيش أنت بدك تقول لنا
+
+330
+00:22:23,190 --> 00:22:27,550
+الروائح عشان إيش اللي بدك تشمهم بيقول لي مثلا alcohol
+
+331
+00:22:27,550 --> 00:22:33,200
+لو شمينا ريحة الـ alcohol لا قدر الله، هو الحمد لله
+
+332
+00:22:33,200 --> 00:22:35,940
+في غزة، الحمد لله يعني الشرب مش موجود هذا الكلام،
+
+333
+00:22:35,940 --> 00:22:39,060
+إلا نادر، لو شمينا ريحة الكحول زي ما موجود للأسف
+
+334
+00:22:39,060 --> 00:22:43,200
+عند كتير من بعض البلدان بره، من الفم، هنقول فورا
+
+335
+00:22:43,200 --> 00:22:47,880
+إن هذا ingestion of alcohol، يعني شارب كحول، يعني
+
+336
+00:22:47,880 --> 00:22:51,930
+مدمن، بمعنى طب لو شمينا ريحة الأمونيا النشادر من
+
+337
+00:22:51,930 --> 00:22:54,390
+اليورين، يعني واحد أجي قال لي يا أستاذ أنا بدأ
+
+338
+00:22:54,390 --> 00:22:58,270
+أكون شاطر، أنا الآن ما أخد مادة assessment والناس
+
+339
+00:22:58,270 --> 00:23:00,810
+عاملاني بتقدم في العلم وأنا حكيت لكم في البداية
+
+340
+00:23:00,810 --> 00:23:04,290
+ممكن تكون هذه أهم مادة في كل الكلية تمام، مش
+
+341
+00:23:04,290 --> 00:23:07,590
+بقولها عشان أنا بدرسها، لأ عشان هتنفعك وتنفعك
+
+342
+00:23:07,590 --> 00:23:10,530
+لمدى الحياة، بيجينا واحد بيقول لك أنا بروح الحمام
+
+343
+00:23:10,530 --> 00:23:15,030
+بشم ريحة سيئة ريحة سيئة كتير بيقول لك زي النشادر
+
+344
+00:23:15,030 --> 00:23:19,370
+بنقول له أفحص البول لأن هذا بيقل إنه عندك UTI اللي
+
+345
+00:23:19,370 --> 00:23:22,630
+هو إيش اختصارها اختصار لـ urinary tract infection
+
+346
+00:23:22,630 --> 00:23:27,390
+طيب bad odor from skin لو شمينا ريحة مش كويسة لكن
+
+347
+00:23:27,390 --> 00:23:31,050
+في الـ skin under arms يعني تحت الإبط أو تحت الـ
+
+348
+00:23:31,050 --> 00:23:35,150
+breast إيش هذا بتقولي فيه poor hygiene طب واحد
+
+349
+00:23:35,150 --> 00:23:41,250
+عنده أو عنده excess perspiration التعرق زاد المصطلح
+
+350
+00:23:41,250 --> 00:23:44,130
+الغريب اللي كتير الناس مايعرفوش لما نصير عند
+
+351
+00:23:44,130 --> 00:23:48,930
+المريض متعرق زائد كتير إيش اسمه bromhidrosis إيش
+
+352
+00:23:48,930 --> 00:23:52,990
+اسمه bromhidrosis لما نقول كلمة bromhidrosis يعني
+
+353
+00:23:52,990 --> 00:23:57,250
+excessive perspiration التعرق الزائد اللي بيصير
+
+354
+00:23:57,250 --> 00:23:59,710
+عند بعض الناس في الأيدين أو تحت الإبط أو تحت الـ
+
+355
+00:23:59,710 --> 00:24:04,050
+breast طيب foul smelling الريحة السيئة اللي مرات
+
+356
+00:24:04,050 --> 00:24:07,330
+بتكون عند الـ perspiration برضه بندور عليها مش كل الناس
+
+357
+00:24:07,330 --> 00:24:12,080
+عنده ريحة لكن لو كانت موجودة بندور عليها طب ريحة الفيسز
+
+358
+00:24:12,080 --> 00:24:17,120
+أكرمني الله يعني ريحة يعني كأنه ريحة وسخ ريحة
+
+359
+00:24:17,120 --> 00:24:20,400
+الـ pus هذه لو طلعت من الـ wound إيش هنشك؟ إذا اجت
+
+360
+00:24:20,400 --> 00:24:22,820
+من الـ wound فورا هنشك في الـ إيش؟ wound abscess.
+
+361
+00:24:23,460 --> 00:24:26,340
+الآن لو شمينا لا قدر الله نفس الريحة بس من وين؟ من
+
+362
+00:24:26,340 --> 00:24:30,660
+الـ vomitus يعني أجتني حالة وقعدت في المستشفى أو
+
+363
+00:24:30,660 --> 00:24:34,740
+في البيت ما لها إله أكمن يوم ما بروحش الحمام يعني ما
+
+364
+00:24:34,740 --> 00:24:38,320
+بيخرجش فيه يمكن تلت أربع أو خمس أيام وعاملة بيصير
+
+365
+00:24:38,320 --> 00:24:40,800
+عنده vomiting كل ما بيأكل بيصير عنده vomiting لما
+
+366
+00:24:40,800 --> 00:24:43,360
+بشم ريحة الـ vomiting كان صار فيه عنده ريحة feces
+
+367
+00:24:43,360 --> 00:24:47,620
+إيش بأشك فورا؟ intestinal obstruction يعني بوا الـ
+
+368
+00:24:47,620 --> 00:24:51,680
+obstruction انسداد معوي علشان هيك بنقول له لأ تعال
+
+369
+00:24:51,680 --> 00:24:55,600
+فورا هذا اللي زيه حالة سريعة بدنا نحاول إيش نعمل a
+
+370
+00:24:55,600 --> 00:24:59,800
+further examination ممكن تحتاج عمل إيه جراحية طيب
+
+371
+00:24:59,800 --> 00:25:03,860
+هلو شمينا نفس الريحة من منطقة الـ rectal area ماحد
+
+372
+00:25:03,860 --> 00:25:06,920
+يقول لي يا أستاذ طب ما هي already من منطقة direct
+
+373
+00:25:06,920 --> 00:25:10,200
+area؟ لأ يا أستاذ أنا بدي أقول لك صحيح منطقة direct
+
+374
+00:25:10,200 --> 00:25:13,260
+area الحمد لله مع الطهارة والنظافة لأ ما بنشمش هذه
+
+375
+00:25:13,260 --> 00:25:17,000
+الريحة لكن لو انشمّت هذه الريحة بيكون عنده fecal
+
+376
+00:25:17,000 --> 00:25:20,960
+incontinence إيش يعني incontinence؟ بيصير لا قدر
+
+377
+00:25:20,960 --> 00:25:24,300
+الله عدم تحكم زي بعض الناس اللي عندهم يعني
+
+378
+00:25:24,300 --> 00:25:27,680
+neurological abnormalities أو neurological disease
+
+379
+00:25:27,680 --> 00:25:32,520
+يعني أي مرض عصبي ممكن يؤثر على عدم التحكم عندهم طب
+
+380
+00:25:32,520 --> 00:25:36,620
+الـ foul smelling الـ foul smelling اللي هي خليني أقول
+
+381
+00:25:36,620 --> 00:25:40,420
+يعني الريحة الصعبة أو يعني الريحة الـ..الـ..الـ
+
+382
+00:25:40,420 --> 00:25:43,440
+offensive odor يعني اللي بتكون كريهة من الـ stool
+
+383
+00:25:43,440 --> 00:25:47,520
+خاصة في حالة الـ infant يعني بتيجي الأم بتقول ممكن
+
+384
+00:25:47,520 --> 00:25:51,860
+تسأل كوا..تقول لك أنا الطفل لما بيروح الحمام يعني كل
+
+385
+00:25:51,860 --> 00:25:55,000
+البيت بن..بنفتح كل الشبابيك والدنيا كلها مش
+
+386
+00:25:55,000 --> 00:25:58,600
+عارفة نعمل وحمّاله بيطلع يعني إخراج كتير هذا إيش
+
+387
+00:25:58,600 --> 00:26:02,960
+اسم المرض؟ بأشك في مرض اسمه malabsorption syndrome
+
+388
+00:26:02,960 --> 00:26:07,240
+مرض سوء الامتصاص طبعا هذا disorder صعب بندرسه على
+
+389
+00:26:07,240 --> 00:26:10,420
+الأطفال اللي بيشتغلوا معاه هم لكن إحنا بداية
+
+390
+00:26:10,420 --> 00:26:13,440
+الطريق اللي قدرنا نَشخّص و قدرنا نعرف إن فيه مشكلة
+
+391
+00:26:13,440 --> 00:26:18,340
+طيب halitosis إيش يعني halitosis؟ الرائحة الكريهة
+
+392
+00:26:18,340 --> 00:26:22,460
+لو اجت من الـ oral يعني واحد قاعد جنبي ريحة فمه
+
+393
+00:26:22,460 --> 00:26:26,280
+كتير سيئة ما نروحش بعيد بيكون عنده bad dental
+
+394
+00:26:26,280 --> 00:26:29,380
+hygiene الرائحة ما حد يقول لي إلا في بعض
+
+445
+00:29:59,950 --> 00:30:03,890
+ايش أعضاء الجسم إلا في حالة الإبدومين، حالة
+
+446
+00:30:03,890 --> 00:30:08,270
+الإبدومين قال لي inspect، تطلع، لاحظ واسكلت
+
+447
+00:30:08,270 --> 00:30:12,310
+استخدم سماعتك، percuss، آخر حاجة بالبيت عشان ممكن
+
+448
+00:30:12,310 --> 00:30:18,330
+يكون فيها ألم، ليه؟ عشان خاصة، خاصة، لو أحد سأل، يا
+
+449
+00:30:18,330 --> 00:30:20,950
+أستاذ طب، ليش ما نستخدمش الـ بالبيت في الأول؟ لو
+
+450
+00:30:20,950 --> 00:30:25,770
+استخدمنا الـ palpation في الأول، بتغير صوت الأمعاء،
+
+451
+00:30:25,770 --> 00:30:29,590
+لو تخيلنا واحد، بدنا نعرف صوت الأمعاء عنده شغالة
+
+452
+00:30:29,590 --> 00:30:33,930
+ولا لأ، لو واحد سألني: "هل لها صوت؟" أه يا أستاذ،
+
+453
+00:30:33,930 --> 00:30:37,970
+الأمعاء بتطلع لها صوت؟ الصوت احنا بنسميه waving
+
+454
+00:30:37,970 --> 00:30:43,010
+sound، يعني اسمه الصوت، ايش يعني waving؟ يعني waving
+
+455
+00:30:43,010 --> 00:30:47,510
+زي الموجات، صوت موجي، زي الأصوات اللي بتطلع من الـ
+
+456
+00:30:47,510 --> 00:30:51,450
+vein، اللي هو من ايه؟ ايش من الوريد، مش الأصوات اللي
+
+457
+00:30:51,450 --> 00:30:55,450
+بتطلع من الشريان، الشريان طبعا اللي هو النابض، لكن في
+
+458
+00:30:55,450 --> 00:31:00,170
+عندنا لما بنتكلم على الـ wave، يعني ايش؟ زي الموجات
+
+459
+00:31:00,170 --> 00:31:06,510
+فبينفعش أمسك البطن، ثم بعد ذلك أنا أحط السماعة، بتغير
+
+460
+00:31:06,510 --> 00:31:11,830
+الصوت. طيب، if there is abnormality، إذا كان في شيء مش
+
+461
+00:31:11,830 --> 00:31:16,570
+طبيعي، هنا بقول: "لا، بدك تزيد الفحص". ايش يعني تزيد؟
+
+462
+00:31:16,570 --> 00:31:20,050
+بدك تعمل further data، يعني انتبه إذا طلع عندك شيء
+
+463
+00:31:20,050 --> 00:31:24,570
+مش طبيعي، يعني في ألم، بدك تسأله: "وين الـ radiation of
+
+464
+00:31:24,570 --> 00:31:28,230
+pain؟" وين الألم بيشع؟ يعني وين بيودي؟ وين بيصير، حسب
+
+465
+00:31:28,230 --> 00:31:33,570
+لغة المرضى. هل بيتأثر من الطعام؟ هل الـ bowels فيها
+
+466
+00:31:33,570 --> 00:31:37,150
+عندها مشكلة؟ هل بيقدر المريض الـ activity of
+
+467
+00:31:37,150 --> 00:31:41,290
+daily living؟ كل الأسئلة هذه، ايش اسمها؟ basic
+
+468
+00:31:41,290 --> 00:31:45,150
+guidelines، عشان تطلع بالـ physical، لسه أنا ما عملتش
+
+469
+00:31:45,150 --> 00:31:49,070
+physical examination، كل اللي بعمله كل تحضير الـ
+
+470
+00:31:49,070 --> 00:31:51,750
+physical examination، اللي هنشرحه إن شاء الله في
+
+471
+00:31:51,750 --> 00:31:56,790
+الشهر القادم. self physical assessment، خلّي المريض
+
+472
+00:31:56,790 --> 00:31:59,930
+في بعض الحالات، شغلات أنا ما بقدرش أعملها examination
+
+473
+00:31:59,930 --> 00:32:04,290
+خاصة لما تكون فيها embarrassment، إحراج، أو هو بيُرفض
+
+474
+00:32:04,290 --> 00:32:08,490
+خاصة الـ male والـ female، يعني ممكن نيجي… ممكن
+
+475
+00:32:08,490 --> 00:32:11,190
+ما نرفعش نيجي نقول: "الـ female بدي أشوف الـ breast وكده"
+
+476
+00:32:11,190 --> 00:32:15,210
+خاصة إذا أنت male أو هي أنت الحكيمة female، ما بنفع
+
+477
+00:32:15,210 --> 00:32:17,410
+تقول: "بدي أشوف منطقة الـ breast أو منطقة الـ
+
+478
+00:32:17,410 --> 00:32:20,630
+testicular عند الـ male"، للـ genital area، أو حتى
+
+479
+00:32:20,630 --> 00:32:24,190
+منطقة الـ foot، يعني الـ foot check، وبالذات للناس اللي
+
+480
+00:32:24,190 --> 00:32:27,130
+عندهم diabetic. ممكن المريض يكون مثقف، المريض يفهم
+
+481
+00:32:27,130 --> 00:32:30,570
+مرضه، هو يقولك: "لا الحمد لله أنا طبيعي، وأنا عارف
+
+482
+00:32:30,570 --> 00:32:33,250
+أنت علشان بتسألني، ما عنديش تقرحات، ما عنديش أي
+
+483
+00:32:33,250 --> 00:32:36,710
+أمراض، ما عنديش أي أشكالية". لو عنده، هو هيقولك، إذا
+
+484
+00:32:36,710 --> 00:32:41,210
+جالك، احنا ممكن نبلغ الطبيب، الأخ الصحي. طيب، allow
+
+485
+00:32:41,210 --> 00:32:45,890
+time for client questions، خلي دائمًا وقت مناسب
+
+486
+00:32:45,890 --> 00:32:52,770
+للمريض يسأل، ما تستعجل إنك أنت تخليه، وكأنك بتقطّع
+
+487
+00:32:52,770 --> 00:32:55,910
+عليه الكلام وما بتخليهوش، خليه براحة يحكيلك. Remember
+
+488
+00:32:55,910 --> 00:32:59,110
+دائمًا ذكر the most important، يعني لما يقولي
+
+489
+00:32:59,110 --> 00:33:01,810
+بالأحمر the most important، مش واحد يقولي: "يعني اه
+
+490
+00:33:01,810 --> 00:33:06,110
+مهم الامتحان لأ"، يعني أهم guideline، أهم guideline
+
+491
+00:33:06,110 --> 00:33:11,530
+اللي عليك في الـ physical، ايش هو؟ continuous practice of
+
+492
+00:33:11,530 --> 00:33:14,830
+physical assessment skills، ايش يعني؟ يعني بيقولي
+
+493
+00:33:14,830 --> 00:33:17,550
+أهم guideline اللي عليك وأنت بتعمل assessment
+
+494
+00:33:17,550 --> 00:33:22,650
+الاستمرارية، هاه، وما تقطع الـ assessment إلا في
+
+495
+00:33:22,650 --> 00:33:27,490
+حالات، ما تبقى قطع، إذا كان كبير في السن، أو يعني لا
+
+496
+00:33:27,490 --> 00:33:31,890
+سَمح الله، مش متعاون معاه، أو لأ، قطع صغير جدًا في هذه
+
+497
+00:33:31,890 --> 00:33:35,950
+الحالة، بقولك: "قطع الـ assessment، وعود كملها"، لكن للـ
+
+498
+00:33:35,950 --> 00:33:39,650
+normal client، عشان ما تنساش، ابدأ معاه وكمل طول ما
+
+499
+00:33:39,650 --> 00:33:44,450
+هو بيتحمل، كمل معاه. طيب، في عندنا حُسْمة variation،
+
+500
+00:33:44,450 --> 00:33:50,950
+اختلافات في الـ physical assessment، زي في حالة الـ
+
+501
+00:33:50,950 --> 00:33:54,330
+pediatrics، أنا تَوِّي حكيت، ايش قلت؟ قلت: "مرات يعني"
+
+502
+00:33:54,330 --> 00:33:59,530
+مرات أنا بحتاج الفيديوهات اللي مش بتعاون معايا، طب
+
+503
+00:33:59,530 --> 00:34:02,130
+أنا بدي أنا أشوف، بدي أعمل تتابع sequence of
+
+504
+00:34:02,130 --> 00:34:05,510
+physical assessment، depends، بيعتمد على ايش؟ على الـ
+
+505
+00:34:05,510 --> 00:34:09,750
+development level of the child، بيعتمد على مستوى
+
+506
+00:34:09,750 --> 00:34:16,500
+تطور ايه؟ تطور المريض. والله، ده لما الطفل مستوعب، بَقى
+
+507
+00:34:16,500 --> 00:34:19,340
+ماشي معاه، مش مستوعب، يعني صار يعيد، زي الأطفال
+
+508
+00:34:19,340 --> 00:34:23,640
+الصغار كثير، أو خاف، أو عنده رهبة، بأجل، بصير أجلس
+
+509
+00:34:23,640 --> 00:34:28,080
+حالة الوضع الـ assessment، حسب استجابة الطفل. بقولي
+
+510
+00:34:28,080 --> 00:34:32,160
+دائمًا كمان، ايش بقولي هنا؟ establishment of rapport،
+
+511
+00:34:32,160 --> 00:34:36,980
+لما تيجي دائمًا، بدنا يعني… يعني نعمل، يمكن هنا في
+
+512
+00:34:36,980 --> 00:34:42,380
+خطأ مطبعي، هي يعني الصح مش rapport، هي ياريت اللي
+
+513
+00:34:42,380 --> 00:34:46,530
+بيسمعني، معلش، أنا نسيت أغيّرها. الـ E بتتغير، بصير A
+
+514
+00:34:46,530 --> 00:34:50,950
+rapport وليس report، هو هنا يقصد، حتى في خطأ يبدو
+
+515
+00:34:50,950 --> 00:34:55,810
+مطبعي في الكتاب نفسه، establishment لازم تبني rapport،
+
+516
+00:34:55,810 --> 00:35:00,750
+معناته ثقة، معناته ايش؟ تأمين الطفل، ايش؟ تأمين الطفل،
+
+517
+00:35:00,750 --> 00:35:07,050
+لازم تحط ثقة بينكما، يعني تخلي الطفل يثق فيك، عشان
+
+518
+00:35:07,050 --> 00:35:09,990
+ايه؟ هنا، عشان most essential step in the
+
+519
+00:35:09,990 --> 00:35:14,950
+physical assessment. جابوا ما احنا نقدر نروح للمريض،
+
+520
+00:35:14,950 --> 00:35:18,230
+على الطفل، هذا اللي مش راضي يتعاون معنا، لازم يكون
+
+521
+00:35:18,230 --> 00:35:21,730
+يعني بينه وبينه ثقة، عشان أنا سميتها establishment
+
+522
+00:35:21,730 --> 00:35:26,230
+ابدأ وحط جسور للثقة بينك وبين الطفل، عشان يقدر
+
+523
+00:35:26,230 --> 00:35:29,870
+يعطيك المعلومات. reduce fearing، خفف الخوف، مجرد
+
+524
+00:35:29,870 --> 00:35:34,060
+مطمئن له، خفف. مش معقول تيجي تعمل assessment، ومعلش يا
+
+525
+00:35:34,060 --> 00:35:36,980
+أستاذ، أنت ما شاء الله عليك طويل، ولاابس الـ code زي
+
+526
+00:35:36,980 --> 00:35:40,400
+بعض الناس اللي كانوا يخطئوا في هذا الأمر، وحاطط
+
+527
+00:35:40,400 --> 00:35:44,160
+كمان قُبْرَتين في جيبه، يعني سرنجتين، يعني الطفل طبعًا
+
+528
+00:35:44,160 --> 00:35:48,240
+يعني ما يشوف فيه دم، التمس، يعني، فقبل ما تبدأ، بدك
+
+529
+00:35:48,240 --> 00:35:53,180
+تكون ايش؟ تخفف الخوف عند الطفل. الآن في بعض الحالات،
+
+530
+00:35:53,180 --> 00:35:56,940
+طبعًا مضطر غصب عني أعمله assessment، مضطر، الطفل مش
+
+531
+00:35:56,940 --> 00:35:59,820
+متعاون، زي في حالات الـ meningitis، أنا مضطر أعمل
+
+532
+00:35:59,820 --> 00:36:03,380
+assessment، أو زي في حالات لا قدر الله، أفرض في
+
+533
+00:36:03,380 --> 00:36:07,300
+firm body، مثلًا، aspiration، طفل بلا وعيه وهو مش
+
+534
+00:36:07,300 --> 00:36:10,560
+متعاون، أنا بصبر في هالحالة، بدي أضطر أعمله
+
+535
+00:36:10,560 --> 00:36:12,760
+physical restraint، ايش كان physical restraint؟
+
+536
+00:36:12,760 --> 00:36:16,910
+بدّه ربطه، بدي أَكْتِفه، طبعًا مش هرْبِطه يعني، بدي أشتري حبل
+
+537
+00:36:16,910 --> 00:36:19,990
+وأقعد أربطه، المقصود هنا إن أخلي أحد يتعاون
+
+538
+00:36:19,990 --> 00:36:24,190
+معايا يثبته منيح عشان أقدر أعمل examination بدون
+
+539
+00:36:24,190 --> 00:36:28,370
+ما أنا أضر، ايش؟ بدون ما أضر الطفل، زي ما مع الأطفال،
+
+540
+00:36:28,370 --> 00:36:34,020
+زي ما مع الأكبار، فيه تغييرات. بعض الحالات بقول لي: "أنت
+
+541
+00:36:34,020 --> 00:36:37,100
+ممكن تستخدم كمان حاجة اللي بيسموها الـ caregiver،
+
+542
+00:36:37,100 --> 00:36:40,420
+مين هو الـ caregiver؟ اللي بتعطي الرعاية والعناية
+
+543
+00:36:40,420 --> 00:36:43,780
+للطفل، ممكن تجيبه، يعني مش شرط تكون الأم، يعني ممكن
+
+544
+00:36:43,780 --> 00:36:49,340
+تحتاج أحد يساعدك وأنت بتعمل assessment، أساسية جدًا، يعني مثلًا
+
+545
+00:36:49,340 --> 00:36:53,160
+زي أمّه… زي أمّه مش… مش إيه؟ زي خالته، زي عمه،
+
+546
+00:36:53,160 --> 00:36:57,500
+قصة، زي إيش؟ زيّك، ممكن ييجي يقولك: "أنا you must
+
+547
+00:36:57,500 --> 00:37:03,330
+facilitate، تساعدني، لأني مش قادر… مش قادر أمشي
+
+548
+00:37:03,330 --> 00:37:07,270
+مع الطفل، فبتيجي الأم بتمسك الطفل، بتحمله، ومش عيب،
+
+549
+00:37:07,270 --> 00:37:11,550
+حتى ومش غلط، ممكنية تحمله وييجي الطبيب يقعد يسمع نفس
+
+550
+00:37:11,550 --> 00:37:15,810
+الطفل وهي حاملها، ما في مشكلة، طالما اطمئن لأمّه أو
+
+551
+00:37:15,810 --> 00:37:19,430
+لخالته أو لعمته. طبعًا هنا assessment approach، دائمًا
+
+552
+00:37:19,430 --> 00:37:23,230
+based on، ايش؟ الـ child's response، يعني ما جيش أستعجل،
+
+553
+00:37:23,230 --> 00:37:30,250
+حسب استجابة الطفل، بأمشي، صار يعيط، بوقف. uncooperative،
+
+554
+00:37:30,250 --> 00:37:34,470
+ايش uncooperative؟ إذا كان الطفل اللي قدامي مش
+
+555
+00:37:34,470 --> 00:37:39,930
+متعاون، ما جيش أقول: "أوف، هو لازم كل الأطفال يكونوا"
+
+556
+00:37:39,930 --> 00:37:44,790
+معانا متعاونين، لأ، لازم نعرف احنا كتمريض إن السلوك
+
+557
+00:37:44,790 --> 00:37:48,710
+يعني الـ… الـ… دائمًا الحركة للـ… للأطفال هذا
+
+558
+00:37:48,710 --> 00:37:52,170
+طبيعي، يعني طبيعي الطفل يكون بيتحرك كثير، طبيعي الطفل
+
+559
+00:37:52,170 --> 00:37:55,670
+يخاف، طبيعي يرفض، اللي مش طبيعي اللي يقولك: "اتفضل، لأن"
+
+560
+00:37:55,670 --> 00:37:58,920
+هو مش كبير، هو في عمره. فدائمًا لازم نعرف إن هذا
+
+561
+00:37:58,920 --> 00:38:02,120
+يُعتَبر normal، إذا جينا الولد مش متعاون معانا، لازم
+
+562
+00:38:02,120 --> 00:38:06,080
+نعتبره normal، الشطارة فينا كيف نخليه متعاون معانا،
+
+563
+00:38:06,080 --> 00:38:10,940
+إما بمساعدت الآخرين، أو إنه هو يكون يعني… معنى، بنجسم
+
+564
+00:38:10,940 --> 00:38:15,460
+الـ assessment شوية شوية. طبعًا هنا كمان في variation،
+
+565
+00:38:15,460 --> 00:38:20,190
+وين؟ في الـ geriatric، في حالة الكبار في السن، أنا مش عاجز
+
+566
+00:38:20,190 --> 00:38:23,650
+أقول: "و الله بدي أنا أعمل ثقة وبدي أجيب أهله وأمّه"
+
+567
+00:38:23,650 --> 00:38:28,130
+مش معقول، لأن هو كبير في السن، وعندي الآن، بنذكر
+
+568
+00:38:28,130 --> 00:38:30,490
+إن في عندنا normal variation، ايش هي الـ normal
+
+569
+00:38:30,490 --> 00:38:33,190
+variation؟ في اختلافات طبيعية اللي علاقة بالـ aging،
+
+570
+00:38:33,190 --> 00:38:35,670
+يعني ما واحد ييجي يقول: "ليه والله، جيت دهره عامل"
+
+571
+00:38:35,670 --> 00:38:39,090
+كذا، والله جيت، اللي مش قادر يقعد، هذا normal، يُعتَبر
+
+572
+00:38:39,090 --> 00:38:42,930
+أو مش قادر يمشي، هذا normal، لكن الـ abnormal إذا كان
+
+573
+00:38:42,930 --> 00:38:46,890
+في عنده أشياء بيشكيها، وباقي اللي في سنه
+
+574
+00:38:46,890 --> 00:38:51,180
+ما بيشكوشها. أهم في الموضوع إنه you must divide the
+
+575
+00:38:51,180 --> 00:38:57,100
+physical assessment، لازم تجزّئ الـ assessment اللي
+
+576
+00:38:57,100 --> 00:39:01,660
+في أجسامه لعدة مراحل، ايش يعني؟ يعني ممكن تيجي يوم
+
+577
+00:39:01,660 --> 00:39:05,410
+تعمل assessment للـ lower limbs، تتركه، تيجي في فترة
+
+578
+00:39:05,410 --> 00:39:09,830
+ثانية للـ upper limbs، تتركه، وبعدين للـ abdomen، ليه؟
+
+579
+00:39:09,830 --> 00:39:13,070
+لأن العجوز أو الكبير في السن ما بيقدرش، لو أنت تخيّلت و
+
+580
+00:39:13,070 --> 00:39:15,970
+تَرَقِّقْتَ، دي حاجة شوية بس هيقولك: "أنا مُتْعَب"، مش
+
+581
+00:39:15,970 --> 00:39:19,910
+هيقدر يتحمل. ما تتوقع إن زيّك هيقدر يتحملك، لأ، مش
+
+582
+00:39:19,910 --> 00:39:23,730
+هيقدر. provide room with a comfortable temperature،
+
+583
+00:39:23,730 --> 00:39:27,650
+الكبير في السن بالذات بدّه comfortable temperature، لأن
+
+584
+00:39:27,650 --> 00:39:32,020
+عنده حساسية للبرد وللحر أكثر منك ومن الأطفال. ممكن
+
+585
+00:39:32,020 --> 00:39:35,840
+تلاقيه في عز الحرّ، ولابس ملابس، واللي عنده جدّه
+
+586
+00:39:35,840 --> 00:39:40,540
+أو جدته، ممكن تلاقيه زي هيك، ليه؟ لأن هم حساسيتهم
+
+587
+00:39:40,540 --> 00:39:43,780
+خاصة الـ nerve endings، نهايات الأعصاب، في مرحلة
+
+588
+00:39:43,780 --> 00:39:47,760
+الشيخوخة بتبدأ تضعف. allow sufficient time for the
+
+589
+00:39:47,760 --> 00:39:51,400
+client to respond، على مهلك، على الكبير في السن أو العجوز،
+
+590
+00:39:51,400 --> 00:39:56,900
+واعطيه وقت كافي حتى ايه؟ يستجيب. الآن إذا استجاب،
+
+591
+00:39:56,900 --> 00:40:01,800
+بمشي، ما استجابش، بوقف. ودائمًا دائمًا، كويس، كويس، إذا
+
+592
+00:40:01,800 --> 00:40:05,880
+بيقدر يقعد… اه، إذا بيقدر يقعد بيكون كويس. if
+
+593
+00:40:05,880 --> 00:40:09,520
+possible… إذا ما بيقدرش، نِيمه بالشكل اللي هو
+
+594
+00:40:09,520 --> 00:40:13,900
+بيرتاح له. and give him full time to understand you،
+
+595
+00:40:13,900 --> 00:40:18,800
+يعني لو سألك الكبير في السن، اعطيه وقت مناسب، مش زي الشباب،
+
+596
+00:40:18,800 --> 00:40:21,720
+أو زي الصغار، ممكن يسألك… ممكن يقولك: "يا ابني، ايش"
+
+597
+00:40:21,720 --> 00:40:25,750
+هذا؟" ما ترجعش تقوله: "أنت إيه وسألت"، أو كل ما يسألك،
+
+598
+00:40:25,750 --> 00:40:30,470
+جاوب، حتى لو أعاد السؤال عن الشيء بعدد مرات، برضه
+
+599
+00:40:30,470 --> 00:40:34,390
+لازم نجاوبه. احنا في الآخر رسل للمهن الإنسانية، و
+
+600
+00:40:34,390 --> 00:40:38,090
+لازم نكون يعني… دعاة سرور، وإن شاء الله نكون يعني
+
+601
+00:40:38,090 --> 00:40:42,330
+كمان مفرحين للي بنعمله assessment، ومباجين طبعًا،
+
+602
+00:40:42,330 --> 00:40:46,870
+احنا بنخلق… أُخْ الذكر معلش، يعني يمكن أنا طولت شوية،
+
+603
+00:40:46,870 --> 00:40:51,490
+بس مضطر يعني أخلّص الـ chapter، سامحوني إن أنا أخدت
+
+604
+00:40:51,490 --> 00:40:56,090
+يعني واحد وأربعين دقيقة، أنا بالعادة ما بطلعش على
+
+605
+00:40:56,090 --> 00:40:59,070
+الثلاثين، بس في هذه المحاضرة، عشان يعني ما بدناش نقطّع،
+
+606
+00:40:59,070 --> 00:41:01,970
+والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e9f11e3830ff629214aa054f3faa3a3cae4bb3d2
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/327g4zeGJX8_raw.srt
@@ -0,0 +1,2432 @@
+1
+00:00:01,080 --> 00:00:03,520
+اقعدوا بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:03,520 --> 00:00:07,380
+الرحيم خلينا نكمل طبعا اللي هو وصلنا في المحاضرة
+
+3
+00:00:07,380 --> 00:00:11,380
+السابقة لعند اللي هو ال skill اللي هو number two
+
+4
+00:00:11,380 --> 00:00:14,760
+اللي هو palpation بس عشان نتذكر احنا بنتكلم في ال
+
+5
+00:00:14,760 --> 00:00:18,480
+skills اللي هي اللي بنعمل فيها بداية ال physical
+
+6
+00:00:18,480 --> 00:00:22,560
+examination و بعدين بال inspection و بعدين هنشتغل
+
+7
+00:00:22,560 --> 00:00:25,440
+على ال palpation و بعدين هيكون percussion و بعدين
+
+8
+00:00:25,440 --> 00:00:28,300
+escalation و احنا قولنا اللي في ال inspection
+
+9
+00:00:28,300 --> 00:00:32,870
+دايما نستخدم إيه يجب نتذكرها ديالشريحة ابن الذكر
+
+10
+00:00:32,870 --> 00:00:36,230
+ايش اهم شي انه بستخدم جاعد عمالي انا ال vision و
+
+11
+00:00:36,230 --> 00:00:39,250
+ال smell و بعدين روحت ايش و وقفت على يمين المريض و
+
+12
+00:00:39,250 --> 00:00:44,510
+بعدين وصلت ل palpation ال palpation بيقول لي touch
+
+13
+00:00:44,510 --> 00:00:48,790
+feel with hands to determine يعني انا بمسك ايدايا
+
+14
+00:00:48,790 --> 00:00:53,850
+اذا ملاحظين الصورة اللي هنا هي مقصودة انه انا
+
+15
+00:00:53,850 --> 00:00:57,990
+بستخدم راحة اليد و راحة الأصابع يعني الايدايا من
+
+16
+00:00:57,990 --> 00:01:02,160
+قدامإلا في حالة واحدة اللي قدامي هقولكوا ليش
+
+17
+00:01:02,160 --> 00:01:05,780
+بنستخدم اللي هو لأ عكس الإيد يعني دهر الإدنى، دهر
+
+18
+00:01:05,780 --> 00:01:10,300
+الإيد، من الآن بقولكوا هي بتستخدم لقياس حرارة
+
+19
+00:01:10,300 --> 00:01:16,320
+الإنسان يعنيكمعرفة عامة سخن ولا مش سخن يعني مثلا
+
+20
+00:01:16,320 --> 00:01:20,320
+مابينفع الواحد براحة اليد يحط ايده يعني بهذا الكف
+
+21
+00:01:20,320 --> 00:01:25,500
+ما هيك يحط ايده على جبهة المريض لأ الصح انه يجلب
+
+22
+00:01:25,500 --> 00:01:30,500
+ايده بالجهة التانية ليه؟ عشان الايد مفتوحة فيها
+
+23
+00:01:30,500 --> 00:01:34,380
+soft tissue وفيها يعني بتتكلموا blood supply كتير
+
+24
+00:01:34,380 --> 00:01:37,400
+و بتتكلموا فيه كمان fatty tissue لكن لو جلبناها
+
+25
+00:01:37,400 --> 00:01:41,280
+عظمها بتلاقي دغري skin وفيه اللي هو nerve endings
+
+26
+00:01:41,280 --> 00:01:46,420
+مباشرةبيقدر يسير إحساس و يقدر يعطي ان هو المريض
+
+27
+00:01:46,420 --> 00:01:50,020
+الأمام نسخون او لا طيب بقولي ال texture و احنا
+
+28
+00:01:50,020 --> 00:01:53,880
+قوللاش ال texture انه بستخدم ايش ال finger traps
+
+29
+00:01:53,880 --> 00:01:57,520
+يعني أطراف الأصابع و احنا قولنا ليش انه بضغط
+
+30
+00:01:57,520 --> 00:02:02,340
+بطرفين الأصبع زي بضغط الإبهام مثلا وسبابة و الوسط
+
+31
+00:02:02,340 --> 00:02:06,600
+مع بعض ممكن ايش اعص شوية عشان احس ايش في تحت الجلد
+
+32
+00:02:07,100 --> 00:02:09,620
+لما انا اضغط على الجلد زى ما قلنا زى واحد بيجيب و
+
+33
+00:02:09,620 --> 00:02:12,620
+بيقول لي في كيس دهني في ورم أو اي شي بحاول انا
+
+34
+00:02:12,620 --> 00:02:17,160
+اضغط عليه و احسه هذا اسمه ال texture اما انا لما
+
+35
+00:02:17,160 --> 00:02:21,680
+امسك ظهر اليد اللى هو يمكن شفتها في سنة أولى
+
+36
+00:02:21,680 --> 00:02:26,340
+حاولكوا عنها انه اليد من بظهرها يعني بجافاها من
+
+37
+00:02:26,340 --> 00:02:30,840
+فوق لو مسكنها و حاولنا نشد الجلد و ثم رخينا الجلد
+
+38
+00:02:30,840 --> 00:02:35,220
+و في انا حاطت صورة اللى قدام هتشوفها هذا اسمه tear
+
+39
+00:02:35,220 --> 00:02:39,170
+guard ايش اسمه tear guardالان ال temperature يوز
+
+40
+00:02:39,170 --> 00:02:41,490
+ايه هى زى ما قلتها بتشوف ال temperature بس استخدم
+
+41
+00:02:41,490 --> 00:02:45,710
+ال back and front زى ما حكينا ال moisture بتشوف ال
+
+42
+00:02:45,710 --> 00:02:52,490
+رطوبة رطوبة الجسم فى عرق فى تصبب فى solution فى اي
+
+43
+00:02:52,490 --> 00:02:56,270
+شي لبركاشن او حجم من هذا القبيل ال organ location
+
+44
+00:02:56,270 --> 00:03:01,790
+and size بتشوف ايش الأعضاء كدهش موجودة كدهش حجمها
+
+45
+00:03:02,430 --> 00:03:06,690
+يعني زي انك تحس لا قدر الله وجود ورم او تحس تشوف
+
+46
+00:03:06,690 --> 00:03:11,790
+المعدة كيف الشكل من منطقة ال liver كيف و هكذا show
+
+47
+00:03:11,790 --> 00:03:15,610
+and symmetric ايش يعني slow .. sorry slow and
+
+48
+00:03:15,610 --> 00:03:20,270
+systematic خليك عمال بطيء شوية شوية و بشكل منتظم و
+
+49
+00:03:20,270 --> 00:03:23,330
+دائما استخدم ال palpation هذا مهم من ال light لل
+
+50
+00:03:23,330 --> 00:03:27,270
+deep يعني عمرك ماتعص كتيرعلى جسم الإنسان لما نقول
+
+51
+00:03:27,270 --> 00:03:32,130
+light يعني ليش الدغط بخفة لما نقول deep الدغط بعمق
+
+52
+00:03:32,130 --> 00:03:38,210
+لما نقول بخفة يعني جداش بتكون سانت اتنين ماشي لكن
+
+53
+00:03:38,210 --> 00:03:42,490
+في بعض الحالات لما نكون deep ممكن يصل لستة وسبعة
+
+54
+00:03:42,490 --> 00:03:45,690
+سانت يعني بتكلم على تلاتة انش ليه خاصة في حالات
+
+55
+00:03:45,690 --> 00:03:49,610
+لما بدى أتأكد زي في حالات ال appendicitis او في
+
+56
+00:03:49,610 --> 00:03:54,210
+حالات لما بدى أشوف إذا بقدر أحس ال goal بلدر إذا
+
+57
+00:03:54,210 --> 00:03:58,890
+اللي هوالحوصرة المرارية اللي أنا بعيدها شوية ال
+
+58
+00:03:58,890 --> 00:04:01,110
+light palpation نستخدمه في ايه؟ في ال tenderness
+
+59
+00:04:01,110 --> 00:04:04,390
+في المناطق اللي فيها ألم ال deep palpation بيستخدم
+
+60
+00:04:04,390 --> 00:04:07,150
+دائما لما نكون في abdominal organs زي ما احنا
+
+61
+00:04:07,150 --> 00:04:10,430
+جولنا من الحسة او في لا قدر الله masses اتطلعوا
+
+62
+00:04:10,430 --> 00:04:13,590
+كيف المنظر اللي احنا قدامنا فيه light palpation
+
+63
+00:04:13,590 --> 00:04:17,610
+الطبيب العامله حاطط ايده زي ما انتوا ملاحظينه
+
+64
+00:04:17,610 --> 00:04:21,580
+مواقف هنا على اليمينالايد اللى مستخدمها ايده طبعا
+
+65
+00:04:21,580 --> 00:04:25,240
+مافيش فيها اضافر و هذا كتير لازم نفهمه لأن كتير
+
+66
+00:04:25,240 --> 00:04:29,940
+مرات بتصير إشكالية بعض الطبيبات بالذات بتخليلها
+
+67
+00:04:29,940 --> 00:04:33,380
+ادفرهان او ادفرهان ما بعرف و مرات تلقى طباء كمان
+
+68
+00:04:33,380 --> 00:04:38,280
+فبيجي بضغط بيتوجع المريض مباشرة فبيفكر انه فيه ألم
+
+69
+00:04:38,280 --> 00:04:41,620
+في هذا المكان هو ماتألمش من اي problem و انما
+
+70
+00:04:41,620 --> 00:04:47,040
+اتألم من الادفر تبع الطبيب لاحظين كيف اتديب و
+
+71
+00:04:47,040 --> 00:04:50,330
+لاحظين كيف ال light الآن هيديب شوف كيفإذا بتبتطلع
+
+72
+00:04:50,330 --> 00:04:53,350
+معايا، مع الضغط حتى هي الخيار اللي مبين، ضغط
+
+73
+00:04:53,350 --> 00:04:56,690
+أصابعه لجوا، خاصة في منطقة الماكبيرني point او
+
+74
+00:04:56,690 --> 00:05:00,250
+بنتكلم ال right هي ال lower quadrant اللي هي منطقة
+
+75
+00:05:00,250 --> 00:05:03,650
+ال abandoned sites أما هنا لاحظوا أنه كان حاط إيده
+
+76
+00:05:03,650 --> 00:05:07,390
+مفتوحة، هنا مضغوطة شوية، خاصة في المناطق اللي إيش
+
+77
+00:05:07,390 --> 00:05:11,560
+إذا بدك تعمل deep assessmentprinciples for
+
+78
+00:05:11,560 --> 00:05:15,900
+accurate palpation شو المبدأ و الأساسيات عشان يكون
+
+79
+00:05:15,900 --> 00:05:19,160
+عندنا ال palpation دقيق جدا أول حاجة ال examiner
+
+80
+00:05:19,160 --> 00:05:22,880
+fingers حكينا عنها لازم يكونش معلوم short طيب use
+
+81
+00:05:22,880 --> 00:05:25,860
+the sensitive part حكينا عنها استخدم أيش منطقة
+
+82
+00:05:25,860 --> 00:05:30,220
+الحساسة من أصابعك ما تستخدم من اللي هو دهر الأصابع
+
+83
+00:05:30,220 --> 00:05:33,800
+ابدأ بال light palpation و بعدين خش على وين على ال
+
+84
+00:05:33,800 --> 00:05:37,100
+deep palpation حكيناها start with a light then
+
+85
+00:05:37,100 --> 00:05:40,160
+deep palpation لاحظين ان احنا كلام بعيد بعضهTender
+
+86
+00:05:40,160 --> 00:05:42,600
+area اشمالها المنطقة اللي فيها قلم ايش بيقولوا
+
+87
+00:05:42,600 --> 00:05:46,020
+palpated last يعني في الآخر بنحاول نعمل assessment
+
+88
+00:05:46,020 --> 00:05:50,820
+حاضر client must relax during palpation لازم
+
+89
+00:05:50,820 --> 00:05:55,060
+المريض يكون مرتاح أثناء ال palpation خلي ال client
+
+90
+00:05:55,060 --> 00:05:58,360
+دايما ايش هنا ياخد دايما deep breath الإنسان
+
+91
+00:05:58,360 --> 00:06:03,180
+الطبيعي لما بنقوله خد نفس عميق ويلا طلعوا شوية
+
+92
+00:06:03,180 --> 00:06:06,540
+شوية مجرد ما الإنسان ياخد نفس عميق ويطلع شوية شوية
+
+93
+00:06:06,540 --> 00:06:10,650
+ايش بيصير عندهبقول لها enhance muscle relaxation
+
+94
+00:06:10,650 --> 00:06:15,510
+بتلاقي عضلات بطنه بترتخي عضلات جسمه بترتخي بيصير
+
+95
+00:06:15,510 --> 00:06:19,950
+الإمكانية انه نعمل palpation بشكل دقيق و صحيح لكن
+
+96
+00:06:19,950 --> 00:06:24,330
+لو كان شادد يعني تخيلوا معايا لو البطن عضلته شادة
+
+97
+00:06:24,330 --> 00:06:27,490
+و انا حاطيت ايدي على البطن لاجيت عضلة شادة ايش
+
+98
+00:06:27,490 --> 00:06:31,710
+هقول؟ هقول there is ايش acute abdomenكلمة acute
+
+99
+00:06:31,710 --> 00:06:34,990
+abdomen او severe abdominal pain او مثلا abdominal
+
+100
+00:06:34,990 --> 00:06:39,290
+rigidity يعني معناته في مشكلة فانا بستعجلش الحكم و
+
+101
+00:06:39,290 --> 00:06:42,370
+انما بطلب من المريض ان يكون soft and relaxed
+
+102
+00:06:42,370 --> 00:06:47,210
+during deep respiration inspiration and expiration
+
+103
+00:06:47,210 --> 00:06:52,150
+طيب بقول هنا depressed area المنطقة اللي بدك تضغط
+
+104
+00:06:52,150 --> 00:06:56,350
+عليها must be approximately 2 cm يعني لو بدنا نعمل
+
+105
+00:06:56,760 --> 00:06:59,880
+لو بدنا نعمل في ال light touch ما نضغطش كتير حاول
+
+106
+00:06:59,880 --> 00:07:03,220
+نضغط قداش يعني لو بدنا نضغط ما نضغطش إلا 2 cm إلا
+
+107
+00:07:03,220 --> 00:07:06,620
+في بعض الحالات لما بدنا نديب إشي تاني assist
+
+108
+00:07:06,620 --> 00:07:09,580
+teargar رجع نقولنا كلمة teargar ال teargar شو هو
+
+109
+00:07:09,580 --> 00:07:15,040
+بقوللي slightly يعني بشكل خفيف grasping تشد ال
+
+110
+00:07:15,040 --> 00:07:21,360
+body part with fingertips أنت شد الجلد تعبئ المريض
+
+111
+00:07:21,360 --> 00:07:29,160
+بأطراف أصابعك و أفضل شيءإنك تمسكه بالإبهام وبإيه
+
+112
+00:07:29,160 --> 00:07:32,720
+باصبع السبابة بالإبهام واصبع السبابة كل واحد فينا
+
+113
+00:07:32,720 --> 00:07:37,500
+بيقدر يعمله نفسه بيمسك دهر الإيد اليسرى و بروح
+
+114
+00:07:37,500 --> 00:07:40,720
+بأصابع اللي هو الإبهام والسبابة بتاعة الإيد اليمنى
+
+115
+00:07:40,720 --> 00:07:46,660
+و بمسك دهر الإيد اليسرى و بشده بشد الجلد ثم برخيه
+
+116
+00:07:46,660 --> 00:07:50,300
+الآن إذا رجع مباشرة الجلد بنقول إيش هنا بنقول
+
+117
+00:07:50,300 --> 00:07:55,450
+elastic skin لما بنقول كلمة elastic skinيعني الجلد
+
+118
+00:07:55,450 --> 00:07:59,830
+كويس و بيرجع طبيعي لما مايرجعش الجلد بنسميه
+
+119
+00:07:59,830 --> 00:08:03,170
+inelastic ايش الفرق بين inelastic و inelastic و
+
+120
+00:08:03,170 --> 00:08:07,510
+بيمكانكوا تشوفوا حتى بعض المقاطع على الفيديو
+
+121
+00:08:07,510 --> 00:08:11,410
+بتشدها بتحكينا عن هذا الكلب في اليوتيوب هذا بيعني
+
+122
+00:08:11,410 --> 00:08:17,190
+ان inelastic اما dehydration او some problems يعني
+
+123
+00:08:17,190 --> 00:08:21,910
+وللأسف قدت انه في low fluid in the body مافيش
+
+124
+00:08:21,910 --> 00:08:26,740
+سوائل اوaging process يعني مع كيفار سنزايف العجائز
+
+125
+00:08:26,740 --> 00:08:33,220
+ال percussion ال percussion زي بتلاحظوا معايا هي
+
+126
+00:08:33,220 --> 00:08:38,460
+المريض جاعد شوية ودهير دهره وهي الطبيب لاحظين
+
+127
+00:08:38,460 --> 00:08:42,500
+معايا كتير من الناس ويمكن انا حزين ان اقولكوا اللي
+
+128
+00:08:42,500 --> 00:08:46,140
+على الطباء كمان كتير منهم بيخطئوا بيصير عندهم
+
+129
+00:08:46,140 --> 00:08:49,920
+بيعملوا صح بيعملوا percussion بس incorrect يعني
+
+130
+00:08:49,920 --> 00:08:56,360
+مابكونش دقيقلما نكون correct ها ويكون يعني true
+
+131
+00:08:56,360 --> 00:09:00,260
+percussion لا نستخدم إلا إصبعين اخليكم معايا لا
+
+132
+00:09:00,260 --> 00:09:03,700
+نستخدم إلا إيه إصبعين هلجيتها هذي ال E اليسرى و
+
+133
+00:09:03,700 --> 00:09:08,240
+هذي ال A اليوم فوق اليمنى الآن ال E اليسرى بناخد
+
+134
+00:09:08,240 --> 00:09:13,800
+ال middle finger of the left hand and middle
+
+135
+00:09:13,800 --> 00:09:19,250
+finger of the right hand هنا بنحط ال Aخلّيكم
+
+136
+00:09:19,250 --> 00:09:24,450
+معايا، هنا بنحط إيه؟ الإصبع تبع اليد اليسرى على
+
+137
+00:09:24,450 --> 00:09:29,750
+جلد المريض مباشرة، جسم المريض، و يطرق، أه هذا
+
+138
+00:09:29,750 --> 00:09:34,410
+المكان التاني، يطرق بالإصبع تبع الإيد اليمنى فوق
+
+139
+00:09:34,410 --> 00:09:38,270
+الـ distal phalanges، إيش عن distal phalanges؟ آخر
+
+140
+00:09:38,270 --> 00:09:41,670
+الآن، اتطلعوا كيف؟جمع phalanges اللي هو phalanges
+
+141
+00:09:41,670 --> 00:09:45,070
+ايش هال phalanges اللي هو .. بنتكلم على فقرات
+
+142
+00:09:45,070 --> 00:09:50,950
+الأصبع نفسه كل أصبع فينا فيه three phalanges فيه
+
+143
+00:09:50,950 --> 00:09:55,230
+تلاتة فيه ال .. اللي هو أول حاجة و فيه اللي هو الف
+
+144
+00:09:55,230 --> 00:09:59,450
+النص و فيه الأخيرة اللي هي الطرفية الطرفية بنسميها
+
+145
+00:09:59,450 --> 00:10:07,670
+distal فانا بدي لما نضغط بصبعنا الأيصر على الجسمو
+
+146
+00:10:07,670 --> 00:10:12,370
+ييجي أصبعنا الأيمن يضغط فوقه يضغط على .. بس على
+
+147
+00:10:12,370 --> 00:10:17,110
+آخر feelings عشان مابديش يضرب على أي مكان بدي يضرب
+
+148
+00:10:17,110 --> 00:10:20,550
+على موضوع ال joint لأن موضوع ال joint هو اللي
+
+149
+00:10:20,550 --> 00:10:23,930
+بيعمل إياش الصوت و إن شاء الله إذا ربنا قدر قعدنا
+
+150
+00:10:23,930 --> 00:10:27,350
+إن شاء الله للجامعة همثل أمامكوا عمليا و هتكون
+
+151
+00:10:27,350 --> 00:10:30,570
+أمور واضحة و الآن لو فتحنا أي مقطع على اليوتيوب
+
+152
+00:10:30,570 --> 00:10:37,300
+هيريحنا أو مش هيكون في أي مشكلة طيبإذا بتلاحظوا ال
+
+153
+00:10:37,300 --> 00:10:39,780
+percussions اللي بقوللي هنا بقوللي tapping body
+
+154
+00:10:39,780 --> 00:10:43,000
+parts إيش يعني tapping يعني كأناك بتنقرها كأناك
+
+155
+00:10:43,000 --> 00:10:48,880
+بتعمل هذا الصوت بتنقر إيش على الجسم تؤسس إيه عشان
+
+156
+00:10:48,880 --> 00:10:52,740
+تشوف هل في tenderness في تشوف ال size تشوف ال
+
+157
+00:10:52,740 --> 00:10:58,040
+location تشوف ال density الكثافة يعني هل كثيف كثير
+
+158
+00:10:58,040 --> 00:11:03,280
+هذا التجمع اللي حسيته أو الورم ولا قليل في direct
+
+159
+00:11:03,280 --> 00:11:07,620
+و في indirect ال direct percussionبستخدم إيش هنا
+
+160
+00:11:07,620 --> 00:11:11,740
+إما إصبع أو اتنين one or two fingers زي إيه إزاي
+
+161
+00:11:11,740 --> 00:11:14,440
+في حالة ال sinuses زي واحد بيقولك أنا عنده صداع
+
+162
+00:11:14,440 --> 00:11:18,940
+باجي أنا بطرق على جبهته من الأمام طرقة بسيطة و
+
+163
+00:11:18,940 --> 00:11:22,540
+بقوله إيه حاسس أنت فيه عندك ألم ولا لأ الطرق
+
+164
+00:11:22,540 --> 00:11:26,820
+البسيط هذا بتدليل إنه في عنده ألم ولا لأ إذا عنده
+
+165
+00:11:26,820 --> 00:11:29,920
+ألم بقول في عنده sinusites طبعا هذا اسمه direct
+
+166
+00:11:29,920 --> 00:11:34,420
+لما نقول indirect لأ اللي هو هذا ال indirect هو
+
+167
+00:11:34,420 --> 00:11:38,130
+هذابس إيش نشرحهم؟ خلينا نشرحهم إنه بستخدم ال
+
+168
+00:11:38,130 --> 00:11:42,590
+middle finger إصبعي اللي في النص of the left hand
+
+169
+00:11:42,590 --> 00:11:45,730
+left hand يعني إيد الشمال against the body بحطه
+
+170
+00:11:45,730 --> 00:11:49,330
+على جسم المريض surface with palm palm إيش يعني
+
+171
+00:11:49,330 --> 00:11:53,250
+palm يعني؟ راحة الأصبع مش دهره راحة الأصبع and
+
+172
+00:11:53,250 --> 00:11:55,850
+fingers remaining of إيش يعني fingers remaining
+
+173
+00:11:55,850 --> 00:12:01,550
+of؟ لو رجعنا شويةحطت أصبعه وباقي الأصابع مرفوعات
+
+174
+00:12:01,550 --> 00:12:08,310
+يعني ايش اللي مناسق لجسم المريض فقط الأصبع الأوسط
+
+175
+00:12:08,310 --> 00:12:11,570
+من اليد اليسرى عشان هيك هذا الخطأ اللي بيجعل فيه
+
+176
+00:12:11,570 --> 00:12:16,210
+الأطباء الأطباء مرات بحط كل إيدهم مانفعش بتلاقي
+
+177
+00:12:16,210 --> 00:12:20,610
+أربع أصابع أو خمسة أو تلاتة احنا بنقول بس أصبع
+
+178
+00:12:20,610 --> 00:12:26,190
+واحد واللي يطرق بس أصبع واحدوالتانى بقول ايه عشان
+
+179
+00:12:26,190 --> 00:12:29,270
+انا remaining of the skin بنخلي الباقى الأصابيع
+
+180
+00:12:29,270 --> 00:12:34,190
+طلعت لبرا ال and ايش بقولها كمان and the tip of
+
+181
+00:12:34,190 --> 00:12:39,970
+the middle finger ايه هنا بقول ايه of the right
+
+182
+00:12:39,970 --> 00:12:45,360
+hand strike انه برضهطرف الإصبع الأيمن من اليد
+
+183
+00:12:45,360 --> 00:12:49,600
+اليمنى انا بحكي عمال عشان تفهموها بيطرق على ايه؟
+
+184
+00:12:49,600 --> 00:12:52,180
+على ال distal joint ايش قلنا distal fillings؟
+
+185
+00:12:52,180 --> 00:12:55,820
+distal joint تبع ايه؟ الإصبع اليسرى ليه؟ عشان
+
+186
+00:12:55,820 --> 00:12:59,660
+يسمعني الصوت اللي جوا بقول use quick and sharp
+
+187
+00:12:59,660 --> 00:13:02,780
+stroke ايش يعني use quick and sharp stroke؟ يعني
+
+188
+00:13:02,780 --> 00:13:06,860
+بقول لو سمحت لما انت تحاول تطرق على جسم الإنسان
+
+189
+00:13:06,860 --> 00:13:10,820
+ماتطرقش كأنك بتطبل على طبلة أو كأنك بتدج على شيء
+
+190
+00:13:11,050 --> 00:13:15,870
+خلّيك سريع عشان تسمع أي صوت غريب طيب فى حاجة اسمها
+
+191
+00:13:15,870 --> 00:13:19,690
+هنا percussion sounds أصوات بتطلع و احنا قاعدين
+
+192
+00:13:19,690 --> 00:13:23,150
+بننقر يعني أنا حكيت فى البداية لما ننقر على الرأس
+
+193
+00:13:23,150 --> 00:13:27,010
+غير لما ننقر على البطن فى حاجة اسمها هنا عشان
+
+194
+00:13:27,010 --> 00:13:31,270
+يكونوا أصوات حنسمعها .. حنقول أسمعها أول صوت اسمه
+
+195
+00:13:31,270 --> 00:13:35,070
+resonant ماحدى يقوليش معناته resonant رنان بغض
+
+196
+00:13:35,070 --> 00:13:39,110
+النظر ال resonant هذا الصوت ال resonant على ال
+
+197
+00:13:39,110 --> 00:13:42,950
+normal lungيعني الصوت عشان واحد يقولي طب كيف هو يا
+
+198
+00:13:42,950 --> 00:13:46,490
+أستاذ؟ ولا حاجة احنا بنجعله ال normal lung اللي هو
+
+199
+00:13:46,490 --> 00:13:48,410
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+200
+00:13:48,410 --> 00:13:49,870
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+201
+00:13:49,870 --> 00:13:49,930
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+202
+00:13:49,930 --> 00:13:50,470
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+203
+00:13:50,470 --> 00:13:51,130
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+204
+00:13:51,130 --> 00:13:51,590
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+205
+00:13:51,590 --> 00:13:52,310
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+206
+00:13:52,310 --> 00:13:52,310
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+207
+00:13:52,310 --> 00:13:56,350
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+208
+00:13:56,350 --> 00:13:56,350
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+209
+00:13:56,350 --> 00:14:00,670
+ال .. ال .. ال ..
+
+210
+00:14:00,670 --> 00:14:07,570
+ال .. ال .. ال .. ال .. ال
+
+211
+00:14:07,930 --> 00:14:11,530
+وفي بعض الحالات اسمها الانفزيما ايش الانفزيما هي
+
+212
+00:14:11,530 --> 00:14:15,950
+عبارة عن هروب الهواء من حواصلات الهوائية في بعض
+
+213
+00:14:15,950 --> 00:14:19,390
+الحالات الغريبة زي في حالات لا قدر الله ال gunshot
+
+214
+00:14:19,390 --> 00:14:23,670
+صابات او ال stab wound يعني حالات اللي هو واحد اكل
+
+215
+00:14:23,670 --> 00:14:29,170
+طعنة بسكينة او حالات يعني ال RTA الصدي عن الحوارات
+
+216
+00:14:29,170 --> 00:14:34,250
+بشكل عام هو مش موضوع انا بذكر مصطلحات ماهيخاف يقول
+
+217
+00:14:34,250 --> 00:14:37,690
+هذه الشيء اللي تبدأ عمله لأ الأمر أبسط من ما تتوقع
+
+218
+00:14:38,310 --> 00:14:42,230
+الصوت التالد اسمه ال timpani اللي هو صوت المعدة لو
+
+219
+00:14:42,230 --> 00:14:45,730
+أجينا عند المعدة .. لو أجينا عند المعدة مش هتكون
+
+220
+00:14:45,730 --> 00:14:49,350
+مليانة يعني الإنسان يكون وسط المعدة بطبيعتها الأكل
+
+221
+00:14:49,350 --> 00:14:52,270
+بينزلها تحت و ال solution و الهواء بيكون طالع لفوق
+
+222
+00:14:52,270 --> 00:14:54,990
+لو طرقنا عليها بتطلع صوت الصوت هذا إيش اسمه
+
+223
+00:14:54,990 --> 00:14:58,450
+timpani لو حد سألني وين المعدة هو عكوا تنسوا ال
+
+224
+00:14:58,450 --> 00:15:02,730
+anatomy المعدة شوية في شمال لفوق .. شوية في شمال
+
+225
+00:15:02,730 --> 00:15:06,170
+لفوق أما الأوروفيز اللي بيبقى على فوق البدايتها
+
+226
+00:15:06,170 --> 00:15:09,190
+اللي بيسموه ال cardiac sphincterاللي هو البدايتها
+
+227
+00:15:09,190 --> 00:15:13,610
+جاية شوية على الوسط يعني قريبة شوية من وسط الصدر
+
+228
+00:15:13,610 --> 00:15:18,990
+الدل .. إيش هذا الدل؟ الصوت اللي بيسموه القاتم صوت
+
+229
+00:15:18,990 --> 00:15:22,810
+غليظ زي إيش صوت ال liver و ال spleen لو حد سأله أن
+
+230
+00:15:22,810 --> 00:15:26,170
+ال liver ع جبالي المعدة على اليمين و بيخدله شوية
+
+231
+00:15:26,170 --> 00:15:30,890
+حيز طب وين ال spleen؟ بنذكركم ع شمال تحت ال إيه؟
+
+232
+00:15:30,890 --> 00:15:35,990
+تحت شوية من اللي هو ال stomach تحت اللي هو المعدة
+
+233
+00:15:35,990 --> 00:15:41,040
+flatالصوت المسطح اللى هو ايش بقوله يعني no air
+
+234
+00:15:41,040 --> 00:15:44,760
+يعني مافيه لا هوا ولا فيه solution طب هى ايش زى
+
+235
+00:15:44,760 --> 00:15:48,980
+ايش بقوله زى ال thigh muscles زى عضلة الفخد زى ال
+
+236
+00:15:48,980 --> 00:15:54,180
+bone العطم زى ال tumor لا قدر الله انه فيه tumor
+
+237
+00:15:54,180 --> 00:15:58,300
+وعملليه solid يعني جامد فلما بضغط عليه اسمه ايش
+
+238
+00:15:58,300 --> 00:16:02,440
+انا flat زى ما نضغط على اللوح المسطح او نضغط على
+
+239
+00:16:02,440 --> 00:16:09,160
+الحيط اسمه flat طيب escalationطبعا انا هذه اجهزة
+
+240
+00:16:09,160 --> 00:16:12,700
+بستخدموها للسماء خاصة مش احنا و في بعضهم بستخدموها
+
+241
+00:16:12,700 --> 00:16:17,810
+جديد كمان في عمليات ال ultrasoundاللي هو لما بدنا
+
+242
+00:16:17,810 --> 00:16:20,750
+نعمله خاصة لل pediatric الأطفال احنا اللي بيعنينا
+
+243
+00:16:20,750 --> 00:16:25,010
+السماعة هذه لكن السماعة اللي انا بقصدها مش السماعة
+
+244
+00:16:25,010 --> 00:16:28,030
+العادية اللي بين اديكم انا بتتكلم على ال medical
+
+245
+00:16:28,030 --> 00:16:31,650
+stethoscope ال medical stethoscope اللي هي رأسين و
+
+246
+00:16:31,650 --> 00:16:34,870
+اكيد منكم كتير اللي جيت حاجة من حد يسمع ان انا
+
+247
+00:16:34,870 --> 00:16:38,730
+بحكي هيتذكرها فى حاجة اسمها بال أديافرام ايش يعني
+
+248
+00:16:38,730 --> 00:16:42,190
+بال أديافرام يعني لحفتين حفة كبيرة زي اللي موجودة
+
+249
+00:16:42,190 --> 00:16:45,070
+عندكم اللي هي المسطح الدائرية اللي موجودة في
+
+250
+00:16:45,070 --> 00:16:49,300
+السماعة اللي معاكموالتالتة او التانية هي الصغيرة
+
+251
+00:16:49,300 --> 00:16:53,540
+جدا اللى بيستخدموها لما بدهم يسمعوا اصوات دقات
+
+252
+00:16:53,540 --> 00:17:00,000
+القلب واصوات حركات القلب خاصة في الأطفال طيب الان
+
+253
+00:17:00,000 --> 00:17:03,220
+ال escalation اذا بنتكلم على السماعة الان اش
+
+254
+00:17:03,220 --> 00:17:07,200
+بقوللي هاي السماعة اللى أنا حكيتها هذه الطرف اسمه
+
+255
+00:17:07,200 --> 00:17:12,660
+bell side و هذا الواسع اسمه diaphrag انا بذكركوا
+
+256
+00:17:12,660 --> 00:17:17,950
+ياريت الكل لما بقول diaphragالـ G لاتلفظ الـ G
+
+257
+00:17:17,950 --> 00:17:22,410
+silent ديافرام مش diaphragm نوع يبقى معناته
+
+258
+00:17:22,410 --> 00:17:24,830
+ديافرام و هذا اللي اللي انا بدي استخدمه بال
+
+259
+00:17:24,830 --> 00:17:30,370
+assessment تستخدمه هو ها هذه السماعة هذه السماعة
+
+260
+00:17:30,370 --> 00:17:34,490
+اسمها ايه اسمها medical stethoscope طبعا ممكن احنا
+
+261
+00:17:34,490 --> 00:17:38,050
+نستخدم سماعة تانية لكن ان وجدت هذه هي الأفضل في ال
+
+262
+00:17:38,050 --> 00:17:43,850
+assessment طيب طيب ليش انا بقى استخدم ال
+
+263
+00:17:43,850 --> 00:17:48,370
+auscultationبستخدم auscultation كمان مرة listening
+
+264
+00:17:48,370 --> 00:17:52,390
+to body sounds يعني بده أشوف أصوات اللي هو الجسم،
+
+265
+00:17:52,390 --> 00:17:55,430
+بده أشوف ال movement of air، حركة الهواء زي في ال
+
+266
+00:17:55,430 --> 00:17:59,210
+lungs، بده أشوف ال blood flow زي حكاية ال heart،
+
+267
+00:17:59,210 --> 00:18:02,730
+بده أشوف ال fluid، ال gas movement زي في ال bowels
+
+268
+00:18:02,730 --> 00:18:06,650
+اللي هو يعني الأمعاء، remember دايما the sound
+
+269
+00:18:06,650 --> 00:18:11,190
+changes، دايما بتتذكر ده فيه أصوات متغيرة في الجسم
+
+270
+00:18:11,190 --> 00:18:17,180
+الإنسان عشان أنت تقدر تعرفهاطيب خلينا نكمل how to
+
+271
+00:18:17,180 --> 00:18:20,140
+begin كيف انا ابدأ بقوللي ال positions دائما ال
+
+272
+00:18:20,140 --> 00:18:22,640
+positions اللي احنا حكينا صورهم في الأول بس
+
+273
+00:18:22,640 --> 00:18:26,020
+بنذكركم هنا بقوللي دائما استخدم ال position
+
+274
+00:18:26,020 --> 00:18:30,280
+المناسب لما انت تتعمل يعني ممكن يكون شوية جاعد
+
+275
+00:18:30,280 --> 00:18:33,780
+ممكن يكون شوية نايم على دهره بس على بطنه لأ بنفعش
+
+276
+00:18:33,780 --> 00:18:36,260
+و recumbent مش هينفع زي ما احنا هقوله لأنه بث
+
+277
+00:18:36,260 --> 00:18:41,560
+العضلات البطن طيب بقول استخدم هنا يعنيما تستخدم
+
+278
+00:18:41,560 --> 00:18:46,100
+يعني بيجي بعض الناس بيقول اتجدش هستخدم اللي هو ال
+
+279
+00:18:46,100 --> 00:18:49,660
+status scope طبعا هذه ال .. السطر هذا كله يقصد هنا
+
+280
+00:18:49,660 --> 00:18:52,940
+انه بيقول longer the tube more sound has to travel
+
+281
+00:18:52,940 --> 00:18:57,580
+احنا مش شرط يعني نستخدم يعني طويل جدا احنا السماعة
+
+282
+00:18:57,580 --> 00:19:01,740
+اللي معناها تقريبا يمكن طول ال .. الطول يمكن
+
+283
+00:19:01,740 --> 00:19:05,380
+اربعين، خمسين صنطي حتى بتصليش خمسين صنطة، اربعين
+
+284
+00:19:05,380 --> 00:19:09,160
+صنطة تقريبا ما بين اللي هو رأس السماعة و ما بين
+
+285
+00:19:09,160 --> 00:19:13,820
+انا بدي أبدأ أسمعلو استخدمنا أطول مش كويس يعني مش
+
+286
+00:19:13,820 --> 00:19:16,200
+.. مش معقول واحد يكونوا بيستخدمله يعني زي مترين
+
+287
+00:19:16,200 --> 00:19:19,640
+عشان يسمع فهو يعني كأنه بيقولنا نستخدم السماعة
+
+288
+00:19:19,640 --> 00:19:23,420
+الطبيعية hold diaphrag firmly ايش يعني ال diaphrag
+
+289
+00:19:23,420 --> 00:19:26,820
+احنا قولنا هي ال diaphrag عشان انا قلت كم مرة هي
+
+290
+00:19:26,820 --> 00:19:30,540
+ال diaphrag هيهم طبعا ايش بيقوللي امسك ال diaphrag
+
+291
+00:19:30,540 --> 00:19:34,740
+ايش بيقوللي امسك ال diaphrag against يعني حطها على
+
+292
+00:19:34,740 --> 00:19:38,200
+ايش على skin of the .. of the client against the
+
+293
+00:19:38,200 --> 00:19:43,620
+clients skin يعني اضغطها مباشرةبدون ايش هنا ها not
+
+294
+00:19:43,620 --> 00:19:48,020
+through clothing ايش يعني مش من خلال الملابس ليه؟
+
+295
+00:19:48,020 --> 00:19:51,760
+عشان مايصيرش الصوت يتخربط اما ال .. ال .. ال ..
+
+296
+00:19:51,760 --> 00:19:55,280
+لما تستخدم ال bell اللي هو الجزء الصغير .. الجزء
+
+297
+00:19:55,280 --> 00:19:58,800
+الصغير من السماعة ماتضغطش كتير لان لما تضغط ..
+
+298
+00:19:58,800 --> 00:20:01,640
+تضغط كتير كأنك ممكن تتوجه المريض لانه انت تتخيل
+
+299
+00:20:01,640 --> 00:20:04,800
+معاه، الان ال diaphragm واسع لما نضغط عليه بيضغط
+
+300
+00:20:04,800 --> 00:20:08,140
+.. مانزلش كتير في جسم الإنسانأما لما نستخدم الصغير
+
+301
+00:20:08,140 --> 00:20:10,740
+اللي هو الطرف الصغير بتلاقي الإنسان اللي هو
+
+302
+00:20:10,740 --> 00:20:13,800
+السماعة دخلت لجوه شوية عشان إيه؟ لإناش نضغط كتير
+
+303
+00:20:13,800 --> 00:20:20,700
+listen خلي إيدك يكون دافيات شوية عشان مايبروش خاصة
+
+304
+00:20:20,700 --> 00:20:24,980
+في الأطفال بعدين اسمع كويس و حاول تركز في إيه؟ في
+
+305
+00:20:24,980 --> 00:20:29,000
+الأصوات الolfaction لو حدثنا الolfaction هو
+
+306
+00:20:29,000 --> 00:20:32,580
+another skills يعني حاجة تانية بس كويسة ومهمة و
+
+307
+00:20:32,580 --> 00:20:36,360
+بدنا إياهابتلزمنا في ايش يا أستاذ؟ بتلزمنا انه
+
+308
+00:20:36,360 --> 00:20:41,500
+ممكن يكون في بعض الروايح تطلع للمريض يبتعمل شغلات
+
+309
+00:20:41,500 --> 00:20:45,560
+خطيرة زي كيف ال body odors ما بقولك تعال شم المريض
+
+310
+00:20:45,560 --> 00:20:48,260
+او ايه كيف كانك تشم إيدي ورجليه، no no no مش هذا
+
+311
+00:20:48,260 --> 00:20:53,200
+اللي قصد، بطلع بعض الأشياء اللي بتعمل عنده بعض
+
+312
+00:20:53,200 --> 00:20:58,580
+الأشياء اللي بتعمل عنده ريحة معينة وهذه الريحةيمكن
+
+313
+00:20:58,580 --> 00:21:03,380
+شوية اتدلل انه فيه مشكلة زي حاجة الآن هقولك هي
+
+314
+00:21:03,380 --> 00:21:07,140
+اسمها diabetic ketoacidosis مثلا diabetic
+
+315
+00:21:07,140 --> 00:21:10,500
+ketoacidosis زي ايش اللي هو حرج السكر اللي بيصير
+
+316
+00:21:10,500 --> 00:21:17,220
+عند بعض المرضى اللي عندهم سكر اقولكوا كيف خلينا
+
+317
+00:21:17,220 --> 00:21:20,440
+نقول الان smelling بقولي بدك تشم عشان اذا في
+
+318
+00:21:20,440 --> 00:21:26,220
+abnormalities اذا في اي اشياء غير طبيعيةغير طبيعية
+
+319
+00:21:26,220 --> 00:21:31,180
+ممكن تحددها عن طريق الشم فلو مريض السكر هذا مريض
+
+320
+00:21:31,180 --> 00:21:37,460
+السكر الآن في مشكلة عنده انحرج السكر انحرج السكر
+
+321
+00:21:37,460 --> 00:21:41,680
+لما انحرج السكر صار عنده بدل ما يستخدم الآن ال
+
+322
+00:21:41,680 --> 00:21:45,650
+glucose و ال carbohydrate صار يستخدمجسمه الفات
+
+323
+00:21:45,650 --> 00:21:49,310
+فصار حمضية فى الدم وانتوا عارفين بيصير كل gram
+
+324
+00:21:49,310 --> 00:21:52,430
+يطلع تسعة kilo calorie فى الفات فهنا بيسموه حمضية
+
+325
+00:21:52,430 --> 00:21:57,810
+فى الدم فكيف بنعرفها فقط من ريحة نفس المريض بيبقى
+
+326
+00:21:57,810 --> 00:22:03,350
+نفسه ريحته زى التفاح اكرمكم الله المعفنزي الريحة
+
+327
+00:22:03,350 --> 00:22:08,490
+التفاح المخمج يعني زي اللي متروك لوقت كبير وصار له
+
+328
+00:22:08,490 --> 00:22:12,430
+ريحة سيئة هذا الريحة بتدللنا انه ايش انه حد صار
+
+329
+00:22:12,430 --> 00:22:15,490
+عنده diabetic keto as those ولو ماشمناش هذا الريحة
+
+330
+00:22:15,490 --> 00:22:19,410
+مش هنقدر نتأكد إلا من فحصات تانية assessment بقولي
+
+331
+00:22:19,410 --> 00:22:23,190
+of characteristic odors كيف طب لإيش انت بدك تقولنا
+
+332
+00:22:23,190 --> 00:22:27,550
+الروايح عشان إيش اللي بدك تشمهم بقولي مثلا alcohol
+
+333
+00:22:27,550 --> 00:22:33,200
+لو شمنا ريحة ال alcoholلا قدر الله، هو الحمد لله
+
+334
+00:22:33,200 --> 00:22:35,940
+في غزة، الحمد لله يعني الشبن مش موجود هذا الكلام،
+
+335
+00:22:35,940 --> 00:22:39,060
+إلا مانادر، لو شمنا ريحة الكحول زي ما موجود للأسف
+
+336
+00:22:39,060 --> 00:22:43,200
+عند كتير من بعض البلدان برا، من الفم، هنقول فورا
+
+337
+00:22:43,200 --> 00:22:47,880
+أن هذا ingestion of alcohol، يعني شارب كحول، يعني
+
+338
+00:22:47,880 --> 00:22:51,930
+مدمن، بما معناهطب لو شمنه ريحة الأمونيا النشادر من
+
+339
+00:22:51,930 --> 00:22:54,390
+اليورانيا، يعني واحد أجي قاللي يا أستاذ أنا بدأ
+
+340
+00:22:54,390 --> 00:22:58,270
+أكون شاطر، أنا الآن ماخد مادة assessment و الناس
+
+341
+00:22:58,270 --> 00:23:00,810
+عامالي بتقدم في العلم و أنا حكيتلكوا في البداية
+
+342
+00:23:00,810 --> 00:23:04,290
+ممكن تكون هذه أهم مادة في كل الكلية تتمرد، مش
+
+343
+00:23:04,290 --> 00:23:07,590
+بقولها عشان أنا بدرسها، لأ عشان هتنفعك و تنفعك
+
+344
+00:23:07,590 --> 00:23:10,530
+لمدى الحياة، بيجينا واحد بيقولك أنا بروح الحمام
+
+345
+00:23:10,530 --> 00:23:15,030
+بشم ريحة سيئةرايحة سيئة كثير بيقولك زي النشادر
+
+346
+00:23:15,030 --> 00:23:19,370
+بنقوله افحص البول لأن هذا مش بدل انه عندك UTI اللي
+
+347
+00:23:19,370 --> 00:23:22,630
+هو ايش اختصارها اختصار ل urinary tract infection
+
+348
+00:23:22,630 --> 00:23:27,390
+طيب bad odor from skin لو شمنا ريحة مش كويسة لكن
+
+349
+00:23:27,390 --> 00:23:31,050
+في ال skin under arms يعني تحت القبض او تحت ال
+
+350
+00:23:31,050 --> 00:23:35,150
+breast ايش هذا بتقولي فيه poor hygiene طب واحد
+
+351
+00:23:35,150 --> 00:23:41,250
+عنده او عنده excess perspiration التعرق زادالمصطلح
+
+352
+00:23:41,250 --> 00:23:44,130
+الغريب اللى كتير الناس مايعرفهوش لما نصير عند
+
+353
+00:23:44,130 --> 00:23:48,930
+المريض متعرق زائد كتير ايش اسمه برومهيدروسيز ايش
+
+354
+00:23:48,930 --> 00:23:52,990
+اسمه برومهيدروسيز لما نقول كلمة برومهيدروسيز يعني
+
+355
+00:23:52,990 --> 00:23:57,250
+excessive perspiration التعرق الزائد اللى بيصير
+
+356
+00:23:57,250 --> 00:23:59,710
+عند بعض الناس في الأيدين او تحت القبض او تحت ال
+
+357
+00:23:59,710 --> 00:24:04,050
+breast طيب foul smelling الريحة السيئة اللى مرات
+
+358
+00:24:04,050 --> 00:24:07,330
+بتكون عند ال perspiration برضه بندونها مش كل الناس
+
+359
+00:24:07,330 --> 00:24:12,080
+عنده ريحة لكن لو كانت موجودة بندونهاطب ريحة الفيسز
+
+360
+00:24:12,080 --> 00:24:17,120
+أكرمكم الله يعني ريحة يعني كأنه ريحة وسخ ريحة
+
+361
+00:24:17,120 --> 00:24:20,400
+الفيسز هذه لو طلعت من ال wound إيش هنشك؟ إذا أجت
+
+362
+00:24:20,400 --> 00:24:22,820
+من ال wound فورا هنشك في ال إيش؟ wound abscess.
+
+363
+00:24:23,460 --> 00:24:26,340
+الآن لو شمنا لأ قدر الله نفس الريحة بس من وين؟ من
+
+364
+00:24:26,340 --> 00:24:30,660
+ال vomitus يعني أجتني حالة و قعدت في المستشفى أو
+
+365
+00:24:30,660 --> 00:24:34,740
+في البيت مالوش إله أكمن يوم بروحش الحماميعني ما
+
+366
+00:24:34,740 --> 00:24:38,320
+أخرجش إليه يمكن تلت أربع أو خمس أيام و عامله بيصير
+
+367
+00:24:38,320 --> 00:24:40,800
+عنده vomiting كل ما بيأكل بيصير عنده vomiting لما
+
+368
+00:24:40,800 --> 00:24:43,360
+بشم ريحة ال vomiting كان صار فيه عنده ريحة feces
+
+369
+00:24:43,360 --> 00:24:47,620
+إيش بشك فورا؟ intestinal obstruction يعني بوا ال
+
+370
+00:24:47,620 --> 00:24:51,680
+obstruction انسداد معوي علشان هيك بنقوله لأ تعال
+
+371
+00:24:51,680 --> 00:24:55,600
+فورا هذا اللي زيه حالة سريعة بدنا نحاول إيش نعمل a
+
+372
+00:24:55,600 --> 00:24:59,800
+further examination ممكن تحتاج عمل إيه جراحية طيب
+
+373
+00:24:59,800 --> 00:25:03,860
+هلو شمنا نفس الريحة من منطقة ال rectal areaماحد
+
+374
+00:25:03,860 --> 00:25:06,920
+يقول لي يا أستاذ طب ما هي already من منطقة direct
+
+375
+00:25:06,920 --> 00:25:10,200
+area؟ لأ يا أستاذ أنا بدي أقولك صحيح منطقة direct
+
+376
+00:25:10,200 --> 00:25:13,260
+area الحمد لله مع الطهارة والنظافة لأ بنشمش هذه
+
+377
+00:25:13,260 --> 00:25:17,000
+الريحة لكن لو انشمت هذه الريحة بيكون عنده fecal
+
+378
+00:25:17,000 --> 00:25:20,960
+incontinence ايش يعني incontinence؟ بيصير لقدر
+
+379
+00:25:20,960 --> 00:25:24,300
+الله عدم تحكم زي بعض الناس اللي عندهم يعني
+
+380
+00:25:24,300 --> 00:25:27,680
+neurological abnormalities أو neurological disease
+
+381
+00:25:27,680 --> 00:25:32,520
+يعني أي مرض عصبي ممكن يؤثر على عدم التحكم عندهمطب
+
+382
+00:25:32,520 --> 00:25:36,620
+الفول سميلينج الفول سميلينج اللي هي خليني أقول
+
+383
+00:25:36,620 --> 00:25:40,420
+يعني الريحة الصعبة أو يعني الريحة ال .. ال .. ال
+
+384
+00:25:40,420 --> 00:25:43,440
+offensive odor يعني اللي بتكون كريهة من ال stool
+
+385
+00:25:43,440 --> 00:25:47,520
+خاصة في حالة ال infant يعني بتيجي الأم بتقول ممكن
+
+386
+00:25:47,520 --> 00:25:51,860
+تسألكوا .. تقولك أنا الطفل لما بروح الحمام يعني كل
+
+387
+00:25:51,860 --> 00:25:55,000
+البيت بن .. بنفتح كل الشبابيك و الدنيا كلها مش
+
+388
+00:25:55,000 --> 00:25:58,600
+عارفش نعمل و حماله بطلع يعني إخراج كتير هذا إيش
+
+389
+00:25:58,600 --> 00:26:02,960
+اسم المرض؟بشك في مرض اسمه mal absorption syndrome
+
+390
+00:26:02,960 --> 00:26:07,240
+مرض سوء الامتصاص طبعا هذا disorder صعب بنوديه على
+
+391
+00:26:07,240 --> 00:26:10,420
+الأطفال اللي بيشتغلوا معاه هم لكن احنا بداية
+
+392
+00:26:10,420 --> 00:26:13,440
+الطريق اللي كدرنا نشخص و كدرنا نعرف ان فيه مشكلة
+
+393
+00:26:13,440 --> 00:26:18,340
+طيب halitosis ايش يعني halitosis؟الرائحة الكريهة
+
+394
+00:26:18,340 --> 00:26:22,460
+لو أجت من ال oral يعني واحد قاعد جنبي ريحة تمه
+
+395
+00:26:22,460 --> 00:26:26,280
+كتير سيئة مانروح لبعيد بيكون عنده bored dental
+
+396
+00:26:26,280 --> 00:26:29,380
+hygiene الرائحة ماحد يقولي إلا في بعض الحالات
+
+397
+00:26:29,380 --> 00:26:33,060
+بيقولك من ال internal body organ زي من المعدة هذه
+
+398
+00:26:33,060 --> 00:26:37,040
+حالة نادرة لكن بشكل عام من وين جاية للأسف من ال
+
+399
+00:26:37,040 --> 00:26:42,020
+dental يعني abnormal hygiene طب لسويت ريحة الاش
+
+400
+00:26:42,020 --> 00:26:46,460
+ريحة يعني حاجة كأنه زي ريحة الحلوياتأو ريحة
+
+401
+00:26:46,460 --> 00:26:49,900
+الفروتي اللى زى اللى حتى انا حكيتها بيجي بعض الناس
+
+402
+00:26:49,900 --> 00:26:55,700
+بيقولك انا شامم ريحة ايه؟ ريحة تفاح، امعفن، هذا
+
+403
+00:26:55,700 --> 00:27:00,520
+ايش؟ هو ال ketones اللى هو ال ketone body طبعا
+
+404
+00:27:00,520 --> 00:27:05,400
+لمين دولة اختصاره؟ diabetic دى، keto هى keto،
+
+405
+00:27:05,400 --> 00:27:08,800
+acetosis ايش acetosis يعني؟ حمضية، يبقى حمضية
+
+406
+00:27:08,800 --> 00:27:12,700
+نادجة عن ايش؟ استخدام السكر من الفتطبعا من وين انا
+
+407
+00:27:12,700 --> 00:27:17,500
+عرفته؟ انا كحكيم عرفته و روح قلت للطبيب musty
+
+408
+00:27:17,500 --> 00:27:23,320
+معناه التعفن لو شم الإنسان ريح التعفن في وين؟ في
+
+409
+00:27:23,320 --> 00:27:27,160
+منطقة ال cast ايش ال cast يعني ال gyps أجاني مريض
+
+410
+00:27:27,160 --> 00:27:31,060
+مركبله جابيرة على أيده أو مركبله جابيرة على رجله
+
+411
+00:27:31,060 --> 00:27:35,550
+أو أي طرف ففجأة لقيت الريحة سيئةفبقوله ايش هاد
+
+412
+00:27:35,550 --> 00:27:39,830
+الريحة؟ بقول مش عارف تطلع مني ريحة سيئة بستناش هذا
+
+413
+00:27:39,830 --> 00:27:43,150
+معناته في infection inside caste يعني هناك التهاب
+
+414
+00:27:43,150 --> 00:27:47,270
+تحت الجبيرة و يجب رفع الجبيرة فورا انا مابرفحاش
+
+415
+00:27:47,270 --> 00:27:51,470
+بحاوله فورا قسم الطوارق برفعوله الجبيرة في حاجة
+
+416
+00:27:51,470 --> 00:27:55,610
+اسمها الريحة النتنة النتنة زي حاجة المبردة القديمة
+
+417
+00:27:55,610 --> 00:27:59,810
+جدا زي واحد انا بقولك ريحته مع البرودة الشديدة
+
+418
+00:27:59,810 --> 00:28:04,620
+ريحة يعني قاتلة هذا اسمها fittedلما نقول fitted
+
+419
+00:28:04,620 --> 00:28:08,340
+ريحانتنا، لو شمينا ريحانتنا من ال tracheostomy،
+
+420
+00:28:08,340 --> 00:28:13,260
+خاصة ال tracheostomy اللي مركبله مبوب يعني في زوره
+
+421
+00:28:13,260 --> 00:28:17,800
+عشان يتنفس، بعض الحالات اللي عندهم difficulty of
+
+422
+00:28:17,800 --> 00:28:21,040
+breathing أو لقدرله عنده tumor، هتلاقوا لما تروحوا
+
+423
+00:28:21,040 --> 00:28:26,110
+تتدربوا، بيركبوله زي .. زي صفار، هيك ..مشاكلها في
+
+424
+00:28:26,110 --> 00:28:30,970
+داخل منطقة الزور اللى في الرقبة فاصلة رقبة بتنفس
+
+425
+00:28:30,970 --> 00:28:35,890
+منها لو صار فيها ريحة مش تمام فورا بنشك ايه انه
+
+426
+00:28:35,890 --> 00:28:41,210
+فيها infection برضه هذا مهم طيب ال basic ال basic
+
+427
+00:28:41,210 --> 00:28:44,890
+ال basic guidelines ال basic guidelines for
+
+428
+00:28:44,890 --> 00:28:48,930
+physical assessment انا بدي انا اشهر الخطوط
+
+429
+00:28:48,930 --> 00:28:51,610
+الرئيسية او الأساسية اللى بدي اعمل فيها physical
+
+430
+00:28:51,610 --> 00:28:55,460
+assessment اول حاجة obtain nursing historyخد
+
+431
+00:28:55,460 --> 00:29:00,420
+التاريخ من المريض، maintain privacy، يعني حاول
+
+432
+00:29:00,420 --> 00:29:03,820
+تحافظ على السرية تبع المريض، explain the
+
+433
+00:29:03,820 --> 00:29:07,120
+procedure، عرف أنت إيش اللي جاي تشتغله، و إيش اللي
+
+434
+00:29:07,120 --> 00:29:11,400
+جاي تعمله عنده، لأنه عشان يكون متقبل أمره يعطيك كل
+
+435
+00:29:11,400 --> 00:29:14,990
+المعلومات اللي عندهواش ال purpose لكل حاجة يعني
+
+436
+00:29:14,990 --> 00:29:18,790
+انا ماتديش تقوله انا اجيسلك الضغط ليش، ماتديش
+
+437
+00:29:18,790 --> 00:29:21,870
+تقوله معلوش بدي اكشف عن بطنك عشان تقوله عشان كده،
+
+438
+00:29:21,870 --> 00:29:25,010
+انا والله لأ معلوش بتعملك تقييم واشوف وضع اذا في
+
+439
+00:29:25,010 --> 00:29:28,770
+اي حاجة غير طبيعية، بيرتاح المريض وبيعطيك
+
+440
+00:29:28,770 --> 00:29:33,010
+المعلومات و هو بكل كامل ارياحيته، follow planned
+
+441
+00:29:33,010 --> 00:29:38,830
+order، ما تشتغل عشوائي، اشتغل حسب ال planningعندك
+
+442
+00:29:38,830 --> 00:29:42,670
+خطة امشي عليها شوية شوية ما تيجي يعني from body
+
+443
+00:29:42,670 --> 00:29:46,450
+system to body system from part to part not from
+
+444
+00:29:46,450 --> 00:29:50,130
+يعني floating floating يعني نط ماتنطش شوية شوية
+
+445
+00:29:50,130 --> 00:29:55,030
+طيب وهي رجع يذكرني كمان مرة inspect palpate
+
+446
+00:29:55,030 --> 00:29:59,950
+percussum واخر حاجة oscultate هذا الطبيعي لكل جسم
+
+447
+00:29:59,950 --> 00:30:03,890
+ايش عضاء الجسم الا في حالة الابدومين حالة
+
+448
+00:30:03,890 --> 00:30:08,270
+الابدوميش قال لي inspectاتطلع، لاحظ و اسكلتت
+
+449
+00:30:08,270 --> 00:30:12,310
+استخدم سماعتك، percuss، أخر حاجة بالبيت عشان ممكن
+
+450
+00:30:12,310 --> 00:30:18,330
+يكون فيها ألم، ليه؟ عشان خاصة خاصة، لو حد سأل، يا
+
+451
+00:30:18,330 --> 00:30:20,950
+أستاذ طب ليش ما نستخدمش ال بالبيت في الأول؟ لو
+
+452
+00:30:20,950 --> 00:30:25,770
+استخدمنا ال bulbation في الأول بتغير صوت الأمعة،
+
+453
+00:30:25,770 --> 00:30:29,590
+لو تخيلنا واحد، بدنا نعرف صوت الأمعة عنده شغالة
+
+454
+00:30:29,590 --> 00:30:33,930
+ولا لأ، لو واحد سألني هو إلها صوت؟ أه يا أستاذ،
+
+455
+00:30:33,930 --> 00:30:37,970
+الأمعة تبعدنا إلها صوت؟الصوت احنا بنسميه waving
+
+456
+00:30:37,970 --> 00:30:43,010
+sound يعني اسمه الصوت ايش يعني waving يعني waving
+
+457
+00:30:43,010 --> 00:30:47,510
+زي الموجات صوت موجي زي الصوات اللي بتطلع من ال
+
+458
+00:30:47,510 --> 00:30:51,450
+vein اللي هو من ايه ايش من الوريد مش الأصوات اللي
+
+459
+00:30:51,450 --> 00:30:55,450
+بتطلع من الشريان الشريان طبعا اللي هو النبط لكن في
+
+460
+00:30:55,450 --> 00:31:00,170
+عنا لما بنتكلم على ال wave يعني ايش زي الموجات
+
+461
+00:31:00,170 --> 00:31:06,510
+فبينفعشأمسك البطن ثم بعد ذلك انا احط السماعة بتغير
+
+462
+00:31:06,510 --> 00:31:11,830
+الصوت طيب if there is abnormality اذا كان في شي مش
+
+463
+00:31:11,830 --> 00:31:16,570
+طبيعي هنا بقول لأ بدك تزيد الفحص ايش يعني تزيد؟
+
+464
+00:31:16,570 --> 00:31:20,050
+بدك تعمل further data يعني انتبه اذا طلع عندك اشي
+
+465
+00:31:20,050 --> 00:31:24,570
+مش طبيعي يعني في قلم بدك تسأله وين ال radiation of
+
+466
+00:31:24,570 --> 00:31:28,230
+pain وين القلم بيشيع يعني وين بيودي وين بيسمع حسب
+
+467
+00:31:28,230 --> 00:31:33,570
+لغة المرضى هل بتأثر من الطعام؟هل ال bowels في
+
+468
+00:31:33,570 --> 00:31:37,150
+عندها مشكلة؟ هل بقدر يؤدي المريض ال activity of
+
+469
+00:31:37,150 --> 00:31:41,290
+daily living كل الأسئلة عامة هذه ايش اسمها basic
+
+470
+00:31:41,290 --> 00:31:45,150
+guidelines عشان تطلع بال physical لسه انا ماعملتش
+
+471
+00:31:45,150 --> 00:31:49,070
+physical لأ examination كل اللي بعمله كل تحضير ال
+
+472
+00:31:49,070 --> 00:31:51,750
+physical examination اللي هنشرحه ان شاء الله في
+
+473
+00:31:51,750 --> 00:31:56,790
+الشهر القادم self physical assessmentخلّي المريض
+
+474
+00:31:56,790 --> 00:31:59,930
+في بعض الحالات شغلات أنا بقدرش أعملها examination
+
+475
+00:31:59,930 --> 00:32:04,290
+خاصة لما تكون فيها embarrassment إحراج أو هو برفض
+
+476
+00:32:04,290 --> 00:32:08,490
+خاصة ال male و ال female يعني ممكن نيجي .. ممكن
+
+477
+00:32:08,490 --> 00:32:11,190
+مرفعش نيجي نقول الفemale بدي أشوف ال breast و كده
+
+478
+00:32:11,190 --> 00:32:15,210
+خاصة إذا أنت male أو هي أنت الحكيمة female مابتنفع
+
+479
+00:32:15,210 --> 00:32:17,410
+تقول بدي أشوف منطقة ال breast أو منطقة ال
+
+480
+00:32:17,410 --> 00:32:20,630
+testicular عند ال male لل genital area أو حتى
+
+481
+00:32:20,630 --> 00:32:24,190
+منطقة ال foot يعني ال foot كي و بالذات للناس اللي
+
+482
+00:32:24,190 --> 00:32:27,130
+عندهم diabeticممكن المريض يكون مثقف، المريض يفهم
+
+483
+00:32:27,130 --> 00:32:30,570
+مرضه، هو يقولك لا الحمد لله أنا طبيعي و انا عارف
+
+484
+00:32:30,570 --> 00:32:33,250
+انت علشان بتسألني، ماعنديش تقرحات، ماعنديش اي
+
+485
+00:32:33,250 --> 00:32:36,710
+أمراض، ماعنديش اي أشكالية، لو عنده هو هيقولك، اذا
+
+486
+00:32:36,710 --> 00:32:41,210
+جالك احنا ممكن نبلغ الطبيب الأخ الصحي طيب allow
+
+487
+00:32:41,210 --> 00:32:45,890
+time for client questions، خلي دايما وقت مناسب
+
+488
+00:32:45,890 --> 00:32:52,770
+للمريض يسأل، ما تستعجل انك انت تخليه و كأنك بتقطم
+
+489
+00:32:52,770 --> 00:32:55,910
+عليه الكلام و مابتخلوهش، خليه براحة يحكيكRemember
+
+490
+00:32:55,910 --> 00:32:59,110
+دايما ذكر the most important يعني لما يقولي
+
+491
+00:32:59,110 --> 00:33:01,810
+بالأحمر the most important مش واحد يقولي يعني اه
+
+492
+00:33:01,810 --> 00:33:06,110
+مهم الامتحان لأ يعني اهم guideline اهم guideline
+
+493
+00:33:06,110 --> 00:33:11,530
+اليك في ال physical ايش هو continuous practice of
+
+494
+00:33:11,530 --> 00:33:14,830
+physical assessment skills ايش يعني يعني بيقولي
+
+495
+00:33:14,830 --> 00:33:17,550
+اهم guideline اليك و انت بتعمل assessment
+
+496
+00:33:17,550 --> 00:33:22,650
+الاستمرارية هه و ما تقطع ال assessment الا في
+
+497
+00:33:22,650 --> 00:33:27,490
+حالاتما تبقى قطع اذا كان كبير في السن او يعني لا
+
+498
+00:33:27,490 --> 00:33:31,890
+سمح الله مش متعاون معاه او لأ قطعي صغير جدا في هذه
+
+499
+00:33:31,890 --> 00:33:35,950
+الحالة بقولك اقطع ال assessment وعود كملها لكن لل
+
+500
+00:33:35,950 --> 00:33:39,650
+normal client عشان ما تنساش ابدأ معاه وكمل طول ما
+
+501
+00:33:39,650 --> 00:33:44,450
+هو متحمل كمل معاه طيب في عندنا حسمة variation
+
+502
+00:33:44,450 --> 00:33:50,950
+اختلافات في ال physical assessment زي في حالة ال
+
+503
+00:33:50,950 --> 00:33:54,330
+pediatrics انا توع حكيت ايش قلت؟قولت مرات يعني
+
+504
+00:33:54,330 --> 00:33:59,530
+مرات انا بحتاج الفيديوهات اللي مش بتعاون معايا طب
+
+505
+00:33:59,530 --> 00:34:02,130
+انا بدي انا اشوف بدي اعمل تتابع sequence of
+
+506
+00:34:02,130 --> 00:34:05,510
+physical assessment depends يعتمد على ايش؟ على ال
+
+507
+00:34:05,510 --> 00:34:09,750
+development level of the gland بيعتمد على مستوى
+
+508
+00:34:09,750 --> 00:34:16,500
+تطور ايه؟ تطور المريض والله ده لما الطفل مستوعببقى
+
+509
+00:34:16,500 --> 00:34:19,340
+ماشي معاه مش مستوعب يعني صار يعيد زي الأطفال
+
+510
+00:34:19,340 --> 00:34:23,640
+الصغار كتير أو خاف أو عنده رهبة بأجل بصير أجسم
+
+511
+00:34:23,640 --> 00:34:28,080
+حالة الوضع ال assessment حسب استجابة الطفل بقولي
+
+512
+00:34:28,080 --> 00:34:32,160
+دايما كمان اش بقولي هنا establishment of report
+
+513
+00:34:32,160 --> 00:34:36,980
+لما تيجي دايما بدنا يعني .. يعني نعمل يمكن هنا في
+
+514
+00:34:36,980 --> 00:34:42,380
+خطأ مطبعي هي يعني الصح مش report هي ياريت اللي
+
+515
+00:34:42,380 --> 00:34:46,530
+بيسمعني معلش أنا نسيت أغيرهاالـ E بتتغير بصير A
+
+516
+00:34:46,530 --> 00:34:50,950
+report وليس report هو هنا يقصد حتى في خطأ يبدو
+
+517
+00:34:50,950 --> 00:34:55,810
+مطبع في الكتاب نفسه establishment لازم تبني report
+
+518
+00:34:55,810 --> 00:35:00,750
+معناته ثقة معناته ايش تأمين الطفل ايش تأمين الطفل
+
+519
+00:35:00,750 --> 00:35:07,050
+لازم تحط ثقة بينكما يعني تخلي الطفل يثق فيك عشان
+
+520
+00:35:07,050 --> 00:35:09,990
+ايه هنا عشان most essential to step in the
+
+521
+00:35:09,990 --> 00:35:14,950
+physical assessmentجابل ما احنا نقدر نروح المريض
+
+522
+00:35:14,950 --> 00:35:18,230
+على الطفل هذا اللي مش راضي يتعاون معنا لازم يكون
+
+523
+00:35:18,230 --> 00:35:21,730
+يعني بينه و بينه ثقة عشان انا سميتها establishment
+
+524
+00:35:21,730 --> 00:35:26,230
+ابدأ و حط جسور للثقة بينك و بين الطفل عشان يقدر
+
+525
+00:35:26,230 --> 00:35:29,870
+يعطيك المعلومات reduce fearing خفف الخوف مجرد
+
+526
+00:35:29,870 --> 00:35:34,060
+مطمئنلك خفف مش معقول تجي تعمل assessmentو معلش يا
+
+527
+00:35:34,060 --> 00:35:36,980
+أستاذ انت ما شاء الله عليك طويل و لابس ال code زي
+
+528
+00:35:36,980 --> 00:35:40,400
+بعض الناس اللي كانوا يخطؤوا في هذا الأمر و حاطط
+
+529
+00:35:40,400 --> 00:35:44,160
+كمان قبرتين في جيبته يعني سرنجان يعني الطفل طبعا
+
+530
+00:35:44,160 --> 00:35:48,240
+يعني ماضالش فيه دم التمس يعني فقبل ما تبدأ بدك
+
+531
+00:35:48,240 --> 00:35:53,180
+تكون ايش تخفف الخوف عند الطفل، الآن في بعض الحالات
+
+532
+00:35:53,180 --> 00:35:56,940
+طبعا مضطر غصب عني اعمله assessment مضطرالطفل مش
+
+533
+00:35:56,940 --> 00:35:59,820
+متعاون زي في حالات ال meningitis انا مضطر اعمل
+
+534
+00:35:59,820 --> 00:36:03,380
+assessment او زي في حالات لا قدر الله افرضه في
+
+535
+00:36:03,380 --> 00:36:07,300
+firm body مثلا aspiration طفل بلا شيء و هو مش
+
+536
+00:36:07,300 --> 00:36:10,560
+متعاون انا بصبورش في هالحالة، بدى اضطر اعمله
+
+537
+00:36:10,560 --> 00:36:12,760
+physical restraint، ايش كان physical restraint؟
+
+538
+00:36:12,760 --> 00:36:16,910
+بده ربطهبدي اكتفه طبعا مش هربطه يعني بدي اشتري حبل
+
+539
+00:36:16,910 --> 00:36:19,990
+و أقعد اربط فيه المقصود هنا ان اخلي حد يتعاون
+
+540
+00:36:19,990 --> 00:36:24,190
+معايا يثبته منيح عشان اقدر اعمل examination بدون
+
+541
+00:36:24,190 --> 00:36:28,370
+ما انا اضر ايش بدون ما اضر الطفل زي ما مع الأطفال
+
+542
+00:36:28,370 --> 00:36:34,020
+زي ما مع الأكبار فيه تغييراتبعض الحالات بقوللي انت
+
+543
+00:36:34,020 --> 00:36:37,100
+ممكن تستخدم كمان حاجة اللي بيسموها ال caregiver
+
+544
+00:36:37,100 --> 00:36:40,420
+مين هو ال caregiver اللي بتعطي الرعاية و العناية
+
+545
+00:36:40,420 --> 00:36:43,780
+للطفل ممكن تجيبه يعني مش شرط تكون الأم يعني ممكن
+
+546
+00:36:43,780 --> 00:36:49,340
+تحتاج حد يساعدك و أنت بتعمل اساسية مدينة يعني مثلا
+
+547
+00:36:49,340 --> 00:36:53,160
+زي أمه .. زي أمه مش .. مش إيه زي أخالته زي عبده
+
+548
+00:36:53,160 --> 00:36:57,500
+قصة زي إيش زييك ممكن ييجي يقولك انا you must
+
+549
+00:36:57,500 --> 00:37:03,330
+facilitateتساعدني لأن أنا مش قادر .. مش قادر أمشي
+
+550
+00:37:03,330 --> 00:37:07,270
+مع الطفل فبتيجي الام بتمسك الطفل بتحمله ومش عيب
+
+551
+00:37:07,270 --> 00:37:11,550
+حتى ومش غلط ممكنية تحمله ويجي الطبيب يقعد يسمع نفس
+
+552
+00:37:11,550 --> 00:37:15,810
+الطفل وهي حاملها مافي مشكلة طالما اطمئن لامه او
+
+553
+00:37:15,810 --> 00:37:19,430
+لخالته او لعمته طبعا هنا assessment approach دايما
+
+554
+00:37:19,430 --> 00:37:23,230
+based on ايش ال child's response يعني ماجيش استعدل
+
+555
+00:37:23,230 --> 00:37:30,250
+حسب استجابة الطفل بامشي صار عيط بوقفuncooperative
+
+556
+00:37:30,250 --> 00:37:34,470
+ايش uncooperative؟ اذا كان الطفل اللي قدامي مش
+
+557
+00:37:34,470 --> 00:37:39,930
+متعاون ماجيش اقول اوف هو لازم كل الأطفال يكونوا
+
+558
+00:37:39,930 --> 00:37:44,790
+معانا متعاونين لأ لازم نعرف احنا كتمريض ان السلوك
+
+559
+00:37:44,790 --> 00:37:48,710
+يعني ال .. ال .. دايما الحرك لل .. للأطفال هذا
+
+560
+00:37:48,710 --> 00:37:52,170
+طبيعي يعني طبيعي الطفل يكون بتحرك كتير طبيعي الطفل
+
+561
+00:37:52,170 --> 00:37:55,670
+يخاف طبيعي يرفض اللي مش طبيعي اللي يقولك اتفضل لإن
+
+562
+00:37:55,670 --> 00:37:58,920
+هو مش كبير هو في الزمنفدائما لازم نعرف أن هذا
+
+563
+00:37:58,920 --> 00:38:02,120
+يعتبر normal إذا لاجينا الولد مش متعاون معانا لازم
+
+564
+00:38:02,120 --> 00:38:06,080
+نعتبره normal الشطارة فينا كيف نخليه متعاون معانا
+
+565
+00:38:06,080 --> 00:38:10,940
+إما مساعد الآخرين أو أنه هو يكون يعني معنى بنجسم
+
+566
+00:38:10,940 --> 00:38:15,460
+ال assessment شوية شوية طبعا هنا كمان في variation
+
+567
+00:38:15,460 --> 00:38:20,190
+وين في ال geriatric في حالة الكبار السنانا مش عاجز
+
+568
+00:38:20,190 --> 00:38:23,650
+اقول و الله بدى انا اعمل ثقة و بدى اجيب اهله و امه
+
+569
+00:38:23,650 --> 00:38:28,130
+مش معقول لان هو اختيار او عجوز و عندي الان بنذكر
+
+570
+00:38:28,130 --> 00:38:30,490
+ان في عنا normal variation ايش هي ال normal
+
+571
+00:38:30,490 --> 00:38:33,190
+variation؟ في اختلفات طبيعية اللي علاقة بال aging
+
+572
+00:38:33,190 --> 00:38:35,670
+يعني ما واحد ييجي يقول ليه و الله لجيت دهره عامل
+
+573
+00:38:35,670 --> 00:38:39,090
+كذا و الله لجيت اللي مش قادر يقعد هذا normal يعتبر
+
+574
+00:38:39,090 --> 00:38:42,930
+او مش قادر يقعد هذا normal لكن ال abnormal إذا كان
+
+575
+00:38:42,930 --> 00:38:46,890
+في عنده أشياء بيشكيها و باقي اللي في سنه
+
+576
+00:38:46,890 --> 00:38:51,180
+مابيشكوهاشأهم في الموضوع أنه you must divide the
+
+577
+00:38:51,180 --> 00:38:57,100
+physical assessment لازم تجسم ال assessment اللي
+
+578
+00:38:57,100 --> 00:39:01,660
+في أجسامه لعدة مراحل، إيش يعني؟ يعني ممكن تيجي يوم
+
+579
+00:39:01,660 --> 00:39:05,410
+تعمل assessment لل lower limbsتتركه تيجي فى فترة
+
+580
+00:39:05,410 --> 00:39:09,830
+تانية لل upper limbs تتركه و بعدين لل abdomen ليه؟
+
+581
+00:39:09,830 --> 00:39:13,070
+لأن العجوز او الاختيار مابقدرش لو انت تخيلت و
+
+582
+00:39:13,070 --> 00:39:15,970
+ترققوا دى عم الحاجة شوية بس هيقولك انا موتت مش
+
+583
+00:39:15,970 --> 00:39:19,910
+هيقدر يتحمل ما تتوقع ان زيك هيقدر يتحملك لأ مش
+
+584
+00:39:19,910 --> 00:39:23,730
+هيقدر provide room with a comfortable temperature
+
+585
+00:39:23,730 --> 00:39:27,650
+الاختيار بالذات بده comfortable temperature لأن
+
+586
+00:39:27,650 --> 00:39:32,020
+عنده حسية للبرد و للشوب أكتر منك و من الأطفالفممكن
+
+587
+00:39:32,020 --> 00:39:35,840
+تلاقيه في عز الشيوب و لابس ملابس و اللي عنده جده
+
+588
+00:39:35,840 --> 00:39:40,540
+او جدته ممكن تلاقيه زي هيك ليه؟ لأن هم حسييتهم
+
+589
+00:39:40,540 --> 00:39:43,780
+خاصة ال nerve endings نهايات العصاب في مرحلة
+
+590
+00:39:43,780 --> 00:39:47,760
+الشيخوخة بتبدأ تضعف allow sufficient time for the
+
+591
+00:39:47,760 --> 00:39:51,400
+client to respond على مهلك على الاختيار او العجوز
+
+592
+00:39:51,400 --> 00:39:56,900
+و اعطيه وقت كافي حتى ايه يستجيب الان اذا استجاب
+
+593
+00:39:56,900 --> 00:40:01,800
+بمشي مستجابش بوقفو دائما دائما اكويس اكويس اذا
+
+594
+00:40:01,800 --> 00:40:05,880
+بيقدر يقعد .. اه اذا بيقدر يقعد بكون كويس if
+
+595
+00:40:05,880 --> 00:40:09,520
+possible .. اذا مابقدرش نيمه بالشكل اللي هو
+
+596
+00:40:09,520 --> 00:40:13,900
+بيرتاحله and give him full time to understand you
+
+597
+00:40:13,900 --> 00:40:18,800
+يعني لو سألك الاختيار اعطيه وقت مناسب مش زي الشباب
+
+598
+00:40:18,800 --> 00:40:21,720
+او زي الصغار ممكن يسألك .. ممكن يقولك يا ابني ايش
+
+599
+00:40:21,720 --> 00:40:25,750
+هذا؟ مابترجعش تقوله انت اتيه و سألتأو كل ما يسألك
+
+600
+00:40:25,750 --> 00:40:30,470
+جاوب حتى لو أعاد السؤال عن الشيء بعدد جوارب برضه
+
+601
+00:40:30,470 --> 00:40:34,390
+لازم نجاوبه احنا في الآخر رسل للمهن الإنسانية و
+
+602
+00:40:34,390 --> 00:40:38,090
+لازم نكون يعني دواعي سرور و ان شاء الله نكون يعني
+
+603
+00:40:38,090 --> 00:40:42,330
+كمان مفرحين للي بنعمله assessment و مباجين طبعا
+
+604
+00:40:42,330 --> 00:40:46,870
+احنا بنخلق .. اخ الله معلش يعني يمكن انا طولت شوية
+
+605
+00:40:46,870 --> 00:40:51,490
+بس مضطر يعني اخلص ال chapter سامحوني ان انا أخدت
+
+606
+00:40:51,490 --> 00:40:56,090
+يعني واحد واربعين دقيقةأنا بالعادة بطلعش على
+
+607
+00:40:56,090 --> 00:40:59,070
+التلاتين بس في هذه المحاضرة عشان يعني بدناش نقطع
+
+608
+00:40:59,070 --> 00:41:01,970
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..fb31f3b85c944298be23d44c71d93468ae48d898
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.json
@@ -0,0 +1 @@
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"word": " رجله", "probability": 0.9755859375}, {"start": 1345.38, "end": 1346.94, "word": " أو", "probability": 0.7255859375}, {"start": 1346.94, "end": 1347.32, "word": " أصابع", "probability": 0.97314453125}, {"start": 1347.32, "end": 1347.52, "word": " رجله", "probability": 0.98681640625}, {"start": 1347.52, "end": 1347.8, "word": " بشكل", "probability": 0.9680989583333334}, {"start": 1347.8, "end": 1348.04, "word": " عام", "probability": 0.99755859375}, {"start": 1348.04, "end": 1348.76, "word": " عشان", "probability": 0.9830729166666666}, {"start": 1348.76, "end": 1349.1, "word": " نشوف", "probability": 0.9939778645833334}, {"start": 1349.1, "end": 1349.46, "word": " هل", "probability": 0.988525390625}, {"start": 1349.46, "end": 1349.64, "word": " هو", "probability": 0.98974609375}, {"start": 1349.64, "end": 1350.5, "word": " اتقلم", "probability": 0.8465576171875}, {"start": 1350.5, "end": 1350.68, "word": " و", "probability": 0.98046875}, {"start": 1350.68, "end": 1350.88, "word": " رفع", "probability": 0.9552408854166666}, {"start": 1350.88, "end": 1351.2, "word": " رجله", "probability": 0.9860026041666666}, {"start": 1351.2, "end": 1351.4, "word": " ولا", "probability": 0.471435546875}, {"start": 1351.4, "end": 1353.98, "word": " لأ،", "probability": 0.7016194661458334}, {"start": 1353.98, "end": 1354.22, "word": " بدنا", "probability": 0.72998046875}, {"start": 1354.22, "end": 1354.44, "word": " نعمل", "probability": 0.9970703125}, {"start": 1354.44, "end": 1354.82, "word": " assessment", "probability": 0.89794921875}, {"start": 1354.82, "end": 1355.22, "word": " كمان", "probability": 0.97216796875}, {"start": 1355.22, "end": 1355.38, "word": " لل", "probability": 0.62158203125}, {"start": 1355.38, "end": 1355.84, "word": " sensitivity", "probability": 0.71435546875}], "temperature": 1.0}, {"id": 56, "seek": 137340, "start": 1356.66, "end": 1373.4, "text": "لليه؟ لل vibrations هل هو عنده حساسية للاهتزازات زي الشوكة الرنانة ولا مانوش علاقة بالاهتزازات يعني لو حطنا شوكة رفعنا شوكة مش حاسس بحاجة سمعنا ضج سمعنا ضج ماسمعش حاجة معناه تكون عنده loss of sensitivity for vibrations", "tokens": [1211, 20292, 3224, 22807, 24976, 32339, 8032, 1211, 31439, 43242, 3224, 11331, 3794, 32277, 10632, 24976, 40294, 2655, 11622, 31377, 9307, 30767, 1829, 25124, 2407, 4117, 3660, 34892, 1863, 7649, 3660, 49429, 3714, 7649, 2407, 8592, 11203, 995, 28671, 20666, 40294, 2655, 11622, 31377, 9307, 37495, 22653, 45164, 11331, 9566, 8315, 13412, 2407, 4117, 3660, 12602, 5172, 3615, 8315, 13412, 2407, 4117, 3660, 37893, 11331, 32277, 3794, 4724, 5016, 26108, 3660, 8608, 2304, 3615, 8315, 48812, 7435, 8608, 2304, 3615, 8315, 48812, 7435, 19446, 38251, 3615, 8592, 11331, 26108, 3660, 20449, 8315, 3224, 6055, 30544, 43242, 3224, 4470, 295, 19392, 337, 32339], "avg_logprob": -0.13713592522352644, "compression_ratio": 1.7598039215686274, "no_speech_prob": 4.172325134277344e-07, "words": [{"start": 1356.66, "end": 1357.18, "word": "لليه؟", "probability": 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"probability": 0.769287109375}, {"start": 1363.44, "end": 1363.82, "word": " علاقة", "probability": 0.9832356770833334}, {"start": 1363.82, "end": 1364.4, "word": " بالاهتزازات", "probability": 0.9761555989583334}, {"start": 1364.4, "end": 1364.64, "word": " يعني", "probability": 0.681396484375}, {"start": 1364.64, "end": 1365.06, "word": " لو", "probability": 0.99267578125}, {"start": 1365.06, "end": 1365.4, "word": " حطنا", "probability": 0.8082682291666666}, {"start": 1365.4, "end": 1365.82, "word": " شوكة", "probability": 0.98876953125}, {"start": 1365.82, "end": 1366.18, "word": " رفعنا", "probability": 0.9239501953125}, {"start": 1366.18, "end": 1366.44, "word": " شوكة", "probability": 0.99267578125}, {"start": 1366.44, "end": 1366.58, "word": " مش", "probability": 0.96337890625}, {"start": 1366.58, "end": 1366.9, "word": " حاسس", "probability": 0.90234375}, {"start": 1366.9, "end": 1367.44, "word": " بحاجة", "probability": 0.9755859375}, {"start": 1367.44, "end": 1368.1, "word": " سمعنا", "probability": 0.80340576171875}, {"start": 1368.1, "end": 1368.38, "word": " ضج", "probability": 0.973388671875}, {"start": 1368.38, "end": 1368.8, "word": " سمعنا", "probability": 0.81268310546875}, {"start": 1368.8, "end": 1369.12, "word": " ضج", "probability": 0.96875}, {"start": 1369.12, "end": 1369.56, "word": " ماسمعش", "probability": 0.8831787109375}, {"start": 1369.56, "end": 1370.06, "word": " حاجة", "probability": 0.9972330729166666}, {"start": 1370.06, "end": 1370.46, "word": " معناه", "probability": 0.82763671875}, {"start": 1370.46, "end": 1370.64, "word": " تكون", "probability": 0.70947265625}, {"start": 1370.64, "end": 1370.96, "word": " عنده", "probability": 0.982421875}, {"start": 1370.96, "end": 1371.26, "word": " loss", "probability": 0.9248046875}, {"start": 1371.26, "end": 1371.48, "word": " of", "probability": 0.9794921875}, {"start": 1371.48, "end": 1372.08, "word": " sensitivity", "probability": 0.97021484375}, {"start": 1372.08, "end": 1372.86, "word": " for", "probability": 0.96484375}, {"start": 1372.86, "end": 1373.4, "word": " vibrations", "probability": 0.79443359375}], "temperature": 1.0}, {"id": 57, "seek": 140120, "start": 1374.32, "end": 1401.2, "text": "كمان بدنا نشوف sensitivity لل positions كيف بقعد، كيف وضعه بشكل عام، يعني هل بجع لما بقعد، هل كويس، و دايما تنساش أنه دايما القارن الأثنين، دايما تنساش و تنساش أنه نقارن ما بين ال right side و ما بين ال left side، يعني ما نركز على الإيد اليامين و نرخي الإيد الشمال أو نركز على الرجل اليسار و نركي الرجل اليامين طيب ال chapter اتناش اللي هو assessment of the breast", "tokens": [24793, 7649, 47525, 8315, 8717, 8592, 38688, 19392, 24976, 8432, 9122, 33911, 4724, 4587, 22488, 12399, 9122, 33911, 4032, 11242, 3615, 3224, 4724, 8592, 28820, 6225, 10943, 12399, 37495, 22653, 8032, 1211, 4724, 7435, 3615, 5296, 15042, 4724, 4587, 22488, 12399, 8032, 1211, 9122, 45865, 3794, 12399, 4032, 11778, 47302, 15042, 6055, 1863, 3794, 33599, 14739, 3224, 11778, 47302, 15042, 25062, 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طبعا", "probability": 0.91455078125}, {"start": 1719.48, "end": 1719.84, "word": " تغييرات", "probability": 0.83173828125}, {"start": 1719.84, "end": 1720.52, "word": " الهرمونية", "probability": 0.867431640625}, {"start": 1720.52, "end": 1721.04, "word": " و", "probability": 0.92626953125}, {"start": 1721.04, "end": 1721.62, "word": " lactation", "probability": 0.7091064453125}, {"start": 1721.62, "end": 1721.74, "word": " و", "probability": 0.7978515625}, {"start": 1721.74, "end": 1721.9, "word": " هذا", "probability": 0.80908203125}, {"start": 1721.9, "end": 1722.38, "word": " حيث", "probability": 0.8702799479166666}, {"start": 1722.38, "end": 1722.74, "word": " سبحان", "probability": 0.9505208333333334}, {"start": 1722.74, "end": 1722.96, "word": " الله", "probability": 0.97216796875}, {"start": 1722.96, "end": 1723.7, "word": " بيعمل", "probability": 0.80096435546875}, {"start": 1723.7, "end": 1724.2, "word": " تغييرات", "probability": 0.9798828125}, {"start": 1724.2, "end": 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أنا", "probability": 0.5107421875}, {"start": 1728.66, "end": 1728.78, "word": " إيش", "probability": 0.8330078125}, {"start": 1728.78, "end": 1729.12, "word": " بقولي", "probability": 0.8370768229166666}, {"start": 1729.12, "end": 1729.66, "word": " هنا؟", "probability": 0.9306640625}], "temperature": 1.0}, {"id": 71, "seek": 175684, "start": 1730.38, "end": 1756.84, "text": "بقول لكن never be omitted ايش يعني never يعني بقول و لو انه قصير لكن ايه يعني انه نحنا نعدمه او نتركه يعني you should do male breast assessment ما نبعد عنه observe the nipple بنلاحظ ال nipple كيف نشوف اذا فيه الareola بنعملها palpation كيف الوضع تبعه بشكل عام اذا فيه ulceration اتقارحات فيه nodules ندبات معينة في swelling discharge", "tokens": [3555, 39648, 44381, 1128, 312, 3406, 3944, 1975, 1829, 8592, 37495, 22653, 1128, 37495, 22653, 4724, 39648, 4032, 45164, 16472, 3224, 12174, 9381, 13546, 44381, 1975, 1829, 3224, 37495, 22653, 16472, 3224, 8717, 5016, 8315, 8717, 22488, 2304, 3224, 1975, 2407, 8717, 2655, 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"end": 1732.68, "word": " omitted", "probability": 0.9609375}, {"start": 1732.68, "end": 1732.9, "word": " ايش", "probability": 0.6253255208333334}, {"start": 1732.9, "end": 1733.04, "word": " يعني", "probability": 0.92333984375}, {"start": 1733.04, "end": 1733.3, "word": " never", "probability": 0.923828125}, {"start": 1733.3, "end": 1733.5, "word": " يعني", "probability": 0.93408203125}, {"start": 1733.5, "end": 1733.8, "word": " بقول", "probability": 0.657958984375}, {"start": 1733.8, "end": 1733.92, "word": " و", "probability": 0.489501953125}, {"start": 1733.92, "end": 1734.02, "word": " لو", "probability": 0.85400390625}, {"start": 1734.02, "end": 1734.26, "word": " انه", "probability": 0.784912109375}, {"start": 1734.26, "end": 1734.7, "word": " قصير", "probability": 0.99658203125}, {"start": 1734.7, "end": 1735.38, "word": " لكن", "probability": 0.771484375}, {"start": 1735.38, "end": 1735.64, "word": " ايه", "probability": 0.5442708333333334}, {"start": 1735.64, "end": 1735.86, "word": " يعني", "probability": 0.9384765625}, {"start": 1735.86, "end": 1736.28, "word": " انه", "probability": 0.792236328125}, {"start": 1736.28, "end": 1736.52, "word": " نحنا", "probability": 0.7125651041666666}, {"start": 1736.52, "end": 1737.02, "word": " نعدمه", "probability": 0.8568115234375}, {"start": 1737.02, "end": 1737.2, "word": " او", "probability": 0.888427734375}, {"start": 1737.2, "end": 1737.68, "word": " نتركه", "probability": 0.99267578125}, {"start": 1737.68, "end": 1738.24, "word": " يعني", "probability": 0.939208984375}, {"start": 1738.24, "end": 1738.44, "word": " you", "probability": 0.958984375}, {"start": 1738.44, "end": 1738.94, "word": " should", "probability": 0.9814453125}, {"start": 1738.94, "end": 1739.68, "word": " do", "probability": 0.9677734375}, {"start": 1739.68, "end": 1740.56, "word": " male", "probability": 0.496337890625}, {"start": 1740.56, "end": 1741.08, "word": " breast", "probability": 0.90185546875}, {"start": 1741.08, "end": 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"end": 1746.88, "word": " اذا", "probability": 0.759033203125}, {"start": 1746.88, "end": 1747.2, "word": " فيه", "probability": 0.7119140625}, {"start": 1747.2, "end": 1747.76, "word": " الareola", "probability": 0.6599934895833334}, {"start": 1747.76, "end": 1748.26, "word": " بنعملها", "probability": 0.8974609375}, {"start": 1748.26, "end": 1748.84, "word": " palpation", "probability": 0.8771158854166666}, {"start": 1748.84, "end": 1749.46, "word": " كيف", "probability": 0.965576171875}, {"start": 1749.46, "end": 1749.72, "word": " الوضع", "probability": 0.84722900390625}, {"start": 1749.72, "end": 1750.02, "word": " تبعه", "probability": 0.788330078125}, {"start": 1750.02, "end": 1750.26, "word": " بشكل", "probability": 0.9899088541666666}, {"start": 1750.26, "end": 1750.54, "word": " عام", "probability": 0.997314453125}, {"start": 1750.54, "end": 1751.22, "word": " اذا", "probability": 0.846923828125}, {"start": 1751.22, "end": 1751.42, "word": " فيه", "probability": 0.757080078125}, {"start": 1751.42, "end": 1752.04, "word": " ulceration", "probability": 0.9055989583333334}, {"start": 1752.04, "end": 1753.4, "word": " اتقارحات", "probability": 0.7050272623697916}, {"start": 1753.4, "end": 1754.02, "word": " فيه", "probability": 0.829345703125}, {"start": 1754.02, "end": 1754.56, "word": " nodules", "probability": 0.874267578125}, {"start": 1754.56, "end": 1755.24, "word": " ندبات", "probability": 0.7298583984375}, {"start": 1755.24, "end": 1755.72, "word": " معينة", "probability": 0.9921875}, {"start": 1755.72, "end": 1755.88, "word": " في", "probability": 0.89453125}, {"start": 1755.88, "end": 1756.24, "word": " swelling", "probability": 0.401123046875}, {"start": 1756.24, "end": 1756.84, "word": " discharge", "probability": 0.71923828125}], "temperature": 1.0}, {"id": 72, "seek": 177653, "start": 1757.41, "end": 1776.53, "text": "هذا كله لازم إذا لا قدر الله موجود طبعا كاتبنا هنا الطبيعي أنه يكون مش موجود لكن لو وجد لازم احنا ايه لازم نبلغه لطبيب المعالج طبعا ال geneto urinary and reproductive assessment مش مشكلة أتركه لكم للدراسة", "tokens": [3224, 15730, 28242, 3224, 5296, 31377, 2304, 11933, 15730, 20193, 12174, 3215, 2288, 21984, 3714, 29245, 23328, 23032, 3555, 3615, 995, 9122, 9307, 3555, 8315, 34105, 41950, 21292, 3615, 1829, 14739, 3224, 7251, 30544, 37893, 3714, 29245, 23328, 44381, 45164, 49610, 3215, 5296, 31377, 2304, 1975, 5016, 8315, 1975, 1829, 3224, 5296, 31377, 2304, 8717, 36150, 17082, 3224, 5296, 9566, 21292, 3555, 9673, 3615, 6027, 7435, 23032, 3555, 3615, 995, 2423, 1049, 19515, 4038, 4066, 293, 33569, 9687, 37893, 37893, 28820, 3660, 5551, 2655, 31747, 3224, 5296, 24793, 24976, 3215, 23557, 3794, 3660], "avg_logprob": -0.16647273539862734, "compression_ratio": 1.6403940886699508, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 1757.41, "end": 1757.87, "word": "هذا", "probability": 0.9755859375}, {"start": 1757.87, "end": 1758.19, "word": " كله", "probability": 0.9921875}, {"start": 1758.19, "end": 1758.49, "word": " لازم", "probability": 0.9816080729166666}, {"start": 1758.49, "end": 1758.71, "word": " إذا", "probability": 0.86962890625}, {"start": 1758.71, "end": 1758.87, "word": " لا", "probability": 0.7099609375}, {"start": 1758.87, "end": 1759.19, "word": " قدر", "probability": 0.8914388020833334}, {"start": 1759.19, "end": 1759.43, "word": " الله", "probability": 0.95703125}, {"start": 1759.43, "end": 1760.25, "word": " موجود", "probability": 0.9737955729166666}, {"start": 1760.25, "end": 1760.69, "word": " طبعا", "probability": 0.8302001953125}, {"start": 1760.69, "end": 1761.97, "word": " كاتبنا", "probability": 0.54498291015625}, {"start": 1761.97, "end": 1762.17, "word": " هنا", "probability": 0.92919921875}, {"start": 1762.17, "end": 1762.59, "word": " الطبيعي", "probability": 0.94189453125}, {"start": 1762.59, "end": 1762.79, "word": " أنه", "probability": 0.70068359375}, {"start": 1762.79, "end": 1762.97, "word": " يكون", "probability": 0.6563720703125}, {"start": 1762.97, "end": 1763.11, "word": " مش", "probability": 0.9814453125}, {"start": 1763.11, "end": 1763.51, "word": " موجود", "probability": 0.98974609375}, {"start": 1763.51, "end": 1764.25, "word": " لكن", "probability": 0.75927734375}, {"start": 1764.25, "end": 1764.53, "word": " لو", "probability": 0.97607421875}, {"start": 1764.53, "end": 1764.97, "word": " وجد", "probability": 0.83203125}, {"start": 1764.97, "end": 1765.53, "word": " لازم", "probability": 0.8977864583333334}, {"start": 1765.53, "end": 1765.81, "word": " احنا", "probability": 0.9148763020833334}, {"start": 1765.81, "end": 1766.15, "word": " ايه", "probability": 0.9069010416666666}, {"start": 1766.15, "end": 1766.87, "word": " لازم", "probability": 0.83251953125}, {"start": 1766.87, "end": 1767.31, "word": " نبلغه", "probability": 0.969482421875}, {"start": 1767.31, "end": 1767.89, "word": " لطبيب", "probability": 0.8541259765625}, {"start": 1767.89, "end": 1768.53, "word": " المعالج", "probability": 0.9832763671875}, {"start": 1768.53, "end": 1769.85, "word": " طبعا", "probability": 0.9736328125}, {"start": 1769.85, "end": 1770.65, "word": " ال", "probability": 0.9287109375}, {"start": 1770.65, "end": 1771.23, "word": " geneto", "probability": 0.469970703125}, {"start": 1771.23, "end": 1772.13, "word": " urinary", "probability": 0.883056640625}, {"start": 1772.13, "end": 1772.49, "word": " and", "probability": 0.41650390625}, {"start": 1772.49, "end": 1772.91, "word": " reproductive", "probability": 0.9296875}, {"start": 1772.91, "end": 1773.53, "word": " assessment", "probability": 0.822265625}, {"start": 1773.53, "end": 1774.13, "word": " مش", "probability": 0.984375}, {"start": 1774.13, "end": 1774.57, "word": " مشكلة", "probability": 0.9801432291666666}, {"start": 1774.57, "end": 1774.97, "word": " أتركه", "probability": 0.7156982421875}, {"start": 1774.97, "end": 1775.29, "word": " لكم", "probability": 0.95703125}, {"start": 1775.29, "end": 1776.53, "word": " للدراسة", "probability": 0.9869140625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1776.76775, "duration_after_vad": 1741.5393749999955}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ad0a830b30c9291cfeb36e8c0d49859c68d5ff8e
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/5GRrYplhOmk_raw.srt
@@ -0,0 +1,1824 @@
+1
+00:00:00,180 --> 00:00:05,880
+فيه ان هنا chapter عشرة بتكلم على ال muscular
+
+2
+00:00:05,880 --> 00:00:10,440
+skeletal system كمان هنا بدنا نعمل كأنه قاعدين
+
+3
+00:00:10,440 --> 00:00:15,820
+نتكلم عشان انا بدنا نعمل assessment لجهاز العضلي و
+
+4
+00:00:15,820 --> 00:00:19,660
+بالمناسبة الجهاز العضلي مرتبط ارتباط مثيق بالجهاز
+
+5
+00:00:19,660 --> 00:00:24,240
+العصبي طيب عشان شوية سامحونا شوية المحاضرة هتكون
+
+6
+00:00:24,240 --> 00:00:28,570
+طويلة شوية عشان أخلص بالمرةبنتكلم على أول حاجة ال
+
+7
+00:00:28,570 --> 00:00:33,050
+subjective ده، تبدأ نسأل على الألم، في عندك وجع،
+
+8
+00:00:33,050 --> 00:00:35,310
+هل الوجع ما له علاقة لا في abdomen و لا له علاقة
+
+9
+00:00:35,310 --> 00:00:37,610
+في ال chest و لا له علاقة في ال heart؟ لأ، بنسأله
+
+10
+00:00:37,610 --> 00:00:41,230
+عن ألم بشكل عام، يعني ألم في عضلاتك، في عظامك، في
+
+11
+00:00:41,230 --> 00:00:46,630
+أطرافك، في المفاصل، بنسأله كيف ال wrist عندك؟ يعني
+
+12
+00:00:46,630 --> 00:00:49,770
+أنت لما ترتاح بتكون كويس، مافيش ألم؟ ولا لما ترتاح
+
+13
+00:00:49,770 --> 00:00:53,290
+بتكون في عندك ألم كمان؟ هل أنت بتمرس exercise ولا
+
+14
+00:00:53,290 --> 00:00:57,530
+الألم وين بيكون موجود؟ نفهم يعني منكاللي بعدها
+
+15
+00:00:57,530 --> 00:01:02,370
+نسأل على ال shape و ال size of extremity يعني كيف
+
+16
+00:01:02,370 --> 00:01:07,370
+شكل الأطراف، كيف وضعهم، ال mobility، كيف الحركة
+
+17
+00:01:07,370 --> 00:01:10,710
+موجودة عندك، كيف ال activities، الأنشطة of daily
+
+18
+00:01:10,710 --> 00:01:13,490
+living يعني أنت كيف بتقوم بحياتك بشكل عام، هذا ال
+
+19
+00:01:13,490 --> 00:01:16,410
+subjective data اللي احنا كل مرة بنحكي فيها، هل
+
+20
+00:01:16,410 --> 00:01:20,550
+بتمارس رياضة، كيف انت عملك، في مشكلة ولا مافيش
+
+21
+00:01:20,550 --> 00:01:23,830
+مشكلة، بيصير عندك stiffness، stiffness اللي هو
+
+22
+00:01:23,830 --> 00:01:26,870
+يعني أكيد كلكم عارفين شو معناه stiffزي التقلصات
+
+23
+00:01:26,870 --> 00:01:30,130
+العضلية اللي بتسير؟ هل ماتوقتش بتسير عندك في
+
+24
+00:01:30,130 --> 00:01:35,990
+اليوم؟ هل إيه العلاقة بالوزن تبعك؟ هل لما تحمل
+
+25
+00:01:35,990 --> 00:01:39,830
+أشياء معينة؟ هل لما تسير عندك رياضة في ناس بيقولك
+
+26
+00:01:39,830 --> 00:01:42,490
+أنا بيسير معايا استف لما بسبح في البحر؟ بيقولك في
+
+27
+00:01:42,490 --> 00:01:45,110
+بعض الناس أنا لما أجى أقوم فيه بيقولك لما أكون
+
+28
+00:01:45,110 --> 00:01:48,370
+قاعد بحس رجليا بيسير فيه معايا استف؟ لازم نسمع من
+
+29
+00:01:48,370 --> 00:01:52,660
+المريض ال sensations كيف الأحساسات؟هل هي decreased
+
+30
+00:01:52,660 --> 00:01:56,200
+or increased؟ يعني هل الإحساس عندك كويس؟ هل اتأثر
+
+31
+00:01:56,200 --> 00:02:00,220
+الإحساس عندك في آخر أشهر في حياتك قبل ما نيجي
+
+32
+00:02:00,220 --> 00:02:04,260
+نعملك assessment؟ أو لا قدر الله absent في حالة ال
+
+33
+00:02:04,260 --> 00:02:08,020
+paralysis؟ بنشوف كمان إذا في readiness أو swelling
+
+34
+00:02:08,020 --> 00:02:12,520
+of joints، يعني بنشوف المفاصل، هل في أحمرار؟ هل في
+
+35
+00:02:12,520 --> 00:02:16,210
+انتفاخ؟ هل في أي ألم؟نشوف كمان ال history of
+
+36
+00:02:16,210 --> 00:02:20,710
+fractures، أي .. أي .. أي، يعني عنده تاريخ أو عنده
+
+37
+00:02:20,710 --> 00:02:24,190
+مثلا و الله حكالنا إيش صار في عنده كسور، زمان وجه
+
+38
+00:02:24,190 --> 00:02:28,030
+على إيده و وجه على رجله و صار عنده حادث، يعني بشكل
+
+39
+00:02:28,030 --> 00:02:30,970
+عام بنقول عن .. نحن بنقول عنه orthopedic problems
+
+40
+00:02:30,970 --> 00:02:34,570
+أو orthopedic surgery، هل اتعرضت لأي عمليات في
+
+41
+00:02:34,570 --> 00:02:38,630
+الإعضاء؟أخر سؤال بيسأله ال occupational history،
+
+42
+00:02:38,630 --> 00:02:43,170
+يعني تاريخك الوظيفي بشكل عام، أنت كيف وظيفتك؟ يمكن
+
+43
+00:02:43,170 --> 00:02:47,270
+وظيفته هي المشكلة، يمكن وظيفته بتتحمل أنه بيشغل في
+
+44
+00:02:47,270 --> 00:02:50,950
+شغل زي طبار، زي بنا، زي كده، أو مزارع فيها تعب و
+
+45
+00:02:50,950 --> 00:02:54,370
+فيها ارهاق، بدنا نشوف هل هي العكس تسلبير على جسمه
+
+46
+00:02:54,370 --> 00:02:58,400
+ولا لأ؟بقولي assessment of musculoskeletal system
+
+47
+00:02:58,400 --> 00:03:01,880
+done by ايه؟ firstly أول حاجة بيكون by client
+
+48
+00:03:01,880 --> 00:03:06,220
+works لما نيجي إذا بدنا نعمل assessment صحيح خل
+
+49
+00:03:06,220 --> 00:03:11,950
+المريض يمشي قدامك ويتحرك منيح هو في السريروعمله
+
+50
+00:03:11,950 --> 00:03:14,670
+بشكل واضح يعني كأنه إنسان طبيعي عشان هيك الطبيب
+
+51
+00:03:14,670 --> 00:03:18,570
+الشاطر بقول للمريض ايقف همشي قدامي عشان تشوف ال
+
+52
+00:03:18,570 --> 00:03:21,730
+physical activity ويتطلع على حاجة اسمها range of
+
+53
+00:03:21,730 --> 00:03:25,310
+motion حاجات بسيطة مابدهاش شرح كتير لإن الأمر بسيط
+
+54
+00:03:25,310 --> 00:03:30,230
+والمصطلحات سهلة بدنا نشوف ال muscle strength نشوف
+
+55
+00:03:30,230 --> 00:03:34,070
+ال tone نشوف ال joint كيف ال joint هل المفاصلة
+
+56
+00:03:34,070 --> 00:03:37,530
+كويسة ولا فيها مشكلةال muscle condition كيف حالة
+
+57
+00:03:37,530 --> 00:03:41,390
+اللي هو العضلات قوية مرخية اليمين أقوى من الشمال
+
+58
+00:03:41,390 --> 00:03:45,710
+الشمال أقوى و هكذا طبعا لازم احنا نفهم حاجة مهمة
+
+59
+00:03:45,710 --> 00:03:48,890
+كتير انه اي muscle problems يعني اي مشكلة في
+
+60
+00:03:48,890 --> 00:03:53,470
+العضلات هي تعتبر عرض لمشكلة في الأعصاب كيف يعني اي
+
+61
+00:03:53,470 --> 00:03:55,630
+مشكلة في العضلات يعني لما واحد بيصير عنده
+
+62
+00:03:55,630 --> 00:03:58,850
+paralysis بنسمع يقول فلان صار عنده شلال مجرد
+
+63
+00:03:58,850 --> 00:04:01,990
+مايصير معاه شلال بتلاقي العضلات ارتخذ على اعتبار
+
+64
+00:04:01,990 --> 00:04:05,650
+ان الأعصاب بتغدي العضلاتالناحية الحركية والحسية
+
+65
+00:04:05,650 --> 00:04:09,250
+فبالتالي فبيقدرش تستجيب .. مافيش استجابة يعني
+
+66
+00:04:09,250 --> 00:04:13,110
+للأعصاب من قبل عضلات فبترتخي علشان هيك لما نلاقي
+
+67
+00:04:13,110 --> 00:04:15,930
+في واحد عنده مشكلة عضلية بدنا ن check دايما ان في
+
+68
+00:04:15,930 --> 00:04:20,130
+عنده مشكلة عصبية فبالتالي و احنا بنعمل assessment
+
+69
+00:04:20,130 --> 00:04:22,790
+لازم الاتنين نعملهم مع بعض اللي هو الجهاز العصبي و
+
+70
+00:04:22,790 --> 00:04:28,310
+الجهاز العضلي ال joints بدنا نشوفهم كمان هل جيت
+
+71
+00:04:28,310 --> 00:04:32,550
+المفاصل هل كلهم بتحركوا زي بعض لأ طبعا فيه يتحركوا
+
+72
+00:04:32,550 --> 00:04:37,130
+سهولةسمناهم free movable زي ايش free movable؟ زي
+
+73
+00:04:37,130 --> 00:04:40,530
+.. زي الـ knee يعني لو واحد اطلع بلاكي بيقدر يمد
+
+74
+00:04:40,530 --> 00:04:43,510
+اللي هو الرب بلاكي يعني عماله بيحرك يمين، شمار،
+
+75
+00:04:43,510 --> 00:04:48,990
+رجله، لقدام، لورا، وفي بعض ال joints slightly، أيش
+
+76
+00:04:48,990 --> 00:04:52,630
+يعني slightly؟ تتحرك بس بصعوبة زي ال spinal
+
+77
+00:04:52,630 --> 00:04:56,470
+vertebra اللي هو زي أيش المفاصل اللي موجودة بين
+
+78
+00:04:56,470 --> 00:05:01,370
+أيش الفقرات اللي في العمود الفقري طيبهنا بقولي
+
+79
+00:05:01,370 --> 00:05:04,430
+assessment of muscle growth بدنا نعمل كمان ايش هنا
+
+80
+00:05:04,430 --> 00:05:08,770
+تقييم لمجموعات العضلية اللي في جسم الإنسان خاصة
+
+81
+00:05:08,770 --> 00:05:12,710
+إذا فينا سمح الله muscle weakness هل في عنده ضعف
+
+82
+00:05:12,710 --> 00:05:16,030
+في العضلات بشكل عام هل في swelling بيجينا بعض
+
+83
+00:05:16,030 --> 00:05:20,910
+المرضى بيقولك أنا حاسس أنه أنا منتفخ عندي اللي هو
+
+84
+00:05:20,910 --> 00:05:24,770
+هذا ال joint أو هذا ال muscle أو هذا المكان حاسس
+
+85
+00:05:24,770 --> 00:05:28,060
+فيه انتفاخ مش قادرزي بعض الدربات و الكدمات اللي
+
+86
+00:05:28,060 --> 00:05:33,240
+بتسير عند الحالات زي حواصي الطرق و غيرها نشوف ال
+
+87
+00:05:33,240 --> 00:05:37,040
+size الحجم و دايما ايش نعمل compare دايما قولنا
+
+88
+00:05:37,040 --> 00:05:41,000
+انقار ما بين الشمال و اليمين عشان نعرف في symmetry
+
+89
+00:05:41,000 --> 00:05:44,400
+ولا في لا قدر لأ abnormalities او unsymmetrical
+
+90
+00:05:44,400 --> 00:05:49,480
+low sides طبعا بقول هنا ال joints should not be
+
+91
+00:05:49,480 --> 00:05:53,640
+forced يعني ايش يعني should not be forcedمش لازم
+
+92
+00:05:53,640 --> 00:05:56,620
+نضغط كتير و احنا بنعمل assessment على ال joints
+
+93
+00:05:56,620 --> 00:06:00,180
+إذا كان فيها painful position إيش يعني؟ يعني افرض
+
+94
+00:06:00,180 --> 00:06:03,360
+أجي أنا واحد بقول أنا منطقة ال .. ال .. ببتجعني
+
+95
+00:06:03,360 --> 00:06:06,860
+لكن إذا أنا فردت إيدي في هذه الاتجاه بتجعني أكتر
+
+96
+00:06:06,860 --> 00:06:10,380
+مابنفع أروح أقول للمريض طب افرد و أوريني لأ هنا
+
+97
+00:06:10,380 --> 00:06:13,680
+مابنفع عشانك دائما في ال painful position مابنفع
+
+98
+00:06:13,680 --> 00:06:20,160
+أتدخل لأن الأمر بكون أشد و شوية أصعب طيب بقولي أنا
+
+99
+00:06:20,160 --> 00:06:25,350
+observe جيتand brochure as a client walk into room
+
+100
+00:06:25,350 --> 00:06:29,870
+واحنا قاعدين بنعمل assessment بدنا نلاحظ كمان ماشي
+
+101
+00:06:29,870 --> 00:06:33,890
+المريض ووضع المريض كيف بشكل عام و هو قاعد بيمشي
+
+102
+00:06:33,890 --> 00:06:38,450
+قدامي في داخل الغرفة عشان أقدر أحدد أنه هل عنده
+
+103
+00:06:38,450 --> 00:06:42,070
+مشكلة ولا لأ حتى هو بيقول ليه normally بشكل طبيعي
+
+104
+00:06:42,070 --> 00:06:47,430
+دايما ال clientwalks ايش يعني انا و انتوا نفس
+
+105
+00:06:47,430 --> 00:06:49,990
+المشيه الصحيه هي المشيه بتقولوا انا المشيه
+
+106
+00:06:49,990 --> 00:06:54,370
+العسكرية يعني المشيه الصحيه هي المشيه العسكرية
+
+107
+00:06:54,840 --> 00:06:57,940
+فبقول ال clients walks إيش يعني؟ with arms، لازم
+
+108
+00:06:57,940 --> 00:07:02,240
+إيدي يكون swinging يعني يتأرجح على الجانبين زي
+
+109
+00:07:02,240 --> 00:07:07,180
+تخيلوا معايا واحد بيمشي وإيدي اللي هو يد اليمنى
+
+110
+00:07:07,180 --> 00:07:11,420
+ويد اليسرى عاملا بتتحركوا يعني أمام خلف أمام خلف و
+
+111
+00:07:11,420 --> 00:07:13,660
+ال head و ال face إيش معنى؟ ال head و ال face
+
+112
+00:07:13,660 --> 00:07:18,490
+leading، إيش يعني leading؟يعني راسه ووجهه يقود
+
+113
+00:07:18,490 --> 00:07:22,970
+الجسم، يعني زي حكاية إنسان منتصب ووجهه للأعلى
+
+114
+00:07:22,970 --> 00:07:26,430
+وعماله مش وجهه للأعلى يعني بتطلع فوق، no، يعني
+
+115
+00:07:26,430 --> 00:07:29,510
+بتطلع على مستوى النظر تبعه، وبحالة كده هي تحت ..
+
+116
+00:07:29,510 --> 00:07:32,490
+هي يعني بتسموها يعني زي ال march، يعني زي كأنها
+
+117
+00:07:32,490 --> 00:07:37,870
+إيش، زي المشي .. العسكرية زي المشية العسكرية اللي
+
+118
+00:07:37,870 --> 00:07:42,010
+بيستخدموها اللي بيكونوا مشتغلين في ال .. خلينا
+
+119
+00:07:42,010 --> 00:07:42,530
+نقول في الأمن
+
+120
+00:07:48,910 --> 00:07:54,170
+طيب طيب loss of height متى بيصير loss of height؟
+
+121
+00:07:54,170 --> 00:07:57,650
+لا قدر الله يعني هنا بيقوللي .. لأ معلش احنا
+
+122
+00:07:57,650 --> 00:08:01,850
+ماصلناش هنا loss of height متى بيصير الإنسان بينجز
+
+123
+00:08:01,850 --> 00:08:06,270
+طوله و هو واقف؟ يعني ارتفاعه متى .. يعني متى
+
+124
+00:08:06,270 --> 00:08:09,230
+بيكسر؟ طبعا إذا كان كبير في العمر و اختيار
+
+125
+00:08:09,230 --> 00:08:13,940
+جرياتريك مافي مشكلة لكن إذا كان صغير شويةممكن يكون
+
+126
+00:08:13,940 --> 00:08:16,760
+ال clinical trial أو ال process أو ال osteoporosis
+
+127
+00:08:16,760 --> 00:08:22,480
+يعني أيا كان في يعني مشكلة في مراكز النمو في العضل
+
+128
+00:08:22,480 --> 00:08:25,800
+لكن إذا كانت normal process ممكن الإنسان زي اللي
+
+129
+00:08:25,800 --> 00:08:29,180
+مابكبر في السن كتير بتلاقي يعني شوية بيقصر شوية
+
+130
+00:08:29,180 --> 00:08:32,500
+عشان هيك هو بيقوللي دايما مع ال aging تعتبر normal
+
+131
+00:08:32,500 --> 00:08:37,930
+ل small amount of age height lossطيب ask a client
+
+132
+00:08:37,930 --> 00:08:42,170
+to put each joint .. كل .. خلي المريض يحط كل joint
+
+133
+00:08:42,170 --> 00:08:46,210
+.. throw full range of motion عشان أقدر أعرف أنه
+
+134
+00:08:46,210 --> 00:08:51,150
+صح وكويس من كل المريض، حرك لكل عضلاتك وحرك لكل
+
+135
+00:08:51,150 --> 00:08:55,390
+المفاصل في الاتجاه اللي أنت بتقدر عليه، وين فيها؟
+
+136
+00:08:55,390 --> 00:08:59,600
+وين في weakness؟ يعني إذا لجيناوالله في هذا ال
+
+137
+00:08:59,600 --> 00:09:03,080
+joint فيه weakness بقوللي إيش هنتحتاجها؟ بدنا نعمل
+
+138
+00:09:03,080 --> 00:09:06,440
+support إيش support؟ بدنا ندعم شوية ال joint عشان
+
+139
+00:09:06,440 --> 00:09:12,000
+نقدر نخليه يتحرك عشان أعرف إن هالمشكلة خطيرة و
+
+140
+00:09:12,000 --> 00:09:15,800
+صعبة حلها و لا المشكلة ممكن تنحل بعلاج طبيعي أو
+
+141
+00:09:15,800 --> 00:09:20,000
+بعلاجات بسيطة بقول normal joint بالنسبة للمفاصلة
+
+142
+00:09:20,000 --> 00:09:23,820
+الطبيعية مش لازم تكون tender يعني non tender مش
+
+143
+00:09:23,820 --> 00:09:29,240
+مؤلمةwithout swelling مافيش فيها انتفاخات أو ألم و
+
+144
+00:09:29,240 --> 00:09:32,440
+تتحرك بسهولة move freely عشان هيك إيش بقوللي دايما
+
+145
+00:09:32,440 --> 00:09:35,980
+إلا ال elderly بدنا نتبه إنه ممكن يكون في عنده
+
+146
+00:09:35,980 --> 00:09:39,200
+swollen and stiff و هذه عتبر normal يعني ماحدة
+
+147
+00:09:39,200 --> 00:09:42,120
+ييجي يقول طب الإختيار إنه روح تعمل assessment مش
+
+148
+00:09:42,120 --> 00:09:45,400
+قادر يحرك لأنه في عنده cartridge إيروجين ممكن يكون
+
+149
+00:09:45,400 --> 00:09:48,420
+في عنده fibrosis تليف في ال membrane خاصة يعني
+
+150
+00:09:48,420 --> 00:09:52,050
+الإنسان كبر في العمروهو مش قادر يخط يرسم وصل 70،
+
+151
+00:09:52,050 --> 00:09:56,330
+80 سنة مش قادر يحرك المفاصل زي أول هل أقول
+
+152
+00:09:56,330 --> 00:09:59,710
+abnormal؟ لأ هذا يعتبر normal aging process خلاص
+
+153
+00:09:59,710 --> 00:10:02,730
+بنعتبر أن هذا normal physiological changes لكن إذا
+
+154
+00:10:02,730 --> 00:10:06,250
+كانت في الشباب ممكن إحنا نلتفت إلى أكتر خلينا
+
+155
+00:10:06,250 --> 00:10:10,870
+نستعجل شوية assessment of neurological system يعني
+
+156
+00:10:10,870 --> 00:10:14,150
+اللي هو احنا بنسأله عمالنا قاعد يبيعوا نعمل
+
+157
+00:10:14,150 --> 00:10:18,470
+physical examinationبنركز على ال cranial nerves ..
+
+158
+00:10:18,470 --> 00:10:22,070
+طبعا ال cranial nerves هي عبارة عن twelve pairs
+
+159
+00:10:22,070 --> 00:10:25,410
+كتير من الطلبة، بفكروها اتناشر فرد لأي عبارة عن
+
+160
+00:10:25,410 --> 00:10:29,250
+اتناشر زوج، يعني اربع عشرين cranial nerves، طبعا
+
+161
+00:10:29,250 --> 00:10:32,870
+على اعتبار ان كل واحد له زوج يمين شمال يمين شمال،
+
+162
+00:10:32,870 --> 00:10:37,710
+فيعني عشان هيك زي ال optic و زي .. يعني مثلا و لسه
+
+163
+00:10:37,710 --> 00:10:40,230
+فرنجل مثلا، انتوا عارفين ان اكتر خطوم في ال
+
+164
+00:10:40,230 --> 00:10:45,580
+anatomy، الآن بقول ال testing بدنا نعمله فحصنتشوف
+
+165
+00:10:45,580 --> 00:10:49,020
+كيف ال head و تشوف كيف ال neck و نفس الوقت بنركز
+
+166
+00:10:49,020 --> 00:10:52,500
+على ال mental status الحالة العقلية cranial nerves
+
+167
+00:10:52,500 --> 00:10:55,380
+sensory functions الإحساسات motor function
+
+168
+00:10:55,380 --> 00:10:58,600
+cerebellar function أنا أضيفت المخيخ ال reflexes
+
+169
+00:10:58,600 --> 00:11:02,000
+اللي هو الأستجابات اللي هو التلقائية كيف بتكون
+
+170
+00:11:02,000 --> 00:11:04,940
+عندهم وهذا طبعا شغل الطبيب الأخصائي لما بيجي
+
+171
+00:11:04,940 --> 00:11:10,870
+يستخدم الاللي هو neurological hammer زي ما .. زي
+
+172
+00:11:10,870 --> 00:11:14,710
+ما تتذكر لما حكينا في الأدوات اللي بيستخدم ..
+
+173
+00:11:14,710 --> 00:11:16,930
+بيستخدمها في ال assessment طبعا في subjective
+
+174
+00:11:16,930 --> 00:11:23,710
+data، أيش بتسأله؟ هل عمرك فقدت وعيك؟ في عندك دوخة؟
+
+175
+00:11:23,710 --> 00:11:26,270
+عمرك صار عندك زي نوع من ال .. إيش fainting؟ يعني
+
+176
+00:11:26,270 --> 00:11:31,120
+حسيت حالك شويه مسطل أو عملك بدك توجع؟فيه headache؟
+
+177
+00:11:31,120 --> 00:11:33,640
+كلها أسئلة عامة اللي علاقة بالـ neurological
+
+178
+00:11:33,640 --> 00:11:36,920
+system فيه numbness خدلان؟ فيه paralysis لاقدرلى
+
+179
+00:11:36,920 --> 00:11:40,440
+اللي هو أشلل؟ فيه neurologia اللي هو ألم في
+
+180
+00:11:40,440 --> 00:11:45,240
+الأعصاب؟ هل عندك فقد في الذاكرة؟ في مشكلة عندك
+
+181
+00:11:45,240 --> 00:11:48,960
+يعني confusion سال تالت يوم visual loss فقدت نظرك؟
+
+182
+00:11:48,960 --> 00:11:52,780
+في عندك blurring يعني عندك زغلة في النظر؟ في
+
+183
+00:11:52,780 --> 00:11:57,800
+facial مثلا بين يعني ألم في وجهك؟هل في مثلا
+
+184
+00:11:57,800 --> 00:11:59,660
+weakness زي بعض الناس اللي عندهم facial pulse اللي
+
+185
+00:11:59,660 --> 00:12:02,620
+بيسموه الشرل اللي هو اللي بيصير شوية أو بيسموه بعض
+
+186
+00:12:02,620 --> 00:12:05,240
+الناس اللي بيسموه اللطف انه بيصير deviation شوية
+
+187
+00:12:05,240 --> 00:12:09,020
+الوجه على شجة تانية؟ بنسأل على speech problem كيف
+
+188
+00:12:09,020 --> 00:12:12,560
+لغتك؟ اللي بيسموه ال aphasia لما الإنسان يكون فقد
+
+189
+00:12:12,560 --> 00:12:17,980
+اللغة ال swallowing البلع بتبلع كويس ولا ماعندكاش
+
+190
+00:12:17,980 --> 00:12:21,320
+قدرة على البلع؟ في drooling اللي هو تسييل من الفم
+
+191
+00:12:21,320 --> 00:12:25,810
+يعني زي بنزل منه secretionsنشوف كمان إذا في neck
+
+192
+00:12:25,810 --> 00:12:29,190
+weakness ألم في الرقبة أو فيه spasm يعني شد في
+
+193
+00:12:29,190 --> 00:12:35,080
+عضلات الرقبة طبعاً كمان هنا بقوليعني بدك تسأل على
+
+194
+00:12:35,080 --> 00:12:38,260
+الـ mental و الـ emotional state بشكل عام و احنا
+
+195
+00:12:38,260 --> 00:12:41,700
+قاعدين بنشرح عنها ما هي أصلا كلها أخدناها في ال
+
+196
+00:12:41,700 --> 00:12:44,680
+nursing care plan يعني و احنا بنجمع يعني الأمر مش
+
+197
+00:12:44,680 --> 00:12:47,940
+هييجي و كأننا و احنا بنعمل assessment بدنا نفرد ال
+
+198
+00:12:47,940 --> 00:12:50,320
+neurology لحاله ما احنا و احنا بنسأل في ال
+
+199
+00:12:50,320 --> 00:12:52,260
+physical و احنا بنقيم في ال biological و احنا
+
+200
+00:12:52,260 --> 00:12:56,180
+بنقيم في ال psychological بيبين انه وضعه كويس و
+
+201
+00:12:56,180 --> 00:12:59,620
+صاحي معنا و جادر يحكي ولا لأ ال conscious level
+
+202
+00:12:59,620 --> 00:13:04,830
+طبعا لو حد سألنا ال consciousnessيا بيكون full
+
+203
+00:13:04,830 --> 00:13:07,790
+range و لما يكون full بنقول إيش هذا بيصير
+
+204
+00:13:07,790 --> 00:13:11,170
+conscious اللي هو complete alert, conscious أو لا
+
+205
+00:13:11,170 --> 00:13:14,210
+قدر الله في بعض الناس بيكون complete unconscious
+
+206
+00:13:14,210 --> 00:13:18,270
+يعني إما يكون conscious أو unconscious أو في النص
+
+207
+00:13:18,270 --> 00:13:21,330
+حاجة اسمها semi-conscious يبقى ال consciousness
+
+208
+00:13:21,330 --> 00:13:25,210
+three levels conscious, semi-conscious,
+
+209
+00:13:25,410 --> 00:13:28,330
+unconscious ال unconscious بيكون unresponsiveness
+
+210
+00:13:28,330 --> 00:13:32,270
+يعني مقدرش يستجيبطب كيف بدي أقدر أحكم عليه؟ بنقدر
+
+211
+00:13:32,270 --> 00:13:36,250
+نحكم على موضوع ال consciousness مرات بسأله أسئلة
+
+212
+00:13:36,250 --> 00:13:39,770
+عادية لكن إذا ماقدرناش و ملاقين المريض اللي قدامي
+
+213
+00:13:39,770 --> 00:13:43,350
+صار فيه خربطة في عندنا قياس موجود في غزة وموجود في
+
+214
+00:13:43,350 --> 00:13:47,550
+العالم كله اسمه glass go coma scale اسمه glass go
+
+215
+00:13:47,550 --> 00:13:50,530
+coma scale هذا عشان يجيس ايه؟ ال level of
+
+216
+00:13:50,530 --> 00:13:53,770
+consciousness يبقى كيف بنقدر نحدد ال level of
+
+217
+00:13:53,770 --> 00:13:58,360
+consciousness؟عند المريض عن طريق الـ Glasgow Coma
+
+218
+00:13:58,360 --> 00:14:03,040
+Scale اللي هو المقياس .. ها .. المقياس اللي بيكون
+
+219
+00:14:03,040 --> 00:14:06,160
+يقدر يحدد مستوى الوعي عند المريض اشهر ال Glasgow
+
+220
+00:14:06,160 --> 00:14:12,300
+Coma Scale باختصار عشان نخلص فيه هناأربع أشياء زي
+
+221
+00:14:12,300 --> 00:14:15,580
+ما انتوا شايفين حاجة الى علاقة بال eyes بالعينين
+
+222
+00:14:15,580 --> 00:14:19,820
+حاجة الى بال verbal استجابة اللفظية حاجة الى بال
+
+223
+00:14:19,820 --> 00:14:23,320
+motor استجابة حركية وحاجة اسمها ال total في الآخر
+
+224
+00:14:23,320 --> 00:14:26,260
+احنا دول التلاتة اللي بنسأل عنه وفي الآخر ايش في
+
+225
+00:14:26,260 --> 00:14:31,000
+عندنا ال total كيف يعني؟الأمر بسيط كتير، أول حاجة
+
+226
+00:14:31,000 --> 00:14:34,160
+مثلا بيجيب نقوله مثلا نبتطلع في المريض، إذا
+
+227
+00:14:34,160 --> 00:14:38,060
+لاجيناه بيفتح عيني لحاله، بتاخد رقم اسمه أربعة،
+
+228
+00:14:38,060 --> 00:14:41,280
+ماحدش، هي زي .. زي .. زي تدريجات، زي الواحد يقول
+
+229
+00:14:41,280 --> 00:14:45,820
+مثلا نقول الـ70% أخدت تلاتة، الـ80% أخدت أربعة،
+
+230
+00:14:45,820 --> 00:14:49,780
+الـ90% أخدت خمسة من خمسة، زي هيك، الـopen eyes إذا
+
+231
+00:14:49,780 --> 00:14:53,440
+بيفتح لحاله أربعة،إذا to speech إذا قلتله افتح
+
+232
+00:14:53,440 --> 00:14:56,660
+عينيك وفتح عينيك باخد تلاتة، إذا مافتحش عينيك لكن
+
+233
+00:14:56,660 --> 00:15:01,040
+أنا جرسته شوية، ضغط علي عندانه، فتح أخد اتنين، إذا
+
+234
+00:15:01,040 --> 00:15:03,760
+لا سمح الله مافتحش باخد رقم واحد، مافيش حاجة اسمه
+
+235
+00:15:03,760 --> 00:15:07,460
+سفر نفس القضية في ال verbal، إذا كان هو بتكلم
+
+236
+00:15:07,460 --> 00:15:11,200
+معايا oriented باخد رقم خمسة، إذا بتكلم بس دايق
+
+237
+00:15:11,200 --> 00:15:15,010
+شوية باخد أربعةإذا inappropriate words يعني بتتكلم
+
+238
+00:15:15,010 --> 00:15:17,810
+معاه بس كلمات غريبة يعني مثلا هو بيحكي معاه بقوله
+
+239
+00:15:17,810 --> 00:15:22,790
+كيف حالك؟ بيقوللي اليوم راحوا الخميس ناكل كلام
+
+240
+00:15:22,790 --> 00:15:27,730
+غريب هذا اسمه تلاتة incomprehensive sounds أنا
+
+241
+00:15:27,730 --> 00:15:32,710
+بحكي معاه بيعطيني أصوات غريبة جدا بتاخد رقم اتنين
+
+242
+00:15:32,710 --> 00:15:36,090
+إذا ماعطانيش ولا حاجة بتاخد واحد ال motor
+
+243
+00:15:36,090 --> 00:15:39,870
+الاستجابة الحركية إذا قلتله رفع إيدك رفع إيده ارفع
+
+244
+00:15:39,870 --> 00:15:44,630
+رجلك رفع رجله باخد رقم ستةإذا قلتله طب وين الألم
+
+245
+00:15:44,630 --> 00:15:47,130
+عندك مش قادر أرفع دي لكن قلنا له وين الألم حدد
+
+246
+00:15:47,130 --> 00:15:51,510
+الألم localized بين حدد الألم أخد جديش خمسة إذا
+
+247
+00:15:51,510 --> 00:15:55,350
+جيت عنده مش قادر أحدد الألم بس طلعت عليه لقيت عنده
+
+248
+00:15:55,350 --> 00:15:58,990
+flexion إيش flexion يعني يعني متجرفص شوية يعني
+
+249
+00:15:58,990 --> 00:16:04,230
+داخل لجوا منكمش بياخد رقم أربعة لكن إذا كان
+
+250
+00:16:04,230 --> 00:16:09,410
+abnormal flexion يعني منكمش بطريقة مش طبيعية كإنه
+
+251
+00:16:09,410 --> 00:16:12,890
+عاصص على نفسه على الآخر بتاخد رقم تلاتةيعني زي
+
+252
+00:16:12,890 --> 00:16:17,750
+حكاية Spasm وهنا إذا لا سمح الله Extension، إيش
+
+253
+00:16:17,750 --> 00:16:21,370
+Extension؟ يعني مرتخع الآخر، مرتخع الآخر، بتاخد
+
+254
+00:16:21,370 --> 00:16:25,930
+رقم اتنين و ده flaccid، إيش flaccid؟ يعني أكرمك و
+
+255
+00:16:25,930 --> 00:16:29,170
+انا زي الشريطة، يعني رفعت إيده بتوجه، رفعت رجله
+
+256
+00:16:29,170 --> 00:16:32,950
+بترجح، يعني بيصير الأمر كأنه .. يعني كأنه أمامنا
+
+257
+00:16:32,950 --> 00:16:37,750
+هلام، و لا شيء، بتاخد رقم واحد، طبعا إيش؟ أنا قصدت
+
+258
+00:16:37,750 --> 00:16:40,600
+في هذا الأمرإن الإنسان كل ما بيجرب على رقم
+
+259
+00:16:40,600 --> 00:16:44,480
+الخمستاش كل ما بيكون إيش conscious وكل ما بنزل على
+
+260
+00:16:44,480 --> 00:16:47,260
+الخمستاش بيبدأ يجرب على ال semi-conscious و بعدين
+
+261
+00:16:47,260 --> 00:16:49,940
+بيروح على إيش على ال unconscious زي كيف يعني ممكن
+
+262
+00:16:49,940 --> 00:16:55,220
+نسأل سؤال يقول المريض الفلاني فتعنيه لما أنا سألته
+
+263
+00:16:55,220 --> 00:17:01,960
+فتعنيه لما أنا سألته و اتكلم بس confused مضطرب و
+
+264
+00:17:01,960 --> 00:17:07,250
+أنا استجابلي حسب ال commands نيجي نحسبهااستجاب لي
+
+265
+00:17:07,250 --> 00:17:10,990
+حسب ال commands أخد ستة ال confused أخدت كم؟ أربعة
+
+266
+00:17:10,990 --> 00:17:15,490
+أربعة لما قلت له open eyes مثلا فتعنيه لما أنا
+
+267
+00:17:15,490 --> 00:17:19,010
+قلتله أخدت تلاتة لما قلنا تلاتة و أربعة سبعة و
+
+268
+00:17:19,010 --> 00:17:23,170
+هأنا ستة كم؟ سبعة و ستة تلتاش نقول نا nearly
+
+269
+00:17:23,170 --> 00:17:27,510
+conscious يعني ما شاء الله كويس لكن لا قدر الله لو
+
+270
+00:17:27,510 --> 00:17:31,770
+بدأ يجيل طبعا متى بنقول أنه بدأ المريض يكون خطير
+
+271
+00:17:31,770 --> 00:17:36,520
+جدا؟ إذا بدأ المريض ينزل عن العشرةووصل ل تمانية
+
+272
+00:17:36,520 --> 00:17:39,180
+بيصير محتاجة لإن أنا مركزة بده يخش على ال ICU
+
+273
+00:17:39,180 --> 00:17:42,680
+Intensive Care Unit وممكن ما حد ييجي يقولي طبوا
+
+274
+00:17:42,680 --> 00:17:45,840
+التلاتة ما هو التلاتة ميت خلاص ليش لأن واحد واحد
+
+275
+00:17:45,840 --> 00:17:48,440
+واحد مافيش سفر يعني واحد ييجي يقولي ال none none
+
+276
+00:17:48,440 --> 00:17:52,240
+none واحد واحد واحد اما انا تمات علشان هيك كل ما
+
+277
+00:17:52,240 --> 00:17:54,520
+بيطلع على العشرة كل ما كان أقرب ال conscious كل ما
+
+278
+00:17:54,520 --> 00:17:58,840
+بنزل كل ما كان أخطر أو ممكن يعني يدخل في deep coma
+
+279
+00:17:58,840 --> 00:18:02,880
+مايكونش يعني يقدر يسيطر على نفسه طبعا assessment
+
+280
+00:18:02,880 --> 00:18:03,960
+of behavioral
+
+281
+00:18:13,080 --> 00:18:17,900
+طيب assessment of ايه behavior and appearance بعد
+
+282
+00:18:17,900 --> 00:18:21,440
+ما خلصنا ال glass go coma scale نجي نتكلم هنا انه
+
+283
+00:18:21,440 --> 00:18:26,000
+طب كيف انا بده اشوف السلوك تبع المريض كيف المظهر
+
+284
+00:18:26,000 --> 00:18:31,120
+تبعه كويس ولا مش كويس يعني كيف مزاجه يعني كيف
+
+285
+00:18:31,120 --> 00:18:35,220
+نظافته كيف هو لابس طبعا هذا كله يعتبر برضه يعطينا
+
+286
+00:18:35,220 --> 00:18:38,140
+information انه كيف ال clients mental states من
+
+287
+00:18:38,140 --> 00:18:42,430
+غير ما اسألهالان واحد عماله الدنيا شتا و لابس يعني
+
+288
+00:18:42,430 --> 00:18:45,770
+نسكم او كده او مش مهتم في نفسه و عنده bizarre
+
+289
+00:18:45,770 --> 00:18:48,570
+behavior بقول انه في مشكلة عنده في ايه في ال
+
+290
+00:18:48,570 --> 00:18:52,110
+mental status كمان بتطلع على ال appearance على
+
+291
+00:18:52,110 --> 00:18:57,410
+اللي هو المشهد كيف ال client feels كيف بيشعر كيف
+
+292
+00:18:57,410 --> 00:19:02,950
+شايف نفسه هذا المريض ال personal hygiene كيف
+
+293
+00:19:02,950 --> 00:19:07,130
+نظافته لجسمهخاصة ال hair unkemت يعني إذا كان شعره
+
+294
+00:19:07,130 --> 00:19:12,790
+مش يعني بلا مغضب مش مش مشتبط يعني منظره دي ارتباطي
+
+295
+00:19:12,790 --> 00:19:16,370
+خليني أقول يعني منظره بشكل عام مزعد يعني فيه قلة
+
+296
+00:19:16,370 --> 00:19:19,810
+نظافة بتطلع في ال fingernails أضافيره غير شكل
+
+297
+00:19:19,810 --> 00:19:23,690
+ووضعه صعب كل وقت إيش بيقولليه بدي أعمله نقطة دي
+
+298
+00:19:23,690 --> 00:19:26,930
+يعني إيش بدي أسجله و أعرف أنه في مشكلة عنده مشكلة
+
+299
+00:19:26,930 --> 00:19:31,290
+ربما تكون العلاقة بالحالة العقلية ال language نشوف
+
+300
+00:19:31,290 --> 00:19:37,000
+لغته هل بقدر يحكيهل بيقدر يسمعنا؟ بيقدر يفهمنا؟
+
+301
+00:19:37,000 --> 00:19:39,640
+أنهي اللغة؟ اللغة اللي هو الكلامية و اللغة
+
+302
+00:19:39,640 --> 00:19:44,440
+الكتابية خاصة كيف بتكلم؟ كيف بيكتب؟ بعض الناس تكون
+
+303
+00:19:44,440 --> 00:19:47,700
+عندهم مشكلة كيف بيقولك أنا مش قادر أنا أمسك حاجة
+
+304
+00:19:47,700 --> 00:19:50,620
+بإيدي؟ طب كيف بتتأكد من الأمر هذا؟ بروح بقوله لو
+
+305
+00:19:50,620 --> 00:19:54,940
+سمحت امسك هذا القلم و اكتب اسمك، بيحاول يكتب اسمه،
+
+306
+00:19:54,940 --> 00:19:58,320
+مابيقدرش، بتصير هذه مشكلة، بتصير ايه؟ هذه مشكلة،
+
+307
+00:19:58,320 --> 00:20:02,770
+تمام؟بنعرف أنه .. و بنقدر أن نعملها تحديد طيب أسس
+
+308
+00:20:02,770 --> 00:20:06,670
+intellectual function بدنا نعمل برضه تقييم للحالة
+
+309
+00:20:06,670 --> 00:20:12,230
+الذهنية هل هذا المريض ذهنه صاحي ولا في عنده مشكلة
+
+310
+00:20:12,230 --> 00:20:16,290
+زي فقد الذاكرة هل عمره لسه محله فقد الذاكرة؟ طب
+
+311
+00:20:16,290 --> 00:20:19,610
+كيف ذاكرته؟ والذاكرة زي ما انتوا عارفين هل هي
+
+312
+00:20:19,610 --> 00:20:24,490
+ذاكرة حالية آنية recent؟ هل immediate؟والا past
+
+313
+00:20:24,490 --> 00:20:27,190
+تلات أنواع يعني هل هو عنده مشكلة في الذاكرة
+
+314
+00:20:27,190 --> 00:20:30,570
+اللحظية و لا الذاكرة القريبة و لا الذاكرة بعيدة
+
+315
+00:20:30,570 --> 00:20:35,330
+المدى بدنا نشوف كمان كيف معرفته هل عنده abstract
+
+316
+00:20:35,330 --> 00:20:37,370
+thinking ايش يعني abstract thinking يعني عنده
+
+317
+00:20:37,370 --> 00:20:40,890
+تفكير مجرد لما نقول كلمة abstract thinking يعني
+
+318
+00:20:40,890 --> 00:20:45,850
+منطقي في الكلام عكسها concrete thinking كيف يعني
+
+319
+00:20:45,850 --> 00:20:48,170
+اعطيكم مثال عشان تعرفوا شو يعني abstract و شو
+
+320
+00:20:48,170 --> 00:20:51,820
+concreteالان لو المريض قاعد بتكلم معايا كأنه بتكلم
+
+321
+00:20:51,820 --> 00:20:56,080
+عن حاجة يعني غريبة، زي ايش؟ يعني انا ممكن اقوله
+
+322
+00:20:56,080 --> 00:20:59,660
+شايف هالبلد، اه البلد مدمرة، اقوله طب ايش رأيك في
+
+323
+00:20:59,660 --> 00:21:03,100
+محمد؟ محمد كويس، طويل، شعره أسود، بتكلم في شغلات
+
+324
+00:21:03,100 --> 00:21:07,160
+يعني غريبة كأنه بتكلم على حاجة تفكير حجري، هذا
+
+325
+00:21:07,160 --> 00:21:10,520
+اسمه concrete thinking، لكن لو اجيني اقوليه ايش
+
+326
+00:21:10,520 --> 00:21:14,730
+رأيك في البلد؟ والله البلد احنا خايفينهل ينتشر
+
+327
+00:21:14,730 --> 00:21:18,150
+المرض، هل يصير مشكلات سياسية بين البلد، الوضع
+
+328
+00:21:18,150 --> 00:21:22,790
+الفقر، الشباب، اتكلم بطريقة منطقية، هذا ايش اسمه؟
+
+329
+00:21:22,790 --> 00:21:27,490
+Abstract Thinking اللي هو التفكير المجرد، طيب، في
+
+330
+00:21:27,490 --> 00:21:30,390
+مرات بيكون في مشكلة عند المرضة في ال judgment، ايش
+
+331
+00:21:30,390 --> 00:21:31,990
+عن ال judgment، فاحنا ناخده ان شاء الله في سنة
+
+332
+00:21:31,990 --> 00:21:36,800
+رابعةفي الحكم المنطقي هل لما بنتكلم عن أشياء بيحكم
+
+333
+00:21:36,800 --> 00:21:41,240
+منطقيا يعني بتحسه بيتكلم عن الناس بمنطقية بيحكم
+
+334
+00:21:41,240 --> 00:21:44,480
+على الناس على الأحداث بشكل منطقي ولا لأ قدر الله
+
+335
+00:21:44,480 --> 00:21:48,540
+في عنده مشكلة كله بكتمه بنشوف ال sensor function
+
+336
+00:21:48,540 --> 00:21:53,560
+كمان جهاز الإحساس تبعه هل بيحس كويس ولا لأ ما هو
+
+337
+00:21:53,560 --> 00:21:56,920
+الإحساس مرتبط كمان في الأعصابخاصة زي ال light
+
+338
+00:21:56,920 --> 00:22:00,660
+touch يعني ممكن نخليه يمسك جطنة صغيرة و مغمض عينيه
+
+339
+00:22:00,660 --> 00:22:04,200
+و نقوله حاسس هذي إيش هذي معناها، ممكن يقولي جطنة،
+
+340
+00:22:04,200 --> 00:22:07,580
+ممكن يقولي ورقة، نشوف إيش بيقدر إحساسه، إيش بيقدر
+
+341
+00:22:07,580 --> 00:22:12,000
+دهنه يحكم، في بعضهم بده لأ، بده أكتر، ممكن نستخدم
+
+342
+00:22:12,000 --> 00:22:14,980
+اللي هو ال .. اللي هو break زي الدبوس، يعني أنا
+
+343
+00:22:14,980 --> 00:22:18,460
+بقولك لأ مش حاسس، زي خاصة بعض الناس اللي لقدر الله
+
+344
+00:22:18,460 --> 00:22:21,700
+عندهم paralysisعشان نتأكد أن الإحساس شغال و لأ
+
+345
+00:22:21,700 --> 00:22:26,940
+بنجيب الدبوس و بننخزه في مكان تحت مثلا عند رجله أو
+
+346
+00:22:26,940 --> 00:22:30,880
+أصابع رجله بشكل عام عشان نشوف هل هو اتقلم و رفع
+
+347
+00:22:30,880 --> 00:22:35,380
+رجله ولا لأ، بدنا نعمل assessment كمان لل
+
+348
+00:22:35,380 --> 00:22:39,620
+sensitivityلليه؟ لل vibrations هل هو عنده حساسية
+
+349
+00:22:39,620 --> 00:22:43,820
+للاهتزازات زي الشوكة الرنانة ولا مانوش علاقة
+
+350
+00:22:43,820 --> 00:22:46,900
+بالاهتزازات يعني لو حطنا شوكة رفعنا شوكة مش حاسس
+
+351
+00:22:46,900 --> 00:22:50,640
+بحاجة سمعنا ضج سمعنا ضج ماسمعش حاجة معناه تكون
+
+352
+00:22:50,640 --> 00:22:55,180
+عنده loss of sensitivity for vibrationsكمان بدنا
+
+353
+00:22:55,180 --> 00:22:58,640
+نشوف sensitivity لل positions كيف بقعد، كيف وضعه
+
+354
+00:22:58,640 --> 00:23:02,240
+بشكل عام، يعني هل بجع لما بقعد، هل كويس، و دايما
+
+355
+00:23:02,240 --> 00:23:06,080
+تنساش أنه دايما القارن الأثنين، دايما تنساش و
+
+356
+00:23:06,080 --> 00:23:08,960
+تنساش أنه نقارن ما بين ال right side و ما بين ال
+
+357
+00:23:08,960 --> 00:23:12,140
+left side، يعني ما نركز على الإيد اليامين و نرخي
+
+358
+00:23:12,140 --> 00:23:16,320
+الإيد الشمال أو نركز على الرجل اليسار و نركي الرجل
+
+359
+00:23:16,320 --> 00:23:20,760
+اليامين طيب ال chapter اتناش اللي هو assessment of
+
+360
+00:23:20,760 --> 00:23:24,760
+the breastبدنا نعمل assessment كمان هنا، أول حاجة
+
+361
+00:23:24,760 --> 00:23:29,400
+بدنا نسأل الأسئلة المعتادة ال subjective data، هل
+
+362
+00:23:29,400 --> 00:23:33,720
+في tenderness؟ هل في pain؟ طبعا مايجيب بانه انه
+
+363
+00:23:33,720 --> 00:23:36,440
+بنا أسئلة لازم يكون الفميل، لأ، كمان ال breast
+
+364
+00:23:36,440 --> 00:23:39,720
+assessment للمال أخطر، لأنه لأ قدر الله، أي
+
+365
+00:23:39,720 --> 00:23:42,620
+problems في ال male breast أخطر بكتير من ال female
+
+366
+00:23:42,620 --> 00:23:46,950
+breastال tenderness فى swelling هل فى change فى ال
+
+367
+00:23:46,950 --> 00:23:50,010
+size تغير فى الحجم of the breast خاصة إذا كان a
+
+368
+00:23:50,010 --> 00:23:52,950
+abnormal change أنا ما بتكلم على developing يعني
+
+369
+00:23:52,950 --> 00:23:57,470
+change هل فى change فى ال position of the nipple
+
+370
+00:23:57,470 --> 00:24:01,630
+يعني خاصة نطقة الحلمة هل فيها مشكلة راحت فوق نزلت
+
+371
+00:24:01,630 --> 00:24:05,730
+هل فى discharge هل فى فرزات هل لا سمح الله فى cyst
+
+372
+00:24:05,730 --> 00:24:09,710
+فى غداد فى lumps حاجة زى إيش زى كتل معينة هل فى
+
+373
+00:24:09,710 --> 00:24:15,690
+lesionsكمان هل عملت عملية او عمل عملية في منطقة ال
+
+374
+00:24:15,690 --> 00:24:18,710
+breast كل هذا بيسأل المريض قبل ما نعمل assessment
+
+375
+00:24:18,710 --> 00:24:23,570
+الان ال female breast طب كيف نعمل assessment؟
+
+376
+00:24:23,570 --> 00:24:27,030
+انتوا هتاخدوها كتير في .. يعني في medical surgical
+
+377
+00:24:27,030 --> 00:24:31,450
+كمان هتاخد ربما كمان بكرا في ال maternity nursing
+
+378
+00:24:31,450 --> 00:24:37,210
+خلينا احنا بشكل عام بس عشان احنا يعني للعلم اكتر
+
+379
+00:24:37,210 --> 00:24:41,400
+كمان اول حاجة نعمل inspectionبنخلّي المريضة تكون
+
+380
+00:24:41,400 --> 00:24:45,480
+قاعدة أو المريض قاعد ال arms إيش ما لهم relaxed
+
+381
+00:24:45,480 --> 00:24:48,500
+يعني بنحط .. بنخلّي المريضة تحط إيديها على الجناب
+
+382
+00:24:48,860 --> 00:24:51,980
+عالجنبين، بعدين اشهرنا inspect areola، بنشوف ال
+
+383
+00:24:51,980 --> 00:24:54,840
+areola و النبلز و كيف ال position تبعتها و ال
+
+384
+00:24:54,840 --> 00:24:59,320
+pigmentation و التلون كيف بالظبط، هل لقدر الله في
+
+385
+00:24:59,320 --> 00:25:02,960
+inversion، كلمة inversion يعني رجوع النبل لجوه،
+
+386
+00:25:02,960 --> 00:25:06,760
+لما يرجع النبل لجوه بيسموها inversion، بعضهم
+
+387
+00:25:06,760 --> 00:25:10,200
+بيسموها retraction، مش مشكلة، لو عشان اسمع المصطلح
+
+388
+00:25:10,200 --> 00:25:14,790
+يعني داخل لجوه، هل في لقدر الله discharge؟هل فيه
+
+389
+00:25:14,790 --> 00:25:17,950
+اللي قدر الله يعني بيطلع من ملفرزات أو crusting زي
+
+390
+00:25:17,950 --> 00:25:21,230
+التشقوقات أو قشور معينة بتطلع أو فيه masses لا سمح
+
+391
+00:25:21,230 --> 00:25:25,650
+الله؟ هل فيه masses يعني فيه كتل موجودة في منطقة
+
+392
+00:25:25,650 --> 00:25:29,510
+ال breast؟ بدنا نشوف ال breast to show بشكل عام،
+
+393
+00:25:29,510 --> 00:25:33,930
+نشوف ال size، الحجم، ال shape اللي هو الشكل، نشوف
+
+394
+00:25:33,930 --> 00:25:37,810
+اللون، اللي قولنا ال canal السيمتري اللي هو يقصد
+
+395
+00:25:37,810 --> 00:25:42,610
+طبعا ال right وال leftال surface ال contour و ال
+
+396
+00:25:42,610 --> 00:25:46,750
+skin characteristics كيف اللي هو الجلد في هذا
+
+397
+00:25:46,750 --> 00:25:50,470
+المكان بعدين بدنا نشوف ال level of breast يعني
+
+398
+00:25:50,470 --> 00:25:54,410
+مستوى ال breast نفسه هل في symmetry ولا في لقدر
+
+399
+00:25:54,410 --> 00:25:57,570
+الله يعني في right problems او في left problems
+
+400
+00:25:57,570 --> 00:26:00,250
+بدنا نشوف اذا في اي مشكلة او اذا في retractions
+
+401
+00:26:00,250 --> 00:26:03,530
+رجوع لجوة او في لسمح الله dimpling of the skin
+
+402
+00:26:03,530 --> 00:26:07,090
+اللي هو يعني بعض اللي هو التقرحات البسيطة بتصير في
+
+403
+00:26:07,090 --> 00:26:11,550
+الجلدأو الندابات اللي هي غريبة بتكون على سطح ال
+
+404
+00:26:11,550 --> 00:26:15,750
+skin اللي سمى dumpling بعدين بعد ما نعمل ال get up
+
+405
+00:26:15,750 --> 00:26:19,150
+كان المريض حاطط إيديه على جنابه بعد شوية ما إيش
+
+406
+00:26:19,150 --> 00:26:22,250
+بنعمل؟ بنخلي المريض إيش يعمل elevate hair hands
+
+407
+00:26:22,250 --> 00:26:27,610
+بنرفع إيديه فوق راسه و بنعمل repeating for إيش
+
+408
+00:26:27,610 --> 00:26:31,110
+observation نفس اللي إحنا لاحظنا هنا بنعيد كمان
+
+409
+00:26:31,110 --> 00:26:36,490
+مرة ملاحظته بس يرفع المريض إيديه فوق راسهبعد هيك
+
+410
+00:26:36,490 --> 00:26:40,470
+بنعمل كمان بنخل المريض يضغط بديه ايش هانا ي press
+
+411
+00:26:40,470 --> 00:26:44,690
+her hands to her hips على منطقة الخسر يعني كأنه
+
+412
+00:26:44,690 --> 00:26:48,550
+بضغط بديه تنتين على منطقة الخسر و بنرجع نعمل كمان
+
+413
+00:26:48,550 --> 00:26:52,330
+مرة observation يبقى في three position أول حاجة
+
+414
+00:26:52,330 --> 00:26:55,570
+المريض قاعد او المريض قاعد ايديه على الجناب بعمل
+
+415
+00:26:55,570 --> 00:27:00,290
+assessment كامل بعدين رفع ايديه فوق على رأسه بعدين
+
+416
+00:27:00,290 --> 00:27:03,950
+حط ايديه على الجنب أو على الخسرتين و بنقدر نعمل
+
+417
+00:27:03,950 --> 00:27:05,270
+assessment بشكل كامل
+
+418
+00:27:08,220 --> 00:27:13,540
+طيب، بقول أفضل شيء يعمل اللي هو يعني إذا ماقدرناش،
+
+419
+00:27:13,540 --> 00:27:16,180
+إذا المريض صعب علينا في ال palpation بالذات، ال
+
+420
+00:27:16,180 --> 00:27:18,680
+palpation بالذات، هناك قولنا إيش؟ احنا متكلمة
+
+421
+00:27:18,680 --> 00:27:21,320
+عملها inspection، هنا في ال palpation بقول أفضل
+
+422
+00:27:21,320 --> 00:27:24,020
+شيء يكون المريض recumbent position يعني زي semi
+
+423
+00:27:24,020 --> 00:27:27,700
+-fowler يعني وانتوا عارفينه recumbent position هذا
+
+424
+00:27:27,700 --> 00:27:31,300
+الكلام مش مشكلة يخلي مرور إيه كنتوا بتدرسوه،
+
+425
+00:27:31,300 --> 00:27:34,740
+ماداعي كتير نشرحه، حتى ما نعمل embarrassing for
+
+426
+00:27:34,740 --> 00:27:39,170
+anyone بشكل عاملكن انا باهمن انه نعرف نقطة skin
+
+427
+00:27:39,170 --> 00:27:42,170
+texture بنشوف ال skin moisture temperature او
+
+428
+00:27:42,170 --> 00:27:46,730
+masses او فيها قدر الله اي مشكلة رطوبة زايدة حرارة
+
+429
+00:27:46,730 --> 00:27:49,910
+زايدة فيها الله سبحان الله يعني كتل ورمية او
+
+430
+00:27:49,910 --> 00:27:54,310
+كشبينة و احنا بنعمل palpation ممكن نبلغ الطبيب و
+
+431
+00:27:54,310 --> 00:27:57,890
+دايما ننساش نعمل compare ايش يعني compare نقارن
+
+432
+00:27:57,890 --> 00:28:02,970
+اليمين بالشمال طبعا اذا فيها الله سبحان الله
+
+433
+00:28:02,970 --> 00:28:05,880
+masses اذا فيها الله سبحان اللهبنتشوف ال location
+
+434
+00:28:05,880 --> 00:28:09,380
+و ال size يعني الشكلها و أين موجودة و أين بالظبط
+
+435
+00:28:09,380 --> 00:28:13,060
+وضعها و إيش فيها أي مشكلة ممكن أنا أحددها و بروح
+
+436
+00:28:13,060 --> 00:28:17,860
+بكتبها لمين للطبيب المعالج ال male breast ما حد
+
+437
+00:28:17,860 --> 00:28:19,760
+هيجي يقول أنه ال male breast اللي بنعملهوش
+
+438
+00:28:19,760 --> 00:28:23,160
+assessment بالعكس اللي لازم نعملهو و في كتير بعض
+
+439
+00:28:23,160 --> 00:28:26,860
+الناس بعتبره حاجة بسيطة لأ مش بسيطة صحيح هو brief
+
+440
+00:28:26,860 --> 00:28:30,520
+هو مختصر على اعتبار أنه يعني الفميل سبحان الله
+
+441
+00:28:30,520 --> 00:28:35,580
+يعني أن ال breast مجهز و محضر لأنه حيصيرفي بعد
+
+442
+00:28:35,580 --> 00:28:39,480
+هيكا اللي هو ال pregnancy و بعد هيكا بتصير طبعا
+
+443
+00:28:39,480 --> 00:28:42,960
+تغييرات الهرمونية و lactation و هذا حيث سبحان الله
+
+444
+00:28:42,960 --> 00:28:47,160
+بيعمل تغييرات في ال size و ال tissue نفسه تبع ال
+
+445
+00:28:47,160 --> 00:28:51,200
+female breast طبعا أنا إيش بقولي هنا؟بقول لكن
+
+446
+00:28:51,200 --> 00:28:54,260
+never be omitted ايش يعني never يعني بقول و لو انه
+
+447
+00:28:54,260 --> 00:28:58,440
+قصير لكن ايه يعني انه نحنا نعدمه او نتركه يعني you
+
+448
+00:28:58,440 --> 00:29:03,140
+should do male breast assessment ما نبعد عنه
+
+449
+00:29:03,140 --> 00:29:06,880
+observe the nipple بنلاحظ ال nipple كيف نشوف اذا
+
+450
+00:29:06,880 --> 00:29:10,260
+فيه الareola بنعملها palpation كيف الوضع تبعه بشكل
+
+451
+00:29:10,260 --> 00:29:15,240
+عام اذا فيه ulceration اتقارحات فيه nodules ندبات
+
+452
+00:29:15,240 --> 00:29:19,190
+معينة في swelling dischargeهذا كله لازم إذا لا قدر
+
+453
+00:29:19,190 --> 00:29:23,110
+الله موجود طبعا كاتبنا هنا الطبيعي أنه يكون مش
+
+454
+00:29:23,110 --> 00:29:27,890
+موجود لكن لو وجد لازم احنا ايه لازم نبلغه لطبيب
+
+455
+00:29:27,890 --> 00:29:32,910
+المعالج طبعا ال geneto urinary and reproductive
+
+456
+00:29:32,910 --> 00:29:36,530
+assessment مش مشكلة أتركه لكم للدراسة
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..6e9f288e896b088fbfc42fce519eafa42842c563
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8.srt
@@ -0,0 +1,1358 @@
+1
+00:00:00,640 --> 00:00:04,740
+بسم الله الرحمن الرحيم خلينا نكمل اليوم في ال
+
+2
+00:00:04,740 --> 00:00:09,080
+chapter الخامس لمساق التقييم الصحي التمريدي وطلبة
+
+3
+00:00:09,080 --> 00:00:14,160
+المستوى الثاني. حياكم الله، واليوم هيكون chapterنا
+
+4
+00:00:14,160 --> 00:00:18,400
+زي ما أنتم شايفين، general assessment including a
+
+5
+00:00:18,400 --> 00:00:21,240
+vital signs. يعني احنا بدأنا الآن، خليني أقول يعني
+
+6
+00:00:21,240 --> 00:00:26,380
+بالشغل الحقيقي اللي هو كيف نعمل physical أو
+
+7
+00:00:26,380 --> 00:00:30,220
+physiological أو biological assessment. نكمل الآن
+
+8
+00:00:30,660 --> 00:00:34,060
+أول حاجة، إذا لاحظتوا الـ equipment اللي احنا دائماً
+
+9
+00:00:34,060 --> 00:00:38,760
+نحتاجها بشكل عام، ليس يعني حكراً على مريض معين، ممكن
+
+10
+00:00:38,760 --> 00:00:42,280
+تكون زي اللي تكون في مختبر أو بتكون في غرفة خاصة
+
+11
+00:00:42,280 --> 00:00:46,600
+في داخل القسم، في داخل المزرعة أو في المركز الصحي
+
+12
+00:00:46,600 --> 00:00:50,440
+لازم يكون فيها حاجة بسمها beam balance scale. لما
+
+13
+00:00:50,440 --> 00:00:53,380
+أقول كلمة beam balance scale، اللي هو شفتوه، أو لما
+
+14
+00:00:53,380 --> 00:00:56,130
+كنتم في سنة أولى في المختبر، اللي هو الميزان اللي
+
+15
+00:00:56,130 --> 00:01:00,170
+بنجيب عليه بيجيب طول و الوزن،  بسمّوه beam balance.
+
+16
+00:01:00,170 --> 00:01:05,150
+بيجيب الإنسان عليه، وفي نفس الوقت بيشوف كده طول...
+
+17
+00:01:05,150 --> 00:01:10,010
+كده فيه فيه تدريج، وبيعطينا كمان المقياس بالـ
+
+18
+00:01:10,010 --> 00:01:15,190
+kilogram. طيب.. الآن، بقول كمان أنا،  tape measure. لما
+
+19
+00:01:15,190 --> 00:01:19,150
+نقول كلمة tape measure، هو يمكن مش دائماً نقدر نجيبه..
+
+20
+00:01:19,150 --> 00:01:25,200
+بتتذكروا، ويمكن إذا حد عمره يتذكر معايا، المتر اللي هو
+
+21
+00:01:25,200 --> 00:01:29,740
+زي الجلد، عامل المتر، هو مش قماش جلدي، بيستخدموه زي
+
+22
+00:01:29,740 --> 00:01:33,680
+الخياطين، اللي بيسمّوه  المدرّج يعني
+
+23
+00:01:33,680 --> 00:01:37,400
+اللي عليه تدريج، يعني زي بعض أنواع المساطر اللي
+
+24
+00:01:37,400 --> 00:01:40,960
+بتتطوى هيك، بتتطوى، ممكن نستخدمها عشان لو بدنا نحتاج
+
+25
+00:01:40,960 --> 00:01:46,320
+نقيس بعض الشغلات في جسم الإنسان. ثيرموميتر، كلنا
+
+26
+00:01:46,320 --> 00:01:49,340
+عارفينه.  سفيغمانوميتر، جهاز الضغط مع ستاثسكوب.
+
+27
+00:01:49,340 --> 00:01:53,310
+تمام. الآن، الـ subject data, current health. أول حاجة
+
+28
+00:01:53,310 --> 00:01:56,150
+اللي عم نقوله، خليني أذاكره، subject فعلاً مش
+
+29
+00:01:56,150 --> 00:01:59,430
+objective. يعني بتاخده منه، بتاخده من المريض، الـ
+
+30
+00:01:59,430 --> 00:02:02,890
+current health، الـ current age، العمر، الـ height، الـ
+
+31
+00:02:02,890 --> 00:02:06,330
+weight، حاجات بسيطة هذه. الـ recent weight changes،
+
+32
+00:02:06,330 --> 00:02:10,090
+صار تغيير، تغييرات. آخر شيء، لكن أهم اللي بهم، ما تتكلمش
+
+33
+00:02:10,090 --> 00:02:13,310
+عن التغييرات الآنية. لما بسمعوا الوزن، آخر ست
+
+34
+00:02:13,310 --> 00:02:17,010
+شهور، بقولوا: آخر ست شهور كيف كان وزنك؟ الـ fever،
+
+35
+00:02:17,010 --> 00:02:21,290
+history of hypertension، إذا هل في عنده hypertension،
+
+36
+00:02:21,290 --> 00:02:25,230
+هل في عنده history of difficulty of breathing، or
+
+37
+00:02:25,230 --> 00:02:30,090
+not؟ هل في عنده changes في الـ pulse أو heart rate؟
+
+38
+00:02:30,090 --> 00:02:33,750
+يعني بشكل عام، عنده مشاكل صحية ولا لأ؟ طيب، الـ
+
+39
+00:02:33,750 --> 00:02:36,850
+objective اللي أنا عمله، بدي أعمله، ايش قياسي؟ بدي
+
+40
+00:02:36,850 --> 00:02:40,310
+أشوف. الـ head to toe examination، بدي أبدأ من أعلى
+
+41
+00:02:40,310 --> 00:02:43,890
+الرأس، اللي زي ما بقوله في المثل، إلى أخمص القدم، هنا
+
+42
+00:02:43,890 --> 00:02:47,800
+تحت. آخر شيء، الآن، وبشوف إذا في، لا سمح الله، حاجة
+
+43
+00:02:47,800 --> 00:02:51,560
+اسمها gross abnormalities. لما نسمع كلمة gross يعني
+
+44
+00:02:51,560 --> 00:02:55,200
+واضح للعين، ايش يعني واضح للعين؟ يعني وأنا
+
+45
+00:02:55,200 --> 00:02:58,320
+بتطلع لمحة عامة، وبتطلع من الرأس للرجل بشكل عام في
+
+46
+00:02:58,320 --> 00:03:02,240
+جسمه، ايش في شيء واضح قدامي؟ يعني في، لا سمح الله،
+
+47
+00:03:02,240 --> 00:03:06,220
+أي defects، أي abnormalities واضحة، وممكن هذه أن
+
+48
+00:03:06,220 --> 00:03:11,610
+أنا أتشد انتباهي أن هذه، لازم أعمل assessment أو
+
+49
+00:03:11,610 --> 00:03:15,890
+further more examination. الآن، الآن بعدين، بنبدأ في
+
+50
+00:03:15,890 --> 00:03:19,730
+assessment of vital signs. الآن، الـ vital signs
+
+51
+00:03:19,730 --> 00:03:21,510
+أنتم عارفين، اللي هو بيشمل الـ temperature و الـ
+
+52
+00:03:21,510 --> 00:03:26,050
+pulse و الـ respiration و الـ blood pressure. كل هذا
+
+53
+00:03:26,050 --> 00:03:30,430
+واحنا لسه ما دخلناش في عمق الـ assessment. بعد that،
+
+54
+00:03:30,430 --> 00:03:33,130
+weigh the client and measure for height. لما يقول لي
+
+55
+00:03:33,130 --> 00:03:37,830
+كلمة weigh، وزن. ذاكرين الـ BMI، body mass index، وأنا
+
+56
+00:03:38,330 --> 00:03:40,750
+في البداية، بس،  أعطيتكم البرنامج اللي كيف
+
+57
+00:03:40,750 --> 00:03:44,310
+ممكن تنزّلوه على هواتفكم. هو أنا شبّكت لكم اللي بدكم
+
+58
+00:03:44,310 --> 00:03:47,750
+نتقارن ما بين طول المريض وما بين وزنه، بس عشان
+
+59
+00:03:47,750 --> 00:03:52,730
+نعرف بشكل عام، المريض ايش يصنّف: obese، less obesity،
+
+60
+00:03:52,730 --> 00:03:57,920
+thin، more thin، وهكذا. طيب، بعدها الـ procedure، بدنا
+
+61
+00:03:57,920 --> 00:04:03,080
+بدنا ندخل في الأمور. أول حاجة، observe، لاحظ، راقب.
+
+62
+00:04:03,080 --> 00:04:06,360
+دائماً تذكروا، لما كنت أقول كلمة think before you act.
+
+63
+00:04:06,360 --> 00:04:12,060
+يعني فكر قبل العمل. الـ behavior، أول حاجة شوف، هل هو
+
+64
+00:04:12,060 --> 00:04:16,000
+cooperative أو uncooperative؟ الطبيعي أن كل إنسان
+
+65
+00:04:16,000 --> 00:04:20,200
+عادي، ومرضه طبيعي، يكون متعاون، cooperative. وشيء
+
+66
+00:04:20,200 --> 00:04:22,080
+مثل الأطفال، زي ما احنا قلنا، ممكن يكون
+
+67
+00:04:22,080 --> 00:04:26,570
+uncooperative. الاختيار يمكن ما يكونش معنا، متعاون، الـ
+
+68
+00:04:26,570 --> 00:04:30,810
+psychotic client، يعني المريض النفسي، اللي لو عنده
+
+69
+00:04:30,810 --> 00:04:33,390
+أي مشكلة نفسية، وأنت لديه problems، ممكن ما يتعاونش.
+
+70
+00:04:33,390 --> 00:04:37,110
+هذه بدنا ننتبه لها. بعدين، ما تشوف الـ mood، الـ mood،
+
+71
+00:04:37,110 --> 00:04:40,870
+يعني المزاج. ما نتكلم عن الـ affect، اللي ذاكرين، واللي
+
+72
+00:04:40,870 --> 00:04:43,770
+ذاكرينه، الشطارين في سنة أولى، لما كنا نقول mood و
+
+73
+00:04:43,770 --> 00:04:45,470
+affect. الـ mood اللي هو الداخلي، الـ affect اللي هو
+
+74
+00:04:45,470 --> 00:04:48,890
+الخارجي. بس من باب التذكير، بلّاحظ الـ mood، هل هو
+
+75
+00:04:48,890 --> 00:04:53,270
+steady، ثابت، ولا anxious، يعني عنده مزاج قلق، ومش
+
+76
+00:04:53,270 --> 00:04:58,280
+قادر يتعامل معاه. الـ appearance، كيف دخوله؟ هل هو
+
+77
+00:04:58,280 --> 00:05:02,520
+يعني المظهر تبعه، واللي dressed، يعني لابس كويس، ولا
+
+78
+00:05:02,520 --> 00:05:05,480
+لبسه bizarre؟ ايش كلمة bizarre؟ قلتها زمان ولا
+
+79
+00:05:05,480 --> 00:05:09,360
+عيدها؟ اللبس الغريب، في وقت غير مناسب. كيف يعني؟
+
+80
+00:05:09,360 --> 00:05:13,060
+يعني هل هو شكله ولبسه غريب؟ الدنيا شوب، ولاابس
+
+81
+00:05:13,060 --> 00:05:17,800
+ملابس ثقيلة، الدنيا برد ومش لابس ملابس يعني ثقيلة،
+
+82
+00:05:17,800 --> 00:05:21,480
+برد، أو inappropriate، أو غير متناسب مع سنه وجنسه؟
+
+83
+00:05:22,240 --> 00:05:25,620
+بتلاقي يعني مثلاً، بدون.. بدون نخش في تفاصيل مثلاً،
+
+84
+00:05:25,620 --> 00:05:28,960
+لما كبير، ولاابس يغلط مثلاً، بتليقش فيه، وهكذا. الـ
+
+85
+00:05:28,960 --> 00:05:31,640
+body movements، حركات الجسد، اللي هو الـ body language،
+
+86
+00:05:31,640 --> 00:05:35,660
+هذه مهمة. coordinated، يعني هل متناسقة مع بعض، ولا
+
+87
+00:05:35,660 --> 00:05:39,820
+uncoordinated، يعني مش متناسقة، ولا shaky and
+
+88
+00:05:39,820 --> 00:05:43,580
+unsteady، يعني هو اللي بيتزلزل، وهو مش ثابت. أقصد هنا،
+
+89
+00:05:43,580 --> 00:05:48,000
+يعني احنا قدامنا البني آدم، هل قدامنا، واحنا بنحكي
+
+90
+00:05:48,000 --> 00:05:51,040
+معاه، بترج ايديه، بترج رجليه؟ جادري، جاف، مش جادري وجاف.
+
+91
+00:05:51,810 --> 00:05:55,610
+يعني كيف أدائه، وكيف أنتم شايفينه، قبل ما احنا نبدأ
+
+92
+00:05:55,610 --> 00:05:59,310
+نعمل assessment، عشان ما نقعش في أي شيء، ممكن لازم
+
+93
+00:05:59,310 --> 00:06:03,650
+يأثر أو يسبب له ضرر. للمرضى الأمامي، نبدأ بالـ vital
+
+94
+00:06:03,650 --> 00:06:06,210
+signs. و الـ vital signs، ما شاء الله، يعني أنتم
+
+95
+00:06:06,210 --> 00:06:09,670
+كلكم يعني أخذتم في السنة الأولى، وأنا متأكد يعني
+
+96
+00:06:09,670 --> 00:06:14,990
+شفتوا الأجهزة، وجهاز الضغط كتير كمان لأهليكم، و
+
+97
+00:06:14,990 --> 00:06:18,290
+الحرارة، والـ pulse، والـ respiration. يعني الإنسان
+
+98
+00:06:18,290 --> 00:06:21,370
+صار في عنده، يعني خليني أقول، خبرة ولو على دول
+
+99
+00:06:21,370 --> 00:06:24,350
+القريبة، إن شاء الله. وبعد هيك بيصير على المرضى، إن
+
+100
+00:06:24,350 --> 00:06:27,930
+شاء الله، بيصير الأمر أدق وأحسن، وبنكسر الحاجز
+
+101
+00:06:27,930 --> 00:06:30,710
+بتاع الخوف. الـ vital signs، احنا زي ما أنتم
+
+102
+00:06:30,710 --> 00:06:33,210
+عارفين، temperature، و pulse، و respiration، و blood
+
+103
+00:06:33,210 --> 00:06:35,730
+pressure. مش هحكي فيها كتير، لأن اللي جاي فيه شغلات
+
+104
+00:06:35,730 --> 00:06:39,010
+أكثر، اسمها ايه؟ في بعض الناس بيسمّوا، بعض الكتب
+
+105
+00:06:39,010 --> 00:06:41,830
+اسمها life signs. يبقى لو قلنا life signs أو
+
+106
+00:06:41,830 --> 00:06:44,450
+vital signs، على فكرة نفس الاسم. الـ vital والـ
+
+107
+00:06:44,450 --> 00:06:48,060
+life، يعني حيوي، يعني حيوية. ايش بتأثر هذه؟ إذا في
+
+108
+00:06:48,060 --> 00:06:52,020
+عندنا physiological status، ايش يعني؟ إذا في
+
+109
+00:06:52,020 --> 00:06:54,360
+abnormalities في الـ physiological status، يعني أي
+
+110
+00:06:54,360 --> 00:07:00,280
+تغيير physiological، بيبين فوراً، نشوف الاستجابة، الـ
+
+111
+00:07:00,280 --> 00:07:03,140
+environmental and physiological stressors، يعني
+
+112
+00:07:03,140 --> 00:07:07,280
+بعض الناس بتأثر من البيئة اللي حولهم، بتأثر من
+
+113
+00:07:07,280 --> 00:07:10,780
+ناحية الفيسيولوجية، من التوترات، أي شيء يؤثر على
+
+114
+00:07:10,780 --> 00:07:14,260
+ناحية النفسية أو على ناحية الجسدية، هينعكس تأثيره
+
+115
+00:07:14,260 --> 00:07:17,150
+على وين؟ على الـ vital signs، أكيد هذا كلام كنا
+
+116
+00:07:17,150 --> 00:07:21,050
+بنعرفه. واحد خاف، معناته ايه؟ لإنه بتتغير كتير، واحد
+
+117
+00:07:21,050 --> 00:07:24,470
+اتنكد عليه، معناته ايه؟ الـ stress عليه، واحد صار في
+
+118
+00:07:24,470 --> 00:07:27,270
+عنده أي التهاب، معناته الحرارة، وهكذا. الـ
+
+119
+00:07:27,270 --> 00:07:32,170
+temperature... بس احنا بنقول هنا، أنه في كتب اختلفت،
+
+120
+00:07:32,170 --> 00:07:34,350
+الكتب. في كتب بتقول أن الـ rectal temperature، the
+
+121
+00:07:34,350 --> 00:07:38,170
+most accurate، حتى بيقولوا preferred، يفضل. طبعاً احنا
+
+122
+00:07:38,170 --> 00:07:41,930
+embarrassing هنا، يعني في غزة ممكن يكون في نوع من
+
+123
+00:07:41,930 --> 00:07:44,770
+الحرج، وما يرضوا الأهل أن أنا آخذ الـ temperature
+
+124
+00:07:44,770 --> 00:07:48,730
+rectally. لكن احنا مرات في بداية الحياة، أول ما يولد
+
+125
+00:07:48,730 --> 00:07:53,970
+الطفل، مضطرين نأخذ الـ temperature rectally، عشان فيه
+
+126
+00:07:53,970 --> 00:07:59,070
+تشخيص اسمه imperforated anus. اسمه imperforated
+
+127
+00:07:59,070 --> 00:08:04,610
+anus، يعني بيسمّوه ايش؟ فتحة الشرج المغلقة خلقياً، طبعاً
+
+128
+00:08:04,610 --> 00:08:08,970
+لما نقول فتحة الشرج مغلقة خلقياً، يعني معناته بدأت
+
+129
+00:08:08,970 --> 00:08:12,090
+تدخل، ما أقدرش أ كشفها، لما أنا آجي أحط الـ thermometer
+
+130
+00:08:12,090 --> 00:08:15,400
+في  بلاصة في أغلاق، يعني في closure، فبتتدخل بعد هيك
+
+131
+00:08:15,400 --> 00:08:19,500
+بيصير أن في إشكالية. فالناس بتتردد، فعشان هيك هو
+
+132
+00:08:19,500 --> 00:08:22,940
+بيقول لي: صح إنها accurate. في كتب قالت لأ، قالت أن الـ
+
+133
+00:08:22,940 --> 00:08:26,760
+oral. وفي ناس قالت لأ، يعني الـ forehead، اللي هو منطقة
+
+134
+00:08:26,760 --> 00:08:30,360
+اللي هو الجبهة. واحنا، إن شاء الله، في ظل جائحة
+
+135
+00:08:30,360 --> 00:08:34,220
+كورونا، يعني، وانتشار الـ coronavirus في معظم
+
+136
+00:08:34,220 --> 00:08:37,320
+المؤسسات الصحية، حتى المؤسسات التجارية، بياخذوا
+
+137
+00:08:37,320 --> 00:08:40,220
+حرارة عن طريق الـ forehead مباشرة، وممكن تكون برضه
+
+138
+00:08:40,220 --> 00:08:44,760
+دقيقة أو بالدقة.  إذا... unless contraindicated، إذا
+
+139
+00:08:44,760 --> 00:08:50,000
+... إذا ممنوع نأخذها a rectal temperature. هنا ايش
+
+140
+00:08:50,000 --> 00:08:52,540
+بتصير خاصة في بعض الحالات. ايش بيقول لي ممنوع تاخذها؟
+
+141
+00:08:52,540 --> 00:08:55,380
+طيب ليش؟ كان في واحد عنده cardiac arrhythmia،
+
+142
+00:08:55,380 --> 00:08:59,500
+يعني هو بيكون ممنوع، يعني معناته... معناته ما لم
+
+143
+00:08:59,500 --> 00:09:02,940
+يكن هناك معنى... يعني هي كاتب هنا unless، ما لم يكن
+
+144
+00:09:02,940 --> 00:09:06,640
+هناك معنى أنه تأخذ الـ rectal، زي في حالة اللي هو
+
+145
+00:09:06,640 --> 00:09:11,340
+الأمراض القلبية، ولو عنده مشكلة في القلب، لأنه يتأثر
+
+146
+00:09:11,830 --> 00:09:16,490
+مجرد ما نحط ال... يعني الـ thermometer في الـ rectum،
+
+147
+00:09:16,490 --> 00:09:20,250
+بيصير تأثير، وبيصير severe tachycardia، لأنه بيشتغل
+
+148
+00:09:20,250 --> 00:09:24,330
+عليها حاجة بيسمّوها vasovagal attack، إنه بيصير يعني
+
+149
+00:09:24,330 --> 00:09:28,150
+احنا بنعمل زي attack لـ nervous system. هنا في حاجة
+
+150
+00:09:28,150 --> 00:09:31,990
+إذا ما كان فيه أنه ممنوع، فبنستخدموش، لكن ده مش أنّه ممنوع
+
+151
+00:09:31,990 --> 00:09:36,770
+بفضل أنه ايش؟ نستخدم الـ rectal temperature. طيب هذه
+
+152
+00:09:36,770 --> 00:09:42,020
+الـ comparison فيه. إنما أنتم عارفين أنه في بعض
+
+153
+00:09:42,020 --> 00:09:44,420
+المقاييس، أو بعض الثرمومترات، بتقيس بحاجة باسم
+
+154
+00:09:44,420 --> 00:09:47,940
+الفهرنهايت. احنا عموماً، الفهرنهايت مش هنلاقيه، يعني
+
+155
+00:09:47,940 --> 00:09:51,240
+احنا غالباً في غزة، أنا ما شفتش، يعني يمكن نلاقي
+
+156
+00:09:51,240 --> 00:09:55,180
+ميزان، ميزانين في قسم، بس... بس هذه لا تعني أن مدى
+
+157
+00:09:55,180 --> 00:09:57,920
+الانتشار. وأنا بتكلم يعني هيك، كأنه بقول الـ normal
+
+158
+00:09:57,920 --> 00:10:02,960
+لازم يكون تقريباً 99 فهرنهايت. أنا بـ... يعني هذا طبعاً
+
+159
+00:10:02,960 --> 00:10:06,420
+أنا في... أنا جربت في oral وفي rectal، وأنا مش
+
+160
+00:10:06,420 --> 00:10:11,000
+يعني ممكن مالخصوش، وبقول لكم هذا بس يعني من باب أن
+
+161
+00:10:11,000 --> 00:10:15,160
+الإنسان يدرسه، يعني ما بندهش لعجبكم، لكن هذا مهم
+
+162
+00:10:15,160 --> 00:10:18,440
+ليش مهم هالجيت هذا؟ الـ temperature اللي هو بتكلم
+
+163
+00:10:18,440 --> 00:10:21,340
+بالـ degree، بالـ centigrade، اللي هو الدرجة المئوية.
+
+164
+00:10:21,340 --> 00:10:24,540
+لما بقول لنا في بعض الناس بقول لك: لو كانت oral، هالجيت
+
+165
+00:10:24,540 --> 00:10:27,740
+أنا متأكد أن كله درسه. يعني مثلاً، واحد سبعة وثلاثين
+
+166
+00:10:27,740 --> 00:10:31,900
+ونص مثلاً، oral، سبعة وثلاثين ونص oral. ترى كده، هنا
+
+167
+00:10:31,900 --> 00:10:34,480
+موجود axilla، اللي صارت ستة وثلاثين وتسعة وعشرة.
+
+168
+00:10:34,480 --> 00:10:37,960
+كده نقصت، لو كنا سبعة وثلاثين ونص، بده ينقص كده ستة
+
+169
+00:10:37,960 --> 00:10:41,180
+وعشرة، يعني زي نص درجة. يعني كأنه بيقول لي... كأنه
+
+170
+00:10:41,180 --> 00:
+
+223
+00:14:18,540 --> 00:14:21,780
+زي ال boom boom boom ايه كان لما نعمل boom boom
+
+224
+00:14:21,780 --> 00:14:28,640
+إذا معناته إيش اسمه bounding pulse طيب respiration
+
+225
+00:14:28,640 --> 00:14:33,400
+كلنا عارفين ال respiration زمان أخذناها و نعيد كام
+
+226
+00:14:33,400 --> 00:14:38,520
+مرة الطبيعي للإنسان الطبيعي من 16 إلى 20 يعني نفس
+
+227
+00:14:38,520 --> 00:14:42,700
+طبيعي في الدقيقة for the healthy person  مش معناه
+
+228
+00:14:42,700 --> 00:14:45,500
+ذلك أن هو مقدس هنلاقي في بعض الناس أقل من 16 و في
+
+229
+00:14:45,500 --> 00:14:49,000
+ناس أكثر من 20، التاكي كار ده بتعمل لدغر التاكي ..
+
+230
+00:14:49,000 --> 00:14:53,120
+آه دغر التاكي البني، بتزود ال fever و هكذا، الجسم
+
+231
+00:14:53,120 --> 00:14:57,620
+الاختيار بيصير يخف نفسه، بيبطل، 16 ممكن يعني يكون
+
+232
+00:14:57,620 --> 00:15:01,340
+أقل من 16، و هكذا، الطفل أكثر، يعني  لعلاقة بالـ
+
+233
+00:15:01,340 --> 00:15:05,500
+.. بالـ variations و ال physiological changes،
+
+234
+00:15:05,500 --> 00:15:10,180
+يبقى .. بتعد قداش؟ ما ينفع واحد يقول لي بدي أعد لنصف
+
+235
+00:15:10,180 --> 00:15:15,230
+دقيقة، لا، النفس بنعدها لدقيقة واحدة الآن ومش بقول
+
+236
+00:15:15,230 --> 00:15:19,690
+كمان لاحظ ال rhythm انتظام depth عمق يعني و إحنا
+
+237
+00:15:19,690 --> 00:15:23,270
+بنعمل assessment لل respiration خلينا نلاحظ كيف
+
+238
+00:15:23,270 --> 00:15:27,750
+عمقه كيف انتظامه، بتنفس صح ولا ما .. يعني ولا في
+
+239
+00:15:27,750 --> 00:15:32,490
+عنده مشكلة، طبعاً هذا الـ الوحيد زي ما إحنا قلنا زمان
+
+240
+00:15:32,490 --> 00:15:35,750
+قلنا في سنة أولى في ال fundamental  أنه ما نعرف
+
+241
+00:15:35,750 --> 00:15:38,230
+المريض أن أنا بتعد له النفس يعني أنا ممكن أقول له
+
+242
+00:15:38,230 --> 00:15:42,570
+بتاخدك الحرارة لو سمحت،  تجيس لك الضغط، ممكن أقول له
+
+243
+00:15:42,570 --> 00:15:46,450
+عادي هذا الكلام، ممكن أقول له بدي آخذك النبض لكن هقول له
+
+244
+00:15:46,450 --> 00:15:50,030
+بدي أعد نفسك، هيصير يدقّش يتحكم، أن أنتو عارفين الـ
+
+245
+00:15:50,030 --> 00:15:53,230
+respiration voluntary و involuntary لذلك إحنا و
+
+246
+00:15:53,230 --> 00:15:57,050
+إحنا قاعدين بناخد ال vital signs خلي عينك على صدر
+
+247
+00:15:57,050 --> 00:16:00,890
+المريض، بتشوف الشرشف اللي فوق صدره أو دبسه،  كتاش
+
+248
+00:16:00,890 --> 00:16:04,650
+بيطلع و بينزل، و بعد كتاش for full minute ال blood
+
+249
+00:16:04,650 --> 00:16:10,070
+pressure عشان أنا أؤكد أن أنا اشتغل صح ولا لأ، يفضل
+
+250
+00:16:10,550 --> 00:16:13,990
+أن جيسه في إيه؟ في إيديه الاتنين هيك تبلي both
+
+251
+00:16:13,990 --> 00:16:17,310
+arms عشان إيه؟ في بعض الحالات بيصير في مشكلة ما
+
+252
+00:16:17,310 --> 00:16:19,970
+بين ال right و ال left لو لاقينا شوية ال left بيزيد
+
+253
+00:16:19,970 --> 00:16:23,250
+شوية، ما نخافش كتير، مش هذا الموضوع قبل بيت systolic
+
+254
+00:16:23,250 --> 00:16:28,210
+pressure before using استيثاسكوب apply كف firmly
+
+255
+00:16:28,210 --> 00:16:30,990
+هذا أنتو كلكوا أخذتوّه، أنا بتذكركوا، تذكروا كلكوا
+
+256
+00:16:30,990 --> 00:16:34,820
+بتجيسوا الضغط، هو جاية بيقول يا ريت ما تخليش إيش يعني
+
+257
+00:16:34,820 --> 00:16:38,700
+ما تخليش الكف too loose ولا إيش، و ما تخليهاش يعني على
+
+258
+00:16:38,700 --> 00:16:41,420
+الآخر برضه حازجة على الآخر، يعني خليها .. بنقول
+
+259
+00:16:41,420 --> 00:16:45,000
+إحنا نستخدم يعني الكف a proper yet size الحجم يكون
+
+260
+00:16:45,000 --> 00:16:50,200
+مناسب، ولما نضغط عليها برضه تكون إيش متناسبة بحيث
+
+261
+00:16:50,200 --> 00:16:55,020
+أنه ما يضلاش نصل إيه إلى مشكلة، يتأثر على الضغط للمريض
+
+262
+00:16:55,020 --> 00:16:59,800
+علشان هيك بقول هنا استخدم المجاس المناسب، معنى
+
+263
+00:16:59,800 --> 00:17:04,800
+المجاس المناسب لأنه فيه مشكلة، أنه ما بينفعش لو واحد
+
+264
+00:17:04,800 --> 00:17:09,660
+obese استخدم واحد ضيق كتير، أو للطفل استخدم يعني
+
+265
+00:17:09,660 --> 00:17:13,820
+ال adult size ما بينفعش، هيأثر على القراءة أي تأثير
+
+266
+00:17:13,820 --> 00:17:18,180
+على القراءة، هيعمل لي مشكلة ما بين الارتفاع و النزول
+
+267
+00:17:18,180 --> 00:17:23,860
+طيب و بيعطيني حتى و لاحظين، إذا مش مقولي، مرات بيقول لي
+
+268
+00:17:23,860 --> 00:17:26,560
+إيش أنا، false reading، إيش أنا، false reading قراءة
+
+269
+00:17:26,560 --> 00:17:29,800
+خاطئة، بيقول لي دائماً يا ريت تشوف ال position بتاع الـ
+
+270
+00:17:29,800 --> 00:17:33,300
+client و إحنا بنجيس ال blood pressure خلينا نعرفين
+
+271
+00:17:33,300 --> 00:17:36,180
+ال position يعني لو واحد سألني يفضل كيف؟ يفضل
+
+272
+00:17:36,180 --> 00:17:39,720
+الإنسان يكون نايم على ضهره أو إيش هنا يعني،  راحة
+
+273
+00:17:39,720 --> 00:17:43,780
+position شوية على ضهره، بلاش يكون واقف و بلاش يكون
+
+274
+00:17:43,780 --> 00:17:47,700
+واقف، أقعد بيهيئة كأنه شهادة حارة، يعني تكون الجلسة
+
+275
+00:17:47,700 --> 00:17:53,740
+فيها استرخاء، طيب لو واحد جاي لي .. يعني جاي يمشي،
+
+276
+00:17:53,740 --> 00:17:57,540
+يعني هو بدي أجيس ضغطه و جاي عليا، دلوقتي أقعده على
+
+277
+00:17:57,540 --> 00:18:00,680
+الكرسي و أجيسه؟ لا، الصح أنه لو جاني لازم يكون
+
+278
+00:18:00,680 --> 00:18:04,680
+supine position قعدة كده، أقل شي عشر دقائق عشان
+
+279
+00:18:04,680 --> 00:18:08,020
+يهدأ الجسم، يعني لو جاني هيك مستعجل بقول، و اِرتاح، خد
+
+280
+00:18:08,020 --> 00:18:12,480
+راحتك، يبدأ ياخد الراحة، قعد له عشر دقائق، بعد هيك
+
+281
+00:18:12,480 --> 00:18:16,160
+أنا إيش بعمل؟ بروح أنا باخذ له إيه؟ باخذ له الضغط
+
+282
+00:18:16,160 --> 00:18:19,400
+عشان ما يصيرش متأثر، لإنه كل إنسان و جاهزيته؟ بقول في
+
+283
+00:18:19,400 --> 00:18:24,460
+عنده إيش يعني، لسه نفسه مش .. مش .. مش مرتاح و دقات
+
+284
+00:18:24,460 --> 00:18:29,340
+قلبه عمالة سريعة شوية، طيب ال instrument needed for
+
+285
+00:18:29,340 --> 00:18:34,280
+physical assessment طبعاً إحنا ذكرنا هنا، ده كلام لما
+
+286
+00:18:34,280 --> 00:18:38,680
+ذكرنا، طبعاً إحنا ال instrument ده اللي حكيناه قبل
+
+287
+00:18:38,680 --> 00:18:41,860
+دقيقة لما جبنا الصورة، إذا بتذكروا معاه، هي الصورة
+
+288
+00:18:41,860 --> 00:18:45,240
+اللي بتحتوي على يعني جميع ال instruments اللي بدي
+
+289
+00:18:45,240 --> 00:18:48,360
+أستخدمها، هو هذا من باب يعني إعادة التذكير مش أكثر
+
+290
+00:18:48,360 --> 00:18:51,040
+يعني كانوا بيقولوا يا ophthalmoscope كلكوا عارفينه
+
+291
+00:18:51,040 --> 00:18:54,360
+يعني أنا بستخدمه ليش؟ من اسمه، phalmo كلمة لاتينية
+
+292
+00:18:54,360 --> 00:18:57,860
+يعني، استخدمه من داخل العين، خاصة إذا بدنا نشوف الـ
+
+293
+00:18:57,860 --> 00:19:02,060
+internal organs of the eye يعني زي بدنا نطلع لجوه
+
+294
+00:19:02,060 --> 00:19:05,260
+عن طريق ال pupil، بدنا نشوف ال iris و كده، بدنا
+
+295
+00:19:05,260 --> 00:19:08,780
+نشوف إذا في،  لله سمح الله، ال lens فيها مشكلة، الـ
+
+296
+00:19:08,780 --> 00:19:12,480
+otoscope يعني منظار للأذن،  إثنين بيسمّوه
+
+297
+00:19:12,480 --> 00:19:15,960
+لوحة الإشارات تابعة ال إيه؟ تابعة لوحة الإشارات
+
+298
+00:19:15,960 --> 00:19:19,080
+بتاعة النظر، أكيد شفتوها، ليه؟ زي في مرات بتحتوي
+
+299
+00:19:19,080 --> 00:19:21,940
+على ال CC زي حرف ال C و في مرات بتحتوي على أحرف
+
+300
+00:19:21,940 --> 00:19:26,170
+إنجليزية زي E و زي غيره، زي و زي غير، و في نازلة
+
+301
+00:19:26,170 --> 00:19:30,610
+speculum نازلة speculum يعني اللي هو اللي بنستخدمه
+
+302
+00:19:30,610 --> 00:19:33,690
+لما نيجي نفحص اللي هو الأنف، ال vagina speculum
+
+303
+00:19:33,690 --> 00:19:36,910
+حكينا عنه خاصة لما نعمل examination لمنطقة الـ
+
+304
+00:19:36,910 --> 00:19:40,670
+cervix أو لل vagina  لل female، tuning fork، شوكر رنينة
+
+305
+00:19:40,670 --> 00:19:43,630
+بنستخدمها خاصة لل auditory function يعني الوظيفة
+
+306
+00:19:43,630 --> 00:19:47,070
+السماعية، ال percussion hammer في عندنا percussion
+
+307
+00:19:47,070 --> 00:19:50,450
+في neurologic ال percussion اسمه reflex hammer
+
+308
+00:19:50,450 --> 00:19:55,010
+بتشوف كده يعني من جزء مدى ال reflex عنده، إذا في، لا
+
+309
+00:19:55,010 --> 00:19:57,750
+سمح الله عنده مشكلة عصبية ولا لأ، و في هنا
+
+310
+00:19:57,750 --> 00:20:00,690
+neurologic فقط للأعصاب يعني الأعصاب، هذا ممكن
+
+311
+00:20:00,690 --> 00:20:03,070
+يُستخدم للعضلات، و هذا ممكن يُستخدم للأعصاب على فكرة
+
+312
+00:20:03,070 --> 00:20:06,670
+حتى هذا ممكن يُستخدم للأعصاب، لكن من الممكن التفريق
+
+313
+00:20:06,670 --> 00:20:09,470
+و إذا بدنا حد يفرّق بين ال percussion hammer و
+
+314
+00:20:09,470 --> 00:20:12,590
+neurologic hammer إيه؟ في الصورة هي بتفرّق لكم إياهم
+
+315
+00:20:12,590 --> 00:20:16,430
+اللي هنا موجود هنا، هذا اسمه percussion، هي شفتوّه
+
+316
+00:20:16,430 --> 00:20:20,510
+percussion hammer، أما اللي موجود إذا شفنا حاجة اسم
+
+317
+00:20:20,510 --> 00:20:23,410
+neurologic hammer، نفس الإيد هذه اللي أنتو شايفينها
+
+318
+00:20:23,410 --> 00:20:27,470
+نفس الإيد، ولكن هنا لاحظين أنّه زي المثلث، بس هذاك
+
+319
+00:20:27,470 --> 00:20:31,410
+بيختلف، لأ هو عبارة عن اسطوانة، اسطوانة neurologic
+
+320
+00:20:31,410 --> 00:20:34,970
+أما اسطوانة من قدام اللي هو مدبّب الطرف، و من وراها
+
+321
+00:20:34,970 --> 00:20:39,770
+اسطوانة من قدام دائرية و من ورا شوية أوسع، نضرب شوية
+
+322
+00:20:39,770 --> 00:20:43,670
+عشان نقدر نستخدمه في أكثر من إيش، في مكان نطرق على
+
+323
+00:20:43,670 --> 00:20:47,310
+جسم الإنسان، يبقى الشكل زي اسطوانة neurologic و
+
+324
+00:20:47,310 --> 00:20:51,790
+الشكل زي المثلث هو ال إيش percussion، طيب positions
+
+325
+00:20:51,790 --> 00:20:56,150
+إيه برضه إحنا بس من باب التذكير، بقول لكم  أذكّركم
+
+326
+00:20:56,150 --> 00:20:59,170
+بالـ positions اللي زمان حكينا لكم عنهم، أنه فيهم زي
+
+327
+00:20:59,170 --> 00:21:01,630
+ال standing و ال position و الـ .. و الـ .. و الـ
+
+328
+00:21:01,630 --> 00:21:04,530
+sitting position و ال supine و ال dorsal recumbent
+
+329
+00:21:04,530 --> 00:21:06,870
+و ال Sims position و الـ .. و ال prone و ال knee
+
+330
+00:21:06,870 --> 00:21:10,250
+chest position، بدأ يزيدنا شوية، ما كانش موجودة ده و
+
+331
+00:21:10,250 --> 00:21:13,210
+اللي هي third position، كل position إيه له إيه
+
+332
+00:21:13,210 --> 00:21:16,190
+specialty؟ شو يعني إيه specialty؟ كل position
+
+333
+00:21:16,190 --> 00:21:20,350
+بنستخدمه during assessment بقدر أعمل assessment لـ
+
+334
+00:21:20,350 --> 00:21:23,670
+area و فيها areas ما بقدر أعملها assessment لما
+
+335
+00:21:23,670 --> 00:21:27,050
+حكينا و قُلت لكم، هيجي دورهم بالتفصيل لما إحنا
+
+336
+00:21:27,050 --> 00:21:32,090
+نذكرهم، هذه الرسمة أنوي ده أظن مرت علينا، يعني ما نضلاش
+
+337
+00:21:32,090 --> 00:21:34,510
+نكثر  نروح فيها كتير لأن .. بس إحنا ذكرنا لما أيام
+
+338
+00:21:34,510 --> 00:21:37,890
+قلنا أن هو هي ال position هو بيوصفه، و هي إيش
+
+339
+00:21:37,890 --> 00:21:40,330
+المناطق اللي ممكن تعملها assessment، و إيش المناطق
+
+340
+00:21:40,330 --> 00:21:43,530
+اللي فيها caution مش هتقدر تعمل فيها assessment في
+
+341
+00:21:43,530 --> 00:21:47,400
+هذا ال position المعين مثلاً، و هان ها هي الشرا قدامنا
+
+342
+00:21:47,400 --> 00:21:50,580
+مثلاً sitting position يعني بيقول لي،  أفرض أن انت في
+
+343
+00:21:50,580 --> 00:21:54,180
+عند .. واحد قاعد، بتقدر تعمل assessment ال head،
+
+344
+00:21:54,180 --> 00:21:58,340
+مظبوط، و ال neck و ال back، posterior، okay صحيح،
+
+345
+00:21:58,340 --> 00:22:00,960
+و ال thorax الصدر، صحيح، و ال lung، واحد قاعد يعني
+
+346
+00:22:00,960 --> 00:22:04,000
+مبين، anterior thorax الصدر الأمامي، ال pressed
+
+347
+00:22:04,000 --> 00:22:09,040
+axilla، ال heart، ال vital signs، upper extremity، كل
+
+348
+00:22:09,040 --> 00:22:11,840
+هذا بنقدر نعمله في sitting position، طب إيش الـ
+
+349
+00:22:11,840 --> 00:22:14,640
+limitations؟ يعني إيش الأشياء اللي أنا ممكن أبعد
+
+350
+00:22:14,640 --> 00:22:18,000
+عنها؟ ما بقدرش .. is a physically weakened client
+
+351
+00:22:18,000 --> 00:22:20,640
+.. إيش يعني؟ إذا جينا المريض اللي أمامي مش قادر
+
+352
+00:22:20,640 --> 00:22:23,400
+يقعد .. مش قادر يقعد .. يعني زي ما أقوله في المثل
+
+353
+00:22:23,400 --> 00:22:27,800
+العربي مش قادر يصلّح حاله .. ما بقدرش أنا أخليه
+
+354
+00:22:27,800 --> 00:22:30,220
+يقعد لأنه ممكن يوجعه .. ما نستخدمش هذه ال position
+
+355
+00:22:31,580 --> 00:22:34,580
+طيب اللي ما بيقدرش أقعده بقول له، سَبقه ممكن ينام على ضهره
+
+356
+00:22:34,580 --> 00:22:39,140
+most normally relaxed إيش يعني؟ أكثر وضع مريح
+
+357
+00:22:39,140 --> 00:22:43,740
+للمريض و للطبيب، أنه يقدر يعمل له assessment، إيش
+
+358
+00:22:43,740 --> 00:22:46,560
+بتقدر تعمل assessment ال head و ال neck و الـ
+
+359
+00:22:46,560 --> 00:22:50,600
+anterior thorax أكيد ال lungs و ال breast، مجزلة
+
+360
+00:22:50,600 --> 00:22:54,260
+لاحظين في قواطع مشتركة ما بين السباقي و ما بين الـ
+
+361
+00:22:54,260 --> 00:22:57,920
+sitting، أنا بحكي بأكثر من وضع عشان مش قادر يقعد
+
+362
+00:22:57,920 --> 00:23:01,360
+بنخلي إيه من المريض؟ بنخليه ينام على ضهره، ال abdomen
+
+363
+00:23:01,360 --> 00:23:05,440
+extremities، طيب بس داخل الخط إيش هنا ال abdomen، لو
+
+364
+00:23:05,440 --> 00:23:08,940
+كنا في ال sitting بقدرش أعمل abdomen assessment، طب
+
+365
+00:23:08,940 --> 00:23:11,500
+وين يا أستاذ؟ في limitations يعني في حدود أو في
+
+366
+00:23:11,500 --> 00:23:16,760
+موانع، ما ممنوع، أنا أستخدم هذا الوضع، بيقول لي دير
+
+367
+00:23:16,760 --> 00:23:21,440
+بالك، ممنوع في هذا اختصار عالمي اسمه SOB shortness
+
+368
+00:23:21,440 --> 00:23:25,900
+of breath أو shortness of breathing، إيش يعني؟ بعض
+
+369
+00:23:25,900 --> 00:23:29,530
+الناس اللي عندهم قصر في التنفس، يعني نفسه، بيقولوا
+
+370
+00:23:29,530 --> 00:23:33,390
+بالعامية نفسه مطرود، اللي عنده ضيق النفس ما ينفعش
+
+371
+00:23:33,390 --> 00:23:36,650
+ينام على ضهره، زي حالات الأزمة، حالات اللي عندهم
+
+372
+00:23:36,650 --> 00:23:39,390
+chronic obstructive pulmonary disease، حالات الـ
+
+373
+00:23:39,390 --> 00:23:42,690
+high ال obesity، هذول الناس مشكلته مشكلة ما بقدرش أنام
+
+374
+00:23:42,690 --> 00:23:46,790
+على ضهره، أول ما بينام على ضهره بتلاقي كأنه إشي بده
+
+375
+00:23:46,790 --> 00:23:52,170
+يخنقه و بيطلع عرقان، فهذا ما يناسبه،  Dorsal recumbent
+
+376
+00:23:52,170 --> 00:23:56,560
+position، بيقول لي ال areas اللي بدنا نستخدمها لها
+
+377
+00:23:56,560 --> 00:23:58,480
+assessment زي ال head و ال neck و ال anterior
+
+378
+00:23:58,480 --> 00:24:01,680
+thorax و ال lung و ال breast ممتاز و ال axilla
+
+379
+00:24:01,680 --> 00:24:06,060
+الطبيعي و الأرض، لأنه إيش؟ dorsal recumbent،  منحني
+
+380
+00:24:06,060 --> 00:24:10,180
+شوية يعني على ضهره بس منحني شوية، زي semi-Fowler، طيب
+
+381
+00:24:10,180 --> 00:24:12,900
+ال limitations بيقول لي ممنوع تستخدمه في ال abdomen
+
+382
+00:24:12,900 --> 00:24:15,660
+ال assessment أكيد، طبعاً، ليه؟ لأنه بيعمل
+
+383
+00:24:15,660 --> 00:24:19,900
+contraction، إيش contraction؟ شد، لأنه بيعمل شد في الـ
+
+384
+00:24:19,900 --> 00:24:24,140
+abdominal muscles، لا تستخدمه لأنه بيعمل شد في الـ
+
+385
+00:24:24,140 --> 00:24:27,460
+abdominal muscles، اللي بعده lithotomy position
+
+386
+00:24:27,460 --> 00:24:31,240
+بيقول لي ممكن إحنا نستخدمه في حالة ال female الـ
+
+387
+00:24:31,240 --> 00:24:34,700
+genitalia و ال genital tract، لكن الصراحة هذا
+
+388
+00:24:34,700 --> 00:24:37,420
+embarrassing، إيش،  uncomfortable، محرج، عشانك الـ
+
+389
+00:24:37,420 --> 00:24:41,140
+limitations، بنحاول ما نستخدموش لأنه uncomfortable
+
+390
+00:24:41,140 --> 00:24:44,700
+مش مريح للمريض، هذا بنستخدموش إلا في الحالات
+
+391
+00:24:44,700 --> 00:24:48,970
+النادرة، إحنا عندنا في المستشفيات مرات بنضطر نستخدمه
+
+392
+
+Please provide the Arabic/English lecture transcript you would like me to correct.
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..ffdba06f8fabfdd38ea653ea5e37e41bd5396001
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 3022, "start": 0.64, "end": 30.22, "text": "بسم الله الرحمن الرحيم خلينا نكمل اليوم في ال chapter الخامس لمساق التقييم الصحي التمريدي وطلبة المستوى التاني حياكم الله و اليوم هيكون chapterنا زي ما انتوا شايفين general assessment including a vital science يعني احنا بدأنا الآن خليني أقول يعني بالشغل الحقيقي اللي هو كيف نعمل physical او physiological او biological assessment نكمل الآن", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 16490, 20292, 8315, 8717, 24793, 1211, 45595, 20498, 8978, 2423, 7187, 33962, 10943, 3794, 32767, 3794, 995, 4587, 16712, 38436, 32640, 31767, 5016, 1829, 16712, 29973, 25708, 1829, 4032, 9566, 46152, 3660, 9673, 14851, 2407, 7578, 16712, 7649, 1829, 11331, 25528, 24793, 21984, 4032, 45595, 20498, 39896, 30544, 7187, 8315, 30767, 1829, 19446, 16472, 2655, 14407, 13412, 995, 33911, 9957, 2674, 9687, 3009, 257, 11707, 3497, 37495, 22653, 1975, 5016, 8315, 47525, 10721, 8315, 6024, 48506, 16490, 1211, 9957, 1829, 5551, 39648, 37495, 22653, 20666, 8592, 17082, 1211, 21542, 38436, 38436, 13672, 1829, 31439, 9122, 33911, 8717, 25957, 1211, 4001, 1975, 2407, 41234, 1975, 2407, 13910, 9687, 8717, 24793, 1211, 6024, 48506], "avg_logprob": -0.16175717774961815, "compression_ratio": 1.8531468531468531, "no_speech_prob": 2.0265579223632812e-06, "words": [{"start": 0.64, "end": 1.0, "word": "بسم", "probability": 0.909423828125}, {"start": 1.0, "end": 1.24, "word": " الله", "probability": 0.96923828125}, {"start": 1.24, "end": 1.68, "word": " الرحمن", "probability": 0.95458984375}, {"start": 1.68, "end": 2.12, "word": " الرحيم", "probability": 0.9957682291666666}, {"start": 2.12, "end": 2.88, "word": " خلينا", "probability": 0.75830078125}, {"start": 2.88, "end": 3.22, "word": " نكمل", "probability": 0.9899088541666666}, {"start": 3.22, "end": 3.62, "word": " اليوم", "probability": 0.973388671875}, {"start": 3.62, "end": 4.48, "word": " في", "probability": 0.8994140625}, {"start": 4.48, "end": 4.74, 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اشي واضح قدامي؟ يعني في لا سمح الله اي defects اي abnormalities واضحة و ممكن هذه ان انا اتشد انتباهي ان هذه لازم اعمل assessment", "tokens": [6027, 7649, 4032, 4724, 8592, 38688, 1975, 15730, 8978, 20193, 8608, 2304, 5016, 21984, 11331, 26108, 3660, 24525, 2304, 11296, 11367, 47104, 16110, 5296, 15042, 8717, 38251, 3615, 9122, 19528, 3660, 11367, 37495, 22653, 4032, 46958, 5016, 24976, 3615, 1829, 6027, 12399, 1975, 1829, 8592, 37495, 22653, 4032, 46958, 5016, 24976, 3615, 1829, 6027, 22807, 37495, 22653, 4032, 1975, 8315, 39894, 9566, 1211, 3615, 32767, 5016, 3660, 6225, 10943, 3660, 4032, 39894, 9566, 1211, 3615, 9154, 34892, 10721, 3794, 24976, 47341, 1211, 4724, 8592, 28820, 6225, 10943, 8978, 10874, 38251, 3224, 12399, 1975, 1829, 8592, 8978, 1975, 8592, 1829, 4032, 46958, 5016, 12174, 3215, 10943, 1829, 22807, 37495, 22653, 8978, 20193, 8608, 2304, 5016, 21984, 1975, 1829, 32655, 1975, 1829, 47104, 16110, 4032, 46958, 5016, 3660, 4032, 3714, 43020, 29538, 16472, 1975, 8315, 1975, 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1664.85, "end": 1665.07, "word": " بس", "probability": 0.995849609375}, {"start": 1665.07, "end": 1665.55, "word": " معلومة", "probability": 0.9927978515625}, {"start": 1665.55, "end": 1666.03, "word": " عالهامش", "probability": 0.93603515625}, {"start": 1666.03, "end": 1666.39, "word": " عشان", "probability": 0.9220377604166666}, {"start": 1666.39, "end": 1666.69, "word": " احنا", "probability": 0.8426106770833334}, {"start": 1666.69, "end": 1667.03, "word": " يعني", "probability": 0.50372314453125}, {"start": 1667.03, "end": 1667.13, "word": " لو", "probability": 0.55615234375}, {"start": 1667.13, "end": 1667.61, "word": " سمعناها", "probability": 0.806201171875}], "temperature": 1.0}, {"id": 63, "seek": 167635, "start": 1668.01, "end": 1676.35, "text": "خلّينا نقفل عند هنا وان شاء الله في المحاضرة القادمة بنبدأ بالمصري ال assessment بإذن الله السلام عليكم ورحمة الله وبركاته", "tokens": [9778, 1211, 11703, 9957, 995, 8717, 4587, 5172, 1211, 43242, 34105, 4032, 7649, 13412, 16606, 21984, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 44945, 44510, 10721, 20666, 2304, 9381, 16572, 2423, 9687, 4724, 28814, 8848, 1863, 21984, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.22155071204563356, "compression_ratio": 1.4657534246575343, "no_speech_prob": 5.364418029785156e-07, "words": [{"start": 1668.01, "end": 1668.61, "word": "خلّينا", "probability": 0.7375}, {"start": 1668.61, "end": 1669.07, "word": " نقفل", "probability": 0.7591552734375}, {"start": 1669.07, "end": 1669.25, "word": " عند", "probability": 0.97412109375}, {"start": 1669.25, "end": 1669.47, "word": " هنا", "probability": 0.493408203125}, {"start": 1669.47, "end": 1669.65, "word": " وان", "probability": 0.706787109375}, {"start": 1669.65, "end": 1669.79, "word": " شاء", "probability": 0.975341796875}, {"start": 1669.79, "end": 1669.93, "word": " الله", "probability": 0.94970703125}, {"start": 1669.93, "end": 1670.07, "word": " في", "probability": 0.84814453125}, {"start": 1670.07, "end": 1670.37, "word": " المحاضرة", "probability": 0.975341796875}, {"start": 1670.37, "end": 1670.89, "word": " القادمة", "probability": 0.9934895833333334}, {"start": 1670.89, "end": 1671.87, "word": " بنبدأ", "probability": 0.8053385416666666}, {"start": 1671.87, "end": 1673.15, "word": " بالمصري", "probability": 0.530242919921875}, {"start": 1673.15, "end": 1673.23, "word": " ال", "probability": 0.69775390625}, {"start": 1673.23, "end": 1673.67, "word": " assessment", "probability": 0.7392578125}, {"start": 1673.67, "end": 1674.03, "word": " بإذن", "probability": 0.9422607421875}, {"start": 1674.03, "end": 1674.15, "word": " الله", "probability": 0.94580078125}, {"start": 1674.15, "end": 1674.49, "word": " السلام", "probability": 0.60400390625}, {"start": 1674.49, "end": 1674.93, "word": " عليكم", "probability": 0.9521484375}, {"start": 1674.93, "end": 1675.61, "word": " ورحمة", "probability": 0.958251953125}, {"start": 1675.61, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..54124bd25b3061c04538c6eba68bab7c2416e226
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+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/7NlokiD91c8_raw.srt
@@ -0,0 +1,1776 @@
+1
+00:00:00,640 --> 00:00:04,740
+بسم الله الرحمن الرحيم خلينا نكمل اليوم في ال
+
+2
+00:00:04,740 --> 00:00:09,080
+chapter الخامس لمساق التقييم الصحي التمريدي وطلبة
+
+3
+00:00:09,080 --> 00:00:14,160
+المستوى التاني حياكم الله و اليوم هيكون chapterنا
+
+4
+00:00:14,160 --> 00:00:18,400
+زي ما انتوا شايفين general assessment including a
+
+5
+00:00:18,400 --> 00:00:21,240
+vital science يعني احنا بدأنا الآن خليني أقول يعني
+
+6
+00:00:21,240 --> 00:00:26,380
+بالشغل الحقيقي اللي هو كيف نعمل physical او
+
+7
+00:00:26,380 --> 00:00:30,220
+physiological او biological assessment نكمل الآن
+
+8
+00:00:30,660 --> 00:00:34,060
+أول حاجة إذا لاحظته ال equipment اللي احنا دائما
+
+9
+00:00:34,060 --> 00:00:38,760
+نحتاجها بشكل عام ليس يعني حكرا على مريض معين ممكن
+
+10
+00:00:38,760 --> 00:00:42,280
+تكون زي اللي تكون في مختبر أو بتكون في غرفة خاصة
+
+11
+00:00:42,280 --> 00:00:46,600
+في داخل القسم في داخل المزارة أو في المركز الصحي
+
+12
+00:00:46,600 --> 00:00:50,440
+لازم يكون فيها حاجة بسمها beam balance scale لما
+
+13
+00:00:50,440 --> 00:00:53,380
+اقول كلمة beam balance scale اللي هو شفته او لما
+
+14
+00:00:53,380 --> 00:00:56,130
+كنت في سنة أولى في المختبراللي هو الميزان اللي
+
+15
+00:00:56,130 --> 00:01:00,170
+بنجف عليه بيجيسه طوله و الوزن سموه بين بلازلان
+
+16
+00:01:00,170 --> 00:01:05,150
+بيجف الإنسان عليه و في نفس الوقت بيشوف كدهش طول ..
+
+17
+00:01:05,150 --> 00:01:10,010
+كدهش فيه فجيه تدريج و بيعطينا كمان المقياس بال
+
+18
+00:01:10,010 --> 00:01:15,190
+kilogramة طيب .. الآنش بقول كمان أنا تب مجر .. لما
+
+19
+00:01:15,190 --> 00:01:19,150
+نقول كلمة تب مجر هو يمكن مش دايما نقدر نجيبه ..
+
+20
+00:01:19,150 --> 00:01:25,200
+بتذكر و يمكن إذا حد عمره يتذكر معاياالميتر اللى هو
+
+21
+00:01:25,200 --> 00:01:29,740
+زى الجلد عامل الميتر هو مش قماش جلدي بيستخدموه زى
+
+22
+00:01:29,740 --> 00:01:33,680
+الخياطين اللى بيسموه ادائش اللى هو المدرج يعنى
+
+23
+00:01:33,680 --> 00:01:37,400
+اللى علي تدريجي يعنى زى بعض أنواع المساطر اللى
+
+24
+00:01:37,400 --> 00:01:40,960
+بتتنها هيك بتتطوى ممكن نستخدمها عشان لو بدنا نحتاج
+
+25
+00:01:40,960 --> 00:01:46,320
+نقيس بعض شغلات في جسم الإنسان ثرموميتر كلنا
+
+26
+00:01:46,320 --> 00:01:49,340
+عارفينه فى جمهور مانوميتر جهاز الضغط مع ستاتسكوب
+
+27
+00:01:49,340 --> 00:01:53,310
+تمامالان ال subject data current health اول حاجة
+
+28
+00:01:53,310 --> 00:01:56,150
+اللى عم نقولها خلّيني اذاكريها subject فعلا مش
+
+29
+00:01:56,150 --> 00:01:59,430
+objective يعني بتاخد منه بتاخد من المريض ال
+
+30
+00:01:59,430 --> 00:02:02,890
+current health ال current age العمر ال height ال
+
+31
+00:02:02,890 --> 00:02:06,330
+weight حاجات بسيطة هذه ال recent weight ال changes
+
+32
+00:02:06,330 --> 00:02:10,090
+صار تغيير تغييرات اخر شي لكن اهم اللي بهم ماتتكلمش
+
+33
+00:02:10,090 --> 00:02:13,310
+عن التغييرات الآن الانية لما بسمعوا الوزن اخر ست
+
+34
+00:02:13,310 --> 00:02:17,010
+شهر بقولوا اخر ست شهور كيف كان وزنك ال fever
+
+35
+00:02:17,010 --> 00:02:21,290
+history of hypertension اذاهل في عنده hypertension
+
+36
+00:02:21,290 --> 00:02:25,230
+هل في عنده history of difficulty of breathing or
+
+37
+00:02:25,230 --> 00:02:30,090
+not هل في عنده changes في ال pulse or heart rate
+
+38
+00:02:30,090 --> 00:02:33,750
+يعني بشكل عام عنده مشاكل صحية ولا لأ طيب ال
+
+39
+00:02:33,750 --> 00:02:36,850
+objective اللي انا عمالي بدي اعمله ايش قياسي بدي
+
+40
+00:02:36,850 --> 00:02:40,310
+اشوف ال head to toe examination بدي ابدأ من اعلى
+
+41
+00:02:40,310 --> 00:02:43,890
+الرأس اللي زي ما بقوله في المثل الى أخمص القدم هنا
+
+42
+00:02:43,890 --> 00:02:47,800
+تحت الأخر شيءالان و بشوف اذا في لا سمح الله حاجة
+
+43
+00:02:47,800 --> 00:02:51,560
+اسمها gross abnormalities لما نسمع كلمة gross يعني
+
+44
+00:02:51,560 --> 00:02:55,200
+واضح للعيال، ايش يعني واضح للعيال؟ يعني و انا
+
+45
+00:02:55,200 --> 00:02:58,320
+بتطلع لمحة عامة و بتطلع من الرأس للرجل بشكل عام في
+
+46
+00:02:58,320 --> 00:03:02,240
+جسمه، ايش في اشي واضح قدامي؟ يعني في لا سمح الله
+
+47
+00:03:02,240 --> 00:03:06,220
+اي defects اي abnormalities واضحة و ممكن هذه ان
+
+48
+00:03:06,220 --> 00:03:11,610
+انا اتشد انتباهي ان هذه لازم اعمل assessmentأو
+
+49
+00:03:11,610 --> 00:03:15,890
+further more examination الان الان بعدين بنبدأ في
+
+50
+00:03:15,890 --> 00:03:19,730
+assessment of a vital signs الان ال vital signs
+
+51
+00:03:19,730 --> 00:03:21,510
+انتوا عارفين اللي هو بيشمل ال temperature و ال
+
+52
+00:03:21,510 --> 00:03:26,050
+pulse و ال respiration و ال blood pressure كل هذا
+
+53
+00:03:26,050 --> 00:03:30,430
+و احنا لسه مدخلناش في عمق ال assessment بعد that
+
+54
+00:03:30,430 --> 00:03:33,130
+weigh the client and measure for height لما يقوللي
+
+55
+00:03:33,130 --> 00:03:37,830
+كلمة weigh وزن ذاكرين ال BMI body mass index و أنا
+
+56
+00:03:38,330 --> 00:03:40,750
+في البداية بس الديكسو اعطيتكوا البرنامج اللي كيف
+
+57
+00:03:40,750 --> 00:03:44,310
+ممكن تنزله على جواراتكوا هو انا شبكوا اللي بدكوا
+
+58
+00:03:44,310 --> 00:03:47,750
+نتقارن ما بين طول المريض و ما بين وزنه بس عشان
+
+59
+00:03:47,750 --> 00:03:52,730
+نعرف بشكل عام المريض ايش يصنف obese less obesity
+
+60
+00:03:52,730 --> 00:03:57,920
+thin more thin و هكذا طيببعدها ال procedure بدنا
+
+61
+00:03:57,920 --> 00:04:03,080
+بدنا ندخل نحرج الأمور أول حاجة observe لاحظ راقب
+
+62
+00:04:03,080 --> 00:04:06,360
+دايما تذكرين لما كنت أقول كلمة think before act
+
+63
+00:04:06,360 --> 00:04:12,060
+يعني تفكر قبل العمل ال behavior أول حاجة شوف ليه
+
+64
+00:04:12,060 --> 00:04:16,000
+cooperative or uncooperative الطبيعي أن كل إنسان
+
+65
+00:04:16,000 --> 00:04:20,200
+عادي ومرضه طبيعي يكون متعاون مع ال cooperative وشي
+
+66
+00:04:20,200 --> 00:04:22,080
+مثل الأطفال زي ما احنا قلنا ممكن يكون
+
+67
+00:04:22,080 --> 00:04:26,570
+uncooperative الاختيار يمكن مايكونش معنا متعاونالـ
+
+68
+00:04:26,570 --> 00:04:30,810
+psychotic client يعني المريض النفسي اللي لو عنده
+
+69
+00:04:30,810 --> 00:04:33,390
+اي مشكلة نفسية و انت لديه problems ممكن مايتعاونش
+
+70
+00:04:33,390 --> 00:04:37,110
+هذه بدنا ننتبه لها بعدين ما تشوف ال mood ال mood
+
+71
+00:04:37,110 --> 00:04:40,870
+يعني المزاج ما بتكلم عن ال effect اللي ذاكر و اللي
+
+72
+00:04:40,870 --> 00:04:43,770
+ذاكر هو الشاطرين في سنة أولة لما كنا نقول mood و
+
+73
+00:04:43,770 --> 00:04:45,470
+effect ال mood اللي هو الداخل ال effect اللي هو
+
+74
+00:04:45,470 --> 00:04:48,890
+الخارجي بس من باب التذكير بلحظ ال mood هل هو
+
+75
+00:04:48,890 --> 00:04:53,270
+steady ثابت و لا anxious يعني عنده مزاج قلق و مش
+
+76
+00:04:53,270 --> 00:04:58,280
+قادر يتعامل معاهال appearance كيف دخوله؟ هل هو
+
+77
+00:04:58,280 --> 00:05:02,520
+يعني المظهر تبعه واللي dressed يعني لابس كويس ولا
+
+78
+00:05:02,520 --> 00:05:05,480
+لبسه bizarre؟ ايش كلمة bizarre قلتها زمان ولا
+
+79
+00:05:05,480 --> 00:05:09,360
+عيدها؟ اللبس الغريب في وقت غير مناسب، كيف يعني؟
+
+80
+00:05:09,360 --> 00:05:13,060
+يعني هل هو شكله و لبسه غريب، الدنيا شوب و لابس
+
+81
+00:05:13,060 --> 00:05:17,800
+ملابس ثقيلة، الدنيا برد و مش لابس ملابس يعني ثقيل
+
+82
+00:05:17,800 --> 00:05:21,480
+برد أو inappropriate أو غير متناسب مع سنه وجنسه؟
+
+83
+00:05:22,240 --> 00:05:25,620
+بتلاقي يعني مثلا بدون .. بدون نخش في تفاصيل مثلا
+
+84
+00:05:25,620 --> 00:05:28,960
+لما كبير و لابس يغلط مثلا بتليقش بيه و هكذا ال
+
+85
+00:05:28,960 --> 00:05:31,640
+body movements حركات الجسد اللي ال body language
+
+86
+00:05:31,640 --> 00:05:35,660
+هذه مهمة coordinated يعني هل متناسقة مع بعض و لا
+
+87
+00:05:35,660 --> 00:05:39,820
+uncoordinated يعني مش متناسقة و لا shaky and
+
+88
+00:05:39,820 --> 00:05:43,580
+unsteady يعني هو اللي بيتز و هو مش ثابت اقصد هنا
+
+89
+00:05:43,580 --> 00:05:48,000
+يعني احنا جدامنا البني ادم هل جدامنا و احنا بنحكي
+
+90
+00:05:48,000 --> 00:05:51,040
+معاه برج ايديه بترج جليه جادري جاف مش جادري و جاف
+
+91
+00:05:51,810 --> 00:05:55,610
+يعني كيف أداء و كيف انتوا شايفينه قبل ما احنا نبدأ
+
+92
+00:05:55,610 --> 00:05:59,310
+نعمل assessment عشان ما نجعش في أي شيء ممكن لازم
+
+93
+00:05:59,310 --> 00:06:03,650
+يأثر أو يسبب له ضرر لمرضى الأمامي نبدأ بال vital
+
+94
+00:06:03,650 --> 00:06:06,210
+science و ال vital science ما شاء الله يعني انتوا
+
+95
+00:06:06,210 --> 00:06:09,670
+كلكوا يعني أخدتوا في السنة الأولى و أنا متأكد يعني
+
+96
+00:06:09,670 --> 00:06:14,990
+شريته الأجهزة و قسطه الضغط كتير كمان لأهليكوا و
+
+97
+00:06:14,990 --> 00:06:18,290
+الحرارةو ال pulse و ال respiration يعني الإنسان
+
+98
+00:06:18,290 --> 00:06:21,370
+صار في عنده يعني خليني أقول خبرة و لو على دول
+
+99
+00:06:21,370 --> 00:06:24,350
+القربة ان شاء الله و بعد هيك بيصير على المرضى ان
+
+100
+00:06:24,350 --> 00:06:27,930
+شاء الله بيصير الأمر أدق و أحسن و بنكسر الحاجز
+
+101
+00:06:27,930 --> 00:06:30,710
+بتاع الخوف ال vital science احنا زي ما انتوا
+
+102
+00:06:30,710 --> 00:06:33,210
+عارفين temperature و pulse و respiration و blood
+
+103
+00:06:33,210 --> 00:06:35,730
+pressure مش هحكي فيها كتير لأن اللي جاي فيه شغلات
+
+104
+00:06:35,730 --> 00:06:39,010
+بدأ أكتر اسمها ايه في بعض الناس بيسموا بعض الكتب
+
+105
+00:06:39,010 --> 00:06:41,830
+اسمها life science يبقى لو قولنا life science او
+
+106
+00:06:41,830 --> 00:06:44,450
+vital science على فكرة نفس الاسم ال vital و ال
+
+107
+00:06:44,450 --> 00:06:48,060
+life يعني حيوي يعني حياءإيش بتأثر هذه؟ إذا في
+
+108
+00:06:48,060 --> 00:06:52,020
+عندنا physiology status، إيش يعني؟ إذا في
+
+109
+00:06:52,020 --> 00:06:54,360
+abnormalities في ال physiology status، يعني أي
+
+110
+00:06:54,360 --> 00:07:00,280
+تغيير physiology بيبين فورا، نشوف الاستجابة، ال
+
+111
+00:07:00,280 --> 00:07:03,140
+environmental and physiological stressors، يعني
+
+112
+00:07:03,140 --> 00:07:07,280
+بعض الناس بتأثر من البيئة اللي حولهم، بتأثر من
+
+113
+00:07:07,280 --> 00:07:10,780
+ناحية الفيسيولوجية، من التوترات، أي شيء يؤثر على
+
+114
+00:07:10,780 --> 00:07:14,260
+ناحية النفسية أو على ناحية الجسدية، هينعكس تأثيره
+
+115
+00:07:14,260 --> 00:07:17,150
+على وين؟ على ال vital cells، أكيد هذا كلامكنا
+
+116
+00:07:17,150 --> 00:07:21,050
+بنعرف واحد خاف معناته ايه لإنه بتتغير كتير، واحد
+
+117
+00:07:21,050 --> 00:07:24,470
+اتنكد عليه معناته ايه ال stress عليه، واحد صار في
+
+118
+00:07:24,470 --> 00:07:27,270
+عنده اي التهاب معناته الحرارة و هكذا ال
+
+119
+00:07:27,270 --> 00:07:32,170
+temperature .. بس احنا بنقول هنا انه في كتب اختلفت
+
+120
+00:07:32,170 --> 00:07:34,350
+الكتب في كتب بتقول ان ال rectal temperature the
+
+121
+00:07:34,350 --> 00:07:38,170
+most accurate حتى بيقولوا preferred يفضل طبعا احنا
+
+122
+00:07:38,170 --> 00:07:41,930
+embarrassing هنا يعني في غزة ممكن يكون في نوع من
+
+123
+00:07:41,930 --> 00:07:44,770
+الحرج و مايرضوا الاهل ان انا ناخد ال temperature
+
+124
+00:07:44,770 --> 00:07:48,730
+rectallyلكن احنا مرات في بداية الحياة اول ما نولد
+
+125
+00:07:48,730 --> 00:07:53,970
+الطفل مضطرين ناخد ال temperature rectally عشان فيه
+
+126
+00:07:53,970 --> 00:07:59,070
+تشخيص اسمه imperforated anus اسمه imperforated
+
+127
+00:07:59,070 --> 00:08:04,610
+anus يعني بيسموه ايش فتحت الشرج المغلقة خلقيا طبعا
+
+128
+00:08:04,610 --> 00:08:08,970
+لما نقول فتحت الشرج مغلق خلقيا يعني معناته بدأت
+
+129
+00:08:08,970 --> 00:08:12,090
+تدخل ماقدرش اكشفها لما انا اجي احط ال thermometer
+
+130
+00:08:12,090 --> 00:08:15,400
+في بلاجي في اغلاقيعني في closure فبتتدخل بعد هيك
+
+131
+00:08:15,400 --> 00:08:19,500
+بيصير أن في أشكالية فالناس بترتاح فعلشان هيك هو
+
+132
+00:08:19,500 --> 00:08:22,940
+بيقوللي صح انها accurate في كتب قالت لأ قالت ان ال
+
+133
+00:08:22,940 --> 00:08:26,760
+oral وفي ناس قال لأ يعني ال forehead اللي هو منطقة
+
+134
+00:08:26,760 --> 00:08:30,360
+اللي هو الجبهة واحنا انتشرفين اليوم في ظل جائحة
+
+135
+00:08:30,360 --> 00:08:34,220
+كورونا يعني وانتشار ال coronavirus في معظم
+
+136
+00:08:34,220 --> 00:08:37,320
+المؤسسات الصحية حتى المؤسسات التجارية بياخدوا
+
+137
+00:08:37,320 --> 00:08:40,220
+حرارة عن طريق ال forehead مباشرة وممكن تكون برضه
+
+138
+00:08:40,220 --> 00:08:44,760
+دقيقة أو بالدلإذا .. أه unless contraindicated إذا
+
+139
+00:08:44,760 --> 00:08:50,000
+.. إذا ممنوع نخدها a rectal temperature هنا إيش
+
+140
+00:08:50,000 --> 00:08:52,540
+بتصير خاصة في بعض الحالات إيش بيقولي ممنوع تخدها
+
+141
+00:08:52,540 --> 00:08:55,380
+طب ليش؟ كان لي ده واحد عنده cardiac arrhythmia
+
+142
+00:08:55,380 --> 00:08:59,500
+يعني هي بيكون ممنوع يعني معناته .. معناته ما لم
+
+143
+00:08:59,500 --> 00:09:02,940
+يكن هناك معنى .. يعني هي كاتب هنا unless ما لم يكن
+
+144
+00:09:02,940 --> 00:09:06,640
+هناك معنى إنه تأخذ ال rectal زي في حالة اللي هو
+
+145
+00:09:06,640 --> 00:09:11,340
+الأمراض القلب و لو عنده مرافقة في القلب لأنه يتأثر
+
+146
+00:09:11,830 --> 00:09:16,490
+مجرد ما نحط ال .. يعني ال thermometer في ال rectum
+
+147
+00:09:16,490 --> 00:09:20,250
+بيصير تأثر و بيصير severe tachycardia لأنه بشتغل
+
+148
+00:09:20,250 --> 00:09:24,330
+عليها حاجة بيسموها vasovagal attack انه بيصير يعني
+
+149
+00:09:24,330 --> 00:09:28,150
+احنا بنعمل زي attack ل nervous system هنا في حاجة
+
+150
+00:09:28,150 --> 00:09:31,990
+اذا ماكان فيه انه ممنوع فبنستخدمهش لكن ده مش أنموع
+
+151
+00:09:31,990 --> 00:09:36,770
+بفضل انه ايش نستخدم ال rectal temperature طيب هذه
+
+152
+00:09:36,770 --> 00:09:42,020
+ال comparison فيه انما انتوا عارفينانه في بعض
+
+153
+00:09:42,020 --> 00:09:44,420
+المقاييس او بعض التراموترات بتقييس بحاجة باسم
+
+154
+00:09:44,420 --> 00:09:47,940
+الفهرانهايت احنا عموما الفهرانهايت مش هنلاقي يعني
+
+155
+00:09:47,940 --> 00:09:51,240
+احنا غالبا في غزة انا ماشوفتش يعني يمكن نلاقي
+
+156
+00:09:51,240 --> 00:09:55,180
+ميزان ميزانين في قسم بس .. بس هذه لا تعني انه مدى
+
+157
+00:09:55,180 --> 00:09:57,920
+الانتشار وانا بتكلم يعني هيك كإنه بقول ال normal
+
+158
+00:09:57,920 --> 00:10:02,960
+لازم يكون أجلش 99 فهرانهايت انا بيعنيش هذا طبعا
+
+159
+00:10:02,960 --> 00:10:06,420
+انا في انا جزيل ارى في oral و في rectal وانا مش
+
+160
+00:10:06,420 --> 00:10:11,000
+يعني ممكن مالخمكوش و بقولكوا هذا بس يعنيمن باب ان
+
+161
+00:10:11,000 --> 00:10:15,160
+الانسان يدرسه يعني مابندهاش لعجبكوا لكن هذا مهم
+
+162
+00:10:15,160 --> 00:10:18,440
+ليش مهم هالجيت هذا ال temperature اللي هو بتكلم
+
+163
+00:10:18,440 --> 00:10:21,340
+بال degree بال centigrade اللي هو الدرجة المئوية
+
+164
+00:10:21,340 --> 00:10:24,540
+لما بقولنا في بعض الناس بقولك لو كانت oral هالجيت
+
+165
+00:10:24,540 --> 00:10:27,740
+انا متأكد ان كله درست يعني مثلا واحد سبعة و تلاتين
+
+166
+00:10:27,740 --> 00:10:31,900
+و نص مثلا oral سبعة و تلاتين و نص oral ترى كدش هنا
+
+167
+00:10:31,900 --> 00:10:34,480
+موجود اكزيل اللي صارت ستة و تلاتين و تسعة و عشرة
+
+168
+00:10:34,480 --> 00:10:37,960
+كدش نقصت لو كنا سبعة و تلاتين و نص بدا نقص كده ستة
+
+169
+00:10:37,960 --> 00:10:41,180
+و عشرة يعني زي نص درجةيعني كأنه بيقوللي .. كأنه
+
+170
+00:10:41,180 --> 00:10:44,520
+بيقوللي .. لاحظين هنا 37.5 طب كده ايش صارت هنا؟
+
+171
+00:10:44,520 --> 00:10:49,720
+صارت 38 يعني كأنه بيقوللي ال oral هي الفيصل فال
+
+172
+00:10:49,720 --> 00:10:54,960
+oral temperature لو كانت 37 هتكون auxiliary 36.5 و
+
+173
+00:10:54,960 --> 00:10:59,040
+هتكون rectally .. هتكون ايش هنا؟ 37.5 يعني أعلى من
+
+174
+00:10:59,040 --> 00:11:03,500
+نص درجة انعيد عشان نتأكد و ماحدش يتخربط يعني لو
+
+175
+00:11:03,500 --> 00:11:09,550
+كانت عن طريق الفم الحرارة 37هتكون عن طريق الأجزلة
+
+176
+00:11:09,550 --> 00:11:14,630
+اللى هو تحت القبض أقل من نص درجة 36.5 طب ال oral
+
+177
+00:11:14,630 --> 00:11:19,630
+كم مارجدش كانت 37 طب كم هتكون ال rectal rectal أو
+
+178
+00:11:19,630 --> 00:11:21,690
+by ear يعني عن طريق الأذن أو عن طريق ال rectum
+
+179
+00:11:21,690 --> 00:11:25,930
+بنزود نص درجة تزويد النص درجة كم يصبح هنا دغر
+
+180
+00:11:25,930 --> 00:11:30,610
+مباشرة 37.5 يبقى كأنا واقفة في نص ال oral ال
+
+181
+00:11:30,610 --> 00:11:33,590
+rectum أعلى منه نص و ال axilla أقل منه نص طب ممكن
+
+182
+00:11:33,590 --> 00:11:39,380
+يجينا السؤال يقولناطب إذا كانت ستة و تلاتين ها ستة
+
+183
+00:11:39,380 --> 00:11:43,240
+و تلاتين أكزلها كده بتكون ركتال إذا ستة و تلاتين
+
+184
+00:11:43,240 --> 00:11:48,100
+أكزلها كده بتكون ركتال او إيردوري بنقول بنزود درجة
+
+185
+00:11:48,100 --> 00:11:52,260
+ليش؟ لإن احنا قولنا الوسيط هذا فلو كانت ستة و
+
+186
+00:11:52,260 --> 00:11:54,280
+تلاتين هذا هتكون سبعة و تلاتين و لو كانت التمانية
+
+187
+00:11:54,280 --> 00:11:58,000
+تلاتين هتكون هنا سبعة و تلاتين و هكذا هذا من
+
+188
+00:11:58,000 --> 00:12:02,120
+البابش وهذه الفروقات اللي موجودة كده لو كانت احنا
+
+189
+00:12:02,120 --> 00:12:06,000
+لو فهمنا القاعدة العامةكده بال range العام بتزيد
+
+190
+00:12:06,000 --> 00:12:12,200
+نص و تنقص نص بتكون أفضل طيب ال parse الطبيعي يكون
+
+191
+00:12:12,200 --> 00:12:16,380
+زي ما تشاهدين من 60 ل 80 beat per minute بي م يعني
+
+192
+00:12:16,380 --> 00:12:21,100
+اختصار ل beat per minute الان الان الطبيعي ال
+
+193
+00:12:21,100 --> 00:12:27,080
+adult الشباب اللي ماعندهم مشكلة من 60 ل 80 دقة قلب
+
+194
+00:12:27,080 --> 00:12:29,900
+في الدقيقة و علمونا و نفسنا و لا الأفضل نعمل
+
+195
+00:12:29,900 --> 00:12:34,020
+complete one minuteيعني assessment او calculation
+
+196
+00:12:34,020 --> 00:12:37,060
+يعني تقييم او اي حساب و انا بفضل دايما ان اتكون
+
+197
+00:12:37,060 --> 00:12:41,040
+مستعجلين و احنا نحسب للمريض نحسبله نص دقيقة لكن
+
+198
+00:12:41,040 --> 00:12:44,420
+ياريت بلاش باقل من ذلك يعني انا بيكون نص دقيقة او
+
+199
+00:12:44,420 --> 00:12:48,120
+اضربه في اتنين يمكن اقرب للصعب من انه بعض اللي
+
+200
+00:12:48,120 --> 00:12:51,380
+حدنا كتير مكونوا مستعجلين فبياخدوا لخمستاشر ثانية
+
+201
+00:12:51,380 --> 00:12:55,560
+و مستعجل الان بعد ما أخدنا بقول هنا palpate the
+
+202
+00:12:55,560 --> 00:12:59,190
+radial كلكوا عارفين ال radial pulseاللي هو عند
+
+203
+00:12:59,190 --> 00:13:02,450
+الإيد تحت اللي هو أموين بيجيه العضم التاني اللي
+
+204
+00:13:02,450 --> 00:13:05,530
+موجودة في إيدنا في قلنة و في radius كلنا عارفين
+
+205
+00:13:05,530 --> 00:13:08,750
+القلنة لداخل و ال radius للخارج لو حتسألني قللي
+
+206
+00:13:08,750 --> 00:13:11,650
+إيش ال radius اللي هو امتداد أصبع الإبهام امتداد
+
+207
+00:13:11,650 --> 00:13:16,170
+أصبع الإبهام لو ورا بعديك باتنين سانت تقريبا حلقي
+
+208
+00:13:16,170 --> 00:13:19,850
+بيبدأ ال pulse بنعدّه لقداش كتبلي 30 second يعني
+
+209
+00:13:19,850 --> 00:13:23,110
+عشان يقوللي يا ريت تعدّوا أقل حاجة ل 30 ثانية
+
+210
+00:13:23,110 --> 00:13:28,380
+تضربوا اتنين عشان نتأكدإذا ال pulse irregular و لا
+
+211
+00:13:28,380 --> 00:13:31,760
+إذا كان لاجئته غير منتظم لازم نعد for full minute
+
+212
+00:13:31,760 --> 00:13:35,740
+يعني لو أنا حاسيت و أنا قاعد أجيس في ال pulse
+
+213
+00:13:35,740 --> 00:13:40,120
+لاجئت فيه اضطراب في يعني مرة بزيد و مرة بنجس هذا
+
+214
+00:13:40,120 --> 00:13:43,600
+في بعض الحالات زي حاجات بسموها extra systole أو في
+
+215
+00:13:43,600 --> 00:13:47,680
+palpitation يعني زي خفقان هذا بنعد دقيقة كاملة
+
+216
+00:13:47,680 --> 00:13:52,780
+عشان نصل لإيه نصل بالظبط لعدة المناسب بعدين و احنا
+
+217
+00:13:52,780 --> 00:13:56,930
+قاعدين بنعدش بقولي لاحظشوف ال pulse strong قوي و
+
+218
+00:13:56,930 --> 00:14:01,330
+لا weak طعيف و لا bounding زى إيش غامض بشد دهيقة و
+
+219
+00:14:01,330 --> 00:14:06,330
+لا 3D خفيف يعني هل بغم معاك هل خفيف كل هذا إيه
+
+220
+00:14:06,330 --> 00:14:10,010
+معناه ال bounding pulse لو حد سألني أنا ترجمتلكوا
+
+221
+00:14:10,010 --> 00:14:13,150
+ياه هنا feel strong and powerful pulse لما إحنا
+
+222
+00:14:13,150 --> 00:14:18,540
+نشعر إنه إشي قوي جدا حق قوي جداوفى نفس الوقت عاملى
+
+223
+00:14:18,540 --> 00:14:21,780
+زى ال boom boom boom ايه كان لما نعمل boom boom
+
+224
+00:14:21,780 --> 00:14:28,640
+اذا معناته ايش اسمه bounding pulse طيب respiration
+
+225
+00:14:28,640 --> 00:14:33,400
+كلنا عارفين ال respiration زمان أخدناها و نعيد كام
+
+226
+00:14:33,400 --> 00:14:38,520
+مرة الطبيعى للانسان الطبيعى من 16 ل20 يعني نفس
+
+227
+00:14:38,520 --> 00:14:42,700
+طبيعى فى الدقيقة for the healthy person مش معناه
+
+228
+00:14:42,700 --> 00:14:45,500
+دالك ان هو مقدس هنلاقي في بعض الناس اقل من 16 و في
+
+229
+00:14:45,500 --> 00:14:49,000
+ناس اكتر من 20ال تاكي كار ده بتعمل لدغر التاكي ..
+
+230
+00:14:49,000 --> 00:14:53,120
+اه دغر التاكي البني، بتزود ال fever و هكذا، الزلم
+
+231
+00:14:53,120 --> 00:14:57,620
+الاختيار بيصير يخف نفسه، بيبطل، 16 ممكن يعني يكون
+
+232
+00:14:57,620 --> 00:15:01,340
+أقل من 16، و هكذا، الطفل أكتر، يعني لعلاقة بالاش
+
+233
+00:15:01,340 --> 00:15:05,500
+.. بالاش variations و ال physiological changes،
+
+234
+00:15:05,500 --> 00:15:10,180
+يبقى .. بتعد قداش؟ مابنفع واحد يقوللي بدي أعد لنص
+
+235
+00:15:10,180 --> 00:15:15,230
+دقيقة، لأ، النفس بنعد لدقيقة واحدةالان ومش بقولي
+
+236
+00:15:15,230 --> 00:15:19,690
+كمان لاحظ ال rhythm انتظام depth عمق يعني و احنا
+
+237
+00:15:19,690 --> 00:15:23,270
+بنعمل assessment لل respiration خلينا نلاحظ كيف
+
+238
+00:15:23,270 --> 00:15:27,750
+عمقه كيف انتظامه بتنفس صح ولا ما .. يعني ولا في
+
+239
+00:15:27,750 --> 00:15:32,490
+عنده مشكلة طبعا هذا الوحيد زي ما احنا جولنا زمان
+
+240
+00:15:32,490 --> 00:15:35,750
+جولنا في سنة أولى في ال fundamental ايه انه مانعرف
+
+241
+00:15:35,750 --> 00:15:38,230
+المريض ان انا بتعدله النفس يعني انا ممكن اقولله
+
+242
+00:15:38,230 --> 00:15:42,570
+بتاخدك الحرارة لو سمحت تجيسلك الضغط ممكن اقوله
+
+243
+00:15:42,570 --> 00:15:46,450
+عادي هذا الكلامممكن اقوله بدي اخدك النبض لكن هقوله
+
+244
+00:15:46,450 --> 00:15:50,030
+بدي اعد نفسك هصير يدقاش يتحكم ان انتوا عارفين ال
+
+245
+00:15:50,030 --> 00:15:53,230
+respiration voluntary و involuntary لذلك احنا و
+
+246
+00:15:53,230 --> 00:15:57,050
+احنا جاعدين بناخد ال vital signs خلي عيننا على صدر
+
+247
+00:15:57,050 --> 00:16:00,890
+المريض بتشوف الشرشف اللي فوق صدره او دبسه كتاش
+
+248
+00:16:00,890 --> 00:16:04,650
+بطلع و بنزل و بعد كتاش for full minute ال blood
+
+249
+00:16:04,650 --> 00:16:10,070
+pressure عشان انا اؤكد ان انا اشتغل صح ولا لأ يفضل
+
+250
+00:16:10,550 --> 00:16:13,990
+انجيصه في ايه؟ في ايدينه التنتين هيك تبلي both
+
+251
+00:16:13,990 --> 00:16:17,310
+arms عشان ايه؟ في بعض الحالات بيصير في مشكلة ما
+
+252
+00:16:17,310 --> 00:16:19,970
+بين ال right و ال left لو لاجينا شوية ال left بزيد
+
+253
+00:16:19,970 --> 00:16:23,250
+شوية مانخافش كتير مش هذا الموضوع قبلبيت systolic
+
+254
+00:16:23,250 --> 00:16:28,210
+pressure before using استيثاسكوب apply كف firmly
+
+255
+00:16:28,210 --> 00:16:30,990
+هذا انتوا كلكوا أخدتوه انا بتذكركوا تذكروا كلكوا
+
+256
+00:16:30,990 --> 00:16:34,820
+بتجيصوا الضغط هو جاعة بيقول يا ريت ماتخليش ايشيعني
+
+257
+00:16:34,820 --> 00:16:38,700
+ماتخليش الكف too loose ولا إيش وماتخليهاش يعني على
+
+258
+00:16:38,700 --> 00:16:41,420
+الآخر برضه حازجة على الآخر يعني خليها .. بنقول
+
+259
+00:16:41,420 --> 00:16:45,000
+احنا نستخدم يعني الكف a proper yet size الحجم يكون
+
+260
+00:16:45,000 --> 00:16:50,200
+مناسب ولمّا نضغط عليها برضه تكون إيش متناسبة بحيث
+
+261
+00:16:50,200 --> 00:16:55,020
+أنه بدلاش نصل إيه إلى مشكلة يتأثر على الضغط للمريض
+
+262
+00:16:55,020 --> 00:16:59,800
+علشان هيكش بقولي هنا استخدم المجاس المناسب معنى
+
+263
+00:16:59,800 --> 00:17:04,800
+المجاس المناسب لأنه فيه مشكلةانه مابينفعش لو واحد
+
+264
+00:17:04,800 --> 00:17:09,660
+obese استخدم واحد ضايق كتير او للطفل استخدم يعني
+
+265
+00:17:09,660 --> 00:17:13,820
+ال adult size مابينفعش هيأثر على القراءة اي تأثير
+
+266
+00:17:13,820 --> 00:17:18,180
+على القراءة هيعمللي مشكلة ما بين الارتفاع و النزول
+
+267
+00:17:18,180 --> 00:17:23,860
+طيب وبيعطيني حتى و لاحظين اذا مش مقولي مرات بيقولي
+
+268
+00:17:23,860 --> 00:17:26,560
+ايش انا false reading ايش انا false reading قراءة
+
+269
+00:17:26,560 --> 00:17:29,800
+خاطئة بيقوللي دايما ياريت تشوف ال position بتاع ال
+
+270
+00:17:29,800 --> 00:17:33,300
+client واحنا بنجيس ال blood pressureخلّيني أعرفين
+
+271
+00:17:33,300 --> 00:17:36,180
+ال position يعني لو واحد سألني يفضّر كيف؟ يفضّر
+
+272
+00:17:36,180 --> 00:17:39,720
+الإنسان يكون نائم على دهره أو إيش هنا يعني ركمة
+
+273
+00:17:39,720 --> 00:17:43,780
+position شوية حان دهره، بلاش يكون واقف و بلاش يكون
+
+274
+00:17:43,780 --> 00:17:47,700
+واقف أقعد بيهيئة كأنه شهادة حارة، يعني تكون الجلسة
+
+275
+00:17:47,700 --> 00:17:53,740
+فيها استرخاء طيب لو واحد جاييني .. يعني جاي يمشي،
+
+276
+00:17:53,740 --> 00:17:57,540
+يعني هو بدي أجيس ضغطه و جاي عليا، دلوقتي أقعد على
+
+277
+00:17:57,540 --> 00:18:00,680
+الكرسي و أجيسه؟ لأ الصحإنه لو أجاني لازم يكون
+
+278
+00:18:00,680 --> 00:18:04,680
+supine position قعده كدهش أقل شي عشر دقائق عشان
+
+279
+00:18:04,680 --> 00:18:08,020
+يبت الجسم يعني لو أجاني هيك مستعجل بقول وارتاح خد
+
+280
+00:18:08,020 --> 00:18:12,480
+راحتك، بدأ ياخد الراحة، قعدله عشر دقائق، بعد هيك
+
+281
+00:18:12,480 --> 00:18:16,160
+أنا إيش بعمل؟ بروح أنا باخدله إيه؟ باخدله الضغط
+
+282
+00:18:16,160 --> 00:18:19,400
+عشان مايصيرش متأثر لإنه كل إنسان وجاهي؟بقول في
+
+283
+00:18:19,400 --> 00:18:24,460
+عنده إيش يعني لسه نفسه مش .. مش .. مش مرتاح و دقت
+
+284
+00:18:24,460 --> 00:18:29,340
+قلبه عمالة سريعة شوية طيب ال instrument needed for
+
+285
+00:18:29,340 --> 00:18:34,280
+physical assessment طبعا احنا ذكرت هنا ده كلام لما
+
+286
+00:18:34,280 --> 00:18:38,680
+ذكرت طبعا احنا ال instrument ده اللي حكيناقبل
+
+287
+00:18:38,680 --> 00:18:41,860
+دقيقة لما جيبنا الصورة إذا بتذكروا معاه هي الصورة
+
+288
+00:18:41,860 --> 00:18:45,240
+اللي بتحتوي على يعني جميع ال instruments اللي بدي
+
+289
+00:18:45,240 --> 00:18:48,360
+أستخدمها، هو هذا من باب يعني إعادة التذكير مش أكتر
+
+290
+00:18:48,360 --> 00:18:51,040
+يعني كانوا بيقولوا يا phalmoscope كلكوا عارفينه
+
+291
+00:18:51,040 --> 00:18:54,360
+يعني أنا بستخدمه ليش من اسمه phalmo كلمة لاتنية
+
+292
+00:18:54,360 --> 00:18:57,860
+يعني استخدم من دار العينخاصة إذا بدنا نشوف ال
+
+293
+00:18:57,860 --> 00:19:02,060
+internal organs of the eye يعني زي بدنا نبطلع لجوه
+
+294
+00:19:02,060 --> 00:19:05,260
+عن طريق ال pupil، بدنا نشوف ال iris وكده، بدنا
+
+295
+00:19:05,260 --> 00:19:08,780
+نشوف اذا في الله سمح الله ال lens فيها مشكلة، ال
+
+296
+00:19:08,780 --> 00:19:12,480
+autoscope يعني منظر للإياش للأذن، اثنين بيسموه
+
+297
+00:19:12,480 --> 00:19:15,960
+لوحة الإشارات تابعة ال ايه؟ تابعة لوحة الإشارات
+
+298
+00:19:15,960 --> 00:19:19,080
+بتاعة النظر، أكيد شفتواها ليه؟ زي في مرات بتحتوي
+
+299
+00:19:19,080 --> 00:19:21,940
+على ال CC زي حرف ال C وفي مرات بتحتوي على أحرف
+
+300
+00:19:21,940 --> 00:19:26,170
+إنجليزية زي E وزي غيرهزي و زي غير و في نازلة
+
+301
+00:19:26,170 --> 00:19:30,610
+spiculum نازلة spiculum يعني اللي هو اللي بنستخدمه
+
+302
+00:19:30,610 --> 00:19:33,690
+لما نجده نفحص اللي هو الأنف ال vagina spiculum
+
+303
+00:19:33,690 --> 00:19:36,910
+حكينا عنه خاصة لما نعمل examination لمنطقة ال
+
+304
+00:19:36,910 --> 00:19:40,670
+cervix أو لفاجاينة الفيميل turning fork شوكر رنينة
+
+305
+00:19:40,670 --> 00:19:43,630
+بستخدامها خاصة لل auditor function يعني الوظيفة
+
+306
+00:19:43,630 --> 00:19:47,070
+السماعية ال percussion hammer في عندنا percussion
+
+307
+00:19:47,070 --> 00:19:50,450
+في neurologic ال percussion اسمه reflex hammer
+
+308
+00:19:50,450 --> 00:19:55,010
+بتشوف كده يعني من جزء مدى ال reflex عندهإذا فى لا
+
+309
+00:19:55,010 --> 00:19:57,750
+سمح الله عنده مشكلة عصبية ولا لأ وفى هنا
+
+310
+00:19:57,750 --> 00:20:00,690
+neurologic فقط للأحصاب يعني الأحصاب هذا ممكن
+
+311
+00:20:00,690 --> 00:20:03,070
+يستخدم للعضلات وهذا ممكن يستخدم للأحصاب على فكرة
+
+312
+00:20:03,070 --> 00:20:06,670
+حتى هذا ممكن يستخدم للأحصاب لكن من الممكن التفريق
+
+313
+00:20:06,670 --> 00:20:09,470
+وإذا بدنا حد يفرق بين ال percussion همر و
+
+314
+00:20:09,470 --> 00:20:12,590
+neurologic همر أيه في الصورة هي بتفرقلكوا إياهم
+
+315
+00:20:12,590 --> 00:20:16,430
+اللى هنا موجود هنا هذا اسمه percussion هيه شفتواه
+
+316
+00:20:16,430 --> 00:20:20,510
+percussion همر أما اللى موجود إذا شوفنا حاجة اسم
+
+317
+00:20:20,510 --> 00:20:23,410
+neurologic همرنفس الإيد هذه اللى انتوا شايفينها
+
+318
+00:20:23,410 --> 00:20:27,470
+نفس الإيد ولكن هنا لاحظين ان انت زى المثلث بس هذاك
+
+319
+00:20:27,470 --> 00:20:31,410
+بختلف لأ هو عبارة عن استوانة استوانة neurologic
+
+320
+00:20:31,410 --> 00:20:34,970
+أما استوانة من قدام اللى هو مدبّب الطرف و من ورايا
+
+321
+00:20:34,970 --> 00:20:39,770
+استوانة من قدام دائري و من ورا شوية أعرض ندفع شوية
+
+322
+00:20:39,770 --> 00:20:43,670
+علشان نقدر نستخدمه في أكتر من إيش في مكان نطرق على
+
+323
+00:20:43,670 --> 00:20:47,310
+جسم الإنسان يبقى الشكل زى استوانة neurologic و
+
+324
+00:20:47,310 --> 00:20:51,790
+الشكل زى المثلث هو ال إيش percussionطيب positions
+
+325
+00:20:51,790 --> 00:20:56,150
+ايه برضه احنا بس من باب التفكير بقوللي ان ذاكرك
+
+326
+00:20:56,150 --> 00:20:59,170
+بال positions اللي زمان حكينالك عنهم انه فيهم زي
+
+327
+00:20:59,170 --> 00:21:01,630
+ال standing و ال position و ال .. و ال .. و ال
+
+328
+00:21:01,630 --> 00:21:04,530
+sitting position و ال subine و ال dorsal recumbent
+
+329
+00:21:04,530 --> 00:21:06,870
+و ال sims position و ال .. و ال prone و ال knee
+
+330
+00:21:06,870 --> 00:21:10,250
+chest position بدا يزودنا شوية ماكانش موجودة ده و
+
+331
+00:21:10,250 --> 00:21:13,210
+اللي هي third position كل position ايه له ايه
+
+332
+00:21:13,210 --> 00:21:16,190
+specialty؟ شو يعني ايه specialty؟ كل position
+
+333
+00:21:16,190 --> 00:21:20,350
+بستخدمه during assessmentبقدر اعمل assessment ل
+
+334
+00:21:20,350 --> 00:21:23,670
+area و فيها areas ما بقدر اعملها assessment لما
+
+335
+00:21:23,670 --> 00:21:27,050
+حكينا و قولتلكوا هيجي دورهم بالتفصيل لما احنا
+
+336
+00:21:27,050 --> 00:21:32,090
+نذكرهم هذه الرسمة انوي ده اظن مرت علينا يعني بدناش
+
+337
+00:21:32,090 --> 00:21:34,510
+نشكر روح فيها كتير لان .. بس احنا ذكرنا لما ايام
+
+338
+00:21:34,510 --> 00:21:37,890
+قلنا ان هو هي ال position هو يوصفه و هي ايش
+
+339
+00:21:37,890 --> 00:21:40,330
+المناطق اللي ممكن تعملها assessment و ايش المناطق
+
+340
+00:21:40,330 --> 00:21:43,530
+اللي فيها caution مش هتقدر تعمل فيها assessment في
+
+341
+00:21:43,530 --> 00:21:47,400
+هذا ال position المعين مثلاو هان هاي الشرا قدامنا
+
+342
+00:21:47,400 --> 00:21:50,580
+مثلا sitting position يعني بيقولي انا افرض انت في
+
+343
+00:21:50,580 --> 00:21:54,180
+عند .. واحد قاعد، بتقدر تعمل assessment ال head،
+
+344
+00:21:54,180 --> 00:21:58,340
+مظبوط، و ال neck و ال back، posterior، okay صحيح،
+
+345
+00:21:58,340 --> 00:22:00,960
+و ال thorax الصدر صحيح، و ال lung، واحد قاعد يعني
+
+346
+00:22:00,960 --> 00:22:04,000
+مبين، anterior thorax الصدر الأمامي ال pressed
+
+347
+00:22:04,000 --> 00:22:09,040
+axilla، ال heart ال vital signsupper extremity كل
+
+348
+00:22:09,040 --> 00:22:11,840
+هذا بنقدر نعمله في sitting position طب إيش ال
+
+349
+00:22:11,840 --> 00:22:14,640
+limitations؟ يعني إيش الأشياء اللي أنا ممكن أبعد
+
+350
+00:22:14,640 --> 00:22:18,000
+عنها؟ مابقدرش .. is a physically weakened client
+
+351
+00:22:18,000 --> 00:22:20,640
+.. إيش يعني؟ إذا لجينا المريض اللي أمامي مش قادر
+
+352
+00:22:20,640 --> 00:22:23,400
+يقعد .. مش قادر يقعد .. يعني زي ما أقوله في المثل
+
+353
+00:22:23,400 --> 00:22:27,800
+العربي مش قادر يصله بحاله .. مابقدرش أنا أخليه
+
+354
+00:22:27,800 --> 00:22:30,220
+يقعد لأنه ممكن يوجع .. مابستخدمش هذه ال position
+
+355
+00:22:31,580 --> 00:22:34,580
+طيب اللي بقعدش بقوليه سباقي ممكن ينام على دهره
+
+356
+00:22:34,580 --> 00:22:39,140
+most normally relaxed ايش يعني اكثر وضع مريح
+
+357
+00:22:39,140 --> 00:22:43,740
+للمريض و للطبيب انه يقدر يعمله assessment ايش
+
+358
+00:22:43,740 --> 00:22:46,560
+بتقدر تعمل assessment ال head و ال neck و ال
+
+359
+00:22:46,560 --> 00:22:50,600
+anterior thorax اكيد ال lungs و ال breast مجزلة
+
+360
+00:22:50,600 --> 00:22:54,260
+لاحظين في قواطع مشتركة ما بين السباقي و ما بين ال
+
+361
+00:22:54,260 --> 00:22:57,920
+setting انا بحكي باكتر من وضع عشان مش قادر يقعد
+
+362
+00:22:57,920 --> 00:23:01,360
+بنخلي ايه من المريض بنخليه ينام على دهرهال abdomen
+
+363
+00:23:01,360 --> 00:23:05,440
+extremities طيب بس داخل الخط ايش هنا ال abdomen لو
+
+364
+00:23:05,440 --> 00:23:08,940
+كنا في ال setting بقدرش اعمل abdomen assessment طب
+
+365
+00:23:08,940 --> 00:23:11,500
+وين يا أستاذ في limitations يعني في حدود او في
+
+366
+00:23:11,500 --> 00:23:16,760
+موانع مات ممنوع انا استخدم هذا الوضع بقول لي دير
+
+367
+00:23:16,760 --> 00:23:21,440
+بالك ممنوع في هذا اختصار عالمي اسمه sob shortness
+
+368
+00:23:21,440 --> 00:23:25,900
+of breath او shortness of breathing ايش يعني بعض
+
+369
+00:23:25,900 --> 00:23:29,530
+الناس اللي عندهم قصر في التنفس يعني نفسهبقولوا
+
+370
+00:23:29,530 --> 00:23:33,390
+بالعامية نفسه مطرود اللى عنده ديق النفس بينفعش
+
+371
+00:23:33,390 --> 00:23:36,650
+انام على دهره زى حالات الأزمة حالات اللى عندهم
+
+372
+00:23:36,650 --> 00:23:39,390
+chronic obstructive pulmonary disease حالات ال
+
+373
+00:23:39,390 --> 00:23:42,690
+high ال obesity هذون الناس مشكلته مشكلة بقدرش انام
+
+374
+00:23:42,690 --> 00:23:46,790
+على دهره اول ما بينام على دهره بتلاقي كأنه اشي بده
+
+375
+00:23:46,790 --> 00:23:52,170
+يخنج و بطلع عارقتين فهذا بينايموش Dorsal recumbent
+
+376
+00:23:52,170 --> 00:23:56,560
+positionبقولي ال areas اللى بدنا نستخدمها لها
+
+377
+00:23:56,560 --> 00:23:58,480
+assessment زى ال head و ال neck و ال anterior
+
+378
+00:23:58,480 --> 00:24:01,680
+thorax و ال lung و ال breast ممتاز و ال axilla
+
+379
+00:24:01,680 --> 00:24:06,060
+الطبيعى و الأرض لأنه ايش؟ dorsal recumbent محنى
+
+380
+00:24:06,060 --> 00:24:10,180
+شوية يعني ع دهره بس محنى شوية زى semi-fowler طيب
+
+381
+00:24:10,180 --> 00:24:12,900
+ال limitations بقولي ممنوع تستخدمه في ال abdomen
+
+382
+00:24:12,900 --> 00:24:15,660
+ال assessment اكيد طبعا ليه؟ لأنه بيعمل
+
+383
+00:24:15,660 --> 00:24:19,900
+contraction ايش contraction؟ شدلأنه بيعمل شد في ال
+
+384
+00:24:19,900 --> 00:24:24,140
+abdominal muscles لا تستخدمه لأنه بيعمل شد في ال
+
+385
+00:24:24,140 --> 00:24:27,460
+abdominal muscles اللي بعده lithotomy position
+
+386
+00:24:27,460 --> 00:24:31,240
+بقول لي ممكن احنا نستخدمه في حالة ال female ال
+
+387
+00:24:31,240 --> 00:24:34,700
+genitalia و ال genital tract لكن الصراحة هذا
+
+388
+00:24:34,700 --> 00:24:37,420
+embarrassing ايش un embarrassing محرج عشانك ال
+
+389
+00:24:37,420 --> 00:24:41,140
+limitations بنحاول ما نستخدموش لأنه uncomfortable
+
+390
+00:24:41,140 --> 00:24:44,700
+مش مريح للمريض هذا بنستخدموش الا في الحالات
+
+391
+00:24:44,700 --> 00:24:48,970
+النادرة احنا عندنا في المستشفياتمرات بنضطر نستخدمه
+
+392
+00:24:48,970 --> 00:24:52,510
+في إذا بدنا نتأكد من ال piles اللي موجودة اللي هو
+
+393
+00:24:52,510 --> 00:24:56,630
+البواصير هل هي external piles ولا internal piles
+
+394
+00:24:56,630 --> 00:25:00,850
+عشان الدكتور يقدر يتأقن دون ذلك بلاش منه لإنه محرج
+
+395
+00:25:00,850 --> 00:25:04,270
+شوية وإذا بدنا نستخدمه بقول إشيا لازم يكون هنا
+
+396
+00:25:04,270 --> 00:25:07,090
+واللي trapped إشيا اللي trapped ده لازم يكون
+
+397
+00:25:07,090 --> 00:25:11,230
+المريض مغطى كويس كويس لإنه عشان مايشعرش بالحرج
+
+398
+00:25:11,230 --> 00:25:15,770
+الزائد وهنا إش بقول يعني ياريت ما نستخدموش إذا
+
+399
+00:25:15,770 --> 00:25:19,440
+المريض عنده ال severeArthritis يعني إذا والله عنده
+
+400
+00:25:19,440 --> 00:25:22,820
+التهاب في ال joints أو joints ال deformity،
+
+401
+00:25:22,820 --> 00:25:27,100
+مفاصله، عنده خشونة في الركب و كده، مابنقدر نعمل
+
+402
+00:25:27,100 --> 00:25:31,380
+lymposy لإنه هيتكسر و مش هيتحمل، هذا من ابتعد عنه،
+
+403
+00:25:31,380 --> 00:25:35,260
+الوضع اللي بعده، الواضع اللي بعده Simplicityسيمس
+
+404
+00:25:35,260 --> 00:25:38,300
+بوزجين اللى بنعمله على شماله شوية و رجله اليامين
+
+405
+00:25:38,300 --> 00:25:40,280
+اللى فوق شوية بتكون مثلينه و كلنا عارفناه خطوفه
+
+406
+00:25:40,280 --> 00:25:43,760
+fundamental هذا بنقدر نعمل assessment لل rectum و
+
+407
+00:25:43,760 --> 00:25:46,300
+لل vagina ممنوع نستخدم برضه في ال joint
+
+408
+00:25:46,300 --> 00:25:50,880
+deformities أكيد ليه؟ لأنه مش قادر يتنيق الواحد ال
+
+409
+00:25:50,880 --> 00:25:54,420
+hip أو ال knee يعني لا قادر يتنيق الحوض من منطقة
+
+410
+00:25:54,420 --> 00:25:58,340
+الحوض و لا منطقة الركبة هذا ممنوع نستخدمه في اي
+
+411
+00:25:58,340 --> 00:26:03,910
+حالة حالة طبعا ال بوزجين اللى بعدهاللي هو ستة,
+
+412
+00:26:04,010 --> 00:26:07,290
+prone position, الـ prone position يعني نايم على
+
+413
+00:26:07,290 --> 00:26:10,890
+بطنه، خاصة في ال muscular skeletal system، بنقوله
+
+414
+00:26:10,890 --> 00:26:14,250
+ارفع رجليك، ارفع إيدك، ارفع راسك، عشان تشوف قداش
+
+415
+00:26:14,250 --> 00:26:18,050
+قوة العضلات عنده، ممنوع تستخدمه برضه إيش، إذا لا
+
+416
+00:26:18,050 --> 00:26:20,970
+سبحان الله، أي مريض عنده respiratory difficulties،
+
+417
+00:26:20,970 --> 00:26:23,870
+إيش يعني؟ عنده ديق في النفس، لو نايمناه على بطنه،
+
+418
+00:26:23,870 --> 00:26:26,990
+بتخافي نخنق، بتخافي موت، علشان هيك بنسأله، شوف
+
+419
+00:26:26,990 --> 00:26:30,930
+نفسه طبيعي و كله تمام، بنقوله، دير نفسك، يعني مافي
+
+420
+00:26:30,930 --> 00:26:34,720
+مشكلةالوضع اللي بعد اسمه knee chest position ..
+
+421
+00:26:34,720 --> 00:26:37,240
+knee chest اللي هو شبيه بالسجود .. شبيه الوضع
+
+422
+00:26:37,240 --> 00:26:40,500
+بالسجود .. هذا طبعا ال area خاصة ال assessment
+
+423
+00:26:40,500 --> 00:26:42,820
+اللي هي ال rectum .. صحيح في حالات ال faecal
+
+424
+00:26:42,820 --> 00:26:45,640
+impaction بكون يعني ماكل شغلات كتير عاملة ال
+
+425
+00:26:45,640 --> 00:26:48,400
+location يعني شوية abstraction في اللي هو ال
+
+426
+00:26:48,400 --> 00:26:51,320
+rectum يعني تحت .. في هذه الحالة في limitations
+
+427
+00:26:51,320 --> 00:26:55,180
+ممنوع لأنه برضه شهنان باريسي محرج و uncomfortable
+
+428
+00:26:55,180 --> 00:26:59,060
+مش مريح فبقوللي ما تستخدموش أبدا في حالة ال
+
+429
+00:26:59,060 --> 00:27:03,840
+arthritisولا ال joint deformities لا تستخدمه لا في
+
+430
+00:27:03,840 --> 00:27:06,800
+حالة ال joint deformities يعني اي قلم او اي ضرر
+
+431
+00:27:06,800 --> 00:27:11,480
+فيه موجود في ال .. يعني خليني اقول ال joints
+
+432
+00:27:11,480 --> 00:27:17,320
+المفاصلة الرجلية بشكل عام بقولي و انت بتعمل .. انت
+
+433
+00:27:17,320 --> 00:27:20,160
+بقى في حاجة اسمها crepitus ال crepitus اسمها
+
+434
+00:27:20,160 --> 00:27:23,580
+crackling sensation noise caused by rubbing of
+
+435
+00:27:23,580 --> 00:27:27,310
+bone fragments بعض الناسعندهم حاجة بيسموها زي جفاف
+
+436
+00:27:27,310 --> 00:27:31,030
+الركبة أو بيقولوا والله أنت عندك يعني خشونة،
+
+437
+00:27:31,030 --> 00:27:34,170
+الخشونة أو الجفاف اللي قاعد بيسير .. الخشونة أو
+
+438
+00:27:34,170 --> 00:27:37,630
+الجفاف اللي قاعد بيسير بيعمل نوع من الطق طقاء،
+
+439
+00:27:37,630 --> 00:27:41,350
+يعني كأنه بيسير كركعة في داخل المفاصل، هذه الكركعة
+
+440
+00:27:41,350 --> 00:27:44,110
+اسمها cryptos، هذه معلومة عالهامش، مش هي مطلوبة
+
+441
+00:27:44,110 --> 00:27:47,610
+مننا، بس معلومة عالهامش عشان احنا يعني لو سمعناها
+
+442
+00:27:48,010 --> 00:27:50,370
+خلّينا نقفل عند هنا وان شاء الله في المحاضرة
+
+443
+00:27:50,370 --> 00:27:54,150
+القادمة بنبدأ بالمصري ال assessment بإذن الله
+
+444
+00:27:54,150 --> 00:27:56,350
+السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE.srt
new file mode 100644
index 0000000000000000000000000000000000000000..0eb5597b23fdcb519c8f3a5401401285dc00cb06
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE.srt
@@ -0,0 +1,1805 @@
+1
+00:00:00,910 --> 00:00:06,050
+بسم الله الرحمن الرحيم. خلينا الآن نكمل، وصلنا طبعًا
+
+2
+00:00:06,050 --> 00:00:09,690
+الـ assessment of  أيّة of thoracic expansion طبعًا
+
+3
+00:00:09,690 --> 00:00:14,770
+أنا يمكن شوية، خليني أقول بطيء شوية بس في.. خاصة
+
+4
+00:00:14,770 --> 00:00:18,030
+في موضوع chest assessment أو respiratory
+
+5
+00:00:18,030 --> 00:00:20,690
+assessment بشكل عام، لأنه في شغلات بدنا نفهمها بشكل
+
+6
+00:00:20,690 --> 00:00:25,770
+واضح، على مهل يعني شوية. الآن لما بيقول لي thoracic
+
+7
+00:00:25,770 --> 00:00:30,300
+expansion، يعني معناته إيش؟ هناك، يعني بقول اتساع القفص
+
+8
+00:00:30,300 --> 00:00:33,560
+الصدر، اتساع قد إيش؟ بيوسع قد إيش لما يكون الإنسان بيتنفس؟
+
+9
+00:00:33,560 --> 00:00:36,860
+الآن، طب كيف أنا بدي أشوف الـ diameter؟ يعني بدي
+
+10
+00:00:36,860 --> 00:00:41,840
+أشوف كيف أنا بدي أعرف أنه هل بيتنفس كثير، بيتنفس
+
+11
+00:00:41,840 --> 00:00:46,040
+قليل، هل أنا اللي شايفه، حكمت عليه بدون ما أتأكد؟
+
+12
+00:00:46,040 --> 00:00:49,380
+خليني أشوفه. الآن الصورتين اللي قادمات إن شاء الله
+
+13
+00:00:49,380 --> 00:00:53,460
+هيبينّ لنا بالضبط اللي إحنا بنحكيه بشكل واضح. أنا الآن
+
+14
+00:00:53,460 --> 00:00:57,220
+هتكلم بس عن إيش الـ الـ الـ بعض العبارات، لكن إن
+
+15
+00:00:57,220 --> 00:01:00,080
+شاء الله الصورة هتصرح أكثر. في حاجة اسمها anterior
+
+16
+00:01:00,080 --> 00:01:03,180
+وفي حاجة اسمها posterior. إيش يعني anterior؟ يعني
+
+17
+00:01:03,180 --> 00:01:06,220
+anterior diameter. أنا بتكلم posterior يعني
+
+18
+00:01:06,220 --> 00:01:10,080
+diameter، يعني المقياس من الأمام أو المقياس من
+
+19
+00:01:10,080 --> 00:01:12,840
+الخلف. مش بحكي إنّها anterior يعني شو معناها؟ لأ، أنا
+
+20
+00:01:12,840 --> 00:01:16,400
+بتكلم إنّ إحنا كيف بدنا نشوف وإحنا بنعمل
+
+21
+00:01:16,400 --> 00:01:20,330
+assessment للمريض، نعرف إنّه قد إيش حجم التنفس لو
+
+22
+00:01:20,330 --> 00:01:23,990
+اتطلعنا عليه من الأمام، وكيف نشوف حجم التنفس لو
+
+23
+00:01:23,990 --> 00:01:28,110
+اتطلعنا عليه من خلفه. طبعًا إيش بقول لي هنا؟ بقول لي
+
+24
+00:01:28,110 --> 00:01:31,110
+استخدم إيدك على إيش؟ على الـ anterolateral. إيش
+
+25
+00:01:31,110 --> 00:01:34,770
+anterolateral؟ بيسمّوه الأمام الجانبي، كيف يعني؟ زي
+
+26
+00:01:34,770 --> 00:01:38,730
+ما يقولوا شمال شرقي مثلًا، لما نقول anterior
+
+27
+00:01:38,730 --> 00:01:43,830
+lateral، يعني بنحط إيدنا على الجنب، ما بين مش أمام
+
+28
+00:01:43,830 --> 00:01:47,330
+مطلق ولا على الجانب مطلق، يعني على جزء ما بين
+
+29
+00:01:47,330 --> 00:01:51,030
+الأمام وما بين الجانب، وبحط أصابع اللي هو الـ
+
+30
+00:01:51,030 --> 00:01:54,990
+thumbs، أصابع الإبهامين تبع إيديّ الاثنين في اتجاه إيش؟
+
+31
+00:01:54,990 --> 00:01:57,650
+هنا الـ coastal margins. قلت بوريكم هين بالضبط
+
+32
+00:01:57,650 --> 00:02:01,510
+إحنا أفضل نروح للصورة عشان نكون واضحين، لكن نكون
+
+33
+00:02:01,510 --> 00:02:05,090
+دقيقين، نخليها في حجم اللي هو الـ tenth rib لما
+
+34
+00:02:05,090 --> 00:02:08,590
+بدنا نقوم نلبسه. طيب، تطلعوا عليها الآن. هذا الـ
+
+35
+00:02:08,590 --> 00:02:12,160
+anterior assessment and thoracic expansion. لاحظين
+
+36
+00:02:12,160 --> 00:02:17,560
+أن هذه المريضة موجودة قدامنا، وإنّ حط اللي هو الطبيب
+
+37
+00:02:17,560 --> 00:02:22,860
+أو حط اللي هو الحكيم، حط إيده على الـ anterolateral
+
+38
+00:02:22,860 --> 00:02:27,280
+يعني ما راحش كله lateral ولا كله anterior، وحط
+
+39
+00:02:27,280 --> 00:02:30,440
+هنا منطقة الـ coast، ليش يعني؟ يعني منطقة اللي هو
+
+40
+00:02:30,440 --> 00:02:33,880
+هذه الضلع، هذه اللي قدامنا، هذه العظمة، اللي عضمة
+
+41
+00:02:33,880 --> 00:02:37,590
+القفص في النص. بعدين نفس القضية، الإيد الثانية..
+
+42
+00:02:37,590 --> 00:02:39,890
+هذه الإيد اليمين، وهذه الإيد الشمال.. نفس القضية،
+
+43
+00:02:39,890 --> 00:02:43,050
+حطّهم، وحطّ إيش.. يعني في فراغ.. شو الفراغ ده؟
+
+44
+00:02:43,050 --> 00:02:45,370
+إحنا عارفين الفراغ؟ في عظمة هنا في النص.. ماشي
+
+45
+00:02:45,370 --> 00:02:48,870
+.. مش هذا موضوعنا.. الموضوع إنّ أنا حطيت إيديا
+
+46
+00:02:48,870 --> 00:02:54,350
+الاثنين على جنبي المريض، وبقول للمريض خذ نفس عميق
+
+47
+00:02:54,350 --> 00:02:57,690
+.. في نفس الوقت أنا ما بضغطش كثير، يعني أنا بحط
+
+48
+00:02:57,690 --> 00:03:02,120
+إيديّ لكن مش بحطّهم كإني أنا.. كإني قاعد بضغط عليه
+
+49
+00:03:02,120 --> 00:03:05,840
+أو بتدخل جهة، لا أبدًا، ولا بحطّهم كإنّهم بدهم يوجعوا
+
+50
+00:03:05,840 --> 00:03:09,280
+دايا، أنا بضغطهم.. يعني بحطّهم على منطقة الصدر، و
+
+51
+00:03:09,280 --> 00:03:12,720
+كإنّهم حرّات الحركة، يعني بيروحوا بيجوا مع عضلات
+
+52
+00:03:12,720 --> 00:03:17,080
+التنفس. الآن بيتنفس، المسافة اللي بيتنفسها، نختار..
+
+53
+00:03:17,080 --> 00:03:20,580
+يعني خليكم تتخيّلوا معايا إنّ الأصابع دول رجعوا شوية
+
+54
+00:03:20,580 --> 00:03:23,980
+هذا الـ hand ورجعوا هذا الإصبع لهنا، يعني مع
+
+55
+00:03:23,980 --> 00:03:27,340
+التنفس، لما ناخذ inspiration رجع شوية، وهذا رجع شوية
+
+56
+00:03:27,340 --> 00:03:30,690
+بعدين مع الـ expiration، عايز أرجعه. أنا بتكلم
+
+57
+00:03:30,690 --> 00:03:35,170
+لما نـ.. رجعوا، مش لما كان المكان. الآن لأ، أول ما يأخذ
+
+58
+00:03:35,170 --> 00:03:39,090
+النفس على الآخر، لو اين وصل؟ نعتقد.. خلينا نفترض
+
+59
+00:03:39,090 --> 00:03:44,090
+أنه وصل التنفس. نفترض الآن أنّ المريض اللي أمامنا
+
+60
+00:03:44,090 --> 00:03:48,110
+أخذ نفس عميق، وهذا الفراغ اللي هنا إيش بيعمل؟ بحطّ
+
+61
+00:03:48,110 --> 00:03:51,610
+علامة هنا وعلامة هنا، قلم جاف مش مشكلة، علامة هنا و
+
+62
+00:03:51,610 --> 00:03:55,470
+علامة هنا، بنجيس المسافة بينهم. مثلًا المسافة طلعت خمسة
+
+63
+00:03:55,470 --> 00:03:58,520
+سنتي، سبعة سنتي، عشرة سنتي، أيّ كانت المسافة
+
+64
+00:03:58,520 --> 00:04:03,540
+تمام؟ هذه المسافة إيش اسمها؟ anterior thoracic
+
+65
+00:04:03,540 --> 00:04:08,620
+diameter. طب نشوف الـ posterior، الـ posterior برضه
+
+66
+00:04:08,620 --> 00:04:12,020
+نرجع شوية الكلام هنا، إيش بيقول لي؟ وين نحطّ؟ حطّ
+
+67
+00:04:12,020 --> 00:04:15,040
+إيديك posterior lateral. هنا وين نحطّ إيديك؟
+
+68
+00:04:15,040 --> 00:04:18,120
+anterior lateral. طب يا ترى أولًا بيقولوا على مناطق
+
+69
+00:04:18,120 --> 00:04:21,280
+إيش؟ حوالي اللي هو الـ tenth rib، يعني عند الـ..
+
+70
+00:04:21,280 --> 00:04:25,140
+تقريبًا الريشة العاشرة، على اعتبار إنّه آخر.. آخر
+
+71
+00:04:25,140 --> 00:04:27,980
+ريش، أنتم عارفين بتكون free movable، يعني متحركة
+
+72
+00:04:27,980 --> 00:04:31,960
+مش.. مش مسكرة. فنرجع نفس الكلام على الصورة، بقول لي
+
+73
+00:04:31,960 --> 00:04:36,360
+اتحطّ إيدك هاي هنا posterior lateral و posterior
+
+74
+00:04:36,360 --> 00:04:39,160
+lateral. طب ما يجي واحد يقول لي طب ليش أساسي مبين إنّ
+
+75
+00:04:39,160 --> 00:04:43,500
+أنا مش قادر؟ ممكن يعني بيبين إيدها أصغر من، مش
+
+76
+00:04:43,500 --> 00:04:46,960
+عارف مين اللي.. لأ في مين يبدو إنّها طبيبة، بيبين
+
+77
+00:04:46,960 --> 00:04:51,970
+إنّ إيدها ما شاء الله يعني well-muscled أو مثلًا
+
+78
+00:04:51,970 --> 00:04:55,450
+obese client أو هكذا، فهي حطّت في نفس الوقت. مش مشكلة،
+
+79
+00:04:55,450 --> 00:04:58,510
+مازال نفس الـ examiner، ما في مشكلة. الآن وبنقول له يلا
+
+80
+00:04:58,510 --> 00:05:02,070
+خذ نفس.. بنجيس المسافة، اللي وين؟ نفس القضية طبعًا،
+
+81
+00:05:02,070 --> 00:05:05,350
+بيخلي إيدينا تتحرّك مع النفس. خذ نفس عميق، بنحطّ هنا
+
+82
+00:05:05,350 --> 00:05:08,750
+إيش برضه؟ علامة وعلامة، وبنجيس المسافة بينهم.
+
+83
+00:05:08,750 --> 00:05:12,270
+الصحيح إنّ تطلع المسافة اللي هنا والمسافة اللي
+
+84
+00:05:12,270 --> 00:05:15,950
+أمام تكون زي بعض. في مشكلة بنبلغ الطبيب. طبعًا هذه
+
+85
+00:05:15,950 --> 00:05:21,580
+للأسف أنا حزين أقول لكم، بيعملوا إيش؟ أنا ما شفتش في
+
+86
+00:05:21,580 --> 00:05:24,700
+غزة من المرة حدّ بيعملها، مع إنّها شغلة من صلب
+
+87
+00:05:24,700 --> 00:05:28,520
+تخصص اللي هو يعني على طبّ الصدرية، وربما هذه
+
+88
+00:05:28,520 --> 00:05:31,580
+تكشف شغلات يعني خطيرة إذا كان لها سمح الله أيّ
+
+89
+00:05:31,580 --> 00:05:33,860
+deformities أو لا سمح الله فيه أيّ حاجة في الـ
+
+90
+00:05:33,860 --> 00:05:38,040
+spinal problems أو tumors أو هكذا. بغض النظر،
+
+91
+00:05:38,040 --> 00:05:40,960
+المهم إحنا هنا الآن by two ways، إيش يعني بالطريقة
+
+92
+00:05:40,960 --> 00:05:43,720
+الثانية، اللي هي الـ anterior والـ posterior، ستشعر
+
+93
+00:05:43,720 --> 00:05:47,030
+بـ amount of thoracic expansion، أكيد طبعًا، بتـ
+
+94
+00:05:47,030 --> 00:05:50,210
+تشوف قد إيش اتساع القفص الصدري ورجوعه، خاصة في الـ
+
+95
+00:05:50,210 --> 00:05:53,530
+deep breathing، يعني قد إيش كان لما ناخذ نفس عميق، و
+
+96
+00:05:53,530 --> 00:05:56,670
+يجي. إيش كمان؟ الـ symmetry، بتـتأكد تشوف إيش الـ
+
+97
+00:05:56,670 --> 00:06:00,350
+symmetry. طبعًا لما نقول كلمة symmetry يعني بتـتأكد
+
+98
+00:06:00,350 --> 00:06:04,550
+تشوف التجانس، هل نفس الشيء.. هل لا؟ سبحان الله
+
+99
+00:06:04,550 --> 00:06:08,730
+بيميل أه، بيميل يمين، بيميل شوية على الشمال. هذا بيصير
+
+100
+00:06:08,730 --> 00:06:13,430
+إيش؟ unsymmetry، يعني مش متجانس، مش متناسق، يعني حاجة
+
+101
+00:06:13,430 --> 00:06:16,590
+بيسمّوها الـ homeostasis، أو لغة لا، سبحان الله، يكون
+
+102
+00:06:16,590 --> 00:06:20,090
+عنده abnormalities. طيب، الآن إيش بقول لي بعديها؟
+
+103
+00:06:20,090 --> 00:06:23,950
+assessment of حاجة اسمها fremitus. شو قصدك في الـ
+
+104
+00:06:23,950 --> 00:06:27,690
+fremitus؟ مصطلح جديد، fremitus هذه اسمها vibration
+
+105
+00:06:27,690 --> 00:06:31,010
+perceptible on إيش؟ on palpation. لو أنتَ حاطّط إيدك
+
+106
+00:06:31,010 --> 00:06:35,230
+على صدر المريض، وجاي بتقول له خذ نفس، سمعت كركعة
+
+107
+00:06:35,230 --> 00:06:38,810
+يعني خرخرة، كركعة، يعني سمعت حاجة تحت أصابعك مش
+
+108
+00:06:38,810 --> 00:06:43,060
+طبيعية. يعني بغض النظر، خرخرة، شخرّة، سمّيها اللي
+
+109
+00:06:43,060 --> 00:06:47,920
+تسمّيه، اهتزاز، شيء مش طبيعي، بنسمّيها fremitus، لأنّ
+
+110
+00:06:47,920 --> 00:06:52,340
+إحنا مش متخصّصين، لقدام شوية إذا لاجينا حالنا يعني
+
+111
+00:06:52,340 --> 00:06:55,760
+متعمّقين في العلم شوية، أنا أعطي الأسماء الحقيقية
+
+112
+00:06:56,370 --> 00:06:58,850
+بعدين، لا قدر الله، بيقول لي شوف إذا في subcutaneous
+
+113
+00:06:58,850 --> 00:07:01,430
+emphysema، وأنا شرحت في المحاضرة السابقة شو الـ
+
+114
+00:07:01,430 --> 00:07:04,830
+emphysema، أعيدها، إنّ لما بيصير مرات في الحويصلات
+
+115
+00:07:04,830 --> 00:07:08,050
+الهوائية بيطلع من الهواء خاصة على اعتبار إنّه احتبس الـ
+
+116
+00:07:08,050 --> 00:07:11,270
+oxygen ما قدرش، والهواء ما قدرش يصير exchange، فصار
+
+117
+00:07:11,270 --> 00:07:16,190
+عملية إيش؟ losing و bulging، مع الفلايفة للأسف طلع
+
+118
+00:07:16,190 --> 00:07:19,650
+الهواء وصار تحت اللي هو الجلد، منطقة الرقبة، و
+
+119
+00:07:19,650 --> 00:07:24,400
+منطقة الكتفين. إيش سمّيناها؟ emphysema. بقول لي يا ريت
+
+120
+00:07:24,400 --> 00:07:28,060
+تشوف الـ tissue اللي حواليها، خاصة إذا في cracking
+
+121
+00:07:28,060 --> 00:07:32,020
+.. إيش cracking notes؟ notes يعني sounds صحيح؟
+
+122
+00:07:32,020 --> 00:07:36,060
+شو cracking sounds؟ في بعض الناس يمكن يعرف إيش
+
+123
+00:07:36,060 --> 00:07:39,300
+معناته. cracking sounds حتى بيسمّوها.. بعض الناس
+
+124
+00:07:39,300 --> 00:07:43,460
+بيسمّوها crepitations.. crepitations اللي هي بسمّوها
+
+125
+00:07:44,800 --> 00:07:50,480
+زي صوت بالضبط، هو صوت زي كركعة الشيشة، شوفت لما..
+
+126
+00:07:50,480 --> 00:07:54,160
+يعني إن شاء الله ما يكون حدّ من الطلاب أو حتى.. لأ
+
+127
+00:07:54,160 --> 00:07:57,820
+تمناً حتى الأهل يكون.. يكون يعني بشيشة. فلما بشيشة
+
+128
+00:07:57,820 --> 00:08:01,220
+.. شوفت الميّة لأ، أو لما إذا تفرّجت عليه مقطع في فيلم،
+
+129
+00:08:01,220 --> 00:08:04,900
+في مسلسل، في كده وهو بيأخذ الشيشة بتلاقي الميّة
+
+130
+00:08:04,900 --> 00:08:09,260
+بتعمل زي كركعة، هي خرخرة مع الفقاعة بتطلع، هذا الصوت
+
+131
+00:08:10,600 --> 00:08:14,760
+بيصير لما يكون اللي سمح الله عنده حالة انفزيما طبعًا،
+
+132
+00:08:14,760 --> 00:08:17,960
+تشبه لو، واحد مش ذاكر، في بعض الحالات أقول لكم
+
+133
+00:08:17,960 --> 00:08:20,660
+ما بتشبهش. إذا أنتم بتعرفوا النيلون اللي بيغلّفوا
+
+134
+00:08:20,660 --> 00:08:25,380
+فيه مرات الأشياء الثمينة، زي العطور الغالية أو حتى
+
+135
+00:08:25,380 --> 00:08:28,420
+أو بعض الأشياء الهدائية بيغلّفوا فيها، فالنيلون اللي
+
+136
+00:08:28,420 --> 00:08:32,200
+بيكون فيه جواه كله حبيبات هوائية، ولما نضغط
+
+137
+00:08:32,200 --> 00:08:35,160
+عليه، حتى بعض الطلاب وبعض البنات حتى بيحبوا هذا الشيء
+
+138
+00:08:35,160 --> 00:08:38,800
+إنّه، لأنّه على فكرة بيعمل حتى شوية راحة نفسية لبعض
+
+139
+00:08:38,800 --> 00:08:43,010
+الناس، إنّه يظلّ يعصر عليه ويظلّ يطقع. يعني فيه هذا يسمّى
+
+140
+00:08:43,010 --> 00:08:45,130
+إيش؟ crepitations. علشان طولنا وإحنا بنحكي في هذا
+
+141
+00:08:45,130 --> 00:08:50,030
+الموضوع. طيب، percussion of the chest. نيجي الآن على
+
+142
+00:08:50,030 --> 00:08:52,030
+ما بعده. استخدام اللي هو الـ skill اللي هي الـ
+
+143
+00:08:52,030 --> 00:08:55,690
+percussion عشان نعمل إيش؟ نشوف في amounts of air لأ
+
+144
+00:08:55,690 --> 00:09:00,030
+قدر الله، في liquid موجود، حاسس لا سمح الله في solid
+
+145
+00:09:00,030 --> 00:09:02,550
+طبعًا إحنا عارفين الأصوات، كل صوت بيختلف يعني، وأنا
+
+146
+00:09:02,550 --> 00:09:05,310
+بعمل.. قاعد بعمل percussion، الصوت بيختلف، يمكن يكون
+
+147
+00:09:05,310 --> 00:09:08,190
+صوت liquid، يمكن يكون صوت solid، لا سمح الله، tumor
+
+148
+00:09:08,190 --> 00:09:11,700
+أو شيء من هذا القبيل. عوين على منطقة الـ lung، الـ
+
+149
+00:09:11,700 --> 00:09:15,640
+lung عشان أشوف وين رايحة الأمور، وبطلع.. بشوف الـ
+
+150
+00:09:15,640 --> 00:09:18,320
+boundaries.. إيش يعني الـ boundaries؟ حدود اللي هو
+
+151
+00:09:18,320 --> 00:09:21,540
+حدود الأعضاء يعني، وإحنا بنعمل assessment، كأنّك..
+
+152
+00:09:21,540 --> 00:09:24,160
+كأنّك بتجيس في الـ a في الـ lungs، كأنّك بتجيس في حجم
+
+153
+00:09:24,160 --> 00:09:27,580
+الـ lungs، قد إيش موجودة، وأنت بتطرق، وبتعرف إنّه وقت
+
+154
+00:09:27,580 --> 00:09:30,560
+إيش صوت بيختلف، انتهت الرئة، ووقت إيش صوت بيختلف
+
+155
+00:09:30,560 --> 00:09:35,300
+يمين، يسار، فوق أو تحت. طيب، الـ percussion، كثير من
+
+156
+00:09:35,300 --> 00:09:38,480
+الناس للأسف بيغلطوا، بس أنا شغلاتي مكونّها واضحين،
+
+157
+00:09:39,300 --> 00:09:44,340
+بيجي للأسف بيعمل عمليّة الطرق الطبيب مرّتين تلاتة
+
+158
+00:09:44,340 --> 00:09:47,120
+على منطقة صدره وكان بيقول لك خلاص بيكفي. لأ، الصح هو
+
+159
+00:09:47,120 --> 00:09:50,640
+بيقول لي عشان نكون صريحين لازم نعمل anterior and
+
+160
+00:09:50,640 --> 00:09:53,540
+posterior and lateral، يعني بدنا على الصدر من
+
+161
+00:09:53,540 --> 00:09:56,860
+الأمام، وعلى الصدر من الخلف، وعلى الجانبين نعمل إيش؟
+
+162
+00:09:56,860 --> 00:10:00,120
+percussion، وبيقول لي all directions، يعني يا ريت
+
+163
+00:10:00,120 --> 00:10:03,340
+الأطباء كمان يعني يتكرموا. وهذه الأمور اللي أنا
+
+164
+00:10:03,340 --> 00:10:08,350
+مرات.. ممكن أنتَ حطّيت hand بعد خمس سنتيمترات من نفس
+
+165
+00:10:08,350 --> 00:10:11,770
+المكان، في عنده مشكلة. فالإنسان يعني بعين الله يعني
+
+166
+00:10:11,770 --> 00:10:16,050
+يتعب شوية ويعمل assessment أكثر، دائمًا with about
+
+167
+00:10:16,050 --> 00:10:18,950
+five centimeters intervals، يعني إيش بقول له؟ يعني
+
+168
+00:10:18,95
+
+223
+00:13:43,210 --> 00:13:45,450
+كانت تحديد يعني كانوا يكونوا معايا طب أنا أكون
+
+224
+00:13:45,450 --> 00:13:48,710
+مسئول عنهم الأمر مش معقد يعني يعني ما أنا بنستعين في
+
+225
+00:13:48,710 --> 00:13:52,210
+نفسنا أنتو الحمد لله بخير و بتقدروا يعني بقولي لو
+
+226
+00:13:52,210 --> 00:13:55,130
+سمحت في هي anterior و في posterior بس بقولي يا ريت
+
+227
+00:13:55,130 --> 00:13:57,650
+و أنتم عارفين في الـ anterior و الـ posterior يا ريت
+
+228
+00:13:57,650 --> 00:14:00,810
+يكونوا اثنا عشر locations اثنا عشر locations يعني
+
+229
+00:14:00,810 --> 00:14:04,670
+اثنا عشر مكان بنقدر نعمله assessment عن طريق الـ
+
+230
+00:14:04,670 --> 00:14:09,260
+stethoscope و 14 من الـ A من الخلف طبعا هو هنا رسم
+
+231
+00:14:09,260 --> 00:14:11,560
+لنا يعني أنا ما بدي أن أنا أشرحه هنا بالظبط أماكن
+
+232
+00:14:11,560 --> 00:14:15,490
+إيه قدامكوا  عشان يقول لي و يأكد لي أنه يعني
+
+233
+00:14:15,490 --> 00:14:19,430
+ما بيجوزش أنك مرتين تسمع في الأمام و مرتين تسمع
+
+234
+00:14:19,430 --> 00:14:23,330
+في الخلف أو مرة و يكفي ذلك، لأ الصح لأن ربما إحنا
+
+235
+00:14:23,330 --> 00:14:26,610
+نكشف شغلة في منطقة معينة يعني ما سمعهاش بعض الناس
+
+236
+00:14:26,610 --> 00:14:31,430
+عنده جال عندك inflammation في الـ lower lung إيش
+
+237
+00:14:31,430 --> 00:14:34,950
+يعني؟ و مرات بيقول لك في الـ lower lobe in the right
+
+238
+00:14:34,950 --> 00:14:39,190
+lung يعني كأنه بيقول لي في الرئة اليمنى في المنطقة
+
+239
+00:14:39,190 --> 00:14:42,310
+يعني معناته الإنسان بيقدر و الـ stethoscope يستطيع
+
+240
+00:14:43,120 --> 00:14:47,460
+يقدر يسمع الصوت نفسه كويس بشكل طبيعي و بيقدر يحدد
+
+241
+00:14:47,460 --> 00:14:50,000
+و هذا أتمنى على الأطباء أنه يقدروا يعملوا بيه.
+
+242
+00:14:50,560 --> 00:14:53,160
+Escalate symmetrically، طبعا مش symmetrically يعني
+
+243
+00:14:53,160 --> 00:14:57,040
+بالتجانس، يعني .. يعني بانتظام زي إيش؟ زي
+
+244
+00:14:57,040 --> 00:15:00,420
+symmetry، بانتظام، ما بدي مرة فوق مرة تحت، لأ امشي
+
+245
+00:15:00,420 --> 00:15:03,680
+بالنقاط شوية شوية نقطة نقطة حتى تصل إيه لنقطة
+
+246
+00:15:03,680 --> 00:15:08,810
+الأخيرة. و زي ما قلنا إذا الإنسان أو الطبيب شوية مش
+
+247
+00:15:08,810 --> 00:15:11,970
+قادر و هذا الكلام موجود عندنا خاصة مع ضغط العمل
+
+248
+00:15:11,970 --> 00:15:15,830
+يسيطر على أقل إنسان فينا يسمع جديش six locations
+
+249
+00:15:15,830 --> 00:15:19,250
+anteriorly and posteriorly يعني لو ما قدرناش على
+
+250
+00:15:19,250 --> 00:15:24,650
+أقل يسمع له ست أماكن يعني هم اختلفوا هل الست
+
+251
+00:15:24,650 --> 00:15:28,630
+الأماكن يعني أمام و ست أماكن خلف، ولا ست أماكن قدام
+
+252
+00:15:28,630 --> 00:15:33,310
+و ورا على أقل يعني إحنا ممكن نقبل في أسوأ الظروف
+
+253
+00:15:33,670 --> 00:15:37,230
+أنه يعني الست أماكن يعني ورا و جدها مش مشكلة يعني
+
+254
+00:15:37,230 --> 00:15:40,830
+بحيث أنه نقدر على الأقل نعرف إذا في مشكلة ولا لأ، و
+
+255
+00:15:40,830 --> 00:15:44,590
+لا و لأ و لأ طبعا يعني غير مقنع علميا بشكل كبير، الـ
+
+256
+00:15:44,590 --> 00:15:50,490
+breath sounds أصوات النفس زي ما فيها hard sounds
+
+257
+00:15:50,490 --> 00:15:54,010
+زي ما في حاجة اسمها breath sounds يعني زي ما في
+
+258
+00:15:54,010 --> 00:15:57,370
+أصوات لدقات القلب dub dub و غيره مثلا، و sound one و
+
+259
+00:15:57,370 --> 00:15:59,630
+sound two و sound three زي ما في عندنا حاجة اسمها
+
+260
+00:15:59,630 --> 00:16:03,320
+إيه في حاجة اسمها أصوات النفس، طب أصوات النفس إيش بدي
+
+261
+00:16:03,320 --> 00:16:06,320
+أعمل فيها؟ بقول لي إيه بدك تعملها؟ analyze according
+
+262
+00:16:06,320 --> 00:16:10,640
+to a to b تشوف حدتها intensity، كتافة شدتها، الـ
+
+263
+00:16:10,640 --> 00:16:14,940
+quality كيف كيفيتها، relative duration، وقتيتها، كدة، شد
+
+264
+00:16:14,940 --> 00:16:17,460
+مدتها بالظبط كدة في الـ inspiration و الـ expiration
+
+265
+00:16:17,460 --> 00:16:24,800
+يعني و أنتم بتسمعوا في صوت النفس شوفوا له حدته، كيفيته
+
+266
+00:16:24,800 --> 00:16:30,850
+قوي ضعيف؟ هل هو ضعيف في الـ inspiration و قوي في الـ
+
+267
+00:16:30,850 --> 00:16:34,790
+expiration و لا العكس؟ بدنا نشوف إيش بالظبط اللي
+
+268
+00:16:34,790 --> 00:16:38,270
+إحنا يعني موجود عشان نقدر نعمل الـ assessment و
+
+269
+00:16:38,270 --> 00:16:42,750
+ندونه، طيب الآن نيجي على الأصوات، و كتير من الناس و
+
+270
+00:16:42,750 --> 00:16:45,970
+ممكن هذه الأسئلة بتيجي مرات كتير في امتحانات
+
+271
+00:16:45,970 --> 00:16:49,750
+التوظيف بالمناسبة بيسألونا في هذه المناطق بالذات
+
+272
+00:16:49,750 --> 00:16:52,970
+بيجي و بيقول لك حاجة فيها يسمى bronchial breath
+
+273
+00:16:52,970 --> 00:16:56,410
+sounds، لما نقول كلمة البرونكا الـ brief sounds يعني
+
+274
+00:16:56,410 --> 00:16:59,130
+أصوات العلاقة ما زال .. ما زال كل كلمة البرونكا
+
+275
+00:16:59,130 --> 00:17:04,030
+يعني جاية من البرونكاس، طيب إيش قصد هذا البرونكاس؟
+
+276
+00:17:04,030 --> 00:17:07,110
+بقول لي الآن هذا القصب الهوائي اللي بتحكي عنه إيش
+
+277
+00:17:07,110 --> 00:17:12,530
+مالها؟ بقول لي normally، عشان تعرف الصوت تبعها، بعض
+
+278
+00:17:12,530 --> 00:17:15,950
+الناس هيقول لي أنا ما بتترجموها و تقولي معناته صوت
+
+279
+00:17:15,950 --> 00:17:19,630
+الهواء في القصب، لأ أنا بدي نعرف وين هذا الصوت و
+
+280
+00:17:19,630 --> 00:17:24,260
+كيف بيكون، وين موجود؟ هذا الصوت موجود بالظبط على
+
+281
+00:17:24,260 --> 00:17:28,860
+القصبة الهوائية، قصب الهواء، لكن كيف أسمعه؟ لو كل واحد
+
+282
+00:17:28,860 --> 00:17:32,820
+فينا، و أكيد كلكم معاكم سماعات، يمسك السماعة اللي
+
+283
+00:17:32,820 --> 00:17:36,980
+معاه، يحطها على دنياه و يحطها عادي هنا، يحطها على
+
+284
+00:17:36,980 --> 00:17:41,300
+منطقة الرقبة من اليمين أو من اليسار، من اليمين أو
+
+285
+00:17:41,300 --> 00:17:45,910
+من اليسار، يعني الآن جاب السماعة حطها في دنياه، حط ..
+
+286
+00:17:45,910 --> 00:17:48,810
+حط .. بعد ما حط السماعة .. الإثنين طبعا الـ tubes
+
+287
+00:17:48,810 --> 00:17:52,030
+في دنياه، جاب حط الـ diaphragm على منطقة اللي هو
+
+288
+00:17:52,030 --> 00:17:55,930
+الرقبة من اليمين أو من اليسار و عص شوية و أخد نفس
+
+289
+00:17:55,930 --> 00:18:01,330
+لو كل واحد فينا بس جربها، أخد نفس هيك هيسمع الصوت
+
+290
+00:18:01,330 --> 00:18:05,210
+هذا، الصوت إيش اسمه؟ اسمه bronchial breath sound
+
+291
+00:18:05,210 --> 00:18:09,510
+خلاص طبعا صوته هتحس كأنه في هوا بدخل في تجويف
+
+292
+00:18:09,890 --> 00:18:13,370
+والتجويف زي كأنه صوت بدخل في مسورة، أنا مش هتكلم
+
+293
+00:18:13,370 --> 00:18:18,370
+كتير في هذه المنطقة لأنه هتسمعوا لحالكم، لكن لو
+
+294
+00:18:18,370 --> 00:18:21,070
+سمعنا .. لو سمعنا هذا الصوت، ما هو ليش بقول لي لازم
+
+295
+00:18:21,070 --> 00:18:24,550
+تسمعوه؟ عشان لو سمعته في مكان تاني معناه فيه مشكلة
+
+296
+00:18:24,550 --> 00:18:28,390
+يعني هذا الصوت اللي سمعناه عند الرقبة اللي هو الـ
+
+297
+00:18:28,390 --> 00:18:31,990
+bronchi اللي بيبقى normal يبقى normal يكون على
+
+298
+00:18:31,990 --> 00:18:34,790
+القصبة لكن abnormal يكون على أماكن تانية زي إيش؟
+
+299
+00:18:34,790 --> 00:18:38,410
+بقول لي افرض أنت روحت سمعته على الـ lung tissue تحت
+
+300
+00:18:38,900 --> 00:18:41,700
+معناته إيش بيقول لي؟ في pathological condition، إيش
+
+301
+00:18:41,700 --> 00:18:46,220
+يعني؟ لأ لأ في شغل مرضية و خطيرة شوية، طب إيش هي؟
+
+302
+00:18:46,220 --> 00:18:50,020
+بيقول لي في بعض الحالات بتكون high pitched loud ..
+
+303
+00:18:50,020 --> 00:18:52,580
+إيش high pitched loud؟ يعني بتكون صوت عالي كتير، الـ
+
+304
+00:18:52,580 --> 00:18:55,960
+sound كمان خاصة في إيش هنا؟ بيقول لي الـ sound هذا
+
+305
+00:18:55,960 --> 00:19:00,000
+decrease in inspiratory and lengthen .. إيش هنا؟
+
+306
+00:19:00,000 --> 00:19:03,980
+increase in expiratory phases، بعض الـ .. يعني ركزوا
+
+307
+00:19:03,980 --> 00:19:07,640
+معايا، بعض الأصوات .. بعض الأصوات بتكون صوت عالي
+
+308
+00:19:07,640 --> 00:19:14,910
+كتير، صوت عالي كتير لكن بتخف في النفس اللي داخل و
+
+309
+00:19:14,910 --> 00:19:19,470
+بتزيد في النفس اللي طالع، طب لو واحد سألني قال طب
+
+310
+00:19:19,470 --> 00:19:22,730
+ليش يا أستاذ خفت في النفس اللي داخل؟ الإنسان لما
+
+311
+00:19:22,730 --> 00:19:26,310
+بياخد النفس هو يعني طبيعي ما فيش مشكلة، افرض و أجد و
+
+312
+00:19:26,310 --> 00:19:30,470
+طلع النفس بشكل عام، لكن في pathological problems أو
+
+313
+00:19:30,470 --> 00:19:33,070
+some abnormalities أو some tumors أو some foreign
+
+314
+00:19:33,070 --> 00:19:36,070
+body، الآن لما نكون في foreign body مش قادر نطلع
+
+315
+00:19:36,070 --> 00:19:41,170
+الهواء بسهولة زي ما أخده، فإيش صار؟ زاد الصوت،
+
+316
+00:19:41,170 --> 00:19:45,010
+معناته أنا ما أقدرش لسه أشخص الآن و أقول فيه مشكلة،
+
+317
+00:19:45,010 --> 00:19:49,710
+لكنه أعطاني .. بعض أعطاني أنه بيقول لي يعني، طب متى
+
+318
+00:19:49,710 --> 00:19:53,230
+بيخف الصوت؟ أنت قولت لنا أن فيه tumor ممكن يكون أو
+
+319
+00:19:53,230 --> 00:19:57,410
+فيه abnormalities أو فيه أي شيء، طب متى بيكون الصوت
+
+320
+00:19:57,410 --> 00:20:01,990
+شبه معدم؟ absent or decreased؟ بيقول لي الصوت مرات
+
+321
+00:20:01,990 --> 00:20:06,110
+بيكون لا قدر الله ممكن يكون مخفف الصوت أو خفيف جدا
+
+322
+00:20:06,110 --> 00:20:10,350
+إذا في foreign body، طب حد بيقول لي طب ليش الـ foreign body
+
+323
+00:20:10,350 --> 00:20:13,350
+هنا؟ أجي كمان مرة أقرأ بس الـ foreign body موجود هنا في
+
+324
+00:20:13,350 --> 00:20:16,510
+الـ pleural space في منطقة الـ pleural cavity، شوف لوين
+
+325
+00:20:16,510 --> 00:20:20,990
+رايح، جوا جوا جوا، فخفف صوت طبع النفس، مش بس هيك
+
+326
+00:20:20,990 --> 00:20:24,130
+bronchial obstruction، إحنا قلنا اللي الصوت هداش
+
+327
+00:20:24,130 --> 00:20:28,390
+بتكون عالي، طب لما الصوت تصير هادية إيش بيكون هنا؟ في
+
+328
+00:20:28,390 --> 00:20:30,750
+علاقة، لا قدر الله، bronchial obstruction زي اللي اسمح
+
+329
+00:20:30,750 --> 00:20:35,030
+الله، bronchial carcinoma مثلا، عنده مصيبة فالصوت
+
+330
+00:20:35,030 --> 00:20:39,120
+بيهدى، يكون عالي كتير، طيب، في بعض الناس بيعرفش ينفس
+
+331
+00:20:39,120 --> 00:20:42,700
+.. نفس سريع، دائما نفسه shallow breathing، إيش
+
+332
+00:20:42,700 --> 00:20:46,080
+يعني الـ shallow breathing؟ يعني نفسه نفس يعني
+
+333
+00:20:46,080 --> 00:20:51,480
+خفيف، نفس سطحي، و النفس السطحي بيكون صوته واطي، زي
+
+334
+00:20:51,480 --> 00:20:54,680
+ما نيجي الطفل، تعالوا جنبه، يدوبك تسمع نفسه، حتى
+
+335
+00:20:54,680 --> 00:20:56,860
+الأمهات بتخاف على إبن الوليد، بيصيروا بتقول لك
+
+336
+00:20:56,860 --> 00:20:59,960
+لحسين يكون صار له حاجة، من شدة ما هو نفسه إيش هنا
+
+337
+00:20:59,960 --> 00:21:03,540
+shallow، لكن لما الإنسان بيكون تعبان و مرهق و عامل
+
+338
+00:21:03,540 --> 00:21:07,550
+و في عنده ضيق نفس بتلاقيه بينفس نفس عميقة، و في حالات
+
+339
+00:21:07,550 --> 00:21:09,850
+إيه كمان؟ في حالات زي ما، طبعا كدة أنتم عرفتوا
+
+340
+00:21:09,850 --> 00:21:13,010
+ليش؟ لأنه الصوت .. لأنه اللي جاي عامل هو كله عمال
+
+341
+00:21:13,010 --> 00:21:15,990
+بيطلع برا فمش قادر الإنسان ياخد النفس زيادة ولا
+
+342
+00:21:15,990 --> 00:21:19,570
+يطلع النفس اللي موجود عنده، فإيش صار هنا؟ صار
+
+343
+00:21:19,570 --> 00:21:23,450
+عملية اللي هو نقص في الصوت اللي هو النفس اللي طالع
+
+344
+00:21:23,450 --> 00:21:30,710
+بالسماعة، طيب normal breath sounds إيش أصواتها؟ طبعا
+
+345
+00:21:30,710 --> 00:21:33,910
+أنا عمال بشرح في هذا .. قلنا الشبط لأنه شوية مهم
+
+346
+00:21:33,910 --> 00:21:39,290
+لنا، عشان نفهم كل حاجة، Normal breath sounds الآن
+
+347
+00:21:39,290 --> 00:21:44,050
+أصوات النفس الطبيعية، أول صوت اسمه Trachea، Trachea
+
+348
+00:21:44,050 --> 00:21:46,970
+اللي إحنا قلنا عنه الصوت اللي وين؟ اللي مباشرة فوق
+
+349
+00:21:46,970 --> 00:21:50,010
+عالي، عالي، عالي، طب ما ما زال عالي و عند الرقبة و كذا
+
+350
+00:21:50,010 --> 00:21:53,130
+إيش قال لي؟ very loud، إيش يعني very loud؟ لو إحنا
+
+351
+00:21:53,130 --> 00:21:57,010
+سمعنا له هنحكي، هتلاقي صوته عالي، high، بتجد حدته
+
+352
+00:21:57,010 --> 00:22:00,390
+عالية، الـ sound كأنه في مسورة هيك بيدخل الهواء
+
+353
+00:22:01,970 --> 00:22:05,410
+inspiratory تساوي إيه؟ expiratory، لو أجي حد سألني
+
+354
+00:22:05,410 --> 00:22:09,750
+طب ليه؟ قال لي في الـ sound هنا duration، يعني في
+
+355
+00:22:09,750 --> 00:22:14,550
+مدة الصوت النفس يعني مدة الصوت سواء الإنسان أخد
+
+356
+00:22:14,550 --> 00:22:19,950
+النفس أو طلع النفس بكون إيش متساوي، ليه متساويين؟
+
+357
+00:22:19,950 --> 00:22:23,910
+عشان النفس هي أصلا مسورة واحدة هي اللي بتدخل و
+
+358
+00:22:23,910 --> 00:22:27,860
+بتطلع، النفس، طب و لما بقول يعني النفس، يعني نفس قطر
+
+359
+00:22:27,860 --> 00:22:31,440
+اللي هو الـ trachea اللي بيدخل فيها الهواء و بيخرج
+
+360
+00:22:31,440 --> 00:22:35,060
+منها، عشان هيك بيطلع نفس اللي هو إيه؟ نفس مدة الصوت
+
+361
+00:22:35,060 --> 00:22:39,180
+سواء دخولا أو خروجا، لكن لما ننزل لتحت شوية لأ
+
+362
+00:22:39,180 --> 00:22:42,040
+بيصير مختلف، لأنه يعني الـ right lung غير على الـ
+
+363
+00:22:42,040 --> 00:22:45,380
+left lung و كذا، خاصة في الـدرس اللي هو التشريحي
+
+364
+00:22:45,380 --> 00:22:48,560
+اللي إحنا أخدناه زمان، في عندنا كمان أنا بقولي
+
+365
+00:22:48,560 --> 00:22:50,520
+over الـ .. ما إحنا قلناه خلاص و إننا بنسمعها في الـ
+
+366
+00:22:50,520 --> 00:22:54,640
+over trachea، طب الـ bronchial، هل جيت حاجة، نزلنا لتحت
+
+367
+00:22:54,640 --> 00:22:58,930
+شوية، الـ bronchial، هل جيت، بقولي برضه إيش هنا؟ loud، هل جيت
+
+368
+00:22:58,930 --> 00:23:04,670
+هذه القصبة تحت الـ bronchial، الـ main bronchi خاصة، الآن
+
+369
+00:23:04,670 --> 00:23:07,230
+بقول لي برضه loud و high و pitch sound، نفس القضية
+
+370
+00:23:07,230 --> 00:23:11,370
+برضه عالي، لكن إيش بقول لي هنا؟ الـ expiratory sound
+
+371
+00:23:11,370 --> 00:23:16,170
+الـ expiratory sound إيش معناه هنا؟ بيكون أكبر من
+
+372
+00:23:16,170 --> 00:23:21,910
+inspiratory sound، أكبر من inspiratory sound، طيب
+
+373
+00:23:21,910 --> 00:23:28,060
+سبحان الله يعني، طب ليش؟ الآن تخيلوا معايا .. الآن
+
+374
+00:23:28,060 --> 00:23:30,460
+.. الآن لما الإنسان بياخد نفسه .. تخيل إن هي أخد
+
+375
+00:23:30,460 --> 00:23:36,760
+نفسه .. طلع نفسه .. نفسه هو طالع بكون شوية سريع
+
+376
+00:23:36,760 --> 00:23:39,340
+أكثر من دخوله .. دخوله اللي بده يتغلغل شوية لتحت
+
+377
+00:23:39,340 --> 00:23:43,400
+عشان يوصل لـ gas exchange، بعدين يطلع مرة واحدة، فهو
+
+378
+00:23:43,400 --> 00:23:46,420
+هنا لما الجسيمة لجوا، الـ expiratory هنا إيش معنها؟
+
+379
+00:23:46,420 --> 00:23:49,920
+أعلى و أكبر شوية من إيش؟ من inspiratory sound، طيب
+
+380
+00:23:49,920 --> 00:23:53,860
+وين نسمعه؟ هيرد هنا على الـ manubrium؟ طبعا أنتم
+
+381
+00:23:53,860 --> 00:23:57,200
+كلكم عارفين من اللي هي الـ manubrium اللي هو خاصة
+
+382
+00:23:57,200 --> 00:24:00,540
+في منطقة القصبة من اللي فوق، أنتم طبعا في
+
+383
+00:24:00,540 --> 00:24:03,000
+التشريح كلكوا ذاكرين هذا المكان بالظبط، التشريح هنا
+
+384
+00:24:03,000 --> 00:24:07,520
+فوق، if هيرد إذا سمعنا الـ bronchial breathing هذا،
+
+385
+00:24:07,520 --> 00:24:11,440
+شفناه لا قدر الله في other location يعني في مكان
+
+386
+00:24:11,440 --> 00:24:15,680
+تاني، إيش بيأكد لي؟ لأ في حاجة اسمها consolidation،
+
+387
+00:24:15,680 --> 00:24:18,780
+إيش هي consolidation؟ ما بدي حد هيترجمها، هاي
+
+388
+00:24:18,780 --> 00:24:22,180
+ترجمة، ترجمة consolidation، اللي lung tissue filled
+
+389
+00:24:22,180 --> 00:24:26,360
+with liquid instead of air، لما لا قدر الله، الرئة
+
+390
+00:24:26,360 --> 00:24:28,480
+دي زي الموضوع في الـ coronavirus اليوم لو بيصير
+
+391
+00:24:28,480 --> 00:24:31,860
+
+445
+00:27:56,330 --> 00:27:59,310
+قضية المية برضه كل ما نضغط عليها أكثر و نفتح بس
+
+446
+00:27:59,310 --> 00:28:03,510
+تقب بزيد قوة المية يبقى الصوت الواطي بيكون
+
+447
+00:28:03,510 --> 00:28:07,320
+bronchitis يبقى معناه جاي من وين؟ من الـ bronchi طب
+
+448
+00:28:07,320 --> 00:28:09,980
+إذا medium .. الـ medium .. أجل الـ medium يعني
+
+449
+00:28:09,980 --> 00:28:14,740
+معناته وين؟ من وسط .. من وسط النفس و أنا بأخذ طب
+
+450
+00:28:14,740 --> 00:28:18,840
+إيش بقول لي هنا؟ بقول لي في الـ mid inspiration آه
+
+451
+00:28:18,840 --> 00:28:23,360
+هذا بيصير في وسط النفس اللي إحنا بناخذه، إذا في وسط
+
+452
+00:28:23,360 --> 00:28:27,040
+النفس اسمعنا .. اسمعنا الـ rail بنسميه medium صوته
+
+453
+00:28:27,040 --> 00:28:31,360
+مش عالي كتير و مش واطي، وسط بيكون، إيش فيه عنده؟ عنده
+
+454
+00:28:31,360 --> 00:28:34,520
+حاجة اسمها bronchiectasis، إيش يعني bronchiectasis؟
+
+455
+00:28:34,750 --> 00:28:38,510
+يعني فيه inflammation في الـ small bronchi، يعني بدأ
+
+456
+00:28:38,510 --> 00:28:42,990
+يصير التهاب في إيش؟ في الشعب الهوائية الصغيرة شوية، مش
+
+457
+00:28:42,990 --> 00:28:47,130
+الشعب الهوائية أو الحويصلات الدقيقة، لأ أنا بأتكلم
+
+458
+00:28:47,130 --> 00:28:50,290
+في الأول الـ main bronchi الشعب الرئيسي، بعدين متفرع
+
+459
+00:28:50,290 --> 00:28:53,310
+منهم، أنتم عارفين في التشريح، في الـ bronchi بعدين
+
+460
+00:28:53,310 --> 00:28:55,550
+الـ bronchioles بعدين الـ alveoli، و الـ alveoli طب
+
+461
+00:28:55,550 --> 00:28:58,770
+الآن .. الآن، بعدين إيش بيصيروا يقولوا له؟ لما
+
+462
+00:28:58,770 --> 00:29:03,440
+يصير التهاب في هذا المكان بقول إيش كلمة bronchitis
+
+463
+00:29:03,440 --> 00:29:06,480
+و ما .. لأ لازم قلت bronchitis، بمعنى بقول مصطلح
+
+464
+00:29:06,480 --> 00:29:09,480
+جديد اسمه bronchiectasis، إيش اسمه bronchiectasis
+
+465
+00:29:09,480 --> 00:29:13,080
+طيب، و لا قدر الله طبعا هذا شوية صعب لإنه ممكن
+
+466
+00:29:13,080 --> 00:29:17,600
+يتحول بعد هيك، مش cancer بس في كتير من الحالات
+
+467
+00:29:17,600 --> 00:29:20,480
+بيصير حاسس أنه بيئمة، يعني بيصير pus بيصير مليان في
+
+468
+00:29:20,480 --> 00:29:27,160
+الرحم و بيصير حتى بعض الحالات في الـ space نفسه الـ
+
+469
+00:29:27,160 --> 00:29:29,800
+intercostal space برضه كمان فيه شوية يعني pus و
+
+470
+00:29:29,800 --> 00:29:34,640
+ممكن الطبيب يتدخل أنه يحاول السحب أو عملية، طيب إذا
+
+471
+00:29:34,640 --> 00:29:38,300
+كانت high معناه إين نزلنا تحت؟ هلجت و أخذ نفس؟
+
+472
+00:29:38,300 --> 00:29:41,840
+الآن صار الصوت عالي كتير، معناه مازال الصوت عالي
+
+473
+00:29:41,840 --> 00:29:45,120
+يبقى وين؟ لأنه صارت إيش؟ عنق و زجاجة بده يضيق،
+
+474
+00:29:45,120 --> 00:29:48,420
+يبقى و الـ .. و الحويصلات وصلت إلى وين؟ للـ bronchioles
+
+475
+00:29:48,900 --> 00:29:52,020
+Alveolitis الحويصلات الداخلية بتاعة الجاذبية تشينجي
+
+476
+00:29:52,020 --> 00:29:55,100
+علشان هيك صار الصوت عالي، يبقى بيصير عنده
+
+477
+00:29:55,100 --> 00:29:59,880
+bronchiolitis أو alveolitis، علشان هيك و خلاص بيصير
+
+478
+00:29:59,880 --> 00:30:01,980
+عند الأطفال يبقى الصوت ما بيكون عالي، ليش؟ على
+
+479
+00:30:01,980 --> 00:30:07,560
+اعتبار أنه القطر تبع النفس الضيق جدا، فالصوت هيكون
+
+480
+00:30:07,560 --> 00:30:10,700
+عالي، علشان هيك سُمّي high pitched، طيب الصوت اللي
+
+481
+00:30:10,700 --> 00:30:14,080
+بعده اسمه إيه؟ معلش أنا بدأت أسرع شوية عشان .. شوية
+
+482
+00:30:14,080 --> 00:30:19,050
+جلطت تلاتين دقيقة، الصوت البعدي اسمه إيش؟ Ronchi ..
+
+483
+00:30:19,050 --> 00:30:22,330
+Ronchi .. الـ Ronchi continuous .. إيش يعني الصوت
+
+484
+00:30:22,330 --> 00:30:25,830
+بيكون إيش؟ مستمر .. لكن خلينا كويسين، عارفين ..
+
+485
+00:30:25,830 --> 00:30:28,290
+هذا الـ Ronchi غير عن الـ rale .. هنا الـ rale ..
+
+486
+00:30:28,290 --> 00:30:30,910
+هنا الـ Ronchi .. طب إيش الـ Ronchi؟ بيقول لي أول
+
+487
+00:30:30,910 --> 00:30:34,610
+حاجة .. الـ Ronchi بيشبه الصوت اللي داخل من نار و
+
+488
+00:30:34,610 --> 00:30:38,310
+بسج .. إيش نار و بسج؟ زي من الممرات الضيقة .. زي
+
+489
+00:30:38,310 --> 00:30:42,710
+في التركية أو الـ Ronchi الـ tree خاصة في شجرة اللي
+
+490
+00:30:42,710 --> 00:30:46,210
+هي الشعيبات الهوائية .. هذا بنسميه musical sounds
+
+491
+00:30:46,580 --> 00:30:50,360
+بيشبه الصوت بالظبط، صرير الهواء اللي بدخل في
+
+492
+00:30:50,360 --> 00:30:54,820
+البربيش اللي عامل زي اللولب، البربيش اللي اللولبي
+
+493
+00:30:54,820 --> 00:30:58,800
+اللي هو زي الزنبرك عامل، بيكون plastic، و هذا لما
+
+494
+00:30:58,800 --> 00:31:02,660
+بيحركه أي بني آدم بيعمل له صوت غريب، لكن هذا الصوت
+
+495
+00:31:02,660 --> 00:31:06,040
+بيطلع سبحان الله في الـ X direction، إيش صار الفرق
+
+496
+00:31:06,040 --> 00:31:09,700
+هناك؟ هناك الصوت في إيه؟ في الـ N direction، هذا الصوت
+
+497
+00:31:09,700 --> 00:31:12,780
+في إيه؟ في الـ X direction، الصوت معناته أنه بيطلع
+
+498
+00:31:12,780 --> 00:31:18,620
+أكثر، و الإنسان بيطلع صوته هناك من جسم لتلت أجسام،
+
+499
+00:31:18,620 --> 00:31:23,540
+هنا بس لجسمين، جسم اسمه low و جسم اسمه high، إيش
+
+500
+00:31:23,540 --> 00:31:26,600
+الـ low؟ الـ low اسمه sonorous، خليكوا حافظين بس
+
+501
+00:31:26,600 --> 00:31:31,600
+كلمات هذه، الآن كم مرة الـ Ronchi صوت موسيقي كأنه
+
+502
+00:31:31,600 --> 00:31:35,520
+في ممرات ضيقة، بيصير الصوت مع خروج النفس مش مع دخول
+
+503
+00:31:35,520 --> 00:31:39,720
+النفس، هذا من قسم لقسمين، إما low و اسمه sonorous،
+
+504
+00:31:39,720 --> 00:31:43,440
+لما أنا أقول كلمة sonorous يعني من وين جاي؟ جاي من
+
+505
+00:31:43,440 --> 00:31:46,420
+الـ large bronchus، يعني من وين؟ من القصبة الهوائية الرئيسية
+
+506
+00:31:46,420 --> 00:31:51,320
+طب لما يقول لي high اسمه Sibilant، يبقى low اسمه
+
+507
+00:31:51,320 --> 00:31:53,840
+Sonorous، خليكوا ذاكرينه، ممكن يجينا في الامتحان، low
+
+508
+00:31:53,840 --> 00:31:57,740
+Sonorous و الـ high إيش اسمه؟ Sibilant، طب الـ
+
+509
+00:31:57,740 --> 00:32:00,360
+Sibilant ده إيش معناه؟ اللي هو الـ wheezes زي
+
+510
+00:32:00,360 --> 00:32:03,960
+الصفير الشديد، بيكون من وين جاي؟ من الـ bronchioles هنا
+
+511
+00:32:03,960 --> 00:32:08,240
+جاي من الشعيبات الصغيرة شوية، هنا جاي من إيش؟ من
+
+512
+00:32:08,240 --> 00:32:11,960
+حول الشعب الهوائية اللي تحت شوية اللي في الآخر
+
+513
+00:32:11,960 --> 00:32:16,380
+علشان هيك .. و لاحظوا أنه بيقول لي هنا أنه هنا جاي
+
+514
+00:32:16,380 --> 00:32:19,700
+في الـ late .. في الـ late expiration و هذا في الـ
+
+515
+00:32:19,700 --> 00:32:22,260
+early زي ما إحنا قلنا في إيش؟ في الـ early، يعني إذا
+
+516
+00:32:22,260 --> 00:32:25,800
+الإنسان أول ما بده يطلع نفسه .. أول ما بده يطلع
+
+517
+00:32:25,800 --> 00:32:30,520
+نفسه، طلع صوت صفير بسميه sonorous و بقول عنده
+
+518
+00:32:30,520 --> 00:32:36,860
+bronchitis، طيب إذا آخر ما طلع نفسه زي هيك .. بعص
+
+519
+00:32:36,860 --> 00:32:41,350
+على حاله شوية، طلع و عصق حاله شوية، اسمه Sibilant و
+
+520
+00:32:41,350 --> 00:32:43,810
+جاي من وين؟ من الـ bronchioles، اللي هو bronchiolitis
+
+521
+00:32:43,810 --> 00:32:49,010
+بدأت أشرح لعين ديانا ده، عشان أوقف لإنه الوقت راح و
+
+522
+00:32:49,010 --> 00:32:53,250
+إيه ما طولش كتير في أخد اللي هو .. هو كام ضايل
+
+523
+00:32:53,250 --> 00:32:59,690
+الشيء؟ لأ، طيب مش .. مش خلصنا، أنا .. نشرح بس اللي
+
+524
+00:32:59,690 --> 00:33:03,560
+ضايل Stridor و خلاص، Stridor اللي بيسموه إيه؟ زي
+
+525
+00:33:03,560 --> 00:33:05,740
+الصرير، إيش يعني Stridor؟ بيقول .. إيش يعني
+
+526
+00:33:05,740 --> 00:33:09,000
+الصرير؟ بيقول inspiratory musical wheeze، هي عبارة عن
+
+527
+00:33:09,000 --> 00:33:16,600
+صوت .. يحدث صوت موسيقي .. sorry عشان تتبعوا معايا ..
+
+528
+00:33:16,600 --> 00:33:20,320
+inspiratory musical wheeze، عبارة عن صوت صفير بيحدث
+
+529
+00:33:20,320 --> 00:33:23,420
+أثناء التنفس، أكثر شيء بيصير عند مين؟ عند الناس
+
+530
+00:33:23,420 --> 00:33:27,080
+اللي عندهم chronic أزمة .. chronic أزمة، هذا اسمه
+
+531
+00:33:27,080 --> 00:33:30,860
+إيش .. هذا اسمه إيش؟ Stridor، بيقول لي بيكون عالي كتير
+
+532
+00:33:30,860 --> 00:33:34,900
+على  التريكيا، جنب اللي هو القصبة الهوائية الرئيسية،
+
+533
+00:33:34,900 --> 00:33:39,760
+suggest إيش بيخلينا نفكر إن فيه تريچيا or larynx
+
+534
+00:33:39,760 --> 00:33:43,000
+فيه إيش هنا؟ incident obstruction، إما من لا سبحان
+
+535
+00:33:43,000 --> 00:33:46,200
+الله من tumor أو from body أو لا سبحان الله أخدت
+
+536
+00:33:46,200 --> 00:33:50,280
+trauma شديدة جدا عملت له obstruction، طبعا هذا تعتبر
+
+537
+00:33:50,280 --> 00:33:52,880
+من الـ medical emergency، لأنه على اعتبار أن هذا
+
+538
+00:33:52,880 --> 00:33:55,800
+يعني دخول الهواء الرئيسي، و إذا ما دخلش دغري بدنا
+
+539
+00:33:55,800 --> 00:33:59,580
+ندخله، نحاول ندخله عشان ندخله النفس، requiring
+
+540
+00:33:59,580 --> 00:34:02,460
+immediate attention، بدنا انتباه فوري، من الانتباه
+
+541
+00:34:02,460 --> 00:34:06,180
+الفوري، في بعض الحالات بيعملوا الفتحة مباشرة في
+
+542
+00:34:06,180 --> 00:34:09,500
+منطقة الحنجرة هنا عشان يتنفس، في بعضهم بدخله دغري على
+
+543
+00:34:09,500 --> 00:34:12,580
+المركز عشان يحطوله تنفس صناعي و endotracheal
+
+544
+00:34:12,580 --> 00:34:18,980
+intubation، طبعا في بعض هنا associated، إيش هنقدر
+
+545
+00:34:18,980 --> 00:34:21,360
+الله إذا inhaled اللي هو from body، بعض الحالات
+
+546
+00:34:21,360 --> 00:34:26,900
+خاصة، أنا شفت من الحالات الغريبة، طفل هو قاعد بياكل
+
+547
+00:34:26,900 --> 00:34:29,880
+و أنا هذا الكلام كويس أنصحكم به، أتركو الضحك و خاصة كان
+
+548
+00:34:29,880 --> 00:34:34,840
+يقول اللي هو الفزق الحلبي، فعمله مجرد ما هو ..
+
+549
+00:34:34,840 --> 00:34:39,660
+تعرفوا يعني زهر الطفل مش كبير، و مجرد ما يعني أنه
+
+550
+00:34:39,660 --> 00:34:43,570
+أشهق شوية، ودّوه على المستشفى، و أنا أذكر إنهم
+
+551
+00:34:43,570 --> 00:34:46,830
+ما قدروش يتسيطروا عليه، أعتقد إنه هو توفى، فالأمر
+
+552
+00:34:46,830 --> 00:34:49,370
+مش سهل، ليه؟ لإنه بيصير مستشفى تدوى، عشان هيك أنا
+
+553
+00:34:49,370 --> 00:34:52,690
+كتير بقول للناس، يعني الإنسان هو أبوه الخاص الأكل
+
+554
+00:34:52,690 --> 00:34:55,370
+اللي فيه أشياء fragments، يعني زي المكسرات، شغلة زي
+
+555
+00:34:55,370 --> 00:34:59,350
+هيك ما يحكيش كتير، ولا .. و أخطر شيء الضحك أثناء الأكل
+
+556
+00:34:59,350 --> 00:35:01,990
+لأنه ممكن يصير form body inhalation، و الله سبحانه
+
+557
+00:35:01,990 --> 00:35:04,870
+يُعمل obstruction، خلينا نتوقف عند هذه الشريحة إن
+
+558
+00:35:04,870 --> 00:35:07,310
+شاء الله، و المحاضرة القادمة إن شاء الله نكمل
+
+559
+00:35:07,310 --> 00:35:09,830
+والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b63b82514f27c82379f415f43054ba472e22df10
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_postprocess.srt
@@ -0,0 +1,2236 @@
+1
+00:00:00,910 --> 00:00:06,050
+بسم الله الرحمن الرحيم خلينا الان نكمل وصلنا طبعا
+
+2
+00:00:06,050 --> 00:00:09,690
+ال assessment of ايه of thoracic expansion طبعا
+
+3
+00:00:09,690 --> 00:00:14,770
+انا يمكن شوية خليني اقول بطيق شوية بس في .. خاصة
+
+4
+00:00:14,770 --> 00:00:18,030
+في موضوع chest assessment او respiratory
+
+5
+00:00:18,030 --> 00:00:20,690
+assessment بشكل عام لأنه في شغلات بدنا نفهمها بشكل
+
+6
+00:00:20,690 --> 00:00:25,770
+واضح على مهل يعني شوية الان لما بيقولي thoracic
+
+7
+00:00:25,770 --> 00:00:30,300
+expansion يعني معناته ايش هناكأني بقول اتساع القفص
+
+8
+00:00:30,300 --> 00:00:33,560
+الصدر اتساع جديش بيوسع جديش لما يكون الإنسان بتنفس
+
+9
+00:00:33,560 --> 00:00:36,860
+.الآن طب كيف أنا بدي أشوف ال diameter؟ يعني بدي
+
+10
+00:00:36,860 --> 00:00:41,840
+أشوف كيف أنا بدي أعرف أنه هل بتنفس كتير، بتنفس
+
+11
+00:00:41,840 --> 00:00:46,040
+جليل، هل أنا اللي شايفه حكمت عليه بدون ما أتأكد؟
+
+12
+00:00:46,040 --> 00:00:49,380
+خلّيني أشوفه.الآن الصورتين اللي قادمات ان شاء الله
+
+13
+00:00:49,380 --> 00:00:53,460
+هيبيننا بالظبط اللي احنا بنحكيهبشكل واضح انا الان
+
+14
+00:00:53,460 --> 00:00:57,220
+هتكلم بس ايش ال .. ال .. ال .. بعض العبارات لكن ان
+
+15
+00:00:57,220 --> 00:01:00,080
+شاء الله الصورة هتصرح أكتر في حاجة اسمها anterior
+
+16
+00:01:00,080 --> 00:01:03,180
+و في حاجة اسمها posterior ايش يعني anterior يعني
+
+17
+00:01:03,180 --> 00:01:06,220
+anterior diameter انا بتكلمه posterior يعني
+
+18
+00:01:06,220 --> 00:01:10,080
+diameter يعني المقياس من الأمام او المقياس من
+
+19
+00:01:10,080 --> 00:01:12,840
+الخلف مش بحكي انها anterior يعني شو معناها لأ انا
+
+20
+00:01:12,840 --> 00:01:16,400
+بتكلم انه احنا كيف بدنا نشوف و احنا بنعمل
+
+21
+00:01:16,400 --> 00:01:20,330
+assessment للمريضنعرف إنه قداش حجم التنفس لو
+
+22
+00:01:20,330 --> 00:01:23,990
+اتطلعنا عليه من الأمام و كيف نشوف حجم التنفس لو
+
+23
+00:01:23,990 --> 00:01:28,110
+اتطلعنا عليه من خلفه طبعا إيش بقولي هنا؟ بقولي
+
+24
+00:01:28,110 --> 00:01:31,110
+استخدم إيدك على إيه؟ على ال anterolateral إيش
+
+25
+00:01:31,110 --> 00:01:34,770
+anterolateral؟ بيسموه الأمام الجانبي، كيف يعني؟ زي
+
+26
+00:01:34,770 --> 00:01:38,730
+ما يقولوا شمال الشرقي مثلا، لما نقول anterior
+
+27
+00:01:38,730 --> 00:01:43,830
+lateral يعني بنحط إيدنا على الجنبمابين مش أمام
+
+28
+00:01:43,830 --> 00:01:47,330
+مطلق ولا على الجانب مطلق يعني على جزء ما بين
+
+29
+00:01:47,330 --> 00:01:51,030
+الأمام و مابين الجانب و بحط أصابع اللي هو ال
+
+30
+00:01:51,030 --> 00:01:54,990
+thumbs أصابع الأتنين تبع إيدي التنتين في اتجاه إيش
+
+31
+00:01:54,990 --> 00:01:57,650
+هنا ال coastal marginal قلت بوريكوا هين بالظبط
+
+32
+00:01:57,650 --> 00:02:01,510
+احنا أفضل نروح للصورة عشان نكون واضحة لكن نكون
+
+33
+00:02:01,510 --> 00:02:05,090
+تاكرين نخليناها في حجم اللي هو ال tenth rib لما
+
+34
+00:02:05,090 --> 00:02:08,590
+بدنا نقوم نلبسه طيب تطلع عليها الآن هذا ال
+
+35
+00:02:08,590 --> 00:02:12,160
+anterior assessment and thoracic expansionلاحظين
+
+36
+00:02:12,160 --> 00:02:17,560
+أن هذه المريضة موجودة قدامنا وإن حط اللي هو الطبيب
+
+37
+00:02:17,560 --> 00:02:22,860
+أو حط اللي هو الحكيم حط إيده على الـ anterolateral
+
+38
+00:02:22,860 --> 00:02:27,280
+يعني ما راحش كله lateral ولا كله anterolateral وحط
+
+39
+00:02:27,280 --> 00:02:30,440
+هنا منطقة ال coast ليش يعني؟ يعني منطقة اللي هو
+
+40
+00:02:30,440 --> 00:02:33,880
+هذه الصينة هذه اللي قدامنا هذا العضمة اللي عضمة
+
+41
+00:02:33,880 --> 00:02:37,590
+القصر في النص بعدين نفسي القضيةالإيد التانية ..
+
+42
+00:02:37,590 --> 00:02:39,890
+هذا الإيد اليمين و هذا الإيد الشمال .. نفس القضية
+
+43
+00:02:39,890 --> 00:02:43,050
+حطهم و حط إيش .. يعني في فراغة .. شو الفراغة ده؟
+
+44
+00:02:43,050 --> 00:02:45,370
+احنا عارفين الفراغة؟ في عضمة هنا في النص .. ماشي
+
+45
+00:02:45,370 --> 00:02:48,870
+.. مش هذا موضوعنا .. الموضوع إن أنا حطيت إيديا
+
+46
+00:02:48,870 --> 00:02:54,350
+تنتين على جنبين المريض و بقول للمريض خد نفس عميق
+
+47
+00:02:54,350 --> 00:02:57,690
+.. في نفس الوقت أنا بتغطش كتير .. يعني أنا بحط
+
+48
+00:02:57,690 --> 00:03:02,120
+إيديالكن مش بحطهم كإني أنا .. كإني قاعد بضغط عليه
+
+49
+00:03:02,120 --> 00:03:05,840
+أو بتدخل جهة، لا أبدا، ولا بحطهم كإنهم بدهم يوجعوا
+
+50
+00:03:05,840 --> 00:03:09,280
+دايا، أنا بضغطهم .. يعني بحطهم على منطقة الصدر و
+
+51
+00:03:09,280 --> 00:03:12,720
+كإنهم حرات الحركة، يعني بروحوا بيجوا مع عضلات
+
+52
+00:03:12,720 --> 00:03:17,080
+التنفس، الآن نتنفس، المسافة اللي اتنفسها نختار ..
+
+53
+00:03:17,080 --> 00:03:20,580
+يعني خليك تخيلوا معايا إن الإصبعين دول رجعوا شوية
+
+54
+00:03:20,580 --> 00:03:23,980
+هذا ال hand و رجعوا هذا الإصبع لهنا، يعني مع
+
+55
+00:03:23,980 --> 00:03:27,340
+التنفس، لما ناخد inspiration رجعه شوية و هذا رجعه
+
+56
+00:03:27,340 --> 00:03:30,690
+شويةبعدين مع ال exploration عاوز أرجعه أنا بتكلم
+
+57
+00:03:30,690 --> 00:03:35,170
+لما ن .. رجعن مش لما كان المكان الآن لأ أول ما أخد
+
+58
+00:03:35,170 --> 00:03:39,090
+النفس على الآخر لو اين وصله نعتقد .. خلينا نفترض
+
+59
+00:03:39,090 --> 00:03:44,090
+أنه وصل التنفس نفترض أنه الآن المريض اللي أمامنا
+
+60
+00:03:44,090 --> 00:03:48,110
+أخد نفس عميق و هذا الفراغ اللي هنا إيش بعمل؟ بحط
+
+61
+00:03:48,110 --> 00:03:51,610
+علامة هنا و علامة هنا جلم جاف مش مشكلة علامة هنا و
+
+62
+00:03:51,610 --> 00:03:55,470
+علامة هنا بجيس المسافة بينهم مثل المسافة طلعت خمسة
+
+63
+00:03:55,470 --> 00:03:58,520
+سانتيسبعة صنطي، عشرة صنطي، أي ان كانت المسافة
+
+64
+00:03:58,520 --> 00:04:03,540
+تمام؟ هذه المسافة إيش اسمها؟ anterior thoracic
+
+65
+00:04:03,540 --> 00:04:08,620
+diameter طب نشوف ال posterior، ال posterior برضه
+
+66
+00:04:08,620 --> 00:04:12,020
+نرجع شوي الكلام هنا، إيش بيقول ليه؟ وين نحط؟ حط
+
+67
+00:04:12,020 --> 00:04:15,040
+إيديك posterior lateral، هنا وين نحط إيديك؟
+
+68
+00:04:15,040 --> 00:04:18,120
+anterior lateral طب يا تر أولين بيقولوا على منطقات
+
+69
+00:04:18,120 --> 00:04:21,280
+إيش؟حوالين اللي هو ال tenth rib يعني عند ال ..
+
+70
+00:04:21,280 --> 00:04:25,140
+تقريبا الريشة العاشرة على اعتبار انه اخر .. اخر
+
+71
+00:04:25,140 --> 00:04:27,980
+رياش انتوا عارفين بتكون free movable يعني متحركة
+
+72
+00:04:27,980 --> 00:04:31,960
+مش .. مش مسكرة فنرجع نفس الكلام على الصورة بقولي
+
+73
+00:04:31,960 --> 00:04:36,360
+اتحط ايدك هاي هنا posterior lateral و posterior
+
+74
+00:04:36,360 --> 00:04:39,160
+lateral طب مايجي واحد يقولي طب ليش أساسي مبين ان
+
+75
+00:04:39,160 --> 00:04:43,500
+انا مش قادر؟ ممكن يعني بيبين ايديها أصغر من مش
+
+76
+00:04:43,500 --> 00:04:46,960
+عارف مين اللي .. لأ في مين يبدو اللي طبيبة بيبين
+
+77
+00:04:46,960 --> 00:04:51,970
+انه ايديها هو ما شاء اللهيعني well-muscled او مثلا
+
+78
+00:04:51,970 --> 00:04:55,450
+obese client او هكذا فهي حطت في نفس الوقت مش مشكلة
+
+79
+00:04:55,450 --> 00:04:58,510
+مازال نفس ال examiner مافي مشكلة الآن و بنقوله يلا
+
+80
+00:04:58,510 --> 00:05:02,070
+اخد نفس .. بنجيس المسافة اللي وين نفس القضية طبعا
+
+81
+00:05:02,070 --> 00:05:05,350
+بيخلي ايدينا يتحركن مع النفس اخد نفس عميق بنحط هنا
+
+82
+00:05:05,350 --> 00:05:08,750
+أيش برضه علامة و علامة و بنجيس المسافة بينهم
+
+83
+00:05:08,750 --> 00:05:12,270
+الصحيح انه تطلع المسافة اللي هنا و المسافة اللي
+
+84
+00:05:12,270 --> 00:05:15,950
+أمام تكون زي بعض في مشكلة بنبلغ الطبيب طبعا هذه
+
+85
+00:05:15,950 --> 00:05:21,580
+للأسف أنا حزين أقولكوابيعملوا إيش؟ أنا ماشوفتش في
+
+86
+00:05:21,580 --> 00:05:24,700
+غزة من المرة حدا بيعملها، مع إنها شغلة من صفة
+
+87
+00:05:24,700 --> 00:05:28,520
+بتخصص اللي هو يعني على طبقة الصدرية و ربما هذه
+
+88
+00:05:28,520 --> 00:05:31,580
+تكشف شغلات يعني خطيرة إذا كان لها سمح الله أي
+
+89
+00:05:31,580 --> 00:05:33,860
+deformities أو لا سمح الله فيه أي حاجة في ال
+
+90
+00:05:33,860 --> 00:05:38,040
+spinal problems أو tumors أو هكذا، بغض النظر،
+
+91
+00:05:38,040 --> 00:05:40,960
+المهم إحنا هنا الآن by two ways، إيش يعني بالطريقة
+
+92
+00:05:40,960 --> 00:05:43,720
+التانية، اللي هي ال anterior و ال posterior، ستشعر
+
+93
+00:05:43,720 --> 00:05:47,030
+بال amount of thoracic expansion، أكيد طبعابتاك
+
+94
+00:05:47,030 --> 00:05:50,210
+تشوف قد ياش اتساء القفص صدري و رجوعه خاصة في ال
+
+95
+00:05:50,210 --> 00:05:53,530
+deep breathing يعني قد ياش كان لما ناخد نفس عميق و
+
+96
+00:05:53,530 --> 00:05:56,670
+جالي ايش كمان ال symmetry بتاك تشوف ايش ال
+
+97
+00:05:56,670 --> 00:06:00,350
+symmetry طبعا لما نقول كلمة symmetry يعني بتاك
+
+98
+00:06:00,350 --> 00:06:04,550
+تشوف التجانس هل نفس الشيء .. هل لا سبحان الله
+
+99
+00:06:04,550 --> 00:06:08,730
+بيميل اه بيميل يمين بيميل شوية ع الشمال هذا بيصير
+
+100
+00:06:08,730 --> 00:06:13,430
+ايش unsymmetry يعني مش متجانس مش متناسق يعني حاجة
+
+101
+00:06:13,430 --> 00:06:16,590
+بيسموها ال homeostasis او اللغة لا سبحان اللهيكون
+
+102
+00:06:16,590 --> 00:06:20,090
+عنده abnormalities طيب، الآن إيش بقولي بعديها
+
+103
+00:06:20,090 --> 00:06:23,950
+assessment of حاجة اسمها fremitus شو قصدك في ال
+
+104
+00:06:23,950 --> 00:06:27,690
+fremitus مصطلح جديد، fremitus هذه اسمها vibration
+
+105
+00:06:27,690 --> 00:06:31,010
+perceptible on إيش؟ on palpation لو أنت حاطط إيدك
+
+106
+00:06:31,010 --> 00:06:35,230
+على صدر المريض و جعمالك بتقوله خد نفس اسمعت كركعة
+
+107
+00:06:35,230 --> 00:06:38,810
+يعني كرهش كركعة يعني اسمعت حاجة تحت أصبيعك مش
+
+108
+00:06:38,810 --> 00:06:43,060
+طبيعيةيعني بغض النظر، خرخة، شكركة، اتسميها اللي
+
+109
+00:06:43,060 --> 00:06:47,920
+تسميها، اهتزاز، اشي مش طبيعي بنسميها fremitus لأن
+
+110
+00:06:47,920 --> 00:06:52,340
+احنا مش متخصين، لقدام شوية إذا لاجينا حالنا يعني
+
+111
+00:06:52,340 --> 00:06:55,760
+متعمقين في العلم بسيط، انا اعطي الأسماء الحقيقية
+
+112
+00:06:56,370 --> 00:06:58,850
+بعدين لأ قدر الله بيقوللي شوف إذا في subcutaneous
+
+113
+00:06:58,850 --> 00:07:01,430
+emphysema و أنا شرحت في المحاضرة السابقة شو ال
+
+114
+00:07:01,430 --> 00:07:04,830
+emphysema، أعيدها إن لما بيصير مرات كنا حوصالات
+
+115
+00:07:04,830 --> 00:07:08,050
+الهوية بيطلع من الهواء خاص على اعتبار إنه احتبس ال
+
+116
+00:07:08,050 --> 00:07:11,270
+oxygen ماقدرش و الهواء ماقدرش يصير exchange فصار
+
+117
+00:07:11,270 --> 00:07:16,190
+عملية إيش، losing و bulging مع الفلايفة للأسف طلع
+
+118
+00:07:16,190 --> 00:07:19,650
+الهواء و صار تحت اللي هو الجلد، منطقة الرقب و
+
+119
+00:07:19,650 --> 00:07:24,400
+منطقة الكتفين إيش سمنها emphysemaبقول لي يا ريت
+
+120
+00:07:24,400 --> 00:07:28,060
+تشوف ال tissue اللي حواليها خاصة إذا في cracking
+
+121
+00:07:28,060 --> 00:07:32,020
+.. إيش cracking notes .. notes يعني sounds صحيح؟
+
+122
+00:07:32,020 --> 00:07:36,060
+شو cracking sounds؟ في بعض الناس يمكن يعرف إيش
+
+123
+00:07:36,060 --> 00:07:39,300
+معناته cracking sounds حتى بسموها .. بعض الناس
+
+124
+00:07:39,300 --> 00:07:43,460
+بسموها crepitations .. crepitations اللي هي بسمها
+
+125
+00:07:44,800 --> 00:07:50,480
+زي صوت بالظبط هو صوت زي كركعة الشيشة شوفت لما ..
+
+126
+00:07:50,480 --> 00:07:54,160
+يعني ان شاء الله مايكون حدا من الطلاب او حتى .. لأ
+
+127
+00:07:54,160 --> 00:07:57,820
+تمنا حتى الأهلي يكون .. يكون يعني بشيش فلما بشيش
+
+128
+00:07:57,820 --> 00:08:01,220
+.. شوفت الميه لأو لما إذا تفرجت عليه مقطع في فيلم،
+
+129
+00:08:01,220 --> 00:08:04,900
+في مسلسل، في كده و هو بياخد الشيشة بتلاقي الميه
+
+130
+00:08:04,900 --> 00:08:09,260
+بتعمل زي كركعة هي خربطة مع الفقاعة بتطلع هذا الصوت
+
+131
+00:08:10,600 --> 00:08:14,760
+بصير لما يكون اللي سمح الله عنده حالة انفزيما طبعا
+
+132
+00:08:14,760 --> 00:08:17,960
+تشبه لو مواحد مش ذاكر في بعض الحالات أقولكم
+
+133
+00:08:17,960 --> 00:08:20,660
+مابتشبهش إذا أنتوا بتعرفوا النيلون اللي بيغلفوا
+
+134
+00:08:20,660 --> 00:08:25,380
+فيه مرات الأشياء الثمينة زي العطور الغالية أو حتى
+
+135
+00:08:25,380 --> 00:08:28,420
+أو بعض الأشياء الهدائية بيغلفوا فيها فالنيلون اللي
+
+136
+00:08:28,420 --> 00:08:32,200
+بيكون في جلبه داخله كله حبيبات هوائية و لما نضغط
+
+137
+00:08:32,200 --> 00:08:35,160
+عليه حتى بعض الطلاب و بعض البلد حتى بيحب هذه الشيء
+
+138
+00:08:35,160 --> 00:08:38,800
+انه لأنه على فكرة بيعمل حتى شوية راحة نفسي على بعض
+
+139
+00:08:38,800 --> 00:08:43,010
+الناسانه يظل يعص عليه ويظل يطجع يعني فيهن هذا يسمى
+
+140
+00:08:43,010 --> 00:08:45,130
+ايش repetitions علشان طولنا و احنا بحكي في هذا
+
+141
+00:08:45,130 --> 00:08:50,030
+الموضوع طيب percussion of the chest نيجي الآن على
+
+142
+00:08:50,030 --> 00:08:52,030
+ما عمل اي استخدام اللي هو ال skill اللي هي ال
+
+143
+00:08:52,030 --> 00:08:55,690
+percussion عشان نعمل ايش نشوف في amounts of air لأ
+
+144
+00:08:55,690 --> 00:09:00,030
+قدر الله في liquid موجود حاسس لأ سمح الله في solid
+
+145
+00:09:00,030 --> 00:09:02,550
+طبعا احنا عارفين الأصوات كل الصوت يختلف يعني و انا
+
+146
+00:09:02,550 --> 00:09:05,310
+بعمل .. قاعد بعمل percussion الصوت اختلف يمكن يكون
+
+147
+00:09:05,310 --> 00:09:08,190
+صوت liquid يمكن يكون صوت solid لأ سمح الله تيومر
+
+148
+00:09:08,190 --> 00:09:11,700
+او شيء من هذا القبيلعوين على منطقة ال lung .. ال
+
+149
+00:09:11,700 --> 00:09:15,640
+lung عشان أشوف أين رايحها الأمور وبطلع .. بشوف ال
+
+150
+00:09:15,640 --> 00:09:18,320
+boundaries .. إيش يعني ال boundaries؟ حدود اللي هو
+
+151
+00:09:18,320 --> 00:09:21,540
+حدود الأعضاء يعني و احنا بنعمل assessment كأنك ..
+
+152
+00:09:21,540 --> 00:09:24,160
+كأنك بتجيس في ال a في ال lungs كأنك بتجيس في حجم
+
+153
+00:09:24,160 --> 00:09:27,580
+ال lungs كديش موجودة و أنت بتطرق و بتعرف أنه وقت
+
+154
+00:09:27,580 --> 00:09:30,560
+إيش صوت اختلف انتهت الرئة و وقت إيش صوت اختلف
+
+155
+00:09:30,560 --> 00:09:35,300
+يمين، يسار، فوق أو تحت طيب ال percussion كتير من
+
+156
+00:09:35,300 --> 00:09:38,480
+الناس للأسف بيغلطوا بس أنا شغلاتي مكونوا واضحين
+
+157
+00:09:39,300 --> 00:09:44,340
+بيجي للأسف بيعمل عميل الطرق الطبيب مرتين اتلاتة
+
+158
+00:09:44,340 --> 00:09:47,120
+على منطقة صدره وكان بيقولك خلاص بيكفي لأ الصح هو
+
+159
+00:09:47,120 --> 00:09:50,640
+بيقوللي عشان نكون صارحين لازم نعمل anterior and
+
+160
+00:09:50,640 --> 00:09:53,540
+posterior and lateral يعني بدنا على الصدر من
+
+161
+00:09:53,540 --> 00:09:56,860
+الأمام وعلى الصدر من الخلف وعلى الجانبين نعمل إيش
+
+162
+00:09:56,860 --> 00:10:00,120
+percussion وبيقوللي all directions يعني يريت
+
+163
+00:10:00,120 --> 00:10:03,340
+الأطباء كمان يعني يتكرموا وهذه الأمور اللي انا
+
+164
+00:10:03,340 --> 00:10:08,350
+مرات .. ممكن انت حطيت hand بعد خمس صنطيمن نفس
+
+165
+00:10:08,350 --> 00:10:11,770
+المكان في عنده مشكلة فالإنسان يعني بعينه الله يعني
+
+166
+00:10:11,770 --> 00:10:16,050
+يتعب شوية و يعمل assessment أكتر دائما with about
+
+167
+00:10:16,050 --> 00:10:18,950
+five centimeters intervals يعني إيش بقوليه؟ يعني
+
+168
+00:10:18,950 --> 00:10:23,610
+يا ريت بقولي بس فقط خد خمسة سنة ما بين كل منطقة و
+
+169
+00:10:23,610 --> 00:10:27,470
+التانية فللأسف بنشوف بعض الناس بعمل طرقتين أمام أو
+
+170
+00:10:27,470 --> 00:10:30,370
+طرقة واحدة من الأمام أو في الخلف طرقتين و خلاص و
+
+171
+00:10:30,370 --> 00:10:33,720
+مع السلامةأما الـ auscultation استخدام السماعة
+
+172
+00:10:33,720 --> 00:10:36,800
+بتعطينا information على الـ function of the
+
+173
+00:10:36,800 --> 00:10:40,620
+respiratory system كيف قريت و كيف الوظيفة النفس
+
+174
+00:10:40,620 --> 00:10:43,860
+شغالة كويسة و لأ بصير أسمع الأصوات من الداخل أنا
+
+175
+00:10:43,860 --> 00:10:46,360
+في الأول كنت بدأ أسمع من الخارج لإذا كان الأمر ..
+
+176
+00:10:46,360 --> 00:10:49,360
+يعني .. كان visible يعني أو .. يعني .. audible
+
+177
+00:10:49,360 --> 00:10:52,980
+..مسموع لكن أنا جدا بدأ أشوف و أسمع .. sorry ..
+
+178
+00:10:52,980 --> 00:10:56,860
+يعني بدأ أسمع بالسماعة إيش موجود جوا عشان إيه؟
+
+179
+00:10:56,860 --> 00:10:59,780
+عشان إذا في detect أي إيش obstruction إذا في أي
+
+180
+00:10:59,780 --> 00:11:03,610
+obstructionفي ال passages فى مورات الهواء دُغر
+
+181
+00:11:03,610 --> 00:11:06,990
+تكشفها السماعة الطبيب اللى متخصص شاطر من السماعة
+
+182
+00:11:06,990 --> 00:11:10,350
+مجرد ما هو بيتنفس المريض حتى مش بس بيعمل .. بيقوله
+
+183
+00:11:10,350 --> 00:11:13,910
+انت عندك obstruction فى .. فى النفس لأ بيقوله عندك
+
+184
+00:11:13,910 --> 00:11:16,110
+obstruction فى البداية و لا فى النهاية و لا فى
+
+185
+00:11:16,110 --> 00:11:18,830
+الوسط و لا فى دخول الهواء و لا فى خروج الهواء
+
+186
+00:11:18,830 --> 00:11:23,630
+سبحان الله كل شيء لها يعني .. لو .. لو تشخيص محدد
+
+187
+00:11:23,630 --> 00:11:29,430
+و سماعة محددة الانش بيقوللى هنابقول لي ال client
+
+188
+00:11:29,430 --> 00:11:31,810
+to breathe through the mouth ليش هنا بقول لي
+
+189
+00:11:31,810 --> 00:11:35,230
+instruct بقول أحسن لما احنا بدنا نعمل assessment
+
+190
+00:11:35,230 --> 00:11:40,470
+خليه يتنفس ع طريق الفم علشان ايه slowly عالمها
+
+191
+00:11:40,470 --> 00:11:45,970
+شوية شوية before beginning بقول قبل ما نبدأ نفس و
+
+192
+00:11:45,970 --> 00:11:49,850
+قبل ما نبدأ نعمل assessment خلي المريض يخدله أكام
+
+193
+00:11:49,850 --> 00:11:54,090
+نفس عمقات مش يعني ليه بيجي الطبيب .. الحكيم بقولي
+
+194
+00:11:54,090 --> 00:12:00,720
+لو سمحت أولا خد راحتك خد نفسبرتاح بتعبى صدره
+
+195
+00:12:00,720 --> 00:12:03,880
+أكسجيني كويس بعدين بنعمل assessment ليه؟ مانجيش
+
+196
+00:12:03,880 --> 00:12:07,280
+للمريض مباغطة عشان ممكن المريض مع الخوف شوية أو
+
+197
+00:12:07,280 --> 00:12:10,860
+خليني أقول من أول استجابة ممكنش هو شوية
+
+198
+00:12:10,860 --> 00:12:15,360
+abnormalities يعني عملتله شوية stress وضيقته طيب
+
+199
+00:12:15,360 --> 00:12:20,060
+أسكالتاتزي ما احنا عملنا بركز كل منطقة برضه سكلتت
+
+200
+00:12:20,060 --> 00:12:23,100
+all area، إيش يعني؟ اسمع كل المناطق، برضه نفس
+
+201
+00:12:23,100 --> 00:12:26,440
+القضية بنقص الأطباء، إنه يريد يسمع كل المناطق، at
+
+202
+00:12:26,440 --> 00:12:29,880
+least إيش هنا؟ بقولي one complete respiration، إيش
+
+203
+00:12:29,880 --> 00:12:33,480
+يعني one؟ يريد، بس هي صعبة صحي على الأطباء، إنه
+
+204
+00:12:33,480 --> 00:12:37,080
+يقصد إنه كل ما نسمع مكان، نسمع complete
+
+205
+00:12:37,080 --> 00:12:40,520
+respiration، يعني كيف؟ أنا حطيت السماعة على مكان
+
+206
+00:12:40,520 --> 00:12:46,010
+معين، كل المريض خد نفس، طلع نفس،بعدين يرفع السماعة
+
+207
+00:12:46,010 --> 00:12:50,930
+مكان تاني، خد نفس؟ أنا اللي استغربتله بعض الأطباء،
+
+208
+00:12:50,930 --> 00:12:54,410
+أنا مابديش أعمم أنه بيجي ويقولوا خد نفس و أثناء ما
+
+209
+00:12:54,410 --> 00:12:58,290
+يقولوا خد نفس هو عمال بياخد inspiration، بيكون إيش
+
+210
+00:12:58,290 --> 00:13:01,290
+نجل ال status scope حوالي تلت أربع مرات، لاحقوا
+
+211
+00:13:01,290 --> 00:13:04,110
+الله و طلبوا الله، و هو بيطلع النفس، كمان نجله
+
+212
+00:13:04,110 --> 00:13:06,950
+مرتين تلتة، بيقولوا الله عطاك العافية، يعني كأنه
+
+213
+00:13:06,950 --> 00:13:10,230
+إيش في نفس واحد استطاع يقدر يعمل assessment كامل،
+
+214
+00:13:10,230 --> 00:13:15,190
+و هذا الكلام صراحة يعني غير دقيق صراحةالـ
+
+215
+00:13:15,190 --> 00:13:18,090
+auscultation و هذا الكلام بنحكيه أكتر لأطباء عشان
+
+216
+00:13:18,090 --> 00:13:21,950
+يكونوا واضحين يعرفوا هذا الأماكن و احنا بسلنا نعرف
+
+217
+00:13:21,950 --> 00:13:25,450
+بالمعرفة يعني و فاهم اللي لنا أنه نعرف أماكن
+
+218
+00:13:25,450 --> 00:13:30,790
+الصحية يمكن يكون لك و يكون لك قدر حلو أنه يوم من
+
+219
+00:13:30,790 --> 00:13:33,710
+الأيام ننصح حتى الأطباء ما تقول أنا وين لا لا لا
+
+220
+00:13:33,710 --> 00:13:37,310
+كتير من ال .. حتى في الأخرين يكون الليجان المشتركة
+
+221
+00:13:37,310 --> 00:13:40,250
+اللي بتسير بالعكس رؤساها التمريد و بيكونوا فيها
+
+222
+00:13:40,250 --> 00:13:43,210
+أطباء كتيرأنا نفسي تعزيزي عامة كتير من اللاجئين
+
+223
+00:13:43,210 --> 00:13:45,450
+كانت تحديد يعني كانوا يكونوا معايا طب انا أكون
+
+224
+00:13:45,450 --> 00:13:48,710
+مسئول عنهم الأمر مش معقد يعني يعني مانا بنستيين في
+
+225
+00:13:48,710 --> 00:13:52,210
+نفسنا انتوا الحمد لله بخير و بتقدروا يعني بقولي لو
+
+226
+00:13:52,210 --> 00:13:55,130
+سمحت في هي anterior و في posterior بس بقولي يا ريت
+
+227
+00:13:55,130 --> 00:13:57,650
+و انت عارف في ال anterior و ال posterior يا ريت
+
+228
+00:13:57,650 --> 00:14:00,810
+يكونوا اتناشر locations اتناشر locations يعني
+
+229
+00:14:00,810 --> 00:14:04,670
+اتناشر مكان بنقدر نعمله assessment عن طريق ال
+
+230
+00:14:04,670 --> 00:14:09,260
+stethoscope و 14من الـ A من الخلف طبعا هو هنا رسم
+
+231
+00:14:09,260 --> 00:14:11,560
+لنا يعني انا مابده ان انا اشرحه هنا بالظبط اماكن
+
+232
+00:14:11,560 --> 00:14:15,490
+ايه قدامكوالكن عشان يقوللي و يأكدلي انه يعني
+
+233
+00:14:15,490 --> 00:14:19,430
+مابيجوزش انه انت مرتين تسمع في الأمام و مرتين تسمع
+
+234
+00:14:19,430 --> 00:14:23,330
+في الخلف او مرة و يكفي ذلك لأ الصح لأن ربما احنا
+
+235
+00:14:23,330 --> 00:14:26,610
+نكشف شغلة في منطقة معينة يعني ماسمعلاش بعض الناس
+
+236
+00:14:26,610 --> 00:14:31,430
+عنده جال عندك inflammation في ال lower lung ايش
+
+237
+00:14:31,430 --> 00:14:34,950
+يعني؟ و مرات بيقولك في ال lower loop in the right
+
+238
+00:14:34,950 --> 00:14:39,190
+lung يعني كأنه بيقوللي في الرقى اليمنى في المنطقة
+
+239
+00:14:39,190 --> 00:14:42,310
+يعني معناته الإنسان بيقدر و ال stethoscope يستطيع
+
+240
+00:14:43,120 --> 00:14:47,460
+يقدر يسمع الصوت نفسه كويس بشكل طبيعي و بيقدر يحدد
+
+241
+00:14:47,460 --> 00:14:50,000
+و هذا اتمنى على الأطباء انه يقدر يجوموا بيه.
+
+242
+00:14:50,560 --> 00:14:53,160
+Escalate symmetrically، طبعا مش symmetrically يعني
+
+243
+00:14:53,160 --> 00:14:57,040
+بالتجانس، يعني .. يعني بانتظام زي ايش؟ زي
+
+244
+00:14:57,040 --> 00:15:00,420
+symmetry، بانتظام، مابدي مرة فوق مرة تحت، لأ امشي
+
+245
+00:15:00,420 --> 00:15:03,680
+بالنقاط شوية شوية نقطة نقطة حتى تصل ايه لنقطة
+
+246
+00:15:03,680 --> 00:15:08,810
+الأخيرة.وزي ما قلنا إذا الإنسان أو الطبيب شوية مش
+
+247
+00:15:08,810 --> 00:15:11,970
+قادر و هذا الكلام موجود عندنا خاصة مع ضغط العمل
+
+248
+00:15:11,970 --> 00:15:15,830
+يسيطر على أقل الإنسان فينا يسمع جديش six locations
+
+249
+00:15:15,830 --> 00:15:19,250
+anteriorly and posteriorly يعني لو ماقدرناش على
+
+250
+00:15:19,250 --> 00:15:24,650
+أقل يسمعله ست أماكن يعني هم اختلفوا هل الست
+
+251
+00:15:24,650 --> 00:15:28,630
+الأماكن يعني أمام و ست أماكن خلف ولا ست أماكن قدام
+
+252
+00:15:28,630 --> 00:15:33,310
+و ورا على أقل يعني احنا ممكن نقبل في أسوأ الظروف
+
+253
+00:15:33,670 --> 00:15:37,230
+إنه يعني الست أماكن يعني ورا وجدها مش مشكلة يعني
+
+254
+00:15:37,230 --> 00:15:40,830
+بحيث أنه نقدر على الأقل نعرف إذا في مشكلة ولا لأ و
+
+255
+00:15:40,830 --> 00:15:44,590
+لا و لأ و لأ طبعا يعني غير مقنع علميا بشكل كبير ال
+
+256
+00:15:44,590 --> 00:15:50,490
+breath sounds أصوات النفس زي ما فيها hard sounds
+
+257
+00:15:50,490 --> 00:15:54,010
+زي ما في حاجة اسمها breath sounds يعني زي ما في
+
+258
+00:15:54,010 --> 00:15:57,370
+أصوات لدقات القلب dub dub وغيره مثلا و sound one و
+
+259
+00:15:57,370 --> 00:15:59,630
+sound two و sound three زي ما في عندنا حاجة اسمة
+
+260
+00:15:59,630 --> 00:16:03,320
+إيه في حاجة اسمة أصوات النفسطب أصوات النفس إيش بده
+
+261
+00:16:03,320 --> 00:16:06,320
+أعمل فيها؟ بقوللي إيه بدك تعملها analyze according
+
+262
+00:16:06,320 --> 00:16:10,640
+to a to b تشوف حدتها intensity كتافة شدتها ال
+
+263
+00:16:10,640 --> 00:16:14,940
+quality كيف كيفيتها relative duration وقتيه كدهش
+
+264
+00:16:14,940 --> 00:16:17,460
+مدتها بالظبط كده في ال inspiration و ال expiration
+
+265
+00:16:17,460 --> 00:16:24,800
+يعني و أنت بتسمع في صوت النفس شوف ليه حدته كيفيته
+
+266
+00:16:24,800 --> 00:16:30,850
+قوي ضعيف هل هو ضعيف في ال inspirationوقوي في ال
+
+267
+00:16:30,850 --> 00:16:34,790
+expiration و لا العكس بدنا نشوف إيش بالظبط اللي
+
+268
+00:16:34,790 --> 00:16:38,270
+احنا يعني موجود علشان نقدر نعمل ال assessment و
+
+269
+00:16:38,270 --> 00:16:42,750
+ندونه طيب الان نيجي على الأصوات و كتير من الناس و
+
+270
+00:16:42,750 --> 00:16:45,970
+ممكن هذه الأسئلة بتيجي مرات كتير في انتحارات
+
+271
+00:16:45,970 --> 00:16:49,750
+التوظيف بالمناسبة بيسألونا في هذه المناطق بالذات
+
+272
+00:16:49,750 --> 00:16:52,970
+بيجي و بيقولك حاجة فيها يسمى bronchial breath
+
+273
+00:16:52,970 --> 00:16:56,410
+soundsلما نقول كلمة البرونكا ال brief sounds يعني
+
+274
+00:16:56,410 --> 00:16:59,130
+أصوات العلاقة ما زال .. ما زال كل كلمة البرونكا
+
+275
+00:16:59,130 --> 00:17:04,030
+يعني جاية من البرونكاس طيب إيش قصد هذا البرونكاس؟
+
+276
+00:17:04,030 --> 00:17:07,110
+بقولي الآن هذا القصب الهوائي اللي بتحكي عنه إيش
+
+277
+00:17:07,110 --> 00:17:12,530
+مالها؟ بقولي normally عشان تعرف الصوت تبعها، بعض
+
+278
+00:17:12,530 --> 00:17:15,950
+الناس هيقولي أنا ما بتترجموها و تقولي معناته صوت
+
+279
+00:17:15,950 --> 00:17:19,630
+الهواء في القصب، لأ أنا بدنا نعرف وين هذا الصوت و
+
+280
+00:17:19,630 --> 00:17:24,260
+كيف بيكون وين موجودهذا الصوت موجود بالظبط على
+
+281
+00:17:24,260 --> 00:17:28,860
+الإتراكية، قصب الهوية، لكن كيف أسمعه؟ لو كل واحد
+
+282
+00:17:28,860 --> 00:17:32,820
+فينا، و أكيد كلكم معاكوا سماعات، يمسك السماعة اللي
+
+283
+00:17:32,820 --> 00:17:36,980
+معاه، يحطها على دنيه و يحطها عايش هنا، يحطها على
+
+284
+00:17:36,980 --> 00:17:41,300
+منطقة الرقبة من اليمين أو من اليسار، من اليمين أو
+
+285
+00:17:41,300 --> 00:17:45,910
+من اليساريعني الآن جاب السماعة حطها في دنيا حط ..
+
+286
+00:17:45,910 --> 00:17:48,810
+حط .. بعد ما حط السماعة .. التنتين طبعا ال tubes
+
+287
+00:17:48,810 --> 00:17:52,030
+في دنيا جاب حط ال diaphragm على منطقة اللي هو
+
+288
+00:17:52,030 --> 00:17:55,930
+الرقبة من اليمين أو من اليسار وعص شوية و أخد نفس
+
+289
+00:17:55,930 --> 00:18:01,330
+لو كل واحد فينا بس جربها أخد نفس هيك هيسمع الصوت
+
+290
+00:18:01,330 --> 00:18:05,210
+هذا الصوت إيش اسمه؟ اسمه bronchial breath sound
+
+291
+00:18:05,210 --> 00:18:09,510
+خلاص طبعا صوته هتحس كأنه في هوا بدخل في تجويف
+
+292
+00:18:09,890 --> 00:18:13,370
+والتجارة زي كأنه صوت بدخل فيه مسورة أنا مش هتكلم
+
+293
+00:18:13,370 --> 00:18:18,370
+كتير في هذه المنطقة لأنه هتسمعوا لحالكم لكن لو
+
+294
+00:18:18,370 --> 00:18:21,070
+سمعنا .. لو سمعنا هذا الصوت ما هو ليش بقولي لازم
+
+295
+00:18:21,070 --> 00:18:24,550
+تسمعوه؟ عشان لو سمعته في مكان تاني معناه فيه مشكلة
+
+296
+00:18:24,550 --> 00:18:28,390
+يعني هذا الصوت اللي سمعناه عند الرقبة اللي هو ال
+
+297
+00:18:28,390 --> 00:18:31,990
+bronchi اللي بيبقى normal يبقى normal يكون على
+
+298
+00:18:31,990 --> 00:18:34,790
+التركية لكن abnormal يكون على أماكن تانية زي ايش
+
+299
+00:18:34,790 --> 00:18:38,410
+بقولي افرض انت روحت اسمعته على ال lung tissue تحت
+
+300
+00:18:38,900 --> 00:18:41,700
+معناته ايش بيقولي؟ في pathological condition ايش
+
+301
+00:18:41,700 --> 00:18:46,220
+يعني؟ لأ لأ في شغل مرضية وخطيرة شوية طب ايش هي؟
+
+302
+00:18:46,220 --> 00:18:50,020
+بيقولي في بعض الحالات بتكون high pitched loud ..
+
+303
+00:18:50,020 --> 00:18:52,580
+ايش high pitched loud؟ يعني بتكون صوت عال كتير ال
+
+304
+00:18:52,580 --> 00:18:55,960
+sound كمان خاصة في ايش هنا؟ بيقولي ال sound هذا
+
+305
+00:18:55,960 --> 00:19:00,000
+decrease in spiratory and lengthen .. ايش هنا؟
+
+306
+00:19:00,000 --> 00:19:03,980
+increase in spiratory phases بعض ال .. يعني ركزوا
+
+307
+00:19:03,980 --> 00:19:07,640
+معايا بعض الأصوات .. بعض الأصوات بتكون صوت عال
+
+308
+00:19:07,640 --> 00:19:14,910
+كتيرصوت عال كتير لكن بتخف في النفس اللي داخل و
+
+309
+00:19:14,910 --> 00:19:19,470
+بتزيد في النفس اللي طالع طب لو واحد سألني قال طب
+
+310
+00:19:19,470 --> 00:19:22,730
+ليش يا أستاذ خفت في النفس اللي داخل؟ الإنسان لما
+
+311
+00:19:22,730 --> 00:19:26,310
+باخد النفس هو يعني طبيعي مافيش مشكلة افرض و أجبد و
+
+312
+00:19:26,310 --> 00:19:30,470
+طلع النفس بشكل عام لكن في pathological problems أو
+
+313
+00:19:30,470 --> 00:19:33,070
+some abnormalities أو some meteors أو some foreign
+
+314
+00:19:33,070 --> 00:19:36,070
+body الآن لما نكون في foreign body مش قادر نطلع
+
+315
+00:19:36,070 --> 00:19:41,170
+الهواء بسهولة زي ما أخدهمفإيش صار؟ زاد الصوت،
+
+316
+00:19:41,170 --> 00:19:45,010
+معناته أنا ماقدرش لسه أشخص الآن و أقول فيه مشكلة،
+
+317
+00:19:45,010 --> 00:19:49,710
+لكنه أعطاني .. بعض أعطاني أنه بيقوللي يعني طب متى
+
+318
+00:19:49,710 --> 00:19:53,230
+بيخف الصوت؟ أنت قولتلنا أن فيه tumor ممكن يكون أو
+
+319
+00:19:53,230 --> 00:19:57,410
+فيه abnormalities أو فيه أي شيء طب متى بيكون الصوت
+
+320
+00:19:57,410 --> 00:20:01,990
+شبه معدم؟ absent or decreased؟ بيقوللي الصوت مرات
+
+321
+00:20:01,990 --> 00:20:06,110
+بيكون لا قدر الله ممكن يكون مخف الصوت أو خفيف جدا
+
+322
+00:20:06,110 --> 00:20:10,350
+إذا في foreign bodyطب حد بيقولي طب ليش الفرنباطي
+
+323
+00:20:10,350 --> 00:20:13,350
+هنا؟ اجي كمان مرة اقرأ بس الفرنباطيون موجود هنا في
+
+324
+00:20:13,350 --> 00:20:16,510
+ال plural space في منطقة ال plural cavity شوف لوين
+
+325
+00:20:16,510 --> 00:20:20,990
+رايح جوا جوا جوا فخفف صوت طبع النفس مش بس هيك
+
+326
+00:20:20,990 --> 00:20:24,130
+bronchial obstruction احنا قلنا اللي الصوت هداش
+
+327
+00:20:24,130 --> 00:20:28,390
+بتكون عالي طب لما الصوت تصير باطي اش بيكون هنا؟ في
+
+328
+00:20:28,390 --> 00:20:30,750
+علاقة در الله bronchial obstruction زي اللي اسمح
+
+329
+00:20:30,750 --> 00:20:35,030
+الله bronchial carcinoma مثلا عنده مصيبة فالصوت
+
+330
+00:20:35,030 --> 00:20:39,120
+بيبطي يكون عالي كتيرطيب، في بعض الناس بيعرفش تنفس
+
+331
+00:20:39,120 --> 00:20:42,700
+.. نفس سريع، دائما نفسه shallow breathing، إيش
+
+332
+00:20:42,700 --> 00:20:46,080
+يعني ال shallow breathing؟ يعني نفسه نفس يعني
+
+333
+00:20:46,080 --> 00:20:51,480
+خفيف، نفس سطحي، والنفس السطحي بيكون صوته واطي، زي
+
+334
+00:20:51,480 --> 00:20:54,680
+ما نيجي الطفل تعالوا جنبه، يدوبك تسمع نفسه، حتى
+
+335
+00:20:54,680 --> 00:20:56,860
+الإمارات بتخاف على إبن الوليد، بيصيروا بتقولك
+
+336
+00:20:56,860 --> 00:20:59,960
+لحسين يكون صارله حاجة، من شدة ما هو نفسه إيش هنا
+
+337
+00:20:59,960 --> 00:21:03,540
+shallow، لكن لما الإنسان بيكون تعبان ومرهق وعمال
+
+338
+00:21:03,540 --> 00:21:07,550
+وفي عنده ديك نفس بتلاقيه بتنفس نفس عميقةوفي حالات
+
+339
+00:21:07,550 --> 00:21:09,850
+ايه كمان؟ في حالتين في زيما، طبعا كده انتوا عرفتوا
+
+340
+00:21:09,850 --> 00:21:13,010
+ليش؟ لأن الصوت .. لأنه اللي جات عمال هو كله عماله
+
+341
+00:21:13,010 --> 00:21:15,990
+بيطلع برا فمش جادر الإنسان ياخد النفس ازاد ولا
+
+342
+00:21:15,990 --> 00:21:19,570
+يطلع النفس اللي موجود عنده، فإيش صار هنا؟ صار
+
+343
+00:21:19,570 --> 00:21:23,450
+عملية اللي هو نقص في الصوت اللي هو النفس اللي طالع
+
+344
+00:21:23,450 --> 00:21:30,710
+بالسمعة طيب normal breath sounds إيش أصوات؟ طبعا
+
+345
+00:21:30,710 --> 00:21:33,910
+أنا عماهل بشرح في هذا .. قلنا الشبط لإنه شويه مهم
+
+346
+00:21:33,910 --> 00:21:39,290
+لناإنه نفهم كل حاجة Normal breath sounds الآن
+
+347
+00:21:39,290 --> 00:21:44,050
+أصوات النفس الطبيعية أول صوت اسمه Trachea Trachea
+
+348
+00:21:44,050 --> 00:21:46,970
+اللي احنا قلنا عنه الصوت اللي وين اللي مباشرة فوق
+
+349
+00:21:46,970 --> 00:21:50,010
+عالي عالي عالي طب ما ما زال عالي و عند الرقم و كذا
+
+350
+00:21:50,010 --> 00:21:53,130
+إيش قال لي very loud إيش يعني very loud لو إحنا
+
+351
+00:21:53,130 --> 00:21:57,010
+سمعنا لحنة هنحكوا هتلاقي صوته عالي high بتجد حدته
+
+352
+00:21:57,010 --> 00:22:00,390
+عالية ال sound كأنه في مصورة هيك بيدخل الهواء
+
+353
+00:22:01,970 --> 00:22:05,410
+inspiratory تساوي إيه؟ expiratory لو أجي حد سألني
+
+354
+00:22:05,410 --> 00:22:09,750
+طب ليه؟ قال لي في ال sound هنا duration يعني في
+
+355
+00:22:09,750 --> 00:22:14,550
+مدة الصوت النفس يعني مدة الصوت سواء الإنسان أخد
+
+356
+00:22:14,550 --> 00:22:19,950
+النفس أو طلع النفس بكون أيش متساوي ليه متساونا؟
+
+357
+00:22:19,950 --> 00:22:23,910
+عشان النفس هي أصلا مصورة واحدة هي اللي بتدخل و
+
+358
+00:22:23,910 --> 00:22:27,860
+بتطلع النفس طب و لما بقول يعني النفسيعني نفس قطر
+
+359
+00:22:27,860 --> 00:22:31,440
+اللي هو التراكية اللي بيدخل فيها الهواء و بيخرج
+
+360
+00:22:31,440 --> 00:22:35,060
+منها عشان هيك بيطلع نفس اللي هو ايه نفس مدة الصوت
+
+361
+00:22:35,060 --> 00:22:39,180
+سواء دخولا او خروجا لكن لما ننزل لتحت شوية لأ
+
+362
+00:22:39,180 --> 00:22:42,040
+بيصير مختلف لأنه يعني ال right lung غير على ال
+
+363
+00:22:42,040 --> 00:22:45,380
+left lung وكذا خاصة في التدريس اللي هو التشرحية
+
+364
+00:22:45,380 --> 00:22:48,560
+اللي احنا أخدناها زمان في عندنا كمان انا بقولي
+
+365
+00:22:48,560 --> 00:22:50,520
+over ال .. ما احنا قلناه خلاص و اننا بنسمعها في ال
+
+366
+00:22:50,520 --> 00:22:54,640
+over تراكية طب ال bronchial هلجيت حاجة ننزلنا لتحت
+
+367
+00:22:54,640 --> 00:22:58,930
+شويةالبرونكيل هلجيت بقولي برضه إيش هنا loud هلجيت
+
+368
+00:22:58,930 --> 00:23:04,670
+هذه القصبة تحت البرونكيل ال main bronchi خاصة الآن
+
+369
+00:23:04,670 --> 00:23:07,230
+بقولي برضه loud و high و pitch sound نفس القضية
+
+370
+00:23:07,230 --> 00:23:11,370
+برضه عالي لكن إيش بقولي هنا ه ال expiratory sound
+
+371
+00:23:11,370 --> 00:23:16,170
+ه ال expiratory sound إيش معنى هنا بكون أكبر من
+
+372
+00:23:16,170 --> 00:23:21,910
+inspiratory sound أكبر من inspiratory sound طيب
+
+373
+00:23:21,910 --> 00:23:28,060
+سبحان الله يعني طب ليش؟الان تخيلوا معايا .. الان
+
+374
+00:23:28,060 --> 00:23:30,460
+.. الان لما الإنسان باخد نفسه .. تخيل إن هي أخد
+
+375
+00:23:30,460 --> 00:23:36,760
+نفسها .. طلع نفسه .. نفسه هو طالع بكون شوية سريع
+
+376
+00:23:36,760 --> 00:23:39,340
+أكتر من دخوله .. دخوله اللي بده يتغلغل شوية لتحت
+
+377
+00:23:39,340 --> 00:23:43,400
+عشان يصل ل gas exchange، بعدين يطلع مرة واحدة، فهو
+
+378
+00:23:43,400 --> 00:23:46,420
+هان لما الجسوها لاجو ال expiratory هنا إيش معنو؟
+
+379
+00:23:46,420 --> 00:23:49,920
+أعلى و أكبر شوية من إياش من inspiratory soundطيب
+
+380
+00:23:49,920 --> 00:23:53,860
+وين نسمعه هيرد هنا على ال manipura؟ طبعا انتوا
+
+381
+00:23:53,860 --> 00:23:57,200
+كلكم عارفين من اللي هي ال maniprium اللي هو خاصة
+
+382
+00:23:57,200 --> 00:24:00,540
+في منطقة الستيارة من اللي فوق، انتوا طبعا في
+
+383
+00:24:00,540 --> 00:24:03,000
+التشريح كلكوا ذاكرين هذا المكان بالظبط التشريح هنا
+
+384
+00:24:03,000 --> 00:24:07,520
+فوق، if هيرد إذا سمعنا ال bronchial breathing هذا،
+
+385
+00:24:07,520 --> 00:24:11,440
+شفنا لا قدر اللهفي other location يعني في مكان
+
+386
+00:24:11,440 --> 00:24:15,680
+تاني، ايش بيأكدلي لأ في حاجة اسمها consolidation،
+
+387
+00:24:15,680 --> 00:24:18,780
+ايش انا consolidation؟ مابدي حد هي ترجمة، هاي
+
+388
+00:24:18,780 --> 00:24:22,180
+ترجمة ترجمة consolidation اللي lung tissue filled
+
+389
+00:24:22,180 --> 00:24:26,360
+with liquid instead of air لما لا قدر الله، الرئة
+
+390
+00:24:26,360 --> 00:24:28,480
+دي زي الموضوع في ال coronavirus اليوم لو بيصير
+
+391
+00:24:28,480 --> 00:24:31,860
+inflammatory process و بيصير يعني صعبة كتير خاصة
+
+392
+00:24:31,860 --> 00:24:36,160
+يعني أخطر من النمونيا نفسهافبسيريام تمتلق اللي هو
+
+393
+00:24:36,160 --> 00:24:40,300
+أنسجة الرئتين بالمية أكترها .. أنسجة الرئتين
+
+394
+00:24:40,300 --> 00:24:44,180
+بالإيه؟ بالمية أكتر من إمتلاقها .. أكتر من
+
+395
+00:24:44,180 --> 00:24:47,780
+إمتلاقها بالهواء هذا إيش بنسميه consolidation يبقى
+
+396
+00:24:47,780 --> 00:24:51,420
+لو سمعنا هذا الصوت في أماكن تانية معناته لأ في
+
+397
+00:24:51,420 --> 00:24:54,620
+حاجة باسمها lung consolidation اللي هي ترجمتها
+
+398
+00:24:54,620 --> 00:24:59,030
+قدامنا طب في حاجة مصطلح جديد اسمه هنا railRail
+
+399
+00:24:59,030 --> 00:25:02,650
+معناه تخرخشة كركعة مش مشكلة بس إحنا بنفهم إيش نقصد
+
+400
+00:25:02,650 --> 00:25:06,190
+فيه أصوات يعني بنفهمها و نعرف إيش خاصة إنه فيه
+
+401
+00:25:06,190 --> 00:25:09,930
+كمان صوت جاينا اسمه Ronkai خليني أتكلم في ال rail
+
+402
+00:25:09,930 --> 00:25:14,350
+أول حاجة ريل عبارة عن short صوت discrete يعني
+
+403
+00:25:14,350 --> 00:25:18,370
+الشديد شوية Interrupted متقطع cracking إيش يعني
+
+404
+00:25:18,370 --> 00:25:22,010
+بحق في بعضه or bubbling يعني إيش bubbling بقبق
+
+405
+00:25:22,010 --> 00:25:25,450
+كأنه بيعمل صوت إيش بقبقه طب إيش أنا بقول most
+
+406
+00:25:25,450 --> 00:25:29,500
+commonly heard during inspirationهذا ال real إذا
+
+407
+00:25:29,500 --> 00:25:32,180
+سمعنا الصوت الكركع زي الصوت اللي احنا قلنا عنه ولا
+
+408
+00:25:32,180 --> 00:25:36,300
+تشبيه زي صوت الشيشة، إذا سمعنا صوت الإشي بيصير عند
+
+409
+00:25:36,300 --> 00:25:41,500
+المريض، هو بياخد النفس، enduring inspiration، إيش
+
+410
+00:25:41,500 --> 00:25:45,900
+بيسموه أنا بقول similar to sound؟ هو يشبه صوت اللي
+
+411
+00:25:45,900 --> 00:25:51,280
+كأنه .. كأنه شعر بنحكه بين أصابعنا rolledbetween
+
+412
+00:25:51,280 --> 00:25:55,000
+fingers ايش هنا close to ears يعني لو واحد جاب
+
+413
+00:25:55,000 --> 00:25:58,680
+شوية اكم من شعره اذا شعره طويل او مثلا حكي اكم من
+
+414
+00:25:58,680 --> 00:26:03,060
+شعره جنب أذنه مباشرة في صوت غريب بيطلع هذا الصوت
+
+415
+00:26:03,060 --> 00:26:07,600
+بيحكم جنب الأذن مباشرة اسمه rail ايش اسمه؟ rail
+
+416
+00:26:07,600 --> 00:26:12,020
+طبعا ماذا هذا الصوت بيصير في ال inspiration طيب
+
+417
+00:26:12,020 --> 00:26:15,440
+خلينا عشان احنا نقدر نحدد الأمور كويس يبقى ال rail
+
+418
+00:26:15,440 --> 00:26:21,430
+صوت متقطعمرات بيصير نوع من .. مش بس ايه كمان، اشي
+
+419
+00:26:21,430 --> 00:26:24,110
+كانوا بحتك في بعضه عملوا بيملق bubbling طب ال
+
+420
+00:26:24,110 --> 00:26:26,190
+bubbling كانت ايه يا عزيزي؟ زي صوت الشعر الجانب
+
+421
+00:26:26,190 --> 00:26:30,290
+الأذن؟ و بيقوللي هذا بيصير في ال inspiration هذا
+
+422
+00:26:30,290 --> 00:26:33,890
+ال rail بنقسم ل 3 أقسام، بنقسم ل إيه؟ 3 أقسام،
+
+423
+00:26:33,890 --> 00:26:39,310
+الآن طبعا هذه شغلات صح تخصية لكن كويس نعرفها برضه
+
+424
+00:26:39,310 --> 00:26:42,270
+و احنا يعني ما نقول والله هذا ال chapter صعب و مش
+
+425
+00:26:42,270 --> 00:26:45,910
+قادرين نفهمه، لأ الأمر كويس نفهمهو كويس نعرفه
+
+426
+00:26:45,910 --> 00:26:49,670
+لحياتنا لكن هو مش .. مش معقد في حاجة منها اسمها
+
+427
+00:26:49,670 --> 00:26:53,150
+low وفي medium وفي high طبعا بناء على كلمة pitched
+
+428
+00:26:53,150 --> 00:26:57,510
+يعني حدة اما حدة الصوت بتكون بسيطة او حدة متوسطة
+
+429
+00:26:57,510 --> 00:27:01,690
+او حدة عالية يعني صوت عالي طيب طبعا كله على بعض في
+
+430
+00:27:01,690 --> 00:27:05,290
+ال inspiration بيقولي ال low بيقولي هذا بيكون
+
+431
+00:27:05,290 --> 00:27:08,910
+course rails occurring in early in inspirationيعني
+
+432
+00:27:08,910 --> 00:27:13,590
+لما نحس أن حدث الصوت بسيطة بتكون في بداية النفس،
+
+433
+00:27:13,590 --> 00:27:18,190
+يعني أول ما يخد النفس ممكن تكون هذه الهوء، ليش؟
+
+434
+00:27:18,190 --> 00:27:20,690
+لانجاف البرونكايتس، إيش يعني ممكن نشك في
+
+435
+00:27:20,690 --> 00:27:24,250
+البرونكايتس؟ التهاب في الشعب الهوائي الرئيسي، لما
+
+436
+00:27:24,250 --> 00:27:27,550
+تكون الشعب الهوائي الرئيسي ملتهبة، المصورة واسعة
+
+437
+00:27:27,550 --> 00:27:31,590
+شوية، فالصوت لما تكون .. كل ما تكون المصورة واسعة،
+
+438
+00:27:31,590 --> 00:27:33,950
+كل ما الصوت بيكون في ضعيفة، تخيلوا معايا، زي لما
+
+439
+00:27:33,950 --> 00:27:36,250
+البربيش زمان و احنا صغار كنا نجيب البربيش اللي كان
+
+440
+00:27:36,250 --> 00:27:40,070
+ينحط فيه سلك الكهربو أي باربيش و نمسكه نلفه بيدنا
+
+441
+00:27:40,070 --> 00:27:43,510
+بلفة سريعة يعمل زي الصوت زي صفير ليه؟ على اعتبار
+
+442
+00:27:43,510 --> 00:27:47,170
+أنه كل ما بيضيق كل ما الصوت عمال بيعلق أكيد الكلام
+
+443
+00:27:47,170 --> 00:27:51,890
+زي ما واحد بيجي بسفر لما بديه يسفر كويس بتلاقي ضم
+
+444
+00:27:51,890 --> 00:27:56,330
+الفم على أصبعه أو أي شي عمل ضم كل ما انت بضايق زي
+
+445
+00:27:56,330 --> 00:27:59,310
+قضية الميه برضه كل ما نضغط عليها أكتر و نفتح بس
+
+446
+00:27:59,310 --> 00:28:03,510
+تقب بزيد قوة الميه يبقى الصوت الواطي بيكون
+
+447
+00:28:03,510 --> 00:28:07,320
+bronchitisيبقى معناته جاي من وين؟ من ال bronchi طب
+
+448
+00:28:07,320 --> 00:28:09,980
+إذا medium .. ال medium .. أجل ال medium يعني
+
+449
+00:28:09,980 --> 00:28:14,740
+معناته وين؟ من وسط .. من وسط النفس و أنا باخد طب
+
+450
+00:28:14,740 --> 00:28:18,840
+إيش بقوللي هنا؟ بقوللي في ال mid inspiration آه
+
+451
+00:28:18,840 --> 00:28:23,360
+هذا بيصير في وسط النفس اللي إحنا بناخده إذا في وسط
+
+452
+00:28:23,360 --> 00:28:27,040
+النفس إسمعنا .. إسمعنا ال rail بنسميه medium صوته
+
+453
+00:28:27,040 --> 00:28:31,360
+مش عالي كتير و مش واطي وسط بيكون إيش في عنده؟ عنده
+
+454
+00:28:31,360 --> 00:28:34,520
+حاجة اسمه bronchiectasis إيش يعني bronchiectasis؟
+
+455
+00:28:34,750 --> 00:28:38,510
+يعني في inflammation في ال small bronchi يعني بدأ
+
+456
+00:28:38,510 --> 00:28:42,990
+يصير التهاب في إيش؟ في الشعب خارجه الصغيرة شوية مش
+
+457
+00:28:42,990 --> 00:28:47,130
+الشعب الهوائية أو الحويصالات الدقيقة لأ أنا بتكلم
+
+458
+00:28:47,130 --> 00:28:50,290
+في الأول ال main bronchs الشعب الرئيسي بعدين متفرع
+
+459
+00:28:50,290 --> 00:28:53,310
+منهم انتوا عارفين في التشريح في ال bronchi بعدين
+
+460
+00:28:53,310 --> 00:28:55,550
+ال bronchioles بعدين ال alveoli و ال alveoli طب
+
+461
+00:28:55,550 --> 00:28:58,770
+الآن .. الآن بعدين ايش بيصيروا يقولوا ليه؟ لما
+
+462
+00:28:58,770 --> 00:29:03,440
+يصير التهابفي هذا المكان بقول إيش كلمة bronchitis
+
+463
+00:29:03,440 --> 00:29:06,480
+و ما .. لأ لازم قلت bronchitis بجعهان بقول مصطلح
+
+464
+00:29:06,480 --> 00:29:09,480
+جديد اسمه bronchiectasis إيش اسمه bronchiectasis
+
+465
+00:29:09,480 --> 00:29:13,080
+طيب و لا خدر الله طبعا هذا شويه صعب لإنه ممكن
+
+466
+00:29:13,080 --> 00:29:17,600
+يتحول بعد هيكم مش cancer بس في كتير من الحالات
+
+467
+00:29:17,600 --> 00:29:20,480
+بيصير حاسسه ان بييمة يعني بيصير bus بيصير مليان في
+
+468
+00:29:20,480 --> 00:29:27,160
+الرقم و بيصير حتى بعض الحالات في ال space نفسهالـ
+
+469
+00:29:27,160 --> 00:29:29,800
+intercostal space برضه كمان فيه شوية يعني bus و
+
+470
+00:29:29,800 --> 00:29:34,640
+ممكن الطبيب يتدخل انه يحاول السحب او عملية طيب إذا
+
+471
+00:29:34,640 --> 00:29:38,300
+كانت high معناه أين نزلنا نتحت؟ هلجت و أخد نفس؟
+
+472
+00:29:38,300 --> 00:29:41,840
+الآن صارت الصوت عالي كتير، معناه مازال الصوت عالي
+
+473
+00:29:41,840 --> 00:29:45,120
+يبقى وين؟ لأنه صارت إيش؟ عنق و زجاجة بده يضيق،
+
+474
+00:29:45,120 --> 00:29:48,420
+يبقى و ال .. و الحوايصل أوصل إلى وين؟ للبرونكيولز
+
+475
+00:29:48,900 --> 00:29:52,020
+Alveolitis الحواصلة الداخلية بتاعة الجاذبكسيتشينجي
+
+476
+00:29:52,020 --> 00:29:55,100
+علشان هيك صار الصوت عالي يبقاش بيصير عنده
+
+477
+00:29:55,100 --> 00:29:59,880
+bronchiolitis أو alveolitis علشان هيك و خلاص بيصير
+
+478
+00:29:59,880 --> 00:30:01,980
+عند الأطفال يبقى الصوت مابيكون عالي ليش؟ على
+
+479
+00:30:01,980 --> 00:30:07,560
+اعتبار أنه القطر تبع النفس الضيق جدا فالصوت هيكون
+
+480
+00:30:07,560 --> 00:30:10,700
+عالي علشان هيك سموه high pitched طيب الصوت اللي
+
+481
+00:30:10,700 --> 00:30:14,080
+بعده اسمه إيه؟ معلش أنا بدأ أسرع شوية عشان .. شوية
+
+482
+00:30:14,080 --> 00:30:19,050
+جلطت تلاتين دقيقةالصوت البعدي اسمه ايش؟ رونكاي ..
+
+483
+00:30:19,050 --> 00:30:22,330
+رونكاي .. الـ Ronkai continuous .. ايش يعني الصوت
+
+484
+00:30:22,330 --> 00:30:25,830
+بيكون ايش مستمر .. لكن خلّينا كويسين، عارفين ..
+
+485
+00:30:25,830 --> 00:30:28,290
+هذا الـ Ronkai غير عن ال rail .. هان ال rail ..
+
+486
+00:30:28,290 --> 00:30:30,910
+هان ال Ronkai .. طب ايش ال Ronkai؟ بيقوللي أول
+
+487
+00:30:30,910 --> 00:30:34,610
+حاجة .. ال Ronkai بيشبه الصوت اللي داخل من النار و
+
+488
+00:30:34,610 --> 00:30:38,310
+بسج .. ايش نار و بسج؟ زي من الممرات الضيقة .. زي
+
+489
+00:30:38,310 --> 00:30:42,710
+في التركية أو ال Ronkia ال tree خاصة في شجرة اللي
+
+490
+00:30:42,710 --> 00:30:46,210
+هو الشعيبات الهوية .. هذا بنسميه musical sounds
+
+491
+00:30:46,580 --> 00:30:50,360
+بيشبه الصوت بالظبط صرير الهواء اللى بدخل فى
+
+492
+00:30:50,360 --> 00:30:54,820
+البربيش اللى عامل زى اللولب البربيش اللى اللولبى
+
+493
+00:30:54,820 --> 00:30:58,800
+اللى هو زى الزنبراك عامل بيكون plastic و هذا لما
+
+494
+00:30:58,800 --> 00:31:02,660
+بيحركه اي بني ادم بيعمله صوت غريب لكن هذا الصوت
+
+495
+00:31:02,660 --> 00:31:06,040
+بيطلع سبحان الله فى ال X direction ايش صار الفرق
+
+496
+00:31:06,040 --> 00:31:09,700
+هناك هناك الصوت فى ايه فى ال N direction هذا الصوت
+
+497
+00:31:09,700 --> 00:31:12,780
+فى ايه فى ال X direction الصوت معناته انه بيطلع
+
+498
+00:31:12,780 --> 00:31:18,620
+اكتر و الإنسان بيطلع الصوتهناك من جسم لتلت أجسام،
+
+499
+00:31:18,620 --> 00:31:23,540
+هنا بس لجسمين، جسم اسمه low و جسم اسمه high، ايش
+
+500
+00:31:23,540 --> 00:31:26,600
+ال low؟ ال low اسمه sonorous، خليكوا حافظين بس
+
+501
+00:31:26,600 --> 00:31:31,600
+كلمات هذه، الآن كمام مرة ال رونكاي صوت موسيقي كأنه
+
+502
+00:31:31,600 --> 00:31:35,520
+في ممرات ضيقة بيصير الصوت مع خروج النفس مش مع دخول
+
+503
+00:31:35,520 --> 00:31:39,720
+النفس، هذا من قسم لقسمين، اما low واسمه sonorous،
+
+504
+00:31:39,720 --> 00:31:43,440
+لما انا اقول كلمة sonorousيعني من وين جاي؟ جاي من
+
+505
+00:31:43,440 --> 00:31:46,420
+ال large bronchus يعني من وين؟ من القصبة الأساسية
+
+506
+00:31:46,420 --> 00:31:51,320
+طب لما يقولي high اسمه Sibilant يبقى low اسمه
+
+507
+00:31:51,320 --> 00:31:53,840
+Sonorous خليكم ذاكرين ممكن يجينا في الامتحان low
+
+508
+00:31:53,840 --> 00:31:57,740
+Sonorous و ال high ايش اسمه؟ Sibilant طب ال
+
+509
+00:31:57,740 --> 00:32:00,360
+Sibilant ده ايش معناته؟ اللي هو ال wheezes زي
+
+510
+00:32:00,360 --> 00:32:03,960
+الصفير الشديد بيكون مين جاي من ال bronpules هنا
+
+511
+00:32:03,960 --> 00:32:08,240
+جاي من الشعيبات الكبيرة شوية هنا جاي من ايش؟من
+
+512
+00:32:08,240 --> 00:32:11,960
+حوالي الصلاة الهوائية اللي تحت شوية اللي في الآخر
+
+513
+00:32:11,960 --> 00:32:16,380
+علشان هيك .. و لاحظوا انه بيقوللي هنا انه هنا جاي
+
+514
+00:32:16,380 --> 00:32:19,700
+في ال late .. في ال late expiration و هذا في ال
+
+515
+00:32:19,700 --> 00:32:22,260
+early زي ما احنا قلنا في ايش؟ في ال early يعني إذا
+
+516
+00:32:22,260 --> 00:32:25,800
+الإنسان أول ما بده يطلع نفسه .. أول ما بده يطلع
+
+517
+00:32:25,800 --> 00:32:30,520
+نفسه طلع صوت صفير بسميه sonorous و بقول عنده
+
+518
+00:32:30,520 --> 00:32:36,860
+bronchitis طيب إذا آخر ما طلع نفسه زي هيك .. بعص
+
+519
+00:32:36,860 --> 00:32:41,350
+على حاله شويةطلع و عصق حال شوية اسمه Sibilant و
+
+520
+00:32:41,350 --> 00:32:43,810
+جاي من وين من ال bronchioles اللي هو Bronchiolitis
+
+521
+00:32:43,810 --> 00:32:49,010
+بدأ اشرح لعين ديانا ده عشان اتوقف لإن الوقت ميت و
+
+522
+00:32:49,010 --> 00:32:53,250
+ايه ماطولش كتير في اخد اللي هو .. هو كام من ضايل
+
+523
+00:32:53,250 --> 00:32:59,690
+الشبطر؟ لأ طيب مش مش خلاني انا .. نشرح بس اللي
+
+524
+00:32:59,690 --> 00:33:03,560
+ضايل Stridor و خلاص Stridorاللي بيسموه إيه زي
+
+525
+00:33:03,560 --> 00:33:05,740
+الصرير، إيش يعني strider؟ بيقول .. إيش يعني
+
+526
+00:33:05,740 --> 00:33:09,000
+الصرير؟ بيقول inspiratory musical ways هي عبارة عن
+
+527
+00:33:09,000 --> 00:33:16,600
+صوت .. يحدث صوت موسيقي .. sorry عشان تتبع معايا ..
+
+528
+00:33:16,600 --> 00:33:20,320
+inspiratory musical ways عبارة عن صوت صفير بيحدث
+
+529
+00:33:20,320 --> 00:33:23,420
+أثناء التنفس أكتر شيء بيصير عند مين؟ عند الناس
+
+530
+00:33:23,420 --> 00:33:27,080
+اللي عندهم chronic أزمة .. chronic أزمة، هذا اسمه
+
+531
+00:33:27,080 --> 00:33:30,860
+إيش .. هذا اسمه إيش striderبقول لي بكون عالي كتير
+
+532
+00:33:30,860 --> 00:33:34,900
+على الاتراكية، جنب اللي هو القصب الهوية الرئيسية،
+
+533
+00:33:34,900 --> 00:33:39,760
+suggest إيش بيخلينا نفكر إن في اتراكيا or larynx
+
+534
+00:33:39,760 --> 00:33:43,000
+فيها إيش هنا incident obstruction إما من لا سبحان
+
+535
+00:33:43,000 --> 00:33:46,200
+الله من tumor أو from body أو لا سبحان الله أخدت
+
+536
+00:33:46,200 --> 00:33:50,280
+trauma شديدة جدا عملتله obstructionطبعا هذا تعتبر
+
+537
+00:33:50,280 --> 00:33:52,880
+من ال medical emergency لأنه على اعتبار ان هذا
+
+538
+00:33:52,880 --> 00:33:55,800
+يعني دخول الهواء الرئيسي و إذا ما دخلش دغري بدنا
+
+539
+00:33:55,800 --> 00:33:59,580
+ندخله نحاول ندخل عشان ندخله النفس requiring
+
+540
+00:33:59,580 --> 00:34:02,460
+immediate attention بدنا انتباه فوري من الانتباه
+
+541
+00:34:02,460 --> 00:34:06,180
+الفوري في بعض الحالات بيعملوا الفتحة مباشرة في
+
+542
+00:34:06,180 --> 00:34:09,500
+مطقة الزغر هنا عشان يتنفس في بعضهم بدخله دغري على
+
+543
+00:34:09,500 --> 00:34:12,580
+المركز عشان يحطوله تنفس صناعي و endotracheal
+
+544
+00:34:12,580 --> 00:34:18,980
+intuition طبعا في بعض هنا associated اش هنالا قدر
+
+545
+00:34:18,980 --> 00:34:21,360
+الله إذا inhaled اللي هو from body، بعض الحالات
+
+546
+00:34:21,360 --> 00:34:26,900
+خاصة انا شفت من الحالات الغريبة طفل هو قاعد بيدحك
+
+547
+00:34:26,900 --> 00:34:29,880
+و أنا هذا الكلام كويس أنصحكم، اتشردك و خاصة كان
+
+548
+00:34:29,880 --> 00:34:34,840
+يقول اللي هو الفزق الحلبي فعمله مجرد ما هو ..
+
+549
+00:34:34,840 --> 00:34:39,660
+تعرفين يعني زهر الطفل مش كبير و مجرد ما يعني أنه
+
+550
+00:34:39,660 --> 00:34:43,570
+أشهج شويةفودّوا على المستشفى و انا اذكر انهم
+
+551
+00:34:43,570 --> 00:34:46,830
+ماقدروش يتسيطروا عليه اعتقد دي ان هو اتوفى فالأمر
+
+552
+00:34:46,830 --> 00:34:49,370
+مش سهل ليه؟ لأنه بيصير مستشفى تدوى عشان هيك انا
+
+553
+00:34:49,370 --> 00:34:52,690
+كتير بقول للناس يعني الإنسان هو ابوك الخاص الأكل
+
+554
+00:34:52,690 --> 00:34:55,370
+اللي فيه أشياء fragments يعني زي المكسرات شغلة زي
+
+555
+00:34:55,370 --> 00:34:59,350
+هيك مايحكيش كتير ولا .. و أخطر شيء ضحك أثناء الأكل
+
+556
+00:34:59,350 --> 00:35:01,990
+لإنه ممكن يصير form body inhalation و الله سبحانه
+
+557
+00:35:01,990 --> 00:35:04,870
+يعمل obstruction خلينا نتوقف عند هذه الشريحة ان
+
+558
+00:35:04,870 --> 00:35:07,310
+شاء الله و المحاضرة القادمة ان شاء الله نكمل
+
+559
+00:35:07,310 --> 00:35:09,830
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..0118a62cb0f45a30eee7c63b4e4f53d1a502bb62
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.json
@@ -0,0 +1 @@
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طبعا هو هنا رسم لنا يعني انا مابده ان انا اشرحه هنا بالظبط اماكن ايه قدامكوا", "tokens": [27842, 2423, 39184, 316, 9154, 33962, 46538, 23032, 3555, 3615, 995, 31439, 34105, 12602, 38251, 5296, 8315, 37495, 22653, 1975, 8315, 3714, 16758, 3215, 3224, 16472, 1975, 8315, 1975, 46309, 5016, 3224, 34105, 20666, 19913, 3555, 9566, 1975, 15042, 19452, 1975, 1829, 3224, 12174, 3215, 10943, 4117, 14407], "avg_logprob": -0.3919005004727111, "compression_ratio": 1.560747663551402, "no_speech_prob": 4.76837158203125e-07, "words": [{"start": 846.5, "end": 846.84, "word": "من", "probability": 0.63427734375}, {"start": 846.84, "end": 847.02, "word": " الـ", "probability": 0.429931640625}, {"start": 847.02, "end": 847.12, "word": " A", "probability": 0.6142578125}, {"start": 847.12, "end": 847.28, "word": " من", "probability": 0.70263671875}, {"start": 847.28, "end": 847.72, "word": " الخلف", "probability": 0.9677734375}, {"start": 847.72, "end": 848.5, "word": " طبعا", "probability": 0.86962890625}, 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fragments", "probability": 0.84912109375}, {"start": 2093.91, "end": 2094.19, "word": " يعني", "probability": 0.9384765625}, {"start": 2094.19, "end": 2094.39, "word": " زي", "probability": 0.95263671875}, {"start": 2094.39, "end": 2094.95, "word": " المكسرات", "probability": 0.9794921875}, {"start": 2094.95, "end": 2095.19, "word": " شغلة", "probability": 0.578857421875}, {"start": 2095.19, "end": 2095.37, "word": " زي", "probability": 0.990478515625}, {"start": 2095.37, "end": 2095.55, "word": " هيك", "probability": 0.73486328125}, {"start": 2095.55, "end": 2096.77, "word": " مايحكيش", "probability": 0.8599853515625}, {"start": 2096.77, "end": 2097.09, "word": " كتير", "probability": 0.9864908854166666}, {"start": 2097.09, "end": 2097.33, "word": " ولا", "probability": 0.7080078125}, {"start": 2097.33, "end": 2097.77, "word": " ..", "probability": 0.336181640625}, {"start": 2097.77, "end": 2097.85, "word": " و", "probability": 0.65771484375}, {"start": 2097.85, "end": 2098.17, "word": " أخطر", "probability": 0.8900146484375}, {"start": 2098.17, "end": 2098.41, "word": " شيء", "probability": 0.928466796875}, {"start": 2098.41, "end": 2098.75, "word": " ضحك", "probability": 0.88671875}, {"start": 2098.75, "end": 2099.03, "word": " أثناء", "probability": 0.974853515625}, {"start": 2099.03, "end": 2099.35, "word": " الأكل", "probability": 0.939453125}, {"start": 2099.35, "end": 2099.95, "word": " لإنه", "probability": 0.8013916015625}, {"start": 2099.95, "end": 2100.11, "word": " ممكن", "probability": 0.96728515625}, {"start": 2100.11, "end": 2100.31, "word": " يصير", "probability": 0.9290364583333334}, {"start": 2100.31, "end": 2100.55, "word": " form", "probability": 0.38427734375}, {"start": 2100.55, "end": 2100.75, "word": " body", "probability": 0.480224609375}, {"start": 2100.75, "end": 2101.29, "word": " inhalation", "probability": 0.735595703125}, {"start": 2101.29, "end": 2101.65, "word": " و", "probability": 0.7939453125}, {"start": 2101.65, "end": 2101.77, "word": " الله", "probability": 0.3525390625}, {"start": 2101.77, "end": 2101.99, "word": " سبحانه", "probability": 0.82470703125}, {"start": 2101.99, "end": 2102.29, "word": " يعمل", "probability": 0.7763671875}, {"start": 2102.29, "end": 2102.69, "word": " obstruction", "probability": 0.6591796875}, {"start": 2102.69, "end": 2103.15, "word": " خلينا", "probability": 0.7413736979166666}, {"start": 2103.15, "end": 2103.71, "word": " نتوقف", "probability": 0.9962158203125}, {"start": 2103.71, "end": 2104.19, "word": " عند", "probability": 0.386474609375}, {"start": 2104.19, "end": 2104.37, "word": " هذه", "probability": 0.9072265625}, {"start": 2104.37, "end": 2104.73, "word": " الشريحة", "probability": 0.9283447265625}, {"start": 2104.73, "end": 2104.87, "word": " ان", "probability": 0.58984375}, {"start": 2104.87, "end": 2105.01, "word": " شاء", "probability": 0.98583984375}, {"start": 2105.01, "end": 2105.15, "word": " الله", "probability": 0.96435546875}, {"start": 2105.15, "end": 2105.65, "word": " و", "probability": 0.7158203125}, {"start": 2105.65, "end": 2106.01, "word": " المحاضرة", "probability": 0.9783935546875}, {"start": 2106.01, "end": 2106.45, "word": " القادمة", "probability": 0.9798177083333334}, {"start": 2106.45, "end": 2106.63, "word": " ان", "probability": 0.63037109375}, {"start": 2106.63, "end": 2106.79, "word": " شاء", "probability": 0.99609375}, {"start": 2106.79, "end": 2106.83, "word": " الله", "probability": 0.96435546875}, {"start": 2106.83, "end": 2107.31, "word": " نكمل", "probability": 0.9933268229166666}, {"start": 2107.31, "end": 2107.91, "word": " والسلام", "probability": 0.79443359375}, {"start": 2107.91, "end": 2108.29, "word": " عليكم", "probability": 0.947998046875}, {"start": 2108.29, "end": 2108.75, "word": " ورحمة", "probability": 0.9329833984375}, {"start": 2108.75, "end": 2109.05, "word": " الله", "probability": 0.97509765625}, {"start": 2109.05, "end": 2109.83, "word": " وبركاته", "probability": 0.98935546875}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2111.4136875, "duration_after_vad": 2077.761249999994}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b63b82514f27c82379f415f43054ba472e22df10
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/C3uqA_pOLHE_raw.srt
@@ -0,0 +1,2236 @@
+1
+00:00:00,910 --> 00:00:06,050
+بسم الله الرحمن الرحيم خلينا الان نكمل وصلنا طبعا
+
+2
+00:00:06,050 --> 00:00:09,690
+ال assessment of ايه of thoracic expansion طبعا
+
+3
+00:00:09,690 --> 00:00:14,770
+انا يمكن شوية خليني اقول بطيق شوية بس في .. خاصة
+
+4
+00:00:14,770 --> 00:00:18,030
+في موضوع chest assessment او respiratory
+
+5
+00:00:18,030 --> 00:00:20,690
+assessment بشكل عام لأنه في شغلات بدنا نفهمها بشكل
+
+6
+00:00:20,690 --> 00:00:25,770
+واضح على مهل يعني شوية الان لما بيقولي thoracic
+
+7
+00:00:25,770 --> 00:00:30,300
+expansion يعني معناته ايش هناكأني بقول اتساع القفص
+
+8
+00:00:30,300 --> 00:00:33,560
+الصدر اتساع جديش بيوسع جديش لما يكون الإنسان بتنفس
+
+9
+00:00:33,560 --> 00:00:36,860
+.الآن طب كيف أنا بدي أشوف ال diameter؟ يعني بدي
+
+10
+00:00:36,860 --> 00:00:41,840
+أشوف كيف أنا بدي أعرف أنه هل بتنفس كتير، بتنفس
+
+11
+00:00:41,840 --> 00:00:46,040
+جليل، هل أنا اللي شايفه حكمت عليه بدون ما أتأكد؟
+
+12
+00:00:46,040 --> 00:00:49,380
+خلّيني أشوفه.الآن الصورتين اللي قادمات ان شاء الله
+
+13
+00:00:49,380 --> 00:00:53,460
+هيبيننا بالظبط اللي احنا بنحكيهبشكل واضح انا الان
+
+14
+00:00:53,460 --> 00:00:57,220
+هتكلم بس ايش ال .. ال .. ال .. بعض العبارات لكن ان
+
+15
+00:00:57,220 --> 00:01:00,080
+شاء الله الصورة هتصرح أكتر في حاجة اسمها anterior
+
+16
+00:01:00,080 --> 00:01:03,180
+و في حاجة اسمها posterior ايش يعني anterior يعني
+
+17
+00:01:03,180 --> 00:01:06,220
+anterior diameter انا بتكلمه posterior يعني
+
+18
+00:01:06,220 --> 00:01:10,080
+diameter يعني المقياس من الأمام او المقياس من
+
+19
+00:01:10,080 --> 00:01:12,840
+الخلف مش بحكي انها anterior يعني شو معناها لأ انا
+
+20
+00:01:12,840 --> 00:01:16,400
+بتكلم انه احنا كيف بدنا نشوف و احنا بنعمل
+
+21
+00:01:16,400 --> 00:01:20,330
+assessment للمريضنعرف إنه قداش حجم التنفس لو
+
+22
+00:01:20,330 --> 00:01:23,990
+اتطلعنا عليه من الأمام و كيف نشوف حجم التنفس لو
+
+23
+00:01:23,990 --> 00:01:28,110
+اتطلعنا عليه من خلفه طبعا إيش بقولي هنا؟ بقولي
+
+24
+00:01:28,110 --> 00:01:31,110
+استخدم إيدك على إيه؟ على ال anterolateral إيش
+
+25
+00:01:31,110 --> 00:01:34,770
+anterolateral؟ بيسموه الأمام الجانبي، كيف يعني؟ زي
+
+26
+00:01:34,770 --> 00:01:38,730
+ما يقولوا شمال الشرقي مثلا، لما نقول anterior
+
+27
+00:01:38,730 --> 00:01:43,830
+lateral يعني بنحط إيدنا على الجنبمابين مش أمام
+
+28
+00:01:43,830 --> 00:01:47,330
+مطلق ولا على الجانب مطلق يعني على جزء ما بين
+
+29
+00:01:47,330 --> 00:01:51,030
+الأمام و مابين الجانب و بحط أصابع اللي هو ال
+
+30
+00:01:51,030 --> 00:01:54,990
+thumbs أصابع الأتنين تبع إيدي التنتين في اتجاه إيش
+
+31
+00:01:54,990 --> 00:01:57,650
+هنا ال coastal marginal قلت بوريكوا هين بالظبط
+
+32
+00:01:57,650 --> 00:02:01,510
+احنا أفضل نروح للصورة عشان نكون واضحة لكن نكون
+
+33
+00:02:01,510 --> 00:02:05,090
+تاكرين نخليناها في حجم اللي هو ال tenth rib لما
+
+34
+00:02:05,090 --> 00:02:08,590
+بدنا نقوم نلبسه طيب تطلع عليها الآن هذا ال
+
+35
+00:02:08,590 --> 00:02:12,160
+anterior assessment and thoracic expansionلاحظين
+
+36
+00:02:12,160 --> 00:02:17,560
+أن هذه المريضة موجودة قدامنا وإن حط اللي هو الطبيب
+
+37
+00:02:17,560 --> 00:02:22,860
+أو حط اللي هو الحكيم حط إيده على الـ anterolateral
+
+38
+00:02:22,860 --> 00:02:27,280
+يعني ما راحش كله lateral ولا كله anterolateral وحط
+
+39
+00:02:27,280 --> 00:02:30,440
+هنا منطقة ال coast ليش يعني؟ يعني منطقة اللي هو
+
+40
+00:02:30,440 --> 00:02:33,880
+هذه الصينة هذه اللي قدامنا هذا العضمة اللي عضمة
+
+41
+00:02:33,880 --> 00:02:37,590
+القصر في النص بعدين نفسي القضيةالإيد التانية ..
+
+42
+00:02:37,590 --> 00:02:39,890
+هذا الإيد اليمين و هذا الإيد الشمال .. نفس القضية
+
+43
+00:02:39,890 --> 00:02:43,050
+حطهم و حط إيش .. يعني في فراغة .. شو الفراغة ده؟
+
+44
+00:02:43,050 --> 00:02:45,370
+احنا عارفين الفراغة؟ في عضمة هنا في النص .. ماشي
+
+45
+00:02:45,370 --> 00:02:48,870
+.. مش هذا موضوعنا .. الموضوع إن أنا حطيت إيديا
+
+46
+00:02:48,870 --> 00:02:54,350
+تنتين على جنبين المريض و بقول للمريض خد نفس عميق
+
+47
+00:02:54,350 --> 00:02:57,690
+.. في نفس الوقت أنا بتغطش كتير .. يعني أنا بحط
+
+48
+00:02:57,690 --> 00:03:02,120
+إيديالكن مش بحطهم كإني أنا .. كإني قاعد بضغط عليه
+
+49
+00:03:02,120 --> 00:03:05,840
+أو بتدخل جهة، لا أبدا، ولا بحطهم كإنهم بدهم يوجعوا
+
+50
+00:03:05,840 --> 00:03:09,280
+دايا، أنا بضغطهم .. يعني بحطهم على منطقة الصدر و
+
+51
+00:03:09,280 --> 00:03:12,720
+كإنهم حرات الحركة، يعني بروحوا بيجوا مع عضلات
+
+52
+00:03:12,720 --> 00:03:17,080
+التنفس، الآن نتنفس، المسافة اللي اتنفسها نختار ..
+
+53
+00:03:17,080 --> 00:03:20,580
+يعني خليك تخيلوا معايا إن الإصبعين دول رجعوا شوية
+
+54
+00:03:20,580 --> 00:03:23,980
+هذا ال hand و رجعوا هذا الإصبع لهنا، يعني مع
+
+55
+00:03:23,980 --> 00:03:27,340
+التنفس، لما ناخد inspiration رجعه شوية و هذا رجعه
+
+56
+00:03:27,340 --> 00:03:30,690
+شويةبعدين مع ال exploration عاوز أرجعه أنا بتكلم
+
+57
+00:03:30,690 --> 00:03:35,170
+لما ن .. رجعن مش لما كان المكان الآن لأ أول ما أخد
+
+58
+00:03:35,170 --> 00:03:39,090
+النفس على الآخر لو اين وصله نعتقد .. خلينا نفترض
+
+59
+00:03:39,090 --> 00:03:44,090
+أنه وصل التنفس نفترض أنه الآن المريض اللي أمامنا
+
+60
+00:03:44,090 --> 00:03:48,110
+أخد نفس عميق و هذا الفراغ اللي هنا إيش بعمل؟ بحط
+
+61
+00:03:48,110 --> 00:03:51,610
+علامة هنا و علامة هنا جلم جاف مش مشكلة علامة هنا و
+
+62
+00:03:51,610 --> 00:03:55,470
+علامة هنا بجيس المسافة بينهم مثل المسافة طلعت خمسة
+
+63
+00:03:55,470 --> 00:03:58,520
+سانتيسبعة صنطي، عشرة صنطي، أي ان كانت المسافة
+
+64
+00:03:58,520 --> 00:04:03,540
+تمام؟ هذه المسافة إيش اسمها؟ anterior thoracic
+
+65
+00:04:03,540 --> 00:04:08,620
+diameter طب نشوف ال posterior، ال posterior برضه
+
+66
+00:04:08,620 --> 00:04:12,020
+نرجع شوي الكلام هنا، إيش بيقول ليه؟ وين نحط؟ حط
+
+67
+00:04:12,020 --> 00:04:15,040
+إيديك posterior lateral، هنا وين نحط إيديك؟
+
+68
+00:04:15,040 --> 00:04:18,120
+anterior lateral طب يا تر أولين بيقولوا على منطقات
+
+69
+00:04:18,120 --> 00:04:21,280
+إيش؟حوالين اللي هو ال tenth rib يعني عند ال ..
+
+70
+00:04:21,280 --> 00:04:25,140
+تقريبا الريشة العاشرة على اعتبار انه اخر .. اخر
+
+71
+00:04:25,140 --> 00:04:27,980
+رياش انتوا عارفين بتكون free movable يعني متحركة
+
+72
+00:04:27,980 --> 00:04:31,960
+مش .. مش مسكرة فنرجع نفس الكلام على الصورة بقولي
+
+73
+00:04:31,960 --> 00:04:36,360
+اتحط ايدك هاي هنا posterior lateral و posterior
+
+74
+00:04:36,360 --> 00:04:39,160
+lateral طب مايجي واحد يقولي طب ليش أساسي مبين ان
+
+75
+00:04:39,160 --> 00:04:43,500
+انا مش قادر؟ ممكن يعني بيبين ايديها أصغر من مش
+
+76
+00:04:43,500 --> 00:04:46,960
+عارف مين اللي .. لأ في مين يبدو اللي طبيبة بيبين
+
+77
+00:04:46,960 --> 00:04:51,970
+انه ايديها هو ما شاء اللهيعني well-muscled او مثلا
+
+78
+00:04:51,970 --> 00:04:55,450
+obese client او هكذا فهي حطت في نفس الوقت مش مشكلة
+
+79
+00:04:55,450 --> 00:04:58,510
+مازال نفس ال examiner مافي مشكلة الآن و بنقوله يلا
+
+80
+00:04:58,510 --> 00:05:02,070
+اخد نفس .. بنجيس المسافة اللي وين نفس القضية طبعا
+
+81
+00:05:02,070 --> 00:05:05,350
+بيخلي ايدينا يتحركن مع النفس اخد نفس عميق بنحط هنا
+
+82
+00:05:05,350 --> 00:05:08,750
+أيش برضه علامة و علامة و بنجيس المسافة بينهم
+
+83
+00:05:08,750 --> 00:05:12,270
+الصحيح انه تطلع المسافة اللي هنا و المسافة اللي
+
+84
+00:05:12,270 --> 00:05:15,950
+أمام تكون زي بعض في مشكلة بنبلغ الطبيب طبعا هذه
+
+85
+00:05:15,950 --> 00:05:21,580
+للأسف أنا حزين أقولكوابيعملوا إيش؟ أنا ماشوفتش في
+
+86
+00:05:21,580 --> 00:05:24,700
+غزة من المرة حدا بيعملها، مع إنها شغلة من صفة
+
+87
+00:05:24,700 --> 00:05:28,520
+بتخصص اللي هو يعني على طبقة الصدرية و ربما هذه
+
+88
+00:05:28,520 --> 00:05:31,580
+تكشف شغلات يعني خطيرة إذا كان لها سمح الله أي
+
+89
+00:05:31,580 --> 00:05:33,860
+deformities أو لا سمح الله فيه أي حاجة في ال
+
+90
+00:05:33,860 --> 00:05:38,040
+spinal problems أو tumors أو هكذا، بغض النظر،
+
+91
+00:05:38,040 --> 00:05:40,960
+المهم إحنا هنا الآن by two ways، إيش يعني بالطريقة
+
+92
+00:05:40,960 --> 00:05:43,720
+التانية، اللي هي ال anterior و ال posterior، ستشعر
+
+93
+00:05:43,720 --> 00:05:47,030
+بال amount of thoracic expansion، أكيد طبعابتاك
+
+94
+00:05:47,030 --> 00:05:50,210
+تشوف قد ياش اتساء القفص صدري و رجوعه خاصة في ال
+
+95
+00:05:50,210 --> 00:05:53,530
+deep breathing يعني قد ياش كان لما ناخد نفس عميق و
+
+96
+00:05:53,530 --> 00:05:56,670
+جالي ايش كمان ال symmetry بتاك تشوف ايش ال
+
+97
+00:05:56,670 --> 00:06:00,350
+symmetry طبعا لما نقول كلمة symmetry يعني بتاك
+
+98
+00:06:00,350 --> 00:06:04,550
+تشوف التجانس هل نفس الشيء .. هل لا سبحان الله
+
+99
+00:06:04,550 --> 00:06:08,730
+بيميل اه بيميل يمين بيميل شوية ع الشمال هذا بيصير
+
+100
+00:06:08,730 --> 00:06:13,430
+ايش unsymmetry يعني مش متجانس مش متناسق يعني حاجة
+
+101
+00:06:13,430 --> 00:06:16,590
+بيسموها ال homeostasis او اللغة لا سبحان اللهيكون
+
+102
+00:06:16,590 --> 00:06:20,090
+عنده abnormalities طيب، الآن إيش بقولي بعديها
+
+103
+00:06:20,090 --> 00:06:23,950
+assessment of حاجة اسمها fremitus شو قصدك في ال
+
+104
+00:06:23,950 --> 00:06:27,690
+fremitus مصطلح جديد، fremitus هذه اسمها vibration
+
+105
+00:06:27,690 --> 00:06:31,010
+perceptible on إيش؟ on palpation لو أنت حاطط إيدك
+
+106
+00:06:31,010 --> 00:06:35,230
+على صدر المريض و جعمالك بتقوله خد نفس اسمعت كركعة
+
+107
+00:06:35,230 --> 00:06:38,810
+يعني كرهش كركعة يعني اسمعت حاجة تحت أصبيعك مش
+
+108
+00:06:38,810 --> 00:06:43,060
+طبيعيةيعني بغض النظر، خرخة، شكركة، اتسميها اللي
+
+109
+00:06:43,060 --> 00:06:47,920
+تسميها، اهتزاز، اشي مش طبيعي بنسميها fremitus لأن
+
+110
+00:06:47,920 --> 00:06:52,340
+احنا مش متخصين، لقدام شوية إذا لاجينا حالنا يعني
+
+111
+00:06:52,340 --> 00:06:55,760
+متعمقين في العلم بسيط، انا اعطي الأسماء الحقيقية
+
+112
+00:06:56,370 --> 00:06:58,850
+بعدين لأ قدر الله بيقوللي شوف إذا في subcutaneous
+
+113
+00:06:58,850 --> 00:07:01,430
+emphysema و أنا شرحت في المحاضرة السابقة شو ال
+
+114
+00:07:01,430 --> 00:07:04,830
+emphysema، أعيدها إن لما بيصير مرات كنا حوصالات
+
+115
+00:07:04,830 --> 00:07:08,050
+الهوية بيطلع من الهواء خاص على اعتبار إنه احتبس ال
+
+116
+00:07:08,050 --> 00:07:11,270
+oxygen ماقدرش و الهواء ماقدرش يصير exchange فصار
+
+117
+00:07:11,270 --> 00:07:16,190
+عملية إيش، losing و bulging مع الفلايفة للأسف طلع
+
+118
+00:07:16,190 --> 00:07:19,650
+الهواء و صار تحت اللي هو الجلد، منطقة الرقب و
+
+119
+00:07:19,650 --> 00:07:24,400
+منطقة الكتفين إيش سمنها emphysemaبقول لي يا ريت
+
+120
+00:07:24,400 --> 00:07:28,060
+تشوف ال tissue اللي حواليها خاصة إذا في cracking
+
+121
+00:07:28,060 --> 00:07:32,020
+.. إيش cracking notes .. notes يعني sounds صحيح؟
+
+122
+00:07:32,020 --> 00:07:36,060
+شو cracking sounds؟ في بعض الناس يمكن يعرف إيش
+
+123
+00:07:36,060 --> 00:07:39,300
+معناته cracking sounds حتى بسموها .. بعض الناس
+
+124
+00:07:39,300 --> 00:07:43,460
+بسموها crepitations .. crepitations اللي هي بسمها
+
+125
+00:07:44,800 --> 00:07:50,480
+زي صوت بالظبط هو صوت زي كركعة الشيشة شوفت لما ..
+
+126
+00:07:50,480 --> 00:07:54,160
+يعني ان شاء الله مايكون حدا من الطلاب او حتى .. لأ
+
+127
+00:07:54,160 --> 00:07:57,820
+تمنا حتى الأهلي يكون .. يكون يعني بشيش فلما بشيش
+
+128
+00:07:57,820 --> 00:08:01,220
+.. شوفت الميه لأو لما إذا تفرجت عليه مقطع في فيلم،
+
+129
+00:08:01,220 --> 00:08:04,900
+في مسلسل، في كده و هو بياخد الشيشة بتلاقي الميه
+
+130
+00:08:04,900 --> 00:08:09,260
+بتعمل زي كركعة هي خربطة مع الفقاعة بتطلع هذا الصوت
+
+131
+00:08:10,600 --> 00:08:14,760
+بصير لما يكون اللي سمح الله عنده حالة انفزيما طبعا
+
+132
+00:08:14,760 --> 00:08:17,960
+تشبه لو مواحد مش ذاكر في بعض الحالات أقولكم
+
+133
+00:08:17,960 --> 00:08:20,660
+مابتشبهش إذا أنتوا بتعرفوا النيلون اللي بيغلفوا
+
+134
+00:08:20,660 --> 00:08:25,380
+فيه مرات الأشياء الثمينة زي العطور الغالية أو حتى
+
+135
+00:08:25,380 --> 00:08:28,420
+أو بعض الأشياء الهدائية بيغلفوا فيها فالنيلون اللي
+
+136
+00:08:28,420 --> 00:08:32,200
+بيكون في جلبه داخله كله حبيبات هوائية و لما نضغط
+
+137
+00:08:32,200 --> 00:08:35,160
+عليه حتى بعض الطلاب و بعض البلد حتى بيحب هذه الشيء
+
+138
+00:08:35,160 --> 00:08:38,800
+انه لأنه على فكرة بيعمل حتى شوية راحة نفسي على بعض
+
+139
+00:08:38,800 --> 00:08:43,010
+الناسانه يظل يعص عليه ويظل يطجع يعني فيهن هذا يسمى
+
+140
+00:08:43,010 --> 00:08:45,130
+ايش repetitions علشان طولنا و احنا بحكي في هذا
+
+141
+00:08:45,130 --> 00:08:50,030
+الموضوع طيب percussion of the chest نيجي الآن على
+
+142
+00:08:50,030 --> 00:08:52,030
+ما عمل اي استخدام اللي هو ال skill اللي هي ال
+
+143
+00:08:52,030 --> 00:08:55,690
+percussion عشان نعمل ايش نشوف في amounts of air لأ
+
+144
+00:08:55,690 --> 00:09:00,030
+قدر الله في liquid موجود حاسس لأ سمح الله في solid
+
+145
+00:09:00,030 --> 00:09:02,550
+طبعا احنا عارفين الأصوات كل الصوت يختلف يعني و انا
+
+146
+00:09:02,550 --> 00:09:05,310
+بعمل .. قاعد بعمل percussion الصوت اختلف يمكن يكون
+
+147
+00:09:05,310 --> 00:09:08,190
+صوت liquid يمكن يكون صوت solid لأ سمح الله تيومر
+
+148
+00:09:08,190 --> 00:09:11,700
+او شيء من هذا القبيلعوين على منطقة ال lung .. ال
+
+149
+00:09:11,700 --> 00:09:15,640
+lung عشان أشوف أين رايحها الأمور وبطلع .. بشوف ال
+
+150
+00:09:15,640 --> 00:09:18,320
+boundaries .. إيش يعني ال boundaries؟ حدود اللي هو
+
+151
+00:09:18,320 --> 00:09:21,540
+حدود الأعضاء يعني و احنا بنعمل assessment كأنك ..
+
+152
+00:09:21,540 --> 00:09:24,160
+كأنك بتجيس في ال a في ال lungs كأنك بتجيس في حجم
+
+153
+00:09:24,160 --> 00:09:27,580
+ال lungs كديش موجودة و أنت بتطرق و بتعرف أنه وقت
+
+154
+00:09:27,580 --> 00:09:30,560
+إيش صوت اختلف انتهت الرئة و وقت إيش صوت اختلف
+
+155
+00:09:30,560 --> 00:09:35,300
+يمين، يسار، فوق أو تحت طيب ال percussion كتير من
+
+156
+00:09:35,300 --> 00:09:38,480
+الناس للأسف بيغلطوا بس أنا شغلاتي مكونوا واضحين
+
+157
+00:09:39,300 --> 00:09:44,340
+بيجي للأسف بيعمل عميل الطرق الطبيب مرتين اتلاتة
+
+158
+00:09:44,340 --> 00:09:47,120
+على منطقة صدره وكان بيقولك خلاص بيكفي لأ الصح هو
+
+159
+00:09:47,120 --> 00:09:50,640
+بيقوللي عشان نكون صارحين لازم نعمل anterior and
+
+160
+00:09:50,640 --> 00:09:53,540
+posterior and lateral يعني بدنا على الصدر من
+
+161
+00:09:53,540 --> 00:09:56,860
+الأمام وعلى الصدر من الخلف وعلى الجانبين نعمل إيش
+
+162
+00:09:56,860 --> 00:10:00,120
+percussion وبيقوللي all directions يعني يريت
+
+163
+00:10:00,120 --> 00:10:03,340
+الأطباء كمان يعني يتكرموا وهذه الأمور اللي انا
+
+164
+00:10:03,340 --> 00:10:08,350
+مرات .. ممكن انت حطيت hand بعد خمس صنطيمن نفس
+
+165
+00:10:08,350 --> 00:10:11,770
+المكان في عنده مشكلة فالإنسان يعني بعينه الله يعني
+
+166
+00:10:11,770 --> 00:10:16,050
+يتعب شوية و يعمل assessment أكتر دائما with about
+
+167
+00:10:16,050 --> 00:10:18,950
+five centimeters intervals يعني إيش بقوليه؟ يعني
+
+168
+00:10:18,950 --> 00:10:23,610
+يا ريت بقولي بس فقط خد خمسة سنة ما بين كل منطقة و
+
+169
+00:10:23,610 --> 00:10:27,470
+التانية فللأسف بنشوف بعض الناس بعمل طرقتين أمام أو
+
+170
+00:10:27,470 --> 00:10:30,370
+طرقة واحدة من الأمام أو في الخلف طرقتين و خلاص و
+
+171
+00:10:30,370 --> 00:10:33,720
+مع السلامةأما الـ auscultation استخدام السماعة
+
+172
+00:10:33,720 --> 00:10:36,800
+بتعطينا information على الـ function of the
+
+173
+00:10:36,800 --> 00:10:40,620
+respiratory system كيف قريت و كيف الوظيفة النفس
+
+174
+00:10:40,620 --> 00:10:43,860
+شغالة كويسة و لأ بصير أسمع الأصوات من الداخل أنا
+
+175
+00:10:43,860 --> 00:10:46,360
+في الأول كنت بدأ أسمع من الخارج لإذا كان الأمر ..
+
+176
+00:10:46,360 --> 00:10:49,360
+يعني .. كان visible يعني أو .. يعني .. audible
+
+177
+00:10:49,360 --> 00:10:52,980
+..مسموع لكن أنا جدا بدأ أشوف و أسمع .. sorry ..
+
+178
+00:10:52,980 --> 00:10:56,860
+يعني بدأ أسمع بالسماعة إيش موجود جوا عشان إيه؟
+
+179
+00:10:56,860 --> 00:10:59,780
+عشان إذا في detect أي إيش obstruction إذا في أي
+
+180
+00:10:59,780 --> 00:11:03,610
+obstructionفي ال passages فى مورات الهواء دُغر
+
+181
+00:11:03,610 --> 00:11:06,990
+تكشفها السماعة الطبيب اللى متخصص شاطر من السماعة
+
+182
+00:11:06,990 --> 00:11:10,350
+مجرد ما هو بيتنفس المريض حتى مش بس بيعمل .. بيقوله
+
+183
+00:11:10,350 --> 00:11:13,910
+انت عندك obstruction فى .. فى النفس لأ بيقوله عندك
+
+184
+00:11:13,910 --> 00:11:16,110
+obstruction فى البداية و لا فى النهاية و لا فى
+
+185
+00:11:16,110 --> 00:11:18,830
+الوسط و لا فى دخول الهواء و لا فى خروج الهواء
+
+186
+00:11:18,830 --> 00:11:23,630
+سبحان الله كل شيء لها يعني .. لو .. لو تشخيص محدد
+
+187
+00:11:23,630 --> 00:11:29,430
+و سماعة محددة الانش بيقوللى هنابقول لي ال client
+
+188
+00:11:29,430 --> 00:11:31,810
+to breathe through the mouth ليش هنا بقول لي
+
+189
+00:11:31,810 --> 00:11:35,230
+instruct بقول أحسن لما احنا بدنا نعمل assessment
+
+190
+00:11:35,230 --> 00:11:40,470
+خليه يتنفس ع طريق الفم علشان ايه slowly عالمها
+
+191
+00:11:40,470 --> 00:11:45,970
+شوية شوية before beginning بقول قبل ما نبدأ نفس و
+
+192
+00:11:45,970 --> 00:11:49,850
+قبل ما نبدأ نعمل assessment خلي المريض يخدله أكام
+
+193
+00:11:49,850 --> 00:11:54,090
+نفس عمقات مش يعني ليه بيجي الطبيب .. الحكيم بقولي
+
+194
+00:11:54,090 --> 00:12:00,720
+لو سمحت أولا خد راحتك خد نفسبرتاح بتعبى صدره
+
+195
+00:12:00,720 --> 00:12:03,880
+أكسجيني كويس بعدين بنعمل assessment ليه؟ مانجيش
+
+196
+00:12:03,880 --> 00:12:07,280
+للمريض مباغطة عشان ممكن المريض مع الخوف شوية أو
+
+197
+00:12:07,280 --> 00:12:10,860
+خليني أقول من أول استجابة ممكنش هو شوية
+
+198
+00:12:10,860 --> 00:12:15,360
+abnormalities يعني عملتله شوية stress وضيقته طيب
+
+199
+00:12:15,360 --> 00:12:20,060
+أسكالتاتزي ما احنا عملنا بركز كل منطقة برضه سكلتت
+
+200
+00:12:20,060 --> 00:12:23,100
+all area، إيش يعني؟ اسمع كل المناطق، برضه نفس
+
+201
+00:12:23,100 --> 00:12:26,440
+القضية بنقص الأطباء، إنه يريد يسمع كل المناطق، at
+
+202
+00:12:26,440 --> 00:12:29,880
+least إيش هنا؟ بقولي one complete respiration، إيش
+
+203
+00:12:29,880 --> 00:12:33,480
+يعني one؟ يريد، بس هي صعبة صحي على الأطباء، إنه
+
+204
+00:12:33,480 --> 00:12:37,080
+يقصد إنه كل ما نسمع مكان، نسمع complete
+
+205
+00:12:37,080 --> 00:12:40,520
+respiration، يعني كيف؟ أنا حطيت السماعة على مكان
+
+206
+00:12:40,520 --> 00:12:46,010
+معين، كل المريض خد نفس، طلع نفس،بعدين يرفع السماعة
+
+207
+00:12:46,010 --> 00:12:50,930
+مكان تاني، خد نفس؟ أنا اللي استغربتله بعض الأطباء،
+
+208
+00:12:50,930 --> 00:12:54,410
+أنا مابديش أعمم أنه بيجي ويقولوا خد نفس و أثناء ما
+
+209
+00:12:54,410 --> 00:12:58,290
+يقولوا خد نفس هو عمال بياخد inspiration، بيكون إيش
+
+210
+00:12:58,290 --> 00:13:01,290
+نجل ال status scope حوالي تلت أربع مرات، لاحقوا
+
+211
+00:13:01,290 --> 00:13:04,110
+الله و طلبوا الله، و هو بيطلع النفس، كمان نجله
+
+212
+00:13:04,110 --> 00:13:06,950
+مرتين تلتة، بيقولوا الله عطاك العافية، يعني كأنه
+
+213
+00:13:06,950 --> 00:13:10,230
+إيش في نفس واحد استطاع يقدر يعمل assessment كامل،
+
+214
+00:13:10,230 --> 00:13:15,190
+و هذا الكلام صراحة يعني غير دقيق صراحةالـ
+
+215
+00:13:15,190 --> 00:13:18,090
+auscultation و هذا الكلام بنحكيه أكتر لأطباء عشان
+
+216
+00:13:18,090 --> 00:13:21,950
+يكونوا واضحين يعرفوا هذا الأماكن و احنا بسلنا نعرف
+
+217
+00:13:21,950 --> 00:13:25,450
+بالمعرفة يعني و فاهم اللي لنا أنه نعرف أماكن
+
+218
+00:13:25,450 --> 00:13:30,790
+الصحية يمكن يكون لك و يكون لك قدر حلو أنه يوم من
+
+219
+00:13:30,790 --> 00:13:33,710
+الأيام ننصح حتى الأطباء ما تقول أنا وين لا لا لا
+
+220
+00:13:33,710 --> 00:13:37,310
+كتير من ال .. حتى في الأخرين يكون الليجان المشتركة
+
+221
+00:13:37,310 --> 00:13:40,250
+اللي بتسير بالعكس رؤساها التمريد و بيكونوا فيها
+
+222
+00:13:40,250 --> 00:13:43,210
+أطباء كتيرأنا نفسي تعزيزي عامة كتير من اللاجئين
+
+223
+00:13:43,210 --> 00:13:45,450
+كانت تحديد يعني كانوا يكونوا معايا طب انا أكون
+
+224
+00:13:45,450 --> 00:13:48,710
+مسئول عنهم الأمر مش معقد يعني يعني مانا بنستيين في
+
+225
+00:13:48,710 --> 00:13:52,210
+نفسنا انتوا الحمد لله بخير و بتقدروا يعني بقولي لو
+
+226
+00:13:52,210 --> 00:13:55,130
+سمحت في هي anterior و في posterior بس بقولي يا ريت
+
+227
+00:13:55,130 --> 00:13:57,650
+و انت عارف في ال anterior و ال posterior يا ريت
+
+228
+00:13:57,650 --> 00:14:00,810
+يكونوا اتناشر locations اتناشر locations يعني
+
+229
+00:14:00,810 --> 00:14:04,670
+اتناشر مكان بنقدر نعمله assessment عن طريق ال
+
+230
+00:14:04,670 --> 00:14:09,260
+stethoscope و 14من الـ A من الخلف طبعا هو هنا رسم
+
+231
+00:14:09,260 --> 00:14:11,560
+لنا يعني انا مابده ان انا اشرحه هنا بالظبط اماكن
+
+232
+00:14:11,560 --> 00:14:15,490
+ايه قدامكوالكن عشان يقوللي و يأكدلي انه يعني
+
+233
+00:14:15,490 --> 00:14:19,430
+مابيجوزش انه انت مرتين تسمع في الأمام و مرتين تسمع
+
+234
+00:14:19,430 --> 00:14:23,330
+في الخلف او مرة و يكفي ذلك لأ الصح لأن ربما احنا
+
+235
+00:14:23,330 --> 00:14:26,610
+نكشف شغلة في منطقة معينة يعني ماسمعلاش بعض الناس
+
+236
+00:14:26,610 --> 00:14:31,430
+عنده جال عندك inflammation في ال lower lung ايش
+
+237
+00:14:31,430 --> 00:14:34,950
+يعني؟ و مرات بيقولك في ال lower loop in the right
+
+238
+00:14:34,950 --> 00:14:39,190
+lung يعني كأنه بيقوللي في الرقى اليمنى في المنطقة
+
+239
+00:14:39,190 --> 00:14:42,310
+يعني معناته الإنسان بيقدر و ال stethoscope يستطيع
+
+240
+00:14:43,120 --> 00:14:47,460
+يقدر يسمع الصوت نفسه كويس بشكل طبيعي و بيقدر يحدد
+
+241
+00:14:47,460 --> 00:14:50,000
+و هذا اتمنى على الأطباء انه يقدر يجوموا بيه.
+
+242
+00:14:50,560 --> 00:14:53,160
+Escalate symmetrically، طبعا مش symmetrically يعني
+
+243
+00:14:53,160 --> 00:14:57,040
+بالتجانس، يعني .. يعني بانتظام زي ايش؟ زي
+
+244
+00:14:57,040 --> 00:15:00,420
+symmetry، بانتظام، مابدي مرة فوق مرة تحت، لأ امشي
+
+245
+00:15:00,420 --> 00:15:03,680
+بالنقاط شوية شوية نقطة نقطة حتى تصل ايه لنقطة
+
+246
+00:15:03,680 --> 00:15:08,810
+الأخيرة.وزي ما قلنا إذا الإنسان أو الطبيب شوية مش
+
+247
+00:15:08,810 --> 00:15:11,970
+قادر و هذا الكلام موجود عندنا خاصة مع ضغط العمل
+
+248
+00:15:11,970 --> 00:15:15,830
+يسيطر على أقل الإنسان فينا يسمع جديش six locations
+
+249
+00:15:15,830 --> 00:15:19,250
+anteriorly and posteriorly يعني لو ماقدرناش على
+
+250
+00:15:19,250 --> 00:15:24,650
+أقل يسمعله ست أماكن يعني هم اختلفوا هل الست
+
+251
+00:15:24,650 --> 00:15:28,630
+الأماكن يعني أمام و ست أماكن خلف ولا ست أماكن قدام
+
+252
+00:15:28,630 --> 00:15:33,310
+و ورا على أقل يعني احنا ممكن نقبل في أسوأ الظروف
+
+253
+00:15:33,670 --> 00:15:37,230
+إنه يعني الست أماكن يعني ورا وجدها مش مشكلة يعني
+
+254
+00:15:37,230 --> 00:15:40,830
+بحيث أنه نقدر على الأقل نعرف إذا في مشكلة ولا لأ و
+
+255
+00:15:40,830 --> 00:15:44,590
+لا و لأ و لأ طبعا يعني غير مقنع علميا بشكل كبير ال
+
+256
+00:15:44,590 --> 00:15:50,490
+breath sounds أصوات النفس زي ما فيها hard sounds
+
+257
+00:15:50,490 --> 00:15:54,010
+زي ما في حاجة اسمها breath sounds يعني زي ما في
+
+258
+00:15:54,010 --> 00:15:57,370
+أصوات لدقات القلب dub dub وغيره مثلا و sound one و
+
+259
+00:15:57,370 --> 00:15:59,630
+sound two و sound three زي ما في عندنا حاجة اسمة
+
+260
+00:15:59,630 --> 00:16:03,320
+إيه في حاجة اسمة أصوات النفسطب أصوات النفس إيش بده
+
+261
+00:16:03,320 --> 00:16:06,320
+أعمل فيها؟ بقوللي إيه بدك تعملها analyze according
+
+262
+00:16:06,320 --> 00:16:10,640
+to a to b تشوف حدتها intensity كتافة شدتها ال
+
+263
+00:16:10,640 --> 00:16:14,940
+quality كيف كيفيتها relative duration وقتيه كدهش
+
+264
+00:16:14,940 --> 00:16:17,460
+مدتها بالظبط كده في ال inspiration و ال expiration
+
+265
+00:16:17,460 --> 00:16:24,800
+يعني و أنت بتسمع في صوت النفس شوف ليه حدته كيفيته
+
+266
+00:16:24,800 --> 00:16:30,850
+قوي ضعيف هل هو ضعيف في ال inspirationوقوي في ال
+
+267
+00:16:30,850 --> 00:16:34,790
+expiration و لا العكس بدنا نشوف إيش بالظبط اللي
+
+268
+00:16:34,790 --> 00:16:38,270
+احنا يعني موجود علشان نقدر نعمل ال assessment و
+
+269
+00:16:38,270 --> 00:16:42,750
+ندونه طيب الان نيجي على الأصوات و كتير من الناس و
+
+270
+00:16:42,750 --> 00:16:45,970
+ممكن هذه الأسئلة بتيجي مرات كتير في انتحارات
+
+271
+00:16:45,970 --> 00:16:49,750
+التوظيف بالمناسبة بيسألونا في هذه المناطق بالذات
+
+272
+00:16:49,750 --> 00:16:52,970
+بيجي و بيقولك حاجة فيها يسمى bronchial breath
+
+273
+00:16:52,970 --> 00:16:56,410
+soundsلما نقول كلمة البرونكا ال brief sounds يعني
+
+274
+00:16:56,410 --> 00:16:59,130
+أصوات العلاقة ما زال .. ما زال كل كلمة البرونكا
+
+275
+00:16:59,130 --> 00:17:04,030
+يعني جاية من البرونكاس طيب إيش قصد هذا البرونكاس؟
+
+276
+00:17:04,030 --> 00:17:07,110
+بقولي الآن هذا القصب الهوائي اللي بتحكي عنه إيش
+
+277
+00:17:07,110 --> 00:17:12,530
+مالها؟ بقولي normally عشان تعرف الصوت تبعها، بعض
+
+278
+00:17:12,530 --> 00:17:15,950
+الناس هيقولي أنا ما بتترجموها و تقولي معناته صوت
+
+279
+00:17:15,950 --> 00:17:19,630
+الهواء في القصب، لأ أنا بدنا نعرف وين هذا الصوت و
+
+280
+00:17:19,630 --> 00:17:24,260
+كيف بيكون وين موجودهذا الصوت موجود بالظبط على
+
+281
+00:17:24,260 --> 00:17:28,860
+الإتراكية، قصب الهوية، لكن كيف أسمعه؟ لو كل واحد
+
+282
+00:17:28,860 --> 00:17:32,820
+فينا، و أكيد كلكم معاكوا سماعات، يمسك السماعة اللي
+
+283
+00:17:32,820 --> 00:17:36,980
+معاه، يحطها على دنيه و يحطها عايش هنا، يحطها على
+
+284
+00:17:36,980 --> 00:17:41,300
+منطقة الرقبة من اليمين أو من اليسار، من اليمين أو
+
+285
+00:17:41,300 --> 00:17:45,910
+من اليساريعني الآن جاب السماعة حطها في دنيا حط ..
+
+286
+00:17:45,910 --> 00:17:48,810
+حط .. بعد ما حط السماعة .. التنتين طبعا ال tubes
+
+287
+00:17:48,810 --> 00:17:52,030
+في دنيا جاب حط ال diaphragm على منطقة اللي هو
+
+288
+00:17:52,030 --> 00:17:55,930
+الرقبة من اليمين أو من اليسار وعص شوية و أخد نفس
+
+289
+00:17:55,930 --> 00:18:01,330
+لو كل واحد فينا بس جربها أخد نفس هيك هيسمع الصوت
+
+290
+00:18:01,330 --> 00:18:05,210
+هذا الصوت إيش اسمه؟ اسمه bronchial breath sound
+
+291
+00:18:05,210 --> 00:18:09,510
+خلاص طبعا صوته هتحس كأنه في هوا بدخل في تجويف
+
+292
+00:18:09,890 --> 00:18:13,370
+والتجارة زي كأنه صوت بدخل فيه مسورة أنا مش هتكلم
+
+293
+00:18:13,370 --> 00:18:18,370
+كتير في هذه المنطقة لأنه هتسمعوا لحالكم لكن لو
+
+294
+00:18:18,370 --> 00:18:21,070
+سمعنا .. لو سمعنا هذا الصوت ما هو ليش بقولي لازم
+
+295
+00:18:21,070 --> 00:18:24,550
+تسمعوه؟ عشان لو سمعته في مكان تاني معناه فيه مشكلة
+
+296
+00:18:24,550 --> 00:18:28,390
+يعني هذا الصوت اللي سمعناه عند الرقبة اللي هو ال
+
+297
+00:18:28,390 --> 00:18:31,990
+bronchi اللي بيبقى normal يبقى normal يكون على
+
+298
+00:18:31,990 --> 00:18:34,790
+التركية لكن abnormal يكون على أماكن تانية زي ايش
+
+299
+00:18:34,790 --> 00:18:38,410
+بقولي افرض انت روحت اسمعته على ال lung tissue تحت
+
+300
+00:18:38,900 --> 00:18:41,700
+معناته ايش بيقولي؟ في pathological condition ايش
+
+301
+00:18:41,700 --> 00:18:46,220
+يعني؟ لأ لأ في شغل مرضية وخطيرة شوية طب ايش هي؟
+
+302
+00:18:46,220 --> 00:18:50,020
+بيقولي في بعض الحالات بتكون high pitched loud ..
+
+303
+00:18:50,020 --> 00:18:52,580
+ايش high pitched loud؟ يعني بتكون صوت عال كتير ال
+
+304
+00:18:52,580 --> 00:18:55,960
+sound كمان خاصة في ايش هنا؟ بيقولي ال sound هذا
+
+305
+00:18:55,960 --> 00:19:00,000
+decrease in spiratory and lengthen .. ايش هنا؟
+
+306
+00:19:00,000 --> 00:19:03,980
+increase in spiratory phases بعض ال .. يعني ركزوا
+
+307
+00:19:03,980 --> 00:19:07,640
+معايا بعض الأصوات .. بعض الأصوات بتكون صوت عال
+
+308
+00:19:07,640 --> 00:19:14,910
+كتيرصوت عال كتير لكن بتخف في النفس اللي داخل و
+
+309
+00:19:14,910 --> 00:19:19,470
+بتزيد في النفس اللي طالع طب لو واحد سألني قال طب
+
+310
+00:19:19,470 --> 00:19:22,730
+ليش يا أستاذ خفت في النفس اللي داخل؟ الإنسان لما
+
+311
+00:19:22,730 --> 00:19:26,310
+باخد النفس هو يعني طبيعي مافيش مشكلة افرض و أجبد و
+
+312
+00:19:26,310 --> 00:19:30,470
+طلع النفس بشكل عام لكن في pathological problems أو
+
+313
+00:19:30,470 --> 00:19:33,070
+some abnormalities أو some meteors أو some foreign
+
+314
+00:19:33,070 --> 00:19:36,070
+body الآن لما نكون في foreign body مش قادر نطلع
+
+315
+00:19:36,070 --> 00:19:41,170
+الهواء بسهولة زي ما أخدهمفإيش صار؟ زاد الصوت،
+
+316
+00:19:41,170 --> 00:19:45,010
+معناته أنا ماقدرش لسه أشخص الآن و أقول فيه مشكلة،
+
+317
+00:19:45,010 --> 00:19:49,710
+لكنه أعطاني .. بعض أعطاني أنه بيقوللي يعني طب متى
+
+318
+00:19:49,710 --> 00:19:53,230
+بيخف الصوت؟ أنت قولتلنا أن فيه tumor ممكن يكون أو
+
+319
+00:19:53,230 --> 00:19:57,410
+فيه abnormalities أو فيه أي شيء طب متى بيكون الصوت
+
+320
+00:19:57,410 --> 00:20:01,990
+شبه معدم؟ absent or decreased؟ بيقوللي الصوت مرات
+
+321
+00:20:01,990 --> 00:20:06,110
+بيكون لا قدر الله ممكن يكون مخف الصوت أو خفيف جدا
+
+322
+00:20:06,110 --> 00:20:10,350
+إذا في foreign bodyطب حد بيقولي طب ليش الفرنباطي
+
+323
+00:20:10,350 --> 00:20:13,350
+هنا؟ اجي كمان مرة اقرأ بس الفرنباطيون موجود هنا في
+
+324
+00:20:13,350 --> 00:20:16,510
+ال plural space في منطقة ال plural cavity شوف لوين
+
+325
+00:20:16,510 --> 00:20:20,990
+رايح جوا جوا جوا فخفف صوت طبع النفس مش بس هيك
+
+326
+00:20:20,990 --> 00:20:24,130
+bronchial obstruction احنا قلنا اللي الصوت هداش
+
+327
+00:20:24,130 --> 00:20:28,390
+بتكون عالي طب لما الصوت تصير باطي اش بيكون هنا؟ في
+
+328
+00:20:28,390 --> 00:20:30,750
+علاقة در الله bronchial obstruction زي اللي اسمح
+
+329
+00:20:30,750 --> 00:20:35,030
+الله bronchial carcinoma مثلا عنده مصيبة فالصوت
+
+330
+00:20:35,030 --> 00:20:39,120
+بيبطي يكون عالي كتيرطيب، في بعض الناس بيعرفش تنفس
+
+331
+00:20:39,120 --> 00:20:42,700
+.. نفس سريع، دائما نفسه shallow breathing، إيش
+
+332
+00:20:42,700 --> 00:20:46,080
+يعني ال shallow breathing؟ يعني نفسه نفس يعني
+
+333
+00:20:46,080 --> 00:20:51,480
+خفيف، نفس سطحي، والنفس السطحي بيكون صوته واطي، زي
+
+334
+00:20:51,480 --> 00:20:54,680
+ما نيجي الطفل تعالوا جنبه، يدوبك تسمع نفسه، حتى
+
+335
+00:20:54,680 --> 00:20:56,860
+الإمارات بتخاف على إبن الوليد، بيصيروا بتقولك
+
+336
+00:20:56,860 --> 00:20:59,960
+لحسين يكون صارله حاجة، من شدة ما هو نفسه إيش هنا
+
+337
+00:20:59,960 --> 00:21:03,540
+shallow، لكن لما الإنسان بيكون تعبان ومرهق وعمال
+
+338
+00:21:03,540 --> 00:21:07,550
+وفي عنده ديك نفس بتلاقيه بتنفس نفس عميقةوفي حالات
+
+339
+00:21:07,550 --> 00:21:09,850
+ايه كمان؟ في حالتين في زيما، طبعا كده انتوا عرفتوا
+
+340
+00:21:09,850 --> 00:21:13,010
+ليش؟ لأن الصوت .. لأنه اللي جات عمال هو كله عماله
+
+341
+00:21:13,010 --> 00:21:15,990
+بيطلع برا فمش جادر الإنسان ياخد النفس ازاد ولا
+
+342
+00:21:15,990 --> 00:21:19,570
+يطلع النفس اللي موجود عنده، فإيش صار هنا؟ صار
+
+343
+00:21:19,570 --> 00:21:23,450
+عملية اللي هو نقص في الصوت اللي هو النفس اللي طالع
+
+344
+00:21:23,450 --> 00:21:30,710
+بالسمعة طيب normal breath sounds إيش أصوات؟ طبعا
+
+345
+00:21:30,710 --> 00:21:33,910
+أنا عماهل بشرح في هذا .. قلنا الشبط لإنه شويه مهم
+
+346
+00:21:33,910 --> 00:21:39,290
+لناإنه نفهم كل حاجة Normal breath sounds الآن
+
+347
+00:21:39,290 --> 00:21:44,050
+أصوات النفس الطبيعية أول صوت اسمه Trachea Trachea
+
+348
+00:21:44,050 --> 00:21:46,970
+اللي احنا قلنا عنه الصوت اللي وين اللي مباشرة فوق
+
+349
+00:21:46,970 --> 00:21:50,010
+عالي عالي عالي طب ما ما زال عالي و عند الرقم و كذا
+
+350
+00:21:50,010 --> 00:21:53,130
+إيش قال لي very loud إيش يعني very loud لو إحنا
+
+351
+00:21:53,130 --> 00:21:57,010
+سمعنا لحنة هنحكوا هتلاقي صوته عالي high بتجد حدته
+
+352
+00:21:57,010 --> 00:22:00,390
+عالية ال sound كأنه في مصورة هيك بيدخل الهواء
+
+353
+00:22:01,970 --> 00:22:05,410
+inspiratory تساوي إيه؟ expiratory لو أجي حد سألني
+
+354
+00:22:05,410 --> 00:22:09,750
+طب ليه؟ قال لي في ال sound هنا duration يعني في
+
+355
+00:22:09,750 --> 00:22:14,550
+مدة الصوت النفس يعني مدة الصوت سواء الإنسان أخد
+
+356
+00:22:14,550 --> 00:22:19,950
+النفس أو طلع النفس بكون أيش متساوي ليه متساونا؟
+
+357
+00:22:19,950 --> 00:22:23,910
+عشان النفس هي أصلا مصورة واحدة هي اللي بتدخل و
+
+358
+00:22:23,910 --> 00:22:27,860
+بتطلع النفس طب و لما بقول يعني النفسيعني نفس قطر
+
+359
+00:22:27,860 --> 00:22:31,440
+اللي هو التراكية اللي بيدخل فيها الهواء و بيخرج
+
+360
+00:22:31,440 --> 00:22:35,060
+منها عشان هيك بيطلع نفس اللي هو ايه نفس مدة الصوت
+
+361
+00:22:35,060 --> 00:22:39,180
+سواء دخولا او خروجا لكن لما ننزل لتحت شوية لأ
+
+362
+00:22:39,180 --> 00:22:42,040
+بيصير مختلف لأنه يعني ال right lung غير على ال
+
+363
+00:22:42,040 --> 00:22:45,380
+left lung وكذا خاصة في التدريس اللي هو التشرحية
+
+364
+00:22:45,380 --> 00:22:48,560
+اللي احنا أخدناها زمان في عندنا كمان انا بقولي
+
+365
+00:22:48,560 --> 00:22:50,520
+over ال .. ما احنا قلناه خلاص و اننا بنسمعها في ال
+
+366
+00:22:50,520 --> 00:22:54,640
+over تراكية طب ال bronchial هلجيت حاجة ننزلنا لتحت
+
+367
+00:22:54,640 --> 00:22:58,930
+شويةالبرونكيل هلجيت بقولي برضه إيش هنا loud هلجيت
+
+368
+00:22:58,930 --> 00:23:04,670
+هذه القصبة تحت البرونكيل ال main bronchi خاصة الآن
+
+369
+00:23:04,670 --> 00:23:07,230
+بقولي برضه loud و high و pitch sound نفس القضية
+
+370
+00:23:07,230 --> 00:23:11,370
+برضه عالي لكن إيش بقولي هنا ه ال expiratory sound
+
+371
+00:23:11,370 --> 00:23:16,170
+ه ال expiratory sound إيش معنى هنا بكون أكبر من
+
+372
+00:23:16,170 --> 00:23:21,910
+inspiratory sound أكبر من inspiratory sound طيب
+
+373
+00:23:21,910 --> 00:23:28,060
+سبحان الله يعني طب ليش؟الان تخيلوا معايا .. الان
+
+374
+00:23:28,060 --> 00:23:30,460
+.. الان لما الإنسان باخد نفسه .. تخيل إن هي أخد
+
+375
+00:23:30,460 --> 00:23:36,760
+نفسها .. طلع نفسه .. نفسه هو طالع بكون شوية سريع
+
+376
+00:23:36,760 --> 00:23:39,340
+أكتر من دخوله .. دخوله اللي بده يتغلغل شوية لتحت
+
+377
+00:23:39,340 --> 00:23:43,400
+عشان يصل ل gas exchange، بعدين يطلع مرة واحدة، فهو
+
+378
+00:23:43,400 --> 00:23:46,420
+هان لما الجسوها لاجو ال expiratory هنا إيش معنو؟
+
+379
+00:23:46,420 --> 00:23:49,920
+أعلى و أكبر شوية من إياش من inspiratory soundطيب
+
+380
+00:23:49,920 --> 00:23:53,860
+وين نسمعه هيرد هنا على ال manipura؟ طبعا انتوا
+
+381
+00:23:53,860 --> 00:23:57,200
+كلكم عارفين من اللي هي ال maniprium اللي هو خاصة
+
+382
+00:23:57,200 --> 00:24:00,540
+في منطقة الستيارة من اللي فوق، انتوا طبعا في
+
+383
+00:24:00,540 --> 00:24:03,000
+التشريح كلكوا ذاكرين هذا المكان بالظبط التشريح هنا
+
+384
+00:24:03,000 --> 00:24:07,520
+فوق، if هيرد إذا سمعنا ال bronchial breathing هذا،
+
+385
+00:24:07,520 --> 00:24:11,440
+شفنا لا قدر اللهفي other location يعني في مكان
+
+386
+00:24:11,440 --> 00:24:15,680
+تاني، ايش بيأكدلي لأ في حاجة اسمها consolidation،
+
+387
+00:24:15,680 --> 00:24:18,780
+ايش انا consolidation؟ مابدي حد هي ترجمة، هاي
+
+388
+00:24:18,780 --> 00:24:22,180
+ترجمة ترجمة consolidation اللي lung tissue filled
+
+389
+00:24:22,180 --> 00:24:26,360
+with liquid instead of air لما لا قدر الله، الرئة
+
+390
+00:24:26,360 --> 00:24:28,480
+دي زي الموضوع في ال coronavirus اليوم لو بيصير
+
+391
+00:24:28,480 --> 00:24:31,860
+inflammatory process و بيصير يعني صعبة كتير خاصة
+
+392
+00:24:31,860 --> 00:24:36,160
+يعني أخطر من النمونيا نفسهافبسيريام تمتلق اللي هو
+
+393
+00:24:36,160 --> 00:24:40,300
+أنسجة الرئتين بالمية أكترها .. أنسجة الرئتين
+
+394
+00:24:40,300 --> 00:24:44,180
+بالإيه؟ بالمية أكتر من إمتلاقها .. أكتر من
+
+395
+00:24:44,180 --> 00:24:47,780
+إمتلاقها بالهواء هذا إيش بنسميه consolidation يبقى
+
+396
+00:24:47,780 --> 00:24:51,420
+لو سمعنا هذا الصوت في أماكن تانية معناته لأ في
+
+397
+00:24:51,420 --> 00:24:54,620
+حاجة باسمها lung consolidation اللي هي ترجمتها
+
+398
+00:24:54,620 --> 00:24:59,030
+قدامنا طب في حاجة مصطلح جديد اسمه هنا railRail
+
+399
+00:24:59,030 --> 00:25:02,650
+معناه تخرخشة كركعة مش مشكلة بس إحنا بنفهم إيش نقصد
+
+400
+00:25:02,650 --> 00:25:06,190
+فيه أصوات يعني بنفهمها و نعرف إيش خاصة إنه فيه
+
+401
+00:25:06,190 --> 00:25:09,930
+كمان صوت جاينا اسمه Ronkai خليني أتكلم في ال rail
+
+402
+00:25:09,930 --> 00:25:14,350
+أول حاجة ريل عبارة عن short صوت discrete يعني
+
+403
+00:25:14,350 --> 00:25:18,370
+الشديد شوية Interrupted متقطع cracking إيش يعني
+
+404
+00:25:18,370 --> 00:25:22,010
+بحق في بعضه or bubbling يعني إيش bubbling بقبق
+
+405
+00:25:22,010 --> 00:25:25,450
+كأنه بيعمل صوت إيش بقبقه طب إيش أنا بقول most
+
+406
+00:25:25,450 --> 00:25:29,500
+commonly heard during inspirationهذا ال real إذا
+
+407
+00:25:29,500 --> 00:25:32,180
+سمعنا الصوت الكركع زي الصوت اللي احنا قلنا عنه ولا
+
+408
+00:25:32,180 --> 00:25:36,300
+تشبيه زي صوت الشيشة، إذا سمعنا صوت الإشي بيصير عند
+
+409
+00:25:36,300 --> 00:25:41,500
+المريض، هو بياخد النفس، enduring inspiration، إيش
+
+410
+00:25:41,500 --> 00:25:45,900
+بيسموه أنا بقول similar to sound؟ هو يشبه صوت اللي
+
+411
+00:25:45,900 --> 00:25:51,280
+كأنه .. كأنه شعر بنحكه بين أصابعنا rolledbetween
+
+412
+00:25:51,280 --> 00:25:55,000
+fingers ايش هنا close to ears يعني لو واحد جاب
+
+413
+00:25:55,000 --> 00:25:58,680
+شوية اكم من شعره اذا شعره طويل او مثلا حكي اكم من
+
+414
+00:25:58,680 --> 00:26:03,060
+شعره جنب أذنه مباشرة في صوت غريب بيطلع هذا الصوت
+
+415
+00:26:03,060 --> 00:26:07,600
+بيحكم جنب الأذن مباشرة اسمه rail ايش اسمه؟ rail
+
+416
+00:26:07,600 --> 00:26:12,020
+طبعا ماذا هذا الصوت بيصير في ال inspiration طيب
+
+417
+00:26:12,020 --> 00:26:15,440
+خلينا عشان احنا نقدر نحدد الأمور كويس يبقى ال rail
+
+418
+00:26:15,440 --> 00:26:21,430
+صوت متقطعمرات بيصير نوع من .. مش بس ايه كمان، اشي
+
+419
+00:26:21,430 --> 00:26:24,110
+كانوا بحتك في بعضه عملوا بيملق bubbling طب ال
+
+420
+00:26:24,110 --> 00:26:26,190
+bubbling كانت ايه يا عزيزي؟ زي صوت الشعر الجانب
+
+421
+00:26:26,190 --> 00:26:30,290
+الأذن؟ و بيقوللي هذا بيصير في ال inspiration هذا
+
+422
+00:26:30,290 --> 00:26:33,890
+ال rail بنقسم ل 3 أقسام، بنقسم ل إيه؟ 3 أقسام،
+
+423
+00:26:33,890 --> 00:26:39,310
+الآن طبعا هذه شغلات صح تخصية لكن كويس نعرفها برضه
+
+424
+00:26:39,310 --> 00:26:42,270
+و احنا يعني ما نقول والله هذا ال chapter صعب و مش
+
+425
+00:26:42,270 --> 00:26:45,910
+قادرين نفهمه، لأ الأمر كويس نفهمهو كويس نعرفه
+
+426
+00:26:45,910 --> 00:26:49,670
+لحياتنا لكن هو مش .. مش معقد في حاجة منها اسمها
+
+427
+00:26:49,670 --> 00:26:53,150
+low وفي medium وفي high طبعا بناء على كلمة pitched
+
+428
+00:26:53,150 --> 00:26:57,510
+يعني حدة اما حدة الصوت بتكون بسيطة او حدة متوسطة
+
+429
+00:26:57,510 --> 00:27:01,690
+او حدة عالية يعني صوت عالي طيب طبعا كله على بعض في
+
+430
+00:27:01,690 --> 00:27:05,290
+ال inspiration بيقولي ال low بيقولي هذا بيكون
+
+431
+00:27:05,290 --> 00:27:08,910
+course rails occurring in early in inspirationيعني
+
+432
+00:27:08,910 --> 00:27:13,590
+لما نحس أن حدث الصوت بسيطة بتكون في بداية النفس،
+
+433
+00:27:13,590 --> 00:27:18,190
+يعني أول ما يخد النفس ممكن تكون هذه الهوء، ليش؟
+
+434
+00:27:18,190 --> 00:27:20,690
+لانجاف البرونكايتس، إيش يعني ممكن نشك في
+
+435
+00:27:20,690 --> 00:27:24,250
+البرونكايتس؟ التهاب في الشعب الهوائي الرئيسي، لما
+
+436
+00:27:24,250 --> 00:27:27,550
+تكون الشعب الهوائي الرئيسي ملتهبة، المصورة واسعة
+
+437
+00:27:27,550 --> 00:27:31,590
+شوية، فالصوت لما تكون .. كل ما تكون المصورة واسعة،
+
+438
+00:27:31,590 --> 00:27:33,950
+كل ما الصوت بيكون في ضعيفة، تخيلوا معايا، زي لما
+
+439
+00:27:33,950 --> 00:27:36,250
+البربيش زمان و احنا صغار كنا نجيب البربيش اللي كان
+
+440
+00:27:36,250 --> 00:27:40,070
+ينحط فيه سلك الكهربو أي باربيش و نمسكه نلفه بيدنا
+
+441
+00:27:40,070 --> 00:27:43,510
+بلفة سريعة يعمل زي الصوت زي صفير ليه؟ على اعتبار
+
+442
+00:27:43,510 --> 00:27:47,170
+أنه كل ما بيضيق كل ما الصوت عمال بيعلق أكيد الكلام
+
+443
+00:27:47,170 --> 00:27:51,890
+زي ما واحد بيجي بسفر لما بديه يسفر كويس بتلاقي ضم
+
+444
+00:27:51,890 --> 00:27:56,330
+الفم على أصبعه أو أي شي عمل ضم كل ما انت بضايق زي
+
+445
+00:27:56,330 --> 00:27:59,310
+قضية الميه برضه كل ما نضغط عليها أكتر و نفتح بس
+
+446
+00:27:59,310 --> 00:28:03,510
+تقب بزيد قوة الميه يبقى الصوت الواطي بيكون
+
+447
+00:28:03,510 --> 00:28:07,320
+bronchitisيبقى معناته جاي من وين؟ من ال bronchi طب
+
+448
+00:28:07,320 --> 00:28:09,980
+إذا medium .. ال medium .. أجل ال medium يعني
+
+449
+00:28:09,980 --> 00:28:14,740
+معناته وين؟ من وسط .. من وسط النفس و أنا باخد طب
+
+450
+00:28:14,740 --> 00:28:18,840
+إيش بقوللي هنا؟ بقوللي في ال mid inspiration آه
+
+451
+00:28:18,840 --> 00:28:23,360
+هذا بيصير في وسط النفس اللي إحنا بناخده إذا في وسط
+
+452
+00:28:23,360 --> 00:28:27,040
+النفس إسمعنا .. إسمعنا ال rail بنسميه medium صوته
+
+453
+00:28:27,040 --> 00:28:31,360
+مش عالي كتير و مش واطي وسط بيكون إيش في عنده؟ عنده
+
+454
+00:28:31,360 --> 00:28:34,520
+حاجة اسمه bronchiectasis إيش يعني bronchiectasis؟
+
+455
+00:28:34,750 --> 00:28:38,510
+يعني في inflammation في ال small bronchi يعني بدأ
+
+456
+00:28:38,510 --> 00:28:42,990
+يصير التهاب في إيش؟ في الشعب خارجه الصغيرة شوية مش
+
+457
+00:28:42,990 --> 00:28:47,130
+الشعب الهوائية أو الحويصالات الدقيقة لأ أنا بتكلم
+
+458
+00:28:47,130 --> 00:28:50,290
+في الأول ال main bronchs الشعب الرئيسي بعدين متفرع
+
+459
+00:28:50,290 --> 00:28:53,310
+منهم انتوا عارفين في التشريح في ال bronchi بعدين
+
+460
+00:28:53,310 --> 00:28:55,550
+ال bronchioles بعدين ال alveoli و ال alveoli طب
+
+461
+00:28:55,550 --> 00:28:58,770
+الآن .. الآن بعدين ايش بيصيروا يقولوا ليه؟ لما
+
+462
+00:28:58,770 --> 00:29:03,440
+يصير التهابفي هذا المكان بقول إيش كلمة bronchitis
+
+463
+00:29:03,440 --> 00:29:06,480
+و ما .. لأ لازم قلت bronchitis بجعهان بقول مصطلح
+
+464
+00:29:06,480 --> 00:29:09,480
+جديد اسمه bronchiectasis إيش اسمه bronchiectasis
+
+465
+00:29:09,480 --> 00:29:13,080
+طيب و لا خدر الله طبعا هذا شويه صعب لإنه ممكن
+
+466
+00:29:13,080 --> 00:29:17,600
+يتحول بعد هيكم مش cancer بس في كتير من الحالات
+
+467
+00:29:17,600 --> 00:29:20,480
+بيصير حاسسه ان بييمة يعني بيصير bus بيصير مليان في
+
+468
+00:29:20,480 --> 00:29:27,160
+الرقم و بيصير حتى بعض الحالات في ال space نفسهالـ
+
+469
+00:29:27,160 --> 00:29:29,800
+intercostal space برضه كمان فيه شوية يعني bus و
+
+470
+00:29:29,800 --> 00:29:34,640
+ممكن الطبيب يتدخل انه يحاول السحب او عملية طيب إذا
+
+471
+00:29:34,640 --> 00:29:38,300
+كانت high معناه أين نزلنا نتحت؟ هلجت و أخد نفس؟
+
+472
+00:29:38,300 --> 00:29:41,840
+الآن صارت الصوت عالي كتير، معناه مازال الصوت عالي
+
+473
+00:29:41,840 --> 00:29:45,120
+يبقى وين؟ لأنه صارت إيش؟ عنق و زجاجة بده يضيق،
+
+474
+00:29:45,120 --> 00:29:48,420
+يبقى و ال .. و الحوايصل أوصل إلى وين؟ للبرونكيولز
+
+475
+00:29:48,900 --> 00:29:52,020
+Alveolitis الحواصلة الداخلية بتاعة الجاذبكسيتشينجي
+
+476
+00:29:52,020 --> 00:29:55,100
+علشان هيك صار الصوت عالي يبقاش بيصير عنده
+
+477
+00:29:55,100 --> 00:29:59,880
+bronchiolitis أو alveolitis علشان هيك و خلاص بيصير
+
+478
+00:29:59,880 --> 00:30:01,980
+عند الأطفال يبقى الصوت مابيكون عالي ليش؟ على
+
+479
+00:30:01,980 --> 00:30:07,560
+اعتبار أنه القطر تبع النفس الضيق جدا فالصوت هيكون
+
+480
+00:30:07,560 --> 00:30:10,700
+عالي علشان هيك سموه high pitched طيب الصوت اللي
+
+481
+00:30:10,700 --> 00:30:14,080
+بعده اسمه إيه؟ معلش أنا بدأ أسرع شوية عشان .. شوية
+
+482
+00:30:14,080 --> 00:30:19,050
+جلطت تلاتين دقيقةالصوت البعدي اسمه ايش؟ رونكاي ..
+
+483
+00:30:19,050 --> 00:30:22,330
+رونكاي .. الـ Ronkai continuous .. ايش يعني الصوت
+
+484
+00:30:22,330 --> 00:30:25,830
+بيكون ايش مستمر .. لكن خلّينا كويسين، عارفين ..
+
+485
+00:30:25,830 --> 00:30:28,290
+هذا الـ Ronkai غير عن ال rail .. هان ال rail ..
+
+486
+00:30:28,290 --> 00:30:30,910
+هان ال Ronkai .. طب ايش ال Ronkai؟ بيقوللي أول
+
+487
+00:30:30,910 --> 00:30:34,610
+حاجة .. ال Ronkai بيشبه الصوت اللي داخل من النار و
+
+488
+00:30:34,610 --> 00:30:38,310
+بسج .. ايش نار و بسج؟ زي من الممرات الضيقة .. زي
+
+489
+00:30:38,310 --> 00:30:42,710
+في التركية أو ال Ronkia ال tree خاصة في شجرة اللي
+
+490
+00:30:42,710 --> 00:30:46,210
+هو الشعيبات الهوية .. هذا بنسميه musical sounds
+
+491
+00:30:46,580 --> 00:30:50,360
+بيشبه الصوت بالظبط صرير الهواء اللى بدخل فى
+
+492
+00:30:50,360 --> 00:30:54,820
+البربيش اللى عامل زى اللولب البربيش اللى اللولبى
+
+493
+00:30:54,820 --> 00:30:58,800
+اللى هو زى الزنبراك عامل بيكون plastic و هذا لما
+
+494
+00:30:58,800 --> 00:31:02,660
+بيحركه اي بني ادم بيعمله صوت غريب لكن هذا الصوت
+
+495
+00:31:02,660 --> 00:31:06,040
+بيطلع سبحان الله فى ال X direction ايش صار الفرق
+
+496
+00:31:06,040 --> 00:31:09,700
+هناك هناك الصوت فى ايه فى ال N direction هذا الصوت
+
+497
+00:31:09,700 --> 00:31:12,780
+فى ايه فى ال X direction الصوت معناته انه بيطلع
+
+498
+00:31:12,780 --> 00:31:18,620
+اكتر و الإنسان بيطلع الصوتهناك من جسم لتلت أجسام،
+
+499
+00:31:18,620 --> 00:31:23,540
+هنا بس لجسمين، جسم اسمه low و جسم اسمه high، ايش
+
+500
+00:31:23,540 --> 00:31:26,600
+ال low؟ ال low اسمه sonorous، خليكوا حافظين بس
+
+501
+00:31:26,600 --> 00:31:31,600
+كلمات هذه، الآن كمام مرة ال رونكاي صوت موسيقي كأنه
+
+502
+00:31:31,600 --> 00:31:35,520
+في ممرات ضيقة بيصير الصوت مع خروج النفس مش مع دخول
+
+503
+00:31:35,520 --> 00:31:39,720
+النفس، هذا من قسم لقسمين، اما low واسمه sonorous،
+
+504
+00:31:39,720 --> 00:31:43,440
+لما انا اقول كلمة sonorousيعني من وين جاي؟ جاي من
+
+505
+00:31:43,440 --> 00:31:46,420
+ال large bronchus يعني من وين؟ من القصبة الأساسية
+
+506
+00:31:46,420 --> 00:31:51,320
+طب لما يقولي high اسمه Sibilant يبقى low اسمه
+
+507
+00:31:51,320 --> 00:31:53,840
+Sonorous خليكم ذاكرين ممكن يجينا في الامتحان low
+
+508
+00:31:53,840 --> 00:31:57,740
+Sonorous و ال high ايش اسمه؟ Sibilant طب ال
+
+509
+00:31:57,740 --> 00:32:00,360
+Sibilant ده ايش معناته؟ اللي هو ال wheezes زي
+
+510
+00:32:00,360 --> 00:32:03,960
+الصفير الشديد بيكون مين جاي من ال bronpules هنا
+
+511
+00:32:03,960 --> 00:32:08,240
+جاي من الشعيبات الكبيرة شوية هنا جاي من ايش؟من
+
+512
+00:32:08,240 --> 00:32:11,960
+حوالي الصلاة الهوائية اللي تحت شوية اللي في الآخر
+
+513
+00:32:11,960 --> 00:32:16,380
+علشان هيك .. و لاحظوا انه بيقوللي هنا انه هنا جاي
+
+514
+00:32:16,380 --> 00:32:19,700
+في ال late .. في ال late expiration و هذا في ال
+
+515
+00:32:19,700 --> 00:32:22,260
+early زي ما احنا قلنا في ايش؟ في ال early يعني إذا
+
+516
+00:32:22,260 --> 00:32:25,800
+الإنسان أول ما بده يطلع نفسه .. أول ما بده يطلع
+
+517
+00:32:25,800 --> 00:32:30,520
+نفسه طلع صوت صفير بسميه sonorous و بقول عنده
+
+518
+00:32:30,520 --> 00:32:36,860
+bronchitis طيب إذا آخر ما طلع نفسه زي هيك .. بعص
+
+519
+00:32:36,860 --> 00:32:41,350
+على حاله شويةطلع و عصق حال شوية اسمه Sibilant و
+
+520
+00:32:41,350 --> 00:32:43,810
+جاي من وين من ال bronchioles اللي هو Bronchiolitis
+
+521
+00:32:43,810 --> 00:32:49,010
+بدأ اشرح لعين ديانا ده عشان اتوقف لإن الوقت ميت و
+
+522
+00:32:49,010 --> 00:32:53,250
+ايه ماطولش كتير في اخد اللي هو .. هو كام من ضايل
+
+523
+00:32:53,250 --> 00:32:59,690
+الشبطر؟ لأ طيب مش مش خلاني انا .. نشرح بس اللي
+
+524
+00:32:59,690 --> 00:33:03,560
+ضايل Stridor و خلاص Stridorاللي بيسموه إيه زي
+
+525
+00:33:03,560 --> 00:33:05,740
+الصرير، إيش يعني strider؟ بيقول .. إيش يعني
+
+526
+00:33:05,740 --> 00:33:09,000
+الصرير؟ بيقول inspiratory musical ways هي عبارة عن
+
+527
+00:33:09,000 --> 00:33:16,600
+صوت .. يحدث صوت موسيقي .. sorry عشان تتبع معايا ..
+
+528
+00:33:16,600 --> 00:33:20,320
+inspiratory musical ways عبارة عن صوت صفير بيحدث
+
+529
+00:33:20,320 --> 00:33:23,420
+أثناء التنفس أكتر شيء بيصير عند مين؟ عند الناس
+
+530
+00:33:23,420 --> 00:33:27,080
+اللي عندهم chronic أزمة .. chronic أزمة، هذا اسمه
+
+531
+00:33:27,080 --> 00:33:30,860
+إيش .. هذا اسمه إيش striderبقول لي بكون عالي كتير
+
+532
+00:33:30,860 --> 00:33:34,900
+على الاتراكية، جنب اللي هو القصب الهوية الرئيسية،
+
+533
+00:33:34,900 --> 00:33:39,760
+suggest إيش بيخلينا نفكر إن في اتراكيا or larynx
+
+534
+00:33:39,760 --> 00:33:43,000
+فيها إيش هنا incident obstruction إما من لا سبحان
+
+535
+00:33:43,000 --> 00:33:46,200
+الله من tumor أو from body أو لا سبحان الله أخدت
+
+536
+00:33:46,200 --> 00:33:50,280
+trauma شديدة جدا عملتله obstructionطبعا هذا تعتبر
+
+537
+00:33:50,280 --> 00:33:52,880
+من ال medical emergency لأنه على اعتبار ان هذا
+
+538
+00:33:52,880 --> 00:33:55,800
+يعني دخول الهواء الرئيسي و إذا ما دخلش دغري بدنا
+
+539
+00:33:55,800 --> 00:33:59,580
+ندخله نحاول ندخل عشان ندخله النفس requiring
+
+540
+00:33:59,580 --> 00:34:02,460
+immediate attention بدنا انتباه فوري من الانتباه
+
+541
+00:34:02,460 --> 00:34:06,180
+الفوري في بعض الحالات بيعملوا الفتحة مباشرة في
+
+542
+00:34:06,180 --> 00:34:09,500
+مطقة الزغر هنا عشان يتنفس في بعضهم بدخله دغري على
+
+543
+00:34:09,500 --> 00:34:12,580
+المركز عشان يحطوله تنفس صناعي و endotracheal
+
+544
+00:34:12,580 --> 00:34:18,980
+intuition طبعا في بعض هنا associated اش هنالا قدر
+
+545
+00:34:18,980 --> 00:34:21,360
+الله إذا inhaled اللي هو from body، بعض الحالات
+
+546
+00:34:21,360 --> 00:34:26,900
+خاصة انا شفت من الحالات الغريبة طفل هو قاعد بيدحك
+
+547
+00:34:26,900 --> 00:34:29,880
+و أنا هذا الكلام كويس أنصحكم، اتشردك و خاصة كان
+
+548
+00:34:29,880 --> 00:34:34,840
+يقول اللي هو الفزق الحلبي فعمله مجرد ما هو ..
+
+549
+00:34:34,840 --> 00:34:39,660
+تعرفين يعني زهر الطفل مش كبير و مجرد ما يعني أنه
+
+550
+00:34:39,660 --> 00:34:43,570
+أشهج شويةفودّوا على المستشفى و انا اذكر انهم
+
+551
+00:34:43,570 --> 00:34:46,830
+ماقدروش يتسيطروا عليه اعتقد دي ان هو اتوفى فالأمر
+
+552
+00:34:46,830 --> 00:34:49,370
+مش سهل ليه؟ لأنه بيصير مستشفى تدوى عشان هيك انا
+
+553
+00:34:49,370 --> 00:34:52,690
+كتير بقول للناس يعني الإنسان هو ابوك الخاص الأكل
+
+554
+00:34:52,690 --> 00:34:55,370
+اللي فيه أشياء fragments يعني زي المكسرات شغلة زي
+
+555
+00:34:55,370 --> 00:34:59,350
+هيك مايحكيش كتير ولا .. و أخطر شيء ضحك أثناء الأكل
+
+556
+00:34:59,350 --> 00:35:01,990
+لإنه ممكن يصير form body inhalation و الله سبحانه
+
+557
+00:35:01,990 --> 00:35:04,870
+يعمل obstruction خلينا نتوقف عند هذه الشريحة ان
+
+558
+00:35:04,870 --> 00:35:07,310
+شاء الله و المحاضرة القادمة ان شاء الله نكمل
+
+559
+00:35:07,310 --> 00:35:09,830
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k.srt
new file mode 100644
index 0000000000000000000000000000000000000000..04600f9cbc524d1a1532533fdabe3f7df905bd56
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k.srt
@@ -0,0 +1,1614 @@
+1
+00:00:00,760 --> 00:00:03,880
+بسم الله الرحمن الرحيم أبنائي وبنات الطلبة اليوم
+
+2
+00:00:03,880 --> 00:00:08,540
+سنبدأ إن شاء الله في chapter رقم 9 assessment of the
+
+3
+00:00:08,540 --> 00:00:12,760
+abdomen طبعًا زي ما اتعودنا في كل مرة، لازم أول حاجة
+
+4
+00:00:12,760 --> 00:00:16,440
+نبحث عن  أي subjective data، وما ننسى أنه طبعًا
+
+5
+00:00:16,440 --> 00:00:20,040
+الـ abdomen بقول عنه largest body cavity، هو أكبر
+
+6
+00:00:20,040 --> 00:00:23,820
+تجويف في جسم الإنسان، لاحتوائه على الـ .. اللي
+
+7
+00:00:23,820 --> 00:00:27,620
+خليني أقول يعني، الـ body organs بشكل عام، يعني أجهزة
+
+8
+00:00:27,620 --> 00:00:32,230
+جسم الإنسان. طيب، أول حاجة، نسأل عن الـ nutritional
+
+9
+00:00:32,230 --> 00:00:34,910
+history، اللي هي على اعتبارها من الحاجات المهمة جدًا
+
+10
+00:00:34,910 --> 00:00:38,170
+والأساسية، اللي هي ممكن تؤثر على صحة الإنسان بشكل
+
+11
+00:00:38,170 --> 00:00:40,990
+عام، وأنتم عارفين أي system حاولنا نعمله
+
+12
+00:00:40,990 --> 00:00:43,470
+assessment، ضروري جدًا نشوف الـ nutritional status
+
+13
+00:00:43,470 --> 00:00:47,690
+لأن في الآخر هي بتودينا إما healthy person أو لا
+
+14
+00:00:47,690 --> 00:00:50,210
+سَمح الله unhealthy person، أو يعني moderate أو
+
+15
+00:00:50,210 --> 00:00:54,870
+هكذا. أول حاجة نسأل عن appetite، شهيته للطعام كيف؟
+
+16
+00:00:55,530 --> 00:00:58,950
+weight loss or gain؟ هل فقد وزنًا أو زاد وزنه؟ طبعًا
+
+17
+00:00:58,950 --> 00:01:02,590
+دائمًا سؤالنا مش على إطلاق، يعني فقدت وزنًا في حياتك
+
+18
+00:01:02,590 --> 00:01:06,150
+لأ، دائمًا احنا سؤالنا بيكون محدد، آخر ستة أشهر، عشان
+
+19
+00:01:06,150 --> 00:01:09,250
+نعرف حالنا بالظبط، وإحنا وين رايحين. ما ينفع نسأله
+
+20
+00:01:09,250 --> 00:01:12,750
+الآن كده، وش فاجأة واحد يكون عامل مثلًا رجيم، أو عامل
+
+21
+00:01:12,750 --> 00:01:15,970
+أي شيء ويقول لك والله أنا إيه الأسبوع ماشي على حمية
+
+22
+00:01:15,970 --> 00:01:20,270
+لأ، احنا نسأله آخر ستة أشهر، كيف كان وضعك؟ اللي بعد ما
+
+23
+00:01:20,270 --> 00:01:23,790
+نسأل السؤال، هل في عندك أعراض gastrointestinal
+
+24
+00:01:23,790 --> 00:01:27,570
+symptoms؟ يعني أعراض لها علاقة بالمعدة، وبالأمعاء
+
+25
+00:01:27,570 --> 00:01:31,730
+يعني كجهاز هضمي وملحقاته؟ زي إيش الأعراض؟ يعني
+
+26
+00:01:31,730 --> 00:01:35,130
+أنت عانيت من dysphagia؟ في عندك صعوبة في البلع؟
+
+27
+00:01:35,130 --> 00:01:38,510
+صار عندك nausea؟ صار في vomiting؟ كلها أنتم
+
+28
+00:01:38,510 --> 00:01:43,400
+عارفين الكلمات هذه؟ كلمات بسيطة، ويعني سهلة. هل في
+
+29
+00:01:43,400 --> 00:01:46,120
+صار indigestion؟ إيش يعني indigestion؟ يعني عسر
+
+30
+00:01:46,120 --> 00:01:49,540
+هضم. هل صار في عندك عسر هضم؟ عشان نقدر نحدد
+
+31
+00:01:49,540 --> 00:01:52,840
+المسارات؟ وين اللي احنا بدنا نجرب؟ لأن هي محطة
+
+32
+00:01:52,840 --> 00:01:56,720
+عشان نقدر نشخص. ثم بعد ذلك، بنسأله عن الـ bowel
+
+33
+00:01:56,720 --> 00:02:00,140
+habits. طبعًا أكيد السؤال ده بشكل يعني .. بشكل
+
+34
+00:02:00,140 --> 00:02:05,300
+اعتِيادي بنسأله، يعني لما بتروح الحمام، جيدًا، بتروح،
+
+35
+00:02:05,300 --> 00:02:10,120
+كيف أنت؟ يعني، هل عندك إشكالية معينة، في problems
+
+36
+00:02:10,120 --> 00:02:15,520
+يعني خاصة، يمكن يقول اه والله في مرات بيصير شوية
+
+37
+00:02:15,520 --> 00:02:19,240
+mucus، ممكن يقول في blood، هو اللي بيحكي بلغته، مش
+
+38
+00:02:19,240 --> 00:02:22,880
+بلغتنا. بنسأله بعدين الـ pain، الألم. نلاحظ أن الـ
+
+39
+00:02:22,880 --> 00:02:25,180
+pain اتأخر شوية، قبل ما نسأله أول حاجة عن normal
+
+40
+00:02:25,180 --> 00:02:29,210
+state، بعدين بنسأله إيش عن abnormal. طيب، في قلم؟ اه
+
+41
+00:02:29,210 --> 00:02:31,430
+والله في قلم. وين موجود عندهم؟ بيقولوا والله عند
+
+42
+00:02:31,430 --> 00:02:34,230
+.. مثلًا عندهم في الجهة اليمين، الجهة اليسار، أيًا
+
+43
+00:02:34,230 --> 00:02:37,790
+كان، يبقى نروح عليها. نسأل وين الـ location، الـ
+
+44
+00:02:37,790 --> 00:02:40,390
+quality، كيفية الألم، الـ pattern، إيش اللي موجود
+
+45
+00:02:40,390 --> 00:02:43,490
+بالظبط، إيش الـ slope تبع الألم، هل هو حاد، هل هو
+
+46
+00:02:43,490 --> 00:02:46,010
+chronic، هل .. إيش اللي موجود بالظبط؟ relationship
+
+47
+00:02:46,010 --> 00:02:49,870
+to إيه؟ ingestion of إيه؟ of food، يعني هل إيه
+
+48
+00:02:49,870 --> 00:02:55,160
+علاقة هذا الألم بابتلاع وأكل الطعام ولا لأ؟ لأن في
+
+49
+00:02:55,160 --> 00:02:58,160
+بعض الناس بيقول لك أنا بيصير معايا ألم لما بأكل كده،
+
+50
+00:02:58,160 --> 00:03:01,580
+هذا غير عن واحد بيقول أنا بيصير معايا ألم لحتى لو
+
+51
+00:03:01,580 --> 00:03:05,740
+ما أكلتش، هذا اختلف الموضوع. طيب، use of medications،
+
+52
+00:03:05,740 --> 00:03:09,040
+بننسأل السؤال العام، هذا بنسأله لأي مريض، أنت بتأخذ
+
+53
+00:03:09,040 --> 00:03:13,080
+علاج؟ بيقول لك آه، لأ. إذا آه، لنَسأله شو العلاج، إذا
+
+54
+00:03:13,080 --> 00:03:16,470
+لأ، وهذا أخذناه في الـ care plan في سنة أولى. الـ
+
+55
+00:03:16,470 --> 00:03:18,630
+بننسأل، إيش طبيعة العلاج؟ ممكن يكون بأخذ أسبيرين،
+
+56
+00:03:18,630 --> 00:03:20,650
+واحد بيقول إيش هي على الأسبيرين؟ الأسبيرين معناه
+
+57
+00:03:20,650 --> 00:03:24,050
+مشكلة. ممكن اللي بدأ عنده، بأخذ أسبيرين بشكل كبير
+
+58
+00:03:24,050 --> 00:03:28,010
+ومستمر، ممكن يصبح عنده شوية stress موجودة، يبقى
+
+59
+00:03:28,010 --> 00:03:30,730
+gastric erosion، راح على .. لأن أنا بتأثر
+
+60
+00:03:30,730 --> 00:03:32,970
+الأسبيرين على الـ parietal cells، تبع إيش؟ تبع الـ
+
+61
+00:03:32,970 --> 00:03:37,710
+stomach، فالـ HCL مع شوية تأثير وهيجان مع الأسبيرين
+
+62
+00:03:37,710 --> 00:03:43,790
+ممكن تعمل للأسف تقرحات، وممكن تصل للسرطان. هل بأخذ
+
+63
+00:03:43,790 --> 00:03:47,910
+anti-inflammatory drugs؟ زي إيش؟ أو steroids؟ يعني
+
+64
+00:03:47,910 --> 00:03:49,870
+هل بأخذ زي الـ anti-inflammatory اللي بكرا هناخدها
+
+65
+00:03:49,870 --> 00:03:52,630
+في الـ Pharmacology؟ زي الـ Diclofenac، الـ
+
+66
+00:03:52,630 --> 00:03:56,230
+Ibuprofen، الـ Naproxen، شغل زي هيك؟ بأخذ Cortisone،
+
+67
+00:03:56,230 --> 00:03:59,210
+Corticosteroids، أي حاجة زي هيك؟ لأن كل هذا يؤثر
+
+68
+00:03:59,210 --> 00:04:03,130
+على المعدة، وكله يحتاج ننتبه إليه، لأنه ممكن تكون
+
+69
+00:04:03,130 --> 00:04:07,810
+المعضلة الأساسية عنده في اللي هو أخذ الأدوية. طيب،
+
+70
+00:04:07,810 --> 00:04:10,410
+نشوف الـ gastrointestinal diagnostic tests، بنسأله
+
+71
+00:04:10,410 --> 00:04:17,160
+هل عملت أي فحوصات أو تشخيصات .. فحصية
+
+72
+00:04:17,160 --> 00:04:22,780
+طبية؟ زي إيش يعني؟ يعني عمرك أنت صورت المعدة؟ عمرك
+
+73
+00:04:22,780 --> 00:04:29,500
+أخذت صبغة وصورت؟ عمره حطوا لك مثلًا أنبوب وحطوا
+
+74
+00:04:29,500 --> 00:04:34,280
+صبغة وعملوا لك مثلًا والله صورة CT، أو مثلًا صورة
+
+75
+00:04:34,280 --> 00:04:38,300
+رنين؟ طيب، عمرك عملت عملية في المعدة أو في الأمعاء؟
+
+76
+00:04:38,300 --> 00:04:41,020
+كل هذا من الأسئلة اللي .. لازم قبل ما ندخل
+
+77
+00:04:41,020 --> 00:04:41,460
+المرحلة
+
+78
+00:04:44,040 --> 00:04:46,880
+Client، الآن بدنا بدنا نشتغل a place in supine
+
+79
+00:04:46,880 --> 00:04:49,060
+position. حطيناها في supine position، على اعتبار أن
+
+80
+00:04:49,060 --> 00:04:53,100
+الـ abdomen بيكون مرتاح شوية، relaxed، بس لازم
+
+81
+00:04:53,100 --> 00:04:57,100
+ما يكونش مشدود المريض، لأ، ما بقول يعني supine، كأنه
+
+82
+00:04:57,100 --> 00:05:02,540
+إحنا حاطينه وشدينه على الآخر، لأ، بنحطه بس بحيث أنه
+
+83
+00:05:02,540 --> 00:05:06,540
+لازم يكون في راحة تُعطى لعضلات البطن. بدنا
+
+84
+00:05:06,540 --> 00:05:10,770
+نجيب small pillows، يعني مخدتين صغيرتين، مش من المخدات
+
+85
+00:05:10,770 --> 00:05:13,610
+الكبار المساندة، مخدتين صغيرتين، زي اللي بيكونوا
+
+86
+00:05:13,610 --> 00:05:16,850
+مُحطوطات على الكنبات، وبنحط واحدة تحت الـ head، و
+
+87
+00:05:16,850 --> 00:05:20,090
+واحدة تحت الـ knees، يعني واحدة تحت رأسه، و
+
+88
+00:05:20,090 --> 00:05:23,330
+واحدة تحت إيش اللي هو الركبتين، بنخليه يثنيهم شوية صغيرة. سبحان الله، مجرد ما الرأس اللي حاطط تحته
+
+89
+00:05:23,330 --> 00:05:26,990
+اللي هو المخدة، والركبتين شوية ينثنوا، بتلاقي إيش
+
+90
+00:05:26,990 --> 00:05:30,430
+صار الـ abdominal muscles completely relaxed، صار في
+
+91
+00:05:30,430 --> 00:05:33,730
+إيش؟ اللي ارتخت العضلات. طبعًا، الـ abdomen exposed،
+
+92
+00:05:33,730 --> 00:05:38,560
+بدنا نكشف الـ abdomen من وين لوين؟ من عند الـ breasts
+
+93
+00:05:38,560 --> 00:05:42,100
+من عند منطقة الثدي إلى الـ symphysis pubis طبعًا
+
+94
+00:05:42,100 --> 00:05:45,600
+بتعرفوا الـ symphysis pubis، اللي هو تحت اللي عند
+
+95
+00:05:45,600 --> 00:05:47,820
+عظمة العانة، ليه؟ علشان هذا هو المكان اللي إحنا
+
+96
+00:05:47,820 --> 00:05:52,020
+بنعمل له assessment. خلصنا إحنا الـ chest، اليوم رايحين
+
+97
+00:05:52,020 --> 00:05:55,080
+على الـ abdomen. طب، كيف بدي أعمل؟ بقول لك أول حاجة
+
+98
+00:05:58,940 --> 00:06:02,660
+start with inspection. أكيد طبعًا عملنا التكشيف
+
+99
+00:06:02,660 --> 00:06:07,590
+للمنطقة. أول حاجة بتطلع بلاحظ. بعدين بجيب السماعة،
+
+100
+00:06:07,590 --> 00:06:10,190
+لاحظوا كيف إيش الترتيب، عمار، اللي بيصير، بجيب إيش
+
+101
+00:06:10,190 --> 00:06:14,950
+السماعة، بعدين إيش بنستخدم percussion، نَقر، آخر
+
+102
+00:06:14,950 --> 00:06:17,910
+حاجة الـ palpation، لاحظوا كيف اختلف ذاكرين، إحنا
+
+103
+00:06:17,910 --> 00:06:21,870
+لما قلنا الترتيب، هنا اختلف الترتيب، غير الترتيب
+
+104
+00:06:21,870 --> 00:06:25,480
+الأولاني اللي كنا نتكلم عنه. طب، ليه هنا اختلف؟ لأن
+
+105
+00:06:25,480 --> 00:06:28,560
+الـ inspection مش مؤذي، الـ auscultation مش مؤذي، الـ
+
+106
+00:06:28,560 --> 00:06:31,240
+percussion برضه مش مؤذي للـ abdomen، لكن الـ
+
+107
+00:06:31,240 --> 00:06:35,360
+palpation ممكن يعمل painful، خاصة لما أنا بدي أعمل
+
+108
+00:06:35,360 --> 00:06:39,140
+شوية pressure، وأضغط على اللي هو السطح البطني
+
+109
+00:06:39,140 --> 00:06:42,860
+للمريض، فممكن يعمل أذى، فبالتالي بأجل الـ palpation
+
+110
+00:06:42,860 --> 00:06:46,580
+للآخر، خاصة إن كان عنده appendicitis، ممكن عنده
+
+111
+00:06:46,580 --> 00:06:50,320
+gastric problem، ممكن يكون عنده cholecystitis، يعني
+
+112
+00:06:50,320 --> 00:06:55,680
+التهاب في اللي هو الحوصلة المرارية. وها كده. طيب، وين
+
+113
+00:06:55,680 --> 00:06:58,060
+أقف؟ إحنا ذاكرين في الـ assessment زمان، أول ما
+
+114
+00:06:58,060 --> 00:07:03,040
+حكينا، بقول لازم أقف على جنب المريض الأيمن، هي على
+
+115
+00:07:03,040 --> 00:07:06,840
+يمينك. you should stand on the right side of the
+
+116
+00:07:06,840 --> 00:07:10,320
+client. طب، ليه؟ عشان تقدر تكون أنت تقدر تعمل
+
+117
+00:07:10,320 --> 00:07:12,820
+assessment، وما تكونش قريب من الجهة الشمال عند
+
+118
+00:07:12,820 --> 00:07:17,690
+القلب مباشرةً. طيب، أول حاجة بعد ما إحنا نيمناه ورتبنا
+
+119
+00:07:17,690 --> 00:07:20,070
+الأمور، بقول بتأكد تعمل assessment زي ما أنتم
+
+120
+00:07:20,070 --> 00:07:24,270
+شايفين symmetrically، يعني بالتجانس، بالانتظام، بدون
+
+121
+00:07:24,270 --> 00:07:28,280
+ما تفتش من مكان لمكان، شوية شوية. Beginning، ابدأ
+
+122
+00:07:28,280 --> 00:07:31,280
+دائمًا من الـ left upper quadrant، مش أنت واقف على
+
+123
+00:07:31,280 --> 00:07:36,940
+اليمين؟ ابدأ دائمًا من الشمال المريض لفوق، يعني أنت
+
+124
+00:07:36,940 --> 00:07:40,180
+واقف على .. يعني زي ما بقوله، ابدأ بالبعيد عنك
+
+125
+00:07:40,180 --> 00:07:43,640
+بعدين تعال على القريب اللي عندك، علشان تقدر تعمل
+
+126
+00:07:43,640 --> 00:07:48,460
+assessment صحيح بشكل واضح. لازم نخلي المريض، يعني
+
+127
+00:07:48,460 --> 00:07:52,180
+أكرِمكم الله، يكون راح على الحمام، ويعني ويعني
+
+128
+00:07:52,180 --> 00:07:56,420
+ما يكونش فيه urine في الـ bladder، علشان نقدر لو
+
+129
+00:07:56,420 --> 00:08:00,140
+عملنا شوية pressure في المنطقة، ما يكون painful يعني
+
+130
+00:08:00,140 --> 00:08:06,240
+area بالنسبة له، وما يكونش fullness of urine. طيب، أول
+
+131
+00:08:06,240 --> 00:08:10,370
+حاجة الـ inspection. بقول هنا، جيب إحنا source of
+
+132
+00:08:10,370 --> 00:08:13,530
+light، بدنا نجيب مصدر ضوء، زي ما اتعلمنا زمان، الضوء
+
+133
+00:08:13,530 --> 00:08:17,070
+هذا ما يكونش يعمل تلون للجلد، لأ، زي ضوء الشمس، زي ضوء
+
+134
+00:08:17,070 --> 00:08:21,490
+مثلًا الإضاءات البيضاء، أو إضاءات مثلًا الشباك، أو
+
+135
+00:08:21,490 --> 00:08:26,450
+هكذا. ليه؟ عشان تشوف it changes. إيش في كلمة هنا
+
+136
+00:08:26,450 --> 00:08:30,230
+اسمها contours، بده يشوف يعني، contours معناه حدود
+
+137
+00:08:30,230 --> 00:08:34,090
+زي حدود أو تضاريس. فبقول ياريت تستخدم ضوء كويس عشان
+
+138
+00:08:34,090 --> 00:08:38,290
+تقدر تشوف حدود البطن، وتشوف إذا في أي abnormalities،
+
+139
+00:08:38,290 --> 00:08:43,670
+أي أشياء مش طبيعية، تقدر إيه تقدر تقدر تسجلها. أولًا
+
+140
+00:08:43,670 --> 00:08:47,790
+بأول، بعدين assess the presence or absence of
+
+141
+00:08:47,790 --> 00:08:51,270
+symmetry. وإحنا قاعدين بنعمل assessment، بدنا نشوف
+
+142
+00:08:51,270 --> 00:08:56,650
+هل في تجانس ولا في عدم تجانس؟ إيش يعني تجانس؟ يعني
+
+143
+00:08:56,650 --> 00:08:59,650
+لأ جيت الشمال غير عن اليمين، لأ جيت الـ abdomen من فوق
+
+144
+00:08:59,650 --> 00:09:02,550
+غير عن اللون من تحت، لأ جناها في الوسط، في مشكلة عند
+
+145
+00:09:02,550 --> 00:09:05,810
+الابانكس، كل وقت بكتبه. فيه distention؟ فيه إشي
+
+146
+00:09:05,810 --> 00:09:10,290
+منتفخ؟ فيه لقدر الله masses؟ هل فيه مثلًا كتل
+
+147
+00:09:10,290 --> 00:09:14,690
+منتفخة؟ هل لقدر الله  انْبين فيه peristaltic
+
+148
+00:09:14,690 --> 00:09:19,390
+waves؟ يعني هل انْبين، المفروض أنه ما تبينش بالمرة
+
+149
+00:09:19,390 --> 00:09:23,550
+حركة الأمعاء، لأنها في داخل البطن، لكن لو بينت، لأ،
+
+150
+00:09:23,550 --> 00:09:26,890
+لو بينت هذه علامة مش سهلة، ممكن يكون عنده abdominal
+
+151
+00:09:26,890 --> 00:09:30,130
+يعني، أو intestinal obstruction، ممكن يكون عنده يعني
+
+152
+00:09:30,130 --> 00:09:36,070
+انسداد، وبتحاول الأمعاء أن بكل قوة تضغط اللي عندها
+
+153
+00:09:36,070 --> 00:09:39,410
+في اتجاه الانسداد، فبيصير يبين حركة الأمعاء تحت
+
+154
+00:09:39,410 --> 00:09:44,030
+الجلد، هذا الكلام عشان نقدر نُحدِّده. بنسأل بعدين
+
+155
+00:09:44,030 --> 00:09:46,810
+وإحنا بنتطلع قاعدين، هل في respiratory movement؟
+
+156
+00:09:46,810 --> 00:09:48,430
+ما حد ييجي يقول لي طب إيش دخل الـ respiratory
+
+157
+00:09:48,430 --> 00:09:52,650
+movement؟ لأ، في بعض الناس كل نفسه بيبين كأنه في
+
+158
+00:09:52,650 --> 00:09:56,380
+البطن، كيف يعني في البطن؟ إن إحنا لما نتش نتطلع
+
+159
+00:09:56,380 --> 00:09:59,640
+عليه، خاصة زي بنات صغار، نتطلع ونلاقي البطن عامًا
+
+160
+00:09:59,640 --> 00:10:04,060
+اللي بيطلع و بينزل، بيطلع و بينزل. فبدنا نشوف هل في
+
+161
+00:10:04,060 --> 00:10:07,520
+respiratory movement في الـ abdomen، يعني هل حركة
+
+162
+00:10:07,520 --> 00:10:10,400
+النفس بتأثر على الـ abdomen في الـ inspiration والـ
+
+163
+00:10:10,400 --> 00:10:14,320
+expiration ولا لأ. طيب، بعدين بقول لك أنا inspect
+
+164
+00:10:14,320 --> 00:10:20,420
+abdominal skin، أتطلع على الجلد المغطي البطن، أتطلع
+
+165
+00:10:20,420 --> 00:10:23,760
+على pigmentation، على اللون اللي هو الجلد تبع البطن
+
+166
+00:10:24,540 --> 00:10:29,740
+لا سمح الله هل فيه jaundice؟ هل فيه lesions؟ أي ..
+
+167
+00:10:29,740 --> 00:10:33,600
+أي .. أي شيء فيه خلل في الجلد، بيسميه lesions في الـ
+
+168
+00:10:33,600 --> 00:10:38,120
+abdomen. هل فيه striae scars؟ هل فيه خطوط موجودة على
+
+169
+00:10:38,120 --> 00:10:42,020
+الـ abdomen، خاصة الستات الحوامل، لما يصير عندهم حمل،
+
+170
+00:10:42,020 --> 00:10:45,260
+توس
+
+223
+00:14:05,980 --> 00:14:10,320
+و الله بطنه بيكون مدور، طبيعي يكون مع الأطفال، وفي
+
+224
+00:14:10,320 --> 00:14:12,940
+المنطقة اللي هو لعند يعني تلات سنوات زي ال toddler
+
+225
+00:14:12,940 --> 00:14:18,340
+لعند سنة سنتين تلاتة، ال .. سبحان الله الطفل أصلا
+
+226
+00:14:18,340 --> 00:14:21,000
+زي ما بقوله يعني لو طلعت على الطفل بتلاقي كأنه كله
+
+227
+00:14:21,000 --> 00:14:26,230
+بطني؛ لأن اعتماده الكامل على إيش؟ تخزينه عن طريق
+
+228
+00:14:26,230 --> 00:14:29,970
+الحليب، فبيصير كل الـ abdomen عمّال وشغال عشان قضية
+
+229
+00:14:29,970 --> 00:14:33,010
+الـ metabolism وقضية الـ anabolism اللي بتكون سريعة
+
+230
+00:14:33,010 --> 00:14:37,450
+كتير، لكن في الـ adult لأ، إذا شفنا الـ rounded
+
+231
+00:14:37,450 --> 00:14:41,910
+abdomen في الـ adult شو بنقول؟ poor muscle، إيه؟
+
+232
+00:14:41,910 --> 00:14:45,210
+شعر، poor muscle، عضلات البطن ضعيفة، عضلات البطن
+
+233
+00:14:45,210 --> 00:14:48,750
+الجانبية ضعيفة، طب إيه اللي خلها ضعيفة؟ excessive، إيه؟
+
+234
+00:14:48,750 --> 00:14:52,910
+هنا subcutaneous fat deposition، طبعا ضعيفة من كتر
+
+235
+00:14:52,910 --> 00:14:57,650
+الدهن اللي موجود فيها، علشان هيك في بعض الناس عندهم
+
+236
+00:14:57,650 --> 00:15:01,650
+سبحان الله، بيجي السمن تبعهم أو النحافة تبعتهم، الـ
+
+237
+00:15:01,650 --> 00:15:04,970
+obesity بتيجي في الـ abdomen، وفي ناس لأ، بتبينش في
+
+238
+00:15:04,970 --> 00:15:07,650
+الـ abdomen، ممكن يكون يعني بيبين في أي مناطق تانية،
+
+239
+00:15:07,650 --> 00:15:10,770
+لكن اللي الناس بتبين عندهم بتلاقي الـ abdomen الـ
+
+240
+00:15:10,770 --> 00:15:16,050
+muscle مش قادر تسيطر، فبتلاقي الـ abdomen متقدم قدام
+
+241
+00:15:16,050 --> 00:15:21,650
+جسمه كتير، عامل round زي كأنه بالون، طيب النوع التالت
+
+242
+00:15:21,650 --> 00:15:25,400
+العكس طبعا، scaffold، مقعر، كيف قال لي كن كيف، إيش
+
+243
+00:15:25,400 --> 00:15:28,320
+كن كيف؟ يعني مقعر، إيش؟ لجوة، in the horizontal line،
+
+244
+00:15:28,320 --> 00:15:32,160
+يعني كأنه الخط المستعرض داخل لجوة، زي لما نيجي
+
+245
+00:15:32,160 --> 00:15:36,240
+إنسان ويحاول إيش؟ يضغط على بطنه، يدخله لجوة، بعض
+
+246
+00:15:36,240 --> 00:15:39,100
+الزمان كانوا يقولوا تقدر تدخل بطنك لجوة، كان
+
+247
+00:15:39,100 --> 00:15:42,900
+الأطفال يبقوا يتبارزوا ما بين بعض، فالإنسان لما
+
+248
+00:15:42,900 --> 00:15:46,780
+يدخل بطنه هذا تصنع، لكن في ناس already من كتر ما هم
+
+249
+00:15:46,780 --> 00:15:49,920
+نحيفين، خاصة الـ very thin persons، والـ very thin
+
+250
+00:15:49,920 --> 00:15:54,040
+clients، هذول خاصة، مش شرط يكون في عمره، فأي عمر هذول
+
+251
+00:15:54,040 --> 00:15:56,800
+اسمهم إيه؟ scaffold، يبقى عرفنا يبقى الـ contour
+
+252
+00:15:56,800 --> 00:16:00,380
+تلاتة: يا بيكون مسطح وهذا كويس، يا بيكون rounded،
+
+253
+00:16:00,380 --> 00:16:03,100
+بيكون فيه fat، دهون كتير، يا إما scaffold بيكون رفيع
+
+254
+00:16:03,100 --> 00:16:08,460
+كتير، طيب بقول لي inspect، اه الكلام اللي إحنا حكيناه
+
+255
+00:16:08,460 --> 00:16:14,850
+قبل شوية، ما تنساش تتطلع على حركات النفس في البطن، حركات
+
+256
+00:16:14,850 --> 00:16:18,250
+النفس في البطن اللي إحنا ممكن نشوفها خاصة
+
+257
+00:16:18,250 --> 00:16:21,010
+Retraction، إيش Retraction؟ طالع ونازل، طالع و
+
+258
+00:16:21,010 --> 00:16:25,770
+نازل الـ abdomen، إيش اسمها دي؟ اسمها Xernus Cyme،
+
+259
+00:16:25,770 --> 00:16:29,470
+اسمها إيه؟ Xernus Cyme، يبقى معناته، لو أجانا
+
+260
+00:16:29,470 --> 00:16:32,590
+السؤال، شو يعني Xernus Cyme؟ أو حد بده يسألنا،
+
+261
+00:16:32,590 --> 00:16:36,010
+وممكن حد في مقابلة عمل أو في وظيفة يغلبنا، شو Xernus
+
+262
+00:16:36,010 --> 00:16:40,800
+Cyme؟ بنقول له abnormal movement of the abdominal
+
+263
+00:16:40,800 --> 00:16:47,980
+wall during inspiration، عشان
+
+264
+00:16:47,980 --> 00:16:52,500
+بتصير، هذه اسمها external sign، طب متى بتصير عند بعض
+
+265
+00:16:52,500 --> 00:16:55,480
+الناس؟ بتصير عند بعض الناس اللي عندهم central
+
+266
+00:16:55,480 --> 00:16:58,880
+nervous system disease، بعض الأمراض اللي بتصيب
+
+267
+00:16:58,880 --> 00:17:03,720
+الجهاز العصبي المركزي، ما زي مرض يعني غريب، مش شرط
+
+268
+00:17:03,720 --> 00:17:05,500
+نشرحه الآن لأن أنتو هتاخدوه في الـ medical
+
+269
+00:17:05,500 --> 00:17:11,330
+surgical، اسمه Curia .. Curia .. هذا Curia، مرض يصيب
+
+270
+00:17:11,330 --> 00:17:13,370
+الجهاز العصبي، زي بعض الناس اللي عندهم rheumatic
+
+271
+00:17:13,370 --> 00:17:17,710
+fever، وبتتطور الحالة بيصير عندهم abnormal jerky
+
+272
+00:17:17,710 --> 00:17:21,290
+movements، بيصير عندهم حركات انتفاضية لا إرادية،
+
+273
+00:17:21,290 --> 00:17:25,030
+يعني ممكن وإحنا قاعدين معاه نعمله assessment، برفع
+
+274
+00:17:25,030 --> 00:17:28,830
+إيده، برجّها، أو بتجي رفع رجله ويرجعها، وممكن حتى
+
+275
+00:17:28,830 --> 00:17:34,030
+يؤذي اللي أمامه لكن بغير قصد، طيب escalation،
+
+276
+00:17:34,890 --> 00:17:37,210
+استخدمنا السماعة الآن، خلصنا inspection، جبنا
+
+277
+00:17:37,210 --> 00:17:40,390
+السماعة، أول حاجة،  بناخد السماعة، بدنا نشوف
+
+278
+00:17:40,390 --> 00:17:44,630
+البريستالتيك sounds، صوت اللي هو إيه؟ الأمعاء، هل
+
+279
+00:17:44,630 --> 00:17:49,550
+الأمعاء لها صوت؟ نعم، بس مش بسرعة الصوت اللي موجود في
+
+280
+00:17:49,550 --> 00:17:52,850
+الـ arteries ولا زي الصوت اللي موجود في الـ veins،
+
+281
+00:17:52,850 --> 00:17:59,200
+هذا الصوت زي waves، موجات، لكن بتمشي بطريقة خاصة، طبعا
+
+282
+00:17:59,200 --> 00:18:03,640
+إيش؟ الـ Verstatic، صحيح هو high، بتشد صوتها high، بتشد
+
+283
+00:18:03,640 --> 00:18:07,600
+يُعتبر حدّته عالية، بس مش معناته إحنا ممكن نسمعه، لأ،
+
+284
+00:18:07,600 --> 00:18:12,530
+ممكن نسمع بعض الأصوات لبعض الناس، إذا كان في عنده
+
+285
+00:18:12,530 --> 00:18:16,370
+اضطراب معوي أو عنده gastroenteritis، نزلة معوية،
+
+286
+00:18:16,370 --> 00:18:20,730
+بتلاقي بنسمع، بنقول: ما بطنك إيه؟ عمال إبو كركع، أنا
+
+287
+00:18:20,730 --> 00:18:24,350
+سامع صوت بطنك، هذا من الناس ما بقدر أقول normal
+
+288
+00:18:24,350 --> 00:18:29,010
+لحدث معين، طلع الصوت حالي لكن بشكل طبيعي، هل كلنا
+
+289
+00:18:29,010 --> 00:18:33,310
+بنقدر نسمع الـ prestatic sounds تبعت معاك؟ لأ، سبحان
+
+290
+00:18:33,310 --> 00:18:37,410
+الله، رحمة ربنا ما خلقنا بعض، عشان هذه من الأشياء
+
+291
+00:18:37,410 --> 00:18:41,510
+اللي سبحان الله ربنا سطرها علينا، طيب لما أبدأ أسمع
+
+292
+00:18:41,510 --> 00:18:44,890
+الـ pre-static sounds، بقول لي at least five
+
+293
+00:18:44,890 --> 00:18:48,750
+minutes، يعني ما تستعجب، حط السماعة وأقعد خمس
+
+294
+00:18:48,750 --> 00:18:53,950
+دقائق، أقل شيء، قبل ما تقول إنه لا سمح الله، إنه
+
+295
+00:18:53,950 --> 00:18:58,130
+في bowel sounds، طبعا مرات بقول لك bowel sounds، و
+
+296
+00:18:58,130 --> 00:19:01,670
+مرات بقول لك intestinal sounds، نفس الكلام، بدنا
+
+297
+00:19:01,670 --> 00:19:05,450
+نقعد خمس دقائق حاطين السماعة قبل ما نحكم إنه في
+
+298
+00:19:05,450 --> 00:19:09,350
+pre-static sounds or not، متى هذا الكلام بنحتاجه؟
+
+299
+00:19:10,060 --> 00:19:14,660
+الآن بنحتاجه، أفرض مريض بنسمع، بعض الناس طلع من
+
+300
+00:19:14,660 --> 00:19:18,920
+العملية بكرة، لما نروح نتدرب هنشوف أول شيء المريض
+
+301
+00:19:18,920 --> 00:19:24,060
+بينسأل من قبل الطبيب المعالج، الجراح: أخرجت ريح على
+
+302
+00:19:24,060 --> 00:19:27,180
+الحمام؟ طب ليش بيسأله هذا السؤال؟ أخرجت ريح، راحت على
+
+303
+00:19:27,180 --> 00:19:30,400
+الحمام؟ لما بيسأله هذا السؤال عشان الـ prestatic
+
+304
+00:19:30,400 --> 00:19:34,320
+movements، يشوفها اتحركت ولا لأ، طيب لو المريض جاله
+
+305
+00:19:34,320 --> 00:19:38,080
+لا، والله ما راحت، مش حاسس، ولا حاسس حالي، بطني واقف،
+
+306
+00:19:38,890 --> 00:19:41,410
+طبعا إيش؟ مش بيعمل .. ما يلبّي، الطبيب الشاطر بحط
+
+307
+00:19:41,410 --> 00:19:45,170
+السماعة أو بيقول للممرض أو للحكيم: حط السماعة على
+
+308
+00:19:45,170 --> 00:19:49,170
+منطقة الـ abdomen، وحطها خمس دقائق، إذا حسّ منها
+
+309
+00:19:49,170 --> 00:19:53,110
+لخمس دقائق اتحركت، صار في waves، كيف صوتها؟ اسمها
+
+310
+00:19:53,110 --> 00:19:56,450
+irregular، عشان regular يعني مش منتظمة، ما حد هيجي
+
+311
+00:19:56,450 --> 00:20:01,850
+يقول لي: والله يا أستاذ حسيت أنه يعني الصوت مرة عالي،
+
+312
+00:20:01,850 --> 00:20:09,500
+مرة واطي، مرة بحس إشي بدخل بقوة، مرة ضعيف، هو أصلا
+
+313
+00:20:09,500 --> 00:20:13,140
+اسمه irregular، يعني مش منتظم، مش زي القلب أو زي الـ
+
+314
+00:20:13,140 --> 00:20:18,420
+.. مش زي كمان الـ veins، طيب الـ duration، مدة الـ
+
+315
+00:20:18,420 --> 00:20:22,040
+single sound، إيش يعني؟ يعني مدة الصوت الواحد، الـ
+
+316
+00:20:22,040 --> 00:20:26,740
+peristaltic movement، بتكون less than a second، أقل من
+
+317
+00:20:26,740 --> 00:20:32,080
+إيه؟ أقل من ثانية واحدة، مرات بتكون إيش؟ أكثر، هذه
+
+318
+00:20:32,080 --> 00:20:35,560
+اللي هي إيه؟ الصوت الواحد، لكن إحنا قلنا عشان نحكم
+
+319
+00:20:35,560 --> 00:20:39,300
+إنه في صوت أو لأ، لازم نطول، عشان لأن في بعض الناس
+
+320
+00:20:39,300 --> 00:20:41,660
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+321
+00:20:41,660 --> 00:20:42,240
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+322
+00:20:42,240 --> 00:20:43,340
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+323
+00:20:43,340 --> 00:20:44,320
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+324
+00:20:44,320 --> 00:20:45,260
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+325
+00:20:45,260 --> 00:20:46,200
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+326
+00:20:46,200 --> 00:20:48,920
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+327
+00:20:48,920 --> 00:20:49,060
+الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ الـ
+
+328
+00:21:02,060 --> 00:21:07,460
+طيب كيف لو أنا حطيت سماعة ومش عارف .. مش عارف
+
+329
+00:21:07,460 --> 00:21:10,960
+أسمع، يعني مش قادر أحكم أنه في مشكلة ولا لأ، مش قادر
+
+330
+00:21:10,960 --> 00:21:14,340
+أحكم أنه في مشكلة ولا لأ، أنه هل عنده مشكلة عشان
+
+331
+00:21:14,340 --> 00:21:19,820
+أقدر أقول للطبيب إنه ما فيش حركة، طيب بقول لي طبعا
+
+332
+00:21:19,820 --> 00:21:24,780
+بقول لي هنا علشان إحنا نتأكد بدك تشجّع الـ
+
+333
+00:21:24,780 --> 00:21:28,800
+peristaltic movements، إيش يعني؟ يعني تشجيع اللي هو
+
+334
+00:21:28,800 --> 00:21:34,600
+الأمعاء إنها تتحرك عشان يطلع صوت، لو حد سألني: طب كيف
+
+335
+00:21:34,600 --> 00:21:38,800
+أنا أشجّع؟ بنقول له: بإيش؟ بحاجة اسمها direct percussion،
+
+336
+00:21:38,800 --> 00:21:42,700
+إيش direct percussion؟ بنعمل حاجة بسموها flicking،
+
+337
+00:21:42,700 --> 00:21:46,620
+إيش يعني flicking؟ زي ما بقوله يعني بالعامية عندنا
+
+338
+00:21:46,620 --> 00:21:50,040
+زي لما واحد بينخز واحد في منطقة الـ abdomen، زي لما
+
+339
+00:21:50,040 --> 00:21:54,540
+بيمزحوا ناس مع بعض وبيجي بيعمل عنده بطنه نخزة بسيطة،
+
+340
+00:21:54,540 --> 00:21:58,140
+أو حركة بسيطة بإصبعه، يعني بتطبطب على بطنه ضغطة
+
+341
+00:21:58,140 --> 00:22:02,390
+صغيرة، هذا بيسمى direct percussion، مجرد ما يعمل ضغط
+
+342
+00:22:02,390 --> 00:22:06,370
+صغير، ضغطة، بتلاقي إيش صار الـ abdominal إيه، يعني
+
+343
+00:22:06,370 --> 00:22:09,680
+الـ abdominal muscles دُغري شدّتو، الـ peristatic
+
+344
+00:22:09,680 --> 00:22:13,920
+waves اتحركت بشكل كبير جدا، فهذا بشجّع، عشان نتأكد
+
+345
+00:22:13,920 --> 00:22:17,220
+دا إكل، لا سمح الله، لو في paralysis، لأ بنوقف، علشان
+
+346
+00:22:17,220 --> 00:22:20,780
+هيك، لما نقول للطبيب، لما نسأل المريض وتأكدنا أنه
+
+347
+00:22:20,780 --> 00:22:24,880
+ما فيش صوت، لأ، بنخليه يقول لا يأكل ولا يشرب مية لما
+
+348
+00:22:24,880 --> 00:22:28,440
+نتأكد أن الأمعاء بدأت تشتغل كويس بعد العمليات
+
+349
+00:22:28,440 --> 00:22:34,390
+الجراحية، طيب بقول لي اسكت كمان، إيش كمان؟ Aortic
+
+350
+00:22:34,390 --> 00:22:37,670
+Sound، إيش دخل الأورطة؟ الأورطة موجودة في القلب،
+
+351
+00:22:37,670 --> 00:22:40,230
+لكن في حاجة .. في حاجة اسمها abdominal aorta،
+
+352
+00:22:40,230 --> 00:22:43,070
+أخذناها في الـ abdomen، أخذناها في الـ Anatomy، لازم
+
+353
+00:22:43,070 --> 00:22:46,230
+نسمع الـ Aortic Sound، وين الـ Aortic Sound يا
+
+354
+00:22:46,230 --> 00:22:51,690
+أستاذ في الـ abdomen؟ لازم نعرف إنه في حاجة موجودة
+
+355
+00:22:51,690 --> 00:22:55,430
+.. يعني لو إحنا جينا عند منطقة الـ Umbilicus وطلعنا
+
+356
+00:22:55,430 --> 00:22:58,330
+فوق الـ Umbilicus، أي إنسان ممكن يسمع .. يعني يسمع
+
+357
+00:22:58,330 --> 00:23:02,500
+حتى لنفسه، فوق الـ Umbilicus شوية، يعني نقول بوصة ونص
+
+358
+00:23:02,500 --> 00:23:05,620
+يعني تقريبا واحد انش، يعني من صنط ل إثنين صنط ونص،
+
+359
+00:23:05,620 --> 00:23:09,840
+لو حطينا السماعة هنسمع حاجة اسمها loud bruits، مش
+
+360
+00:23:09,840 --> 00:23:12,380
+loud bruits، مش لازم تكون عالية كتير، إحنا هنقول كلمة
+
+361
+00:23:12,380 --> 00:23:15,740
+bruits يعني اللي هو تدفق الدم في داخل جدار
+
+362
+00:23:15,740 --> 00:23:20,780
+الشريان، اسمه bruits، طيب لو سمعنا الصوت عالي، لا قدر
+
+363
+00:23:20,780 --> 00:23:24,290
+الله، زيادة عن اللزوم، لا، هذا بخوّف، بيكون إيش؟ هذا بيدل
+
+364
+00:23:24,290 --> 00:23:29,450
+إنه في aortic aneurysm، عنده فتق أو انبعاج في إيش؟
+
+365
+00:23:29,450 --> 00:23:32,570
+في الأورطة الصاعدة اللي موجودة فوق في الـ heart،
+
+366
+00:23:32,570 --> 00:23:36,490
+علشان هيك الطبيعي نسمع .. إحنا نسمع، ولا المريض ..
+
+367
+00:23:36,490 --> 00:23:40,070
+الطبيعي نسمع صوت بسيط جدا، لكن إذا الصوت عالي بدنا
+
+368
+00:23:40,070 --> 00:23:45,110
+نبلغ، لأنه ممكن يكون عنده مشكلة صحية خطيرة، بقول لي
+
+369
+00:23:45,110 --> 00:23:48,460
+أنا listen for bruits، يعني الـ friction rub، إيش كمان
+
+370
+00:23:48,460 --> 00:23:51,940
+بيقول لي: يا ريت وأنت بتسمع كمان، وإحنا قلناها قبل
+
+371
+00:23:51,940 --> 00:23:55,300
+هيك، إيش معنى friction rub؟ اسمع حوالين من منطقة
+
+372
+00:23:55,300 --> 00:23:59,380
+البين كل الـ .. الـ .. الـ abdominal organs، ما عداها،
+
+373
+00:23:59,380 --> 00:24:02,600
+ما عدا الـ kidneys اللي ورا، وما عدا اللي
+
+374
+00:24:02,600 --> 00:24:05,080
+بالعربي يعني، أنا بتكلم بشكل عام، الـ reproductive
+
+375
+00:24:05,080 --> 00:24:09,480
+system، سبحان الله، يعني سواء كان للذكر أو للأنثى،
+
+376
+00:24:09,480 --> 00:24:13,100
+وبتكلم كمان الـ urinary system، الله سبحانه وتعالى
+
+377
+00:24:13,100 --> 00:24:16,550
+خلاه extra-peritoneal، إيش يعني extra-peritoneal؟ يعني
+
+378
+00:24:16,550 --> 00:24:20,370
+خارج البريتون، بدون، زي المعدة والأمعاء والكبد
+
+379
+00:24:20,370 --> 00:24:24,690
+والطحال، كلها موجودة جوة البريتون، مرات البريتون
+
+380
+00:24:24,690 --> 00:24:27,790
+هذا اللي بيكون مغلّف ومغطّي، اللي هو زي المنديل،
+
+381
+00:24:27,790 --> 00:24:32,050
+بيسموه مغطّي كتير، زي ما شوفتوا عمركم كيف لما بيكون
+
+382
+00:24:32,050 --> 00:24:35,270
+اللحمة يعني، زي الخروف أو العجل، اللي لما بيجي و
+
+383
+00:24:35,270 --> 00:24:38,730
+بنفتح عشان نطلع الكرشة، الغشاء الكامل هذا اللي مغطّي
+
+384
+00:24:38,730 --> 00:24:43,180
+كل الـ organs هذه، اسمه peritoneal، بقول إن في بعض
+
+385
+00:24:43,180 --> 00:24:46,580
+الحالات ممكن يصير إنه friction، جفاف، عمل زي إشي
+
+386
+00:24:4
+
+445
+00:28:47,370 --> 00:28:51,190
+liver enlargement طالما كبر الـ liver organ يبقى بصير
+
+446
+00:28:51,190 --> 00:28:54,430
+بقدر كان أنا examiner كان أنا يعني قدام المريض
+
+447
+00:28:54,430 --> 00:28:59,760
+بقدر أعمله detection. خلينا .. بدنا نشرح هذه الـ
+
+448
+00:28:59,760 --> 00:29:03,580
+slide. أولا، شرا نتوقف للمحاضرة القادمة عشان ما
+
+449
+00:29:03,580 --> 00:29:07,380
+نكثِر الوقت كثيرًا. هالجد بيقولي طب كيف تعرف الـ
+
+450
+00:29:07,380 --> 00:29:11,560
+liver size؟ يعني كيف بدك تعرف حجم الكبد؟ الأقل حجم
+
+451
+00:29:11,560 --> 00:29:14,060
+الكبد أنا ما بدي أقعد أجيب ولا بدي أجيب يعني كأنه
+
+452
+00:29:14,060 --> 00:29:17,480
+أنا في عندي التصوير أو ultrasound، بيقولي أول حاجة
+
+453
+00:29:17,480 --> 00:29:20,920
+أنت قاعد بتعمل percussion، روح على الـ right، طبعًا
+
+454
+00:29:20,920 --> 00:29:24,080
+إحنا نقول الكبد وين؟ الكبد في اليمين، بيقول روح
+
+455
+00:29:24,080 --> 00:29:27,300
+على الـ right، بدك أول حاجة تبدأ من تحت، روح على الـ
+
+456
+00:29:27,300 --> 00:29:30,240
+right iliac crest. كلنا عارفين هذه الحوض وعظمة
+
+457
+00:29:30,240 --> 00:29:33,140
+الحوض .. روح على الـ right iliac crest على الحافة
+
+458
+00:29:33,140 --> 00:29:37,560
+بالضبط اللي في المنتصف تبع الـ iliac bone، وابدأ من
+
+459
+00:29:37,560 --> 00:29:40,660
+عندها اعمل percussion، وظلّ اعمل percussion وأنتَ
+
+460
+00:29:40,660 --> 00:29:42,340
+طالع .. يعني نعمل percussion .. percussion ..
+
+461
+00:29:42,340 --> 00:29:44,980
+percussion .. ونظلّ رايحين باتجاه الـ
+
+462
+00:29:44,980 --> 00:29:47,480
+midclavicular .. إيش يعني mid .. يعني رايحين
+
+463
+00:29:47,480 --> 00:29:51,760
+باتجاه اللي هو نصّ عظمة الترقوة، يعني تقريبًا على جبال
+
+464
+00:29:51,760 --> 00:29:55,180
+النّبل .. على جبال إيش .. النّبل اللي هو تبع الـ breast
+
+465
+00:29:55,480 --> 00:29:58,700
+ونضلّ طالعين، وإحنا بنطلع شوي شوي بنلاقي الصوت
+
+466
+00:29:58,700 --> 00:30:02,400
+إيه اختلف .. أول ما الصوت يختلف بيصير عندنا صوت
+
+467
+00:30:02,400 --> 00:30:05,240
+اسمه dullness اللي هو sound of ايه of liver ..
+
+468
+00:30:05,240 --> 00:30:09,300
+نعيد .. أول شيء بنروح على مبتدأ الـ right إلى الـ
+
+469
+00:30:09,300 --> 00:30:12,640
+crest، وبنبدأ نعمل percussion، وإحنا نعمل
+
+470
+00:30:12,640 --> 00:30:15,820
+percussion من تحت الصوت عادي عادي عادي .. أول ما
+
+471
+00:30:15,820 --> 00:30:19,620
+يصير dull، بروح بعلم، بقول هذه حدود الـ liver
+
+472
+00:30:19,620 --> 00:30:23,820
+السفلية، أول ما بيصير الصوت يختلف بحط خط وبقول هاي
+
+473
+00:30:23,820 --> 00:30:26,940
+صوت اللي هذا حدود الـ liver عشان نسميه lower border
+
+474
+00:30:26,940 --> 00:30:30,940
+طب كيف أعرف الـ upper ها؟ كيف بتعرف الـ upper
+
+475
+00:30:30,940 --> 00:30:34,600
+border؟ يعني كيف بتعرف الحدود العلوية؟ باجي العكس
+
+476
+00:30:34,600 --> 00:30:38,020
+بطلع فوق، بننزل من فوق لتحت، من أين ببدأ؟ من الـ
+
+477
+00:30:38,020 --> 00:30:40,920
+nipple، من منطقة الـ nipple في الـ midiclavicular،
+
+478
+00:30:40,920 --> 00:30:44,960
+نفس اليمين برضه، من عند اللي هو عظمة الترقوة من
+
+479
+00:30:44,960 --> 00:30:48,860
+النص، من عند الـ nipple اللي هو .. اللي هو تبع الـ
+
+480
+00:30:48,860 --> 00:30:52,860
+breast، اللي هو يعني عند الثدي الأيمن، وبننزل برضه
+
+481
+00:30:52,860 --> 00:30:55,100
+نفس القضية، بنضل نعمل percussion .. percussion
+
+482
+00:30:55,100 --> 00:31:00,100
+لَغاية ما الصوت يختلف، أو لأنّ وإحنا بنضغط فوق تنسوا
+
+483
+00:31:00,100 --> 00:31:03,460
+أنّ في rib cage يعني في قفص صدري، هيكون الصوت مختلف
+
+484
+00:31:03,460 --> 00:31:08,240
+مجرد ما الصوت يصير dull، الصوت يكون فيه ثقل، بقول اه
+
+485
+00:31:08,240 --> 00:31:14,160
+هاي حدود الكبد العلوية، وبروح إيش بحط خط صغير، بجيب
+
+486
+00:31:14,160 --> 00:31:18,580
+الخط طبعًا، هو مش بقول لك هنا هتلاقيه، يعني ما بين الـ
+
+487
+00:31:18,580 --> 00:31:22,300
+intercostal space الخامس أو السادس أو السابع حسب
+
+488
+00:31:22,300 --> 00:31:26,580
+اللي هو بنية الجسم اللي أمامنا، طبعًا أنا بجيب من
+
+489
+00:31:26,580 --> 00:31:32,680
+فوق، حطيت الخط، ومن تحت حطيت الخط، بجيب بينهم كده، بطلع
+
+490
+00:31:32,680 --> 00:31:37,260
+عندي من 6 إلى 12 سنتيمتر، هذه حدود الـ liver، طبعًا أنا
+
+491
+00:31:37,260 --> 00:31:40,380
+مش حاجة أسألكوا يعني وأقول لكم كيف بدك تشرح لي بالظبط
+
+492
+00:31:40,380 --> 00:31:44,020
+لأ، أنا بس يعني ممكن يجي طبيعة السؤال إنّه بس نعرف
+
+493
+00:31:44,020 --> 00:31:46,600
+كيف من الـ assessment للـ border، ممكن يجيك سؤال صح
+
+494
+00:31:46,600 --> 00:31:51,730
+وإحنا بنعطي أسئلة مثلًا multiple choice من هذا القبيل، لكنّ
+
+495
+00:31:51,730 --> 00:31:55,390
+أنا أقصد يعني ممكن أنا لقدر ما واحد حاسس أنّ الـ
+
+496
+00:31:55,390 --> 00:31:58,730
+liver عنده كبير ب .. بـ simple assessment ممكن نعرف
+
+497
+00:31:58,730 --> 00:32:02,130
+إنّه كبير ولا صغير بناءً على هذه الطريقة، طب الـ
+
+498
+00:32:02,130 --> 00:32:05,170
+stomach كيف؟ نفس الطريقة، بندقّ، نفس الطريقة
+
+499
+00:32:05,170 --> 00:32:07,890
+بدل ما نروح ناحية اليمين، خلينا نروح شوية على الشمال
+
+500
+00:32:07,890 --> 00:32:11,070
+ونضل نعمل إيش percussion، نفس القضية بس اللهمّ
+
+501
+00:32:11,070 --> 00:32:14,850
+الصوت هنا اسمه dull، الصوت هنا اسمه dullness، الصوت
+
+502
+00:32:14,850 --> 00:32:18,490
+هنا إيش اسمه tympani، برضه نفس القضية بنروح على
+
+503
+00:32:18,490 --> 00:32:21,630
+منطقة الـ stomach، وبننزل شوية من منطقة الـ rib cage
+
+504
+00:32:21,630 --> 00:32:25,750
+اللي هو برضه من القفص، بس من وين؟ من الأمام، يعني
+
+505
+00:32:25,750 --> 00:32:28,790
+المعدة هذه مش رايحة شوية على الشمال اللي ورا، لأ
+
+506
+00:32:28,790 --> 00:32:34,330
+رايحة جاية على الوسط شوية، مائلة ميل بسيط باتجاه
+
+507
+00:32:34,330 --> 00:32:36,230
+اليسار، ما أنتم عارفين في الـ anatomy، أمّا الـ liver
+
+508
+00:32:36,230 --> 00:32:41,110
+ماخذ شوية يعني المنطقة من فوق لتحت ومائل شوية
+
+509
+00:32:41,110 --> 00:32:44,550
+لليمين، إذًا بنعمل نفس القضية بنضل نعمل
+
+510
+00:32:44,550 --> 00:32:48,570
+percussion percussion، لما نوصل الصوت يختلف من فوق
+
+511
+00:32:48,570 --> 00:32:53,070
+والصوت من تحت كمان يختلف، بنقول هاي حدود المعدة
+
+512
+00:32:53,070 --> 00:32:57,410
+خلينا نوقف عند هذه الشريحة، ونكمل إن شاء الله
+
+513
+00:32:57,410 --> 00:33:01,550
+المحاضرة القادمة بإذن الله، السلام عليكم ورحمة الله
+
+514
+00:33:01,550 --> 00:33:02,070
+وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b35a11eeac62d3487549936dcaabea0858325ae6
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_postprocess.srt
@@ -0,0 +1,2056 @@
+1
+00:00:00,760 --> 00:00:03,880
+بسم الله الرحمن الرحيم ابني و بنات الطلبة اليوم
+
+2
+00:00:03,880 --> 00:00:08,540
+هنبدأ ان شاء الله في chapter رقم 9 اسيسمنت of the
+
+3
+00:00:08,540 --> 00:00:12,760
+abdomen طبعا زي ما اتعودنا في كل مرة لازم أول حاجة
+
+4
+00:00:12,760 --> 00:00:16,440
+نبحث عن ايه ال subjective data و ماننساش أنه طبعا
+
+5
+00:00:16,440 --> 00:00:20,040
+ال abdomen بقول عنه largest body cavity هو أكبر
+
+6
+00:00:20,040 --> 00:00:23,820
+تجويف في جسم الإنسان على احتوائه من ال .. اللي
+
+7
+00:00:23,820 --> 00:00:27,620
+خليني اقول يعني ال body organs بشكل عام يعني أجهزة
+
+8
+00:00:27,620 --> 00:00:32,230
+جسم الإنسان طيبأول حاجة نسأل على ال nutritional
+
+9
+00:00:32,230 --> 00:00:34,910
+history اللي هي على اعتبارها من الحاجات المهمة جدا
+
+10
+00:00:34,910 --> 00:00:38,170
+و الأساسية اللي هي ممكن تأثر على صحة الإنسان بشكل
+
+11
+00:00:38,170 --> 00:00:40,990
+عام و أنتوا عارفين أي system حاولنا نعمله
+
+12
+00:00:40,990 --> 00:00:43,470
+assessment ضروري جدا نشوف ال nutritional status
+
+13
+00:00:43,470 --> 00:00:47,690
+لأن في الآخر هي بتودينا إما healthy person أو لا
+
+14
+00:00:47,690 --> 00:00:50,210
+سمح الله unhealthy persons أو يعني moderate أو
+
+15
+00:00:50,210 --> 00:00:54,870
+هكذا أول حاجة نسأل على appetite شهيته للطعام كيف؟
+
+16
+00:00:55,530 --> 00:00:58,950
+weight loss organ هل فقد وزن او زاد وزنه طبعا
+
+17
+00:00:58,950 --> 00:01:02,590
+دائما سؤالنا مش على اطلاق يعني فقدت وزن في حياتك
+
+18
+00:01:02,590 --> 00:01:06,150
+لأ دائما احنا سؤالنا يكون محدد اخر ست شهور عشان
+
+19
+00:01:06,150 --> 00:01:09,250
+نعرف حالنا بالظبط و احنا وين رايحين مابينفع نسأله
+
+20
+00:01:09,250 --> 00:01:12,750
+الآن كده وش فاجدت واحد يكون عامل مثلا رجيم او عامل
+
+21
+00:01:12,750 --> 00:01:15,970
+اي شيء ويقولك والله انا ايه الاسبوع ماشي على حمية
+
+22
+00:01:15,970 --> 00:01:20,270
+لأ احنا نسأله اخر ست شهور كيف كان وضعك اللي بعد ما
+
+23
+00:01:20,270 --> 00:01:23,790
+نسأل السؤالهل في عندك أعراض gastrointestinal
+
+24
+00:01:23,790 --> 00:01:27,570
+symptoms يعني أعراض إلى علاقة بالمعدة و بالأمعاء
+
+25
+00:01:27,570 --> 00:01:31,730
+يعني كجهاز هضمي و ملحقاته؟ زي إيش الأعراض؟ يعني
+
+26
+00:01:31,730 --> 00:01:35,130
+أنت عانيت من dysphagia؟ في عندك صعوبة في البلع؟
+
+27
+00:01:35,130 --> 00:01:38,510
+صار عندك nausea؟ صار في vomiting؟ كل ان انتوا
+
+28
+00:01:38,510 --> 00:01:43,400
+عارفين الكلمات هذه؟كلمات بسيطة و يعني سهلة، هل في
+
+29
+00:01:43,400 --> 00:01:46,120
+صار indigestion؟ إيش يعني indigestion؟ يعني عصر
+
+30
+00:01:46,120 --> 00:01:49,540
+هضم، هل صار في عندك عصر هضم عشان نقدر نحدد
+
+31
+00:01:49,540 --> 00:01:52,840
+المسافات؟ وين اللي احنا بدنا نجرب؟ لأن هي محطة
+
+32
+00:01:52,840 --> 00:01:56,720
+عشان نقدر نشخص، ثم بعد ذلك بنسأله عن ال bowel
+
+33
+00:01:56,720 --> 00:02:00,140
+habits، طبعا أكيد السؤال ده بشكل يعني .. بشكل
+
+34
+00:02:00,140 --> 00:02:05,300
+اعتيادي بنسأله، يعني لما بتروح الحمامجديش بتروح،
+
+35
+00:02:05,300 --> 00:02:10,120
+كيف انت يعني هل عندك إشكالية معينة، في problems
+
+36
+00:02:10,120 --> 00:02:15,520
+يعني خاصة يمكن يقول اه والله في مرات بيصير شوية
+
+37
+00:02:15,520 --> 00:02:19,240
+mucus، ممكن يقول في blood، هو اللي بيحكي بلغته مش
+
+38
+00:02:19,240 --> 00:02:22,880
+بلغتنا، بنسأله بعدين ال pain، الألم، نلاحظين أن ال
+
+39
+00:02:22,880 --> 00:02:25,180
+pain اتأخر شوية قبل ما نسأله أول حاجة عن normal
+
+40
+00:02:25,180 --> 00:02:29,210
+state، بعدين بنسأله أيش عن abnormalطيب في قلم؟ اه
+
+41
+00:02:29,210 --> 00:02:31,430
+والله في قلم، وين موجود عندهم؟ بيقولوا والله عند
+
+42
+00:02:31,430 --> 00:02:34,230
+.. مثلا عندهم في الجهة اليمين، الجهة اليسار، ايا
+
+43
+00:02:34,230 --> 00:02:37,790
+كان، يبقى نروح عليها، نسأل وين ال location، ال
+
+44
+00:02:37,790 --> 00:02:40,390
+quality كيفية القلم، ال pattern، إيش اللي موجود
+
+45
+00:02:40,390 --> 00:02:43,490
+بالظبط، إيش ال slope تبع القلم، هل هو حاد، هل هو
+
+46
+00:02:43,490 --> 00:02:46,010
+chronic، هل .. إيش اللي موجود بالظبط؟ relationship
+
+47
+00:02:46,010 --> 00:02:49,870
+to إيه؟ ingestion of إيه؟ of food، يعني هل إيه
+
+48
+00:02:49,870 --> 00:02:55,160
+علاقة هذا القلم بابتلاع وأكل الطعام ولا لأ؟لأن في
+
+49
+00:02:55,160 --> 00:02:58,160
+بعض الناس بيقولك أنا بيصير معايا ألم لما باكل كده،
+
+50
+00:02:58,160 --> 00:03:01,580
+هذا غير عن واحد بيقول أنا بيصير معايا ألم لحتى لو
+
+51
+00:03:01,580 --> 00:03:05,740
+ماكلتش، هذا اختلف الموضوع طيب use of medications،
+
+52
+00:03:05,740 --> 00:03:09,040
+بنسأل السؤال العام، هذا بنسأله لأي مريض، أنت بتاخد
+
+53
+00:03:09,040 --> 00:03:13,080
+علاج، بيقولك أه، لأ، إذا أه، لنسأله شو الإلاج، إذا
+
+54
+00:03:13,080 --> 00:03:16,470
+لأ، و هذا خدناه في ال care plan في سنة أولىالابن
+
+55
+00:03:16,470 --> 00:03:18,630
+سأله ايش طبيعة العلاج؟ ممكن يكون باخد أسبيرين،
+
+56
+00:03:18,630 --> 00:03:20,650
+واحد بيقول ايش هي على الأسبيرين؟ الأسبيرين معناه
+
+57
+00:03:20,650 --> 00:03:24,050
+مشكلة، ممكن اللي بدأ عنده باخد أسبيرين بشكل كبير
+
+58
+00:03:24,050 --> 00:03:28,010
+ومستمر، ممكن يصبح عنده شوية stress موجودة، يبقى
+
+59
+00:03:28,010 --> 00:03:30,730
+gastric erogenous، راح على .. لإن أنا بتأثر
+
+60
+00:03:30,730 --> 00:03:32,970
+الأسبيرين على البريتل سيتز، تبعت إيش؟ تبعت ال
+
+61
+00:03:32,970 --> 00:03:37,710
+stomach، فال HCL مع شوية تأثر وهيجان مع الأسبيرين
+
+62
+00:03:37,710 --> 00:03:43,790
+ممكن تعمل للأسف تقرحات وممكن تصل لألسر، هل باخد
+
+63
+00:03:43,790 --> 00:03:47,910
+anti-inflammatory drugs؟زي أيش؟ أو سترويتز؟ يعني
+
+64
+00:03:47,910 --> 00:03:49,870
+هل بأخد زي الـ Anti-inflammatory اللي بكرا هناخدها
+
+65
+00:03:49,870 --> 00:03:52,630
+في الـ Pharmacology؟ زي الـ Diclofene، الـ
+
+66
+00:03:52,630 --> 00:03:56,230
+Propheno، الروفينال، شغل زي هيك؟ بأخد Cortisone،
+
+67
+00:03:56,230 --> 00:03:59,210
+Corticosteroids، أي حاجة زي هيك؟ لأن كل هذا يؤثر
+
+68
+00:03:59,210 --> 00:04:03,130
+على المعدة وكله يحتاج ننتبه إليه لأنه ممكن تكون
+
+69
+00:04:03,130 --> 00:04:07,810
+المعضلة الأساسية عنده في اللي هو أخذ الهلاجة طيب،
+
+70
+00:04:07,810 --> 00:04:10,410
+نشوف ال gastrointestinal diagnostic test، بنسأله
+
+71
+00:04:10,410 --> 00:04:17,160
+هل عملت أي فحوصات أو تشخيصاتفحصية .. تشخصات فحصية
+
+72
+00:04:17,160 --> 00:04:22,780
+إليك زي إيش يعني؟ يعني عمرك أنت صورت المعدة؟ عمرك
+
+73
+00:04:22,780 --> 00:04:29,500
+أخدت سبغة و صورت؟ عمره حطولك مثلا بربيش و حطوا
+
+74
+00:04:29,500 --> 00:04:34,280
+سبغة و اعملولك مثلا والله صورة CT أو مثلا صورة
+
+75
+00:04:34,280 --> 00:04:38,300
+رنين؟ طيب عمرك عملت عملية في المعدة أو في الأمعاء؟
+
+76
+00:04:38,300 --> 00:04:41,020
+كل هذا من الأسئلة اللي .. اللازم قبل ما ندخل
+
+77
+00:04:41,020 --> 00:04:41,460
+المرحلة
+
+78
+00:04:44,040 --> 00:04:46,880
+Client الآن بدنا بدنا نشتغل a place in sublime
+
+79
+00:04:46,880 --> 00:04:49,060
+position حطناها في sublime position على اعتبار ان
+
+80
+00:04:49,060 --> 00:04:53,100
+ال abdomen بيكون مرتاح شوية relaxed بس لازم
+
+81
+00:04:53,100 --> 00:04:57,100
+مايكونش مشدود المريض لأ ما بقول يعني sublime كأنه
+
+82
+00:04:57,100 --> 00:05:02,540
+احنا حاطينه و شدينه على الاخر لأ بنحطه بس بحيث انه
+
+83
+00:05:02,540 --> 00:05:06,540
+لازم يكون الراحة اللي تعطيني لعضلات البطن بدنا
+
+84
+00:05:06,540 --> 00:05:10,770
+نجيب small pillows يعني مخدتين صغارمش من المخدات
+
+85
+00:05:10,770 --> 00:05:13,610
+الكبار المساندة، مخدتين أصغر زي اللي بيكونوا
+
+86
+00:05:13,610 --> 00:05:16,850
+محتوطات على الكنبات و بنحط واحدة تحت ال head و
+
+87
+00:05:16,850 --> 00:05:20,090
+واحدة تحت ال knees، يعني تحت واحدة تحت رأسه و
+
+88
+00:05:20,090 --> 00:05:23,330
+واحدة تحت إيش اللي هو الركبتين، بنخليه يثنيهم و
+
+89
+00:05:23,330 --> 00:05:26,990
+شوية صغيرة، سبحان الله مجرد ما الرأس اللي حاط تحته
+
+90
+00:05:26,990 --> 00:05:30,430
+اللي هو المخدة و الركبتين شوية ينفنوا، بتلاقي إيش
+
+91
+00:05:30,430 --> 00:05:33,730
+صار ال abdominal muscle completely relaxed، صار في
+
+92
+00:05:33,730 --> 00:05:38,560
+إيش؟ اللي ارتخت العضلاتطبعا ال abdomen exposed
+
+93
+00:05:38,560 --> 00:05:42,100
+بدنا نكشف ال abdomen من وين لوين من عند ال breast
+
+94
+00:05:42,100 --> 00:05:45,600
+من عند منطقة الثدى لل synthesis بيوبيسون طبعا
+
+95
+00:05:45,600 --> 00:05:47,820
+بتعرفين ال synthesis بيوبيسون اللي و تحت اللي عند
+
+96
+00:05:47,820 --> 00:05:52,020
+أول العنة ليه؟ علشان هذا هو المكان اللي احنا
+
+97
+00:05:52,020 --> 00:05:55,080
+بنعمله assessment خلصنا احنا ال chest اليوم رايحين
+
+98
+00:05:55,080 --> 00:05:58,940
+على ال abdomen طب كيف بدي اعمل؟ بقولي أول حاجة
+
+99
+00:05:58,940 --> 00:06:02,660
+start with inspection أكيد طبعا عملناه التكشيف
+
+100
+00:06:02,660 --> 00:06:07,590
+للمنطقة أول حاجة بتطلع بلاحظبعدين بجيب السماعة،
+
+101
+00:06:07,590 --> 00:06:10,190
+لاحظين كيف ايش الترتيب عمار اللي بيصير، بجيب ايش
+
+102
+00:06:10,190 --> 00:06:14,950
+السماعة، بعدين ايش بستخدم percussion، نقر، اخر
+
+103
+00:06:14,950 --> 00:06:17,910
+حاجة ال palpation، لاحظين كيف اختلف ذاكرين، احنا
+
+104
+00:06:17,910 --> 00:06:21,870
+لما نقولنا الترتيب، هنا اختلف الترتيب غير الترتيب
+
+105
+00:06:21,870 --> 00:06:25,480
+الأولان اللي كنا نتكلم عنه، طب ليه هنا اختلف؟لأن
+
+106
+00:06:25,480 --> 00:06:28,560
+ال inspection مش مؤذى، ال auscultation مش مؤذى، ال
+
+107
+00:06:28,560 --> 00:06:31,240
+percussion برضه مش مؤذى لل abdomen، لكن ال
+
+108
+00:06:31,240 --> 00:06:35,360
+palpation ممكن يعمل painful خاصة لما أنا بده أعمل
+
+109
+00:06:35,360 --> 00:06:39,140
+شوية pressure و أضغط على اللي هو السطح البطن
+
+110
+00:06:39,140 --> 00:06:42,860
+للمريض فممكن يعمل أذى، فبالتالي بأجل ال palpation
+
+111
+00:06:42,860 --> 00:06:46,580
+للآخر خاصة إن كان عنده appendicitis، ممكن عنده
+
+112
+00:06:46,580 --> 00:06:50,320
+gastric problem، ممكن يكون عنده cholecystitis يعني
+
+113
+00:06:50,320 --> 00:06:55,680
+التهابفي اللي هو الحواصلة المرارية وها كده طيب وين
+
+114
+00:06:55,680 --> 00:06:58,060
+أجاف؟ احنا ذاكرين في ال assessment زمان أول ما
+
+115
+00:06:58,060 --> 00:07:03,040
+حكينا بقول لازم أجاف على جنب المريض الأيمن هي على
+
+116
+00:07:03,040 --> 00:07:06,840
+يمين you should stand in the right side of the
+
+117
+00:07:06,840 --> 00:07:10,320
+client طب ليه؟ عشان تقدر تكون أنت تقدر تعمل
+
+118
+00:07:10,320 --> 00:07:12,820
+assessment وما تكونش قريب من الجهة الشمال عند
+
+119
+00:07:12,820 --> 00:07:17,690
+القلب مباشرةطيب أول حاجة بعد ما احنا نيمنا و رتبنا
+
+120
+00:07:17,690 --> 00:07:20,070
+الأمور بقول بتاكد تعمل assessment زي ما انتوا
+
+121
+00:07:20,070 --> 00:07:24,270
+شايفين symmetrically يعني بالتجانس بالانتظام بدون
+
+122
+00:07:24,270 --> 00:07:28,280
+ما تفطش من مكان لمكان شوية شويةBeginning ابدأ
+
+123
+00:07:28,280 --> 00:07:31,280
+دايما من الـ left upper quadrant مش انت واقف على
+
+124
+00:07:31,280 --> 00:07:36,940
+اليمين ابدأ دايما من الشمال المريض لفوق يعني انت
+
+125
+00:07:36,940 --> 00:07:40,180
+واقف على .. يعني زي ما بقوله ابدأ بالبعيد عنك
+
+126
+00:07:40,180 --> 00:07:43,640
+بعدين تعال على الجريب اللي عندك علشان تقدر تعمل
+
+127
+00:07:43,640 --> 00:07:48,460
+assessment صحيح بشكل واضحلازم نخلي المريض يعني
+
+128
+00:07:48,460 --> 00:07:52,180
+أكرمكم الله يكون رعي على الحمام ويعني ويعني
+
+129
+00:07:52,180 --> 00:07:56,420
+مايكونش فيه urine في ال bladder علشان نقدر لو
+
+130
+00:07:56,420 --> 00:08:00,140
+عملنا شوية pressure في المنطقة مايكون painful يعني
+
+131
+00:08:00,140 --> 00:08:06,240
+area بالنسبة له ومايكونش fullness of urine طيب أول
+
+132
+00:08:06,240 --> 00:08:10,370
+حاجة ال inspectionبقول هنا جيب احنا source of
+
+133
+00:08:10,370 --> 00:08:13,530
+light بدنا نجيب مصدر ضوء زي ما اتعلمنا زمان الضوء
+
+134
+00:08:13,530 --> 00:08:17,070
+هذا ميكونش يعمل تلوين للجلد لأ زي ضوء الشمس زي ضوء
+
+135
+00:08:17,070 --> 00:08:21,490
+مثلا الإضاءات البيضاء او إضاءات مثلا الشباك او
+
+136
+00:08:21,490 --> 00:08:26,450
+هكذا ليه؟ عشان تشوف it changes ايش في كلمة هنا
+
+137
+00:08:26,450 --> 00:08:30,230
+اسمها contours بده يشوف يعني contours معناه حدود
+
+138
+00:08:30,230 --> 00:08:34,090
+زي حدود او تضاريس فبقول ياريت تستخدم ضوء كويس عشان
+
+139
+00:08:34,090 --> 00:08:38,290
+تقدر تشوف حدود البطنوتشوف اذا في اي abnormalities
+
+140
+00:08:38,290 --> 00:08:43,670
+اي اشياء مش طبيعية تقدر ايه تقدر تقدر تسجلها اولا
+
+141
+00:08:43,670 --> 00:08:47,790
+باول بعدين assess the presence or absence of
+
+142
+00:08:47,790 --> 00:08:51,270
+symmetry واحنا قاعدين بنعمل assessment بدنا نشوف
+
+143
+00:08:51,270 --> 00:08:56,650
+هل في تجانس ولا في عدم تجانس ايش يعني تجانس يعني
+
+144
+00:08:56,650 --> 00:08:59,650
+لاجيت الشمال غير عن اليمين لاجيت ال abdomen من فوق
+
+145
+00:08:59,650 --> 00:09:02,550
+غير عن اللون من تحت لاجناها في الوسط في مشكلة عند
+
+146
+00:09:02,550 --> 00:09:05,810
+الاباناكس كل وقت بكتبهفيه distention؟ فيه إشي
+
+147
+00:09:05,810 --> 00:09:10,290
+منتفق؟ فيه لقدر الله masses؟ هل فيه مثلا كتل
+
+148
+00:09:10,290 --> 00:09:14,690
+انبينة؟ هل لقدر الله انبينه فيه breast-tactic
+
+149
+00:09:14,690 --> 00:09:19,390
+wave؟ يعني هل انبين المفروض أنه ما تبينش بالمرة
+
+150
+00:09:19,390 --> 00:09:23,550
+حركة الأمعاء لأنها في داخل البطن لكن لو بينت، لأ
+
+151
+00:09:23,550 --> 00:09:26,890
+لو بينت هذه علامة مش سهلة ممكن يكون عنده abdominal
+
+152
+00:09:26,890 --> 00:09:30,130
+يعني أو intestinal obstruction ممكن يكون عنده يعني
+
+153
+00:09:30,130 --> 00:09:36,070
+انسدادوبتحاول الأمعاء أن بكل قوة تضغط اللي عندها
+
+154
+00:09:36,070 --> 00:09:39,410
+في اتجاه الانزداد فبصير يبين حركة الأمعاء تحت
+
+155
+00:09:39,410 --> 00:09:44,030
+الجلد، هذا الكلام عشان نقدر ندونه، بنسأل بعدين
+
+156
+00:09:44,030 --> 00:09:46,810
+واحنا بنتطلع قاعدين، هل في respiratory movement؟
+
+157
+00:09:46,810 --> 00:09:48,430
+ما حد ييجي يقولي طب إيش دخل ال respiratory
+
+158
+00:09:48,430 --> 00:09:52,650
+movement؟ لأ، في بعض الناس كل نفسه بيبين كأنه في
+
+159
+00:09:52,650 --> 00:09:56,380
+البطن، كيف يعني في البطن؟إن احنا لما نتش نتطلع
+
+160
+00:09:56,380 --> 00:09:59,640
+عليه خاصة زي بنات صغار نتطلع و نلاقي البطن عاما
+
+161
+00:09:59,640 --> 00:10:04,060
+اللي بيطلع و بينزل بيطلع و بينزل فبدنا نشوف هل في
+
+162
+00:10:04,060 --> 00:10:07,520
+respiratory movement في ال abdomen يعني هل حركة
+
+163
+00:10:07,520 --> 00:10:10,400
+النفس من عكس على ال abdomen في ال inspiration و ال
+
+164
+00:10:10,400 --> 00:10:14,320
+expiration ولا لأ طيب بعدين بقولي انا inspect
+
+165
+00:10:14,320 --> 00:10:20,420
+abdominal skin اتطلع على الجلد المغطي البطن اتطلع
+
+166
+00:10:20,420 --> 00:10:23,760
+على pigmentation على اللون اللي هو الجلد تبع البطن
+
+167
+00:10:24,540 --> 00:10:29,740
+لا سمح الله هل فيه جونديز؟ هل فيه legions؟ أي ..
+
+168
+00:10:29,740 --> 00:10:33,600
+اي .. اي شيء فيه خلل في الجلد بيسميه legions في ال
+
+169
+00:10:33,600 --> 00:10:38,120
+abdomen هل فيه stria scars؟ هل فيه خطوط موجودة على
+
+170
+00:10:38,120 --> 00:10:42,020
+ال abdomen خاصة الستات الحوامل لما يصير عندهم حمله
+
+171
+00:10:42,020 --> 00:10:45,260
+توسع نظرهم في بعض الشباب كمان لما بيرعبوا رياضة
+
+172
+00:10:45,260 --> 00:10:49,300
+بتلاقي في إيديهم لما توسعت العضلات تبعتهم بيعمل زي
+
+173
+00:10:49,300 --> 00:10:52,700
+نوع من حاجة بيسموها stria scarsاللي خطوط عملت زي
+
+174
+00:10:52,700 --> 00:10:56,740
+ندبات زي خطوط في داخل جسمهم، هل في موجود خطوط ولا
+
+175
+00:10:56,740 --> 00:11:00,540
+لا؟ هل في dehydration؟ انبين على جلد بطنه انه فيه
+
+176
+00:11:00,540 --> 00:11:04,860
+جفاف وانبين زي ما بيقولوا زي جلدة على عطمة بمعناه؟
+
+177
+00:11:04,860 --> 00:11:07,360
+يعني بشكل عام نشوف ايش ال general nutritional
+
+178
+00:11:07,360 --> 00:11:12,960
+status الحالة الغذائية بشكل عام، كل هذا الكلام
+
+179
+00:11:12,960 --> 00:11:17,580
+بدلل انه انا كيف صحيت المريض بشكل عام، لسه انا
+
+180
+00:11:17,580 --> 00:11:21,120
+بتطلع، لسه ما مدتش ايدي، كله inspectionبشوف
+
+181
+00:11:21,120 --> 00:11:24,860
+الambulicus منطقة كمان السرة هل فيها مشكلة ولا
+
+182
+00:11:24,860 --> 00:11:29,220
+مافيها مشكلة كل وقتش بيعطيني general state of
+
+183
+00:11:29,220 --> 00:11:32,100
+health يعني معناته ال inspection of the abdomen
+
+184
+00:11:32,100 --> 00:11:36,940
+هذا هو مربط الفرص بيقول ليه بيعطيك اللي هو الحكم
+
+185
+00:11:36,940 --> 00:11:42,760
+العام على المستوى الصحي للمريض طيب نيجي على الكلمة
+
+186
+00:11:42,760 --> 00:11:45,760
+على الكلمة اللي أنا حكيتها وقولت كلمة contour of
+
+187
+00:11:45,760 --> 00:11:48,420
+the abdomenهل جيت لما نقول كلمة contour of the
+
+188
+00:11:48,420 --> 00:11:52,180
+abdomen يعني حدود .. حدود ال إيه؟ البطن هل جيت هل
+
+189
+00:11:52,180 --> 00:11:57,060
+كل ال abdomen .. كل ال abdomen زي بعض؟ هل كل الناس
+
+190
+00:11:57,060 --> 00:12:00,540
+زي بعض؟ أبدا لا ولا واحد مافيش أصلا لا يمكن أن
+
+191
+00:12:00,540 --> 00:12:04,900
+يتطابق أي عضو يعني خاص يكون خارجي مع أي إنسان
+
+192
+00:12:04,900 --> 00:12:07,540
+سبحان الله إيه يعني plus or minus دايما فيه
+
+193
+00:12:07,540 --> 00:12:10,780
+اختلافات فيه تقارب فيه تشابه لكن مافيش تطابق ال
+
+194
+00:12:10,780 --> 00:12:15,260
+contour لل abdomen بيوصف بتلات كلمات كيف يعني تلات
+
+195
+00:12:15,260 --> 00:12:19,480
+كلمات؟يعني لو جينا بدنا نقول كيف حدود البطن عند
+
+196
+00:12:19,480 --> 00:12:21,880
+الراجل الفلاني، عند الست الفلانية، عند الطفل
+
+197
+00:12:21,880 --> 00:12:26,400
+فلاني، يا بيكون Flat، يا بيكون Rounded، يا بيكون
+
+198
+00:12:26,400 --> 00:12:30,540
+Scaphoid، الآن هنشرح إيش معناة Flat، إيش Rounded،
+
+199
+00:12:30,540 --> 00:12:35,200
+إيش Scaphoid، طبعا Flat مسطح، Rounded يعني زي إيش،
+
+200
+00:12:35,200 --> 00:12:39,260
+Round كأنه ملفوف لف، Scaphoid لأ زي الرفيع جدا
+
+201
+00:12:39,260 --> 00:12:42,920
+اللي بيكون داخل لجوه، زي اللي هو العدسة المقعرة،
+
+202
+00:12:42,920 --> 00:12:47,120
+يعني لجوه شويةطيب ال contour ليش احنا بدناها عشان
+
+203
+00:12:47,120 --> 00:12:49,800
+هو انا بعمل inspection اعرف وبيعطينا description
+
+204
+00:12:49,800 --> 00:12:53,020
+عشان اتطلع على ال line هذا اللي موجود اللي من ال
+
+205
+00:12:53,020 --> 00:12:56,280
+rib margin من المنطقة اللي هو ايش القفص الصدري
+
+206
+00:12:56,280 --> 00:13:00,180
+لعند ايش ال pubic bone اللي عند عضمة اللي هو اللي
+
+207
+00:13:00,180 --> 00:13:06,880
+هو التحت عضمة العين علشان اشوف عضمة الحوت لفوق مع
+
+208
+00:13:06,880 --> 00:13:11,100
+القفص الصدري بتطلع عليه بشوف ال contour حدود ال
+
+209
+00:13:11,100 --> 00:13:15,110
+abdomen كله بشكل عامإذا لجيت ال abdomen مسطّعت زي
+
+210
+00:13:15,110 --> 00:13:19,730
+الناس الرياضيين، إيش اسم هذا؟ Flat contour، مين
+
+211
+00:13:19,730 --> 00:13:23,210
+هذول الناس اللي هم muscularly إيش هذا competent؟
+
+212
+00:13:23,210 --> 00:13:26,930
+الناس اللي رياضيين أو الناس اللي مش نصحين ولا
+
+213
+00:13:26,930 --> 00:13:30,600
+ارفع؟الناس يعني اللي جسم .. اللي بطنه ما شاء الله
+
+214
+00:13:30,600 --> 00:13:34,780
+ماشي كله مع الصدر مصدرة زي منتصب القامة بيمشي
+
+215
+00:13:34,780 --> 00:13:39,260
+بتلاقي مش هو يتصنع لأ هو مافيش abdomen طالع ولا ال
+
+216
+00:13:39,260 --> 00:13:42,960
+abdomen داخل هو يعني جسمه طبيعي هذا إيش بنقول عنه
+
+217
+00:13:42,960 --> 00:13:46,340
+well nourished يعني هذا بنقول عنه إيش هذا متغذى
+
+218
+00:13:46,340 --> 00:13:50,940
+جيدا بشكل عام و بيكون صحته منيحة النوع التاني اسمه
+
+219
+00:13:50,940 --> 00:13:55,060
+rounded abdomenاللي هو الإنسان صاحب البطن الاش
+
+220
+00:13:55,060 --> 00:13:57,960
+الملفوف، يعني اللي زي المدور، اللي عامل زي
+
+221
+00:13:57,960 --> 00:14:02,680
+الدائرة، طب عليش أقول أنا normally بشكل طبيعي؟بكون
+
+222
+00:14:02,680 --> 00:14:05,980
+عند ال infant يعني مايجي واحد يقولي طيب الطفل صغير
+
+223
+00:14:05,980 --> 00:14:10,320
+و الله بطنه بكون مدور طبيعي يكون مع الأطفال و في
+
+224
+00:14:10,320 --> 00:14:12,940
+المنطقة اللي هو لعند يعني تلت سنوات زي ال toddler
+
+225
+00:14:12,940 --> 00:14:18,340
+لعند سنة سنتين تلاتة ال .. سبحان الله الطفل أصلا
+
+226
+00:14:18,340 --> 00:14:21,000
+زي ما بقوله يعني لو طلعت على الطفل بتلاقي كأنه كله
+
+227
+00:14:21,000 --> 00:14:26,230
+بطني لأن اعتماده الكامل على إيش تخزيتهعن طريق
+
+228
+00:14:26,230 --> 00:14:29,970
+الحليب فبصير كل ال abdomen عمّال و شغال عشان قضية
+
+229
+00:14:29,970 --> 00:14:33,010
+ال metabolism و قضية ال anabolism اللي بتكون سريعة
+
+230
+00:14:33,010 --> 00:14:37,450
+كتير لكن في ال adult لأ اذا شفنا ال rounded
+
+231
+00:14:37,450 --> 00:14:41,910
+abdomen في ال adult شو بيقوم بنقول poor muscle ايه
+
+232
+00:14:41,910 --> 00:14:45,210
+شعر poor muscle عضلات البطن ضعيفة عضلات البطن
+
+233
+00:14:45,210 --> 00:14:48,750
+أشمالها ضعيفة طب ايه اللي خلها ضعيفة excessive ايه
+
+234
+00:14:48,750 --> 00:14:52,910
+هنا subcutaneous fat depos gene طبعا ضعيفة من كتر
+
+235
+00:14:52,910 --> 00:14:57,650
+الفات اللي موجود فيهاعلشان هيك في بعض الناس عندهم
+
+236
+00:14:57,650 --> 00:15:01,650
+سبحان الله بيجي السمن تبعهم او النصاحة تبعتهم ال
+
+237
+00:15:01,650 --> 00:15:04,970
+obesity بتيجي في ال abdomen و في ناس لأ بتبينش في
+
+238
+00:15:04,970 --> 00:15:07,650
+ال abdomen ممكن يكون يعني بيبين في اي مناطق تانية
+
+239
+00:15:07,650 --> 00:15:10,770
+لكن اللي ناس بتبين عندهم بتلاقي ال abdomen ال
+
+240
+00:15:10,770 --> 00:15:16,050
+muscle مش قادر تسيطر فبتلاقي ال abdomen متقدم قدام
+
+241
+00:15:16,050 --> 00:15:21,650
+جسمه كتير عامل round زي كأنه بلون طيب النوع التالت
+
+242
+00:15:21,650 --> 00:15:25,400
+العكس طبعا scaffoldمزلس كفويت قال لي كن كيف، إيش
+
+243
+00:15:25,400 --> 00:15:28,320
+كن كيف يعني مقعر، إيش لجوة، in the horizontal line
+
+244
+00:15:28,320 --> 00:15:32,160
+يعني كأنه الخط المستعدر داخل لجوة زي لما نيجي
+
+245
+00:15:32,160 --> 00:15:36,240
+إنسان و يحاول إيش، يضغط على بطنه، يدخله لجوة بعض
+
+246
+00:15:36,240 --> 00:15:39,100
+الزمان كانوا يقولوا تقدر تدخل بطنك لجوة كان
+
+247
+00:15:39,100 --> 00:15:42,900
+الأطفال يبقوا يتبارزوا ما بين بعض فالإنسان لما
+
+248
+00:15:42,900 --> 00:15:46,780
+يدخل بطنه هذا تصنع لكن في ناس already من كتر ما هم
+
+249
+00:15:46,780 --> 00:15:49,920
+thin خاصة ال very thin personsو ال very thin
+
+250
+00:15:49,920 --> 00:15:54,040
+clients هذول خاصة مش شرط يكون في عمره فأي عمر هذول
+
+251
+00:15:54,040 --> 00:15:56,800
+اسمهم ايه scaffold يبقى عارفنا يبقى ال contour
+
+252
+00:15:56,800 --> 00:16:00,380
+تلاتة يا بيكون مسطح و هذا كويس يا بيكون rounded
+
+253
+00:16:00,380 --> 00:16:03,100
+بيكون fat دبوسين كتير يا اما scaffold بيكون رفيع
+
+254
+00:16:03,100 --> 00:16:08,460
+كتير طيب بقولي inspect اه الكلام اللي احنا حكيناه
+
+255
+00:16:08,460 --> 00:16:14,850
+قبل شويةتنساش تتطلع على حركات النفس في البطن حركات
+
+256
+00:16:14,850 --> 00:16:18,250
+النفس في البطن اللي احنا ممكن نشوفها خاصة
+
+257
+00:16:18,250 --> 00:16:21,010
+Retraction، ايش Retraction؟ طالع و نازل، طالع و
+
+258
+00:16:21,010 --> 00:16:25,770
+نازل ال abdomen، ايش اسمها دي؟ اسمها Xernus Cyme،
+
+259
+00:16:25,770 --> 00:16:29,470
+اسم ايه؟ Xernus Cyme، يبقى معناته، لو أجانا
+
+260
+00:16:29,470 --> 00:16:32,590
+السؤال، شو يعني Xernus Cyme؟ أو حد بدي يسألنا،
+
+261
+00:16:32,590 --> 00:16:36,010
+وممكن حد في مقابلة مكرا في وظيفة يغلبنا، شو Xernus
+
+262
+00:16:36,010 --> 00:16:40,800
+Cyme؟بنقوله abnormal movement of the abdominal
+
+263
+00:16:40,800 --> 00:16:47,980
+wall during inspiration عشان
+
+264
+00:16:47,980 --> 00:16:52,500
+بتصير هذي اسمها exernal sign طب متى بتصير عند بعض
+
+265
+00:16:52,500 --> 00:16:55,480
+الناس بتصير عند بعض الناس اللي عندهم central
+
+266
+00:16:55,480 --> 00:16:58,880
+nervous system disease بعض الأمراض اللي بتصيب
+
+267
+00:16:58,880 --> 00:17:03,720
+الجهاز العصبي المركزي مزايش مرض يعني غريب مش شرط
+
+268
+00:17:03,720 --> 00:17:05,500
+تشرحه الآن لأن انتوا هتاخدوه في ال medical
+
+269
+00:17:05,500 --> 00:17:11,330
+surgicalاسمه Curia .. Curia .. هذا Curia مرض يصيب
+
+270
+00:17:11,330 --> 00:17:13,370
+الجهاز العصبي زي بعض الناس اللي عندهم rheumatic
+
+271
+00:17:13,370 --> 00:17:17,710
+fever و بتتطور الحالة بيصير عندهم abnormal jerky
+
+272
+00:17:17,710 --> 00:17:21,290
+movements بيصير عندهم حركات انتفاضية لا إرادية
+
+273
+00:17:21,290 --> 00:17:25,030
+يعني ممكن و إحنا قاعدين معاه نعمله assessment برفع
+
+274
+00:17:25,030 --> 00:17:28,830
+إيده برجّه أو بتجي رفع رجله و رجعها و ممكن حتى
+
+275
+00:17:28,830 --> 00:17:34,030
+يؤذي اللي أمامه لكن بغير القصد طيب escalation
+
+276
+00:17:34,890 --> 00:17:37,210
+استخدمنا السماعة الآن خلصنا inspection جبنا
+
+277
+00:17:37,210 --> 00:17:40,390
+السماعة أول حاجة لاقاش السماعة بدنا نشوف
+
+278
+00:17:40,390 --> 00:17:44,630
+البريستالتيك sounds صوت اللي هو أيه الأمعاء هل
+
+279
+00:17:44,630 --> 00:17:49,550
+الأمعاء لصوت نعم بس مش بسرعة الصوت اللي موجود في
+
+280
+00:17:49,550 --> 00:17:52,850
+ال arteries ولا زي الصوت اللي موجود في ال veins
+
+281
+00:17:52,850 --> 00:17:59,200
+هذا الصوت زي waves موجات لكن بتمشي بطريقة خاصةطبعا
+
+282
+00:17:59,200 --> 00:18:03,640
+ايش ال Verstatic صحيح هو high بتشد صوتها high بتشد
+
+283
+00:18:03,640 --> 00:18:07,600
+يعتبر حدته عالية بس مش معناته احنا ممكن نسمعه لأ
+
+284
+00:18:07,600 --> 00:18:12,530
+ممكن نسمع بعض الأصوات لبعض الناسإذا كان في عنده
+
+285
+00:18:12,530 --> 00:18:16,370
+اضطراب معوي أو عنده gastroenteritis نزلة معوية
+
+286
+00:18:16,370 --> 00:18:20,730
+بتلاقي بنسمع بنقول ما البطنك إيه عمال إبو كركع أنا
+
+287
+00:18:20,730 --> 00:18:24,350
+سامع صوت بطنك هذا من الناس ما بقدر أقول normal
+
+288
+00:18:24,350 --> 00:18:29,010
+لحدث معين طلع الصوت حالي لكن بشكل طبيعي هل كلنا
+
+289
+00:18:29,010 --> 00:18:33,310
+بنقدر نسمع ال prestatic sounds تبعت معاك؟ لأ سبحان
+
+290
+00:18:33,310 --> 00:18:37,410
+الله رحمة ربنا ماخلقنا بعض عشان هذه من الأشياء
+
+291
+00:18:37,410 --> 00:18:41,510
+اللي سبحان الله ربنا سطرها علينا طيبلما بدأ أسمع
+
+292
+00:18:41,510 --> 00:18:44,890
+ال pre-static sounds، بقوللي at least five
+
+293
+00:18:44,890 --> 00:18:48,750
+minutes، يعني ما تستعجب، حط السماعة و أقعد خمس
+
+294
+00:18:48,750 --> 00:18:53,950
+دقائق، أقل شيء، قبل ما تقول إنه لا سمح الله، إنه
+
+295
+00:18:53,950 --> 00:18:58,130
+في bowel sounds، طبعا مرات بقولك bowel sounds و
+
+296
+00:18:58,130 --> 00:19:01,670
+مرات بقولك intestinal sounds، نفس الكلام، بدنا
+
+297
+00:19:01,670 --> 00:19:05,450
+نقعد خمس دقائق حاطين السماعة قبل ما نحكم إنه في
+
+298
+00:19:05,450 --> 00:19:09,350
+pre-static sounds or not، متى هذا كلام بنحتاجه؟
+
+299
+00:19:10,060 --> 00:19:14,660
+الان بنحتاجه افرضه مريض بنسمع بعض الناس طلع من
+
+300
+00:19:14,660 --> 00:19:18,920
+العملية بكرا لما روح نتدرب هنشوف اول شي المريض
+
+301
+00:19:18,920 --> 00:19:24,060
+بينسأل من قبل الطبيب المعالج الجراح اخرجت ريح على
+
+302
+00:19:24,060 --> 00:19:27,180
+الحمام طب ليش بيسأله ده السؤال اخرجت ريح روحت على
+
+303
+00:19:27,180 --> 00:19:30,400
+الحمام لما بيسأله ده السؤال عشان ال prestatic
+
+304
+00:19:30,400 --> 00:19:34,320
+movements يشوفها اتحركت ولا لأ طيب لو المريض جاله
+
+305
+00:19:34,320 --> 00:19:38,080
+لا و الله ماروحتش مش حاسس ولا حاسس حالي بطني واقف
+
+306
+00:19:38,890 --> 00:19:41,410
+طبعا إيش مش بيعمل .. مالبيش الطبيب الشاطر بحط
+
+307
+00:19:41,410 --> 00:19:45,170
+السماعة أو بيقول للممرض أو للحكيم حطل السماعة على
+
+308
+00:19:45,170 --> 00:19:49,170
+منطقة ال abdomen و حطها خمس دقايق إذا حاس منها
+
+309
+00:19:49,170 --> 00:19:53,110
+لخمس دقايق اتحركت صار في waves كيف صوتها اسمها
+
+310
+00:19:53,110 --> 00:19:56,450
+irregular عشان regular يعني مش منتظمة ماحد هيجي
+
+311
+00:19:56,450 --> 00:20:01,850
+يقولي والله يا أستاذ حاسيت أنه يعني الصوت مرة بعلة
+
+312
+00:20:01,850 --> 00:20:09,500
+مرة بوطة مرة بحس إشي بدخل بقوة مرة ضعيفهو اصلا
+
+313
+00:20:09,500 --> 00:20:13,140
+اسمه irregular يعني مش منتظر مش زي القلب او زي ال
+
+314
+00:20:13,140 --> 00:20:18,420
+.. مش زي كمان ال veins طيب ال duration مدة ال
+
+315
+00:20:18,420 --> 00:20:22,040
+single sound ايش يعني؟ يعني مدة الصوت الواحد ال
+
+316
+00:20:22,040 --> 00:20:26,740
+peristaltic movement بتكون less than second اقل من
+
+317
+00:20:26,740 --> 00:20:32,080
+ايه؟ اقل من ثانية واحدة مرات بتكون ايش؟ اكثرهذه
+
+318
+00:20:32,080 --> 00:20:35,560
+اللي هي ايه الصوت الواحد لكن احنا قلنا عشان نحكم
+
+319
+00:20:35,560 --> 00:20:39,300
+انه في صوت او لأ لازم اطول عشان لأن في بعض الناس
+
+320
+00:20:39,300 --> 00:20:41,660
+يعني ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+321
+00:20:41,660 --> 00:20:42,240
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+322
+00:20:42,240 --> 00:20:43,340
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+323
+00:20:43,340 --> 00:20:44,320
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+324
+00:20:44,320 --> 00:20:45,260
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+325
+00:20:45,260 --> 00:20:46,200
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+326
+00:20:46,200 --> 00:20:48,920
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+327
+00:20:48,920 --> 00:20:49,060
+ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال ال
+
+328
+00:21:02,060 --> 00:21:07,460
+طيب كيف لو أنا حطيت سماعة و مش عارف .. مش عارف
+
+329
+00:21:07,460 --> 00:21:10,960
+أسمع يعني مش قادر أحكم أنه في مشكلة ولا لأ مش قادر
+
+330
+00:21:10,960 --> 00:21:14,340
+أحكم أنه في مشكلة ولا لأ أنه هل عنده مشكلة عشان
+
+331
+00:21:14,340 --> 00:21:19,820
+أقدر أقول للطبيب أنه مافيش حركة طيب بقوللي طبعا
+
+332
+00:21:19,820 --> 00:21:24,780
+بقوللي هنا علشان احنا نتأكد بدك تشجع ال
+
+333
+00:21:24,780 --> 00:21:28,800
+peristaltic movements ايش يعني يعني الشجع اللي هو
+
+334
+00:21:28,800 --> 00:21:34,600
+الأمعاءإنها تتحرك عشان يطلع صوت لو حد سألني طب كيف
+
+335
+00:21:34,600 --> 00:21:38,800
+أنا أشجع بقولنا بإيش بحاجة اسمها direct percussion
+
+336
+00:21:38,800 --> 00:21:42,700
+إيش direct percussion بنعمل حاجة بسموها flicking
+
+337
+00:21:42,700 --> 00:21:46,620
+إيش يعني flicking زي ما بقوله يعني بالعامية عندنا
+
+338
+00:21:46,620 --> 00:21:50,040
+زي لما واحد بينخز واحد في مطقة ال abdomen زي لما
+
+339
+00:21:50,040 --> 00:21:54,540
+بيمزحوا ناس مع بعض وبيجي بعمله عند بطنه نخزة بسيطة
+
+340
+00:21:54,540 --> 00:21:58,140
+أو حركة بسيطة بإصبعه يعني بتغطله على بطنه ضغطة
+
+341
+00:21:58,140 --> 00:22:02,390
+صغيرةهذا بيسمى direct percussion، مجرد ما يعمل ضغط
+
+342
+00:22:02,390 --> 00:22:06,370
+صغير، ضغطة، بتلاقي إيش صار ال abdominal إيه، يعني
+
+343
+00:22:06,370 --> 00:22:09,680
+ال abdominal muscles دُغر شدّتو الـ prostatic
+
+344
+00:22:09,680 --> 00:22:13,920
+waves اتحركت بشكل كبير جدا فهذا بشجع عشان نتأكد
+
+345
+00:22:13,920 --> 00:22:17,220
+داكل لا سمح الله لو في paralysis لأ بنوقف علشان
+
+346
+00:22:17,220 --> 00:22:20,780
+هيك لما نقول للطبيب لما نسأل المريض و أتأكدنا أنه
+
+347
+00:22:20,780 --> 00:22:24,880
+مافيش صوت لأ بنخلوش يقول لا أكل ولا يشرب ميه لما
+
+348
+00:22:24,880 --> 00:22:28,440
+نتأكد أن الأمعاق بدأت تشغل كويس بعد العمليات
+
+349
+00:22:28,440 --> 00:22:34,390
+الجراحية طيب بقول ياسكلتت كمان ايش كمان؟Aortic
+
+350
+00:22:34,390 --> 00:22:37,670
+Sound، إيش دخل الأورطة؟ الأورطة موجودة في القلب،
+
+351
+00:22:37,670 --> 00:22:40,230
+لكن في حاجة .. في حاجة اسمها أبدومنا الأورطة،
+
+352
+00:22:40,230 --> 00:22:43,070
+أخدناها في الأبدوم، أخدناها في الـ Anatomy لازم
+
+353
+00:22:43,070 --> 00:22:46,230
+نسمع الـ Aortic Sound، وين الـ Aortic Sound يا
+
+354
+00:22:46,230 --> 00:22:51,690
+أستاذ في الأبدومين؟ لازم نعرف إنه في حاجة موجودة
+
+355
+00:22:51,690 --> 00:22:55,430
+.. يعني لو إحنا جينا عند مطقة الـ Umbricus وطلعنا
+
+356
+00:22:55,430 --> 00:22:58,330
+فوق الـ Umbricus، أي إنسان ممكن يسمع .. يعني يسمع
+
+357
+00:22:58,330 --> 00:23:02,500
+حتى لنفسه، فوق الـ Umbricus شويةيعني نقول بصنط و
+
+358
+00:23:02,500 --> 00:23:05,620
+نص يعني تقريبا واحد انش يعني من صنط ل اتن صنط و نص
+
+359
+00:23:05,620 --> 00:23:09,840
+لو حطينا السماعة هنسمع حاجة اسمها loud brutes مش
+
+360
+00:23:09,840 --> 00:23:12,380
+loud brutes مش لازم تكون عالي كتير ماحنا هقولنا
+
+361
+00:23:12,380 --> 00:23:15,740
+كلمة brutes يعني اللي هو تدفق الدم في داخل جدار
+
+362
+00:23:15,740 --> 00:23:20,780
+الشريان اسمه brutes طيب لو سمعنا الصوت عالي لاقدر
+
+363
+00:23:20,780 --> 00:23:24,290
+الله زيادة عن الزوم لا هذا بخوفبكون إيش؟ هذا بيدل
+
+364
+00:23:24,290 --> 00:23:29,450
+إنه في أوورتك أنيوريزم عنده فتق أو انبعاج في إيش؟
+
+365
+00:23:29,450 --> 00:23:32,570
+في الأورطة المركزي اللي موجودة فوق في ال heart
+
+366
+00:23:32,570 --> 00:23:36,490
+علشان هيك الطبيعي نسمع .. إحنا نسمع ولا المريض ..
+
+367
+00:23:36,490 --> 00:23:40,070
+الطبيعي نسمع صوت بسيط جدا لكن إذا الصوت عالي بدنا
+
+368
+00:23:40,070 --> 00:23:45,110
+نبلغ لأنه ممكن يكون عنده مشكلة صحية خطيرة بقولي
+
+369
+00:23:45,110 --> 00:23:48,460
+أنا listenfor Breton يعني ال friction rub ايش كمان
+
+370
+00:23:48,460 --> 00:23:51,940
+بيقولي يا ريت و انت بتسمع كمان و احنا قولناها قبل
+
+371
+00:23:51,940 --> 00:23:55,300
+هيك ايش بمعنى friction rub اسمع حوالين من منطقة
+
+372
+00:23:55,300 --> 00:23:59,380
+البين كل ال .. ال .. ال abdominal organs ما عداها
+
+373
+00:23:59,380 --> 00:24:02,600
+ما عدا ال kidneys اللي اللي ورا و ما عدا اللي
+
+374
+00:24:02,600 --> 00:24:05,080
+بالعربي يعني انا بتكلم بشكل عام ال reproductive
+
+375
+00:24:05,080 --> 00:24:09,480
+system سبحان الله يعني سواء كان للمل و لا ل الفميل
+
+376
+00:24:09,480 --> 00:24:13,100
+و بتكلم كمان ال urinary system الله سبحانه وتعالى
+
+377
+00:24:13,100 --> 00:24:16,550
+خلاه extra Bretonإيش يعني extra-peritoneal يعني
+
+378
+00:24:16,550 --> 00:24:20,370
+خارج البريتون بدون ذلك زي المعدة و الأمعاء و الكبد
+
+379
+00:24:20,370 --> 00:24:24,690
+و السفين كلها موجودة جوا البريتون مرات البريتون
+
+380
+00:24:24,690 --> 00:24:27,790
+هذا اللي بيكون مغلف و مغطى اللي هو زي المنديل
+
+381
+00:24:27,790 --> 00:24:32,050
+بيسموه مغطى كتير زي ما شوفتوا عمركوا كيف لما بيكون
+
+382
+00:24:32,050 --> 00:24:35,270
+اللحمة يعني زي الخروف أو العجل اللي لما بيجي و
+
+383
+00:24:35,270 --> 00:24:38,730
+بفتح عشان يطول الكرشة الغشاء الكامل هذا اللي مغط
+
+384
+00:24:38,730 --> 00:24:43,180
+كل ال organs هذه اسمه peritonealبقول ان في بعض
+
+385
+00:24:43,180 --> 00:24:46,580
+الحالات ممكن يصير انه friction رب جفاف عمل زي اشي
+
+386
+00:24:46,580 --> 00:24:51,080
+محتك احتكاك خاصة في منطقة ال liver منطقة الكبد او
+
+387
+00:24:51,080 --> 00:24:56,020
+منطقة اي اتحال هذا بتدل ان او لا قدر الله في
+
+388
+00:24:56,020 --> 00:24:59,860
+abscess او لا قدر الله في مثلا hepatitis او liver
+
+389
+00:24:59,860 --> 00:25:04,260
+cirrhosis تليف كبد كل هذا كلام وين ممكن نسمعه؟
+
+390
+00:25:04,260 --> 00:25:07,500
+بقول في اللي هو ال rib cage يعني تحت القفص الصدري
+
+391
+00:25:08,000 --> 00:25:12,900
+ما احنا عارفين ال liver في اليمين لفوق، ال spleen
+
+392
+00:25:12,900 --> 00:25:17,700
+في اليسار لتحت شوية، يعني جانب المعدة، ليه؟ فين؟
+
+393
+00:25:17,700 --> 00:25:21,140
+لا قدر الله لو سمعنا صوت، اشي محتاج مع بعض كيف
+
+394
+00:25:21,140 --> 00:25:25,340
+محتاج، هيه بيشرحلي، بقول لي بيشبه كأنه two pieces
+
+395
+00:25:25,340 --> 00:25:30,970
+كأنه قطعتين ورق مع بعضLether بحتكن مع بعض لو شعرنا
+
+396
+00:25:30,970 --> 00:25:34,150
+و احنا بنحط السماعة في المنطقة اليمين او في
+
+397
+00:25:34,150 --> 00:25:37,610
+المنطقة اليسار حسينا كأنه اشي بحتك في بعضه زي هذا
+
+398
+00:25:37,610 --> 00:25:42,310
+الصقب كأنه اشي بحتك بنروح بنبلغ الطبيب المعالج انه
+
+399
+00:25:42,310 --> 00:25:46,550
+في friction rub هذا يعني انه لقدر الله ممكن يكون
+
+400
+00:25:46,550 --> 00:25:50,750
+يعني liver organ كبر على درجة انه ضغط على منطقة
+
+401
+00:25:50,750 --> 00:25:56,790
+البريتونوعملت عملية اللي هو يعني خليني أقول فقدت
+
+402
+00:25:56,790 --> 00:26:01,390
+اللزوجة فصار يحتاج كأنه بيحتاج أشياء يعني hard
+
+403
+00:26:01,390 --> 00:26:05,190
+pieces كأنه أشياء يعني قوية و ناشفة بتحتاج مع بعض
+
+404
+00:26:05,190 --> 00:26:12,270
+طيب نيجي على ال percussion لجيت
+
+405
+00:26:12,270 --> 00:26:15,450
+ال percussion بيقولي عشان تعمل detection لل fluid
+
+406
+00:26:15,450 --> 00:26:19,690
+orgasis بدك تعمل ال percussion عشان تشوف كده كمية
+
+407
+00:26:19,690 --> 00:26:24,320
+السوائل كده كمزاتقداش كمية الانتفاخات أو لا قدر
+
+408
+00:26:24,320 --> 00:26:27,520
+الله هل فيه masses؟ هل في أشياء في ال abdomen يعني
+
+409
+00:26:27,520 --> 00:26:31,020
+لا قدر الله أو رامشي من هذا القبيل؟ هل في solid
+
+410
+00:26:31,020 --> 00:26:35,100
+structures؟ هل في أشياء يعني جامدة في جلب البطن و
+
+411
+00:26:35,100 --> 00:26:38,800
+لا؟ بقى بقدر أعرف لاب سماعة و أنا بقدر أشوفها بال
+
+412
+00:26:38,800 --> 00:26:42,480
+inspection هل بدت بال percussion و بتأكد في ال
+
+413
+00:26:42,480 --> 00:26:45,380
+palpation في الآخر ال percussion كلكم عارفين ال
+
+414
+00:26:45,380 --> 00:26:47,440
+direct و ال indirect زي ما احنا اتعلمنا في البداية
+
+415
+00:26:47,440 --> 00:26:52,210
+لما شرحنا ال skills of assessment طيببقولي هنا أول
+
+416
+00:26:52,210 --> 00:26:55,630
+حاجة ياريت انك ما احنا اتعلمنا في ال Anatomy لما
+
+417
+00:26:55,630 --> 00:26:59,610
+نجسمنا ال abdomen ل quadrant لاقاش؟ يعني زي أربع
+
+418
+00:26:59,610 --> 00:27:03,590
+أربع و احنا جسمونا لتسعة فالان بقولي أسس ايه؟
+
+419
+00:27:03,590 --> 00:27:07,270
+دايما بدك تشوف ال timpani و ال dullness لو حد قالش
+
+420
+00:27:07,270 --> 00:27:11,090
+timpani و اللي شاطر يتذكر هي sound of ايه؟ sound
+
+421
+00:27:11,090 --> 00:27:14,250
+of stomach صوت المعدد اسمه timpani طب ايش ال
+
+422
+00:27:14,250 --> 00:27:17,850
+dullness؟ زي sound of liver زي sound مثلا of
+
+423
+00:27:17,850 --> 00:27:21,510
+spleen أو sound of thighالشغلات بتكون جامدة شوية
+
+424
+00:27:21,510 --> 00:27:28,050
+طيب ممكن يكون في painful هنا لأ painful area وين
+
+425
+00:27:28,050 --> 00:27:32,100
+ما نلاقي painful area ايش بيقولي ابعد عنهاPercuss
+
+426
+00:27:32,100 --> 00:27:35,500
+last و احنا بنعمل percussion لو حسنا انه في منطقة
+
+427
+00:27:35,500 --> 00:27:41,040
+تقلمت ما تكمل واجف وروح كمل باقي الأماكن في ال
+
+428
+00:27:41,040 --> 00:27:44,640
+abdomen ثم بعد ذلك ارجع للمكان هذا حتى مايصيرش
+
+429
+00:27:44,640 --> 00:27:48,820
+refusal from the client and exaggeration يعني يكون
+
+430
+00:27:48,820 --> 00:27:51,680
+عنده تهيج وزعل و aggressiveness ومايقدرش أي شي
+
+431
+00:27:51,680 --> 00:27:55,380
+يتحمل كلامه عشان هي الطبيب الشاطر لما يلاقي في
+
+432
+00:27:55,380 --> 00:27:58,480
+منطقة مؤلمة يجف ويروح يكمل بعدين في الآخر بنرجع
+
+433
+00:27:58,480 --> 00:28:02,620
+إلى هنابيركاشن بيقولي allow you to identify
+
+434
+00:28:02,620 --> 00:28:06,320
+borders of the liver بيقولي لما تعمل بيركاشن
+
+435
+00:28:06,320 --> 00:28:12,260
+بيخليك تعرف حدود ال liver وقداش حجم ال liver طبعا
+
+436
+00:28:12,260 --> 00:28:16,860
+ما حد ييجي يقولي هو ال liver بنحس بسهولة لا .. لا
+
+437
+00:28:16,860 --> 00:28:19,800
+ال liver ولا ال spleen ما تتوقع انك انت مجرد ما
+
+438
+00:28:19,800 --> 00:28:23,240
+حطيت ايدك او عملت شوية percussion انك تعرف الحدود
+
+439
+00:28:23,240 --> 00:28:27,180
+او تعرف ايش ال liver لأ له اسلوب علمي هلجيت احنا
+
+440
+00:28:27,180 --> 00:28:31,050
+بقولكوا ايش لكن لا قدر اللهلو كبر ال liver organ
+
+441
+00:28:31,050 --> 00:28:35,830
+او كبر ال spleen organ بصير احنا بنقدر نحسه زي في
+
+442
+00:28:35,830 --> 00:28:38,990
+حالات ايه في ال liver مثلا قللي زي ال cirrhosis
+
+443
+00:28:38,990 --> 00:28:43,370
+تلاقي او لا سمح الله cancer، spleen ولا حتى في ال
+
+444
+00:28:43,370 --> 00:28:47,370
+liver، تنتين زي ال hepatitis، هذول كله مش بيعملوا
+
+445
+00:28:47,370 --> 00:28:51,190
+liver enlargement طالما كبر liver organ يبقى بصير
+
+446
+00:28:51,190 --> 00:28:54,430
+بقدر كان انا examiner كان انا يعني قدام المريض
+
+447
+00:28:54,430 --> 00:28:59,760
+بقدر اعمله detectionخلّينا .. بدنا نشرح هذه ال
+
+448
+00:28:59,760 --> 00:29:03,580
+slide أولا شرا نتوقف للمحاضرة القادمة عشان ما
+
+449
+00:29:03,580 --> 00:29:07,380
+نكترش الوقت كتير. هالجد بيقولي طب كيف تعرف ال
+
+450
+00:29:07,380 --> 00:29:11,560
+liver size؟ يعني كيف بدك تعرف حجم الكبد؟ الأقل حجم
+
+451
+00:29:11,560 --> 00:29:14,060
+الكبد أنا مابدي أقعد أجيس ولا بدي أجيب يعني كأنه
+
+452
+00:29:14,060 --> 00:29:17,480
+أنا في عند التصوير أو ultrasound، بيقولي أول حاجة
+
+453
+00:29:17,480 --> 00:29:20,920
+أنت قاعد بتعمل percussion، روح على ال right، طبعا
+
+454
+00:29:20,920 --> 00:29:24,080
+إحنا نقول الكبد وين؟ الكبد في اليمين، بيقول روح
+
+455
+00:29:24,080 --> 00:29:27,300
+على right، بدك أول حاجة تبدأ من تحت،روح على ال
+
+456
+00:29:27,300 --> 00:29:30,240
+right iliac crest كلنا عارفين هذه الحوض و عضمة
+
+457
+00:29:30,240 --> 00:29:33,140
+الحوض .. روح على ال right iliac crest على الحافة
+
+458
+00:29:33,140 --> 00:29:37,560
+بالظبط اللي في المنتصف تبع ال iliac bone و ابدأ من
+
+459
+00:29:37,560 --> 00:29:40,660
+عندها اعمل percussion و ضلك اعمل percussion و انت
+
+460
+00:29:40,660 --> 00:29:42,340
+طالع .. يعني نعمل percussion .. percussion ..
+
+461
+00:29:42,340 --> 00:29:44,980
+percussion .. و نظلنا رايحين باتجاه ال
+
+462
+00:29:44,980 --> 00:29:47,480
+midclavicular .. ايش يعني mid .. يعني رايحين
+
+463
+00:29:47,480 --> 00:29:51,760
+باتجاه اللي هو نص عضمة الترقوة يعني تقريبا ع جبال
+
+464
+00:29:51,760 --> 00:29:55,180
+النبل .. ع جبال ايش .. النبل اللي هو تبع ال breast
+
+465
+00:29:55,480 --> 00:29:58,700
+و بنضلنا طالعين و احنا بنطلع شوي شوي بنلاقي الصوت
+
+466
+00:29:58,700 --> 00:30:02,400
+ايه اختلف .. اول ما الصوت يختلف بيصير عندنا صوت
+
+467
+00:30:02,400 --> 00:30:05,240
+اسمه dullness اللي هو sound of ايه of liver ..
+
+468
+00:30:05,240 --> 00:30:09,300
+انعيد .. اول شي بنروح على مبتدة ال right الى ال
+
+469
+00:30:09,300 --> 00:30:12,640
+crest و بنبدأ نعمل percussion و احنا نعمل
+
+470
+00:30:12,640 --> 00:30:15,820
+percussion من تحت الصوت عادي عادي عادي .. اول ما
+
+471
+00:30:15,820 --> 00:30:19,620
+يصير dullبروح بعلم، بقول هذه حدود ال liver
+
+472
+00:30:19,620 --> 00:30:23,820
+السفلية، أول ما بصير الصوت اختلف بحط خط و بقول هاي
+
+473
+00:30:23,820 --> 00:30:26,940
+صوت اللي هذا حدود ال liver عشان يكسمه lower border
+
+474
+00:30:26,940 --> 00:30:30,940
+طب كيف أعرف ال upper ها؟ كيف بتعرف ال upper
+
+475
+00:30:30,940 --> 00:30:34,600
+border؟ يعني كيف بتعرف الحدود العلوية؟باجي العكس
+
+476
+00:30:34,600 --> 00:30:38,020
+بطلع فوق الأهل من فوق لتحت، من أين ببدأ؟ من ال
+
+477
+00:30:38,020 --> 00:30:40,920
+nipple، من منطقة ال nipple في ال midiclavicular،
+
+478
+00:30:40,920 --> 00:30:44,960
+نفس اليمين برضه، من عند اللي هو عظمة الترقوة من
+
+479
+00:30:44,960 --> 00:30:48,860
+النص، من عند ال nipple اللي هو .. اللي هو تبع ال
+
+480
+00:30:48,860 --> 00:30:52,860
+breastاللي هو يعني عند الثدي الأيمن و بننزل برضه
+
+481
+00:30:52,860 --> 00:30:55,100
+نفس القضية بضعنا نعمل percussion .. percussion
+
+482
+00:30:55,100 --> 00:31:00,100
+لعند ما الصوت يختلف أو لإن واحنا بنضغط فوق تنسوش
+
+483
+00:31:00,100 --> 00:31:03,460
+أنه في rib cage يعني في قفص صدري هيكون الصوت مختلف
+
+484
+00:31:03,460 --> 00:31:08,240
+مجرد ما الصوت يصير dull الصوت يكون فيه ثقل بقول اه
+
+485
+00:31:08,240 --> 00:31:14,160
+هاي حدود الكبد العلوية و بروح ايش بحط خط صغيربجيس
+
+486
+00:31:14,160 --> 00:31:18,580
+الخط طبعا هو مش بقولي هنا هتلاقيه يعني ما بين ال
+
+487
+00:31:18,580 --> 00:31:22,300
+inter coaster space الخامس أو السادس أو السابع حسب
+
+488
+00:31:22,300 --> 00:31:26,580
+اللي هو بنية الجسم اللي أمامنا طبعا أنا بجيس من
+
+489
+00:31:26,580 --> 00:31:32,680
+فوق حطت الخط و من تحت حطت الخطبجيس بينهم كده بطلع
+
+490
+00:31:32,680 --> 00:31:37,260
+عندي من 6 ل 12 سنتيمتر هذه حدود ال liver طبعا انا
+
+491
+00:31:37,260 --> 00:31:40,380
+مش حاجة اسألكوا يعني و اقولك كيف بدك تشرحلي بالظبط
+
+492
+00:31:40,380 --> 00:31:44,020
+لأ انا بس يعني ممكن يجي طبيعة السؤال انه بس نعرف
+
+493
+00:31:44,020 --> 00:31:46,600
+كيف من ال assessment لل border ممكن يجيك سؤال صح
+
+494
+00:31:46,600 --> 00:31:51,730
+انا اعطيك سؤالمثلا مالتامتشوسكشي من هذا القبيل لكن
+
+495
+00:31:51,730 --> 00:31:55,390
+انا اقصد يعني ممكن انا لقدر ما واحد حاسس ان ال
+
+496
+00:31:55,390 --> 00:31:58,730
+liver عنده كبير ب .. ب simple assessment ممكن نعرف
+
+497
+00:31:58,730 --> 00:32:02,130
+انه كبير و لا صغير بناء على هذه الطريقة طب ال
+
+498
+00:32:02,130 --> 00:32:05,170
+stomach كيف؟ نفس الطريقة بندقش اتطول نفس الطريقة
+
+499
+00:32:05,170 --> 00:32:07,890
+بدل ما نروح نعليه اليمين خلينا نروح شويه ع الشمال
+
+500
+00:32:07,890 --> 00:32:11,070
+و بضلنا نعمل أيش percussion نفس القضية بس اللهم
+
+501
+00:32:11,070 --> 00:32:14,850
+الصوت هنا اسمه dull الصوت هنا اسمه dullness الصوت
+
+502
+00:32:14,850 --> 00:32:18,490
+هنا ايش اسمه timpaniبرضه نفس القضية بنروح على
+
+503
+00:32:18,490 --> 00:32:21,630
+منطقة ال stomach و بننزل شوية من منطقة ال rib cage
+
+504
+00:32:21,630 --> 00:32:25,750
+اللي هو برضه من القفص بس من وين من الأمام يعني
+
+505
+00:32:25,750 --> 00:32:28,790
+المعي ده مش رايحة شوية على الشمال اللي ورا لأ
+
+506
+00:32:28,790 --> 00:32:34,330
+رايحة جاية على الوسط شوية مائلة ميل بسيط اتجاه
+
+507
+00:32:34,330 --> 00:32:36,230
+اليسار ما انتوا عارفين في ال anatomy أما ال liver
+
+508
+00:32:36,230 --> 00:32:41,110
+ماخد شوية يعني المنطقةمن فوق لتحت وماقل شوية
+
+509
+00:32:41,110 --> 00:32:44,550
+لليمين إذا مش بنعمل نفس القضية بنضل نعمل
+
+510
+00:32:44,550 --> 00:32:48,570
+percussion percussion لما نيصل الصوت يختلف من فوق
+
+511
+00:32:48,570 --> 00:32:53,070
+والصوت من تحت كمان يختلف بنقول هاي حدود المعدة
+
+512
+00:32:53,070 --> 00:32:57,410
+خلينا نجف عند هذا الشريحة ونكمل ان شاء الله
+
+513
+00:32:57,410 --> 00:33:01,550
+المحاضرة القادمة بإذن الله السلام عليكم ورحمة الله
+
+514
+00:33:01,550 --> 00:33:02,070
+وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..46e4597a81a5f6f0a525a474eecc1e308589aecb
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/E2U53EyLa8k_raw.json
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"word": " بسيط", "probability": 0.99609375}, {"start": 1953.47, "end": 1954.33, "word": " اتجاه", "probability": 0.9544677734375}, {"start": 1954.33, "end": 1954.83, "word": " اليسار", "probability": 0.9816080729166666}, {"start": 1954.83, "end": 1954.95, "word": " ما", "probability": 0.386474609375}, {"start": 1954.95, "end": 1955.07, "word": " انتوا", "probability": 0.7744140625}, {"start": 1955.07, "end": 1955.27, "word": " عارفين", "probability": 0.9835205078125}, {"start": 1955.27, "end": 1955.37, "word": " في", "probability": 0.82373046875}, {"start": 1955.37, "end": 1955.43, "word": " ال", "probability": 0.91943359375}, {"start": 1955.43, "end": 1955.61, "word": " anatomy", "probability": 0.375732421875}, {"start": 1955.61, "end": 1955.91, "word": " أما", "probability": 0.748046875}, {"start": 1955.91, "end": 1955.99, "word": " ال", "probability": 0.78466796875}, {"start": 1955.99, "end": 1956.23, "word": " liver", "probability": 0.9765625}, {"start": 1956.23, "end": 1956.99, "word": " ماخد", "probability": 0.9085286458333334}, {"start": 1956.99, "end": 1957.49, "word": " شوية", "probability": 0.9557291666666666}, {"start": 1957.49, "end": 1958.31, "word": " يعني", "probability": 0.93212890625}, {"start": 1958.31, "end": 1959.17, "word": " المنطقة", "probability": 0.9454345703125}], "temperature": 1.0}, {"id": 80, "seek": 198207, "start": 1959.47, "end": 1982.07, "text": "من فوق لتحت وماقل شوية لليمين إذا مش بنعمل نفس القضية بنضل نعمل percussion percussion لما نيصل الصوت يختلف من فوق والصوت من تحت كمان يختلف بنقول هاي حدود المعدة خلينا نجف عند هذا الشريحة ونكمل ان شاء الله المحاضرة القادمة بإذن الله السلام عليكم ورحمة الله وبركاته", "tokens": [27842, 6156, 30543, 5296, 2655, 33753, 4032, 15042, 4587, 1211, 13412, 2407, 10632, 24976, 32640, 9957, 11933, 15730, 37893, 44945, 25957, 1211, 8717, 36178, 25062, 11242, 10632, 44945, 11242, 1211, 8717, 25957, 1211, 44430, 44430, 5296, 15042, 8717, 1829, 36520, 31767, 35473, 7251, 46456, 46538, 9154, 6156, 30543, 16070, 9381, 35473, 9154, 6055, 33753, 9122, 2304, 7649, 7251, 46456, 46538, 44945, 39648, 8032, 47302, 11331, 3215, 23328, 9673, 22488, 3660, 16490, 20292, 8315, 8717, 7435, 5172, 43242, 23758, 25124, 16572, 5016, 3660, 4032, 1863, 24793, 1211, 16472, 13412, 16606, 21984, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 4724, 28814, 8848, 1863, 21984, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.1633279878869016, "compression_ratio": 1.8658536585365855, "no_speech_prob": 8.940696716308594e-06, "words": [{"start": 1959.47, "end": 1959.75, "word": "من", "probability": 0.9423828125}, {"start": 1959.75, "end": 1960.11, "word": " فوق", "probability": 0.99267578125}, {"start": 1960.11, "end": 1960.45, "word": " لتحت", "probability": 0.9791666666666666}, {"start": 1960.45, "end": 1960.83, "word": " وماقل", "probability": 0.7215576171875}, {"start": 1960.83, "end": 1961.11, "word": " شوية", "probability": 0.7337239583333334}, {"start": 1961.11, "end": 1961.53, "word": " لليمين", "probability": 0.80908203125}, {"start": 1961.53, "end": 1962.17, "word": " إذا", "probability": 0.5882568359375}, {"start": 1962.17, "end": 1962.39, "word": " مش", "probability": 0.59326171875}, {"start": 1962.39, "end": 1962.73, "word": " بنعمل", "probability": 0.9708658854166666}, {"start": 1962.73, "end": 1963.05, "word": " نفس", "probability": 0.996337890625}, {"start": 1963.05, "end": 1963.61, "word": " القضية", "probability": 0.9825846354166666}, {"start": 1963.61, "end": 1964.23, "word": " بنضل", "probability": 0.61865234375}, {"start": 1964.23, "end": 1964.55, "word": " نعمل", "probability": 0.91455078125}, {"start": 1964.55, "end": 1965.01, "word": " percussion", "probability": 0.8740234375}, {"start": 1965.01, "end": 1965.51, "word": " percussion", "probability": 0.30126953125}, {"start": 1965.51, "end": 1966.25, "word": " لما", "probability": 0.857666015625}, {"start": 1966.25, "end": 1966.61, "word": " نيصل", "probability": 0.677001953125}, {"start": 1966.61, "end": 1967.15, "word": " الصوت", "probability": 0.967041015625}, {"start": 1967.15, "end": 1968.07, "word": " يختلف", "probability": 0.9957682291666666}, {"start": 1968.07, "end": 1968.21, "word": " من", "probability": 0.9921875}, {"start": 1968.21, "end": 1968.57, "word": " فوق", "probability": 0.988037109375}, {"start": 1968.57, "end": 1969.51, "word": " والصوت", "probability": 0.7977701822916666}, {"start": 1969.51, "end": 1969.71, "word": " من", "probability": 0.98974609375}, {"start": 1969.71, "end": 1970.01, "word": " تحت", "probability": 0.991455078125}, {"start": 1970.01, "end": 1970.33, "word": " كمان", "probability": 0.9729817708333334}, {"start": 1970.33, "end": 1970.87, "word": " يختلف", "probability": 0.9959309895833334}, {"start": 1970.87, "end": 1971.65, "word": " بنقول", "probability": 0.903076171875}, {"start": 1971.65, "end": 1971.89, "word": " هاي", "probability": 0.551025390625}, {"start": 1971.89, "end": 1972.35, "word": " حدود", "probability": 0.9814453125}, {"start": 1972.35, "end": 1973.07, "word": " المعدة", "probability": 0.71484375}, {"start": 1973.07, "end": 1973.79, "word": " خلينا", "probability": 0.7962239583333334}, {"start": 1973.79, "end": 1974.21, "word": " نجف", "probability": 0.7268880208333334}, {"start": 1974.21, "end": 1975.17, "word": " عند", "probability": 0.91552734375}, {"start": 1975.17, "end": 1975.47, "word": " هذا", "probability": 0.453125}, {"start": 1975.47, "end": 1976.23, "word": " الشريحة", "probability": 0.9893798828125}, {"start": 1976.23, "end": 1976.83, "word": " ونكمل", "probability": 0.9066162109375}, {"start": 1976.83, "end": 1976.95, "word": " ان", "probability": 0.67138671875}, {"start": 1976.95, "end": 1977.19, "word": " شاء", "probability": 0.982177734375}, {"start": 1977.19, "end": 1977.41, "word": " الله", "probability": 0.95166015625}, {"start": 1977.41, "end": 1979.05, "word": " المحاضرة", "probability": 0.9815673828125}, {"start": 1979.05, "end": 1979.41, "word": " القادمة", "probability": 0.9921875}, {"start": 1979.41, "end": 1979.71, "word": " بإذن", "probability": 0.9080810546875}, {"start": 1979.71, "end": 1979.93, "word": " الله", "probability": 0.94873046875}, {"start": 1979.93, "end": 1980.69, "word": " السلام", "probability": 0.8818359375}, {"start": 1980.69, "end": 1981.01, "word": " عليكم", "probability": 0.9208984375}, {"start": 1981.01, "end": 1981.37, "word": " ورحمة", "probability": 0.9710693359375}, {"start": 1981.37, "end": 1981.55, "word": " الله", "probability": 0.974609375}, {"start": 1981.55, "end": 1982.07, "word": " وبركاته", "probability": 0.991796875}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1990.902125, "duration_after_vad": 1954.032499999994}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A.srt
new file mode 100644
index 0000000000000000000000000000000000000000..39a16c13df6330c9f48198afb12d344e683c73d9
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A.srt
@@ -0,0 +1,1290 @@
+1
+00:00:00,930 --> 00:00:04,390
+بسم الله الرحمن الرحيم، خلينا
+
+2
+00:00:04,390 --> 00:00:08,390
+نكمل طبعًا على... في الـ chapter التالي، واحنا طبعًا
+
+3
+00:00:08,390 --> 00:00:12,250
+من باب التفكير بس، احنا يعني كنا بنتكلم طبعًا في
+
+4
+00:00:12,250 --> 00:00:16,390
+بدايته، هذا الـ chapter، في موضوع الـ health history
+
+5
+00:00:16,390 --> 00:00:20,910
+في بدايته، واحنا بس عشان نربط الكلام في بعضه يعني
+
+6
+00:00:20,910 --> 00:00:26,330
+خلينا احنا يعني خاصة الـ... يعني لما حكينا البنود
+
+7
+00:00:26,330 --> 00:00:30,390
+وصلنا... بدنا لـ بند رقم 7، لكن عشان نربط الكلام في
+
+8
+00:00:30,390 --> 00:00:35,410
+بعضه، بدينا أول حاجة هي موجودة عندنا بس عشان باب
+
+9
+00:00:35,410 --> 00:00:38,550
+التفكير لإنه نربط كل الـ... كل الـ chapter مع بعض
+
+10
+00:00:38,550 --> 00:00:41,150
+ما بنفعش كل chapter لما نقول components of a
+
+11
+00:00:41,150 --> 00:00:43,810
+history، وبدينا في الـ biographical data والـ
+
+12
+00:00:43,810 --> 00:00:45,670
+biographical data لما نقول المعلومات الأساسية
+
+13
+00:00:45,670 --> 00:00:48,630
+للمريض، وحكينا رقم 2 اللي هو the chief complaint
+
+14
+00:00:48,630 --> 00:00:52,350
+لما نقول شو الشكوى الرئيسية اللي خلت المريض ييجي
+
+15
+00:00:52,350 --> 00:00:56,880
+فيه، كمان حكينا البند الثالث اللي هو الـ history of
+
+16
+00:00:56,880 --> 00:00:59,920
+present illness، وصرنا نتكلم إيش طبيعة المرض اللي
+
+17
+00:00:59,920 --> 00:01:03,820
+جابه، خلاه ييجي على المستشفى، ونسأل عنه، بعدين الـ
+
+18
+00:01:03,820 --> 00:01:06,780
+components تبع الـ present illness، وبعدين الـ past
+
+19
+00:01:06,780 --> 00:01:10,540
+health history، رقم 4، وسألنا إنه إذا كان عنده
+
+20
+00:01:10,540 --> 00:01:13,760
+مشكلة أو كان اتعرض لأي حوادث سابقة، وكيف كانت
+
+21
+00:01:13,760 --> 00:01:17,140
+مرحلة طفولته، أو أي مشكلة كانت يعني دخلت المستشفى
+
+22
+00:01:17,140 --> 00:01:20,260
+أو صار عنده أي إشكالية صحية، بعدين سألنا عن الـ
+
+23
+00:01:20,260 --> 00:01:22,440
+family history كمان، وحكينا واحنا بناخد الـ health
+
+24
+00:01:22,440 --> 00:01:26,040
+history، وبرضه شفنا الوضع بشكل عام، إيش تاريخ
+
+25
+00:01:26,040 --> 00:01:28,780
+العائلة؟ هل في عندهم مشكلة في العائلة؟ هل في عندهم
+
+26
+00:01:28,780 --> 00:01:33,060
+لا سمح الله يعني diseases، يعني أمراض عندهم؟ أو في
+
+27
+00:01:33,060 --> 00:01:36,280
+عندهم cause of death for family؟ أو أي شيء في مشاكل
+
+28
+00:01:36,280 --> 00:01:41,380
+قريبة؟ وصلنا لعند environmental history، حد يمكن
+
+29
+00:01:41,380 --> 00:01:43,600
+ممكن يسأل يقولنا طب إيه؟ إيش داخل الـ environmental
+
+30
+00:01:43,600 --> 00:01:47,040
+history في الموضوع؟ مرات بتكون المشكلة الصحية اللي
+
+31
+00:01:47,040 --> 00:01:49,380
+موجودة عند المريض كلها جاية من وين؟ من الـ
+
+32
+00:01:49,380 --> 00:01:53,680
+environment، ما أحد يستهين، يعني احنا يمكن احنا عشان
+
+33
+00:01:53,680 --> 00:01:58,060
+بيئاتنا متقاربة، مش كلها تختلف اختلافًا جذريًا عن بعض
+
+34
+00:01:58,060 --> 00:02:04,360
+لكن في ناس في عندهم مشكلات مرتبطة بس بإيش؟ بالبيئة
+
+35
+00:02:04,360 --> 00:02:08,260
+وتغيرات البيئة، أو شكل البيئة، أو سكانهم في مكان
+
+36
+00:02:08,260 --> 00:02:12,300
+معين، في hazards يعني في مخاطر، الـ purpose طبعًا الغرض
+
+37
+00:02:12,300 --> 00:02:16,180
+هنا، ليش هذا الغرض؟ بقول أنا بدأت آخذ إيش هنا الـ
+
+38
+00:02:16,180 --> 00:02:17,640
+information اللي له علاقة بالـ surroundings
+
+39
+00:02:17,640 --> 00:02:21,700
+المحيط، بنبدأ بالـ client، يعني أول حاجة طبعًا ما يجي
+
+40
+00:02:21,700 --> 00:02:25,300
+حد في بالنا أنه بنتكلم دائمًا البيئة، بس البيئة الـ
+
+41
+00:02:25,300 --> 00:02:28,660
+physical environment، يعني البيئة الطبيعية في
+
+42
+00:02:28,660 --> 00:02:34,520
+طبيعتها، يعني زي السكن، والبنايات، والعمارات
+
+43
+00:02:34,520 --> 00:02:37,880
+أو الشجرة، أو كذا، لأ، هذا يسمى physical، في الـ psycho
+
+44
+00:02:37,880 --> 00:02:41,420
+social environment، يمكن تكون أخطر في social
+
+45
+00:02:41,420 --> 00:02:45,700
+environment لوحدها، في psychological لوحدها طبعًا
+
+46
+00:02:45,700 --> 00:02:49,200
+ليه؟ هأشرح لكم ليه، في حاجة نتكلم عن الـ
+
+47
+00:02:49,200 --> 00:02:53,700
+presence of hazards، يعني وجود المخاطر، وخاصة زي الـ
+
+48
+00:02:53,700 --> 00:02:57,120
+pollutants، اللي هو إيه الـ pollutants؟ أنتم عارفين
+
+49
+00:02:57,120 --> 00:03:02,740
+زي اللي بتعمل التلوثات البيئية اللي بتصير ربما من
+
+50
+00:03:02,740 --> 00:03:08,420
+مصانع، من متاجر معينة، من محاجر، إذا كانوا موجودين
+
+51
+00:03:08,420 --> 00:03:11,240
+احنا ممكن ما عندناش في غزة، لكن في الضفة الغربية موجود
+
+52
+00:03:11,240 --> 00:03:14,680
+عندهم، أخطر شيء عندهم اللي هو قضية المحاجر، إن هم
+
+53
+00:03:15,750 --> 00:03:19,850
+كسارات الصخور، لأنها بتطلع من ضمن شغلها يعني المواد
+
+54
+00:03:19,850 --> 00:03:24,290
+المسرطنة، وبدنا نسأل على الـ safety measures، إيش
+
+55
+00:03:24,290 --> 00:03:26,030
+يعني الـ safety measures؟ يعني الإجراءات اللي هو
+
+56
+00:03:26,030 --> 00:03:28,510
+الحماية، والبقايا اللي موجودة بالعيلة، بدي أعطيكم
+
+57
+00:03:28,510 --> 00:03:32,290
+مثال عشان نفهم إيش المقصود، الآن بيجينا مثلًا أحد
+
+58
+00:03:32,290 --> 00:03:35,630
+المرضى، بيجي يقول لك أنا، المريض عنده peptic ulcer
+
+59
+00:03:35,630 --> 00:03:39,730
+قرحة المعدة، أو الاثنى عشر، سألنا إيش اللي موجود، بيقول لك
+
+60
+00:03:39,730 --> 00:03:44,120
+أنا ما عنديش مشكلة، طب أكل مني اهبس، عايش في stress
+
+61
+00:03:44,120 --> 00:03:48,340
+24 ساعة، و7 أيام في الأسبوع، يعني معناته طول الوقت
+
+62
+00:03:48,340 --> 00:03:51,600
+عايش في stress، ليش عايش في stress؟ لأن البيت كله فيه
+
+63
+00:03:51,600 --> 00:03:54,520
+مشكلة، في مشاكل، في عندهم psychological problems، وفي
+
+64
+00:03:54,520 --> 00:03:57,860
+social problems، شدة المشاكل أكيد بتخلي الـ
+
+65
+00:03:57,860 --> 00:04:02,300
+parietal cells تت... تت... كتير، يعني تنتج الـ HCL
+
+66
+00:04:02,300 --> 00:04:08,090
+وتفرز HCL، فبيصير للأسف يعني مع قلة الطعام، ما بده
+
+67
+00:04:08,090 --> 00:04:10,450
+أقول زي auto digestion، يعني كاللي بتصير للمعدة
+
+68
+00:04:10,450 --> 00:04:14,630
+فبيصير بتتحول لوين؟ من وين؟ آجانب البيئة، بتتحول لقرحة
+
+69
+00:04:14,630 --> 00:04:17,550
+كتير من الحالات اللي علاقة كمان بالـ environment
+
+70
+00:04:17,550 --> 00:04:20,850
+بتجينا حالات بيكون عندهم cancer في إيه؟ cancer في
+
+71
+00:04:20,850 --> 00:04:25,350
+الـ lung، نسأله من وين أنتم ساكنين؟ أول سؤال، يطلعوا
+
+72
+00:04:25,350 --> 00:04:27,670
+ساكنين في مناطق معينة، احنا ما بدنا نذكر لأن كتير
+
+73
+00:04:27,670 --> 00:04:31,280
+هيتفرجوا على الفيديو، ربما من خارج القطاع، ممكن
+
+74
+00:04:31,280 --> 00:04:34,180
+يكونوا جنب بعض، الناس اللي بيشتغلوا بالإيه؟ اللي
+
+75
+00:04:34,180 --> 00:04:39,680
+بيشتغلوا بتنظيف السيارات بالرمل، في ماكينات بالرمل
+
+76
+00:04:39,680 --> 00:04:43,780
+بتعمل زي... والرمل ما أحد يستخف فيه، الرمل بيكون يعني
+
+77
+00:04:43,780 --> 00:04:49,040
+لدرجة إنه بيعمل زي الفرد، أكيد بعض الطلاب يمكن
+
+78
+00:04:49,040 --> 00:04:52,700
+يتذكر إيش اللي بحكيه، وأكيد الطلبة يمكن يشوفوه على
+
+79
+00:04:52,700 --> 00:04:57,800
+يوتيوب أو غيره، بتلاقي هذا الفرد زي وعاء معين بنحط
+
+80
+00:04:57,800 --> 00:05:01,360
+فيه مادة زي مادة البوية، بس هي بيحطوا فيه الرمل، و
+
+81
+00:05:01,360 --> 00:05:05,000
+الرمل أصلاً قوي جدًا، وبيصنع منه طبعًا الزجاج، فبيبقى
+
+82
+00:05:05,000 --> 00:05:09,600
+يضخ فيه، وينظف كل البوية، هذا اللي بيطلع كله للأسف
+
+83
+00:05:09,600 --> 00:05:12,940
+طبعًا carcinogenic، لأن أنت بتتكلم على رمل، وبتتكلم
+
+84
+00:05:12,940 --> 00:05:16,760
+على بعض تركيبة الـ asbestos، كل هذا مسرطنات، فبيصير
+
+85
+00:05:16,760 --> 00:05:21,220
+عند هؤلاء الناس cancer lung، بعض الحالات كمان أجتنا
+
+86
+00:05:21,220 --> 00:05:25,660
+بعض العائلات كان عندهم في مشكلة برضه، لما سألنا من
+
+87
+00:05:25,660 --> 00:05:28,830
+وين الـ cancer؟ عندهم cancer صار أكثر من مرة، كان
+
+88
+00:05:28,830 --> 00:05:31,190
+صار شيء في الـ chest، وشيء في البطن، ولما سألنا
+
+89
+00:05:31,190 --> 00:05:37,450
+لقينا بيستخدموا أدوية خاصة لـ... هم مزارعين، و
+
+90
+00:05:37,450 --> 00:05:42,840
+بيستخدموا أدوية للأسف كثيرة مسرطنة، كتير بيستخدموها
+
+91
+00:05:42,840 --> 00:05:45,700
+فلقيناها كتير موجودة، يعني الـ trans familiar موجود
+
+92
+00:05:45,700 --> 00:05:49,540
+في العائلة، اضطرينا نعطيهم نصائح إنه لأ، هذا بدنا
+
+93
+00:05:49,540 --> 00:05:52,900
+نوقف، ونستخدم أشياء ثانية، أو نستخدم اللي هو safety
+
+94
+00:05:52,900 --> 00:05:56,680
+measures أخرى، طبعًا كل هذا السؤال عشان نبين إنه
+
+95
+00:05:56,680 --> 00:05:59,460
+مرات المرض كله جاي من وين؟ جاي من الـ environment
+
+96
+00:05:59,460 --> 00:06:03,340
+عشان ما نستهينش فيها، طيب، سبعة، بنتكلم على الـ
+
+97
+00:06:03,340 --> 00:06:06,440
+current health information، إيش يعني current health
+
+98
+00:06:06,440 --> 00:06:10,120
+information؟ يعني بدي أسأله على الوضع الصحي الحالي
+
+99
+00:06:10,120 --> 00:06:14,620
+الوضع الصحي الحالي، السؤال الحالي، إيش يعني؟ باجي
+
+100
+00:06:14,620 --> 00:06:18,820
+بقول له الآن بدي منك إيش في عندك major و current
+
+101
+00:06:18,820 --> 00:06:21,980
+health related information، يعني بيجي بنسأله في
+
+102
+00:06:21,980 --> 00:06:26,340
+وضعك الحالي في حياتك الطبيعية اللي أنت عايشها، أول
+
+103
+00:06:26,340 --> 00:06:30,100
+سؤال بنسأله عن الـ allergies، الـ allergies يا جماعة
+
+104
+00:06:30,100 --> 00:06:33,540
+عشان تكونوا عندكم علم، من أخطر الأمراض اللي ممكن
+
+105
+00:06:33,540 --> 00:06:37,920
+تصيب البني آدم، ليه؟ الـ allergy، بدنا نتكلم على الحساسية
+
+106
+00:06:37,920 --> 00:06:41,700
+ما أحد يجيب بباله بس حساسية كأنه جلده حمر، أو كذا، لأ
+
+107
+00:06:41,700 --> 00:06:45,460
+فيه من الحساسية ممكن تعمل حاجة بسمها anaphylaxis
+
+108
+00:06:45,460 --> 00:06:48,460
+أو بسمها anaphylactic shock، الـ anaphylaxis أو الـ
+
+109
+00:06:48,460 --> 00:06:52,580
+anaphylactic shock، هذه بتعمل إيه؟ بتعمل... بتعمل
+
+110
+00:06:52,580 --> 00:06:56,520
+نوع من الحساسية الشديدة جدًا اللي يصعب السيطرة
+
+111
+00:06:56,520 --> 00:07:01,660
+عليها، وما بنقدرش مرات احنا نتصرف في هذه الحالات طبعًا
+
+112
+00:07:01,660 --> 00:07:05,610
+ليه؟ ممكن تكون ناتجة من أي مركب، ممكن تكون بعض الناس
+
+113
+00:07:05,610 --> 00:07:08,450
+عندهم environmental، أجتنا حالات بس عندها الـ
+
+114
+00:07:08,450 --> 00:07:12,450
+allergy من وين؟ إنه لما بننظف في البيت، لما بننظف في
+
+115
+00:07:12,450 --> 00:07:16,070
+البيت، بيصير عنده أشياء دائمًا بتحمل اللي هو الغبار
+
+116
+00:07:16,070 --> 00:07:20,450
+بتحمل اللي بيطلع زي القراد، اللي هو هذه بتعمل له
+
+117
+00:07:20,450 --> 00:07:23,290
+حساسية شديدة، بتحمله أشياء، بيصير عنده ما يقدرش ياخد نفس
+
+118
+00:07:23,290 --> 00:07:28,070
+في عندهم allergy from ingestion، إيش يعني ingestion؟
+
+119
+00:07:28,070 --> 00:07:32,270
+ingestion يعني من بلع شيء معين، أو من أكل شيء معين
+
+120
+00:07:32,270 --> 00:07:35,900
+بيصير معه حساسية، زي... مش شرط تكون، أنا لما أتكلم يعني
+
+121
+00:07:35,900 --> 00:07:38,600
+كأنه موجود علانية، يعني في ناس بيقول لك أنا أكلت سمك
+
+122
+00:07:38,600 --> 00:07:41,800
+ورحت شربت حليب، بيصير معايا حساسية جديدة ما أقدرش
+
+123
+00:07:41,800 --> 00:07:46,420
+أتحملها، وفي ناس ممكن يأكل سمك، ويشرب حليب، ويروح
+
+124
+00:07:46,420 --> 00:07:49,520
+كمان يأكل كمان خضار، ويأكل فواكه، يأكل أي شيء،
+
+125
+00:07:49,520 --> 00:07:52,420
+ما يصيرش عندهم، نقدر نقول لكن مش كل الناس،
+
+126
+00:07:52,420 --> 00:07:56,780
+موضوع الـ drug، برضه نفس القضية، مش كل الناس بيقدروا
+
+127
+00:07:56,780 --> 00:08:00,540
+يسيطرون، عشان يكونوا واضحين، مش كل العلاجات زي بعض،
+
+128
+00:08:00,540 --> 00:08:04,700
+لأ، في علاجات بتؤدي الإنسان لـ allergy، و severe
+
+129
+00:08:04,700 --> 00:08:07,960
+allergy، وممكن الإنسان ما يقدرش يسيطر عليها، ما
+
+130
+00:08:07,960 --> 00:08:11,340
+بتذكر أسماء، يعني في بعض العلاجات أنا ما كنت أتخيل
+
+131
+00:08:11,340 --> 00:08:14,660
+أنه ممكن يصير، وصارت، أجونا عندهم حساسية من الـ
+
+132
+00:08:14,660 --> 00:08:16,980
+diclofenac، اللي هو non-steroidal anti-inflammatory
+
+133
+00:08:16,980 --> 00:08:20,560
+drug، أجونا ناس عندهم حساسية كتير من الـ antibiotic
+
+134
+00:08:21,140 --> 00:08:23,500
+فيها، زي الكفليكس، فيها، زي البنسلين، فيها، زي
+
+135
+00:08:23,500 --> 00:08:26,500
+إيه على كتير، طبعًا لازم نسأله ليه، عشان برضه نكون
+
+136
+00:08:26,500 --> 00:08:29,400
+واضحين وصادقين، قبل ما نعطي أي شيء، الـ habits،
+
+137
+00:08:29,400 --> 00:08:32,300
+العادات، احنا الحمد لله ربنا مكرمنا، في غزة أو
+
+138
+00:08:32,300 --> 00:08:36,320
+نادر نلاقي حد بيشرب كحول وغيره، لكن دائمًا بيحطوه
+
+139
+00:08:36,320 --> 00:08:40,480
+ما أنتم عارفين اسمه لكل العالم، فبنَسأل عن الكحول،
+
+140
+00:08:40,480 --> 00:08:44,240
+احنا بالنسبة لنا بنسأل عن الدخان، والـ tobacco اللي
+
+141
+00:08:44,240 --> 00:08:47,860
+هي زي موضوعات اللي كانوا بيستخدموها في، للأسف
+
+142
+00:08:47,860 --> 00:08:52,210
+الشيشة وغيره، بنسأله هل بياخد قهوة؟ بياخد drug معين
+
+143
+00:08:52,210 --> 00:08:57,050
+أو هل بيشرب كافيين بشكل كبير؟ يعني هل بيشرب كتير جدًا؟
+
+144
+00:08:57,050 --> 00:09:03,710
+كتير مثلًا زي المشروبات الغازية، ولا
+
+145
+00:09:03,710 --> 00:09:07,310
+عنده مشكلة في الأمور هذه، لازم احنا نكتبها بشكل عام
+
+146
+00:09:07,310 --> 00:09:10,370
+لإن هو الـ habits، ومرتبطة بالأمراض الموجودة عندنا
+
+147
+00:09:10,370 --> 00:09:14,870
+طيب، بنشتغل على الـ medications بشكل عام، أول سؤال
+
+148
+00:09:14,870 --> 00:09:18,710
+بنسأله: أنت بتاخد أدوية؟ لما نقول له بتاخد علاج، لازم
+
+149
+00:09:18,710 --> 00:09:22,990
+نسأل سؤال واضح، هل العلاج بتاخده regular or not؟
+
+150
+00:09:22,990 --> 00:09:26,810
+إذا قال لي regular، بقول له طبي، من دكتور، or self
+
+151
+00:09:26,810 --> 00:09:29,970
+prescription؟ في بعض الناس بيقول لي كيف يعني self
+
+152
+00:09:29,970 --> 00:09:32,810
+prescription؟ أعطيكم مثال، ألاجد فيه ناس بيجيبون
+
+153
+00:09:32,810 --> 00:09:35,770
+ويقول لك أنا كل ما بيصير معايا صداع بأخذ ecamol،
+
+154
+00:09:35,770 --> 00:09:37,650
+التاني بيقول: لما بيصير معايا صداع، لأ، بأخذ الـ
+
+155
+00:09:37,650 --> 00:09:40,790
+paracetamol، الثالث بيقول: لأ، بأخذ علاج اسمه migraine،
+
+156
+00:09:40,790 --> 00:09:44,020
+ليه؟ بيقول لي الـ migraine لأنه علاج مخصوص لعلاج الصداع
+
+157
+00:09:44,020 --> 00:09:48,260
+الشقيقة، الآن بنسأل السؤال، هل بتاخده أنت لحالك
+
+158
+00:09:48,260 --> 00:09:51,400
+بانتظام؟ بقول: منتظم، بنسأل السؤال: أنت بتاخده لحالك
+
+159
+00:09:51,400 --> 00:09:55,760
+ولا الدكتور يعني أعطاك إياه؟ طبعًا إذا هو لحاله بيوصف
+
+160
+00:09:55,760 --> 00:09:59,000
+لنَفسه، هنا مكمن الخطر، لازم نكون منتبهين، أما إذا
+
+161
+00:09:59,000 --> 00:10:01,720
+الدكتور بيوصف له، خلاص ما في مشكلة، يبقى نقول
+
+162
+00:10:01,720 --> 00:10:05,780
+بيصير نعرف إنه أجا بـ medical prescription، وما في
+
+163
+00:10:05,780 --> 00:10:10,570
+مشكلة، الـ exercise بشكل عام، نسأله: أنت كيف
+
+164
+00:10:10,570 --> 00:10:14,350
+حياتك؟ هل هي حالة حياة خاملة، وقاعد، و sedentary life
+
+165
+00:10:14,350 --> 00:10:19,450
+ولا بطريقة حياتك بتمشي، بتروح، بتيجي، وهكذا، نسأله
+
+166
+00:10:19,450 --> 00:10:23,250
+على الـ sleep، كيف نومك بشكل عام؟ وخاصة احنا حكينا
+
+167
+00:10:23,250 --> 00:10:27,930
+في sleep assessment، نسأله على الـ routine sleeping
+
+168
+00:10:27,930 --> 00:10:31,350
+نسأله على الـ daily sleeping، ونسأله على الـ hours، و
+
+169
+00:10:31,350 --> 00:10:36,270
+هكذا، وقد إيش؟ هل عنده مثلًا، إذا أي اضطراب، سواء كانت
+
+170
+00:10:36,2
+
+223
+00:13:43,340 --> 00:13:46,320
+عباله ممكن ما تأثرش عليه أي وضع فاحنا لازم نسألكوا
+
+224
+00:13:46,320 --> 00:13:50,660
+سؤالنا واضح، ثمانية، بدنا نتكلم عليها، ROS اختصار
+
+225
+00:13:50,660 --> 00:13:54,060
+عالمي، Review of Systems، مراجعة أجهزة، لسه أنا
+
+226
+00:13:54,060 --> 00:13:59,220
+ما شرحتش، الأجهزة،  لقدامها نعمل assessment لكل جهاز
+
+227
+00:13:59,220 --> 00:14:02,460
+لوحده، من عند الـ skin مع الـ digestion والرسميرات
+
+228
+00:14:02,460 --> 00:14:06,020
+وهاكذا، احنا بنقول.. بنعمل review لما أقول
+
+229
+00:14:06,020 --> 00:14:08,720
+كلمة review بنعمل collection of data about past
+
+230
+00:14:08,720 --> 00:14:13,020
+and present for each client system، يعني كويس نيجي
+
+231
+00:14:13,020 --> 00:14:16,380
+نسأله، يعني، واحنا بنقعد نسأل، احنا بنتكلم على
+
+232
+00:14:16,380 --> 00:14:19,520
+.. بناخد history، بنسأل على الـ clients physical و
+
+233
+00:14:19,520 --> 00:14:24,220
+الـ social والـ psychological status، ليه؟ ممكن يكون
+
+234
+00:14:24,220 --> 00:14:27,540
+هو بيحكيلنا، يعني ممكن يحكيلنا، بنقول له طب أنت كيف
+
+235
+00:14:27,540 --> 00:14:34,210
+نفسك؟ حياتك كيف؟ كيف هضمك للطعام؟ كيف أنت بتتحرك
+
+236
+00:14:34,210 --> 00:14:36,850
+كويس، احنا قاعدين نتكلم عن جهاز عصب وجهاز نفس و
+
+237
+00:14:36,850 --> 00:14:41,130
+مش كل الأجهزة، الآن ممكن هو بيحكيلي شغلة يطلع في
+
+238
+00:14:41,130 --> 00:14:44,750
+عنده حاجة hidden problem، إيش يعني hidden؟ إيش مخفي،
+
+239
+00:14:44,750 --> 00:14:47,670
+يعني ممكن هو قاعد بيقول ليه، بيقول والله بس أنا
+
+240
+00:14:47,670 --> 00:14:52,370
+بتغلب لما براق الحمام، ولما براق الحمام بيصير عندي
+
+241
+00:14:52,370 --> 00:14:55,960
+في الأسبوع مرات مرتين، إيش طاري ستول، إيش طاري ستول
+
+242
+00:14:55,960 --> 00:15:00,040
+يعني؟ severely black stool، يعني عنده براز لونه
+
+243
+00:15:00,040 --> 00:15:03,220
+أسود جدا، معناته بيدلّي عليه إنه في عنده هذا اسمه
+
+244
+00:15:03,220 --> 00:15:07,800
+نزيف، يعني في عنده للأسف internal hemorrhage، وهذا
+
+245
+00:15:07,800 --> 00:15:10,100
+الـ internal hemorrhage قاعد بيطلع في الـ stool، هو
+
+246
+00:15:10,100 --> 00:15:13,580
+حكى الكلمة ومش عارف، قاعد يقول يمكن عشان بيصير
+
+247
+00:15:13,580 --> 00:15:16,920
+معايا مساج، بيصير معايا إمساك، لكن أنا كحكيم أو
+
+248
+00:15:16,920 --> 00:15:19,960
+كحكيمة، دغري بقول إنه لأ، هذا بيقول إن في عندك
+
+249
+00:15:19,960 --> 00:15:23,020
+hidden problem، لازم أكون متبحر، عشان هيك لازم
+
+250
+00:15:23,020 --> 00:15:27,380
+يكون دائماً نستغل الـ opportunity، أي فرصة، to indicate
+
+251
+00:15:27,380 --> 00:15:31,880
+the client strength and weakness، أي نقطة فيها نقطة
+
+252
+00:15:31,880 --> 00:15:36,460
+قوة أو نقطة ضعف للمريض نركز عليها، كيف يعني هو قاعد
+
+253
+00:15:36,460 --> 00:15:40,080
+بيحكي، نعرف نقاط القوة ونقاط الضعف، إيش اللي
+
+254
+00:15:40,080 --> 00:15:42,660
+مضايقه وإيش اللي مش مضايقه، عشان لما آجي أبدأ بكرا
+
+255
+00:15:42,660 --> 00:15:46,100
+الـ plan، أبدأ بناءً على وين الـ weak points وأبدأ
+
+256
+00:15:46,100 --> 00:15:50,640
+أشتغل عليها، طيب الـ physical systems
+
+257
+00:15:52,950 --> 00:15:55,850
+الـ physical systems طبعاً includes، إيش هنا
+
+258
+00:15:55,850 --> 00:16:00,150
+assessment of general، review of skin، hair والـ
+
+259
+00:16:00,150 --> 00:16:03,510
+head والـ face والـ eyes والـ ears والـ nose،
+
+260
+00:16:03,510 --> 00:16:06,530
+لاحظين إنه إيش بتكلم أنا هنا؟ بتكلم على physical
+
+261
+00:16:06,530 --> 00:16:09,790
+بدنا، لما نقول كلمة physical يعني bio، احنا الآن
+
+262
+00:16:09,790 --> 00:16:14,630
+أخذنا الشقة، الـ psychosocial،أخذنا الشيخ تبع الـ sleep
+
+263
+00:16:14,630 --> 00:16:18,170
+وأخذنا يعني كأنه في موضوع الـ spiritual كمان و
+
+264
+00:16:18,170 --> 00:16:21,930
+الروحانيات، كنا نسأل المريض، اليوم نسأله في حالات، بس
+
+265
+00:16:21,930 --> 00:16:24,410
+الـ physical زي بنسمع ونقول كلمة physical
+
+266
+00:16:24,410 --> 00:16:27,990
+examination، physical assessment، سألناها بس على
+
+267
+00:16:27,990 --> 00:16:33,430
+أجهزته، كيف عينيه، وجهه، دنياه، كيف عنده الجيوب الأنفية
+
+268
+00:16:33,430 --> 00:16:36,890
+كيف عنده الفم، عنده اللي هو الحلق، كيف عنده الرقبة
+
+269
+00:16:36,890 --> 00:16:41,610
+كيف عنده، يعني إذا في عنده notes معينة، زي الغدد
+
+270
+00:16:41,610 --> 00:16:44,890
+الليمفاوية والـ breast، وهسأل عادية، بعدين ببدأ شوية
+
+271
+00:16:44,890 --> 00:16:48,230
+بسأل عن الـ respiratory، لاحظين كيف بالترتيب بنزل
+
+272
+00:16:48,230 --> 00:16:51,330
+على الـ respiratory system، كيف وضعك، كيف جهازك
+
+273
+00:16:51,330 --> 00:16:55,490
+التنفسي، كيف أنت حاسس، القلب عندك كويس، في عندك
+
+274
+00:16:55,490 --> 00:16:58,330
+ضغط، فإذا عندك ضغط، باجي أبدأ أسأل عن gastrointestinal
+
+275
+00:16:58,330 --> 00:17:02,210
+system، كيف الأكل معاك كويس، الصبح بتاكل منيح و
+
+276
+00:17:02,210 --> 00:17:05,370
+الظهر بتاكل منيح، بتشعر، عندك Nausea، vomiting، loss of
+
+277
+00:17:05,370 --> 00:17:09,430
+appetite، أسئلة عامة، لسه ما عملناش assessment للـ
+
+278
+00:17:09,430 --> 00:17:12,700
+system نفسه، لأ، احنا سؤال عام، نسأل، بعدين على إيه
+
+279
+00:17:12,700 --> 00:17:17,040
+الـ urinary system، كيف الوضع عندك فيه، مثلاً
+
+280
+00:17:17,040 --> 00:17:20,200
+هل في عندك حرقة في البول، بتروح الحمام كويس،
+
+281
+00:17:20,200 --> 00:17:23,860
+بتحس فيه مشكلة عندك، بتروح كتير الحمام، ممكن يلحق
+
+282
+00:17:23,860 --> 00:17:27,460
+ويدلّي إن فيه ديابيت مثلاً، من ضمن الأسئلة، لما
+
+283
+00:17:27,460 --> 00:17:30,280
+يجاوبني، بعدين نسأل على الـ genital system، كيف
+
+284
+00:17:30,280 --> 00:17:33,720
+الوضع عندك بشكل عام، هل في عندك مثلاً، كلمة خاصة
+
+285
+00:17:33,720 --> 00:17:36,660
+الأمراض اللي لها علاقة بالجنسية، أو الأمراض اللي
+
+286
+00:17:36,660 --> 00:17:41,220
+ممكن تكون مرتبطة بهذا المكان بالذات، ممكن هو يحكيلي،
+
+287
+00:17:41,220 --> 00:17:43,700
+بالشرط إن أنا.. ممكن يكون embarrassing ومحرج،
+
+288
+00:17:43,700 --> 00:17:47,020
+لكن هو يتكلم لي، بعدين بدي أعمل له assessment of
+
+289
+00:17:47,020 --> 00:17:50,000
+extremities والـ musculoskeletal system، كيف
+
+290
+00:17:50,000 --> 00:17:53,360
+عضلاتك، كيف أدائك، بتروح وبتيجي منيح، ما فيش عندك
+
+291
+00:17:53,360 --> 00:17:57,160
+أي مشاكل، بدي أسأله الـ endocrine، الحمد لله
+
+292
+00:17:57,160 --> 00:18:00,020
+ما عندكش سكر، ما عندكش مشاكل اللي علاقة بالغدد
+
+293
+00:18:00,020 --> 00:18:03,540
+الداخلية، عمرك فحصت، كلمات زي هيك، بعدين أنا بسأله كمان
+
+294
+00:18:03,540 --> 00:18:07,020
+على الـ hematobiotic، hematobiotic system، يعني ما
+
+295
+00:18:07,020 --> 00:18:10,540
+أتكلم على الـ system اللي بشكل عام بصنع اللي هو الـ
+
+296
+00:18:10,540 --> 00:18:13,120
+red blood cells، خاصة في الـ internal، اللي وين
+
+297
+00:18:13,120 --> 00:18:17,260
+internal موجود، في جلب الـ bone marrow، جوا في جلب
+
+298
+00:18:17,260 --> 00:18:20,380
+الأضام، فيه إن الـ bone marrow هو المسؤول عن تصنيع
+
+299
+00:18:20,380 --> 00:18:23,500
+أكيد أخذتوها.. أكيد أخذتوها أنتم في سنة أولى الـ
+
+300
+00:18:23,500 --> 00:18:25,520
+hematopoiesis، أنا مش حاجة، أسأله على الأضام بس، بسأله
+
+301
+00:18:25,520 --> 00:18:28,860
+بشكل عام، كيف الدم، كيف جوة الـ hemoglobin عندك، يعني
+
+302
+00:18:28,860 --> 00:18:31,720
+بيعطينا دلالات عامة، ممكن لحاله أقول اه والله، ما فحصت
+
+303
+00:18:31,720 --> 00:18:34,970
+الدم، موجود، وهالجزء، assessment of social، كيف وضعك
+
+304
+00:18:34,970 --> 00:18:37,650
+الاجتماعي، والـ psychological، كيف وضعك النفسي، كيف
+
+305
+00:18:37,650 --> 00:18:41,330
+أمورك، لاحظين كل الأسئلة متراكمة وبتتركب عندي
+
+306
+00:18:41,330 --> 00:18:44,910
+معلومات، عشان بعدين أنا أبدأ أبسط أكثر الأشياء فيها
+
+307
+00:18:44,910 --> 00:18:47,670
+طبعاً أكيد الـ nutrition and health history، مش هتكلم
+
+308
+00:18:47,670 --> 00:18:50,150
+فيها الآن، لأنها كتبت لكم أنا هنا، discussed before
+
+309
+00:18:50,150 --> 00:18:52,690
+شرحنا فيها عامة كتير في الـ  nutrition أو الـ
+
+310
+00:18:52,690 --> 00:18:56,270
+optimal أو الـ over consumption، طيب الـ 11 هنا إيش
+
+311
+00:18:56,270 --> 00:19:00,740
+مقول هنا؟ بيجي هو طبعاً آخر شيء هو الـ 11، بسأله عن الـ
+
+312
+00:19:00,740 --> 00:19:04,280
+interpersonal factors، وما تنسوش كلمة inter و intra
+
+313
+00:19:04,280 --> 00:19:08,220
+هي سؤال عن الـ interpersonal، يعني العلاقة بينه وبين
+
+314
+00:19:08,220 --> 00:19:11,280
+بين الناس الآخرين، أو علاقته في المجتمع اللي حواليه
+
+315
+00:19:11,280 --> 00:19:16,200
+أما intra، علاقته مع نفسه، السؤال هنا بيجي بيسأل كيف
+
+316
+00:19:16,200 --> 00:19:19,120
+علاقة البني آدم اللي هو اللي قدامنا، الـ client اللي
+
+317
+00:19:19,120 --> 00:19:22,900
+قدامنا مع الآخرين اللي حواليه، أول سؤال بسأله عن
+
+318
+00:19:22,900 --> 00:19:26,350
+موضوع الـ ethnic، الـ ethnic معناته العرق، من هون جاي
+
+319
+00:19:26,350 --> 00:19:28,830
+والـ cultural background، طبعاً الحمد لله احنا كلنا
+
+320
+00:19:28,830 --> 00:19:32,970
+عرقنا واحد، نقدر يعني نلاقي إن واحد جاي مثلاً من
+
+321
+00:19:32,970 --> 00:19:36,410
+جنوب أفريقيا وساكن عندنا، ولا أصله مثلاً يبان و
+
+322
+00:19:36,410 --> 00:19:40,090
+ساكن، نقدر نعرف ازاي يعني الـ cultural background
+
+323
+00:19:40,090 --> 00:19:44,130
+ربما تختلف في اختلاف بسيط ما بين وين ساكن الإنسان
+
+324
+00:19:44,130 --> 00:19:49,530
+يعني في.. في المدينة، شرق، غرب، مثلاً في قرية، في مخيم
+
+325
+00:19:49,530 --> 00:19:52,670
+الـ spoken language، بتكلم طبعاً أكيد، والقيم
+
+326
+00:19:52,670 --> 00:19:56,270
+الموجودة، الـ values، اعتياد الصحي للثبات، والـ family
+
+327
+00:19:56,270 --> 00:19:59,110
+relationship، طبعاً الـ family relationship، أقصد إن
+
+328
+00:19:59,110 --> 00:20:01,810
+هناك عائلات مرتبطة ارتباط شديد حتى في موضوع
+
+329
+00:20:01,810 --> 00:20:05,630
+العلاقات، حتى في موضوع الزواج، يعني أنا ألاحظ، برا
+
+330
+00:20:05,630 --> 00:20:08,460
+بيجي بيقولوا لي، يعني بعض الطلاب كانوا يقولوا لي إنه احنا
+
+331
+00:20:08,460 --> 00:20:11,360
+عيلة، الابن ما يطلعش، لا يمكن البنت تطلع خارج العيلة ولا
+
+332
+00:20:11,360 --> 00:20:14,120
+الولد يطلع معها، طبعاً هو.. بيقول لي احنا مثلاً..
+
+333
+00:20:14,120 --> 00:20:17,100
+المثل اللي قائم عندنا زيتنا في طحيننا، طبعاً أنا
+
+334
+00:20:17,100 --> 00:20:20,000
+متحفظ جداً على كلام هذا، ومش بس أنا، النبي صلى الله
+
+335
+00:20:20,000 --> 00:20:23,260
+عليه وسلم، قبلنا وقبل 14 قرن كان يقول، يعني، غربوا
+
+336
+00:20:23,260 --> 00:20:26,180
+النكاح، بمعنى الحديث صلى الله عليه وسلم، فيعني بعض
+
+337
+00:20:26,180 --> 00:20:29,640
+العائلات مرتبطة مع بعضها، في بعض العائلات متحدة وفي
+
+338
+00:20:29,640 --> 00:20:33,260
+بعض العائلات ما بتعرفش أحداً، يعني ممكن تكون هو ساكن
+
+339
+00:20:33,260 --> 00:20:36,850
+لحاله وما عندهم مشكلة في التعامل، بنسألهم عن الـ life
+
+340
+00:20:36,850 --> 00:20:39,990
+style بشكل عام، كيف الـ rest وكيف الـ sleep، better،
+
+341
+00:20:39,990 --> 00:20:43,470
+كيف الـ self concept، perception، كيف الـ strength
+
+342
+00:20:43,470 --> 00:20:49,190
+يعني، كيف نقاط القوة، نقاط الضعف، desired changes، إيش
+
+343
+00:20:49,190 --> 00:20:52,950
+في عندهم شغلات يعني اللي علاقة بالإدراك هنا، إيش
+
+344
+00:20:52,950 --> 00:20:56,170
+يعني بالإدراك؟ هل يدركون إيش نقاط القوة أو نقاط
+
+345
+00:20:56,170 --> 00:21:00,830
+الضعف؟ هو التعامل مع الآخرين؟ يعني ممكن هو يقول أنا
+
+346
+00:21:00,830 --> 00:21:03,550
+والله عندي نقطة ضعف، ما عرفش أتعامل مع الناس، أنا
+
+347
+00:21:03,550 --> 00:21:06,830
+عندي مشكلة، أنا schizoid، أنا منطوي على نفسي،
+
+348
+00:21:06,830 --> 00:21:11,670
+ما عنديش رغبة إني بدي أغير، أو عندي رغبة desired أو
+
+349
+00:21:11,670 --> 00:21:14,170
+عندي رغبة إني بدي أغير، هو يقول لي، بنسأل الـ
+
+350
+00:21:14,170 --> 00:21:17,130
+sexuality، طبعاً الـ sexuality، developmental level
+
+351
+00:21:17,130 --> 00:21:21,750
+يعني بشكل عام، هل هو كيف هو، مستوى صغير، كبير، ناضج
+
+352
+00:21:21,750 --> 00:21:28,150
+كبير، هل هو يعني تخطى سن معين، متزوج، مش متزوج، وبنسأل
+
+353
+00:21:28,150 --> 00:21:31,470
+طبعاً نفس الخيطية في موضوع الـ stress response and
+
+354
+00:21:31,470 --> 00:21:35,270
+coping، يعني برضه في موضوع إيه، موضوع الاستجابة
+
+355
+00:21:35,270 --> 00:21:39,470
+للتوتر، وكيف بشكل عام أنت كـ client وأنت بتعامل مع
+
+356
+00:21:39,470 --> 00:21:42,430
+الناس، لو أحد سألني طب ليش يا أستاذ، السؤال رجع كمان
+
+357
+00:21:42,430 --> 00:21:46,090
+مرة؟ لأ، هنا بنتكلم عن الـ interpersonal، كيف علاقتك
+
+358
+00:21:46,090 --> 00:21:48,590
+بالـ stress مع الناس وكيف تستجيب لها؟ يعني هو ممكن
+
+359
+00:21:48,590 --> 00:21:51,530
+يقول لك أنا بأخذ على جنب وبأسكت لما أتعامل مع
+
+360
+00:21:51,530 --> 00:21:54,470
+الناس، وممكن يقول لك لأ، أنا بحب أقاتل مع الناس و
+
+361
+00:21:54,470 --> 00:21:57,230
+ممكن واحد يقول لك أنا بعمل على الشر بغنم حسب ما
+
+362
+00:21:57,230 --> 00:22:00,390
+بيقول، باجي بسأله فيه، هل عنده support system، جهاز
+
+363
+00:22:00,390 --> 00:22:04,390
+داعم، حتى بيدعم الأمر هذا، يعني شخصيته؟ هل في
+
+364
+00:22:04,390 --> 00:22:08,030
+عنده مشكلة، perception of current؟ anticipated
+
+365
+00:22:08,030 --> 00:22:13,030
+stressors، يعني هل في عنده مشكلة في إدراكه للمخاطر
+
+366
+00:22:13,030 --> 00:22:17,850
+أو للموترات اللي محتملة، ولا هو يعني مش عارف،
+
+367
+00:22:17,850 --> 00:22:20,630
+الدنيا، في بعض الناس بقول لك أنا عندي هاجس وما بحبش
+
+368
+00:22:20,630 --> 00:22:23,270
+أتعامل مع الناس لأن بلاقي المشاكل منهم، في بعض
+
+369
+00:22:23,270 --> 00:22:26,370
+الناس بقول لك لأ، أنا بحب أروح مع الناس وأحس إنه أنا
+
+370
+00:22:26,370 --> 00:22:29,910
+ممكن أنا أعيش كويس وأحس إنه يعني بيكون أنا حياتي
+
+371
+00:22:29,910 --> 00:22:32,950
+معهم، طبعاً أنا هذه المحاضرة بخليها قصيرة، بيتكفل
+
+372
+00:22:32,950 --> 00:22:36,700
+هنا، عشان نخلص الـ chapter إن شاء الله ونبدأ في
+
+373
+00:22:36,700 --> 00:22:41,140
+المحاضرة إن شاء الله القادمة في الـ chapter الثالث
+
+374
+00:22:41,140 --> 00:22:44,020
+اللي بعده بإذن الله، والسلام عليكم ورحمة الله
+
+375
+00:22:44,020 --> 00:22:44,780
+وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..eeb76fa9bd77ff0f04b2fcc2cb8af5b85a43c951
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_postprocess.srt
@@ -0,0 +1,1500 @@
+1
+00:00:00,930 --> 00:00:04,390
+اعود بالهيشتراجين بسم الله الرحمن الرحيم خلينا
+
+2
+00:00:04,390 --> 00:00:08,390
+نكمل طبعا على .. في ال chapter التالد و احنا طبعا
+
+3
+00:00:08,390 --> 00:00:12,250
+من باب التفكير بس احنا يعني كنا بنتكلم طبعا في
+
+4
+00:00:12,250 --> 00:00:16,390
+بدايته هذا ال chapter في موضوع ال health history
+
+5
+00:00:16,390 --> 00:00:20,910
+في بدايته و احنا بس عشان نربط الكلام في بعضه يعني
+
+6
+00:00:20,910 --> 00:00:26,330
+خلينا احنا يعني خاصة ال .. يعني لما حكينا البنود
+
+7
+00:00:26,330 --> 00:00:30,390
+وصلنا .. بدنا ل bandرقم 7 لكن عشان نربط الكلام في
+
+8
+00:00:30,390 --> 00:00:35,410
+بعضه بدينا أول حاجة هي موجودة عندنا بس عشان الباب
+
+9
+00:00:35,410 --> 00:00:38,550
+التفكير لإنه نربط كل ال .. كل ال chapter مع بعض
+
+10
+00:00:38,550 --> 00:00:41,150
+مابنفعش كل chapter لما نقولنا components of a
+
+11
+00:00:41,150 --> 00:00:43,810
+history و بدينا في ال biographical data و ال
+
+12
+00:00:43,810 --> 00:00:45,670
+biographical data لما نقولنا المعلومات الأساسية
+
+13
+00:00:45,670 --> 00:00:48,630
+للمريض و حكينا رقم 2 اللي هو the chief complaint
+
+14
+00:00:48,630 --> 00:00:52,350
+لما نقولنا شو الشكوه الرئيسية اللي خلت المريض ييجي
+
+15
+00:00:52,350 --> 00:00:56,880
+فيه كمان حكيناالبند التلاتة اللى هو ال history of
+
+16
+00:00:56,880 --> 00:00:59,920
+present illness وصرنا نتكلم إيش طبيعة المرض اللى
+
+17
+00:00:59,920 --> 00:01:03,820
+جابه خلاه ييجي ع المستشفى و نسأل عنه بعدين ال
+
+18
+00:01:03,820 --> 00:01:06,780
+components تبع ال present illness و بعدين ال past
+
+19
+00:01:06,780 --> 00:01:10,540
+health history رقم 4 و سألنا إنه إذا كان عنده
+
+20
+00:01:10,540 --> 00:01:13,760
+مشكلة أو كان اتعرض لأي حوادث سابقة و كيف كانت
+
+21
+00:01:13,760 --> 00:01:17,140
+مرحلة طفولته أو أي مشكلة كانت يعني دخلت المستشفى
+
+22
+00:01:17,140 --> 00:01:20,260
+أو صار عند أي إشكالية صحية بعدين سألنا عن ال
+
+23
+00:01:20,260 --> 00:01:22,440
+family history كمان حكينا و احنا بناخد ال health
+
+24
+00:01:22,440 --> 00:01:26,040
+historyوبرضه شفنا الوضع بشكل عام، ايش تاريخ
+
+25
+00:01:26,040 --> 00:01:28,780
+العائلة؟ هل في عندهم مشكلة في العائلة؟ هل في عندهم
+
+26
+00:01:28,780 --> 00:01:33,060
+لا سمح الله يعني diseases يعني شساري عندهم؟ او في
+
+27
+00:01:33,060 --> 00:01:36,280
+عندهم cause of death for family؟ او اي شي في مشاكل
+
+28
+00:01:36,280 --> 00:01:41,380
+قارب؟ وصلنا لعند environmental history، حد يمكن
+
+29
+00:01:41,380 --> 00:01:43,600
+ممكن يسأل يقولنا طب ايه؟ ايش داخل ال environmental
+
+30
+00:01:43,600 --> 00:01:47,040
+history في الموضوع؟ مرات بتكون المشكلة الصحية اللى
+
+31
+00:01:47,040 --> 00:01:49,380
+موجودة عند المريض كلها جاي من وين؟ من ال
+
+32
+00:01:49,380 --> 00:01:53,680
+environment، ماحد يستهينيعني احنا يمكن احنا عشان
+
+33
+00:01:53,680 --> 00:01:58,060
+بيئاتنا متقاربة مش كلها تختلف اختلاف جدرى عن بعض
+
+34
+00:01:58,060 --> 00:02:04,360
+لكن فى ناس فى عندهم مشكلتات مرتبطة بس بايش بالبيئة
+
+35
+00:02:04,360 --> 00:02:08,260
+و تغيرات البيئة او شكل البيئة او سكانهم فى مكان
+
+36
+00:02:08,260 --> 00:02:12,300
+معين في hazard يعني في مخاطر ال purpose طبعا الغرض
+
+37
+00:02:12,300 --> 00:02:16,180
+هنا ليش هذا الغرض بقولي انا بدأ اخد ايش هنا ال
+
+38
+00:02:16,180 --> 00:02:17,640
+information اللى له علاقة بال surroundings
+
+39
+00:02:17,640 --> 00:02:21,700
+المحيطاتبنبيل بال client يعني اول حاجة طبعا مايجيه
+
+40
+00:02:21,700 --> 00:02:25,300
+حد فى بالنا انه بنتكلم دايما البيئة بس البيئة ال
+
+41
+00:02:25,300 --> 00:02:28,660
+physical environment يعني البيئة الطبيعية فى
+
+42
+00:02:28,660 --> 00:02:34,520
+طبيعتها يعني زى السكن و البنايات و العمارات
+
+43
+00:02:34,520 --> 00:02:37,880
+او الشجرة او كذا لأ هذا يسمى physical فى ال psycho
+
+44
+00:02:37,880 --> 00:02:41,420
+social environment يمكن تكون اخطر فى social
+
+45
+00:02:41,420 --> 00:02:45,700
+environment لوحدها فى psychological لوحدها طبعا
+
+46
+00:02:45,700 --> 00:02:49,200
+ليه هشل جدا هحكيلكوا ليشفي حاجة نتكلم عن ال
+
+47
+00:02:49,200 --> 00:02:53,700
+presence of hazards يعني وجود المخاطر و خاصة زي ال
+
+48
+00:02:53,700 --> 00:02:57,120
+pollutants اللي هو ايه ال pollutants انتوا عارفين
+
+49
+00:02:57,120 --> 00:03:02,740
+زي اللي بتعمل التلوثات البيئية اللي بتصير ربما من
+
+50
+00:03:02,740 --> 00:03:08,420
+مصانع من متاجر معينة من محاجر اذا كانوا موجودين
+
+51
+00:03:08,420 --> 00:03:11,240
+احنا ممكن ماعناش في غزة لكن في الطفل الغربية موجود
+
+52
+00:03:11,240 --> 00:03:14,680
+عندهم اخطر شي عندهم اللي هو قضية المحاجر ان هم
+
+53
+00:03:15,750 --> 00:03:19,850
+كسرات الصخور لأنها بتطلع من ضمن شغلها يعني المواد
+
+54
+00:03:19,850 --> 00:03:24,290
+مسارطنها و بدنا نسأل على ال safety measures ايش
+
+55
+00:03:24,290 --> 00:03:26,030
+يعني ال safety measures يعني الإجراءات اللي هو
+
+56
+00:03:26,030 --> 00:03:28,510
+الحماية و البقايا اللي موجودة بالعيلة بدي أعطيكم
+
+57
+00:03:28,510 --> 00:03:32,290
+مثال عشان نفهم أيش المقصود الآن بيجينا مثلا أحد
+
+58
+00:03:32,290 --> 00:03:35,630
+المرضى بيجي يقولك أنا المرضى عنده peptic ulcer
+
+59
+00:03:35,630 --> 00:03:39,730
+قرحة المعدة او ال 12 سألنا أيش اللي موجود بيقولك
+
+60
+00:03:39,730 --> 00:03:44,120
+أنا ماعنديش مشكلة طب أكلك مني اهبس عايش في stress
+
+61
+00:03:44,120 --> 00:03:48,340
+24 ساعة و 7 أيام في السبوع يعني معناته لطول وقت
+
+62
+00:03:48,340 --> 00:03:51,600
+عايش في stress ليش عايش في stress لأن البيت كله في
+
+63
+00:03:51,600 --> 00:03:54,520
+مشكلة في مشاكل في عندهم psychological problems و
+
+64
+00:03:54,520 --> 00:03:57,860
+في social problems شدة المشاكل أكيد تخلى ال
+
+65
+00:03:57,860 --> 00:04:02,300
+parietal cyst تتس .. تتس .. كتير يعني تنتج ال HCL
+
+66
+00:04:02,300 --> 00:04:08,090
+و تفرز HCL فبصير للأسف يعني مع قلة الطعاممابده
+
+67
+00:04:08,090 --> 00:04:10,450
+اقول زي auto digestion يعني كاللي بتيصير للمعدة
+
+68
+00:04:10,450 --> 00:04:14,630
+فبيصير بتتحول لوين من وين أجانب البيئة تتحول لقرحة
+
+69
+00:04:14,630 --> 00:04:17,550
+كتير من الحالات اللي علاقة كمان بال environment
+
+70
+00:04:17,550 --> 00:04:20,850
+بقتجين الحالات يكون عندهم cancer في ايه؟ cancer في
+
+71
+00:04:20,850 --> 00:04:25,350
+ال lung نسأله من وين انتوا ساكنين؟ اول سؤال يطلعوا
+
+72
+00:04:25,350 --> 00:04:27,670
+ساكنين في مناطق معينة احنا مابداش نذكر لإن كتير
+
+73
+00:04:27,670 --> 00:04:31,280
+هيتفرجوا على الفيديو ربما من خارج القطاعممكن
+
+74
+00:04:31,280 --> 00:04:34,180
+يكونوا جنب بعض الناس اللي بيشتغلوا بالإيه اللي
+
+75
+00:04:34,180 --> 00:04:39,680
+بيشتغلوا بتنظيف السيارات بالرمل في ماكينات بالرمل
+
+76
+00:04:39,680 --> 00:04:43,780
+بتعمل زي و الرمل ما حد يستيين بيه الرمل بيكون يعني
+
+77
+00:04:43,780 --> 00:04:49,040
+لدرجة انه بيعمل زي الفرد اكيد بعض الطلاب يمكن
+
+78
+00:04:49,040 --> 00:04:52,700
+يتذكر اش اللي بحكيه و اكيد الطلبات يمكن يشوفوه على
+
+79
+00:04:52,700 --> 00:04:57,800
+يوتيوب او غيره بتلاقي هذا الفرد زي وعاء معين بنحط
+
+80
+00:04:57,800 --> 00:05:01,360
+فيه مادة زي مادة البويةبس هى بيحطوا فيه الرمل و
+
+81
+00:05:01,360 --> 00:05:05,000
+الرمل اصلا قوى جدا و بيصنع منه طبعا الزجاج فبيبقى
+
+82
+00:05:05,000 --> 00:05:09,600
+يضخ فيه و ينظف كل البوية هذا اللى بيطلع كله للأسف
+
+83
+00:05:09,600 --> 00:05:12,940
+طبعا carcinogenic لأن انت بتتكلم على سان و بتتكلم
+
+84
+00:05:12,940 --> 00:05:16,760
+على بعض تركيبة ال asbestos كل هذا مسرطنات فبيصير
+
+85
+00:05:16,760 --> 00:05:21,220
+عند دول الناس cancer lung بعض الحالات كمان أجتنا
+
+86
+00:05:21,220 --> 00:05:25,660
+بعض العائلات كان عندهم في مشكلة برضه لما سألنا من
+
+87
+00:05:25,660 --> 00:05:28,830
+وين ال cancer عندهم cancer صارو أكتر من مرة كان
+
+88
+00:05:28,830 --> 00:05:31,190
+صار إشي في ال chest و إشي في الأبد و لما سألنا
+
+89
+00:05:31,190 --> 00:05:37,450
+لقنا بيستخدموا أدوية خاصة ل .. هم مزارعين و
+
+90
+00:05:37,450 --> 00:05:42,840
+بيستخدموا أدوية للأسف كثرة مسرطنو كتير بيستخدموها
+
+91
+00:05:42,840 --> 00:05:45,700
+فلاقينا كتير موجودة يعني ال trans familiar موجود
+
+92
+00:05:45,700 --> 00:05:49,540
+في العائلة اضطرينا نعطيهم نصايح انه لأ هذا بدنا
+
+93
+00:05:49,540 --> 00:05:52,900
+نوقف و نستخدم اشياء تانية او نستخدم اللي هو safety
+
+94
+00:05:52,900 --> 00:05:56,680
+measures اخرى طبعا كل هذا السؤال عشان نبين انه
+
+95
+00:05:56,680 --> 00:05:59,460
+مرات المرض كله جاي من وين جاي من ال environment
+
+96
+00:05:59,460 --> 00:06:03,340
+عشان ما نستهينش بيها طيب سبعة بنتكلم على ال
+
+97
+00:06:03,340 --> 00:06:06,440
+current health information ايش يعني current health
+
+98
+00:06:06,440 --> 00:06:10,120
+informationيعني بدي اسأله على الوضع الصحي الحالي
+
+99
+00:06:10,120 --> 00:06:14,620
+الوضع الصحي العالي السؤال الحالي ايش يعني باجي
+
+100
+00:06:14,620 --> 00:06:18,820
+بقوله الان بدي منك ايش في عندك major و current
+
+101
+00:06:18,820 --> 00:06:21,980
+health related information يعني بيجي بنسأله في
+
+102
+00:06:21,980 --> 00:06:26,340
+وضعك الحالي في حياتك الطبيعي اللي انت عايشها اول
+
+103
+00:06:26,340 --> 00:06:30,100
+سؤال بنسأله عن ال allergies ال allergies يا جماعة
+
+104
+00:06:30,100 --> 00:06:33,540
+عشان تكونوا عندكوا علم من اخطر الأمراض اللي ممكن
+
+105
+00:06:33,540 --> 00:06:37,920
+تصيب البني آدم ليه؟الاليرجبت ان نتكلم على الحساسية
+
+106
+00:06:37,920 --> 00:06:41,700
+ما حد يجيب باله بس حساسية كأنه جلده حمر او كذا لأ
+
+107
+00:06:41,700 --> 00:06:45,460
+فيه من الحساسية ممكن تعمل حاجة بسمها anaphylaxis
+
+108
+00:06:45,460 --> 00:06:48,460
+او بسمها anaphylactic shock ال anaphylaxis او ال
+
+109
+00:06:48,460 --> 00:06:52,580
+anaphylactic shock هذه بتعمل ايه؟ بتعمل .. بتعمل
+
+110
+00:06:52,580 --> 00:06:56,520
+نوع من الحساسية الشديدة جدا اللي يصعب السيطرة
+
+111
+00:06:56,520 --> 00:07:01,660
+عليها و بنقدرش مرات احنا نتصرف في هذه الحالات طبعا
+
+112
+00:07:01,660 --> 00:07:05,610
+ليش؟ ممكن تكون ناتج من اي مركبيمكن تكون بعض الناس
+
+113
+00:07:05,610 --> 00:07:08,450
+عندهم environmental اجتناح حالات بس عنده ال
+
+114
+00:07:08,450 --> 00:07:12,450
+allergy من وين انه لما بنظفه في البيت لما بنظفه في
+
+115
+00:07:12,450 --> 00:07:16,070
+البيت بيصير عنده اش دايما بتحملش اللي هو الغبرة
+
+116
+00:07:16,070 --> 00:07:20,450
+بتحملش اللي بيطلع زي القمليات اللي هو هذه بتعمله
+
+117
+00:07:20,450 --> 00:07:23,290
+حسية شديدة بتحمله اش بيصير عنده مايقدرش ياخد نفس
+
+118
+00:07:23,290 --> 00:07:28,070
+في عندهم allergy from ingestion اش يعني ingestion؟
+
+119
+00:07:28,070 --> 00:07:32,270
+ingestion يعني من بلع شيء معين او من اكل شيء معين
+
+120
+00:07:32,270 --> 00:07:35,900
+بيصير معه حسية زيشمش شرط تكون انا لما اتكلم يعني
+
+121
+00:07:35,900 --> 00:07:38,600
+كأنه موجود علنا، يعني في ناس بيقولك انا اتكلت سمك
+
+122
+00:07:38,600 --> 00:07:41,800
+و روحت شربت حليب، بيصير معايا حسية جديدة ماقدرش
+
+123
+00:07:41,800 --> 00:07:46,420
+اتحملها، و في ناس ممكن ياكل سمك و يشرب حليب و يروح
+
+124
+00:07:46,420 --> 00:07:49,520
+كمان ياكل كمان خضار و ياكل فواكه، ياكل اي شيء،
+
+125
+00:07:49,520 --> 00:07:52,420
+مايصيرش عندهم اقبل نقدر نقول لكن مش كل الناس،
+
+126
+00:07:52,420 --> 00:07:56,780
+موضوع ال drug، برضه نفس القضيةمش كل الناس بيقدروا
+
+127
+00:07:56,780 --> 00:08:00,540
+يسيطروا عشان يكونوا واضحين، مش كل العلاجات زي بعض،
+
+128
+00:08:00,540 --> 00:08:04,700
+لأ في علاجات تؤدي بالإنسان لاليرجي و severe
+
+129
+00:08:04,700 --> 00:08:07,960
+allergy و ممكن الإنسان مايقدرش يسيطر عليها، ما
+
+130
+00:08:07,960 --> 00:08:11,340
+بتذكر أسماء، يعني في بعض العلاجات أنا ماكنتش أتخيل
+
+131
+00:08:11,340 --> 00:08:14,660
+أنه ممكن يصير، وصارت، أجونا عندهم حسية من ال
+
+132
+00:08:14,660 --> 00:08:16,980
+declufine اللي هو non-steroidal anti-inflammatory
+
+133
+00:08:16,980 --> 00:08:20,560
+drug، أجونا ناس عندهم حسية كتير من ال antibiotic
+
+134
+00:08:21,140 --> 00:08:23,500
+فيها جنم الكفليكس، فيها جنم البنسيلين، فيها جنم
+
+135
+00:08:23,500 --> 00:08:26,500
+ايه على كتير، طبعا لازم نسأله ليه عشان برضه نكون
+
+136
+00:08:26,500 --> 00:08:29,400
+واضحين وصارحين، قبل ما نعطي اي شيء ال habits،
+
+137
+00:08:29,400 --> 00:08:32,300
+العداد، احنا الحمد لله ربنا مكرم نفش في غزا أو
+
+138
+00:08:32,300 --> 00:08:36,320
+نادر نلاقي حد بيشرب كحول وغيره، لكن دايما بيحطوه
+
+139
+00:08:36,320 --> 00:08:40,480
+ما انتوا عارفين اسمه لكل العالم، فبنسأل عن الكحول،
+
+140
+00:08:40,480 --> 00:08:44,240
+احنا بالنسبة لنا بنسأل عن الدخان و ال tobacco اللي
+
+141
+00:08:44,240 --> 00:08:47,860
+هي زي موضوعات اللي كانوا بيستخدموها في للأسف
+
+142
+00:08:47,860 --> 00:08:52,210
+الشيشة وغيرهبنسأله هل بياخد قهوة بياخد drug معين
+
+143
+00:08:52,210 --> 00:08:57,050
+او هل بيشرب كفاين بشكل كبير يعني هل بيشرب كتير جهة
+
+144
+00:08:57,050 --> 00:09:03,710
+كتير مثلا زي المواد seven cola مشروبات غزية ولا
+
+145
+00:09:03,710 --> 00:09:07,310
+عنده مشكلة في الأمور هذه لازم احنا نكتبها بشكل عام
+
+146
+00:09:07,310 --> 00:09:10,370
+لإن هو the habits و مرتبطة بالأمراض الموجودة عندنا
+
+147
+00:09:10,370 --> 00:09:14,870
+طيب بنشتغل على ال medications بشكل عام أول سؤال
+
+148
+00:09:14,870 --> 00:09:18,710
+بنسأله أنت بتاخد ولاش؟لما نقوله بتاخد علاج لازم
+
+149
+00:09:18,710 --> 00:09:22,990
+نسأل سؤال واضح، هل العلاج بتاخده regular or not؟
+
+150
+00:09:22,990 --> 00:09:26,810
+إذا قاللي regular بقوله طبي دكتور or self
+
+151
+00:09:26,810 --> 00:09:29,970
+prescription؟ في بعض الناس بيقولي كيف يعني self
+
+152
+00:09:29,970 --> 00:09:32,810
+prescription؟ أعطيكم مثال، ألاجد فيه ناس بيجيبون
+
+153
+00:09:32,810 --> 00:09:35,770
+ويقولك أنا كل ما بيصير معايا صداعة باخد ecamol،
+
+154
+00:09:35,770 --> 00:09:37,650
+التاني بيقول لما بيصير معايا صداعة لأ باخد ال
+
+155
+00:09:37,650 --> 00:09:40,790
+trophy، التالت بيقول لأ باخد علاج اسمه migraine،
+
+156
+00:09:40,790 --> 00:09:44,020
+ليه؟ بيقولي ال migraine لأنه علاج لص علاجلصداع
+
+157
+00:09:44,020 --> 00:09:48,260
+شقيقة، الآن بنسأل السؤال هل بتاخده انت لحالك
+
+158
+00:09:48,260 --> 00:09:51,400
+منتظم؟ بقولك منتظم، بنسأل السؤال انت بتاخد لوحدك
+
+159
+00:09:51,400 --> 00:09:55,760
+ولا الدكتور يعني اعطاكيه؟ طبعا إذا هو لحاله بيوصف
+
+160
+00:09:55,760 --> 00:09:59,000
+لنفسه، هنا مكمن الخطر لازم نكون منتبهين، أما إذا
+
+161
+00:09:59,000 --> 00:10:01,720
+الدكتور بيوصف ليه، خلاص مافي مشكلة، يبقى نقوله
+
+162
+00:10:01,720 --> 00:10:05,780
+بيصير نعرف أنه أجا ب medical prescription و مافي
+
+163
+00:10:05,780 --> 00:10:10,570
+مشكلةال exercise better بشكل عام نسأله في انت كيف
+
+164
+00:10:10,570 --> 00:10:14,350
+حياتك؟ هللي حالة حياة خامل و قاعد و sedentary life
+
+165
+00:10:14,350 --> 00:10:19,450
+ولا بطريقة حياتك بتمشي بتروح بتيجي و هكذا نسأله
+
+166
+00:10:19,450 --> 00:10:23,250
+على ال sleep كيف نومك بشكل عام و خاصة احنا حكينا
+
+167
+00:10:23,250 --> 00:10:27,930
+في sleep assessment نسأله على ال routine sleeping
+
+168
+00:10:27,930 --> 00:10:31,350
+نسأله على ال daily sleeping و نسأله على ال hours و
+
+169
+00:10:31,350 --> 00:10:36,270
+هكذا وقداشي هل عنده مثلا اذا اي اضطرابسواء كانت
+
+170
+00:10:36,270 --> 00:10:39,670
+انسمنيا او hypersomnia او هكذا The pattern of life
+
+171
+00:10:39,670 --> 00:10:42,010
+في الأخر نسأله طبيعة حياتك هل هي sedentary or
+
+172
+00:10:42,010 --> 00:10:45,490
+active طبعا اليوم معظم الناس sedentary life عشان
+
+173
+00:10:45,490 --> 00:10:48,470
+أوضاعنا اليوم مختلفة مش بس عشان موضوع كورونا
+
+174
+00:10:48,470 --> 00:10:53,430
+وجلوسنا في البيت لأ يعني قلة العمل وقلة الإنتاجية
+
+175
+00:10:53,430 --> 00:10:56,830
+في البلد وعدم وجود كفاءة يعني خلنا نقول كفايات
+
+176
+00:10:56,830 --> 00:11:02,270
+تستوعب وتستوعب ويعني الشركات ومؤسسات ووزارات
+
+177
+00:11:02,270 --> 00:11:05,980
+تستوعبالخراجين فبتصير للأسف تتحول للحياة to
+
+178
+00:11:05,980 --> 00:11:08,520
+sedentary life اللي هي الحياة الخاملة أما ال
+
+179
+00:11:08,520 --> 00:11:11,460
+active life اللي هو نطلوع و ننزول و أكتر الناس هم
+
+180
+00:11:11,460 --> 00:11:15,560
+الفلاحين اللي بيروح على أرضهم طيب بنتكلم بعدي على
+
+181
+00:11:15,560 --> 00:11:18,980
+ال psycho social assessment حد هيسأل يقولي طيب إيش
+
+182
+00:11:18,980 --> 00:11:22,320
+ال psycho social assessment؟ بنتكلم على أول حاجة
+
+183
+00:11:22,320 --> 00:11:25,700
+على ناحية النفسية الإجتماعية طبعا دايما مرتبطة
+
+184
+00:11:25,700 --> 00:11:28,920
+النفسية بالاجتماعية أكيد احنا حاكينا هذا كلام بس
+
+185
+00:11:28,920 --> 00:11:31,800
+بنعيده بس كلمتينانه دايما ال social بيأثر على ال
+
+186
+00:11:31,800 --> 00:11:33,440
+psychological و ال psychological بيأثر على ال
+
+187
+00:11:33,440 --> 00:11:37,140
+social how a client and his family coop with
+
+188
+00:11:37,140 --> 00:11:39,780
+disease و احنا هقولنا ايش معناه ال cope adjustment
+
+189
+00:11:39,780 --> 00:11:43,660
+زي adaptation ابنتي بنسأله اول سؤال بنسأله انتوا
+
+190
+00:11:43,660 --> 00:11:47,120
+كيف بتتأقلموا مع الأمراض كيف بتتعاملوا مع ال
+
+191
+00:11:47,120 --> 00:11:50,540
+stress يمكن هذا البني ادم اللي عنده peptic ulcer و
+
+192
+00:11:50,540 --> 00:11:53,720
+عيلته عنده peptic ulcerعندهم مشكلة ايش المشكلة ان
+
+193
+00:11:53,720 --> 00:11:57,860
+في عندهم مشكلة خليني اقول loss of coping styles
+
+194
+00:11:57,860 --> 00:12:01,400
+يعني عندهم مش مهارات التأقلم مشكلتهم مش قادرين
+
+195
+00:12:01,400 --> 00:12:05,800
+يتحملهم في بناك يا جماعة عائلات كلها عصبية عجلشي
+
+196
+00:12:05,800 --> 00:12:09,200
+ادفشي دايما البيت نار نار مولع هذول الناس بيقول
+
+197
+00:12:09,200 --> 00:12:12,540
+عندهم والله عندهم loss of coping في ناس عندهم high
+
+198
+00:12:12,540 --> 00:12:16,280
+coping كيف يعني؟ لأ بتأقلم يعني و لو قلتلهم مات
+
+199
+00:12:16,280 --> 00:12:19,600
+فلان مات على عبالهم احنا مابتناش نكون لا هيك و لا
+
+200
+00:12:19,600 --> 00:12:22,680
+هيك ببنا الوسطيةhow they response to illness case
+
+201
+00:12:22,680 --> 00:12:26,320
+بيستجيبه للقياس للأمراض و للناحية الصحية يعني انا
+
+202
+00:12:26,320 --> 00:12:28,840
+ممكن تسأله تقوله انت بشكل عام بتروح على الرياضة
+
+203
+00:12:28,840 --> 00:12:32,920
+بقولك أبدا في للأسف ناس انا سألته من عمره خمسين
+
+204
+00:12:32,920 --> 00:12:36,240
+سنة و يمكن أكتر انا سألته قولتله انت عمرك عملت
+
+205
+00:12:36,240 --> 00:12:39,600
+تحليل؟ تقولي أبدا انا في حياتي ماعملت تحليل مش
+
+206
+00:12:39,600 --> 00:12:42,920
+شطارة طبعا تروح بيعمل بتفاجأة انه عنده كل المصائب
+
+207
+00:12:42,920 --> 00:12:47,360
+ففي ناس عائلات زيك و في ناس لأ بيحبوا دايما يعني
+
+208
+00:12:47,360 --> 00:12:50,590
+يستمروا يعملوا حصات لنفسه على فكرةالمثل اللي بيقول
+
+209
+00:12:50,590 --> 00:12:54,190
+باب النجار مخلق صحيح بيلاقي كتير من الأطباء ومن
+
+210
+00:12:54,190 --> 00:12:57,950
+التمردهم أكتر ناس انجسرين في حالهم وفي عمل انه في
+
+211
+00:12:57,950 --> 00:13:02,450
+الانتباه للصحة تبعاتهم وانتباه لموضوع المرض بيقولي
+
+212
+00:13:02,450 --> 00:13:04,570
+النقطة التانية you can assess if there is
+
+213
+00:13:04,570 --> 00:13:08,470
+psychological or social problems and if it affects
+
+214
+00:13:08,470 --> 00:13:11,990
+هل تؤثر على ال general health of the client يعني
+
+215
+00:13:11,990 --> 00:13:17,150
+سؤالنا لازم نشوف هل الحالةالنفسية والحالة
+
+216
+00:13:17,150 --> 00:13:20,090
+الاجتماعية، يعني هل المشكلات النفسية المجتمعية
+
+217
+00:13:20,090 --> 00:13:25,250
+مأثرة على مستوى الصحة العام في البيت، مستوى الصحة
+
+218
+00:13:25,250 --> 00:13:29,490
+العام للفرد؟ طبعا و أكيد بتأثر، في ناس في طبيعتهم
+
+219
+00:13:29,490 --> 00:13:32,770
+بتنشهم، ممكن ماتأثرش، ماتستغربوش تقولي أه يستثمر
+
+220
+00:13:32,770 --> 00:13:36,600
+كل البيوت ليك، لأفيه ممكن تلاقي في نفس البيت أخوك
+
+221
+00:13:36,600 --> 00:13:39,780
+ممكن يكون او ممكن انت او انت ممكن تلاقي أخوك واحد
+
+222
+00:13:39,780 --> 00:13:43,340
+من الأخوة ولا عباله يعني ممكن كل الدنيا تنحرج ولا
+
+223
+00:13:43,340 --> 00:13:46,320
+عباله ممكن ماتأثرش عليه اي وضع فاحنا لازم نسألكوا
+
+224
+00:13:46,320 --> 00:13:50,660
+سؤالنا واضح تمانية بدا نتكلم عليها ROS اختصار
+
+225
+00:13:50,660 --> 00:13:54,060
+عالمي Review of Systems مراجعة أجهزة لسه انا
+
+226
+00:13:54,060 --> 00:13:59,220
+ماشرحتش الأجهزة لقدامها نعمل assessment لكل جهاز
+
+227
+00:13:59,220 --> 00:14:02,460
+لوحده من عند ال skin مع ال digestion والرسميرات
+
+228
+00:14:02,460 --> 00:14:06,020
+وها كذالكن احنا بنقول .. بنعمل review لما اقول
+
+229
+00:14:06,020 --> 00:14:08,720
+كلمة review بنعمل collection of data about past
+
+230
+00:14:08,720 --> 00:14:13,020
+and present for each client system يعني كويس نيجي
+
+231
+00:14:13,020 --> 00:14:16,380
+نسأله يعني و احنا بنقعديل السؤال احنا بنتكلم على
+
+232
+00:14:16,380 --> 00:14:19,520
+.. بناخد history بنسأل على ال clients physical و
+
+233
+00:14:19,520 --> 00:14:24,220
+ال social و ال psychological status ليه؟ ممكن يكون
+
+234
+00:14:24,220 --> 00:14:27,540
+هو بيحكيلنا يعني ممكن يحكيلنا بنقول له طب انت كيف
+
+235
+00:14:27,540 --> 00:14:34,210
+نفسك؟ حياتك كيف؟ كيف هضمك للطعام؟كيف انت بتتحرك
+
+236
+00:14:34,210 --> 00:14:36,850
+كويس، احنا قاعدين نتكلم عن جهاز عصب و جهاز نفس و
+
+237
+00:14:36,850 --> 00:14:41,130
+مش كل الأجزة، الان ممكن هو بيحكيلي شغلة يطلع في
+
+238
+00:14:41,130 --> 00:14:44,750
+عنده حاجة hidden problem، اش يعني hidden؟ اش مخفي،
+
+239
+00:14:44,750 --> 00:14:47,670
+يعني ممكن هو قاعد بيقول ليه، بيقول والله بس أنا
+
+240
+00:14:47,670 --> 00:14:52,370
+بتغلب لما براق الحمام و لما براق الحمام بيصير عندى
+
+241
+00:14:52,370 --> 00:14:55,960
+في السبوع مرات مرتينانه طاري ستول ايش طاري ستول
+
+242
+00:14:55,960 --> 00:15:00,040
+يعني؟ severely black school يعني عنده براز لونه
+
+243
+00:15:00,040 --> 00:15:03,220
+أسود جدا معناته بيدللي عليهش في عنده هذا اسمه
+
+244
+00:15:03,220 --> 00:15:07,800
+ملينة يعني في عنده للأسف internal hemorrhage و هذا
+
+245
+00:15:07,800 --> 00:15:10,100
+ال internal hemorrhage قاعد بيطلع في ال stool هو
+
+246
+00:15:10,100 --> 00:15:13,580
+حكى الكلمة و مش عارف فقاعد يقول يمكن عشان بيصير
+
+247
+00:15:13,580 --> 00:15:16,920
+معايا مساج بيصير معايا زجاج لكن انا كحكيم او
+
+248
+00:15:16,920 --> 00:15:19,960
+كحكيمة دغري بقول انه لأ هذا بيقول ان في عندك
+
+249
+00:15:19,960 --> 00:15:23,020
+hidden problem لازم اكون من تبهله عشان هيك لازم
+
+250
+00:15:23,020 --> 00:15:27,380
+يكون دايمانستغل ال opportunity اي فرصة to indicate
+
+251
+00:15:27,380 --> 00:15:31,880
+the client strength and weakness اي نقطة فيها نقطة
+
+252
+00:15:31,880 --> 00:15:36,460
+قوة او نقطة ضعف للمريض نركز عليها كيف يعني هو جاعد
+
+253
+00:15:36,460 --> 00:15:40,080
+بيحكي نعرف و النقاط القوة و النقاط الضعف ايش اللي
+
+254
+00:15:40,080 --> 00:15:42,660
+مضايقه و ايش اللي مش مضايقه عشان لما اجي ابدا بكرا
+
+255
+00:15:42,660 --> 00:15:46,100
+ال plan ابدا بناء على وين ال weak points و ابدا
+
+256
+00:15:46,100 --> 00:15:50,640
+اشتغل عليها طيب ال physical systems
+
+257
+00:15:52,950 --> 00:15:55,850
+ال physical systems طبعا includes ايش هنا
+
+258
+00:15:55,850 --> 00:16:00,150
+assessment of general, review of skin, hair و ال
+
+259
+00:16:00,150 --> 00:16:03,510
+head و ال face و ال eyes و ال ears و ال nose،
+
+260
+00:16:03,510 --> 00:16:06,530
+لاحظين انه ايش بتكلم انا هنا؟ بتكلم على physical
+
+261
+00:16:06,530 --> 00:16:09,790
+بدنا، لما نقول كلمة physical يعني bio، احنا الآن
+
+262
+00:16:09,790 --> 00:16:14,630
+أخد الشقة ال psychosocialأخدنا الشيخ تبع ال sleep
+
+263
+00:16:14,630 --> 00:16:18,170
+و أخدنا يعني كأنه في موضوع ال spiritual كمان و
+
+264
+00:16:18,170 --> 00:16:21,930
+الروحانيات كنا نسأل المريض اليوم نسأله في حالات بس
+
+265
+00:16:21,930 --> 00:16:24,410
+ال physical زي بنسمع و نقول كلمة physical
+
+266
+00:16:24,410 --> 00:16:27,990
+examination physical assessment سألناها بس على
+
+267
+00:16:27,990 --> 00:16:33,430
+أجهزته كيف عينيك وجهه دنيا كيف عنده الجيوب الأنفية
+
+268
+00:16:33,430 --> 00:16:36,890
+كيف عنده الفم عنده اللي هو الحلق كيف عنده الرقبة
+
+269
+00:16:36,890 --> 00:16:41,610
+كيف عنده يعني إذا في عنده notes معينة زيهده
+
+270
+00:16:41,610 --> 00:16:44,890
+الينفاوية و ال breast وهسئل عادية بعدين ببدأ شويه
+
+271
+00:16:44,890 --> 00:16:48,230
+بسأل عن ال respiratory لاحظين كيف بالترتيب بنزل
+
+272
+00:16:48,230 --> 00:16:51,330
+على ال respiratory system كيف وضعك كيف جهازك
+
+273
+00:16:51,330 --> 00:16:55,490
+التنفسي كيف انت حاسس انت الجلب عندك كويس فى عندك
+
+274
+00:16:55,490 --> 00:16:58,330
+ضغط فاش عندك ضغط باجي بدأ أسئل عن gastrointestinal
+
+275
+00:16:58,330 --> 00:17:02,210
+system كيف الأكل معاك كويس الصبح بتاكل منيح و
+
+276
+00:17:02,210 --> 00:17:05,370
+الظهر بتاكل منيح بتشعر عندك نوزيا vomiting loss of
+
+277
+00:17:05,370 --> 00:17:09,430
+appetite أسئل عامة لسه ماعملناش assessment لل
+
+278
+00:17:09,430 --> 00:17:12,700
+system نفسه لأ احنا سؤال عامنسأل بعدين على إيه
+
+279
+00:17:12,700 --> 00:17:17,040
+الشناء، urinary system، كيف الوضع عندك فيه، مثلا
+
+280
+00:17:17,040 --> 00:17:20,200
+هل في عندك حراجان في البول، بتروح الحمام كويس،
+
+281
+00:17:20,200 --> 00:17:23,860
+بتحس فيه مشكلة عندك، بتروح كتير الحمام، ممكن يلحق
+
+282
+00:17:23,860 --> 00:17:27,460
+و يدللي إن فيه ديابيط مثلا من ضمن الأسئلة، لما
+
+283
+00:17:27,460 --> 00:17:30,280
+يجاوبني، بعدين نسأل على ال genital system، كيف
+
+284
+00:17:30,280 --> 00:17:33,720
+الوضع عندك بشكل عام، هل في عندك مثلا كلمة خاصة
+
+285
+00:17:33,720 --> 00:17:36,660
+الأمراض اللي اللي علاقة بالجنسية أو الأمراض اللي
+
+286
+00:17:36,660 --> 00:17:41,220
+ممكن تكون مرتبطة بهذه المكان بالذاتممكن هو يحكيلي،
+
+287
+00:17:41,220 --> 00:17:43,700
+بالشرط ان انا .. ممكن يكون embarrassing و محرج،
+
+288
+00:17:43,700 --> 00:17:47,020
+لكن هو يتكلملي، بعدين بدي اعمله assessment of
+
+289
+00:17:47,020 --> 00:17:50,000
+extremities و ال musculoskeletal system، كيف
+
+290
+00:17:50,000 --> 00:17:53,360
+عضلاتك، كيف أدائك، بتروح و بتيجي منيح، مافيش عندك
+
+291
+00:17:53,360 --> 00:17:57,160
+اي مشاكل، بدي اسأله ال endocrine، الحمد لله
+
+292
+00:17:57,160 --> 00:18:00,020
+ماعندكاش سكر، ماعندكاش مشاكل اللي علاقة بالغضب
+
+293
+00:18:00,020 --> 00:18:03,540
+دراقية، عمرك فحصت كلمات زيك، بعدين أنا بسأله كمان
+
+294
+00:18:03,540 --> 00:18:07,020
+على ال hematobiotic، hematobiotic systemيعني ما
+
+295
+00:18:07,020 --> 00:18:10,540
+اتكلم على ال system اللى بشكل و بصنع اللى هو ال
+
+296
+00:18:10,540 --> 00:18:13,120
+red blood cells خاصة في ال internal اللى وين
+
+297
+00:18:13,120 --> 00:18:17,260
+internal موجود في جلب ال bone marrow جوا في جلب
+
+298
+00:18:17,260 --> 00:18:20,380
+الأضام فيه أن ال bone marrow هو المسئول عن تصنيع
+
+299
+00:18:20,380 --> 00:18:23,500
+أكيد أخدتوا .. أكيد أخدتوها انتوا في سنة أولى ال
+
+300
+00:18:23,500 --> 00:18:25,520
+herbicides أنا مش حاجة أسأله على الأضام بس بسأله
+
+301
+00:18:25,520 --> 00:18:28,860
+بشكل عام كيف الدم كيف جوة ال hemoglobin عندك يعني
+
+302
+00:18:28,860 --> 00:18:31,720
+بيعطينا دلالات عامة ممكن لحالي أقول أه والله مفحصت
+
+303
+00:18:31,720 --> 00:18:34,970
+الدم موجود و هالجدassessment of social كيف وضعك
+
+304
+00:18:34,970 --> 00:18:37,650
+الاجتماعي و ال psychological كيف وضعك النفسي كيف
+
+305
+00:18:37,650 --> 00:18:41,330
+أمورك لحظين كل الأسئلة متراكمة و بتركب عندى
+
+306
+00:18:41,330 --> 00:18:44,910
+معلومات عشان بعدين انا ابدا ابسح اكتر الاشي فيها
+
+307
+00:18:44,910 --> 00:18:47,670
+طبعا اكيد ال nutrition and health history مش هتكلم
+
+308
+00:18:47,670 --> 00:18:50,150
+فيها الآن لأنه كاتبتكوا انا هنا discussed before
+
+309
+00:18:50,150 --> 00:18:52,690
+شرحنا فيها عامة كتير في المال ال nutrition او ال
+
+310
+00:18:52,690 --> 00:18:56,270
+optimal او ال over consumption طيب ال 11 هنا ايش
+
+311
+00:18:56,270 --> 00:19:00,740
+مقول هنا؟بيجي هو طبعا أخر شي هو ال 11 بسأله عن ال
+
+312
+00:19:00,740 --> 00:19:04,280
+interpersonal factors وما تنسوش كلمة inter و intra
+
+313
+00:19:04,280 --> 00:19:08,220
+هي سؤال عن ال interpersonal يعني العلاقة بينه و
+
+314
+00:19:08,220 --> 00:19:11,280
+بين الناس الأخرين أو علاقته في المجتمع اللي حواليه
+
+315
+00:19:11,280 --> 00:19:16,200
+أما intra علاقته مع نفسه السؤال هنا بيجي بيسأل كيف
+
+316
+00:19:16,200 --> 00:19:19,120
+علاقة البني آدم اللي هو اللي قدامنا ال client اللي
+
+317
+00:19:19,120 --> 00:19:22,900
+أمامنا مع الأخرين اللي حواليه أول سؤال بسأله عن
+
+318
+00:19:22,900 --> 00:19:26,350
+موضوع ال ethnic ال ethnic معنات العرقلأ من هون جاي
+
+319
+00:19:26,350 --> 00:19:28,830
+و ال culture background طبعا الحمد لله احنا كلنا
+
+320
+00:19:28,830 --> 00:19:32,970
+عرقنا واحد نقدر يعني نلاقي ان واحد جاي مثلا من
+
+321
+00:19:32,970 --> 00:19:36,410
+جنوب أفريقيا و ساكن عندنا و لا أصله مثلا يبان و
+
+322
+00:19:36,410 --> 00:19:40,090
+ساكن نقدر نجعلنا ازاي يعني ال culture background
+
+323
+00:19:40,090 --> 00:19:44,130
+ربما تختلف في اختلاف بسيط ما بين وين ساكن الإنسان
+
+324
+00:19:44,130 --> 00:19:49,530
+يعني في .. في المدينة شرق غرب مثلا في قرية في مخيم
+
+325
+00:19:49,530 --> 00:19:52,670
+ال spoken language بتكلم طبعا أكيد و القيم
+
+326
+00:19:52,670 --> 00:19:56,270
+الموجودة ال valueاعتاد الصحي للثبات وال family
+
+327
+00:19:56,270 --> 00:19:59,110
+relationship طبعا ال family relationship اقصد ان
+
+328
+00:19:59,110 --> 00:20:01,810
+هناك عائلات مرتبطة ارتباط شديد حتى في موضوع
+
+329
+00:20:01,810 --> 00:20:05,630
+العلاقات حتى في موضوع الزواج يعني انا باطلعوش برا
+
+330
+00:20:05,630 --> 00:20:08,460
+بيجي بقولنا يعني بعض الطلاب كانوا يقولوليإنه احنا
+
+331
+00:20:08,460 --> 00:20:11,360
+عيلة ابن طلعش، لا يمكن البنت تطلع خارج العيلة ولا
+
+332
+00:20:11,360 --> 00:20:14,120
+الولد يطلع معها، طبعا هو .. بقولي احنا مثلا ..
+
+333
+00:20:14,120 --> 00:20:17,100
+المثل اللي قايم عندنا زيتنا في تكيكنا، طبعا أنا
+
+334
+00:20:17,100 --> 00:20:20,000
+متحفظ جدا على كلام هذا ومش بس أنا النبي صلى الله
+
+335
+00:20:20,000 --> 00:20:23,260
+عليه وسلم قبلنا وقبل 14 قرن كان يقول يعني غربوا
+
+336
+00:20:23,260 --> 00:20:26,180
+النكاح بمعنى الحديث صلى الله عليه وسلم، فيعني بعض
+
+337
+00:20:26,180 --> 00:20:29,640
+العائلات مرتبطة مع بعضه، في بعض العائلات متدة وفي
+
+338
+00:20:29,640 --> 00:20:33,260
+بعض العائلات بتعرفش حدا، يعني ممكن تكون عم هو ساكن
+
+339
+00:20:33,260 --> 00:20:36,850
+لحاله وماعندهم مشكلة في التعاملبنسألهم عن ال life
+
+340
+00:20:36,850 --> 00:20:39,990
+style بشكل عام، كيف ال rest و كيف ال sleep better،
+
+341
+00:20:39,990 --> 00:20:43,470
+كيف ال self concept perception، كيف ال strength
+
+342
+00:20:43,470 --> 00:20:49,190
+يعني، كيف نقاط القوةنقاط الضعف desired changes ايش
+
+343
+00:20:49,190 --> 00:20:52,950
+في عندهم شغلات يعني اللي علاقة بالادراك هنا، ايش
+
+344
+00:20:52,950 --> 00:20:56,170
+يعني بالادراك؟ هل يدركوا ايش نقاط القوة او نقاط
+
+345
+00:20:56,170 --> 00:21:00,830
+الضعف هو التعامل مع الآخرين؟ يعني ممكن هو يقول انا
+
+346
+00:21:00,830 --> 00:21:03,550
+والله عند نقطة ضعف، ماعرفش اتعامل مع الناس، انا
+
+347
+00:21:03,550 --> 00:21:06,830
+عندي مشكلة، انا schizoid، انا منطوع على نفسي،
+
+348
+00:21:06,830 --> 00:21:11,670
+ماعنديش رغبة اني بده اتغير او عندي رغبة desired او
+
+349
+00:21:11,670 --> 00:21:14,170
+عندي رغبة اني بده اتغير، هو يقولليبنسأل ال
+
+350
+00:21:14,170 --> 00:21:17,130
+sexuality طبعا ال sexuality developmental level
+
+351
+00:21:17,130 --> 00:21:21,750
+يعني بشكل عام هل هو كيف هو مستوى صغير كبير ناضج
+
+352
+00:21:21,750 --> 00:21:28,150
+كبير هل هو يعني تخطى سن معين متزوج مش متزوج وبنسأل
+
+353
+00:21:28,150 --> 00:21:31,470
+طبعا نفس الخضية في موضوع ال stress response and
+
+354
+00:21:31,470 --> 00:21:35,270
+coping يعني برضه في موضوع ايه موضوع الاستجابة
+
+355
+00:21:35,270 --> 00:21:39,470
+لالتوتر وكيف بشكل عام انت ك client وانت بتتعامل مع
+
+356
+00:21:39,470 --> 00:21:42,430
+الناسلو حد سألني طب ليش يا رستازي السؤال رجع كمان
+
+357
+00:21:42,430 --> 00:21:46,090
+مرة؟ لأ هنا بنتكلم عن ال interpersonal كيف علاقتك
+
+358
+00:21:46,090 --> 00:21:48,590
+بال stress مع الناس و كيف تستجيب لها؟ يعني هو ممكن
+
+359
+00:21:48,590 --> 00:21:51,530
+يقولك أنا باخد على جانبي و باسكت لما أتعامل مع
+
+360
+00:21:51,530 --> 00:21:54,470
+الناس و ممكن يقولك لأ أنا بحب أتقاتل مع الناس و
+
+361
+00:21:54,470 --> 00:21:57,230
+ممكن واحد يقولك أنا بعمل عن الشر بغنم حسب ما
+
+362
+00:21:57,230 --> 00:22:00,390
+بيقوليه باجي بسأله فيه هل عنده support system جهاز
+
+363
+00:22:00,390 --> 00:22:04,390
+داعم حتى بيدعم الأمر هذا يعني يبقوا شخصيته؟ هل في
+
+364
+00:22:04,390 --> 00:22:08,030
+عنده مشكلة perception of current؟anticipated
+
+365
+00:22:08,030 --> 00:22:13,030
+stressors يعني هل في عنده مشكلة فى إدراكه للمخاطر
+
+366
+00:22:13,030 --> 00:22:17,850
+أو للموترات اللى محتملة ولا هو يعني مش عبارة عن
+
+367
+00:22:17,850 --> 00:22:20,630
+الدنيا فى بعض الناس بقولك أنا عندي هاجس وماحبش
+
+368
+00:22:20,630 --> 00:22:23,270
+أتعامل مع الناس لإن بلاقي المشاكل منهم فى بعض
+
+369
+00:22:23,270 --> 00:22:26,370
+الناس بقولك لأ أنا بحب أروح مع الناس و أحس أنه انا
+
+370
+00:22:26,370 --> 00:22:29,910
+ممكن انا أعيش كويس و أحس أنه يعني بكون أنا حياتى
+
+371
+00:22:29,910 --> 00:22:32,950
+معهم طبعا انا هذه المحاضرة بيخليها قصيرة بيتكفل
+
+372
+00:22:32,950 --> 00:22:36,700
+هناعشان نخلص ال chapter ان شاء الله و نبدأ في
+
+373
+00:22:36,700 --> 00:22:41,140
+المحاضرة ان شاء الله القادمة في ال chapter الثالث
+
+374
+00:22:41,140 --> 00:22:44,020
+اللي بعد بإذن الله والسلام عليكم ورحمة الله
+
+375
+00:22:44,020 --> 00:22:44,780
+وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..eeb76fa9bd77ff0f04b2fcc2cb8af5b85a43c951
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/G8L__BhtV3A_raw.srt
@@ -0,0 +1,1500 @@
+1
+00:00:00,930 --> 00:00:04,390
+اعود بالهيشتراجين بسم الله الرحمن الرحيم خلينا
+
+2
+00:00:04,390 --> 00:00:08,390
+نكمل طبعا على .. في ال chapter التالد و احنا طبعا
+
+3
+00:00:08,390 --> 00:00:12,250
+من باب التفكير بس احنا يعني كنا بنتكلم طبعا في
+
+4
+00:00:12,250 --> 00:00:16,390
+بدايته هذا ال chapter في موضوع ال health history
+
+5
+00:00:16,390 --> 00:00:20,910
+في بدايته و احنا بس عشان نربط الكلام في بعضه يعني
+
+6
+00:00:20,910 --> 00:00:26,330
+خلينا احنا يعني خاصة ال .. يعني لما حكينا البنود
+
+7
+00:00:26,330 --> 00:00:30,390
+وصلنا .. بدنا ل bandرقم 7 لكن عشان نربط الكلام في
+
+8
+00:00:30,390 --> 00:00:35,410
+بعضه بدينا أول حاجة هي موجودة عندنا بس عشان الباب
+
+9
+00:00:35,410 --> 00:00:38,550
+التفكير لإنه نربط كل ال .. كل ال chapter مع بعض
+
+10
+00:00:38,550 --> 00:00:41,150
+مابنفعش كل chapter لما نقولنا components of a
+
+11
+00:00:41,150 --> 00:00:43,810
+history و بدينا في ال biographical data و ال
+
+12
+00:00:43,810 --> 00:00:45,670
+biographical data لما نقولنا المعلومات الأساسية
+
+13
+00:00:45,670 --> 00:00:48,630
+للمريض و حكينا رقم 2 اللي هو the chief complaint
+
+14
+00:00:48,630 --> 00:00:52,350
+لما نقولنا شو الشكوه الرئيسية اللي خلت المريض ييجي
+
+15
+00:00:52,350 --> 00:00:56,880
+فيه كمان حكيناالبند التلاتة اللى هو ال history of
+
+16
+00:00:56,880 --> 00:00:59,920
+present illness وصرنا نتكلم إيش طبيعة المرض اللى
+
+17
+00:00:59,920 --> 00:01:03,820
+جابه خلاه ييجي ع المستشفى و نسأل عنه بعدين ال
+
+18
+00:01:03,820 --> 00:01:06,780
+components تبع ال present illness و بعدين ال past
+
+19
+00:01:06,780 --> 00:01:10,540
+health history رقم 4 و سألنا إنه إذا كان عنده
+
+20
+00:01:10,540 --> 00:01:13,760
+مشكلة أو كان اتعرض لأي حوادث سابقة و كيف كانت
+
+21
+00:01:13,760 --> 00:01:17,140
+مرحلة طفولته أو أي مشكلة كانت يعني دخلت المستشفى
+
+22
+00:01:17,140 --> 00:01:20,260
+أو صار عند أي إشكالية صحية بعدين سألنا عن ال
+
+23
+00:01:20,260 --> 00:01:22,440
+family history كمان حكينا و احنا بناخد ال health
+
+24
+00:01:22,440 --> 00:01:26,040
+historyوبرضه شفنا الوضع بشكل عام، ايش تاريخ
+
+25
+00:01:26,040 --> 00:01:28,780
+العائلة؟ هل في عندهم مشكلة في العائلة؟ هل في عندهم
+
+26
+00:01:28,780 --> 00:01:33,060
+لا سمح الله يعني diseases يعني شساري عندهم؟ او في
+
+27
+00:01:33,060 --> 00:01:36,280
+عندهم cause of death for family؟ او اي شي في مشاكل
+
+28
+00:01:36,280 --> 00:01:41,380
+قارب؟ وصلنا لعند environmental history، حد يمكن
+
+29
+00:01:41,380 --> 00:01:43,600
+ممكن يسأل يقولنا طب ايه؟ ايش داخل ال environmental
+
+30
+00:01:43,600 --> 00:01:47,040
+history في الموضوع؟ مرات بتكون المشكلة الصحية اللى
+
+31
+00:01:47,040 --> 00:01:49,380
+موجودة عند المريض كلها جاي من وين؟ من ال
+
+32
+00:01:49,380 --> 00:01:53,680
+environment، ماحد يستهينيعني احنا يمكن احنا عشان
+
+33
+00:01:53,680 --> 00:01:58,060
+بيئاتنا متقاربة مش كلها تختلف اختلاف جدرى عن بعض
+
+34
+00:01:58,060 --> 00:02:04,360
+لكن فى ناس فى عندهم مشكلتات مرتبطة بس بايش بالبيئة
+
+35
+00:02:04,360 --> 00:02:08,260
+و تغيرات البيئة او شكل البيئة او سكانهم فى مكان
+
+36
+00:02:08,260 --> 00:02:12,300
+معين في hazard يعني في مخاطر ال purpose طبعا الغرض
+
+37
+00:02:12,300 --> 00:02:16,180
+هنا ليش هذا الغرض بقولي انا بدأ اخد ايش هنا ال
+
+38
+00:02:16,180 --> 00:02:17,640
+information اللى له علاقة بال surroundings
+
+39
+00:02:17,640 --> 00:02:21,700
+المحيطاتبنبيل بال client يعني اول حاجة طبعا مايجيه
+
+40
+00:02:21,700 --> 00:02:25,300
+حد فى بالنا انه بنتكلم دايما البيئة بس البيئة ال
+
+41
+00:02:25,300 --> 00:02:28,660
+physical environment يعني البيئة الطبيعية فى
+
+42
+00:02:28,660 --> 00:02:34,520
+طبيعتها يعني زى السكن و البنايات و العمارات
+
+43
+00:02:34,520 --> 00:02:37,880
+او الشجرة او كذا لأ هذا يسمى physical فى ال psycho
+
+44
+00:02:37,880 --> 00:02:41,420
+social environment يمكن تكون اخطر فى social
+
+45
+00:02:41,420 --> 00:02:45,700
+environment لوحدها فى psychological لوحدها طبعا
+
+46
+00:02:45,700 --> 00:02:49,200
+ليه هشل جدا هحكيلكوا ليشفي حاجة نتكلم عن ال
+
+47
+00:02:49,200 --> 00:02:53,700
+presence of hazards يعني وجود المخاطر و خاصة زي ال
+
+48
+00:02:53,700 --> 00:02:57,120
+pollutants اللي هو ايه ال pollutants انتوا عارفين
+
+49
+00:02:57,120 --> 00:03:02,740
+زي اللي بتعمل التلوثات البيئية اللي بتصير ربما من
+
+50
+00:03:02,740 --> 00:03:08,420
+مصانع من متاجر معينة من محاجر اذا كانوا موجودين
+
+51
+00:03:08,420 --> 00:03:11,240
+احنا ممكن ماعناش في غزة لكن في الطفل الغربية موجود
+
+52
+00:03:11,240 --> 00:03:14,680
+عندهم اخطر شي عندهم اللي هو قضية المحاجر ان هم
+
+53
+00:03:15,750 --> 00:03:19,850
+كسرات الصخور لأنها بتطلع من ضمن شغلها يعني المواد
+
+54
+00:03:19,850 --> 00:03:24,290
+مسارطنها و بدنا نسأل على ال safety measures ايش
+
+55
+00:03:24,290 --> 00:03:26,030
+يعني ال safety measures يعني الإجراءات اللي هو
+
+56
+00:03:26,030 --> 00:03:28,510
+الحماية و البقايا اللي موجودة بالعيلة بدي أعطيكم
+
+57
+00:03:28,510 --> 00:03:32,290
+مثال عشان نفهم أيش المقصود الآن بيجينا مثلا أحد
+
+58
+00:03:32,290 --> 00:03:35,630
+المرضى بيجي يقولك أنا المرضى عنده peptic ulcer
+
+59
+00:03:35,630 --> 00:03:39,730
+قرحة المعدة او ال 12 سألنا أيش اللي موجود بيقولك
+
+60
+00:03:39,730 --> 00:03:44,120
+أنا ماعنديش مشكلة طب أكلك مني اهبس عايش في stress
+
+61
+00:03:44,120 --> 00:03:48,340
+24 ساعة و 7 أيام في السبوع يعني معناته لطول وقت
+
+62
+00:03:48,340 --> 00:03:51,600
+عايش في stress ليش عايش في stress لأن البيت كله في
+
+63
+00:03:51,600 --> 00:03:54,520
+مشكلة في مشاكل في عندهم psychological problems و
+
+64
+00:03:54,520 --> 00:03:57,860
+في social problems شدة المشاكل أكيد تخلى ال
+
+65
+00:03:57,860 --> 00:04:02,300
+parietal cyst تتس .. تتس .. كتير يعني تنتج ال HCL
+
+66
+00:04:02,300 --> 00:04:08,090
+و تفرز HCL فبصير للأسف يعني مع قلة الطعاممابده
+
+67
+00:04:08,090 --> 00:04:10,450
+اقول زي auto digestion يعني كاللي بتيصير للمعدة
+
+68
+00:04:10,450 --> 00:04:14,630
+فبيصير بتتحول لوين من وين أجانب البيئة تتحول لقرحة
+
+69
+00:04:14,630 --> 00:04:17,550
+كتير من الحالات اللي علاقة كمان بال environment
+
+70
+00:04:17,550 --> 00:04:20,850
+بقتجين الحالات يكون عندهم cancer في ايه؟ cancer في
+
+71
+00:04:20,850 --> 00:04:25,350
+ال lung نسأله من وين انتوا ساكنين؟ اول سؤال يطلعوا
+
+72
+00:04:25,350 --> 00:04:27,670
+ساكنين في مناطق معينة احنا مابداش نذكر لإن كتير
+
+73
+00:04:27,670 --> 00:04:31,280
+هيتفرجوا على الفيديو ربما من خارج القطاعممكن
+
+74
+00:04:31,280 --> 00:04:34,180
+يكونوا جنب بعض الناس اللي بيشتغلوا بالإيه اللي
+
+75
+00:04:34,180 --> 00:04:39,680
+بيشتغلوا بتنظيف السيارات بالرمل في ماكينات بالرمل
+
+76
+00:04:39,680 --> 00:04:43,780
+بتعمل زي و الرمل ما حد يستيين بيه الرمل بيكون يعني
+
+77
+00:04:43,780 --> 00:04:49,040
+لدرجة انه بيعمل زي الفرد اكيد بعض الطلاب يمكن
+
+78
+00:04:49,040 --> 00:04:52,700
+يتذكر اش اللي بحكيه و اكيد الطلبات يمكن يشوفوه على
+
+79
+00:04:52,700 --> 00:04:57,800
+يوتيوب او غيره بتلاقي هذا الفرد زي وعاء معين بنحط
+
+80
+00:04:57,800 --> 00:05:01,360
+فيه مادة زي مادة البويةبس هى بيحطوا فيه الرمل و
+
+81
+00:05:01,360 --> 00:05:05,000
+الرمل اصلا قوى جدا و بيصنع منه طبعا الزجاج فبيبقى
+
+82
+00:05:05,000 --> 00:05:09,600
+يضخ فيه و ينظف كل البوية هذا اللى بيطلع كله للأسف
+
+83
+00:05:09,600 --> 00:05:12,940
+طبعا carcinogenic لأن انت بتتكلم على سان و بتتكلم
+
+84
+00:05:12,940 --> 00:05:16,760
+على بعض تركيبة ال asbestos كل هذا مسرطنات فبيصير
+
+85
+00:05:16,760 --> 00:05:21,220
+عند دول الناس cancer lung بعض الحالات كمان أجتنا
+
+86
+00:05:21,220 --> 00:05:25,660
+بعض العائلات كان عندهم في مشكلة برضه لما سألنا من
+
+87
+00:05:25,660 --> 00:05:28,830
+وين ال cancer عندهم cancer صارو أكتر من مرة كان
+
+88
+00:05:28,830 --> 00:05:31,190
+صار إشي في ال chest و إشي في الأبد و لما سألنا
+
+89
+00:05:31,190 --> 00:05:37,450
+لقنا بيستخدموا أدوية خاصة ل .. هم مزارعين و
+
+90
+00:05:37,450 --> 00:05:42,840
+بيستخدموا أدوية للأسف كثرة مسرطنو كتير بيستخدموها
+
+91
+00:05:42,840 --> 00:05:45,700
+فلاقينا كتير موجودة يعني ال trans familiar موجود
+
+92
+00:05:45,700 --> 00:05:49,540
+في العائلة اضطرينا نعطيهم نصايح انه لأ هذا بدنا
+
+93
+00:05:49,540 --> 00:05:52,900
+نوقف و نستخدم اشياء تانية او نستخدم اللي هو safety
+
+94
+00:05:52,900 --> 00:05:56,680
+measures اخرى طبعا كل هذا السؤال عشان نبين انه
+
+95
+00:05:56,680 --> 00:05:59,460
+مرات المرض كله جاي من وين جاي من ال environment
+
+96
+00:05:59,460 --> 00:06:03,340
+عشان ما نستهينش بيها طيب سبعة بنتكلم على ال
+
+97
+00:06:03,340 --> 00:06:06,440
+current health information ايش يعني current health
+
+98
+00:06:06,440 --> 00:06:10,120
+informationيعني بدي اسأله على الوضع الصحي الحالي
+
+99
+00:06:10,120 --> 00:06:14,620
+الوضع الصحي العالي السؤال الحالي ايش يعني باجي
+
+100
+00:06:14,620 --> 00:06:18,820
+بقوله الان بدي منك ايش في عندك major و current
+
+101
+00:06:18,820 --> 00:06:21,980
+health related information يعني بيجي بنسأله في
+
+102
+00:06:21,980 --> 00:06:26,340
+وضعك الحالي في حياتك الطبيعي اللي انت عايشها اول
+
+103
+00:06:26,340 --> 00:06:30,100
+سؤال بنسأله عن ال allergies ال allergies يا جماعة
+
+104
+00:06:30,100 --> 00:06:33,540
+عشان تكونوا عندكوا علم من اخطر الأمراض اللي ممكن
+
+105
+00:06:33,540 --> 00:06:37,920
+تصيب البني آدم ليه؟الاليرجبت ان نتكلم على الحساسية
+
+106
+00:06:37,920 --> 00:06:41,700
+ما حد يجيب باله بس حساسية كأنه جلده حمر او كذا لأ
+
+107
+00:06:41,700 --> 00:06:45,460
+فيه من الحساسية ممكن تعمل حاجة بسمها anaphylaxis
+
+108
+00:06:45,460 --> 00:06:48,460
+او بسمها anaphylactic shock ال anaphylaxis او ال
+
+109
+00:06:48,460 --> 00:06:52,580
+anaphylactic shock هذه بتعمل ايه؟ بتعمل .. بتعمل
+
+110
+00:06:52,580 --> 00:06:56,520
+نوع من الحساسية الشديدة جدا اللي يصعب السيطرة
+
+111
+00:06:56,520 --> 00:07:01,660
+عليها و بنقدرش مرات احنا نتصرف في هذه الحالات طبعا
+
+112
+00:07:01,660 --> 00:07:05,610
+ليش؟ ممكن تكون ناتج من اي مركبيمكن تكون بعض الناس
+
+113
+00:07:05,610 --> 00:07:08,450
+عندهم environmental اجتناح حالات بس عنده ال
+
+114
+00:07:08,450 --> 00:07:12,450
+allergy من وين انه لما بنظفه في البيت لما بنظفه في
+
+115
+00:07:12,450 --> 00:07:16,070
+البيت بيصير عنده اش دايما بتحملش اللي هو الغبرة
+
+116
+00:07:16,070 --> 00:07:20,450
+بتحملش اللي بيطلع زي القمليات اللي هو هذه بتعمله
+
+117
+00:07:20,450 --> 00:07:23,290
+حسية شديدة بتحمله اش بيصير عنده مايقدرش ياخد نفس
+
+118
+00:07:23,290 --> 00:07:28,070
+في عندهم allergy from ingestion اش يعني ingestion؟
+
+119
+00:07:28,070 --> 00:07:32,270
+ingestion يعني من بلع شيء معين او من اكل شيء معين
+
+120
+00:07:32,270 --> 00:07:35,900
+بيصير معه حسية زيشمش شرط تكون انا لما اتكلم يعني
+
+121
+00:07:35,900 --> 00:07:38,600
+كأنه موجود علنا، يعني في ناس بيقولك انا اتكلت سمك
+
+122
+00:07:38,600 --> 00:07:41,800
+و روحت شربت حليب، بيصير معايا حسية جديدة ماقدرش
+
+123
+00:07:41,800 --> 00:07:46,420
+اتحملها، و في ناس ممكن ياكل سمك و يشرب حليب و يروح
+
+124
+00:07:46,420 --> 00:07:49,520
+كمان ياكل كمان خضار و ياكل فواكه، ياكل اي شيء،
+
+125
+00:07:49,520 --> 00:07:52,420
+مايصيرش عندهم اقبل نقدر نقول لكن مش كل الناس،
+
+126
+00:07:52,420 --> 00:07:56,780
+موضوع ال drug، برضه نفس القضيةمش كل الناس بيقدروا
+
+127
+00:07:56,780 --> 00:08:00,540
+يسيطروا عشان يكونوا واضحين، مش كل العلاجات زي بعض،
+
+128
+00:08:00,540 --> 00:08:04,700
+لأ في علاجات تؤدي بالإنسان لاليرجي و severe
+
+129
+00:08:04,700 --> 00:08:07,960
+allergy و ممكن الإنسان مايقدرش يسيطر عليها، ما
+
+130
+00:08:07,960 --> 00:08:11,340
+بتذكر أسماء، يعني في بعض العلاجات أنا ماكنتش أتخيل
+
+131
+00:08:11,340 --> 00:08:14,660
+أنه ممكن يصير، وصارت، أجونا عندهم حسية من ال
+
+132
+00:08:14,660 --> 00:08:16,980
+declufine اللي هو non-steroidal anti-inflammatory
+
+133
+00:08:16,980 --> 00:08:20,560
+drug، أجونا ناس عندهم حسية كتير من ال antibiotic
+
+134
+00:08:21,140 --> 00:08:23,500
+فيها جنم الكفليكس، فيها جنم البنسيلين، فيها جنم
+
+135
+00:08:23,500 --> 00:08:26,500
+ايه على كتير، طبعا لازم نسأله ليه عشان برضه نكون
+
+136
+00:08:26,500 --> 00:08:29,400
+واضحين وصارحين، قبل ما نعطي اي شيء ال habits،
+
+137
+00:08:29,400 --> 00:08:32,300
+العداد، احنا الحمد لله ربنا مكرم نفش في غزا أو
+
+138
+00:08:32,300 --> 00:08:36,320
+نادر نلاقي حد بيشرب كحول وغيره، لكن دايما بيحطوه
+
+139
+00:08:36,320 --> 00:08:40,480
+ما انتوا عارفين اسمه لكل العالم، فبنسأل عن الكحول،
+
+140
+00:08:40,480 --> 00:08:44,240
+احنا بالنسبة لنا بنسأل عن الدخان و ال tobacco اللي
+
+141
+00:08:44,240 --> 00:08:47,860
+هي زي موضوعات اللي كانوا بيستخدموها في للأسف
+
+142
+00:08:47,860 --> 00:08:52,210
+الشيشة وغيرهبنسأله هل بياخد قهوة بياخد drug معين
+
+143
+00:08:52,210 --> 00:08:57,050
+او هل بيشرب كفاين بشكل كبير يعني هل بيشرب كتير جهة
+
+144
+00:08:57,050 --> 00:09:03,710
+كتير مثلا زي المواد seven cola مشروبات غزية ولا
+
+145
+00:09:03,710 --> 00:09:07,310
+عنده مشكلة في الأمور هذه لازم احنا نكتبها بشكل عام
+
+146
+00:09:07,310 --> 00:09:10,370
+لإن هو the habits و مرتبطة بالأمراض الموجودة عندنا
+
+147
+00:09:10,370 --> 00:09:14,870
+طيب بنشتغل على ال medications بشكل عام أول سؤال
+
+148
+00:09:14,870 --> 00:09:18,710
+بنسأله أنت بتاخد ولاش؟لما نقوله بتاخد علاج لازم
+
+149
+00:09:18,710 --> 00:09:22,990
+نسأل سؤال واضح، هل العلاج بتاخده regular or not؟
+
+150
+00:09:22,990 --> 00:09:26,810
+إذا قاللي regular بقوله طبي دكتور or self
+
+151
+00:09:26,810 --> 00:09:29,970
+prescription؟ في بعض الناس بيقولي كيف يعني self
+
+152
+00:09:29,970 --> 00:09:32,810
+prescription؟ أعطيكم مثال، ألاجد فيه ناس بيجيبون
+
+153
+00:09:32,810 --> 00:09:35,770
+ويقولك أنا كل ما بيصير معايا صداعة باخد ecamol،
+
+154
+00:09:35,770 --> 00:09:37,650
+التاني بيقول لما بيصير معايا صداعة لأ باخد ال
+
+155
+00:09:37,650 --> 00:09:40,790
+trophy، التالت بيقول لأ باخد علاج اسمه migraine،
+
+156
+00:09:40,790 --> 00:09:44,020
+ليه؟ بيقولي ال migraine لأنه علاج لص علاجلصداع
+
+157
+00:09:44,020 --> 00:09:48,260
+شقيقة، الآن بنسأل السؤال هل بتاخده انت لحالك
+
+158
+00:09:48,260 --> 00:09:51,400
+منتظم؟ بقولك منتظم، بنسأل السؤال انت بتاخد لوحدك
+
+159
+00:09:51,400 --> 00:09:55,760
+ولا الدكتور يعني اعطاكيه؟ طبعا إذا هو لحاله بيوصف
+
+160
+00:09:55,760 --> 00:09:59,000
+لنفسه، هنا مكمن الخطر لازم نكون منتبهين، أما إذا
+
+161
+00:09:59,000 --> 00:10:01,720
+الدكتور بيوصف ليه، خلاص مافي مشكلة، يبقى نقوله
+
+162
+00:10:01,720 --> 00:10:05,780
+بيصير نعرف أنه أجا ب medical prescription و مافي
+
+163
+00:10:05,780 --> 00:10:10,570
+مشكلةال exercise better بشكل عام نسأله في انت كيف
+
+164
+00:10:10,570 --> 00:10:14,350
+حياتك؟ هللي حالة حياة خامل و قاعد و sedentary life
+
+165
+00:10:14,350 --> 00:10:19,450
+ولا بطريقة حياتك بتمشي بتروح بتيجي و هكذا نسأله
+
+166
+00:10:19,450 --> 00:10:23,250
+على ال sleep كيف نومك بشكل عام و خاصة احنا حكينا
+
+167
+00:10:23,250 --> 00:10:27,930
+في sleep assessment نسأله على ال routine sleeping
+
+168
+00:10:27,930 --> 00:10:31,350
+نسأله على ال daily sleeping و نسأله على ال hours و
+
+169
+00:10:31,350 --> 00:10:36,270
+هكذا وقداشي هل عنده مثلا اذا اي اضطرابسواء كانت
+
+170
+00:10:36,270 --> 00:10:39,670
+انسمنيا او hypersomnia او هكذا The pattern of life
+
+171
+00:10:39,670 --> 00:10:42,010
+في الأخر نسأله طبيعة حياتك هل هي sedentary or
+
+172
+00:10:42,010 --> 00:10:45,490
+active طبعا اليوم معظم الناس sedentary life عشان
+
+173
+00:10:45,490 --> 00:10:48,470
+أوضاعنا اليوم مختلفة مش بس عشان موضوع كورونا
+
+174
+00:10:48,470 --> 00:10:53,430
+وجلوسنا في البيت لأ يعني قلة العمل وقلة الإنتاجية
+
+175
+00:10:53,430 --> 00:10:56,830
+في البلد وعدم وجود كفاءة يعني خلنا نقول كفايات
+
+176
+00:10:56,830 --> 00:11:02,270
+تستوعب وتستوعب ويعني الشركات ومؤسسات ووزارات
+
+177
+00:11:02,270 --> 00:11:05,980
+تستوعبالخراجين فبتصير للأسف تتحول للحياة to
+
+178
+00:11:05,980 --> 00:11:08,520
+sedentary life اللي هي الحياة الخاملة أما ال
+
+179
+00:11:08,520 --> 00:11:11,460
+active life اللي هو نطلوع و ننزول و أكتر الناس هم
+
+180
+00:11:11,460 --> 00:11:15,560
+الفلاحين اللي بيروح على أرضهم طيب بنتكلم بعدي على
+
+181
+00:11:15,560 --> 00:11:18,980
+ال psycho social assessment حد هيسأل يقولي طيب إيش
+
+182
+00:11:18,980 --> 00:11:22,320
+ال psycho social assessment؟ بنتكلم على أول حاجة
+
+183
+00:11:22,320 --> 00:11:25,700
+على ناحية النفسية الإجتماعية طبعا دايما مرتبطة
+
+184
+00:11:25,700 --> 00:11:28,920
+النفسية بالاجتماعية أكيد احنا حاكينا هذا كلام بس
+
+185
+00:11:28,920 --> 00:11:31,800
+بنعيده بس كلمتينانه دايما ال social بيأثر على ال
+
+186
+00:11:31,800 --> 00:11:33,440
+psychological و ال psychological بيأثر على ال
+
+187
+00:11:33,440 --> 00:11:37,140
+social how a client and his family coop with
+
+188
+00:11:37,140 --> 00:11:39,780
+disease و احنا هقولنا ايش معناه ال cope adjustment
+
+189
+00:11:39,780 --> 00:11:43,660
+زي adaptation ابنتي بنسأله اول سؤال بنسأله انتوا
+
+190
+00:11:43,660 --> 00:11:47,120
+كيف بتتأقلموا مع الأمراض كيف بتتعاملوا مع ال
+
+191
+00:11:47,120 --> 00:11:50,540
+stress يمكن هذا البني ادم اللي عنده peptic ulcer و
+
+192
+00:11:50,540 --> 00:11:53,720
+عيلته عنده peptic ulcerعندهم مشكلة ايش المشكلة ان
+
+193
+00:11:53,720 --> 00:11:57,860
+في عندهم مشكلة خليني اقول loss of coping styles
+
+194
+00:11:57,860 --> 00:12:01,400
+يعني عندهم مش مهارات التأقلم مشكلتهم مش قادرين
+
+195
+00:12:01,400 --> 00:12:05,800
+يتحملهم في بناك يا جماعة عائلات كلها عصبية عجلشي
+
+196
+00:12:05,800 --> 00:12:09,200
+ادفشي دايما البيت نار نار مولع هذول الناس بيقول
+
+197
+00:12:09,200 --> 00:12:12,540
+عندهم والله عندهم loss of coping في ناس عندهم high
+
+198
+00:12:12,540 --> 00:12:16,280
+coping كيف يعني؟ لأ بتأقلم يعني و لو قلتلهم مات
+
+199
+00:12:16,280 --> 00:12:19,600
+فلان مات على عبالهم احنا مابتناش نكون لا هيك و لا
+
+200
+00:12:19,600 --> 00:12:22,680
+هيك ببنا الوسطيةhow they response to illness case
+
+201
+00:12:22,680 --> 00:12:26,320
+بيستجيبه للقياس للأمراض و للناحية الصحية يعني انا
+
+202
+00:12:26,320 --> 00:12:28,840
+ممكن تسأله تقوله انت بشكل عام بتروح على الرياضة
+
+203
+00:12:28,840 --> 00:12:32,920
+بقولك أبدا في للأسف ناس انا سألته من عمره خمسين
+
+204
+00:12:32,920 --> 00:12:36,240
+سنة و يمكن أكتر انا سألته قولتله انت عمرك عملت
+
+205
+00:12:36,240 --> 00:12:39,600
+تحليل؟ تقولي أبدا انا في حياتي ماعملت تحليل مش
+
+206
+00:12:39,600 --> 00:12:42,920
+شطارة طبعا تروح بيعمل بتفاجأة انه عنده كل المصائب
+
+207
+00:12:42,920 --> 00:12:47,360
+ففي ناس عائلات زيك و في ناس لأ بيحبوا دايما يعني
+
+208
+00:12:47,360 --> 00:12:50,590
+يستمروا يعملوا حصات لنفسه على فكرةالمثل اللي بيقول
+
+209
+00:12:50,590 --> 00:12:54,190
+باب النجار مخلق صحيح بيلاقي كتير من الأطباء ومن
+
+210
+00:12:54,190 --> 00:12:57,950
+التمردهم أكتر ناس انجسرين في حالهم وفي عمل انه في
+
+211
+00:12:57,950 --> 00:13:02,450
+الانتباه للصحة تبعاتهم وانتباه لموضوع المرض بيقولي
+
+212
+00:13:02,450 --> 00:13:04,570
+النقطة التانية you can assess if there is
+
+213
+00:13:04,570 --> 00:13:08,470
+psychological or social problems and if it affects
+
+214
+00:13:08,470 --> 00:13:11,990
+هل تؤثر على ال general health of the client يعني
+
+215
+00:13:11,990 --> 00:13:17,150
+سؤالنا لازم نشوف هل الحالةالنفسية والحالة
+
+216
+00:13:17,150 --> 00:13:20,090
+الاجتماعية، يعني هل المشكلات النفسية المجتمعية
+
+217
+00:13:20,090 --> 00:13:25,250
+مأثرة على مستوى الصحة العام في البيت، مستوى الصحة
+
+218
+00:13:25,250 --> 00:13:29,490
+العام للفرد؟ طبعا و أكيد بتأثر، في ناس في طبيعتهم
+
+219
+00:13:29,490 --> 00:13:32,770
+بتنشهم، ممكن ماتأثرش، ماتستغربوش تقولي أه يستثمر
+
+220
+00:13:32,770 --> 00:13:36,600
+كل البيوت ليك، لأفيه ممكن تلاقي في نفس البيت أخوك
+
+221
+00:13:36,600 --> 00:13:39,780
+ممكن يكون او ممكن انت او انت ممكن تلاقي أخوك واحد
+
+222
+00:13:39,780 --> 00:13:43,340
+من الأخوة ولا عباله يعني ممكن كل الدنيا تنحرج ولا
+
+223
+00:13:43,340 --> 00:13:46,320
+عباله ممكن ماتأثرش عليه اي وضع فاحنا لازم نسألكوا
+
+224
+00:13:46,320 --> 00:13:50,660
+سؤالنا واضح تمانية بدا نتكلم عليها ROS اختصار
+
+225
+00:13:50,660 --> 00:13:54,060
+عالمي Review of Systems مراجعة أجهزة لسه انا
+
+226
+00:13:54,060 --> 00:13:59,220
+ماشرحتش الأجهزة لقدامها نعمل assessment لكل جهاز
+
+227
+00:13:59,220 --> 00:14:02,460
+لوحده من عند ال skin مع ال digestion والرسميرات
+
+228
+00:14:02,460 --> 00:14:06,020
+وها كذالكن احنا بنقول .. بنعمل review لما اقول
+
+229
+00:14:06,020 --> 00:14:08,720
+كلمة review بنعمل collection of data about past
+
+230
+00:14:08,720 --> 00:14:13,020
+and present for each client system يعني كويس نيجي
+
+231
+00:14:13,020 --> 00:14:16,380
+نسأله يعني و احنا بنقعديل السؤال احنا بنتكلم على
+
+232
+00:14:16,380 --> 00:14:19,520
+.. بناخد history بنسأل على ال clients physical و
+
+233
+00:14:19,520 --> 00:14:24,220
+ال social و ال psychological status ليه؟ ممكن يكون
+
+234
+00:14:24,220 --> 00:14:27,540
+هو بيحكيلنا يعني ممكن يحكيلنا بنقول له طب انت كيف
+
+235
+00:14:27,540 --> 00:14:34,210
+نفسك؟ حياتك كيف؟ كيف هضمك للطعام؟كيف انت بتتحرك
+
+236
+00:14:34,210 --> 00:14:36,850
+كويس، احنا قاعدين نتكلم عن جهاز عصب و جهاز نفس و
+
+237
+00:14:36,850 --> 00:14:41,130
+مش كل الأجزة، الان ممكن هو بيحكيلي شغلة يطلع في
+
+238
+00:14:41,130 --> 00:14:44,750
+عنده حاجة hidden problem، اش يعني hidden؟ اش مخفي،
+
+239
+00:14:44,750 --> 00:14:47,670
+يعني ممكن هو قاعد بيقول ليه، بيقول والله بس أنا
+
+240
+00:14:47,670 --> 00:14:52,370
+بتغلب لما براق الحمام و لما براق الحمام بيصير عندى
+
+241
+00:14:52,370 --> 00:14:55,960
+في السبوع مرات مرتينانه طاري ستول ايش طاري ستول
+
+242
+00:14:55,960 --> 00:15:00,040
+يعني؟ severely black school يعني عنده براز لونه
+
+243
+00:15:00,040 --> 00:15:03,220
+أسود جدا معناته بيدللي عليهش في عنده هذا اسمه
+
+244
+00:15:03,220 --> 00:15:07,800
+ملينة يعني في عنده للأسف internal hemorrhage و هذا
+
+245
+00:15:07,800 --> 00:15:10,100
+ال internal hemorrhage قاعد بيطلع في ال stool هو
+
+246
+00:15:10,100 --> 00:15:13,580
+حكى الكلمة و مش عارف فقاعد يقول يمكن عشان بيصير
+
+247
+00:15:13,580 --> 00:15:16,920
+معايا مساج بيصير معايا زجاج لكن انا كحكيم او
+
+248
+00:15:16,920 --> 00:15:19,960
+كحكيمة دغري بقول انه لأ هذا بيقول ان في عندك
+
+249
+00:15:19,960 --> 00:15:23,020
+hidden problem لازم اكون من تبهله عشان هيك لازم
+
+250
+00:15:23,020 --> 00:15:27,380
+يكون دايمانستغل ال opportunity اي فرصة to indicate
+
+251
+00:15:27,380 --> 00:15:31,880
+the client strength and weakness اي نقطة فيها نقطة
+
+252
+00:15:31,880 --> 00:15:36,460
+قوة او نقطة ضعف للمريض نركز عليها كيف يعني هو جاعد
+
+253
+00:15:36,460 --> 00:15:40,080
+بيحكي نعرف و النقاط القوة و النقاط الضعف ايش اللي
+
+254
+00:15:40,080 --> 00:15:42,660
+مضايقه و ايش اللي مش مضايقه عشان لما اجي ابدا بكرا
+
+255
+00:15:42,660 --> 00:15:46,100
+ال plan ابدا بناء على وين ال weak points و ابدا
+
+256
+00:15:46,100 --> 00:15:50,640
+اشتغل عليها طيب ال physical systems
+
+257
+00:15:52,950 --> 00:15:55,850
+ال physical systems طبعا includes ايش هنا
+
+258
+00:15:55,850 --> 00:16:00,150
+assessment of general, review of skin, hair و ال
+
+259
+00:16:00,150 --> 00:16:03,510
+head و ال face و ال eyes و ال ears و ال nose،
+
+260
+00:16:03,510 --> 00:16:06,530
+لاحظين انه ايش بتكلم انا هنا؟ بتكلم على physical
+
+261
+00:16:06,530 --> 00:16:09,790
+بدنا، لما نقول كلمة physical يعني bio، احنا الآن
+
+262
+00:16:09,790 --> 00:16:14,630
+أخد الشقة ال psychosocialأخدنا الشيخ تبع ال sleep
+
+263
+00:16:14,630 --> 00:16:18,170
+و أخدنا يعني كأنه في موضوع ال spiritual كمان و
+
+264
+00:16:18,170 --> 00:16:21,930
+الروحانيات كنا نسأل المريض اليوم نسأله في حالات بس
+
+265
+00:16:21,930 --> 00:16:24,410
+ال physical زي بنسمع و نقول كلمة physical
+
+266
+00:16:24,410 --> 00:16:27,990
+examination physical assessment سألناها بس على
+
+267
+00:16:27,990 --> 00:16:33,430
+أجهزته كيف عينيك وجهه دنيا كيف عنده الجيوب الأنفية
+
+268
+00:16:33,430 --> 00:16:36,890
+كيف عنده الفم عنده اللي هو الحلق كيف عنده الرقبة
+
+269
+00:16:36,890 --> 00:16:41,610
+كيف عنده يعني إذا في عنده notes معينة زيهده
+
+270
+00:16:41,610 --> 00:16:44,890
+الينفاوية و ال breast وهسئل عادية بعدين ببدأ شويه
+
+271
+00:16:44,890 --> 00:16:48,230
+بسأل عن ال respiratory لاحظين كيف بالترتيب بنزل
+
+272
+00:16:48,230 --> 00:16:51,330
+على ال respiratory system كيف وضعك كيف جهازك
+
+273
+00:16:51,330 --> 00:16:55,490
+التنفسي كيف انت حاسس انت الجلب عندك كويس فى عندك
+
+274
+00:16:55,490 --> 00:16:58,330
+ضغط فاش عندك ضغط باجي بدأ أسئل عن gastrointestinal
+
+275
+00:16:58,330 --> 00:17:02,210
+system كيف الأكل معاك كويس الصبح بتاكل منيح و
+
+276
+00:17:02,210 --> 00:17:05,370
+الظهر بتاكل منيح بتشعر عندك نوزيا vomiting loss of
+
+277
+00:17:05,370 --> 00:17:09,430
+appetite أسئل عامة لسه ماعملناش assessment لل
+
+278
+00:17:09,430 --> 00:17:12,700
+system نفسه لأ احنا سؤال عامنسأل بعدين على إيه
+
+279
+00:17:12,700 --> 00:17:17,040
+الشناء، urinary system، كيف الوضع عندك فيه، مثلا
+
+280
+00:17:17,040 --> 00:17:20,200
+هل في عندك حراجان في البول، بتروح الحمام كويس،
+
+281
+00:17:20,200 --> 00:17:23,860
+بتحس فيه مشكلة عندك، بتروح كتير الحمام، ممكن يلحق
+
+282
+00:17:23,860 --> 00:17:27,460
+و يدللي إن فيه ديابيط مثلا من ضمن الأسئلة، لما
+
+283
+00:17:27,460 --> 00:17:30,280
+يجاوبني، بعدين نسأل على ال genital system، كيف
+
+284
+00:17:30,280 --> 00:17:33,720
+الوضع عندك بشكل عام، هل في عندك مثلا كلمة خاصة
+
+285
+00:17:33,720 --> 00:17:36,660
+الأمراض اللي اللي علاقة بالجنسية أو الأمراض اللي
+
+286
+00:17:36,660 --> 00:17:41,220
+ممكن تكون مرتبطة بهذه المكان بالذاتممكن هو يحكيلي،
+
+287
+00:17:41,220 --> 00:17:43,700
+بالشرط ان انا .. ممكن يكون embarrassing و محرج،
+
+288
+00:17:43,700 --> 00:17:47,020
+لكن هو يتكلملي، بعدين بدي اعمله assessment of
+
+289
+00:17:47,020 --> 00:17:50,000
+extremities و ال musculoskeletal system، كيف
+
+290
+00:17:50,000 --> 00:17:53,360
+عضلاتك، كيف أدائك، بتروح و بتيجي منيح، مافيش عندك
+
+291
+00:17:53,360 --> 00:17:57,160
+اي مشاكل، بدي اسأله ال endocrine، الحمد لله
+
+292
+00:17:57,160 --> 00:18:00,020
+ماعندكاش سكر، ماعندكاش مشاكل اللي علاقة بالغضب
+
+293
+00:18:00,020 --> 00:18:03,540
+دراقية، عمرك فحصت كلمات زيك، بعدين أنا بسأله كمان
+
+294
+00:18:03,540 --> 00:18:07,020
+على ال hematobiotic، hematobiotic systemيعني ما
+
+295
+00:18:07,020 --> 00:18:10,540
+اتكلم على ال system اللى بشكل و بصنع اللى هو ال
+
+296
+00:18:10,540 --> 00:18:13,120
+red blood cells خاصة في ال internal اللى وين
+
+297
+00:18:13,120 --> 00:18:17,260
+internal موجود في جلب ال bone marrow جوا في جلب
+
+298
+00:18:17,260 --> 00:18:20,380
+الأضام فيه أن ال bone marrow هو المسئول عن تصنيع
+
+299
+00:18:20,380 --> 00:18:23,500
+أكيد أخدتوا .. أكيد أخدتوها انتوا في سنة أولى ال
+
+300
+00:18:23,500 --> 00:18:25,520
+herbicides أنا مش حاجة أسأله على الأضام بس بسأله
+
+301
+00:18:25,520 --> 00:18:28,860
+بشكل عام كيف الدم كيف جوة ال hemoglobin عندك يعني
+
+302
+00:18:28,860 --> 00:18:31,720
+بيعطينا دلالات عامة ممكن لحالي أقول أه والله مفحصت
+
+303
+00:18:31,720 --> 00:18:34,970
+الدم موجود و هالجدassessment of social كيف وضعك
+
+304
+00:18:34,970 --> 00:18:37,650
+الاجتماعي و ال psychological كيف وضعك النفسي كيف
+
+305
+00:18:37,650 --> 00:18:41,330
+أمورك لحظين كل الأسئلة متراكمة و بتركب عندى
+
+306
+00:18:41,330 --> 00:18:44,910
+معلومات عشان بعدين انا ابدا ابسح اكتر الاشي فيها
+
+307
+00:18:44,910 --> 00:18:47,670
+طبعا اكيد ال nutrition and health history مش هتكلم
+
+308
+00:18:47,670 --> 00:18:50,150
+فيها الآن لأنه كاتبتكوا انا هنا discussed before
+
+309
+00:18:50,150 --> 00:18:52,690
+شرحنا فيها عامة كتير في المال ال nutrition او ال
+
+310
+00:18:52,690 --> 00:18:56,270
+optimal او ال over consumption طيب ال 11 هنا ايش
+
+311
+00:18:56,270 --> 00:19:00,740
+مقول هنا؟بيجي هو طبعا أخر شي هو ال 11 بسأله عن ال
+
+312
+00:19:00,740 --> 00:19:04,280
+interpersonal factors وما تنسوش كلمة inter و intra
+
+313
+00:19:04,280 --> 00:19:08,220
+هي سؤال عن ال interpersonal يعني العلاقة بينه و
+
+314
+00:19:08,220 --> 00:19:11,280
+بين الناس الأخرين أو علاقته في المجتمع اللي حواليه
+
+315
+00:19:11,280 --> 00:19:16,200
+أما intra علاقته مع نفسه السؤال هنا بيجي بيسأل كيف
+
+316
+00:19:16,200 --> 00:19:19,120
+علاقة البني آدم اللي هو اللي قدامنا ال client اللي
+
+317
+00:19:19,120 --> 00:19:22,900
+أمامنا مع الأخرين اللي حواليه أول سؤال بسأله عن
+
+318
+00:19:22,900 --> 00:19:26,350
+موضوع ال ethnic ال ethnic معنات العرقلأ من هون جاي
+
+319
+00:19:26,350 --> 00:19:28,830
+و ال culture background طبعا الحمد لله احنا كلنا
+
+320
+00:19:28,830 --> 00:19:32,970
+عرقنا واحد نقدر يعني نلاقي ان واحد جاي مثلا من
+
+321
+00:19:32,970 --> 00:19:36,410
+جنوب أفريقيا و ساكن عندنا و لا أصله مثلا يبان و
+
+322
+00:19:36,410 --> 00:19:40,090
+ساكن نقدر نجعلنا ازاي يعني ال culture background
+
+323
+00:19:40,090 --> 00:19:44,130
+ربما تختلف في اختلاف بسيط ما بين وين ساكن الإنسان
+
+324
+00:19:44,130 --> 00:19:49,530
+يعني في .. في المدينة شرق غرب مثلا في قرية في مخيم
+
+325
+00:19:49,530 --> 00:19:52,670
+ال spoken language بتكلم طبعا أكيد و القيم
+
+326
+00:19:52,670 --> 00:19:56,270
+الموجودة ال valueاعتاد الصحي للثبات وال family
+
+327
+00:19:56,270 --> 00:19:59,110
+relationship طبعا ال family relationship اقصد ان
+
+328
+00:19:59,110 --> 00:20:01,810
+هناك عائلات مرتبطة ارتباط شديد حتى في موضوع
+
+329
+00:20:01,810 --> 00:20:05,630
+العلاقات حتى في موضوع الزواج يعني انا باطلعوش برا
+
+330
+00:20:05,630 --> 00:20:08,460
+بيجي بقولنا يعني بعض الطلاب كانوا يقولوليإنه احنا
+
+331
+00:20:08,460 --> 00:20:11,360
+عيلة ابن طلعش، لا يمكن البنت تطلع خارج العيلة ولا
+
+332
+00:20:11,360 --> 00:20:14,120
+الولد يطلع معها، طبعا هو .. بقولي احنا مثلا ..
+
+333
+00:20:14,120 --> 00:20:17,100
+المثل اللي قايم عندنا زيتنا في تكيكنا، طبعا أنا
+
+334
+00:20:17,100 --> 00:20:20,000
+متحفظ جدا على كلام هذا ومش بس أنا النبي صلى الله
+
+335
+00:20:20,000 --> 00:20:23,260
+عليه وسلم قبلنا وقبل 14 قرن كان يقول يعني غربوا
+
+336
+00:20:23,260 --> 00:20:26,180
+النكاح بمعنى الحديث صلى الله عليه وسلم، فيعني بعض
+
+337
+00:20:26,180 --> 00:20:29,640
+العائلات مرتبطة مع بعضه، في بعض العائلات متدة وفي
+
+338
+00:20:29,640 --> 00:20:33,260
+بعض العائلات بتعرفش حدا، يعني ممكن تكون عم هو ساكن
+
+339
+00:20:33,260 --> 00:20:36,850
+لحاله وماعندهم مشكلة في التعاملبنسألهم عن ال life
+
+340
+00:20:36,850 --> 00:20:39,990
+style بشكل عام، كيف ال rest و كيف ال sleep better،
+
+341
+00:20:39,990 --> 00:20:43,470
+كيف ال self concept perception، كيف ال strength
+
+342
+00:20:43,470 --> 00:20:49,190
+يعني، كيف نقاط القوةنقاط الضعف desired changes ايش
+
+343
+00:20:49,190 --> 00:20:52,950
+في عندهم شغلات يعني اللي علاقة بالادراك هنا، ايش
+
+344
+00:20:52,950 --> 00:20:56,170
+يعني بالادراك؟ هل يدركوا ايش نقاط القوة او نقاط
+
+345
+00:20:56,170 --> 00:21:00,830
+الضعف هو التعامل مع الآخرين؟ يعني ممكن هو يقول انا
+
+346
+00:21:00,830 --> 00:21:03,550
+والله عند نقطة ضعف، ماعرفش اتعامل مع الناس، انا
+
+347
+00:21:03,550 --> 00:21:06,830
+عندي مشكلة، انا schizoid، انا منطوع على نفسي،
+
+348
+00:21:06,830 --> 00:21:11,670
+ماعنديش رغبة اني بده اتغير او عندي رغبة desired او
+
+349
+00:21:11,670 --> 00:21:14,170
+عندي رغبة اني بده اتغير، هو يقولليبنسأل ال
+
+350
+00:21:14,170 --> 00:21:17,130
+sexuality طبعا ال sexuality developmental level
+
+351
+00:21:17,130 --> 00:21:21,750
+يعني بشكل عام هل هو كيف هو مستوى صغير كبير ناضج
+
+352
+00:21:21,750 --> 00:21:28,150
+كبير هل هو يعني تخطى سن معين متزوج مش متزوج وبنسأل
+
+353
+00:21:28,150 --> 00:21:31,470
+طبعا نفس الخضية في موضوع ال stress response and
+
+354
+00:21:31,470 --> 00:21:35,270
+coping يعني برضه في موضوع ايه موضوع الاستجابة
+
+355
+00:21:35,270 --> 00:21:39,470
+لالتوتر وكيف بشكل عام انت ك client وانت بتتعامل مع
+
+356
+00:21:39,470 --> 00:21:42,430
+الناسلو حد سألني طب ليش يا رستازي السؤال رجع كمان
+
+357
+00:21:42,430 --> 00:21:46,090
+مرة؟ لأ هنا بنتكلم عن ال interpersonal كيف علاقتك
+
+358
+00:21:46,090 --> 00:21:48,590
+بال stress مع الناس و كيف تستجيب لها؟ يعني هو ممكن
+
+359
+00:21:48,590 --> 00:21:51,530
+يقولك أنا باخد على جانبي و باسكت لما أتعامل مع
+
+360
+00:21:51,530 --> 00:21:54,470
+الناس و ممكن يقولك لأ أنا بحب أتقاتل مع الناس و
+
+361
+00:21:54,470 --> 00:21:57,230
+ممكن واحد يقولك أنا بعمل عن الشر بغنم حسب ما
+
+362
+00:21:57,230 --> 00:22:00,390
+بيقوليه باجي بسأله فيه هل عنده support system جهاز
+
+363
+00:22:00,390 --> 00:22:04,390
+داعم حتى بيدعم الأمر هذا يعني يبقوا شخصيته؟ هل في
+
+364
+00:22:04,390 --> 00:22:08,030
+عنده مشكلة perception of current؟anticipated
+
+365
+00:22:08,030 --> 00:22:13,030
+stressors يعني هل في عنده مشكلة فى إدراكه للمخاطر
+
+366
+00:22:13,030 --> 00:22:17,850
+أو للموترات اللى محتملة ولا هو يعني مش عبارة عن
+
+367
+00:22:17,850 --> 00:22:20,630
+الدنيا فى بعض الناس بقولك أنا عندي هاجس وماحبش
+
+368
+00:22:20,630 --> 00:22:23,270
+أتعامل مع الناس لإن بلاقي المشاكل منهم فى بعض
+
+369
+00:22:23,270 --> 00:22:26,370
+الناس بقولك لأ أنا بحب أروح مع الناس و أحس أنه انا
+
+370
+00:22:26,370 --> 00:22:29,910
+ممكن انا أعيش كويس و أحس أنه يعني بكون أنا حياتى
+
+371
+00:22:29,910 --> 00:22:32,950
+معهم طبعا انا هذه المحاضرة بيخليها قصيرة بيتكفل
+
+372
+00:22:32,950 --> 00:22:36,700
+هناعشان نخلص ال chapter ان شاء الله و نبدأ في
+
+373
+00:22:36,700 --> 00:22:41,140
+المحاضرة ان شاء الله القادمة في ال chapter الثالث
+
+374
+00:22:41,140 --> 00:22:44,020
+اللي بعد بإذن الله والسلام عليكم ورحمة الله
+
+375
+00:22:44,020 --> 00:22:44,780
+وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ea2db23a5ee4e6956beb53f09c69ca4e468bcb3a
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU.srt
@@ -0,0 +1,1237 @@
+1
+00:00:02,020 --> 00:00:04,360
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,360 --> 00:00:07,900
+الرحيم والصلاة والسلام على أشرف المرسلين سيدنا
+
+3
+00:00:07,900 --> 00:00:11,560
+محمد وعلى آله وصحبه وسلم أما بعد أبنائي وبناتي
+
+4
+00:00:11,560 --> 00:00:14,620
+طلبة المستوى الثاني بكلية التمريض بالجامعة
+
+5
+00:00:14,620 --> 00:00:18,060
+الإسلامية أحييكم بتحية الإسلام السلام عليكم
+
+6
+00:00:18,060 --> 00:00:23,860
+ورحمة الله وبركاته. نحن بصدد شرح مساق التقييم الصحي
+
+7
+00:00:23,860 --> 00:00:29,120
+التمريضي، اللي هو مطلب تخصصي لكم في المستوى الثاني.
+
+8
+00:00:30,030 --> 00:00:34,090
+وصدقا، يعني أنا كنت أتمنى أن يكون التعليم وجاهيًا في
+
+9
+00:00:34,090 --> 00:00:38,310
+داخل الجامعة، ولكن الأمر يعني أكبر مني ومنكم، وبناءً
+
+10
+00:00:38,310 --> 00:00:41,210
+على قرارات وزارة التعليم وكذلك الجامعة الإسلامية،
+
+11
+00:00:41,210 --> 00:00:44,510
+بأن التعليم يكون في المرحلة الحالية تعليمًا
+
+12
+00:00:44,510 --> 00:00:49,770
+إلكترونيًا. سأسعى جاهدًا بإذن الله أن تكون المعلومات
+
+13
+00:00:49,770 --> 00:00:56,520
+مبسطة، وسأشرح بالشرح الذي يعني يمكن لأي طالب
+
+14
+00:00:56,520 --> 00:01:01,220
+أي طالب أو أي طالبة أن يتفهموه، وخاصة أنه يعني
+
+15
+00:01:01,220 --> 00:01:06,440
+هذا المساق صدقًا، وليس يعني صراحة أني يعني أجامل،
+
+16
+00:01:06,440 --> 00:01:11,300
+هو مساق بسيط وسهل وسلس المنال، يعني يمكن لو حكيته
+
+17
+00:01:11,300 --> 00:01:14,700
+لعلم النفس أقول لكم فيه سهولة، لكن بده شوية دراسة و
+
+18
+00:01:14,700 --> 00:01:19,360
+بده شوية يعني حفظ، بس التقييم هذا لا بده صحيح حفظ،
+
+19
+00:01:19,360 --> 00:01:22,890
+لكن بده فهم أكثر. التقييم الصحي حاجة في حياتنا
+
+20
+00:01:22,890 --> 00:01:28,430
+يعني دائمًا احنا بنستخدمها، ودائمًا احنا بنجدها في
+
+21
+00:01:28,430 --> 00:01:32,450
+تعاملنا مع المرضى من كافة شرائح المجتمع. عمومًا، أنا
+
+22
+00:01:32,450 --> 00:01:39,810
+الآن يعني بصدد شرح وصف المساق ومقدمة في المساق في
+
+23
+00:01:39,810 --> 00:01:42,550
+البداية، أحب أجاوب على بعض الأسئلة اللي هي أسئلة
+
+24
+00:01:42,550 --> 00:01:47,150
+شائعة، عشان ما أحد يسأل فيها بعدين. حيسأل البعض، طيب
+
+25
+00:01:47,150 --> 00:01:51,060
+نجيب كتاب ولا slides؟ أنا ريحتكم وحطيت الـ
+
+26
+00:01:51,060 --> 00:01:53,860
+slides كلها، من الآن موجودة كلها، علشان الـ Moodle
+
+27
+00:01:53,860 --> 00:01:56,640
+إحنا ستكون المنصة الأساسية اللي هي الـ Moodle
+
+28
+00:01:56,640 --> 00:02:01,360
+المحاضرات المصورة، برضه هيحط الـ link الرابط على الـ
+
+29
+00:02:01,360 --> 00:02:05,140
+Moodle، والجامعة، هي التعليم الإلكتروني سيرفع
+
+30
+00:02:05,140 --> 00:02:09,240
+المحاضرات على الـ Drive عندهم، وتصير أنت مجرد بتضغط
+
+31
+00:02:09,240 --> 00:02:14,610
+على الرابط، هتحضر المحاضرة. كمان غير هيك، أنا هعمل
+
+32
+00:02:14,610 --> 00:02:17,870
+قناة خاصة، قناة يوتيوب كمان، أنا هرفعها لكم، هلق عشان
+
+33
+00:02:17,870 --> 00:02:21,910
+بعض الناس ربما يكون عنده الـ net شوية يعني يكون مش
+
+34
+00:02:21,910 --> 00:02:25,630
+دائمًا متوفر، أو الـ net شوية مش قوي. حطيتها كمان
+
+35
+00:02:25,630 --> 00:02:28,510
+هحطها كمان على اليوتيوب، عشان على جوال بدك تحضر،
+
+36
+00:02:28,510 --> 00:02:33,030
+تحضر على Laptop، على iPad، أي جهاز، أي كان تستطيع تحضر
+
+37
+00:02:33,030 --> 00:02:36,050
+في أي وقت. يبقى السؤال الأول، طبيعة المحاضرات موجودة
+
+38
+00:02:36,050 --> 00:02:39,670
+لو سألنا، طب إيش أجيب؟ أنا أفضل إنك تجيب، هو مش أفضل
+
+39
+00:02:39,670 --> 00:02:44,650
+وصف الكتاب، المنهج. لو أحد سألني، لأن الكتاب دائمًا
+
+40
+00:02:44,650 --> 00:02:48,310
+العموم يغني عن الخصوص. أقصد هنا، لما يكون معك
+
+41
+00:02:48,310 --> 00:02:51,990
+الكتاب، بيكون بيكفي عن الـ slides وعن كلّه. ما فيش
+
+42
+00:02:51,990 --> 00:02:54,790
+معك كتاب، يعني مش كتير بينفع إنك تاخد slides
+
+43
+00:02:54,790 --> 00:02:59,630
+لوحدها، هذا ما يكفي، خاصة أنه إحنا مش موجودين أمامكم
+
+44
+00:02:59,630 --> 00:03:04,090
+عشان نقدر يعني نعمل interaction و communication أو
+
+45
+00:03:04,090 --> 00:03:07,170
+نتواصل، ونقدر يعني نجيب على كل الأسئلة، فبالتالي
+
+46
+00:03:07,170 --> 00:03:11,050
+الكتاب هو المركزي. طيب، لو أحد سألني، طب يا أستاذ أنا
+
+47
+00:03:11,050 --> 00:03:14,520
+بدي أجيب الاثنين، أو لا؟ يعني إذا أحد بيقدر يجيب
+
+48
+00:03:14,520 --> 00:03:19,020
+أنا ما بدي أخسركم، إذا الأمر تستطيعون تجيبوا معظمكم
+
+49
+00:03:19,020 --> 00:03:22,920
+كويس إنكم تجيبوا الكتاب، وتجيبوا الـ PowerPoint
+
+50
+00:03:22,920 --> 00:03:26,600
+اللي هو الـ slides، على أن الـ slides مختصر وملخص من
+
+51
+00:03:26,600 --> 00:03:29,660
+الكتاب، فبالتالي الأمر مُترك لكم. هذا السؤال الأول.
+
+52
+00:03:29,660 --> 00:03:35,240
+السؤال الثاني، لو أحد سألني، طيب يا أستاذ هل ستكون
+
+53
+00:03:35,240 --> 00:03:39,380
+المحاضرات في يوم محدد، أو ستكون يعني أنتم ستكونون معنا
+
+54
+00:03:39,380 --> 00:03:42,400
+في وقت محدد، إحنا نكون معكم؟ لأ، أنا بريحكم.
+
+55
+00:03:42,400 --> 00:03:46,700
+المحاضرات سأرفعها، وأنتم وأنتن في أي وقت ممكن تحضروا
+
+56
+00:03:46,700 --> 00:03:50,660
+المحاضرة. يعني أقصد، اليوم نزلت المحاضرة، ما يجي واحد
+
+57
+00:03:50,660 --> 00:03:53,480
+زعلان، يقول والله يا أستاذ أنا ما لحقتهاش، أنا كده لأ.
+
+58
+00:03:53,480 --> 00:03:59,880
+مش هغلبكم، مش هنعمل يعني لقائات zoom، أو ستكون
+
+59
+00:03:59,880 --> 00:04:05,260
+يعني شغلات علاقة بالمنصات الإلكترونية. هيكون يعني
+
+60
+00:04:05,260 --> 00:04:08,300
+في المعظم... يعني الـ... المجموع، هتكون
+
+61
+00:04:08,300 --> 00:04:12,360
+محاضرات مسجلة. فبالتالي المحاضرة هتكون موجودة،
+
+62
+00:04:12,360 --> 00:04:15,900
+ما قدرت أحضرها اليوم، بكرا، بعده، ما قدرت، وأجد ما
+
+63
+00:04:15,900 --> 00:04:20,920
+بدي أحضره. بس أنا نصيحتي، لو أحد سأل، كم نحضر؟ هل
+
+64
+00:04:20,920 --> 00:04:24,500
+نحضر مرة واحدة؟ أول مرة، وياريت لما نيجي نحضر
+
+65
+00:04:24,500 --> 00:04:28,140
+المحاضرة، ما نمر عليها زي ما بنمر على مقاطع، أو بنمر
+
+66
+00:04:28,140 --> 00:04:31,680
+على أي فيلم، أو أي مسلسل، وكأنه شيء عابر، أو معلومة
+
+67
+00:04:31,680 --> 00:04:37,630
+وماشية، لأ، لأن هذا الشرح سيكون منهجيًا، فبالتالي أنا
+
+68
+00:04:37,630 --> 00:04:43,110
+قاصد الأمر يكون مرتبًا ويكون متسلسلًا. فأنا بتمنى أنه
+
+69
+00:04:43,110 --> 00:04:48,110
+أول مرة تبقوا تتابعوه. وكمان بعض الكلمات الصعبة شوية،
+
+70
+00:04:48,110 --> 00:04:52,690
+أنا هحاول أترجمها. لكن أنتم، الحمد لله، الآن خلصتوا سنة
+
+71
+00:04:52,690 --> 00:04:55,630
+أولى، وأنا متأكد إن، الحمد لله، مستوى كان أغير يعني.
+
+72
+00:04:55,630 --> 00:04:59,010
+لو نرجع للعهد الأول، في مستوى أول، لأ، كنت أنا أحكي
+
+73
+00:04:59,010 --> 00:05:02,310
+يعني كلمة كلمة، زي ما يقولوا، يعني تاتا تاتا. لكن
+
+74
+00:05:02,310 --> 00:05:05,370
+اليوم، لأ، الحمد لله، عندكم قاموس لغوي، وعندكم قاموس
+
+75
+00:05:05,370 --> 00:05:09,490
+يعني، رصيد ثقافي وتعليمي صار واسعًا، فبالتالي إن شاء
+
+76
+00:05:09,490 --> 00:05:12,450
+الله، مش معناه ذلك أن كأني أنا، أنا بدي أعطيكم يعني
+
+77
+00:05:12,450 --> 00:05:15,530
+مستوى عالي يخوف أبدًا، وبإمكانكم تسألوا
+
+78
+00:05:15,530 --> 00:05:19,470
+الطلبة السابقين اللي سبقوكم، المادة سهلة جدًا جدًا.
+
+79
+00:05:19,470 --> 00:05:25,040
+هي بتقدر تقولوا يعني زي مقدمات للجراحة، مقدمات يعني
+
+80
+00:05:25,040 --> 00:05:30,420
+لما الإنسان ياخد التشريح، اتنين مقدمات، يعني لأي
+
+81
+00:05:30,420 --> 00:05:34,920
+مادة علمية، بتتكلم على تشريح ووظائف أعضاء ليه؟ لأن
+
+82
+00:05:34,920 --> 00:05:40,320
+أنا ببدأ أشرح كيف نقيم الإنسان من رأسه إلى قدمه بكل
+
+83
+00:05:40,320 --> 00:05:43,580
+الجوانب. طبعًا أنا هذه الأسئلة العامة، حابب أجاوب
+
+84
+00:05:43,580 --> 00:05:46,680
+عنها، علشان إحنا ما يصيرش إشكال فيها. أنا سيكون التواصل
+
+85
+00:05:46,680 --> 00:05:49,680
+بإذن الله كمان، إن شاء الله، عبر نادي التمريض اللي
+
+86
+00:05:49,680 --> 00:05:53,300
+هيكون حلقة التواصل بيننا وبينكم. أول مرة،
+
+87
+00:05:53,300 --> 00:05:57,600
+في المحاضرات، سواء كانت على الـ Drive، أو سواء كانت
+
+88
+00:05:57,600 --> 00:06:00,580
+على اليوتيوب. أول مرة، إن شاء الله، هبعت الروابط
+
+89
+00:06:00,580 --> 00:06:04,860
+علشان تكون جاهزة لكم في أي وقت، تقدروا إن شاء الله
+
+90
+00:06:04,860 --> 00:06:10,160
+تتابعوها. ففي البداية، الآن بدنا نتكلم عن course، الـ
+
+91
+00:06:10,160 --> 00:06:12,600
+Course، الـ Course، اللي هو الـ Course، والمساق طبعًا
+
+92
+00:06:12,600 --> 00:06:18,160
+اللي هو أمامكم زي ما أنتم عارفين، المساق يعني هو
+
+93
+00:06:18,160 --> 00:06:22,480
+... ما أنتم عارفين، هان لما أقول 2012. بس من باب
+
+94
+00:06:22,480 --> 00:06:25,540
+التذكير، 2012، يعني إحنا المستوى الثاني، 2012
+
+95
+00:06:25,540 --> 00:06:28,760
+الثاني. عدد الساعات، عشان لو أي مسح، لو ألف وثلاث مئة،
+
+96
+00:06:28,760 --> 00:06:31,620
+بيصير زي سنة... إذا بتذكر السنة الأولى كانت ألف
+
+97
+00:06:31,620 --> 00:06:34,940
+ثلاث مئة وخمس وعشرين، فكانت ألف يعني سنة أولى وثلاث
+
+98
+00:06:34,940 --> 00:06:38,740
+مئة، يعني ثلاث ساعات. إحنا ساعتين، كم سيكون في كل
+
+99
+00:06:38,740 --> 00:06:42,680
+أسبوع؟ إحنا بنحاول نُجتهد تكون المحاضرات بسيطة و
+
+100
+00:06:42,680 --> 00:06:45,680
+مركزة. كيف بسيطة؟ يعني إن شاء الله مش هتكون
+
+101
+00:06:45,680 --> 00:06:51,730
+المحاضرة مش هتَنْقُط نصف ساعة، يعني هتكون ما بين أربع
+
+102
+00:06:51,730 --> 00:06:54,090
+وعشرين... خمس وعشرين... ست وعشرين... سبع وعشرين دقيقة.
+
+103
+00:06:54,090 --> 00:06:58,550
+أقل، أكثر، مش هتكون يعني أكثر من ثلاثين دقيقة بأي
+
+104
+00:06:58,550 --> 00:07:02,650
+حال، حوالي إن شاء الله، إلا إذا اضطررنا لشيء معين، و
+
+105
+00:07:02,650 --> 00:07:06,570
+هتكون غالبًا محاضرتين في الأسبوع، عشان الأمر يكون
+
+106
+00:07:06,570 --> 00:07:10,310
+سهل عليكم، وسهل المادة. وحتى إذا لجأنا للأمر
+
+107
+00:07:10,310 --> 00:07:13,370
+يعني، بدأنا إن شاء الله نسيطر على المادة، ممكن أسيطر
+
+108
+00:07:13,370 --> 00:07:17,930
+وأحط لكم بس يعني... يعني محاضرة واحدة أسبوعيًا، ليه؟
+
+109
+00:07:17,930 --> 00:07:21,640
+عشان أنا بدي فهم، وبدي حفظ، وبدي يكون يعني حب للمادة
+
+110
+00:07:21,640 --> 00:07:24,700
+واطمئنان، وأنا ما بدي أسبق الأحداث. أنتم ستشوفون
+
+111
+00:07:24,700 --> 00:07:27,220
+المادة، وأنتم تعرفوني... تعرفون طريقة تعليمي.
+
+112
+00:07:27,220 --> 00:07:30,380
+هتَنْبَسِطُوا مع المادة أكثر من علم النفس، لأن أنا بعرف
+
+113
+00:07:30,380 --> 00:07:34,080
+إيش هذه المادة، وهذه المادة أكثر ما بتفيد، بتفيدكم
+
+114
+00:07:34,080 --> 00:07:38,060
+وبتفيدكم في حياتكم قبل ما تفيد الناس، عشان أنا أعرف
+
+115
+00:07:38,060 --> 00:07:41,420
+حاليًا مش بقاله زمان، يقول واحد راسي بيوجعني، ليه؟ طب كنا
+
+116
+00:07:41,420 --> 00:07:43,780
+نقول في بداية طب، ليش رأسه بيوجعني؟ كنا نستعجل، خذ حبة
+
+117
+00:07:43,780 --> 00:07:48,760
+أكرامول، لأ، سنتعلم في هذه المادة إيش اللي بيوجعه. سنتعلم
+
+118
+00:07:48,760 --> 00:07:52,620
+إن واحد عنده صار مشاكل في أظافره، مشاكل صار عنده في
+
+119
+00:07:52,620 --> 00:07:56,820
+الشعر، مشاكل في البطن، كل لمحات عن ما فتحه معنا
+
+120
+00:07:56,820 --> 00:08:00,420
+كويس، هتلاقوا الأمور سلسة إن شاء الله. عبارة هي عن
+
+121
+00:08:00,420 --> 00:08:03,680
+إيش هنا؟ لازم يكون جاب الإنسان، ماخذ Anatomy، على
+
+122
+00:08:03,680 --> 00:08:07,820
+قل واحد، وماخذ إيش في Surgery، اللي هو كمان بيقولي A
+
+123
+00:08:07,820 --> 00:08:11,940
+and B، في بعض الحالات، عشان نقدر نستوعب اللي بده
+
+124
+00:08:11,940 --> 00:08:18,570
+شرح، لكن الأمر مش بسيط، أسرع يعني، مش صعب، معلش. طيب،
+
+125
+00:08:18,570 --> 00:08:21,270
+الـ course description، وصف المساق، زي ما أنتم شايفينه
+
+126
+00:08:21,270 --> 00:08:23,210
+هنا، يعني This course is designed for second level
+
+127
+00:08:23,210 --> 00:08:25,870
+students، يعني لطلاب المستوى الثاني، who have completed
+
+128
+00:08:25,870 --> 00:08:28,150
+basic anatomy and physiology courses successfully.
+
+129
+00:08:28,150 --> 00:08:31,690
+يعني هذا سيكون للي خلص Anatomy and Physiology، حاضر،
+
+130
+00:08:31,690 --> 00:08:34,490
+وهو كلكم ما شاء الله خلصتوه، واللي ما خلصش مش
+
+131
+00:08:34,490 --> 00:08:38,990
+مشكلة، إحنا في عندنا يعني قانون، اللي بيرسب في مساق
+
+132
+00:08:38,990 --> 00:08:44,150
+يُعتبر كأنه اجتازه، كمقدمة لهذا المساق، اللي هو
+
+133
+00:08:44,150 --> 00:08:47,670
+التقييم الصحي. طبعًا بيحتوي على الـ theories، والـ
+
+134
+00:08:47,670 --> 00:08:49,290
+skills، والـ history collected، اللي هو
+
+135
+00:08:49,290 --> 00:08:52,490
+comprehensive health history. Health history يعني
+
+136
+00:08:52,490 --> 00:08:56,750
+التاريخ المرضي، اللي موجود عند المريض، as
+
+137
+00:08:56,750 --> 00:08:59,810
+a holistic approach. Holistic يعني الشامل، الكلمات
+
+138
+00:08:59,810 --> 00:09:02,590
+الصعبة شوية، ممكن أحكي فيها البسيط، ده نمشي فيها.
+
+139
+00:09:02,590 --> 00:09:05,110
+Includes interview. سنتكلم عن interview.
+
+140
+00:09:05,110 --> 00:09:08,530
+Psychosocial assessment, nutritional assessment,
+
+141
+00:09:08,530 --> 00:09:12,110
+assessment of sleep wakefulness patterns, and
+
+142
+00:09:12,110 --> 00:09:15,030
+health history. In addition to perform a complete
+
+143
+00:09:15,030 --> 00:09:18,690
+physical assessment. خلينا نجافي شوية صغيرة هنا.
+
+144
+00:09:18,690 --> 00:09:21,390
+إيش بيقول؟ حاجة اسمها physical assessment، في
+
+145
+00:09:21,390 --> 00:09:24,250
+القديم، كان المساق اسمه physical examination، أو
+
+146
+00:09:24,250 --> 00:09:27,770
+physical assessment، يعني اسمه تقييم الـ biology فقط.
+
+147
+00:09:27,770 --> 00:09:31,930
+اليوم، لأ، التقييم اسمه health assessment، فرق كبير.
+
+148
+00:09:31,930 --> 00:09:35,250
+لما أقول تقييم صحي، غير أن أقول تقييم biological.
+
+149
+00:09:35,250 --> 00:09:41,990
+التقييم الصحي بيشمل أربعة جوانب، أربعة لجسم الإنسان،
+
+150
+00:09:41,990 --> 00:09:45,860
+صحة الإنسان. شو هي اللي إحنا سمعنا عنها، وأعيدها
+
+151
+00:09:45,860 --> 00:09:49,720
+عليكم مرة ثانية، اسمها Bio, Psycho, Social, and
+
+152
+00:09:49,720 --> 00:09:55,920
+Spiritual. Bio يعني بيولوجي، حيوي، جسدي، physiology
+
+153
+00:09:55,920 --> 00:09:59,720
+يعني. طيب، Psycho، psychology، يعني علم نفسي، يعني
+
+154
+00:09:59,720 --> 00:10:02,780
+الشغل اللي علاقة بالنفس، يعني... يعني. الطيب اللي بعدها
+
+155
+00:10:02,780 --> 00:10:06,020
+Social، يعني إيش الـ Social؟ جاي من المجتمع، تخيل
+
+156
+00:10:06,020 --> 00:10:12,100
+مجتمعي. Spiritual، روحاني. طب إيش قصدك؟ أقصد هنا أن
+
+157
+00:10:12,100 --> 00:10:18,560
+التقييم الصحي هو تقييم شامل للإنسان من أربعة جوانب،
+
+158
+00:10:18,560 --> 00:10:22,380
+وهو الجانب الحيوي، والجانب النفسي، والجانب الاجتماعي،
+
+159
+00:10:22,380 --> 00:10:26,320
+والجانب الروحاني. فعشان هيك ما نستغربش لو قلنا
+
+160
+00:10:26,320 --> 00:10:30,960
+التقييم الغذائي، التقييم النفسي، التقييم الاجتماعي،
+
+161
+00:10:30,960 --> 00:10:35,980
+التقييم الشخصي. هذا كلّه مقصود، لأن كلكم عارفين أن
+
+162
+00:10:35,980 --> 00:10:41,340
+اليوم إحنا كل شيء يتأثر بالثاني، والثاني يتأثر به،
+
+163
+00:10:41,340 --> 00:10:45,500
+بنفس الشيء، العلاقة تبادلية. زي كيف حديث النبي صلى
+
+164
+00:10:45,500 --> 00:10:48,620
+الله عليه وسلم، إذا اشتكى... شوف كيف نتكلم عن
+
+165
+00:10:48,620 --> 00:10:54,240
+الجسد، إذا اشتكى... إذا اشتكى عظم من الجسد، تداعى له
+
+166
+00:10:54,240 --> 00:10:57,000
+بأعضاء الجسد، بالسرّ والحمق، أو كما قال النبي صلى
+
+167
+00:10:57,000 --> 00:11:01,040
+الله عليه وسلم. أقصد يعني هنا إحنا نتكلم إن
+
+168
+00:11:01,040 --> 00:11:05,310
+الإنسان يتأثر. أنا ممكن أكون كويس، وصحتي ممتازة، لكن أنا
+
+1
+
+223
+00:14:27,490 --> 00:14:32,410
+نلاقي يعني كيف حرف صغيرة ممكن تكون يعني أول حرف
+
+224
+00:14:32,410 --> 00:14:36,730
+اختصار لكلمة، وبعدين كلمة ثانية كيف يعني؟ يعني لما
+
+225
+00:14:36,730 --> 00:14:42,890
+نقول أن عندها .. هذه معناته North American Nursing
+
+226
+00:14:42,890 --> 00:14:48,500
+Diagnosis Association يعني سيحكمنا، وأكيد سمعناها
+
+227
+00:14:48,500 --> 00:14:51,480
+في الـ nursing process وفي الـ health assessment
+
+228
+00:14:51,480 --> 00:14:57,740
+المنظمة الأمريكية العالمية للتشخيص التمريضي
+
+229
+00:14:57,740 --> 00:15:01,440
+المنظمة الأمريكية العالمية للتشخيص التمريضي عشان
+
+230
+00:15:01,440 --> 00:15:05,040
+إحنا هيفرّج كتير بين الـ nursing diagnosis وبين الـ
+
+231
+00:15:05,040 --> 00:15:07,660
+medical diagnosis هلاقي في المساء إن شاء الله
+
+232
+00:15:07,660 --> 00:15:12,220
+لقدام كتير للأسف ناس بيظلمونا وبيظلموا التمريض
+
+233
+00:15:12,220 --> 00:15:16,820
+بيقول أكيد هو التمريض بيشخص، الطبيب لما بيشخص بس بقول
+
+234
+00:15:16,820 --> 00:15:21,540
+diabetes كلمة واحدة، أو بقول للتاني hypertension
+
+235
+00:15:21,540 --> 00:15:27,200
+كلمة واحدة، أو للتالت بقوله headache لكن إحنا الـ
+
+236
+00:15:27,200 --> 00:15:31,260
+nursing diagnosis إحنا بنتكلم على التشخيصات
+
+237
+00:15:31,260 --> 00:15:37,200
+المصاحبة والتابعة والمرافقة للتشخيص، إيه الطبيب؟ عشان
+
+238
+00:15:37,200 --> 00:15:40,960
+هيك هيكون فرق كبير عموما لجوا،  الدّهب شوية هنعمل إيش؟
+
+239
+00:15:41,440 --> 00:15:44,280
+يعني شرح وتوضيح للـ functional health patterns
+
+240
+00:15:44,280 --> 00:15:47,680
+اللي إحنا مرّت علينا برضه في الفن من ثانية الـ
+
+241
+00:15:47,680 --> 00:15:51,140
+course هيقدم لنا different assessment skills في
+
+242
+00:15:51,140 --> 00:15:55,300
+إيش؟ يعني هنقدر نتعلم مهارات كيف نقدر نقيم المريض
+
+243
+00:15:55,300 --> 00:15:58,880
+الأولى، المهارة الأولى اسمها inspection، التقييم
+
+244
+00:15:58,880 --> 00:16:02,580
+بالملاحظة، palpation، التقييم باللمس، بمدّ اليد
+
+245
+00:16:02,580 --> 00:16:07,720
+التقييم هنا percussion بالنقر، زي ما نقر على الشيء أو
+
+246
+00:16:07,720 --> 00:16:10,600
+على الـ board زي ما نقر، بالنقر، زي كده مثلاً هيك
+
+247
+00:16:10,600 --> 00:16:14,820
+زي ما بنقر على الجهاز، آخر حاجة auscultation يعني
+
+248
+00:16:14,820 --> 00:16:17,980
+بالسمع طبعاً، اللي هو بالسمع يعني بالـ stethoscope
+
+249
+00:16:17,980 --> 00:16:23,500
+طبعاً هنا أنا بأتكلم، هدول بيسمّوهم الـ four assessment
+
+250
+00:16:23,500 --> 00:16:27,760
+skills، لكن في كتب ثانية بتكتب five assessment
+
+251
+00:16:27,760 --> 00:16:32,320
+skills، على اعتبار فيه skill خامس، الـ skills الخامس
+
+252
+00:16:32,320 --> 00:16:35,660
+مش مكتوب هنا بالكتاب، على اعتبار إن إحنا اعتمدنا هذا
+
+253
+00:16:35,660 --> 00:16:39,540
+الكتاب، لكن في، إحنا عندنا اعتماد هيكون يعني إحنا
+
+254
+00:16:39,540 --> 00:16:44,660
+عشان نستفيد من أكتر من جهة، هنجيبه، الخامس اسمه olfaction
+
+255
+00:16:44,660 --> 00:16:49,100
+factory، olfaction factory اسمها يعني التقييم بالشم
+
+256
+00:16:49,100 --> 00:16:52,880
+التقييم بإيه؟ بالشم؟ هنقول إيش يعني بالشم؟ لأ إحنا
+
+257
+00:16:52,880 --> 00:16:57,940
+في، فيه مرات بنضطر، مرات بنضطر إنه وإحنا قاعدين
+
+258
+00:16:57,940 --> 00:17:02,540
+بنقيم المريض اللي أمامنا، فيه ريحة معينة صدرت من
+
+259
+00:17:02,540 --> 00:17:05,480
+المريض، مش أنا قاعد بقول والله بدّي أروح أشم المريض
+
+260
+00:17:05,480 --> 00:17:11,980
+أبداً، يمكن تطلع ريحة تشبه مثلاً زي ريحة التفاح الفاسد
+
+261
+00:17:11,980 --> 00:17:16,040
+أو ريحة الفاكهة المحروقة أو فاسدة، بقول دغري هذا
+
+262
+00:17:16,040 --> 00:17:19,260
+معناته عنده حرق في السكر، اللي هي اختصارها يمكن
+
+263
+00:17:19,260 --> 00:17:23,340
+بعضكم بيعرفها، اسمها DKA، اللي هو Diabetic
+
+264
+00:17:23,340 --> 00:17:28,520
+Ketoacidosis، DKA، طب إيش يعني؟ معناته أنا بنشم شخصياً
+
+265
+00:17:28,520 --> 00:17:33,710
+المريض، فبنقدرش نهمل، الرائحة تكون مهمة كمان في
+
+266
+00:17:33,710 --> 00:17:37,430
+التقييم، نكمل course objectives، خلاص هيكون الإنسان
+
+267
+00:17:37,430 --> 00:17:41,390
+بعد ما يخلص الفصل إن شاء الله بيقدر ياخد history
+
+268
+00:17:41,390 --> 00:17:45,930
+بيقدر يعمل interview، بيقدر يستخدم الـ empathy، كلكم
+
+269
+00:17:45,930 --> 00:17:48,470
+عارفين شو الـ empathy وشو الـ sympathy؟ هو يكون
+
+270
+00:17:48,470 --> 00:17:52,790
+إنسان، أنا بقول empathy، الـ sympathy إن أنا أقعد مع
+
+271
+00:17:52,790 --> 00:17:56,530
+العيان وأبكي معاه، وألطم معاه، هو بيقول يا ويلي و
+
+272
+00:17:56,530 --> 00:18:00,120
+أنا بقول يا ويلي، يا خرابي يا خرابي، وهذا طبعاً مش
+
+273
+00:18:00,120 --> 00:18:03,640
+معقول، إحنا مش قاعدين نلطم هنا، طب هاي إيش هنا؟
+
+274
+00:18:03,640 --> 00:18:09,660
+Empathy، أتعاطف شعورياً وأتعاطف إحساسياً لكن
+
+275
+00:18:09,660 --> 00:18:14,440
+مابتعاطفش وجودياً وكيانياً، أروح كل نفسي وأقول،
+
+276
+00:18:14,440 --> 00:18:18,720
+لأ، ما بنفعش، إحنا مهنتنا حساسة، ما حد بيعيط وحد حزين و
+
+277
+00:18:18,720 --> 00:18:23,000
+حد بضحك زي ما كل واحد بيعمل زي ما هو موجود عنده،
+
+278
+00:18:23,000 --> 00:18:26,480
+معناته آخر اليوم بتصفي، ما بدّيش أقول ولا حاجة،
+
+279
+00:18:26,480 --> 00:18:31,220
+خليني هيك،  الـ psychosocial assessment أكيد ما إحنا
+
+280
+00:18:31,220 --> 00:18:35,580
+قلنا إيه؟ بيو psychosocial، هنعمل تقييم نفسي جماعي
+
+281
+00:18:35,580 --> 00:18:39,060
+حاضر، nutritional status، بدنا نقدر نعمل تقييم
+
+282
+00:18:39,060 --> 00:18:43,240
+للحالة الغذائية، الحالة الغذائية مش هتوسّع فيها كتير
+
+283
+00:18:43,240 --> 00:18:46,400
+كونكم أخذتو الـ clinical nutrition في السنة
+
+284
+00:18:46,400 --> 00:18:50,220
+الأولى، لكن هحكي الشغلات المهمة بس، في حالة تقييم
+
+285
+00:18:50,220 --> 00:18:54,340
+المريض، هيكون إن الـ four assessment techniques اللي
+
+286
+00:18:54,340 --> 00:18:58,050
+إحنا حكينا عنها، والآن مش وجدتها قاعدة كام مرة، لكن
+
+287
+00:18:58,050 --> 00:19:02,310
+لقدام، الـ skills هشرحها من عند الـ inspection و
+
+288
+00:19:02,310 --> 00:19:04,690
+الـ palpation، والـ auscultation، والـ percussion، و
+
+289
+00:19:04,690 --> 00:19:08,610
+اللي معهم الخامسة، الـ olfaction، هنتعود على إيش كمان؟
+
+290
+00:19:08,610 --> 00:19:11,530
+ونتعلّم على الـ normal positions، اللي هو الـ
+
+291
+00:19:11,530 --> 00:19:15,590
+examination، شو أوضاع اللي بقدر أعمل فيها
+
+292
+00:19:15,590 --> 00:19:18,870
+examination؟ هل دائماً لازم المريض يكون نايم على بطنه
+
+293
+00:19:18,870 --> 00:19:22,970
+أو على ظهره؟ لأ، ممكن أفحص شغلته وهو واقف، أفحص وهو
+
+294
+00:19:22,970 --> 00:19:26,320
+نايم على جنبه، لأ، قدامه، هو هيتكلم، طبعاً أول شيء
+
+295
+00:19:26,320 --> 00:19:32,260
+هنبدأ general، بعدين vital signs، وكلكم ما شاء الله
+
+296
+00:19:32,260 --> 00:19:34,540
+أخذتوها في السنة الأولى، نسينا الباب، تذكير لها
+
+297
+00:19:34,540 --> 00:19:38,560
+أكتر، هنتكلم عن الـ body systems، كل الأجهزة، شو الـ
+
+298
+00:19:38,560 --> 00:19:41,260
+normal والـ abnormal finding، هنعرف إيش الطبيعي وإيش
+
+299
+00:19:41,260 --> 00:19:44,940
+إيش مش طبيعي، ننساش الـ Nanda طبعاً، هندخل على الـ
+
+300
+00:19:44,940 --> 00:19:48,020
+nursing diagnosis اللي علاقتها بالناندة، بعدين الـ
+
+301
+00:19:48,020 --> 00:19:51,100
+course outlines، إيش اللي بدّي أشرحهم على رأس
+
+302
+00:19:51,100 --> 00:19:54,360
+الأولوية، الـ interview، و هذه الـ interview، المقابلة
+
+303
+00:19:54,780 --> 00:19:57,660
+كمان مش بس للمريض، بدّي أعلّمكم وأعلّمكم كيف تعملوا
+
+304
+00:19:57,660 --> 00:20:01,420
+مقابلة مع المريض، وبالمناسبة بالمرة هشرح لكم كيف
+
+305
+00:20:01,420 --> 00:20:05,940
+المقابلة بتنعمل، عشان أنتم لما ربنا يكرمكم وتخلصوا في
+
+306
+00:20:05,940 --> 00:20:09,880
+المستقبل وتحتاجوا لمقابلة في أي وظيفة تكونوا جاهزين وعلى
+
+307
+00:20:09,880 --> 00:20:13,580
+أعلى استعداد إن شاء الله، psycho social
+
+308
+00:20:13,580 --> 00:20:16,640
+assessment، حاضر، الـ nutritional assessment
+
+309
+00:20:16,640 --> 00:20:20,900
+assessment of sleep and wakefulness patterns، هنعمل
+
+310
+00:20:20,900 --> 00:20:24,140
+كمان تقييم للناحية اللي هو كيف نوم الإنسان وكيف
+
+311
+00:20:24,140 --> 00:20:28,300
+راحته، health history، حاضر، الناندة بإذن الله
+
+312
+00:20:28,300 --> 00:20:31,940
+كمان، assessment techniques، طبعاً أنا ما بترجمش لأن
+
+313
+00:20:31,940 --> 00:20:34,920
+دي كلمات مرّت علينا، ولأ أنا أصلاً حكيت فيها، الـ
+
+314
+00:20:34,920 --> 00:20:37,360
+general assessment including vital signs، هذا
+
+315
+00:20:37,360 --> 00:20:42,780
+الchapter، الchapter اللي بعده، skin, hair, nails، لاحظين
+
+316
+00:20:42,780 --> 00:20:46,820
+أنتوا؟ بنبدأ من فوق، أعلى إيش في الجسم؟ إيش هنا؟ في
+
+317
+00:20:46,820 --> 00:20:51,360
+إيش هنا؟ الشعر، الشعر جاي من وين؟ نابت من الجلد، في
+
+318
+00:20:51,360 --> 00:20:55,080
+إيش كمان؟ ملزق في الجلد، الـ nails، بعدين بندخل شوية
+
+319
+00:20:55,080 --> 00:21:00,140
+ears، الأذن اللي هي طالعة طبعاً، والـ nose، الأنف
+
+320
+00:21:00,140 --> 00:21:02,600
+بعدين الـ throat، اللي هو البلعوم، وهكذا شوية شوية
+
+321
+00:21:02,600 --> 00:21:07,320
+الحلق، الـ eyes، هنبدأ كمان، جوا، تقييم العيون، بعدين الـ
+
+322
+00:21:07,320 --> 00:21:11,000
+head، الرأس، بعدين الـ face، والـ neck، والـ breast، والـ
+
+323
+00:21:11,000 --> 00:21:13,720
+lymphatic system، الجهاز اللمفاوي، respiratory
+
+324
+00:21:13,720 --> 00:21:18,060
+system، cardiovascular system، الأمر، أنتوا لاحظين كده
+
+325
+00:21:18,060 --> 00:21:22,590
+ترتيبي جاي، abdomen، بعدين أنا أعيش هنا أي نصّ
+
+326
+00:21:22,590 --> 00:21:27,570
+rectosigmoid region، منطقة اللي تحت، يعني آخر شيء
+
+327
+00:21:27,570 --> 00:21:32,230
+بالقناة الهضمية، طيب، بعدين musculoskeletal system
+
+328
+00:21:32,230 --> 00:21:36,710
+نشوف كيف يعني الجهاز العضلي، وعضلات الإنسان كيف
+
+329
+00:21:36,710 --> 00:21:42,170
+توزعت وكيف تقيمها، نشوف الـ mental status، هل هو
+
+330
+00:21:42,170 --> 00:21:47,490
+يعني mental status، يعني كيف وضعه، مصحصح معايا، مش
+
+331
+00:21:47,490 --> 00:21:51,120
+مصحصح، فاهمه؟  واليوم إيش لقدام إن شاء الله
+
+332
+00:21:51,120 --> 00:21:54,320
+assessment of neurological system، تقييم الجهاز
+
+333
+00:21:54,320 --> 00:21:58,220
+العصبي، وآخر شيء assessment of male and female
+
+334
+00:21:58,220 --> 00:22:01,540
+genital، اللي هو الجهاز التناسلي، طيب، teaching
+
+335
+00:22:01,540 --> 00:22:05,960
+methods، هيكون إن للأسف .. مش للأسف، أنا كائن ندمان
+
+336
+00:22:05,960 --> 00:22:08,860
+لكن كنت أتمنى نكون في الجامعة، هيكون mood lectures
+
+337
+00:22:08,860 --> 00:22:12,240
+audio visual aids، إن شاء الله، يعني مساعدات أي
+
+338
+00:22:12,240 --> 00:22:16,180
+معناها محاضرات مصورة ومسجلة، demonstration، نسأل الله
+
+339
+00:22:16,180 --> 00:22:19,970
+إن شاء الله نقدر يصير لنا استطاعة نذهب لمستشفيات
+
+340
+00:22:19,970 --> 00:22:23,230
+ونقدر نطبق على المرضى، بالنسبة للـ evaluation، مش
+
+341
+00:22:23,230 --> 00:22:26,810
+هنغلبكم بالمدّة زي ما الجامعة حكت، بنمشي إن شاء الله
+
+342
+00:22:26,810 --> 00:22:31,230
+المدّة، term، أربعين، والـ final exam، ستين، وكمان مرة
+
+343
+00:22:31,230 --> 00:22:34,850
+بدّي أطمئنكم، المدّة سهلة وبسيطة جداً، وأنتوا لحالكم
+
+344
+00:22:34,850 --> 00:22:38,510
+هتحكموا، أنا بعرف إيش اللي بأتكلم عنه، وفاهم إيش
+
+345
+00:22:38,510 --> 00:22:44,050
+اللي أنا، يعني، إيش أنتم اللي في وجه نظركم بالأمر
+
+346
+00:22:44,050 --> 00:22:49,660
+مش صعب كتير، الـ references، لا داعي إنه ندور على هذه
+
+347
+00:22:49,660 --> 00:22:52,940
+الكتب، يكفينا الكتاب اللي بين أيدينا، ويعطيكم يعني
+
+348
+00:22:52,940 --> 00:22:56,820
+اللي عارف، بكافة، ما ابدأش يعني، كل ما إحنا استوعبنا
+
+349
+00:22:56,820 --> 00:23:01,660
+والله إنه هذا يعني الكتاب اللي بين إيدينا، بس قادر أفهمه
+
+350
+00:23:01,660 --> 00:23:06,540
+ودي نصيحتي، حتى لو خلصتوا من الفصل، بالذات كتاب الـ
+
+351
+00:23:06,540 --> 00:23:10,940
+assessment، ما تعطوهوش لحد، مش من باب إنه يعني كأن
+
+352
+00:23:10,940 --> 00:23:14,140
+أنا ما بدّيش، أنا، ابقوا قدامنا على خير، أبداً، لأنه
+
+353
+00:23:14,140 --> 00:23:17,430
+هيفيدكم، وهيفيدكم لمدى الحياة، كتير فيه شغلات مهمة
+
+354
+00:23:17,430 --> 00:23:21,370
+لأنه مذكور فيه شغلات الإنسان بينساها، لأ، ليش؟ لأنه
+
+355
+00:23:21,370 --> 00:23:25,610
+بكرا بنتكلم على مقياس فيه طول ووزن وكيف تقييم
+
+356
+00:23:25,610 --> 00:23:28,730
+العين، وتقييم النظر، وتقييم .. فا خسارة يعني، ربما
+
+357
+00:23:28,730 --> 00:23:32,850
+في أشياء بتنّسى، لكن هذا إن شاء الله دائماً بيكون
+
+358
+00:23:32,850 --> 00:23:36,690
+ذاكر .. يعني ذاكركم أنا اللي عندي، أنا بكفي شرح الـ
+
+359
+00:23:36,690 --> 00:23:39,970
+syllabus، إن شاء الله، المحاضرة القادمة هتكون أول
+
+360
+00:23:39,970 --> 00:23:46,020
+محاضرة، هتكلم ب .. بإذن الله، اللي هو ما قدمت الـ
+
+361
+00:23:46,020 --> 00:23:49,480
+health assessment، اللي هو nursing process، وإن شاء
+
+362
+00:23:49,480 --> 00:23:53,080
+الله، بإذن الله، هتكون الأمور يعني على أفضل ما يكون
+
+363
+00:23:53,080 --> 00:23:55,540
+والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..dd5ebb69bdf9c536cd23ec526f70acd95cce8f9a
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/K1tDnzGoucU_raw.srt
@@ -0,0 +1,1452 @@
+1
+00:00:02,020 --> 00:00:04,360
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,360 --> 00:00:07,900
+الرحيم والصلاة والسلام على أشرف المرسلين سيدنا
+
+3
+00:00:07,900 --> 00:00:11,560
+محمد وعلى أليه وصحبه وسلم أما بعد أبنائي وابنتي
+
+4
+00:00:11,560 --> 00:00:14,620
+طلبت المستوى الثاني بكلية التمريد بالجامعة
+
+5
+00:00:14,620 --> 00:00:18,060
+الإسلامية أحييكم بتحية الإسلام في السلام عليكم
+
+6
+00:00:18,060 --> 00:00:23,860
+ورحمة الله وبركاته نحن بصدد شرح مساق التقييم الصحي
+
+7
+00:00:23,860 --> 00:00:29,120
+التمريدي اللي هو مضطلب تخصصي لكم في المستوى الثاني
+
+8
+00:00:30,030 --> 00:00:34,090
+وصدقا يعني أنا كنت أتمنى أن يكون التعليم مجاهي في
+
+9
+00:00:34,090 --> 00:00:38,310
+داخل الجامعة ولكن الأمر يعني أكبر مني ومنكم وبناء
+
+10
+00:00:38,310 --> 00:00:41,210
+على قرارات وزارة التعليم وكذلك الجامعة الإسلامية
+
+11
+00:00:41,210 --> 00:00:44,510
+بأن التعليم يكون في المرحلة الحالية تعليما
+
+12
+00:00:44,510 --> 00:00:49,770
+إلكترونيا سأسعى جاهدا بإذن الله أن تكون المعلومات
+
+13
+00:00:49,770 --> 00:00:56,520
+مبسطةو سأشرح بالشرح ال .. الذي يعني يمكن لأي طالب
+
+14
+00:00:56,520 --> 00:01:01,220
+.. اي طالب او اي طالبة ان يتفهموا و خاصة انه يعني
+
+15
+00:01:01,220 --> 00:01:06,440
+هذا المساق صدقا و ليس يعني صراحة ان انا يعني بجامل
+
+16
+00:01:06,440 --> 00:01:11,300
+هو بساط بسيط وسهل وسلس المنال يعني يمكن لو حكيته
+
+17
+00:01:11,300 --> 00:01:14,700
+لعلم النفس اقولكوا فيها سهولة لكن بده شوية دراسة و
+
+18
+00:01:14,700 --> 00:01:19,360
+بده شوية يعني حفظ بس التقييم هذا لأ بده صحيح حفظ
+
+19
+00:01:19,360 --> 00:01:22,890
+لكن بده فهم كمان اكترالتقييم الصحي حاجة في حياتنا
+
+20
+00:01:22,890 --> 00:01:28,430
+يعني دايما احنا بنستخدمها و دايما احنا بنجدها في
+
+21
+00:01:28,430 --> 00:01:32,450
+تعاملنا مع المرضى من كافة شرائح المجتمع عموما انا
+
+22
+00:01:32,450 --> 00:01:39,810
+الآن يعني بصدد شرح وصف المساء ومقدمة في المساء في
+
+23
+00:01:39,810 --> 00:01:42,550
+البداية بحب اجاوب على بعض الأسئلة اللي هي أسئلة
+
+24
+00:01:42,550 --> 00:01:47,150
+شائعة عشان ماحد يسأل فيها بعدين حيسأل للبعض طيب
+
+25
+00:01:47,150 --> 00:01:51,060
+انجيب كتاب ولا slide addأنا ريحتكوا وحطيت ال
+
+26
+00:01:51,060 --> 00:01:53,860
+slides كلهم من الآن موجودات كلهم علشان ال model
+
+27
+00:01:53,860 --> 00:01:56,640
+احنا ستكون المنصة الأساسية اللي هي ال model
+
+28
+00:01:56,640 --> 00:02:01,360
+المحاضرات المصورة برضه هيحط ال link الرابط على ال
+
+29
+00:02:01,360 --> 00:02:05,140
+model والجامعة هي التعليم الإلكتروني سيرفع
+
+30
+00:02:05,140 --> 00:02:09,240
+المحاضرات على ال drive عندهم وتصير انت مجرد بتضغط
+
+31
+00:02:09,240 --> 00:02:14,610
+على الرابط هتحضر المحاضرةكمان غير هيكة انا هقيلى
+
+32
+00:02:14,610 --> 00:02:17,870
+قناة خاصة قناة يوتيوب كمان انا هرفعلكى هلأ عشان
+
+33
+00:02:17,870 --> 00:02:21,910
+بعض الناس ربما تكون عنده ال net شوية يعني يكون مش
+
+34
+00:02:21,910 --> 00:02:25,630
+دائما متوفر او ال net شوية مش قوي حطيتها كمان
+
+35
+00:02:25,630 --> 00:02:28,510
+هحطها كمان على اليوتيوب عشان على جوال بدك تحضر
+
+36
+00:02:28,510 --> 00:02:33,030
+احضر على laptop على اي باد اي ان كان تستطيع تحضر
+
+37
+00:02:33,030 --> 00:02:36,050
+في اي وقت يبقى السؤال الاول طبيعة المحاضرات موجودة
+
+38
+00:02:36,050 --> 00:02:39,670
+لو سألنا طب ايش اجيب انا افضل انك اجيه هو مش افضل
+
+39
+00:02:39,670 --> 00:02:44,650
+وصفه الكتاب المنهجيلو حد مسألني لأن الكتاب دائما
+
+40
+00:02:44,650 --> 00:02:48,310
+العموم يغني عن الخصوص اقصد هنا لما يكون معاك
+
+41
+00:02:48,310 --> 00:02:51,990
+الكتاب بيكون بيكفي عن ال slides و عن كله مافيش
+
+42
+00:02:51,990 --> 00:02:54,790
+معاك كتاب يعني مش كتير بينفع انك تاخد slides
+
+43
+00:02:54,790 --> 00:02:59,630
+لوحدهم هذا ما بيكفي خاصة انه احنا مش موجود امامكوا
+
+44
+00:02:59,630 --> 00:03:04,090
+عشان نقدر يعني نعمل interaction و communication او
+
+45
+00:03:04,090 --> 00:03:07,170
+نبور و نقدر يعني نجيب على كل الأسئلة فبالتالي
+
+46
+00:03:07,170 --> 00:03:11,050
+الكتاب هو المركزي طيب لو حد سألني طب يا أستاذ أنا
+
+47
+00:03:11,050 --> 00:03:14,520
+بدي أجيب التنيننور و لا نور يعني إذا حد بيقدر يجيب
+
+48
+00:03:14,520 --> 00:03:19,020
+أنا مابدي أخسركوا إذا الأمر تستطيعوا تجيبوا معظمكم
+
+49
+00:03:19,020 --> 00:03:22,920
+كويس إنكوا تجيبوا الكتاب و تجيبوا ال powerpoint
+
+50
+00:03:22,920 --> 00:03:26,600
+اللي هو ال slides على إن ال slides مختصر و ملخص من
+
+51
+00:03:26,600 --> 00:03:29,660
+الكتاب فبالتالي الأمر متركلكوا هذا السؤال الأول
+
+52
+00:03:29,660 --> 00:03:35,240
+السؤال التاني لو حد سألني طيب يا أستاذهل هتكون
+
+53
+00:03:35,240 --> 00:03:39,380
+المحاضرات في يوم محدد او هتكون يعني انت هتكون معنا
+
+54
+00:03:39,380 --> 00:03:42,400
+في وقت محدد احنا نكون معاك لأ انا بتريحكم
+
+55
+00:03:42,400 --> 00:03:46,700
+المحاضرات سارفعها وانت وانتي في اي وقت ممكن تحضر
+
+56
+00:03:46,700 --> 00:03:50,660
+المحاضرة يعني اقصد اليوم نزلت المحاضرة مايجي واحد
+
+57
+00:03:50,660 --> 00:03:53,480
+زعلان يقول والله يا استاذ انا مالحقتهاش انا كده لأ
+
+58
+00:03:53,480 --> 00:03:59,880
+مش هغلبكم مش هنعمل يعني لقائات هتكون zoom او هتكون
+
+59
+00:03:59,880 --> 00:04:05,260
+يعني شغلات العلاقة بالمنصات الإلكترونيةهيكون يعني
+
+60
+00:04:05,260 --> 00:04:08,300
+في المعظم .. يعني ال .. الميكروفين المجمل هتكون
+
+61
+00:04:08,300 --> 00:04:12,360
+محاضرات مسجلة فبالتالي المحاضرة هتكون موجودة،
+
+62
+00:04:12,360 --> 00:04:15,900
+ماقدرتش أحضرها اليوم، بكرا، بعده، ماقدرتش واجد ما
+
+63
+00:04:15,900 --> 00:04:20,920
+بدي أحضره بس أنا نصيحتي لو حد سأل كام نحضر، هل
+
+64
+00:04:20,920 --> 00:04:24,500
+نحضر مرة أول بول؟ أول بول و ياريت لما نيجي نحضر
+
+65
+00:04:24,500 --> 00:04:28,140
+المحاضرة مانمر عليها زي ما بنمر علي مقاطع أو بنمر
+
+66
+00:04:28,140 --> 00:04:31,680
+علي أي فيلم أو أي سلسل و كأنه شي عابر أو معظة
+
+67
+00:04:31,680 --> 00:04:37,630
+وماشية، لألأن هذا الشرح هيكون منهجي فبالتالي أنا
+
+68
+00:04:37,630 --> 00:04:43,110
+قاصد الأمر يكون مرتب ويكون متسلسل فانا بتمنى انه
+
+69
+00:04:43,110 --> 00:04:48,110
+أول بول تبقى تابعه وكمان بعض الكلمات الصعبة شوية
+
+70
+00:04:48,110 --> 00:04:52,690
+انا هحاول اترجمها لكن انت الحمد لله الآن خلصت سنة
+
+71
+00:04:52,690 --> 00:04:55,630
+أولى وانا متأكد ان الحمد لله مستوى كنت اغير يعني
+
+72
+00:04:55,630 --> 00:04:59,010
+لو نرجع للعهد الأول في مستوى أول لأ كنت انا احكي
+
+73
+00:04:59,010 --> 00:05:02,310
+يعني كلمة كلمة زي ما يقولوا يعني تاتا تاتالكن
+
+74
+00:05:02,310 --> 00:05:05,370
+اليوم لأ الحمد لله عندكوا قموس لغوي و عندكوا قموس
+
+75
+00:05:05,370 --> 00:05:09,490
+يعني ارتف ثقافي و تعليمي صار واسع فبالتالي ان شاء
+
+76
+00:05:09,490 --> 00:05:12,450
+الله مش معناه ذلك ان كأني انا انا بدي اعطيكوا يعني
+
+77
+00:05:12,450 --> 00:05:15,530
+مستوى العالي اللي يخوف ابدا و بإمكانكوا تسألوا
+
+78
+00:05:15,530 --> 00:05:19,470
+الطلبة السابقين اللي سابقوكوا المادة سهلة جدا جدا
+
+79
+00:05:19,470 --> 00:05:25,040
+هي بتقدر تقولوا يعني زي مقدمات للجراحةمقدمات يعني
+
+80
+00:05:25,040 --> 00:05:30,420
+لما الإنسان ياخد التشريح اتنين مقدمات يعني لأي
+
+81
+00:05:30,420 --> 00:05:34,920
+مادة علمية بتتكلم على تشريح ووظائف أعضاء ليه؟ لأن
+
+82
+00:05:34,920 --> 00:05:40,320
+أنا بدأ أشرح كيف نقيم الإنسان من رأسه إلى قدمه بكل
+
+83
+00:05:40,320 --> 00:05:43,580
+الجوانب طبعا انا هذه الأسئلة العامة حابيت أجاوب
+
+84
+00:05:43,580 --> 00:05:46,680
+عنها علشان احنا مايصيرش أشكاليها انا هيكون التواصل
+
+85
+00:05:46,680 --> 00:05:49,680
+بإذن الله كمان ان شاء الله عبر النادي التمريد اللي
+
+86
+00:05:49,680 --> 00:05:53,300
+هيكون حلقة التواصل بيننا و بينكم أول بغملأول مرة
+
+87
+00:05:53,300 --> 00:05:57,600
+في المحاضرات سواء كانت على ال drive أو سواء كانت
+
+88
+00:05:57,600 --> 00:06:00,580
+على اليوتيوب أول بول ان شاء الله هبعت الروابط
+
+89
+00:06:00,580 --> 00:06:04,860
+علشان تكون جاهزة لكم في أي وقت تقدروا ان شاء الله
+
+90
+00:06:04,860 --> 00:06:10,160
+تتابعوها ففي البداية الآن بدنا نتكلم عن course ال
+
+91
+00:06:10,160 --> 00:06:12,600
+bus course ال bus اللي هو ال bus و المساق طبعا
+
+92
+00:06:12,600 --> 00:06:18,160
+اللي هو أمامكوا زي ما انتوا عارفين المساق يعني هو
+
+93
+00:06:18,160 --> 00:06:22,480
+.. ما انتوا عارفين هان لما أقول 2012بس من باب
+
+94
+00:06:22,480 --> 00:06:25,540
+التذكير اتنين يعني احنا المستوى التانى، اتنين
+
+95
+00:06:25,540 --> 00:06:28,760
+التانى عدد الساعات عشان لو اي مسح لو الف و تلت مية
+
+96
+00:06:28,760 --> 00:06:31,620
+بيصير زي سنه .. اذا بتذكر السنة الأولى كانت الف
+
+97
+00:06:31,620 --> 00:06:34,940
+تلت مية و خمس عشرين فكانت الف يعني سنة أولى و تلت
+
+98
+00:06:34,940 --> 00:06:38,740
+مية يعني تلت ساعات، احنا ساعتين كام هيكون في كل
+
+99
+00:06:38,740 --> 00:06:42,680
+أسبوع؟ احنا بنحاول نجتهد تكون المحاضرات بسيطة و
+
+100
+00:06:42,680 --> 00:06:45,680
+مركزة كيف بسيطة؟ يعني ان شاء الله مش هتكون
+
+101
+00:06:45,680 --> 00:06:51,730
+المحاضرة مش هتنقطت نصف ساعةيعني هتكون ما بين اربع
+
+102
+00:06:51,730 --> 00:06:54,090
+عشرين .. خمسة عشرين .. ستة عشرين .. سبع عشر دقيقة
+
+103
+00:06:54,090 --> 00:06:58,550
+أقل أكثر مش هتكون يعني أكتر من تلاتين دقيقة بأي
+
+104
+00:06:58,550 --> 00:07:02,650
+حمل حوالي ان شاء الله إلا إذا اضطررنا لشي معين و
+
+105
+00:07:02,650 --> 00:07:06,570
+هتكون غالبا محاضرتين في الأسبوع عشان الأمر يكون
+
+106
+00:07:06,570 --> 00:07:10,310
+سهل بين ديكم و سهل الملادة و حتى إذا لجينا الأمر
+
+107
+00:07:10,310 --> 00:07:13,370
+يعني بدينا ان شاء الله نسيطر على المادة ممكن أسيطر
+
+108
+00:07:13,370 --> 00:07:17,930
+و أحطلكم بس يعني .. يعني محاضرة واحدة أسبوعيا ليه؟
+
+109
+00:07:17,930 --> 00:07:21,640
+عشان أنا بدي فاهموبدى حفظ وبدى يكون يعني حب للمادة
+
+110
+00:07:21,640 --> 00:07:24,700
+وارتياح وانا ما بدى أسبق الأحداث انتوا هتشوفوا
+
+111
+00:07:24,700 --> 00:07:27,220
+المادة وانتوا عارفيني .. عارفين طريقة التعليم
+
+112
+00:07:27,220 --> 00:07:30,380
+هتنبسطوا مع المادة أكتر من علم النفس لإن أنا بعرف
+
+113
+00:07:30,380 --> 00:07:34,080
+إيش هذه المادة وهذه المادة أكتر ما بتفيد بتفيدك
+
+114
+00:07:34,080 --> 00:07:38,060
+وبتفيدك في حياتك قبل ما تفيد الناس عشان أنا أعرف
+
+115
+00:07:38,060 --> 00:07:41,420
+حالي مش بقال زمان يقول واحد راسي بوجعه ليه طب كنا
+
+116
+00:07:41,420 --> 00:07:43,780
+نقول في بداية طب ليش راسه بوجعه كنا نستعجل خد حبة
+
+117
+00:07:43,780 --> 00:07:48,760
+أكامول لأ هنتعلم في هذه المادة أيش اللي بيخهنتعلم
+
+118
+00:07:48,760 --> 00:07:52,620
+إن واحد عنده صار مشاكل في أضافه، مشاكل صار عنده في
+
+119
+00:07:52,620 --> 00:07:56,820
+الشعر، مشاكل في البطن، كل لمحات عن ما فتحه معانا
+
+120
+00:07:56,820 --> 00:08:00,420
+كويس، هتلاقي الأمور سلسة ان شاء الله، عبارة هي عن
+
+121
+00:08:00,420 --> 00:08:03,680
+إيه هنا، لازم يكون جابنا الإنسان ماخد Anatomy على
+
+122
+00:08:03,680 --> 00:08:07,820
+قل واحد وماخد إيش في Surgery اللي هو كمان بيقولي A
+
+123
+00:08:07,820 --> 00:08:11,940
+and B في بعض الحلات عشان نقدر نستوعجه اللي بده
+
+124
+00:08:11,940 --> 00:08:18,570
+شحن، لكن أمر مش بسيط، أسرع يعني، مش صعب، معلشطيب
+
+125
+00:08:18,570 --> 00:08:21,270
+ال course description وصف المساقى زي ما انت شايفه
+
+126
+00:08:21,270 --> 00:08:23,210
+هنا يعني this course designed to second level
+
+127
+00:08:23,210 --> 00:08:25,870
+students يعني ولا لمستوى التالي had completed
+
+128
+00:08:25,870 --> 00:08:28,150
+basic anatomy and physiology courses successfully
+
+129
+00:08:28,150 --> 00:08:31,690
+يعني هذا هيكون للي خلص anatomy and physiology حاضر
+
+130
+00:08:31,690 --> 00:08:34,490
+و هو كلكوا ما شاء الله خلصته و اللي ما خلصش مش
+
+131
+00:08:34,490 --> 00:08:38,990
+مشكلة احنا في عندنا يعني قانون اللي بيرسق في مساقى
+
+132
+00:08:38,990 --> 00:08:44,150
+يعتبر كأنه اجتازه كمقدم لهذا المساقى اللي هو
+
+133
+00:08:44,150 --> 00:08:47,670
+التقييم الصحيطبعا بيحتوي على ال theories و ال
+
+134
+00:08:47,670 --> 00:08:49,290
+skills و ال history collected اللي هو
+
+135
+00:08:49,290 --> 00:08:52,490
+comprehensive health history health history يعني
+
+136
+00:08:52,490 --> 00:08:56,750
+التاريخ ايه الصحي المرضى اللى موجود عند المريض as
+
+137
+00:08:56,750 --> 00:08:59,810
+a holistic approach holistic يعني الشمولى الكلمات
+
+138
+00:08:59,810 --> 00:09:02,590
+الصعبة شوية ممكن احكي فيها البسيط ده نمشي فيها
+
+139
+00:09:02,590 --> 00:09:05,110
+includes interview هنتكلم عن interview
+
+140
+00:09:05,110 --> 00:09:08,530
+psychosocial assessment nutritional assessment
+
+141
+00:09:08,530 --> 00:09:12,110
+assessment of sleep wakefulness patterns and
+
+142
+00:09:12,110 --> 00:09:15,030
+health historyin addition to perform complete
+
+143
+00:09:15,030 --> 00:09:18,690
+physical assessment خلّينا نجافى شوية صغيرة هنا
+
+144
+00:09:18,690 --> 00:09:21,390
+إيش بيقولي حاجة اسمها physical assessment في
+
+145
+00:09:21,390 --> 00:09:24,250
+الخديم كان المساق اسمه physical examination أو
+
+146
+00:09:24,250 --> 00:09:27,770
+physical assessment يعني اسمه تقييم ال biology فقط
+
+147
+00:09:27,770 --> 00:09:31,930
+اليوم لأ التقييم اسمه health assessment فرق كبير
+
+148
+00:09:31,930 --> 00:09:35,250
+لما أقول تقييم صحي غير أن أقول تقييم biological
+
+149
+00:09:35,250 --> 00:09:41,990
+التقييم الصحي بيشمل أربعة جوانب أربعة لجسم الإنسان
+
+150
+00:09:41,990 --> 00:09:45,860
+صحية الإنسانشو هي اللي احنا سمعنا عنها و اعيدها
+
+151
+00:09:45,860 --> 00:09:49,720
+عليكم المرة اسمها bio, psycho, social and
+
+152
+00:09:49,720 --> 00:09:55,920
+spiritual bio يعني بيولوجي، حيوي، جسدي، physiology
+
+153
+00:09:55,920 --> 00:09:59,720
+يعني طيب، psycho، psychology يعني علم نفسي يعني
+
+154
+00:09:59,720 --> 00:10:02,780
+الشغل اللي علاق من نفسي يعني يعني الطيب اللي بعدها
+
+155
+00:10:02,780 --> 00:10:06,020
+social يعني ايه ال social جاي من المجتمع تخيل
+
+156
+00:10:06,020 --> 00:10:12,100
+مجتمعي spiritual روحاني طب إيش قصدك؟ أقصد هناأن
+
+157
+00:10:12,100 --> 00:10:18,560
+التقييم الصحي هو تقييم شامل للإنسان من أربع جوانب
+
+158
+00:10:18,560 --> 00:10:22,380
+وهو الجانب الحيوي والجانب النفسي والجانب الاجتماعي
+
+159
+00:10:22,380 --> 00:10:26,320
+والجانب الروحاني فعلشان هيك ما نستغربش لو قلنا
+
+160
+00:10:26,320 --> 00:10:30,960
+التقييم الغذائي التقييم النفسي التقييم الاجتماعي
+
+161
+00:10:30,960 --> 00:10:35,980
+التقييم الشخصي هذا كله مقصود لأن كلكم عارفين أن
+
+162
+00:10:35,980 --> 00:10:41,340
+اليوم احنا كل شيء يتأثر بالتانيوالتانى يتأثر بيه
+
+163
+00:10:41,340 --> 00:10:45,500
+بنفس الشيء العلاقة تبدلية زى كيف حديث النبي صلى
+
+164
+00:10:45,500 --> 00:10:48,620
+الله عليه و سلم إذا اشتكى .. شوف كيف نتكلم عن
+
+165
+00:10:48,620 --> 00:10:54,240
+الجسد إذا اشتكى .. إذا اشتكى عضم من الجسد تداعى لو
+
+166
+00:10:54,240 --> 00:10:57,000
+سأل عن الأعضاء بالسر الحمق أو كما قال النبي صلى
+
+167
+00:10:57,000 --> 00:11:01,040
+الله عليه و سلم أقصد يعني هنا إحنا نتكلم إن
+
+168
+00:11:01,040 --> 00:11:05,310
+الإنسان يتأثر أنا يمكن كويس و صحت ميحنلكن انا
+
+169
+00:11:05,310 --> 00:11:08,890
+اتنكدت من فلان، انا اتنكدت من المادة الفلانية، انا
+
+170
+00:11:08,890 --> 00:11:13,090
+اتذكرت ايش نكد عليها فأثر على صحتى، فبنقدرش نفصل
+
+171
+00:11:13,090 --> 00:11:15,210
+الاتنين عن بعض و احنا خدنا في مقدمة في علم النفس
+
+172
+00:11:15,210 --> 00:11:20,090
+انه قولنا زي ما فيه جوانب فسيولوجية زي ما فيه
+
+173
+00:11:20,090 --> 00:11:23,750
+جوانب نفسية زي ما فيه جوانب اجتماعية، فكل واحد
+
+174
+00:11:23,750 --> 00:11:27,430
+بأثر على التاني طيب ال student اشبه جليان ياريت كل
+
+175
+00:11:27,430 --> 00:11:30,510
+واحد فينا بيكون عارف ال skills، يعني الشوية
+
+176
+00:11:30,510 --> 00:11:33,740
+المهارات اللى بيقدر يعمل فيها assessment حادةال
+
+177
+00:11:33,740 --> 00:11:37,740
+student can practice these skills احنا كنا نتمنى
+
+178
+00:11:37,740 --> 00:11:41,560
+practice يعني انه يقدر يطبق هذه المهارة طبعا كنا
+
+179
+00:11:41,560 --> 00:11:45,380
+نتمنى و انا يعني على يقين بإذن الله ان الله لا
+
+180
+00:11:45,380 --> 00:11:48,820
+يخيب املنا و انا سانعود للجامعة الإسلامية و انتوا
+
+181
+00:11:48,820 --> 00:11:54,320
+يعني صراحتا يعني يمكن اكتر مستوى ربما يعني انا ..
+
+182
+00:11:54,320 --> 00:11:58,820
+انا زعلان عليه مش مجاملة صدقا انتوا كل كوا ابنائي
+
+183
+00:11:58,820 --> 00:12:01,880
+و بناتي لكن انا زعلان لإن انتوا المفروض في هذه
+
+184
+00:12:01,880 --> 00:12:05,980
+الأيام كنتوا في المستشفياتيعني و في حياة العمل و
+
+185
+00:12:05,980 --> 00:12:09,920
+حياة المستشفيات و المراكز الصحية مش مجاملة هي أفضل
+
+186
+00:12:09,920 --> 00:12:12,840
+.. أفضل .. أفضل شيء يعني لدرجة ان انتوا شايفين
+
+187
+00:12:12,840 --> 00:12:16,240
+الآن في كورونا مين اللي واقفين خط الدفاع الأول هو
+
+188
+00:12:16,240 --> 00:12:19,000
+التمرد مش تقولولي انكوا خفتوا او التمستوا لأ لأبدا
+
+189
+00:12:19,000 --> 00:12:23,200
+بالعكس هذا أكبر شرف عظيم اللي بيقدر يقدهم اللي هم
+
+190
+00:12:23,200 --> 00:12:27,680
+شرف المهنة قدسية المهنة الان اللي موجود في البلد
+
+191
+00:12:27,680 --> 00:12:32,900
+مين هم شقين الصحة و الأمل باقي كل المجتمعيعني إما
+
+192
+00:12:32,900 --> 00:12:36,260
+.. يعني جالس في بيته و إما له ظرف معين بيقديه و
+
+193
+00:12:36,260 --> 00:12:39,500
+بيخلص فالتمرد كنت أتمنى أنه في هذه الأيام لو
+
+194
+00:12:39,500 --> 00:12:43,860
+الأمور رائعة كان كل كلان منتشرين في ربوع قطاع
+
+195
+00:12:43,860 --> 00:12:47,460
+الزمن عموما الان مش وقته نسأله سبحانه تعالى أن
+
+196
+00:12:47,460 --> 00:12:51,160
+تعود الأيام يعني إلى سابق عهد ان شاء الله و نرجع
+
+197
+00:12:51,160 --> 00:12:54,180
+يعني في الأيام الحلوة طبعا هو بيقول أنه لازم نطبق
+
+198
+00:12:54,180 --> 00:12:58,240
+هذه ال skills أكيد لكن ما .. إذا ماقدرناش طبعا
+
+199
+00:12:58,240 --> 00:13:02,250
+خليني نشرح ال skillsلكن التدريب تدريب و لو حصل فيه
+
+200
+00:13:02,250 --> 00:13:06,310
+مابعد ان شاء الله مش هنضيعكوا يعني بإذن الله the
+
+201
+00:13:06,310 --> 00:13:09,630
+course focus on to be honest هنا كتبلي on a health
+
+202
+00:13:09,630 --> 00:13:13,530
+history حاضر اللي هو غالبا بيقولي neglected ايش ال
+
+203
+00:13:13,530 --> 00:13:17,390
+health history كتير من المرضى للأسف بيكون عندهم
+
+204
+00:13:17,390 --> 00:13:20,310
+المرض لو احنا سمعنا منهم لعرفنا طبيعة المرض
+
+205
+00:13:20,310 --> 00:13:24,070
+هيقوللي واحد طب ايش السيزون باخدوش منهم معلومات
+
+206
+00:13:24,070 --> 00:13:28,820
+للأسف كتير من الأطباء حتى من التمريدمش انا لا سمح
+
+207
+00:13:28,820 --> 00:13:33,180
+الله كأني انا بتهمهم ب .. لا سمح الله بالتقصير
+
+208
+00:13:33,180 --> 00:13:37,380
+أبدا، لكن كتير منهم بيجي افلار حط يده على اليمين
+
+209
+00:13:37,380 --> 00:13:41,280
+يبقى عنده زايدة يلا اعمله .. معلش احصاد مباصرة و
+
+210
+00:13:41,280 --> 00:13:45,260
+يلا خلينا نعمله عملية، طب يمكن عنده قلن عصبي، طب
+
+211
+00:13:45,260 --> 00:13:49,120
+يمكن عنده يعني شغل تاني، يمكن عنده افتاج مثلا
+
+212
+00:13:49,120 --> 00:13:52,890
+هيرنياهنا بقولي ال history هو مهم جدا كتبلي انا ال
+
+213
+00:13:52,890 --> 00:13:55,750
+most important عارفين ليه؟ لأنه انا اذا عرفت ..
+
+214
+00:13:55,750 --> 00:13:59,170
+اذا عرفت السبب بطل عجب فاحنا بدنا نتعلم كيف ناخد
+
+215
+00:13:59,170 --> 00:14:01,670
+history بعرف انه في سنة أولى خدنا في ال
+
+216
+00:14:01,670 --> 00:14:05,290
+fundamental علمونا في أول chapter في ال .. في ال
+
+217
+00:14:05,290 --> 00:14:07,950
+fundamental و التاني chapter كيف نكتب history و
+
+218
+00:14:07,950 --> 00:14:10,910
+كيف نكتب notes لأ بس احنا هنا بدنا نتعمق شوية
+
+219
+00:14:10,910 --> 00:14:14,250
+صغيرة انه كيف بدنا نطولي المعلومات اللي عند المريض
+
+220
+00:14:14,250 --> 00:14:17,550
+بإذن الله طبعا مين بدي يحكمنا في كل المعلومات
+
+221
+00:14:17,550 --> 00:14:21,350
+ننساش اختصارها ده NAND دههذه كام من حرف؟ طبعا لما
+
+222
+00:14:21,350 --> 00:14:27,490
+نلاقي حروف كبيرة بيكون كل حرف اختصار لكلمة لكن لما
+
+223
+00:14:27,490 --> 00:14:32,410
+نلاقي يعني كيف حرف صغيرة ممكن تكون يعني اول حرف
+
+224
+00:14:32,410 --> 00:14:36,730
+اختصار لكلمة و بعدين كلمة تانية كيف يعني؟ يعني لما
+
+225
+00:14:36,730 --> 00:14:42,890
+نقول ان عندها .. هذه معناته North American Nursing
+
+226
+00:14:42,890 --> 00:14:48,500
+Diagnosis Associationيعني سيحكمنا و أكيد سمعناها
+
+227
+00:14:48,500 --> 00:14:51,480
+في ال nursing process و في ال health assessment
+
+228
+00:14:51,480 --> 00:14:57,740
+المنظمة الأمريكية العالمية للتشخيص التمريضي
+
+229
+00:14:57,740 --> 00:15:01,440
+المنظمة الأمريكية العالمية للتشخيص التمريضي عشان
+
+230
+00:15:01,440 --> 00:15:05,040
+احنا هيفرج كتير بين ال nursing diagnosis و بين ال
+
+231
+00:15:05,040 --> 00:15:07,660
+medical diagnosis هلاجي في المساء ان شاء الله
+
+232
+00:15:07,660 --> 00:15:12,220
+لقدام كتير للأسف ناس بيظلمونا و بيظلموا التمريض
+
+233
+00:15:12,220 --> 00:15:16,820
+بيقول أكيد هو التمريض بشخصالطبيب لما بشخص بس بقول
+
+234
+00:15:16,820 --> 00:15:21,540
+diabetes كلمة واحدة او بقول للتاني hypertension
+
+235
+00:15:21,540 --> 00:15:27,200
+كلمة واحدة او للتالت بقوله headache لكن احنا ال
+
+236
+00:15:27,200 --> 00:15:31,260
+nursing diagnosis احنا بنتكلم على التشخصات
+
+237
+00:15:31,260 --> 00:15:37,200
+المصاحبة والتابعة والمرافقة للتشخيص ايه الطبي عشان
+
+238
+00:15:37,200 --> 00:15:40,960
+هيك هيكون فرق كبير عموما لجوا الدهب شوية هنعمل ايش
+
+239
+00:15:41,440 --> 00:15:44,280
+يعني شرح و توضيح لل functional health patterns
+
+240
+00:15:44,280 --> 00:15:47,680
+اللي احنا مرت علينا برضه في الفن من تانية ال
+
+241
+00:15:47,680 --> 00:15:51,140
+course هيقدم لنا different assessment skills في
+
+242
+00:15:51,140 --> 00:15:55,300
+ايش يعني هنقدر نتعلم مهارات كيف نقدر نقيم المريض
+
+243
+00:15:55,300 --> 00:15:58,880
+الأمامي المهارة الأولى اسمها inspection التقييم
+
+244
+00:15:58,880 --> 00:16:02,580
+بالملاحظة palpation التقييم باللمس بماد اليد
+
+245
+00:16:02,580 --> 00:16:07,720
+التقييم هنا percussionبالنقر زى ما نقر على الشى أو
+
+246
+00:16:07,720 --> 00:16:10,600
+على ال board زى ما نقر على النقر زى كده مثلا هيك
+
+247
+00:16:10,600 --> 00:16:14,820
+زى ما بقى على الجهاز اخر حاجة auscultation يعني
+
+248
+00:16:14,820 --> 00:16:17,980
+بالسمعة طبعا اللى هو بالسمعة يعني بال stethoscope
+
+249
+00:16:17,980 --> 00:16:23,500
+طبعا هنا انا باتكلم هدول بيسموه ال four assessment
+
+250
+00:16:23,500 --> 00:16:27,760
+skills لكن في كتب تانية بتكتب five assessment
+
+251
+00:16:27,760 --> 00:16:32,320
+skills على اعتبار في skills خامس ال skills الخامس
+
+252
+00:16:32,320 --> 00:16:35,660
+مش مكتوب هنا بالصليبسالاعتبار ان احنا اعتمدنا هذا
+
+253
+00:16:35,660 --> 00:16:39,540
+الكتاب لكن في احنا عندنا اعتماد هيكون يعني احنا
+
+254
+00:16:39,540 --> 00:16:44,660
+عشان نستفيد من اكتر من جهة هنجيبه فالخامس اسمه oil
+
+255
+00:16:44,660 --> 00:16:49,100
+factory oil factory اسمها يعني التقييم بالشم
+
+256
+00:16:49,100 --> 00:16:52,880
+التقييم بإيه بالشم؟ هنقول ايش يعني بالشم؟ لأ احنا
+
+257
+00:16:52,880 --> 00:16:57,940
+فينا فيه مرات بنضطر مرات بنضطر انه واحنا قاعدين
+
+258
+00:16:57,940 --> 00:17:02,540
+بنقيم المريض اللي أمامنا فيه ريحة معينة صدرت من
+
+259
+00:17:02,540 --> 00:17:05,480
+المريضمش انا قاعد بقول و الله بدروح اشم المريض
+
+260
+00:17:05,480 --> 00:17:11,980
+ابدا يمكن طلع ريحة تشبه مثلا زي ريحة التفاح الفاسد
+
+261
+00:17:11,980 --> 00:17:16,040
+او ريحة الفاكهة المحروجة او فاسدة بقول دغري هذا
+
+262
+00:17:16,040 --> 00:17:19,260
+معناته عنده حرق في السكر اللي هي اختصارها يمكن
+
+263
+00:17:19,260 --> 00:17:23,340
+بعضكم بيعرفها اسمها DKA اللي هو Diabetic
+
+264
+00:17:23,340 --> 00:17:28,520
+Ketoacidos DKA طب ايش يعني معناته انا بنشم شخصي
+
+265
+00:17:28,520 --> 00:17:33,710
+المريض فبنقدرش نهملان الرائحة تكون مهمة كمان في
+
+266
+00:17:33,710 --> 00:17:37,430
+التقييم نكمل course objectives خلاص هيكون الانسان
+
+267
+00:17:37,430 --> 00:17:41,390
+بعد ما يخلص الفصل ان شاء الله بيقدر ياخد history
+
+268
+00:17:41,390 --> 00:17:45,930
+بيقدر يعمل interview بيقدر يستخدم ال empathy كلكوا
+
+269
+00:17:45,930 --> 00:17:48,470
+عارفين شو ال empathy و شو ال sympathy هو يكون
+
+270
+00:17:48,470 --> 00:17:52,790
+انسان انا بقول empathy ال sympathy ان انا اقعد مع
+
+271
+00:17:52,790 --> 00:17:56,530
+العيان و اعيد معاه و ألطم معاه هو بيقول يا ويلي و
+
+272
+00:17:56,530 --> 00:18:00,120
+انا بقول يا ويلييا خرابي يا خرابي، و هذا طبعا مش
+
+273
+00:18:00,120 --> 00:18:03,640
+معقول، احنا مش قاعدين لطمات هنا، طب هاي إيش هنا؟
+
+274
+00:18:03,640 --> 00:18:09,660
+Empathy، أتعاطف شعوريا و أتعاطف إحساسيا لكن
+
+275
+00:18:09,660 --> 00:18:14,440
+مابتعاطفش وجوديا و كيانيا، أروح كل نفسي و أقل،
+
+276
+00:18:14,440 --> 00:18:18,720
+لابنفعش، احنا مهنتنا حاسس ما حد بيعيط و حد حزين و
+
+277
+00:18:18,720 --> 00:18:23,000
+حد بضحك زي ما كل واحد بدعمل زي ما هو موجود عنده،
+
+278
+00:18:23,000 --> 00:18:26,480
+معناته آخر اليوم بتصفي، مابديش أقول ولا حاجة،
+
+279
+00:18:26,480 --> 00:18:31,220
+خليني هيكالان psychosocial assessment اكيد ما احنا
+
+280
+00:18:31,220 --> 00:18:35,580
+قولنا ايه بيو psychosocial هنعمل تقييم نفسي جماعي
+
+281
+00:18:35,580 --> 00:18:39,060
+حاضر nutritional status بدنا نقدر نعمل تقييم
+
+282
+00:18:39,060 --> 00:18:43,240
+للحالة الغذائية الحالة الغذائية مش هتوسع فيها كتير
+
+283
+00:18:43,240 --> 00:18:46,400
+كونكوا أخدتوا ال clinical nutrition في السنة
+
+284
+00:18:46,400 --> 00:18:50,220
+الأولى لكن هحكي الشغلات المهمة بس في حالة تقييم
+
+285
+00:18:50,220 --> 00:18:54,340
+المريض هيكون ان ال four assessment techniques اللي
+
+286
+00:18:54,340 --> 00:18:58,050
+احنا حكينا عنهاوالان مش وجدتها قاعدة كام مرة لكن
+
+287
+00:18:58,050 --> 00:19:02,310
+لا قدامش ال skills هشرحها من عند ال inspection و
+
+288
+00:19:02,310 --> 00:19:04,690
+ال palpation و ال escalation و ال percussion و
+
+289
+00:19:04,690 --> 00:19:08,610
+اللي معهم الخامسة ال oifection هنتعود على إيش كمان
+
+290
+00:19:08,610 --> 00:19:11,530
+و نتعلم على ال normal positions اللي هو ال
+
+291
+00:19:11,530 --> 00:19:15,590
+examination شو أوضاع اللي بقدر أعمل فيها
+
+292
+00:19:15,590 --> 00:19:18,870
+examination هل دائما لازم المرض يكون نايم على بطنه
+
+293
+00:19:18,870 --> 00:19:22,970
+أو على دهره؟ لأ ممكن أفحص شغلته و هو واقف أفحص و
+
+294
+00:19:22,970 --> 00:19:26,320
+هو نايم على جنبه لا قدامش هو هتكلمطبعا أول شي
+
+295
+00:19:26,320 --> 00:19:32,260
+هنبدأ general بعدين vital signs وكلكم ما شاء الله
+
+296
+00:19:32,260 --> 00:19:34,540
+أخدتواها في السنة الأولى نسينا الباب تذكير لها
+
+297
+00:19:34,540 --> 00:19:38,560
+أكتر هنتكلم عن ال body systems كل الأجزة شو ال
+
+298
+00:19:38,560 --> 00:19:41,260
+normal و ال abnormal finding هنعرف إيش الطبيعي و
+
+299
+00:19:41,260 --> 00:19:44,940
+إيش مش طبيعي ننساش ال ناندة طبعا هندق على ال
+
+300
+00:19:44,940 --> 00:19:48,020
+nursing diagnosis اللي علاقة بالناندة بعدين ال
+
+301
+00:19:48,020 --> 00:19:51,100
+course outlines إيش اللي بده أشرحهم على رأس
+
+302
+00:19:51,100 --> 00:19:54,360
+الأولوية ال interview و هذه ال interview المقابلة
+
+303
+00:19:54,780 --> 00:19:57,660
+كمان مش بس للمريض بدي أعلمك و أعلمك كيف تعمل
+
+304
+00:19:57,660 --> 00:20:01,420
+مقابلة مع المريض و بالمناسبة بالمرة هشرحلك كيف
+
+305
+00:20:01,420 --> 00:20:05,940
+المقابلة بتنعمل عشان انت لما ربنا يكرمك و تخلص في
+
+306
+00:20:05,940 --> 00:20:09,880
+المستقبل و تحتاج لمقابلة في أي وظيفة يتكون جاهز و
+
+307
+00:20:09,880 --> 00:20:13,580
+على أغبة الاستعداد ان شاء الله psycho social
+
+308
+00:20:13,580 --> 00:20:16,640
+assessment حاضر ال nutritional assessment
+
+309
+00:20:16,640 --> 00:20:20,900
+assessment of sleep and wakefulness patterns هنعمل
+
+310
+00:20:20,900 --> 00:20:24,140
+كمان تقييم للناحية اللي هوكيف نوم الإنسان و كيف
+
+311
+00:20:24,140 --> 00:20:28,300
+راحته, health history حاضر, الناندة بإذن الله
+
+312
+00:20:28,300 --> 00:20:31,940
+كمان, assessment techniques طبعا أنا مابترجمش لإن
+
+313
+00:20:31,940 --> 00:20:34,920
+دي كلمات مرد علينا ولأ أنا اصلا حاكيت فيها ال
+
+314
+00:20:34,920 --> 00:20:37,360
+general assessment including vital signs هذا
+
+315
+00:20:37,360 --> 00:20:42,780
+الشبتر الشبتر اللي بعده skin, hair, nails لاحظين
+
+316
+00:20:42,780 --> 00:20:46,820
+انتوا؟ بنبدأ من فوق أعلى إيش في الجسم إيش هنا؟ في
+
+317
+00:20:46,820 --> 00:20:51,360
+إيش هنا؟ الشعر الشعر جاي من وين؟ نابت من الجلدفي
+
+318
+00:20:51,360 --> 00:20:55,080
+ايش كمان ملزق في الجلد ال nails بعدين بندخل شوية
+
+319
+00:20:55,080 --> 00:21:00,140
+ears الأذن اللي هي طالعة طبعا و ال nose الأنف
+
+320
+00:21:00,140 --> 00:21:02,600
+بعدين ال throat اللي هو البلعوب و هكذا شوية شوية
+
+321
+00:21:02,600 --> 00:21:07,320
+الحلق ال eyes هنبدأ كمان جوا تقييم العيون بعدين ال
+
+322
+00:21:07,320 --> 00:21:11,000
+head الرأس بعدين ال face و ال neck و ال breast و
+
+323
+00:21:11,000 --> 00:21:13,720
+ال lymphatic system الجهاز اللي الفاوي respiratory
+
+324
+00:21:13,720 --> 00:21:18,060
+system cardiovascular system الأمر انت لاحظين كده
+
+325
+00:21:18,060 --> 00:21:22,590
+ترتيبي جاي abdomenبعدين انا اعيش هنا اي نص
+
+326
+00:21:22,590 --> 00:21:27,570
+rectosigmoid region منطقة اللي تحت يعني اخر شي
+
+327
+00:21:27,570 --> 00:21:32,230
+بالقناة الهضمية طيب بعدين musculoskeletal system
+
+328
+00:21:32,230 --> 00:21:36,710
+نشوف كيف يعني الجهاز العضلي و عضلات الإنسان كيف
+
+329
+00:21:36,710 --> 00:21:42,170
+توزعت و كيف تقيمها نشوف ال mental status هل هو
+
+330
+00:21:42,170 --> 00:21:47,490
+يعني mental status يعني كيف وضعه مصحصح معايا مش
+
+331
+00:21:47,490 --> 00:21:51,120
+مصحصح فاهمه و مويلواليوم ايش لقدام ان شاء الله
+
+332
+00:21:51,120 --> 00:21:54,320
+assessment of neurological system تقييم الجهاز
+
+333
+00:21:54,320 --> 00:21:58,220
+العصبي واخر شي assessment of male and female
+
+334
+00:21:58,220 --> 00:22:01,540
+genital اللي هو الجهاز التناسبي طيب teaching
+
+335
+00:22:01,540 --> 00:22:05,960
+methods هيكون ان للأسف .. مش للأسف انا كائن ندمان
+
+336
+00:22:05,960 --> 00:22:08,860
+لكن كنت اتمنى نكون في الجامعة هيكون mood lectures
+
+337
+00:22:08,860 --> 00:22:12,240
+audio visual aids ان شاء الله يعني مساعدات أي
+
+338
+00:22:12,240 --> 00:22:16,180
+معناة محاضرات مصورة ومسجلة demonstration نسأل الله
+
+339
+00:22:16,180 --> 00:22:19,970
+ان شاء الله نقدرو يصير لنا استطاعة نذهب لمستشفيات
+
+340
+00:22:19,970 --> 00:22:23,230
+و نقدر نطبق على المرضى بالنسبة لل evaluation مش
+
+341
+00:22:23,230 --> 00:22:26,810
+هنغلبكوا المدت زي ما الجامعة حكت بنمشي ان شاء الله
+
+342
+00:22:26,810 --> 00:22:31,230
+المدت term اربعين و ال final exam ستين و كمان مرة
+
+343
+00:22:31,230 --> 00:22:34,850
+بدي أطمنكوا المدة سلسة و بسيطة جدا و انتوا لحالكوا
+
+344
+00:22:34,850 --> 00:22:38,510
+هتحكموا انا بعرف ايش اللي بتكلم عنه و فاهم ايش
+
+345
+00:22:38,510 --> 00:22:44,050
+اللي انا يعني ايش انتوا اللي في وجه نظركوا فالأمر
+
+346
+00:22:44,050 --> 00:22:49,660
+مش صعب كتيرال references لا داعي انه ندور على هذه
+
+347
+00:22:49,660 --> 00:22:52,940
+الكتب يكفينا الكتاب اللي بين ادينا و يعطيكوا يعني
+
+348
+00:22:52,940 --> 00:22:56,820
+اللي عارف بكافة ماابدناش يعني كل ما احنا استوعبنا
+
+349
+00:22:56,820 --> 00:23:01,660
+و الله انه هذا يعني الكتاب اللي بيني بس قادر افهمه
+
+350
+00:23:01,660 --> 00:23:06,540
+و دي نصيحتي حتى لو خلصتوا من الفصل بالذات كتاب ال
+
+351
+00:23:06,540 --> 00:23:10,940
+assessment ماتعطوهش لحدها مش من باب انه يعني كأن
+
+352
+00:23:10,940 --> 00:23:14,140
+انا مابديش انا ابقى قدامنا على خير أبدا لأنه
+
+353
+00:23:14,140 --> 00:23:17,430
+هيفيدك و هيفيدك لمدى الحياةكتير فيه شغلات حكومية
+
+354
+00:23:17,430 --> 00:23:21,370
+لإنه مذكور فيها شغلات الإنسان بينسى لأ ليش لإنه
+
+355
+00:23:21,370 --> 00:23:25,610
+بكرا بنتكلم على مقيّس فيه طول و وزن و كيف تقييم
+
+356
+00:23:25,610 --> 00:23:28,730
+العين و تقييم النظر و تقييم .. فاخسارة يعني ربما
+
+357
+00:23:28,730 --> 00:23:32,850
+في أشياء بتنسى لكن هذا ان شاء الله دائما بيكون
+
+358
+00:23:32,850 --> 00:23:36,690
+ذاكر .. يعني ذاكركم انا اللي عندها انا بكفي شرح ال
+
+359
+00:23:36,690 --> 00:23:39,970
+syllabus ان شاء الله المحاضرة القادمة هتكون أول
+
+360
+00:23:39,970 --> 00:23:46,020
+محاضرة هتكلم ب .. بإذن اللهاللي هو ما قدمت ال
+
+361
+00:23:46,020 --> 00:23:49,480
+health assessment اللي هو nursing process وان شاء
+
+362
+00:23:49,480 --> 00:23:53,080
+الله بإذن الله هتكون الأمور يعني على أفضل ما يكون
+
+363
+00:23:53,080 --> 00:23:55,540
+والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Qg_uCrvanIs_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Qg_uCrvanIs_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..4cd03bf99b1f327b989380f8b4507424be8c3e98
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Qg_uCrvanIs_raw.json
@@ -0,0 +1 @@
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\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..53f22bcc6dfa05e3325db585bf6540eafd7eb2d7
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_postprocess.srt
@@ -0,0 +1,2064 @@
+1
+00:00:00,450 --> 00:00:02,730
+أعوذ بالله من الشرفان الرجيم بسم الله الرحمن
+
+2
+00:00:02,730 --> 00:00:05,650
+الرحيم والصلاة والسلام على أشرف المرسلين سيدنا
+
+3
+00:00:05,650 --> 00:00:09,330
+محمد وعلى أليه وصحبه وسلم أما بعد أبنائي وابنتي
+
+4
+00:00:09,330 --> 00:00:13,110
+طلبة المستوى الثاني المسجلين لمساق التقييم الصح
+
+5
+00:00:13,110 --> 00:00:15,890
+التمردى اليوم هنبدأ ان شاء الله في ال chapter
+
+6
+00:00:15,890 --> 00:00:18,930
+التالت اللي هو ال health history وان شاء الله
+
+7
+00:00:18,930 --> 00:00:22,750
+تستفيدوا معانا الان ال health history أنا حكيت
+
+8
+00:00:22,750 --> 00:00:26,080
+لمحة بسيطة في بداية ال chapterالأولان اللى كان فى
+
+9
+00:00:26,080 --> 00:00:29,300
+introduction و اللى كان فى .. و حكيته انه مش كله
+
+10
+00:00:29,300 --> 00:00:31,080
+موجود فى الكتابة و أنا قلتلكوا موجود كله على ال
+
+11
+00:00:31,080 --> 00:00:34,420
+powerpoint اللى انا حطيتها على ال model و أنا
+
+12
+00:00:34,420 --> 00:00:37,580
+قلتلكوا كله هنسير نتناول اتباعه عن سواء ال NAND او
+
+13
+00:00:37,580 --> 00:00:40,820
+غيره او يعني ال nursing care plan as a general
+
+14
+00:00:40,820 --> 00:00:43,560
+اللى أخدناه في السنة الأولى لكن انا هظن أشرع عشان
+
+15
+00:00:43,560 --> 00:00:48,210
+اوضح الأمور بشكل أوضح و ارتب ان شاء اللهالتعريف
+
+16
+00:00:48,210 --> 00:00:51,150
+اللي هو ال health history أنا مابتدأش يعني ندخل في
+
+17
+00:00:51,150 --> 00:00:54,290
+التفاصيل عميقة و مابقولك يعني تحفظها بالضبط لكن
+
+18
+00:00:54,290 --> 00:00:57,210
+على الأقل تفهم شو يعني ال health history عبارة عن
+
+19
+00:00:57,210 --> 00:00:59,650
+systematic collection of subjective and objective
+
+20
+00:00:59,650 --> 00:01:03,470
+data لكن هذا بدي يريحنا و يذكرنا في زمان انه يعني
+
+21
+00:01:03,470 --> 00:01:06,880
+كأنه بس بدي نعيد الكلام كمان مرةبدى يقولنا انه
+
+22
+00:01:06,880 --> 00:01:10,620
+دربالك احنا بنجمع معلومات طبعا اللى كويس فيها انه
+
+23
+00:01:10,620 --> 00:01:14,700
+سماها systematic يعني معلومات منتظمة يتم جمعها من
+
+24
+00:01:14,700 --> 00:01:18,600
+ال client عشان نقدر المعلومة عشان نقدر المعلومات
+
+25
+00:01:18,600 --> 00:01:24,600
+هذه اللى بنطبقها يعنى ونفهم منها الأمور بشكل نطبق
+
+26
+00:01:24,600 --> 00:01:29,120
+هذه المعلومات طبعا بكرا في لما بدى أصيغي problems
+
+27
+00:01:29,120 --> 00:01:32,480
+لما بدى أعمل نفسي ال diagnosis بدى أشوف ال science
+
+28
+00:01:32,480 --> 00:01:36,260
+أشوف ال symptomsبدأ أعمل follow up ل ال case و
+
+29
+00:01:36,260 --> 00:01:39,360
+هكذا طبعا كلكوا عارفين شو الفرق بين ال subjective
+
+30
+00:01:39,360 --> 00:01:42,540
+و ال objective احنا مش مصدد ان نعيد و نكرر نفس
+
+31
+00:01:42,540 --> 00:01:46,560
+الموضوع باختصار لما قلنا كلمة لجيتها ها vital
+
+32
+00:01:46,560 --> 00:01:50,580
+signs ال vital signs شغلات يعني ماقدراش نجيسها
+
+33
+00:01:50,580 --> 00:01:54,660
+حرارة، ضغط، التنفس، بنجيسهم، الآن بنتطلع على إيش؟
+
+34
+00:01:54,660 --> 00:01:57,880
+طبعا شغل هو بشكيها، لجيت الآن في شغل اللي أنا
+
+35
+00:01:57,880 --> 00:02:02,350
+بشكيها المريضو بقدر انا بقدر والله انا مش عارف
+
+36
+00:02:02,350 --> 00:02:05,130
+اخدها الا منه، هذه انا مابقدر، subjective انا
+
+37
+00:02:05,130 --> 00:02:09,790
+مابقدرش اشوفها، لكن لو اشي انا بجيسه، انا بجيسه و
+
+38
+00:02:09,790 --> 00:02:13,790
+باخد منه معلومات و بقدر ادقنه و observed يعني ممكن
+
+39
+00:02:13,790 --> 00:02:17,510
+ان انا اقدر الاحظها، هذا بنسميه ايش هذا؟ بنسميه
+
+40
+00:02:17,510 --> 00:02:20,590
+objective، هي عشان كتبنا objective اللي هو بتكون
+
+41
+00:02:20,590 --> 00:02:24,940
+هنا observed by the trainersالنان ده ميدناش ندخل
+
+42
+00:02:24,940 --> 00:02:27,760
+بالتفاصيل العميقة لان لكن ميدنقول ان ال North
+
+43
+00:02:27,760 --> 00:02:31,160
+American Nursing Diagnosis Association اللي اتأسست
+
+44
+00:02:31,160 --> 00:02:36,100
+في 1994 هي اول منظمة امريكية او انظمة عالمية
+
+45
+00:02:36,100 --> 00:02:40,220
+بتاعنا بال nursing diagnosis وفرقت بين ال nursing
+
+46
+00:02:40,220 --> 00:02:44,300
+diagnosis و بين ال medical diagnosis وخلت التمريض
+
+47
+00:02:44,300 --> 00:02:50,010
+يلو دور أساسي في موضوع انه كيف يصليعني على عتبات
+
+48
+00:02:50,010 --> 00:02:53,530
+الرعاية الصحية المتميزة مش يبقى دائما يعني as a
+
+49
+00:02:53,530 --> 00:02:57,170
+follower يعني يكون تابع وخلاص ينفذ لأ صار انه في
+
+50
+00:02:57,170 --> 00:03:01,210
+حاجة independent role دور يعني صراحة مستقل و بيقدر
+
+51
+00:03:01,210 --> 00:03:04,630
+يجوم بيه الان طب ايش تعريف ال nursing diagnosis
+
+52
+00:03:04,630 --> 00:03:09,550
+clinical judgment about individual حكم كليكي about
+
+53
+00:03:09,550 --> 00:03:13,250
+individual على المريض family community responses
+
+54
+00:03:13,250 --> 00:03:17,070
+to actual and potential health problems and life
+
+55
+00:03:17,590 --> 00:03:20,750
+responses يعني هو كأنه بيقوللي ال nursing
+
+56
+00:03:20,750 --> 00:03:24,230
+diagnosis عبارة عن صيغة إيه كلينيكية؟تعنى بإيش
+
+57
+00:03:24,230 --> 00:03:28,490
+بصيغة مشكلة تهم المريض أو العائلة أو حتى المجتمع
+
+58
+00:03:28,490 --> 00:03:32,830
+بشكل عام اللي موجود بحيث انه احنا نقدر نحل هذه
+
+59
+00:03:32,830 --> 00:03:36,050
+المشكلة هذه تعتبر health problem وانا بدي احاول
+
+60
+00:03:36,050 --> 00:03:41,230
+اعمل حل لها علشان اقدر اتعامل او يعني افهم ايش ال
+
+61
+00:03:41,230 --> 00:03:44,670
+follow up ايش اللي بدي يصير بعد ذلك هل بدي يصير
+
+62
+00:03:44,670 --> 00:03:47,450
+complication هل بدي اتطور حالته هل بدي اتروح
+
+63
+00:03:47,450 --> 00:03:52,230
+negative او positive للمريض اللي اماميphases of
+
+64
+00:03:52,230 --> 00:03:55,470
+taking health history كيف باخد health history باخد
+
+65
+00:03:55,470 --> 00:03:59,630
+بإيش مرحلتين ال health history تأخد بإيش بمرحلتين
+
+66
+00:03:59,630 --> 00:04:02,270
+المرحلة الأولى اسمها interview طبعا المرحلة طويلة
+
+67
+00:04:02,270 --> 00:04:05,570
+هذا ال interview و هحكي فيها كتير المرحلة التانية
+
+68
+00:04:05,570 --> 00:04:09,610
+recording phase يعني شوفوا احنا قلنا يمكن اختلافنا
+
+69
+00:04:09,610 --> 00:04:13,410
+عن باق المهن الصحية الأخرى من الطب لغيره ان هم
+
+70
+00:04:13,410 --> 00:04:18,610
+ممكن تصير عملية ال assessment و في الآخر يعني يتم
+
+71
+00:04:18,610 --> 00:04:22,600
+عملية التدوينبعد ما نشوف أكتر من حالة، احنا لأ،
+
+72
+00:04:22,600 --> 00:04:26,220
+نتكلم بشكل واضح انه اللي .. اللي بتسير معنا انه
+
+73
+00:04:26,220 --> 00:04:30,040
+احنا بدنا نقعد مع المريض و ناخد المعلومات
+
+74
+00:04:30,040 --> 00:04:33,080
+الأساسية، المعلومات الكاملة و نعمل summarization
+
+75
+00:04:33,080 --> 00:04:36,720
+زي ما اتفقنا و بعدين دغري أدونها علشان انا ماسيرش
+
+76
+00:04:36,720 --> 00:04:40,690
+يعني إيش أتذكرليش؟ لأنه قال قولنا زمان don't rely
+
+77
+00:04:40,690 --> 00:04:45,410
+on memory، يعني دائما ما تعتمدش على الذاكرة، يعني
+
+78
+00:04:45,410 --> 00:04:49,150
+ما تقولش I must remember، no حاول تكتب أول ما قول،
+
+79
+00:04:49,150 --> 00:04:52,670
+لأن ال documentation يعتبر خط دفاع أول عن التمريد
+
+80
+00:04:52,670 --> 00:04:58,070
+بشكل أساسي، طيب الآن ال guidelines ل taking إيش
+
+81
+00:04:58,070 --> 00:05:00,650
+أنا nursing history، كيف بدي أخد أول حاجة دي،
+
+82
+00:05:00,650 --> 00:05:03,720
+أعطاني توجيهاتال guide ده زي التوجيهات العامة زي
+
+83
+00:05:03,720 --> 00:05:06,580
+حكاية ال canyon لما بقولك guide بتعمل guide يعني
+
+84
+00:05:06,580 --> 00:05:10,300
+اشي بوجهك وين رايح زي الإبرة اللي بتكون في داخل ال
+
+85
+00:05:10,300 --> 00:05:13,340
+canyon اللي بتعملك guide وانت بقرا لما تركب ال
+
+86
+00:05:13,340 --> 00:05:17,500
+canyon لها الان اول حاجة private comfortable and
+
+87
+00:05:17,500 --> 00:05:22,160
+quiet environment بدنا نختار اول حاجة البيئة
+
+88
+00:05:22,160 --> 00:05:26,240
+المناسبة الهادية مايكونش فيلي حوالي ناس كتير مع
+
+89
+00:05:26,240 --> 00:05:30,540
+المريض واهمة في الموضوع اول كلمة privateطبعا كلمة
+
+90
+00:05:30,540 --> 00:05:34,120
+private يعني احط في بالكوا privacy يعني احط في
+
+91
+00:05:34,120 --> 00:05:37,860
+بالكوا confidentiality السرية و الكتمان و لازم انا
+
+92
+00:05:37,860 --> 00:05:40,820
+احافظ عليها حاضر عشان المريض يطمئن و يعطيني ال
+
+93
+00:05:40,820 --> 00:05:43,820
+history اللي بعد بقول allow the client to state
+
+94
+00:05:43,820 --> 00:05:46,960
+problems and expectations ايه هنا for the
+
+95
+00:05:46,960 --> 00:05:50,860
+interview يعني قبل كل حاجة خلي المريض نفسهإذا في
+
+96
+00:05:50,860 --> 00:05:55,040
+عندهم مشكلة أو مشاكل معينة يحكي أو متوقع أشياء
+
+97
+00:05:55,040 --> 00:05:59,340
+معينة عن ال interview يتكلم يعني مثلا احنا طالب من
+
+98
+00:05:59,340 --> 00:06:03,080
+سنة تانية السلام عليكم وحابب أعمل معاك مقابلة هذا
+
+99
+00:06:03,080 --> 00:06:06,040
+لمصلحتك بيجي يقولك طب لا إيش المقابلة هذا اسمها
+
+100
+00:06:06,040 --> 00:06:08,640
+expectation أو بيجي يقولك بس ما تكونش معلومة
+
+101
+00:06:08,640 --> 00:06:12,280
+تروحها expectation خل المريض يتكلم اللي في نفسه
+
+102
+00:06:12,280 --> 00:06:17,140
+قبل ما نبدأ طيب بعد إيش أنا orient لما يقولي
+
+103
+00:06:17,140 --> 00:06:19,980
+orient client بدك تعطي إيش أنا مش تعرف عن نفسك لأ
+
+104
+00:06:20,280 --> 00:06:23,200
+احنا عرفنا عن نفسنا لما دخلنا عند المريض لكن انا
+
+105
+00:06:23,200 --> 00:06:25,800
+بتعريفه عن إيش ال structure و ال purpose و ال
+
+106
+00:06:25,800 --> 00:06:29,780
+expectation of the history يعني ايه كويس انكله هذه
+
+107
+00:06:29,780 --> 00:06:34,980
+عبارة عن شيء منظملك و الغرض منه الأساسي انه احنا
+
+108
+00:06:34,980 --> 00:06:38,240
+بناخد معلومات يمكن تفيدك في علاجك و ان شاء الله مش
+
+109
+00:06:38,240 --> 00:06:42,640
+هتضرك و يمكن نتوقع انه هذه اتغير مسار العلاج او
+
+110
+00:06:42,640 --> 00:06:45,460
+اذا في أشياء معينة لازم نحكيها للطبيب نحكيها و
+
+111
+00:06:45,460 --> 00:06:48,240
+احنا مطمئنين هذا الامر كله بنعطيه الامين للمريض
+
+112
+00:06:48,240 --> 00:06:52,240
+الكلام قبل ما احنا نبدأ طيببقول لي communicate and
+
+113
+00:06:52,240 --> 00:06:55,720
+negotiate priorities with the client و احنا نتذكر
+
+114
+00:06:55,720 --> 00:06:59,480
+في سنة أولى كلمة negotiation معناه تتفاوت، بقوللي
+
+115
+00:06:59,480 --> 00:07:02,840
+اول حاجة communicate يعني تواصل، negotiate يعني
+
+116
+00:07:02,840 --> 00:07:06,360
+تفاوت، طب ايش بقوللي انا priorities الأولويات،
+
+117
+00:07:06,360 --> 00:07:10,820
+يعني انا مابديش تبدأ على كيفك كممرض او كممرضة
+
+118
+00:07:10,820 --> 00:07:15,600
+حكيمةما بنفعش نبدأ زي ما بدنا من وين نسأل، يمكن
+
+119
+00:07:15,600 --> 00:07:18,860
+المريض مثلا احنا بدنا نسأله، بنقوله مثلا احنا
+
+120
+00:07:18,860 --> 00:07:22,720
+والله بدنا نسألك عن صحتك وعن وضعتك وعن مرضك وعن
+
+121
+00:07:22,720 --> 00:07:28,800
+الأعراض اللي عندك، يمكن هو يقول لحانه ايش رأيك يا
+
+122
+00:07:28,800 --> 00:07:34,740
+أستاذ تبدأ معاي في وضعي العائلي أو في وضعي النوم؟
+
+123
+00:07:34,740 --> 00:07:37,520
+طبعا لما بيقولي ايش رأيك، هذا اسمه negotiate،
+
+124
+00:07:37,520 --> 00:07:41,780
+communicateأنا مش مستعجل باخد منه يعني ما المانع
+
+125
+00:07:41,780 --> 00:07:44,140
+أنه أبدأ بدل مبدأ بال size و ال symptoms ببدأ
+
+126
+00:07:44,140 --> 00:07:47,200
+بحاجات تانية ماعناه مشكلة يمكن التفاوت مع المريض
+
+127
+00:07:47,200 --> 00:07:50,220
+من مصطحد المريض أنه يحط ال priorities من وين أبدأ
+
+128
+00:07:50,220 --> 00:07:53,680
+حاجة بعدين مش بيقول الخانين الذاكرين listen more
+
+129
+00:07:53,680 --> 00:07:58,020
+than talk مايزعلوش مني دائما المشكلة احنا بنحب
+
+130
+00:07:58,020 --> 00:08:01,520
+الكلام لكتير لأ هو بيقولك دائما اسمع اكتر من ما
+
+131
+00:08:01,520 --> 00:08:04,400
+تحكي على فكرة حتى لما نتقضي بكرة في سنة رابعة ان
+
+132
+00:08:04,400 --> 00:08:10,170
+شاء اللههتذكروا الكلام معايا من 65 ل 70 سماع في
+
+133
+00:08:10,170 --> 00:08:14,080
+المية طبعاويدهم تلاتين في المية يدهم ربما يمكن أقل
+
+134
+00:08:14,080 --> 00:08:17,900
+لازم يكون هو ايش كلام ليه اش .. لأن احنا كتير
+
+135
+00:08:17,900 --> 00:08:21,860
+الكلام مرات بيتعب فانا كل ما بسمع كل ما بركز اكتر
+
+136
+00:08:21,860 --> 00:08:25,740
+للمريض كل ما بضن اقاطعه مش هيفعشان هيك انا بد اسمع
+
+137
+00:08:25,740 --> 00:08:29,880
+هذا المصطلح ليه مش للمريض يعني انا لازم اسمع اكتر
+
+138
+00:08:29,880 --> 00:08:33,560
+من ايه من الحكي بعدين ايش بيقولي هنا observe non
+
+139
+00:08:33,560 --> 00:08:36,560
+verbal communications شو المقصود في هذا ال body
+
+140
+00:08:36,560 --> 00:08:39,820
+language اللي ال body language ال voice tone نقبة
+
+141
+00:08:39,820 --> 00:08:43,770
+الصوتال appearance المظهر، الآن في مثل على فكرة
+
+142
+00:08:43,770 --> 00:08:47,810
+حلو كان زوجوله زمان يسمع كلامك أصدقك أو أصدقك زي
+
+143
+00:08:47,810 --> 00:08:52,090
+ما يقولونها و أشوف أفعالك أستعجب أو أستغرب، إيش
+
+144
+00:08:52,090 --> 00:08:55,330
+المعنى؟ المعنى هنا إن الإنسان ممكن كل واحد فينا
+
+145
+00:08:55,330 --> 00:08:58,580
+يحكي كلام حلو، زي ما يقعد يقول أتانى أنا بحبكأو
+
+146
+00:08:58,580 --> 00:09:02,560
+انا اقولها كذا زي اللي خدناها زمان بسموها double
+
+147
+00:09:02,560 --> 00:09:05,760
+orders او dual orders اللي خدناها السنة الأولى انه
+
+148
+00:09:05,760 --> 00:09:09,880
+الاب لما انطلب من الولد اذا حابب تطلع تلعب العب
+
+149
+00:09:09,880 --> 00:09:12,380
+برا لكن كان شريله حذاء جديد و ماعرفوش خاطر يطلع
+
+150
+00:09:12,380 --> 00:09:17,260
+فهو ايش بقول هنا احنا عشان نكون صادقين بنسمع
+
+151
+00:09:17,260 --> 00:09:20,460
+المريض و بنطلع و احنا بنسمع بنلاحظ ال body
+
+152
+00:09:20,460 --> 00:09:23,700
+language لازم يكون عندك و عندك حاجة اسمها clinical
+
+153
+00:09:23,700 --> 00:09:28,090
+sense ال clinical sense يعني حس ايش حس كليكيكيف
+
+154
+00:09:28,090 --> 00:09:31,850
+يحس كلينيكيا؟ أنا لما كنت أشتغل في زمان في الوزارة
+
+155
+00:09:31,850 --> 00:09:34,610
+يعني يمكن قبل 25 سنة أعرف اللي عنده appendicitis
+
+156
+00:09:34,610 --> 00:09:38,250
+قبل ما يحكي، حاطط إيده على جنبه اليمين و امطمل،
+
+157
+00:09:38,250 --> 00:09:41,090
+خلاص appendicitis، حاطط إيده على .. مثلا على جافة
+
+158
+00:09:41,090 --> 00:09:44,110
+دهره من ورا و عماله مش قادر يمشي بقول له back pain
+
+159
+00:09:44,110 --> 00:09:49,110
+و هكذا، هذا مش تخمين، مش كأننا بنضرب بالمندل، لأ،
+
+160
+00:09:49,110 --> 00:09:52,490
+الجثة كيف هنا أنه بيصير عندنا clinical sense طيب،
+
+161
+00:09:52,490 --> 00:09:55,130
+أنا بدأ أسمع من المريض و بدأ أشوف ال body language
+
+162
+00:09:55,530 --> 00:09:58,430
+لو حد سألنا مين أصدق ال body language more
+
+163
+00:09:58,430 --> 00:10:02,390
+accurate لكن ايانا نروح نقول للمريض بس انت بتحكيك
+
+164
+00:10:02,390 --> 00:10:05,410
+لكن انت مبين عليك متوتر يعني انا ممكن اقولك والله
+
+165
+00:10:05,410 --> 00:10:08,210
+أنا الحمد لله مبسوط و انا شاعر حالي كويس لكن هو
+
+166
+00:10:08,210 --> 00:10:11,370
+بيحكي بيحكي بنبرة اتغضب بنبرة قاعد برجع عنده
+
+167
+00:10:11,370 --> 00:10:14,550
+ragors او عنده يعني aggressiveness بينفعش ايش
+
+168
+00:10:14,550 --> 00:10:18,450
+اقوله هي بس مش مبين عليك انت بتكذب علينا انت بتمزح
+
+169
+00:10:18,450 --> 00:10:22,070
+لأ بيصير مشكلة احنا بناخد و بندون لكن بنقول ال
+
+170
+00:10:22,070 --> 00:10:26,960
+body language عنده واحد اتنين تلاتة طيبالان اش
+
+171
+00:10:26,960 --> 00:10:30,120
+بقول هي review information about past history انا
+
+172
+00:10:30,120 --> 00:10:33,580
+عندي past history من اول قبل ما ابدا يعني انا عندي
+
+173
+00:10:33,580 --> 00:10:36,540
+معلومات مش هو الاستاذ اش جالناه هيقول للاستاذ قبل
+
+174
+00:10:36,540 --> 00:10:38,960
+ما تخش على المريض دايما اقرا الملف هذه قبل ما اقرا
+
+175
+00:10:38,960 --> 00:10:41,740
+الملف يعني قبل ما اروح على المريض اقرا الملف يمكن
+
+176
+00:10:41,740 --> 00:10:45,040
+المريض يكون infected يمكن معدي يمكن المريض يكون في
+
+177
+00:10:45,040 --> 00:10:48,040
+عنده embarrassing something يعني شيء معرج علشان
+
+178
+00:10:48,040 --> 00:10:54,400
+هيك بقول ليه اطلع اقرا قبل ما تروح عشان انت تعمل
+
+179
+00:10:54,400 --> 00:10:58,370
+ايش مراجعة للمعلومات حاضربعدين بقولي balance، إيش
+
+180
+00:10:58,370 --> 00:11:01,350
+يعني balance؟ ال balance معناته توازن، إيش يعني
+
+181
+00:11:01,350 --> 00:11:05,210
+توازن؟ بقول خليك عامل توازن، لإيش التوازن؟ بدك
+
+182
+00:11:05,210 --> 00:11:08,490
+تعمل توازن بين انه تخلي المريض يحكي allowing the
+
+183
+00:11:08,490 --> 00:11:13,010
+client to talk in a unstructured manner and the
+
+184
+00:11:13,010 --> 00:11:16,570
+need to structure requested information، شو يعني؟
+
+185
+00:11:16,570 --> 00:11:20,230
+unstructured يعني مش منتظم، شو يعني؟ بقولي يا ريد
+
+186
+00:11:20,230 --> 00:11:23,890
+تعمل توازن و أنت بتحكي معاهالمريض، يعني يمكن
+
+187
+00:11:23,890 --> 00:11:27,570
+المريض هو بيحكي، بيحكي، بيحكي، صار خربط، ليه صار
+
+188
+00:11:27,570 --> 00:11:31,910
+خربط؟ يعني صار يجي بشمال و يحط عيمين، أنا مش فاهم،
+
+189
+00:11:31,910 --> 00:11:35,170
+صار اسمه unstructured manner، شو أنا بقوله؟ طب لو
+
+190
+00:11:35,170 --> 00:11:39,950
+سمحت، بس أنت على مهل، ركز في علوماتك، يعني أنت ركز
+
+191
+00:11:39,950 --> 00:11:44,900
+في اللي أنا طلبته منكهدى وشوف ايش اللى بتلاقي زى
+
+192
+00:11:44,900 --> 00:11:48,180
+اللى صفط الكلمات تصفيت ورتبها هذا ايش معناه نعمل
+
+193
+00:11:48,180 --> 00:11:51,400
+balance يعني من حين لآخر بتاك تعمل توازن بالكلام
+
+194
+00:11:51,400 --> 00:11:54,520
+بينك و بين المريض و تخليه يحاول يحكي شوي شوي
+
+195
+00:11:54,520 --> 00:11:59,080
+براحته عشان تقدر تستفيد منه طب لو حكى شغلات غامضة
+
+196
+00:11:59,080 --> 00:12:03,160
+بقول clarify the clients definitions terms and ايش
+
+197
+00:12:03,160 --> 00:12:08,570
+ايش هنا descriptions و الاوصال يعنييمكن أنا المريض
+
+198
+00:12:08,570 --> 00:12:11,470
+حكى كلمة أنا مافهمتهاش مش غلط و مش عايز بقوله
+
+199
+00:12:11,470 --> 00:12:15,610
+ماعليش إيش قصدك فيها دي زي ما هو بيسألني و بيقولي
+
+200
+00:12:15,610 --> 00:12:18,890
+إيش قصدك يعني لما أنت بتقولي بتاخد history ممكن
+
+201
+00:12:18,890 --> 00:12:21,790
+تطعملني كلمة عرفها ويا اقول لأ history بتاخد منك
+
+202
+00:12:21,790 --> 00:12:26,890
+معلومات لمصلحتك لحياتك نشوف إيش هو كذلك لما يحكي
+
+203
+00:12:26,890 --> 00:12:30,850
+كلمات يمكن أنت مثلا تشوفها غامضة خليه يحكيها و أنا
+
+204
+00:12:30,850 --> 00:12:35,650
+باسأله عنها عشان أستفيد أكتر avoid yes or no
+
+205
+00:12:35,650 --> 00:12:39,100
+questions إيش بيقول يعنيبقولي ابعد عن ال yes or no
+
+206
+00:12:39,100 --> 00:12:42,520
+questions لأن الأسئلة دي شويه مزعجة بعدين
+
+207
+00:12:42,520 --> 00:12:44,620
+بنستخدمها في الموضوع ال listed questions زي ما
+
+208
+00:12:44,620 --> 00:12:47,580
+احنا قلنا زي الموضوع ال smoking مثلا does you
+
+209
+00:12:47,580 --> 00:12:50,140
+smoke جاله مثلا no او do you smoke جاله no او yes
+
+210
+00:12:50,140 --> 00:12:53,560
+هذا شيء تاني مثلا انت بتعتبر حالك obese yes or no
+
+211
+00:12:53,560 --> 00:12:57,720
+هذا شيء تاني لكن هو بيقولي حاول قدر الإمكان تبعد
+
+212
+00:12:57,720 --> 00:13:00,660
+عن ال yes or no ليه اذا انت بدك detail ايش عن
+
+213
+00:13:00,660 --> 00:13:05,120
+detail يعني بدنا معلومات مستفيدة وزيادة يعني كل ما
+
+214
+00:13:05,120 --> 00:13:08,480
+بدي معلومات اكتركل ما ابعد عن ال yes or no
+
+215
+00:13:08,480 --> 00:13:13,180
+questions بقولي كمان write adequate notes for
+
+216
+00:13:13,180 --> 00:13:18,300
+recording ايش يعني اكتب معلومات واضحة كافية
+
+217
+00:13:18,300 --> 00:13:22,080
+للتسجيل ما نكتب معلومات ناقصة يعني اخدت معلومات من
+
+218
+00:13:22,080 --> 00:13:25,080
+المريض انا مابقولش اكتب كل كلامه لكن لما تيجي بدك
+
+219
+00:13:25,080 --> 00:13:28,720
+تعطيني عبارة او للطبيب عبارة تعطيني عبارة تكون
+
+220
+00:13:28,720 --> 00:13:33,600
+واضحةوصريحة نقدر نفهمها .. نقدر نفهمها علشان ما
+
+221
+00:13:33,600 --> 00:13:36,800
+تكونش المعلومة منتقصة يعني مثلا إذا قال والله أنا
+
+222
+00:13:36,800 --> 00:13:40,640
+عندي وجع في اليمين في بطني و أنا بحس أنه بيسمع في
+
+223
+00:13:40,640 --> 00:13:44,660
+ظهري في منطقة كذا نكتبها زي ما هي مش بس بقول مثلا
+
+224
+00:13:44,660 --> 00:13:48,740
+right abdominal مثلا أو quadrant مثلا بين لأ بقول
+
+225
+00:13:48,740 --> 00:13:52,930
+radiate to كذا كذا arearecord nursing health
+
+226
+00:13:52,930 --> 00:13:55,690
+history soon after interview هذا الكلام اللي أنا
+
+227
+00:13:55,690 --> 00:13:58,330
+أكد عليه و دايما بأكد عليه شايفين ايش بقولي soon
+
+228
+00:13:58,330 --> 00:14:02,110
+مجرد ما انخلص ال health history مع المريض فورا
+
+229
+00:14:02,110 --> 00:14:07,350
+بروح بسجنه علشان أقدر أكون ذاكر و أقدر ألخص
+
+230
+00:14:07,350 --> 00:14:11,010
+المعلومات و انا لسه في نفس الحالة و في نفس الدقيقة
+
+231
+00:14:11,010 --> 00:14:16,550
+و في نفس اللحظات types of nursing health history
+
+232
+00:14:17,150 --> 00:14:20,370
+أنواع ال nursing health history عبارة عن تلاتة
+
+233
+00:14:20,370 --> 00:14:24,210
+خليكوا ذاكرين هذا مهم و خلينا نحفظه لما بتاخد
+
+234
+00:14:24,210 --> 00:14:28,530
+health history حاجة كبيرة اسمها complete و حاجة
+
+235
+00:14:28,530 --> 00:14:32,490
+وسط بنسميها interval و حاجة مركزة بنسميها problem
+
+236
+00:14:32,490 --> 00:14:37,510
+focus الكبيرة اسمها ال complete health history ال
+
+237
+00:14:37,510 --> 00:14:40,690
+complete health history بتأخد أول ما يدخل المريض
+
+238
+00:14:40,690 --> 00:14:44,470
+للمستشفى يعني أجى المريض على استقبال فحوله على قسم
+
+239
+00:14:44,470 --> 00:14:49,990
+البطنةأو الجراحة او القلب او اي ان كان يعني اول ما
+
+240
+00:14:49,990 --> 00:14:52,690
+يدخل على القسم هذا بيسموه ال initial visit نسأله
+
+241
+00:14:52,690 --> 00:14:56,830
+قوله قبل يك عمرك نمت في مستشفى قوليه اول مرة قبل
+
+242
+00:14:56,830 --> 00:14:59,830
+ما نعمل اي شيء لازم ناخد منه complete health
+
+243
+00:14:59,830 --> 00:15:04,510
+history طبعا الطبيب بياخد و التمريد بياخد حتى اللي
+
+244
+00:15:04,510 --> 00:15:07,910
+في القسم كمان ايش بياخد يعني ده حد تاني ممكن كلهم
+
+245
+00:15:07,910 --> 00:15:12,050
+ايش ايش يصير عندهم عملية الاخد علشان ايه هذا مفيد
+
+246
+00:15:12,050 --> 00:15:16,390
+للجميع طبعا الان طب لايش هذه المعلوماتبدو ينبني
+
+247
+00:15:16,390 --> 00:15:19,570
+عليها أشياء كتير في الرعاية في المرحلة القادمة
+
+248
+00:15:19,570 --> 00:15:23,530
+interval health history الانش بقول ال interval
+
+249
+00:15:23,530 --> 00:15:27,690
+مرحلية بيسموها، إيش يعني؟ بدك تجمع المعلومات اللي
+
+250
+00:15:27,690 --> 00:15:31,050
+هو in visits following the initial database is
+
+251
+00:15:31,050 --> 00:15:33,450
+collected يعني أعطيكم مثل زي المريض أو المبروه على
+
+252
+00:15:33,450 --> 00:15:36,340
+الطبيبأول مرة دخل إليها ال doctor بيسأله و بيقوله
+
+253
+00:15:36,340 --> 00:15:39,260
+عمره انت أتيت و أنت قالله لأ عمرك عانيت و راح تعمل
+
+254
+00:15:39,260 --> 00:15:42,980
+صحيفة لأ أخد منه المعلومات الكاملة سجلها كلها عنده
+
+255
+00:15:42,980 --> 00:15:46,500
+أرشفها الجد صار يعمل يقوله يعمل .. بدك تجي مراجعات
+
+256
+00:15:46,500 --> 00:15:49,680
+تسمع و تقول للطبيب راجعني بعد سبوع أو بعد عشر أي
+
+257
+00:15:49,680 --> 00:15:54,180
+مراجعة بتصير ال information بتصير هنا بنسميها
+
+258
+00:15:54,180 --> 00:15:57,720
+interval بعد هيك يعني احنا بعد ما احنا قاعدين
+
+259
+00:15:57,720 --> 00:16:00,660
+بناخد معلومات عشان نتأكد من المعلومات الأولانية
+
+260
+00:16:00,660 --> 00:16:03,440
+اللي خدام ال complete طب صارت في عنده مشكلة خاصة
+
+261
+00:16:04,240 --> 00:16:07,920
+بتصير بعد هيك اسمها problem focused health history
+
+262
+00:16:09,640 --> 00:16:13,780
+انا باخد history تركز على ايش التركيز التركيز على
+
+263
+00:16:13,780 --> 00:16:17,220
+المشكلة التركيز على المشكلة اللي صارت عنده زي كيف
+
+264
+00:16:17,220 --> 00:16:20,960
+يعني فرضا المريض فرضا المريض صار عنده يعني بشكي
+
+265
+00:16:20,960 --> 00:16:24,780
+بشكي من مشكلة معينة صارت جديدة يعني هو مثلا كان
+
+266
+00:16:24,780 --> 00:16:28,340
+يروح يراجع القلب ففجأة قال له الدكتور انا صراحة
+
+267
+00:16:28,340 --> 00:16:32,240
+انا بدي اقولك ان في صرفي عندك مشكلة صحية جديدة هذه
+
+268
+00:16:32,240 --> 00:16:36,240
+المشكلة الصحية الجديدة تستدعي انه بدي اعملك قسترة
+
+269
+00:16:36,240 --> 00:16:40,410
+هذا شيء جديدالشيء الجديد هذا ايش بنسميه problem
+
+270
+00:16:40,410 --> 00:16:45,590
+focused يعني انا باخد بس معلومات متركزة حول
+
+271
+00:16:45,590 --> 00:16:49,770
+المشكلة عشان هيك سمنها specific history يعني اشي
+
+272
+00:16:49,770 --> 00:16:53,690
+محدث specific problem هنا عن كل حاجة في حياة
+
+273
+00:16:53,690 --> 00:16:56,970
+المريض هنا في الزيارات المتعاقبة ودخول المريض
+
+274
+00:16:56,970 --> 00:17:00,750
+المتكرر هنا على المشكلة الخاصة اللي احنا بدنا نركز
+
+275
+00:17:00,750 --> 00:17:04,550
+عليها طيب components of health history ال
+
+276
+00:17:04,550 --> 00:17:08,230
+components of health historyأول حاجة في ان هنا
+
+277
+00:17:08,230 --> 00:17:12,370
+لاحظين هذه اسمه بيوغرافيكال داتا يعني المعلومات
+
+278
+00:17:12,370 --> 00:17:15,860
+الأساسيةطبعا المعلومة الاساسية سهلة جدا هذا ممكن
+
+279
+00:17:15,860 --> 00:17:18,920
+نعملها زي ايه زي check list اللي هي الاسم و
+
+280
+00:17:18,920 --> 00:17:23,560
+العنوان و يعني وين ساكن و ال birth date و طيب و
+
+281
+00:17:23,560 --> 00:17:26,780
+الجنس و ال religion طبعا ماجيش اسأله اذا انا موجود
+
+282
+00:17:26,780 --> 00:17:29,860
+في غزا اكيد هاعرف ان هو مسلم يعني مش حلو اني اسأله
+
+283
+00:17:29,860 --> 00:17:32,860
+اقوله لو سمحت ان انا مسلم ولا مسيحي او روحي احد
+
+284
+00:17:32,860 --> 00:17:36,400
+يغلط يعني والله حبيت اسأله من باب التأكيد اشي من
+
+285
+00:17:36,400 --> 00:17:39,280
+باب التأكيد انا ببين الانسان ماريت ال status متجوز
+
+286
+00:17:39,280 --> 00:17:43,410
+مش متجوزsocial security في عنده مثلا تأمين أو يعني
+
+287
+00:17:43,410 --> 00:17:49,150
+مثلا زي قضية لاجئ مواطن بتعالج في السويد، بتعالج
+
+288
+00:17:49,150 --> 00:17:53,450
+في حكومة؟ occupation هل عنده وظيفة؟ كيف تم تحويله
+
+289
+00:17:53,450 --> 00:17:58,670
+للمستشفى؟ في ال health care منهم دايما بروح بتلقى
+
+290
+00:17:58,670 --> 00:18:02,320
+الرعاية، هل من عيادة، هل من عيادة خاصة؟طيب ال
+
+291
+00:18:02,320 --> 00:18:05,460
+source of reliability information المصدر المعلومات
+
+292
+00:18:05,460 --> 00:18:07,980
+الصادقة من وين جيبها يعني الصدق المعلومات تبعتنا
+
+293
+00:18:07,980 --> 00:18:11,980
+هل تمدنا كلها بس على المريض ولا جيبنا معلومات من
+
+294
+00:18:11,980 --> 00:18:15,440
+قريب المريض لما يكون عنده مغيب او كذا ال date of
+
+295
+00:18:15,440 --> 00:18:19,060
+interview تاريخ المقابلة هذي كلها شق واحد اسمه
+
+296
+00:18:19,060 --> 00:18:23,000
+biographical data طيب الآن اللي بعد اسمه chief
+
+297
+00:18:23,000 --> 00:18:26,140
+complaint كتير في ناس بغلطوا فيها بسموه الشكوه
+
+298
+00:18:26,140 --> 00:18:29,220
+الرئيسية لما انا اقولكوا ايش الشكوه الرئيسية يعني
+
+299
+00:18:29,220 --> 00:18:33,420
+reason for hospitalizationلو حد بيسألنا ما المقصود
+
+300
+00:18:33,420 --> 00:18:36,640
+بكلمة ال chief complaint بقى يجيب أقوله يعني ليش
+
+301
+00:18:36,640 --> 00:18:39,080
+أنت جيت على المستشفى، يبقى هاي معناه ال chief
+
+302
+00:18:39,080 --> 00:18:42,860
+complaint لما ييجي للمريض في الباطنة هي أكيد جابته
+
+303
+00:18:42,860 --> 00:18:44,660
+مشكلة باطنه، في الجراحة هي أكيد جابته مشكلة
+
+304
+00:18:44,660 --> 00:18:48,300
+الجراحية، يبقى نيجي بنعطيكم مثال أو أمثلة على ال
+
+305
+00:18:48,300 --> 00:18:52,640
+chief complaint عشان كتير بعض الناس بيخربطوا فيها،
+
+306
+00:18:52,640 --> 00:18:56,040
+بيجي بقول chest pain for three days، بقول والله يا
+
+307
+00:18:56,040 --> 00:18:59,560
+شيخ أنا عندي وجع في صدري، بس أنا ذاكر اليومين أو
+
+308
+00:18:59,560 --> 00:19:03,560
+تلاتة، بسهذه chief complaint لكن لو كان ليه old
+
+309
+00:19:03,560 --> 00:19:07,060
+problem بعتبرهاش chief complaint لأ خلاص بعتبرها
+
+310
+00:19:07,060 --> 00:19:11,180
+old history واحد بيقول لي في عن مثلا هنا swelling
+
+311
+00:19:11,180 --> 00:19:14,560
+ankles for two weeks طب ليش؟ بقول والله كنت ألعب
+
+312
+00:19:14,560 --> 00:19:17,200
+كورة اتفجأت اني مرة و جاعت و انا مااخدتش فيه ولا
+
+313
+00:19:17,200 --> 00:19:21,140
+اعطيت وانتفخت ال ankles عندي تحت وانا المرفق هذا
+
+314
+00:19:21,140 --> 00:19:24,920
+مش عارف صار عندي ال joint متعبني و صار انا منتفق
+
+315
+00:19:24,920 --> 00:19:27,860
+okay هذا برضه chief complaint اجت على المستشفى
+
+316
+00:19:27,860 --> 00:19:31,630
+fever قداش ال fever عندك headache؟والله حوالي الى
+
+317
+00:19:31,630 --> 00:19:35,130
+يمكن 12 الى 24 ساعة، يمكن يعني اليوم، دغري من
+
+318
+00:19:35,130 --> 00:19:38,270
+جيبه، باب سمير needed، في بعض الحالات كلمة باب
+
+319
+00:19:38,270 --> 00:19:41,190
+سمير هذه هي ال screening نعملها لل female خاصة
+
+320
+00:19:41,190 --> 00:19:45,930
+يعني من ال cervix يعني بناخده من ال cervix of the
+
+321
+00:19:45,930 --> 00:19:48,590
+uterus عشان لما نبدأ نعمل بعض الفحص، يعني بتيجي ال
+
+322
+00:19:48,590 --> 00:19:51,430
+set بتقول أنا جاية عشان أعمل هذا الفحص، هو فحص
+
+323
+00:19:51,430 --> 00:19:55,050
+عالمي ومعروف عشان يكتشف whether في لا سمح الله أي
+
+324
+00:19:55,050 --> 00:19:58,650
+carcinogenic somethingاللي بعد بيجي بعض الناس
+
+325
+00:19:58,650 --> 00:20:00,230
+بيقولك انا جاي لأ انا جاي عشان physical
+
+326
+00:20:00,230 --> 00:20:03,770
+examination ليه for مثلا بكتاب ليه needed for camp
+
+327
+00:20:03,770 --> 00:20:07,090
+مش شرط يكون camp ممكن واحد يقولك لأ انا جاي اعمل
+
+328
+00:20:07,090 --> 00:20:10,950
+فحص كامل لياقى لإن انا بده التحق بده .. ب ..
+
+329
+00:20:10,950 --> 00:20:14,430
+deploy شرطة او انا بده اتوظف او انا بده كده ايا
+
+330
+00:20:14,430 --> 00:20:16,930
+كان هذه كلها ايش اسمها chief complaint شكوهة
+
+331
+00:20:16,930 --> 00:20:21,830
+رئيسية طيب رقم تلاتة بيقوللي ايش هنا history of
+
+332
+00:20:21,830 --> 00:20:26,160
+present illness خلصناالشكوة تبعته باجي أول سؤال
+
+333
+00:20:26,160 --> 00:20:31,080
+باسأله بقوله لو سمحت هذا اللي صار عندك باسأله عن
+
+334
+00:20:31,080 --> 00:20:34,640
+المشكلة اللي موجودة ايش معنى فيها بجمع المعلومات
+
+335
+00:20:34,640 --> 00:20:39,080
+المتعلقة المجموعات المتعلقة بالشكوة اللي هو شكاها
+
+336
+00:20:39,080 --> 00:20:42,440
+المريض الشكوهالة زي ايش مثلا بيجي يقولك انا والله
+
+337
+00:20:42,440 --> 00:20:46,200
+عندي swollen ankles او عندي انا والله في في عندي
+
+338
+00:20:46,200 --> 00:20:49,620
+fever او عندي headache باجي المعلومات اللي بحكي
+
+339
+00:20:49,620 --> 00:20:54,400
+عنها باجي بسأله بقوله لو سمحت كيف صار عندكإيش اللي
+
+340
+00:20:54,400 --> 00:20:57,740
+خلّى القلمة دي زيد عندك؟ شو اللي نجسه؟ طب إيش أنت
+
+341
+00:20:57,740 --> 00:21:01,820
+بالظبط كيف يعني بداية الوجع صار؟ كله إيش اسمه إما
+
+342
+00:21:01,820 --> 00:21:05,360
+essential أو إما relevant؟ إيش يعني essential؟ إيش
+
+343
+00:21:05,360 --> 00:21:09,800
+معنى relevant؟ الآن في معلومات أساسية وفي معلومات
+
+344
+00:21:09,800 --> 00:21:15,840
+متعلقة بالمرضة أعطيكم مثال، الآن هو بيحكيلي، بيقول
+
+345
+00:21:15,840 --> 00:21:21,480
+أنا أول ما حاولت أحمل شيء صار دهري جوعني، هذا اسمه
+
+346
+00:21:21,480 --> 00:21:27,320
+essential، essential إيه؟problem بعد شوية بقول حتى
+
+347
+00:21:27,320 --> 00:21:31,480
+انا و انا ماشي صرت أتعب شوية هذا اسمه relevant ال
+
+348
+00:21:31,480 --> 00:21:35,660
+essential معلومة أساسية علاقة بالإيه؟ علاقة بالمرض
+
+349
+00:21:35,660 --> 00:21:40,240
+ال relevant معلومات متعلقة بالمرض يمكن يكون عنده
+
+350
+00:21:40,240 --> 00:21:44,360
+medical treatment بدي أشوف يعني ممكن يقول لحاله
+
+351
+00:21:44,360 --> 00:21:48,950
+والله أنا روحت شريت diclofene واشربتصح نفسي ان شاء
+
+352
+00:21:48,950 --> 00:21:51,330
+الله لكن لأ ماقدرش أقول هي سبب في المشكلة هي
+
+353
+00:21:51,330 --> 00:21:54,250
+relevant بدونها و بكتبها عشان أحكيها لمين؟ أحكيها
+
+354
+00:21:54,250 --> 00:21:57,770
+للطبيب المعالج يبقى أنا أخدت المعلومات طيب بعديها
+
+355
+00:21:57,770 --> 00:22:02,110
+ال components of present illness ال components of
+
+356
+00:22:02,110 --> 00:22:05,670
+present illness أول عجة introduction طبعا أخدنا
+
+357
+00:22:05,670 --> 00:22:08,090
+عملنا class summary و ال usual health أخدنا
+
+358
+00:22:08,090 --> 00:22:11,030
+المعلومات الكاملة و ال investigation of symptoms
+
+359
+00:22:11,030 --> 00:22:15,190
+أنا قاعد بتفحص الأيش الأعراض قاعد أنا بسألهيعني
+
+360
+00:22:15,190 --> 00:22:18,890
+وقت إيش صارت و وديت و ال gradual هى هل ده الألم
+
+361
+00:22:18,890 --> 00:22:22,490
+أجى عندك عمهل gradual و لا صدل يعني واحد بيجيني و
+
+362
+00:22:22,490 --> 00:22:25,210
+بيقولي والله صدر بجعني بقولش بقولي والله إيه تلت
+
+363
+00:22:25,210 --> 00:22:28,250
+أيام بس كل ماله بزيت شوية اسمه gradual لكن لو واحد
+
+364
+00:22:28,250 --> 00:22:31,290
+أجي قاللي أنا فجأة صار زي السكين لأ او صار burning
+
+365
+00:22:31,290 --> 00:22:34,310
+sensation بقوله تعال أكتر ال duration بتطول ولا
+
+366
+00:22:34,310 --> 00:22:37,570
+بتطورش ال frequency كم مرة بيجي ال location وينما
+
+367
+00:22:37,570 --> 00:22:41,370
+كان و ال quality ال quality ايش جودته يعني حدته
+
+368
+00:22:41,370 --> 00:22:44,700
+قوي ولا مش قويايش ال alleviating و أيش ال
+
+369
+00:22:44,700 --> 00:22:48,700
+aggravating factors ما هي الأشياء التي تزيد القلم
+
+370
+00:22:48,700 --> 00:22:52,360
+و ما هي الأشياء اللي بتجلل القلم alleviating تقلل
+
+371
+00:22:52,360 --> 00:22:56,020
+الأعراض aggravating تزيد الأعراض يعني ممكن يقولي
+
+372
+00:22:56,020 --> 00:22:59,200
+والله يا أستاذ لما بعمل واحد اتنين تلاتة بزيد عندي
+
+373
+00:22:59,200 --> 00:23:01,860
+القلم و لما بعمل واحد اتنين تلاتة بجلي القلم
+
+374
+00:23:01,860 --> 00:23:05,820
+بكتبها و بقول عنها alleviating factors و بقول عنها
+
+375
+00:23:05,820 --> 00:23:08,620
+أيش aggravating factors سامحوني لو أنا كنت سريع
+
+376
+00:23:08,620 --> 00:23:11,560
+شوية بتعيدوا الفيديو مرة و مرتين ان شاء الله بتكون
+
+377
+00:23:11,560 --> 00:23:14,390
+أمور واضحة عنكمبدي أسأل إن الـ negative
+
+378
+00:23:14,390 --> 00:23:17,510
+information معلومات سلبية ممكن يعطيني معلومات
+
+379
+00:23:17,510 --> 00:23:20,730
+مالهاش علاقة مضللة ما بكتبها بس أنا بتكون واضح و
+
+380
+00:23:20,730 --> 00:23:23,310
+أعرف إيش اللي بيحكي ليها و بصنف إن هذه negative
+
+381
+00:23:23,310 --> 00:23:26,430
+information أو positive relevant family
+
+382
+00:23:26,430 --> 00:23:29,250
+information إذا والله في معلومات في العائلة اللي
+
+383
+00:23:29,250 --> 00:23:32,970
+لها علاقة يعني ممكن ييجي يقول أنا صدري بجوعني بس
+
+384
+00:23:32,970 --> 00:23:35,650
+الله أنا خايف ليه؟ لأنه عندنا تاريخ في العائلة
+
+385
+00:23:35,650 --> 00:23:39,510
+بيصير معنى .. هو بيقول تاريخ في العائلة بيصير معنى
+
+386
+00:23:39,510 --> 00:23:43,210
+جلطة هذا باخده على محمل جد اسم relevant familyطيب
+
+387
+00:23:43,210 --> 00:23:46,450
+ممكن يكون في عنده disability affected the clients
+
+388
+00:23:46,450 --> 00:23:50,250
+total life يمكن اللي صار عنده واحد أكل هوايا في
+
+389
+00:23:50,250 --> 00:23:53,850
+راسه فلا سمح الله ان ضرب صار عنده شوية bleeding
+
+390
+00:23:53,850 --> 00:23:56,790
+subdural bleeding او مثلا diural bleeding او brain
+
+391
+00:23:56,790 --> 00:24:00,250
+hematoma صار عنده disability يعني هذا النظيف اللي
+
+392
+00:24:00,250 --> 00:24:03,370
+في المخ صار ايش صار عنده إعاقة كله بدونه و بكتبه
+
+393
+00:24:03,370 --> 00:24:10,190
+كله هاد اسم component of present illness طيب ال
+
+394
+00:24:10,190 --> 00:24:14,980
+past health historyPast يعني الشكل التاريخي القديم
+
+395
+00:24:14,980 --> 00:24:18,140
+بيربوس ايش أنا بتكلم ال major past health problems
+
+396
+00:24:18,140 --> 00:24:21,700
+بسأله عن المشكلات الصحية الموجودة عنده بس ايش هي
+
+397
+00:24:21,700 --> 00:24:25,980
+اللي كانت في حياته تعتبر زي major problem احنا
+
+398
+00:24:25,980 --> 00:24:30,080
+ممكن اسأله هل في حياتك انت صار عندك حادث سير او
+
+399
+00:24:30,080 --> 00:24:33,000
+عندك سبحان الله دخلت مستشفى صار عندك عملية جراحية
+
+400
+00:24:33,000 --> 00:24:36,760
+اي شيء طبعا اول سؤال بنسأله في ال childhood
+
+401
+00:24:36,760 --> 00:24:42,360
+illness بنسأله في الطفولة كيف كانت طفولتك كويسةولا
+
+402
+00:24:42,360 --> 00:24:45,500
+مش كويسة؟ هل كان عندك rheumatic fever؟ عمره صار
+
+403
+00:24:45,500 --> 00:24:48,660
+عندك حمض رheumatism؟ أسخنت وانت صغير؟ صار عندك
+
+404
+00:24:48,660 --> 00:24:53,920
+مثلا meningitis؟ التهاب صحيح؟ أي شيء كله باسأله
+
+405
+00:24:53,920 --> 00:24:57,340
+التطعمات كويسة كانت عندك ولا لأ؟ history of
+
+406
+00:24:57,340 --> 00:25:01,200
+accidents؟ هل في عندك يعني اتعرضت لأي .. مش شرط
+
+407
+00:25:01,200 --> 00:25:04,020
+يكون حادث لما نقول accidents يعني حادث سيارة جبان؟
+
+408
+00:25:04,020 --> 00:25:08,500
+لأ أوجعت، انصبت بشيص، اتسوابت ارصاص، أي شيء
+
+409
+00:25:08,500 --> 00:25:12,930
+history of hospitalization؟عمرك دخلت المستشفى؟ إذا
+
+410
+00:25:12,930 --> 00:25:16,310
+دخلت يا ريت تقولنا متى؟ وإيش اللي كان موجود؟ ولمّا
+
+411
+00:25:16,310 --> 00:25:19,110
+أنت دخلت إيش كان ال complaint؟ إيش الشكوى؟ وإيش ال
+
+412
+00:25:19,110 --> 00:25:22,570
+discharge diagnosis؟ وإيش التشخيص كان؟ وهل ضلتك
+
+413
+00:25:22,570 --> 00:25:26,330
+عامل follow-up؟ يعني كأنه بدنا نربط ما بين مشكلات
+
+414
+00:25:26,330 --> 00:25:29,890
+المريض اللي في السابق وما بين المشكلة اللي موجودة
+
+415
+00:25:29,890 --> 00:25:34,450
+الآن حاليًا ال history of operations بسأله إذا في
+
+416
+00:25:34,450 --> 00:25:37,950
+عندك عمليات عملتها في حياتك وهل العمليات كانت هذه
+
+417
+00:25:37,950 --> 00:25:42,340
+تعتبرعملية كبيرة ولا .. يعني minor ولا major؟ يعني
+
+418
+00:25:42,340 --> 00:25:44,860
+يمكن يقول أه والله مرة جراحت و بنجون و عملوله
+
+419
+00:25:44,860 --> 00:25:47,820
+غراز، هذه تعتبر minor لكن ممكن يقول اللي عملت
+
+420
+00:25:47,820 --> 00:25:52,640
+عملية إزالة المرارة، لأ هذه اسمها major operation.
+
+421
+00:25:53,180 --> 00:25:56,440
+History of immunizations، إذا عندك أي شيء أطعمتله
+
+422
+00:25:56,440 --> 00:25:59,860
+أو لا سمح الله عندك حسية عشان أنا أعرف، يمكن يجي
+
+423
+00:25:59,860 --> 00:26:03,130
+يقولي والله أه أنا زمانحاول و أنا صغير كان عندى
+
+424
+00:26:03,130 --> 00:26:05,810
+سخونة و حاول يعطونى إبره اسم البنسالين كتير من
+
+425
+00:26:05,810 --> 00:26:08,670
+الحلات هيقولك زي هيك فمجرد ماجوا يعطونى البنسالين
+
+426
+00:26:08,670 --> 00:26:13,070
+اللى انا اتفاجأت انه ايش و عندي حسيسية و منعونى
+
+427
+00:26:13,070 --> 00:26:15,950
+الأطباء و قالوا بعدين اقعد تاخد إبره هه بيعطينى
+
+428
+00:26:15,950 --> 00:26:20,610
+ايش alarm انه انتبه ال physical examinations و ال
+
+429
+00:26:20,610 --> 00:26:23,410
+diagnostic test برضه بتطلع الطبيب اعمله physical
+
+430
+00:26:23,410 --> 00:26:27,130
+examination ايش هو الادات اللى عملها و ال
+
+431
+00:26:27,130 --> 00:26:31,880
+information اللى كتبها عشان انا اكمل على المعمولو
+
+432
+00:26:31,880 --> 00:26:35,300
+بتطلع على الفحوصات اللي هو عملها عامل CPC عامل
+
+433
+00:26:35,300 --> 00:26:39,060
+Chemistry عامل Serology عامل Urinalysis باجراهم و
+
+434
+00:26:39,060 --> 00:26:42,640
+اليوم الحمد لله صاروا معظم المختبرات بتكتبلكوا ال
+
+435
+00:26:42,640 --> 00:26:45,820
+normal و ال abnormal عشان نقدر نفسر لو الناس مش
+
+436
+00:26:45,820 --> 00:26:50,520
+عارفين Family History ال family history كتير في
+
+437
+00:26:50,520 --> 00:26:54,280
+بعض الحلات بيسألونا بيقولناإنه إيش داخله؟ بنيجي
+
+438
+00:26:54,280 --> 00:26:57,520
+بنسأل إنه البربوس ليه؟ أول حاجة عشان نشوف ال
+
+439
+00:26:57,520 --> 00:27:00,260
+general health تبعت إيه، خاصة في ال blood
+
+440
+00:27:00,260 --> 00:27:04,800
+relatives، يعني بدنا نسأله في أقاربه، يمكن عنده
+
+441
+00:27:04,800 --> 00:27:09,200
+مشكلة نادرة، باجي بسأله في حد في البيت، هاي
+
+442
+00:27:09,200 --> 00:27:12,000
+الموضوع ال family، زيك، بقولك أه، يعني زي حالات
+
+443
+00:27:12,000 --> 00:27:15,900
+الثلاثيميا أو يعني في حالات كتيرة بتتصل عليه بعض
+
+444
+00:27:15,900 --> 00:27:18,960
+الناس، باجي بسأل، باجي بتصير عندهم حالة
+
+445
+00:27:18,960 --> 00:27:21,990
+schizophrenia، باجي بسأل السؤالبقول له طيب عمره حد
+
+446
+00:27:21,990 --> 00:27:25,710
+صار؟ قال اه والله عم كان عنده وحتى انا سيدي قبل
+
+447
+00:27:25,710 --> 00:27:29,230
+هيكة بقوله انه يعني كائن عنده اعراض زيك، اذا انا
+
+448
+00:27:29,230 --> 00:27:32,750
+بشوف هل صارت عنده مشكلة؟ و هو كمان في مرحلة
+
+449
+00:27:32,750 --> 00:27:36,070
+الطفولة، healthy كان عنده مشكلة او environmental
+
+450
+00:27:36,070 --> 00:27:40,470
+او genetic؟ يعني اقصدإذا كانت في مشكلة لبيئتهم
+
+451
+00:27:40,470 --> 00:27:43,310
+الموجودة في بعض الناس، بيجيب و بيقولّك احنا والله
+
+452
+00:27:43,310 --> 00:27:46,410
+عيلتنا فيها مرض سكري أكتر، احنا ساكنين في مكان
+
+453
+00:27:46,410 --> 00:27:50,270
+معين، ضارين على طقوس معينة، بناكل أكلات خاصة،
+
+454
+00:27:50,270 --> 00:27:54,510
+بنربط المرض اللي موجود الآن بأي إيش familiar
+
+455
+00:27:54,510 --> 00:27:57,910
+نتيريان في الطبيعة العائلية، هذا كله عشان إيش؟
+
+456
+00:27:57,910 --> 00:28:01,350
+عشان نسأل على clients health problems، يعني
+
+457
+00:28:01,350 --> 00:28:04,830
+بينجوسين كل هذا المكتوب و كأنه بيقولّي نسأل عن
+
+458
+00:28:04,830 --> 00:28:08,550
+تاريخ العائلةهل هناك ارتباط بين المرض الموجود عند
+
+459
+00:28:08,550 --> 00:28:11,870
+المريض الآن الحالي وبين الأمراض الموجودة في
+
+460
+00:28:11,870 --> 00:28:15,410
+العائلة؟ وهل هذا مرض ساري؟ عشان اشوف اذا الموضوع
+
+461
+00:28:15,410 --> 00:28:18,770
+genetic فيه ولا لا؟ وهل له علاقة بزواج أقارب او
+
+462
+00:28:18,770 --> 00:28:23,940
+زواج يعني ناس يعني كتير في بعض الناس؟من شدة يعني
+
+463
+00:28:23,940 --> 00:28:27,100
+بتلاقي ابن عمه و هو ابنت عمه و بيزوجوا بعض و
+
+464
+00:28:27,100 --> 00:28:31,520
+النساء برضه بنت عم و قريبات لبعض يعني بتكون ال
+
+465
+00:28:31,520 --> 00:28:35,020
+close relatives فيها problems عشان نقدر نعرف و نحط
+
+466
+00:28:35,020 --> 00:28:40,510
+ايدنا وين بالظبط ال source of problemال family
+
+467
+00:28:40,510 --> 00:28:44,490
+history of communicable disease برضه سؤال العائلة
+
+468
+00:28:44,490 --> 00:28:47,170
+عن المرضى السارية لما نقول كلمة communicable
+
+469
+00:28:47,170 --> 00:28:50,810
+disease هي ايش؟ يعني في عندهم بعض العائلات مرض
+
+470
+00:28:50,810 --> 00:28:54,050
+معين مستوطن يعني مرض شكر موجود عندهم هذول الناس
+
+471
+00:28:54,050 --> 00:28:56,950
+بصير عندهم جلطات في القلب هذه العائلة المعينة في
+
+472
+00:28:56,950 --> 00:29:01,010
+بعض العائلات بالمناسبة يعني عندهم بموتوا بدري مثلا
+
+473
+00:29:01,010 --> 00:29:05,790
+فهم عندهم مشكلة ال source مثلا of problem الموجودة
+
+474
+00:29:05,790 --> 00:29:09,050
+في ال family كله بسجلههل في عندهم مشكلات في ال
+
+475
+00:29:09,050 --> 00:29:12,690
+hereditary يعني مثلا في ال genetic يعني ورثية خاصة
+
+476
+00:29:12,690 --> 00:29:15,210
+العلاقة بال disease كله بكتبه يعني انا ممكن ييجي
+
+477
+00:29:15,210 --> 00:29:19,050
+يقولي هو لحالي يقولي احنا عيلتنا فيها مرض كده
+
+478
+00:29:19,050 --> 00:29:23,190
+بدونه هل في عنده strong family history of certain
+
+479
+00:29:23,190 --> 00:29:26,550
+problem هل في مشكلة في العيلة يعني الكلام بعيد
+
+480
+00:29:26,550 --> 00:29:31,990
+نفسه اذا في مشكلة حقيقية في العيلة بكتبها بتطلع
+
+481
+00:29:31,990 --> 00:29:34,810
+خاصة في موضوع ال maternal وال parents موضوع
+
+482
+00:29:34,810 --> 00:29:40,220
+الأمهات والآباءالأقارب والعمات والخالات يعني أنا
+
+483
+00:29:40,220 --> 00:29:44,200
+بسأل بشكل عام انه اتذكر يا أستاذ او اتذكر يا حجة
+
+484
+00:29:44,200 --> 00:29:48,080
+او اتذكر يا حجة اذا في حد زي هي كان عنده يعني في
+
+485
+00:29:48,080 --> 00:29:52,280
+نفس غيلتكم عشان هذا كله بفيدكم عشان احنا بدنا
+
+486
+00:29:52,280 --> 00:29:56,600
+نستفيد ومابدناش احنا نستعجل في انه نحكم عليكم ان
+
+487
+00:29:56,600 --> 00:30:00,660
+هذا السبب من كده او من كده في بعض الحالات بيجي
+
+488
+00:30:00,660 --> 00:30:02,940
+نسأل ال cause of death of the family members
+
+489
+00:30:03,500 --> 00:30:06,120
+immediate and extended family طبعا لما نقول كلمة
+
+490
+00:30:06,120 --> 00:30:09,120
+immediate العائلة القريبة العائلة البسيطة العائلة
+
+491
+00:30:09,120 --> 00:30:12,060
+النووية الأب و الأم و الأولاد لما نقول extended
+
+492
+00:30:12,060 --> 00:30:16,420
+يعني اللي هو الأعمام و الجد و البني العمومة هذا
+
+493
+00:30:16,420 --> 00:30:19,880
+كله إيه؟ يسموه العائلة الممتدة ده طب ليش بتسأل؟
+
+494
+00:30:19,880 --> 00:30:23,860
+الجد بقى بتبسأل لأن أنا مرت عليه حالات أنه مثلا
+
+495
+00:30:23,860 --> 00:30:29,560
+بيجي مريض صار عمره مش كبير خمسين سنة صار أدوكادك
+
+496
+00:30:29,560 --> 00:30:33,510
+أرسله ماتكمان مرة، نفس .. نفس العمر كاردك أرسته
+
+497
+00:30:33,510 --> 00:30:36,590
+مات، ابليش بنسأل بيقول طب ليش مرتين كاردك أرسته؟
+
+498
+00:30:36,590 --> 00:30:39,210
+وين المشكلة اللي موجودة؟ عشان أنا أقدر أعرف وين
+
+499
+00:30:39,210 --> 00:30:41,830
+المشكلة الموجودة، بيجيب ويقولي والله لأ احنا في
+
+500
+00:30:41,830 --> 00:30:45,210
+العائلة في عندنا cause of death، على عمر محدد
+
+501
+00:30:45,210 --> 00:30:49,270
+بيصير كاردك أرسته، ليش؟ لأن كل عيلتنا عندنا ال
+
+502
+00:30:49,270 --> 00:30:53,660
+cholesterol دايما عاليواحد من مرة يعني لجاني وقال
+
+503
+00:30:53,660 --> 00:30:55,880
+لي انا فحصت ال cholesterol بقوله ليش انتوا
+
+504
+00:30:55,880 --> 00:30:58,880
+مشكلتكوا زي هيك معظمكوا فاتفاجأت ال cholesterol
+
+505
+00:30:58,880 --> 00:31:02,820
+يعني up to 200 يعني ممكن يكون يصل ل 200 وهذا
+
+506
+00:31:02,820 --> 00:31:07,760
+normal بطل اللي هو عنده 570 انا انساقت فبس انه
+
+507
+00:31:07,760 --> 00:31:10,360
+بقوله ليش قاللي احنا هيك بطلع انه يعني مش شرط
+
+508
+00:31:10,360 --> 00:31:12,800
+بتقولولي ان هو من ال sedentary life عشان هو جاعد
+
+509
+00:31:12,800 --> 00:31:16,840
+او كزلاءلا ممكن ماعيش .. خلاص هم أيه كده، هذول
+
+510
+00:31:16,840 --> 00:31:19,500
+الناس العيلة تقول بإننا نهتم لهم و نسير نعطيهم
+
+511
+00:31:19,500 --> 00:31:23,960
+دائما أولى الاهتمام في موضوع العلاجات و موضوع ال
+
+512
+00:31:23,960 --> 00:31:26,380
+future خليني أقول health عشان يقدر .. يعني ممكن
+
+513
+00:31:26,380 --> 00:31:29,440
+نعطيهم علاجات خافقة لكوليسترول و دائما متابعة لمرض
+
+514
+00:31:29,440 --> 00:31:32,300
+القلب عشان مايجعش في أي إشكالية خليني نجح لعند
+
+515
+00:31:32,300 --> 00:31:37,100
+environmental history عشان الآن صار عن .. يعني 31
+
+516
+00:31:37,100 --> 00:31:39,960
+دقيقة يكفي ذلك والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..53f22bcc6dfa05e3325db585bf6540eafd7eb2d7
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/RWoeto-uk-A_raw.srt
@@ -0,0 +1,2064 @@
+1
+00:00:00,450 --> 00:00:02,730
+أعوذ بالله من الشرفان الرجيم بسم الله الرحمن
+
+2
+00:00:02,730 --> 00:00:05,650
+الرحيم والصلاة والسلام على أشرف المرسلين سيدنا
+
+3
+00:00:05,650 --> 00:00:09,330
+محمد وعلى أليه وصحبه وسلم أما بعد أبنائي وابنتي
+
+4
+00:00:09,330 --> 00:00:13,110
+طلبة المستوى الثاني المسجلين لمساق التقييم الصح
+
+5
+00:00:13,110 --> 00:00:15,890
+التمردى اليوم هنبدأ ان شاء الله في ال chapter
+
+6
+00:00:15,890 --> 00:00:18,930
+التالت اللي هو ال health history وان شاء الله
+
+7
+00:00:18,930 --> 00:00:22,750
+تستفيدوا معانا الان ال health history أنا حكيت
+
+8
+00:00:22,750 --> 00:00:26,080
+لمحة بسيطة في بداية ال chapterالأولان اللى كان فى
+
+9
+00:00:26,080 --> 00:00:29,300
+introduction و اللى كان فى .. و حكيته انه مش كله
+
+10
+00:00:29,300 --> 00:00:31,080
+موجود فى الكتابة و أنا قلتلكوا موجود كله على ال
+
+11
+00:00:31,080 --> 00:00:34,420
+powerpoint اللى انا حطيتها على ال model و أنا
+
+12
+00:00:34,420 --> 00:00:37,580
+قلتلكوا كله هنسير نتناول اتباعه عن سواء ال NAND او
+
+13
+00:00:37,580 --> 00:00:40,820
+غيره او يعني ال nursing care plan as a general
+
+14
+00:00:40,820 --> 00:00:43,560
+اللى أخدناه في السنة الأولى لكن انا هظن أشرع عشان
+
+15
+00:00:43,560 --> 00:00:48,210
+اوضح الأمور بشكل أوضح و ارتب ان شاء اللهالتعريف
+
+16
+00:00:48,210 --> 00:00:51,150
+اللي هو ال health history أنا مابتدأش يعني ندخل في
+
+17
+00:00:51,150 --> 00:00:54,290
+التفاصيل عميقة و مابقولك يعني تحفظها بالضبط لكن
+
+18
+00:00:54,290 --> 00:00:57,210
+على الأقل تفهم شو يعني ال health history عبارة عن
+
+19
+00:00:57,210 --> 00:00:59,650
+systematic collection of subjective and objective
+
+20
+00:00:59,650 --> 00:01:03,470
+data لكن هذا بدي يريحنا و يذكرنا في زمان انه يعني
+
+21
+00:01:03,470 --> 00:01:06,880
+كأنه بس بدي نعيد الكلام كمان مرةبدى يقولنا انه
+
+22
+00:01:06,880 --> 00:01:10,620
+دربالك احنا بنجمع معلومات طبعا اللى كويس فيها انه
+
+23
+00:01:10,620 --> 00:01:14,700
+سماها systematic يعني معلومات منتظمة يتم جمعها من
+
+24
+00:01:14,700 --> 00:01:18,600
+ال client عشان نقدر المعلومة عشان نقدر المعلومات
+
+25
+00:01:18,600 --> 00:01:24,600
+هذه اللى بنطبقها يعنى ونفهم منها الأمور بشكل نطبق
+
+26
+00:01:24,600 --> 00:01:29,120
+هذه المعلومات طبعا بكرا في لما بدى أصيغي problems
+
+27
+00:01:29,120 --> 00:01:32,480
+لما بدى أعمل نفسي ال diagnosis بدى أشوف ال science
+
+28
+00:01:32,480 --> 00:01:36,260
+أشوف ال symptomsبدأ أعمل follow up ل ال case و
+
+29
+00:01:36,260 --> 00:01:39,360
+هكذا طبعا كلكوا عارفين شو الفرق بين ال subjective
+
+30
+00:01:39,360 --> 00:01:42,540
+و ال objective احنا مش مصدد ان نعيد و نكرر نفس
+
+31
+00:01:42,540 --> 00:01:46,560
+الموضوع باختصار لما قلنا كلمة لجيتها ها vital
+
+32
+00:01:46,560 --> 00:01:50,580
+signs ال vital signs شغلات يعني ماقدراش نجيسها
+
+33
+00:01:50,580 --> 00:01:54,660
+حرارة، ضغط، التنفس، بنجيسهم، الآن بنتطلع على إيش؟
+
+34
+00:01:54,660 --> 00:01:57,880
+طبعا شغل هو بشكيها، لجيت الآن في شغل اللي أنا
+
+35
+00:01:57,880 --> 00:02:02,350
+بشكيها المريضو بقدر انا بقدر والله انا مش عارف
+
+36
+00:02:02,350 --> 00:02:05,130
+اخدها الا منه، هذه انا مابقدر، subjective انا
+
+37
+00:02:05,130 --> 00:02:09,790
+مابقدرش اشوفها، لكن لو اشي انا بجيسه، انا بجيسه و
+
+38
+00:02:09,790 --> 00:02:13,790
+باخد منه معلومات و بقدر ادقنه و observed يعني ممكن
+
+39
+00:02:13,790 --> 00:02:17,510
+ان انا اقدر الاحظها، هذا بنسميه ايش هذا؟ بنسميه
+
+40
+00:02:17,510 --> 00:02:20,590
+objective، هي عشان كتبنا objective اللي هو بتكون
+
+41
+00:02:20,590 --> 00:02:24,940
+هنا observed by the trainersالنان ده ميدناش ندخل
+
+42
+00:02:24,940 --> 00:02:27,760
+بالتفاصيل العميقة لان لكن ميدنقول ان ال North
+
+43
+00:02:27,760 --> 00:02:31,160
+American Nursing Diagnosis Association اللي اتأسست
+
+44
+00:02:31,160 --> 00:02:36,100
+في 1994 هي اول منظمة امريكية او انظمة عالمية
+
+45
+00:02:36,100 --> 00:02:40,220
+بتاعنا بال nursing diagnosis وفرقت بين ال nursing
+
+46
+00:02:40,220 --> 00:02:44,300
+diagnosis و بين ال medical diagnosis وخلت التمريض
+
+47
+00:02:44,300 --> 00:02:50,010
+يلو دور أساسي في موضوع انه كيف يصليعني على عتبات
+
+48
+00:02:50,010 --> 00:02:53,530
+الرعاية الصحية المتميزة مش يبقى دائما يعني as a
+
+49
+00:02:53,530 --> 00:02:57,170
+follower يعني يكون تابع وخلاص ينفذ لأ صار انه في
+
+50
+00:02:57,170 --> 00:03:01,210
+حاجة independent role دور يعني صراحة مستقل و بيقدر
+
+51
+00:03:01,210 --> 00:03:04,630
+يجوم بيه الان طب ايش تعريف ال nursing diagnosis
+
+52
+00:03:04,630 --> 00:03:09,550
+clinical judgment about individual حكم كليكي about
+
+53
+00:03:09,550 --> 00:03:13,250
+individual على المريض family community responses
+
+54
+00:03:13,250 --> 00:03:17,070
+to actual and potential health problems and life
+
+55
+00:03:17,590 --> 00:03:20,750
+responses يعني هو كأنه بيقوللي ال nursing
+
+56
+00:03:20,750 --> 00:03:24,230
+diagnosis عبارة عن صيغة إيه كلينيكية؟تعنى بإيش
+
+57
+00:03:24,230 --> 00:03:28,490
+بصيغة مشكلة تهم المريض أو العائلة أو حتى المجتمع
+
+58
+00:03:28,490 --> 00:03:32,830
+بشكل عام اللي موجود بحيث انه احنا نقدر نحل هذه
+
+59
+00:03:32,830 --> 00:03:36,050
+المشكلة هذه تعتبر health problem وانا بدي احاول
+
+60
+00:03:36,050 --> 00:03:41,230
+اعمل حل لها علشان اقدر اتعامل او يعني افهم ايش ال
+
+61
+00:03:41,230 --> 00:03:44,670
+follow up ايش اللي بدي يصير بعد ذلك هل بدي يصير
+
+62
+00:03:44,670 --> 00:03:47,450
+complication هل بدي اتطور حالته هل بدي اتروح
+
+63
+00:03:47,450 --> 00:03:52,230
+negative او positive للمريض اللي اماميphases of
+
+64
+00:03:52,230 --> 00:03:55,470
+taking health history كيف باخد health history باخد
+
+65
+00:03:55,470 --> 00:03:59,630
+بإيش مرحلتين ال health history تأخد بإيش بمرحلتين
+
+66
+00:03:59,630 --> 00:04:02,270
+المرحلة الأولى اسمها interview طبعا المرحلة طويلة
+
+67
+00:04:02,270 --> 00:04:05,570
+هذا ال interview و هحكي فيها كتير المرحلة التانية
+
+68
+00:04:05,570 --> 00:04:09,610
+recording phase يعني شوفوا احنا قلنا يمكن اختلافنا
+
+69
+00:04:09,610 --> 00:04:13,410
+عن باق المهن الصحية الأخرى من الطب لغيره ان هم
+
+70
+00:04:13,410 --> 00:04:18,610
+ممكن تصير عملية ال assessment و في الآخر يعني يتم
+
+71
+00:04:18,610 --> 00:04:22,600
+عملية التدوينبعد ما نشوف أكتر من حالة، احنا لأ،
+
+72
+00:04:22,600 --> 00:04:26,220
+نتكلم بشكل واضح انه اللي .. اللي بتسير معنا انه
+
+73
+00:04:26,220 --> 00:04:30,040
+احنا بدنا نقعد مع المريض و ناخد المعلومات
+
+74
+00:04:30,040 --> 00:04:33,080
+الأساسية، المعلومات الكاملة و نعمل summarization
+
+75
+00:04:33,080 --> 00:04:36,720
+زي ما اتفقنا و بعدين دغري أدونها علشان انا ماسيرش
+
+76
+00:04:36,720 --> 00:04:40,690
+يعني إيش أتذكرليش؟ لأنه قال قولنا زمان don't rely
+
+77
+00:04:40,690 --> 00:04:45,410
+on memory، يعني دائما ما تعتمدش على الذاكرة، يعني
+
+78
+00:04:45,410 --> 00:04:49,150
+ما تقولش I must remember، no حاول تكتب أول ما قول،
+
+79
+00:04:49,150 --> 00:04:52,670
+لأن ال documentation يعتبر خط دفاع أول عن التمريد
+
+80
+00:04:52,670 --> 00:04:58,070
+بشكل أساسي، طيب الآن ال guidelines ل taking إيش
+
+81
+00:04:58,070 --> 00:05:00,650
+أنا nursing history، كيف بدي أخد أول حاجة دي،
+
+82
+00:05:00,650 --> 00:05:03,720
+أعطاني توجيهاتال guide ده زي التوجيهات العامة زي
+
+83
+00:05:03,720 --> 00:05:06,580
+حكاية ال canyon لما بقولك guide بتعمل guide يعني
+
+84
+00:05:06,580 --> 00:05:10,300
+اشي بوجهك وين رايح زي الإبرة اللي بتكون في داخل ال
+
+85
+00:05:10,300 --> 00:05:13,340
+canyon اللي بتعملك guide وانت بقرا لما تركب ال
+
+86
+00:05:13,340 --> 00:05:17,500
+canyon لها الان اول حاجة private comfortable and
+
+87
+00:05:17,500 --> 00:05:22,160
+quiet environment بدنا نختار اول حاجة البيئة
+
+88
+00:05:22,160 --> 00:05:26,240
+المناسبة الهادية مايكونش فيلي حوالي ناس كتير مع
+
+89
+00:05:26,240 --> 00:05:30,540
+المريض واهمة في الموضوع اول كلمة privateطبعا كلمة
+
+90
+00:05:30,540 --> 00:05:34,120
+private يعني احط في بالكوا privacy يعني احط في
+
+91
+00:05:34,120 --> 00:05:37,860
+بالكوا confidentiality السرية و الكتمان و لازم انا
+
+92
+00:05:37,860 --> 00:05:40,820
+احافظ عليها حاضر عشان المريض يطمئن و يعطيني ال
+
+93
+00:05:40,820 --> 00:05:43,820
+history اللي بعد بقول allow the client to state
+
+94
+00:05:43,820 --> 00:05:46,960
+problems and expectations ايه هنا for the
+
+95
+00:05:46,960 --> 00:05:50,860
+interview يعني قبل كل حاجة خلي المريض نفسهإذا في
+
+96
+00:05:50,860 --> 00:05:55,040
+عندهم مشكلة أو مشاكل معينة يحكي أو متوقع أشياء
+
+97
+00:05:55,040 --> 00:05:59,340
+معينة عن ال interview يتكلم يعني مثلا احنا طالب من
+
+98
+00:05:59,340 --> 00:06:03,080
+سنة تانية السلام عليكم وحابب أعمل معاك مقابلة هذا
+
+99
+00:06:03,080 --> 00:06:06,040
+لمصلحتك بيجي يقولك طب لا إيش المقابلة هذا اسمها
+
+100
+00:06:06,040 --> 00:06:08,640
+expectation أو بيجي يقولك بس ما تكونش معلومة
+
+101
+00:06:08,640 --> 00:06:12,280
+تروحها expectation خل المريض يتكلم اللي في نفسه
+
+102
+00:06:12,280 --> 00:06:17,140
+قبل ما نبدأ طيب بعد إيش أنا orient لما يقولي
+
+103
+00:06:17,140 --> 00:06:19,980
+orient client بدك تعطي إيش أنا مش تعرف عن نفسك لأ
+
+104
+00:06:20,280 --> 00:06:23,200
+احنا عرفنا عن نفسنا لما دخلنا عند المريض لكن انا
+
+105
+00:06:23,200 --> 00:06:25,800
+بتعريفه عن إيش ال structure و ال purpose و ال
+
+106
+00:06:25,800 --> 00:06:29,780
+expectation of the history يعني ايه كويس انكله هذه
+
+107
+00:06:29,780 --> 00:06:34,980
+عبارة عن شيء منظملك و الغرض منه الأساسي انه احنا
+
+108
+00:06:34,980 --> 00:06:38,240
+بناخد معلومات يمكن تفيدك في علاجك و ان شاء الله مش
+
+109
+00:06:38,240 --> 00:06:42,640
+هتضرك و يمكن نتوقع انه هذه اتغير مسار العلاج او
+
+110
+00:06:42,640 --> 00:06:45,460
+اذا في أشياء معينة لازم نحكيها للطبيب نحكيها و
+
+111
+00:06:45,460 --> 00:06:48,240
+احنا مطمئنين هذا الامر كله بنعطيه الامين للمريض
+
+112
+00:06:48,240 --> 00:06:52,240
+الكلام قبل ما احنا نبدأ طيببقول لي communicate and
+
+113
+00:06:52,240 --> 00:06:55,720
+negotiate priorities with the client و احنا نتذكر
+
+114
+00:06:55,720 --> 00:06:59,480
+في سنة أولى كلمة negotiation معناه تتفاوت، بقوللي
+
+115
+00:06:59,480 --> 00:07:02,840
+اول حاجة communicate يعني تواصل، negotiate يعني
+
+116
+00:07:02,840 --> 00:07:06,360
+تفاوت، طب ايش بقوللي انا priorities الأولويات،
+
+117
+00:07:06,360 --> 00:07:10,820
+يعني انا مابديش تبدأ على كيفك كممرض او كممرضة
+
+118
+00:07:10,820 --> 00:07:15,600
+حكيمةما بنفعش نبدأ زي ما بدنا من وين نسأل، يمكن
+
+119
+00:07:15,600 --> 00:07:18,860
+المريض مثلا احنا بدنا نسأله، بنقوله مثلا احنا
+
+120
+00:07:18,860 --> 00:07:22,720
+والله بدنا نسألك عن صحتك وعن وضعتك وعن مرضك وعن
+
+121
+00:07:22,720 --> 00:07:28,800
+الأعراض اللي عندك، يمكن هو يقول لحانه ايش رأيك يا
+
+122
+00:07:28,800 --> 00:07:34,740
+أستاذ تبدأ معاي في وضعي العائلي أو في وضعي النوم؟
+
+123
+00:07:34,740 --> 00:07:37,520
+طبعا لما بيقولي ايش رأيك، هذا اسمه negotiate،
+
+124
+00:07:37,520 --> 00:07:41,780
+communicateأنا مش مستعجل باخد منه يعني ما المانع
+
+125
+00:07:41,780 --> 00:07:44,140
+أنه أبدأ بدل مبدأ بال size و ال symptoms ببدأ
+
+126
+00:07:44,140 --> 00:07:47,200
+بحاجات تانية ماعناه مشكلة يمكن التفاوت مع المريض
+
+127
+00:07:47,200 --> 00:07:50,220
+من مصطحد المريض أنه يحط ال priorities من وين أبدأ
+
+128
+00:07:50,220 --> 00:07:53,680
+حاجة بعدين مش بيقول الخانين الذاكرين listen more
+
+129
+00:07:53,680 --> 00:07:58,020
+than talk مايزعلوش مني دائما المشكلة احنا بنحب
+
+130
+00:07:58,020 --> 00:08:01,520
+الكلام لكتير لأ هو بيقولك دائما اسمع اكتر من ما
+
+131
+00:08:01,520 --> 00:08:04,400
+تحكي على فكرة حتى لما نتقضي بكرة في سنة رابعة ان
+
+132
+00:08:04,400 --> 00:08:10,170
+شاء اللههتذكروا الكلام معايا من 65 ل 70 سماع في
+
+133
+00:08:10,170 --> 00:08:14,080
+المية طبعاويدهم تلاتين في المية يدهم ربما يمكن أقل
+
+134
+00:08:14,080 --> 00:08:17,900
+لازم يكون هو ايش كلام ليه اش .. لأن احنا كتير
+
+135
+00:08:17,900 --> 00:08:21,860
+الكلام مرات بيتعب فانا كل ما بسمع كل ما بركز اكتر
+
+136
+00:08:21,860 --> 00:08:25,740
+للمريض كل ما بضن اقاطعه مش هيفعشان هيك انا بد اسمع
+
+137
+00:08:25,740 --> 00:08:29,880
+هذا المصطلح ليه مش للمريض يعني انا لازم اسمع اكتر
+
+138
+00:08:29,880 --> 00:08:33,560
+من ايه من الحكي بعدين ايش بيقولي هنا observe non
+
+139
+00:08:33,560 --> 00:08:36,560
+verbal communications شو المقصود في هذا ال body
+
+140
+00:08:36,560 --> 00:08:39,820
+language اللي ال body language ال voice tone نقبة
+
+141
+00:08:39,820 --> 00:08:43,770
+الصوتال appearance المظهر، الآن في مثل على فكرة
+
+142
+00:08:43,770 --> 00:08:47,810
+حلو كان زوجوله زمان يسمع كلامك أصدقك أو أصدقك زي
+
+143
+00:08:47,810 --> 00:08:52,090
+ما يقولونها و أشوف أفعالك أستعجب أو أستغرب، إيش
+
+144
+00:08:52,090 --> 00:08:55,330
+المعنى؟ المعنى هنا إن الإنسان ممكن كل واحد فينا
+
+145
+00:08:55,330 --> 00:08:58,580
+يحكي كلام حلو، زي ما يقعد يقول أتانى أنا بحبكأو
+
+146
+00:08:58,580 --> 00:09:02,560
+انا اقولها كذا زي اللي خدناها زمان بسموها double
+
+147
+00:09:02,560 --> 00:09:05,760
+orders او dual orders اللي خدناها السنة الأولى انه
+
+148
+00:09:05,760 --> 00:09:09,880
+الاب لما انطلب من الولد اذا حابب تطلع تلعب العب
+
+149
+00:09:09,880 --> 00:09:12,380
+برا لكن كان شريله حذاء جديد و ماعرفوش خاطر يطلع
+
+150
+00:09:12,380 --> 00:09:17,260
+فهو ايش بقول هنا احنا عشان نكون صادقين بنسمع
+
+151
+00:09:17,260 --> 00:09:20,460
+المريض و بنطلع و احنا بنسمع بنلاحظ ال body
+
+152
+00:09:20,460 --> 00:09:23,700
+language لازم يكون عندك و عندك حاجة اسمها clinical
+
+153
+00:09:23,700 --> 00:09:28,090
+sense ال clinical sense يعني حس ايش حس كليكيكيف
+
+154
+00:09:28,090 --> 00:09:31,850
+يحس كلينيكيا؟ أنا لما كنت أشتغل في زمان في الوزارة
+
+155
+00:09:31,850 --> 00:09:34,610
+يعني يمكن قبل 25 سنة أعرف اللي عنده appendicitis
+
+156
+00:09:34,610 --> 00:09:38,250
+قبل ما يحكي، حاطط إيده على جنبه اليمين و امطمل،
+
+157
+00:09:38,250 --> 00:09:41,090
+خلاص appendicitis، حاطط إيده على .. مثلا على جافة
+
+158
+00:09:41,090 --> 00:09:44,110
+دهره من ورا و عماله مش قادر يمشي بقول له back pain
+
+159
+00:09:44,110 --> 00:09:49,110
+و هكذا، هذا مش تخمين، مش كأننا بنضرب بالمندل، لأ،
+
+160
+00:09:49,110 --> 00:09:52,490
+الجثة كيف هنا أنه بيصير عندنا clinical sense طيب،
+
+161
+00:09:52,490 --> 00:09:55,130
+أنا بدأ أسمع من المريض و بدأ أشوف ال body language
+
+162
+00:09:55,530 --> 00:09:58,430
+لو حد سألنا مين أصدق ال body language more
+
+163
+00:09:58,430 --> 00:10:02,390
+accurate لكن ايانا نروح نقول للمريض بس انت بتحكيك
+
+164
+00:10:02,390 --> 00:10:05,410
+لكن انت مبين عليك متوتر يعني انا ممكن اقولك والله
+
+165
+00:10:05,410 --> 00:10:08,210
+أنا الحمد لله مبسوط و انا شاعر حالي كويس لكن هو
+
+166
+00:10:08,210 --> 00:10:11,370
+بيحكي بيحكي بنبرة اتغضب بنبرة قاعد برجع عنده
+
+167
+00:10:11,370 --> 00:10:14,550
+ragors او عنده يعني aggressiveness بينفعش ايش
+
+168
+00:10:14,550 --> 00:10:18,450
+اقوله هي بس مش مبين عليك انت بتكذب علينا انت بتمزح
+
+169
+00:10:18,450 --> 00:10:22,070
+لأ بيصير مشكلة احنا بناخد و بندون لكن بنقول ال
+
+170
+00:10:22,070 --> 00:10:26,960
+body language عنده واحد اتنين تلاتة طيبالان اش
+
+171
+00:10:26,960 --> 00:10:30,120
+بقول هي review information about past history انا
+
+172
+00:10:30,120 --> 00:10:33,580
+عندي past history من اول قبل ما ابدا يعني انا عندي
+
+173
+00:10:33,580 --> 00:10:36,540
+معلومات مش هو الاستاذ اش جالناه هيقول للاستاذ قبل
+
+174
+00:10:36,540 --> 00:10:38,960
+ما تخش على المريض دايما اقرا الملف هذه قبل ما اقرا
+
+175
+00:10:38,960 --> 00:10:41,740
+الملف يعني قبل ما اروح على المريض اقرا الملف يمكن
+
+176
+00:10:41,740 --> 00:10:45,040
+المريض يكون infected يمكن معدي يمكن المريض يكون في
+
+177
+00:10:45,040 --> 00:10:48,040
+عنده embarrassing something يعني شيء معرج علشان
+
+178
+00:10:48,040 --> 00:10:54,400
+هيك بقول ليه اطلع اقرا قبل ما تروح عشان انت تعمل
+
+179
+00:10:54,400 --> 00:10:58,370
+ايش مراجعة للمعلومات حاضربعدين بقولي balance، إيش
+
+180
+00:10:58,370 --> 00:11:01,350
+يعني balance؟ ال balance معناته توازن، إيش يعني
+
+181
+00:11:01,350 --> 00:11:05,210
+توازن؟ بقول خليك عامل توازن، لإيش التوازن؟ بدك
+
+182
+00:11:05,210 --> 00:11:08,490
+تعمل توازن بين انه تخلي المريض يحكي allowing the
+
+183
+00:11:08,490 --> 00:11:13,010
+client to talk in a unstructured manner and the
+
+184
+00:11:13,010 --> 00:11:16,570
+need to structure requested information، شو يعني؟
+
+185
+00:11:16,570 --> 00:11:20,230
+unstructured يعني مش منتظم، شو يعني؟ بقولي يا ريد
+
+186
+00:11:20,230 --> 00:11:23,890
+تعمل توازن و أنت بتحكي معاهالمريض، يعني يمكن
+
+187
+00:11:23,890 --> 00:11:27,570
+المريض هو بيحكي، بيحكي، بيحكي، صار خربط، ليه صار
+
+188
+00:11:27,570 --> 00:11:31,910
+خربط؟ يعني صار يجي بشمال و يحط عيمين، أنا مش فاهم،
+
+189
+00:11:31,910 --> 00:11:35,170
+صار اسمه unstructured manner، شو أنا بقوله؟ طب لو
+
+190
+00:11:35,170 --> 00:11:39,950
+سمحت، بس أنت على مهل، ركز في علوماتك، يعني أنت ركز
+
+191
+00:11:39,950 --> 00:11:44,900
+في اللي أنا طلبته منكهدى وشوف ايش اللى بتلاقي زى
+
+192
+00:11:44,900 --> 00:11:48,180
+اللى صفط الكلمات تصفيت ورتبها هذا ايش معناه نعمل
+
+193
+00:11:48,180 --> 00:11:51,400
+balance يعني من حين لآخر بتاك تعمل توازن بالكلام
+
+194
+00:11:51,400 --> 00:11:54,520
+بينك و بين المريض و تخليه يحاول يحكي شوي شوي
+
+195
+00:11:54,520 --> 00:11:59,080
+براحته عشان تقدر تستفيد منه طب لو حكى شغلات غامضة
+
+196
+00:11:59,080 --> 00:12:03,160
+بقول clarify the clients definitions terms and ايش
+
+197
+00:12:03,160 --> 00:12:08,570
+ايش هنا descriptions و الاوصال يعنييمكن أنا المريض
+
+198
+00:12:08,570 --> 00:12:11,470
+حكى كلمة أنا مافهمتهاش مش غلط و مش عايز بقوله
+
+199
+00:12:11,470 --> 00:12:15,610
+ماعليش إيش قصدك فيها دي زي ما هو بيسألني و بيقولي
+
+200
+00:12:15,610 --> 00:12:18,890
+إيش قصدك يعني لما أنت بتقولي بتاخد history ممكن
+
+201
+00:12:18,890 --> 00:12:21,790
+تطعملني كلمة عرفها ويا اقول لأ history بتاخد منك
+
+202
+00:12:21,790 --> 00:12:26,890
+معلومات لمصلحتك لحياتك نشوف إيش هو كذلك لما يحكي
+
+203
+00:12:26,890 --> 00:12:30,850
+كلمات يمكن أنت مثلا تشوفها غامضة خليه يحكيها و أنا
+
+204
+00:12:30,850 --> 00:12:35,650
+باسأله عنها عشان أستفيد أكتر avoid yes or no
+
+205
+00:12:35,650 --> 00:12:39,100
+questions إيش بيقول يعنيبقولي ابعد عن ال yes or no
+
+206
+00:12:39,100 --> 00:12:42,520
+questions لأن الأسئلة دي شويه مزعجة بعدين
+
+207
+00:12:42,520 --> 00:12:44,620
+بنستخدمها في الموضوع ال listed questions زي ما
+
+208
+00:12:44,620 --> 00:12:47,580
+احنا قلنا زي الموضوع ال smoking مثلا does you
+
+209
+00:12:47,580 --> 00:12:50,140
+smoke جاله مثلا no او do you smoke جاله no او yes
+
+210
+00:12:50,140 --> 00:12:53,560
+هذا شيء تاني مثلا انت بتعتبر حالك obese yes or no
+
+211
+00:12:53,560 --> 00:12:57,720
+هذا شيء تاني لكن هو بيقولي حاول قدر الإمكان تبعد
+
+212
+00:12:57,720 --> 00:13:00,660
+عن ال yes or no ليه اذا انت بدك detail ايش عن
+
+213
+00:13:00,660 --> 00:13:05,120
+detail يعني بدنا معلومات مستفيدة وزيادة يعني كل ما
+
+214
+00:13:05,120 --> 00:13:08,480
+بدي معلومات اكتركل ما ابعد عن ال yes or no
+
+215
+00:13:08,480 --> 00:13:13,180
+questions بقولي كمان write adequate notes for
+
+216
+00:13:13,180 --> 00:13:18,300
+recording ايش يعني اكتب معلومات واضحة كافية
+
+217
+00:13:18,300 --> 00:13:22,080
+للتسجيل ما نكتب معلومات ناقصة يعني اخدت معلومات من
+
+218
+00:13:22,080 --> 00:13:25,080
+المريض انا مابقولش اكتب كل كلامه لكن لما تيجي بدك
+
+219
+00:13:25,080 --> 00:13:28,720
+تعطيني عبارة او للطبيب عبارة تعطيني عبارة تكون
+
+220
+00:13:28,720 --> 00:13:33,600
+واضحةوصريحة نقدر نفهمها .. نقدر نفهمها علشان ما
+
+221
+00:13:33,600 --> 00:13:36,800
+تكونش المعلومة منتقصة يعني مثلا إذا قال والله أنا
+
+222
+00:13:36,800 --> 00:13:40,640
+عندي وجع في اليمين في بطني و أنا بحس أنه بيسمع في
+
+223
+00:13:40,640 --> 00:13:44,660
+ظهري في منطقة كذا نكتبها زي ما هي مش بس بقول مثلا
+
+224
+00:13:44,660 --> 00:13:48,740
+right abdominal مثلا أو quadrant مثلا بين لأ بقول
+
+225
+00:13:48,740 --> 00:13:52,930
+radiate to كذا كذا arearecord nursing health
+
+226
+00:13:52,930 --> 00:13:55,690
+history soon after interview هذا الكلام اللي أنا
+
+227
+00:13:55,690 --> 00:13:58,330
+أكد عليه و دايما بأكد عليه شايفين ايش بقولي soon
+
+228
+00:13:58,330 --> 00:14:02,110
+مجرد ما انخلص ال health history مع المريض فورا
+
+229
+00:14:02,110 --> 00:14:07,350
+بروح بسجنه علشان أقدر أكون ذاكر و أقدر ألخص
+
+230
+00:14:07,350 --> 00:14:11,010
+المعلومات و انا لسه في نفس الحالة و في نفس الدقيقة
+
+231
+00:14:11,010 --> 00:14:16,550
+و في نفس اللحظات types of nursing health history
+
+232
+00:14:17,150 --> 00:14:20,370
+أنواع ال nursing health history عبارة عن تلاتة
+
+233
+00:14:20,370 --> 00:14:24,210
+خليكوا ذاكرين هذا مهم و خلينا نحفظه لما بتاخد
+
+234
+00:14:24,210 --> 00:14:28,530
+health history حاجة كبيرة اسمها complete و حاجة
+
+235
+00:14:28,530 --> 00:14:32,490
+وسط بنسميها interval و حاجة مركزة بنسميها problem
+
+236
+00:14:32,490 --> 00:14:37,510
+focus الكبيرة اسمها ال complete health history ال
+
+237
+00:14:37,510 --> 00:14:40,690
+complete health history بتأخد أول ما يدخل المريض
+
+238
+00:14:40,690 --> 00:14:44,470
+للمستشفى يعني أجى المريض على استقبال فحوله على قسم
+
+239
+00:14:44,470 --> 00:14:49,990
+البطنةأو الجراحة او القلب او اي ان كان يعني اول ما
+
+240
+00:14:49,990 --> 00:14:52,690
+يدخل على القسم هذا بيسموه ال initial visit نسأله
+
+241
+00:14:52,690 --> 00:14:56,830
+قوله قبل يك عمرك نمت في مستشفى قوليه اول مرة قبل
+
+242
+00:14:56,830 --> 00:14:59,830
+ما نعمل اي شيء لازم ناخد منه complete health
+
+243
+00:14:59,830 --> 00:15:04,510
+history طبعا الطبيب بياخد و التمريد بياخد حتى اللي
+
+244
+00:15:04,510 --> 00:15:07,910
+في القسم كمان ايش بياخد يعني ده حد تاني ممكن كلهم
+
+245
+00:15:07,910 --> 00:15:12,050
+ايش ايش يصير عندهم عملية الاخد علشان ايه هذا مفيد
+
+246
+00:15:12,050 --> 00:15:16,390
+للجميع طبعا الان طب لايش هذه المعلوماتبدو ينبني
+
+247
+00:15:16,390 --> 00:15:19,570
+عليها أشياء كتير في الرعاية في المرحلة القادمة
+
+248
+00:15:19,570 --> 00:15:23,530
+interval health history الانش بقول ال interval
+
+249
+00:15:23,530 --> 00:15:27,690
+مرحلية بيسموها، إيش يعني؟ بدك تجمع المعلومات اللي
+
+250
+00:15:27,690 --> 00:15:31,050
+هو in visits following the initial database is
+
+251
+00:15:31,050 --> 00:15:33,450
+collected يعني أعطيكم مثل زي المريض أو المبروه على
+
+252
+00:15:33,450 --> 00:15:36,340
+الطبيبأول مرة دخل إليها ال doctor بيسأله و بيقوله
+
+253
+00:15:36,340 --> 00:15:39,260
+عمره انت أتيت و أنت قالله لأ عمرك عانيت و راح تعمل
+
+254
+00:15:39,260 --> 00:15:42,980
+صحيفة لأ أخد منه المعلومات الكاملة سجلها كلها عنده
+
+255
+00:15:42,980 --> 00:15:46,500
+أرشفها الجد صار يعمل يقوله يعمل .. بدك تجي مراجعات
+
+256
+00:15:46,500 --> 00:15:49,680
+تسمع و تقول للطبيب راجعني بعد سبوع أو بعد عشر أي
+
+257
+00:15:49,680 --> 00:15:54,180
+مراجعة بتصير ال information بتصير هنا بنسميها
+
+258
+00:15:54,180 --> 00:15:57,720
+interval بعد هيك يعني احنا بعد ما احنا قاعدين
+
+259
+00:15:57,720 --> 00:16:00,660
+بناخد معلومات عشان نتأكد من المعلومات الأولانية
+
+260
+00:16:00,660 --> 00:16:03,440
+اللي خدام ال complete طب صارت في عنده مشكلة خاصة
+
+261
+00:16:04,240 --> 00:16:07,920
+بتصير بعد هيك اسمها problem focused health history
+
+262
+00:16:09,640 --> 00:16:13,780
+انا باخد history تركز على ايش التركيز التركيز على
+
+263
+00:16:13,780 --> 00:16:17,220
+المشكلة التركيز على المشكلة اللي صارت عنده زي كيف
+
+264
+00:16:17,220 --> 00:16:20,960
+يعني فرضا المريض فرضا المريض صار عنده يعني بشكي
+
+265
+00:16:20,960 --> 00:16:24,780
+بشكي من مشكلة معينة صارت جديدة يعني هو مثلا كان
+
+266
+00:16:24,780 --> 00:16:28,340
+يروح يراجع القلب ففجأة قال له الدكتور انا صراحة
+
+267
+00:16:28,340 --> 00:16:32,240
+انا بدي اقولك ان في صرفي عندك مشكلة صحية جديدة هذه
+
+268
+00:16:32,240 --> 00:16:36,240
+المشكلة الصحية الجديدة تستدعي انه بدي اعملك قسترة
+
+269
+00:16:36,240 --> 00:16:40,410
+هذا شيء جديدالشيء الجديد هذا ايش بنسميه problem
+
+270
+00:16:40,410 --> 00:16:45,590
+focused يعني انا باخد بس معلومات متركزة حول
+
+271
+00:16:45,590 --> 00:16:49,770
+المشكلة عشان هيك سمنها specific history يعني اشي
+
+272
+00:16:49,770 --> 00:16:53,690
+محدث specific problem هنا عن كل حاجة في حياة
+
+273
+00:16:53,690 --> 00:16:56,970
+المريض هنا في الزيارات المتعاقبة ودخول المريض
+
+274
+00:16:56,970 --> 00:17:00,750
+المتكرر هنا على المشكلة الخاصة اللي احنا بدنا نركز
+
+275
+00:17:00,750 --> 00:17:04,550
+عليها طيب components of health history ال
+
+276
+00:17:04,550 --> 00:17:08,230
+components of health historyأول حاجة في ان هنا
+
+277
+00:17:08,230 --> 00:17:12,370
+لاحظين هذه اسمه بيوغرافيكال داتا يعني المعلومات
+
+278
+00:17:12,370 --> 00:17:15,860
+الأساسيةطبعا المعلومة الاساسية سهلة جدا هذا ممكن
+
+279
+00:17:15,860 --> 00:17:18,920
+نعملها زي ايه زي check list اللي هي الاسم و
+
+280
+00:17:18,920 --> 00:17:23,560
+العنوان و يعني وين ساكن و ال birth date و طيب و
+
+281
+00:17:23,560 --> 00:17:26,780
+الجنس و ال religion طبعا ماجيش اسأله اذا انا موجود
+
+282
+00:17:26,780 --> 00:17:29,860
+في غزا اكيد هاعرف ان هو مسلم يعني مش حلو اني اسأله
+
+283
+00:17:29,860 --> 00:17:32,860
+اقوله لو سمحت ان انا مسلم ولا مسيحي او روحي احد
+
+284
+00:17:32,860 --> 00:17:36,400
+يغلط يعني والله حبيت اسأله من باب التأكيد اشي من
+
+285
+00:17:36,400 --> 00:17:39,280
+باب التأكيد انا ببين الانسان ماريت ال status متجوز
+
+286
+00:17:39,280 --> 00:17:43,410
+مش متجوزsocial security في عنده مثلا تأمين أو يعني
+
+287
+00:17:43,410 --> 00:17:49,150
+مثلا زي قضية لاجئ مواطن بتعالج في السويد، بتعالج
+
+288
+00:17:49,150 --> 00:17:53,450
+في حكومة؟ occupation هل عنده وظيفة؟ كيف تم تحويله
+
+289
+00:17:53,450 --> 00:17:58,670
+للمستشفى؟ في ال health care منهم دايما بروح بتلقى
+
+290
+00:17:58,670 --> 00:18:02,320
+الرعاية، هل من عيادة، هل من عيادة خاصة؟طيب ال
+
+291
+00:18:02,320 --> 00:18:05,460
+source of reliability information المصدر المعلومات
+
+292
+00:18:05,460 --> 00:18:07,980
+الصادقة من وين جيبها يعني الصدق المعلومات تبعتنا
+
+293
+00:18:07,980 --> 00:18:11,980
+هل تمدنا كلها بس على المريض ولا جيبنا معلومات من
+
+294
+00:18:11,980 --> 00:18:15,440
+قريب المريض لما يكون عنده مغيب او كذا ال date of
+
+295
+00:18:15,440 --> 00:18:19,060
+interview تاريخ المقابلة هذي كلها شق واحد اسمه
+
+296
+00:18:19,060 --> 00:18:23,000
+biographical data طيب الآن اللي بعد اسمه chief
+
+297
+00:18:23,000 --> 00:18:26,140
+complaint كتير في ناس بغلطوا فيها بسموه الشكوه
+
+298
+00:18:26,140 --> 00:18:29,220
+الرئيسية لما انا اقولكوا ايش الشكوه الرئيسية يعني
+
+299
+00:18:29,220 --> 00:18:33,420
+reason for hospitalizationلو حد بيسألنا ما المقصود
+
+300
+00:18:33,420 --> 00:18:36,640
+بكلمة ال chief complaint بقى يجيب أقوله يعني ليش
+
+301
+00:18:36,640 --> 00:18:39,080
+أنت جيت على المستشفى، يبقى هاي معناه ال chief
+
+302
+00:18:39,080 --> 00:18:42,860
+complaint لما ييجي للمريض في الباطنة هي أكيد جابته
+
+303
+00:18:42,860 --> 00:18:44,660
+مشكلة باطنه، في الجراحة هي أكيد جابته مشكلة
+
+304
+00:18:44,660 --> 00:18:48,300
+الجراحية، يبقى نيجي بنعطيكم مثال أو أمثلة على ال
+
+305
+00:18:48,300 --> 00:18:52,640
+chief complaint عشان كتير بعض الناس بيخربطوا فيها،
+
+306
+00:18:52,640 --> 00:18:56,040
+بيجي بقول chest pain for three days، بقول والله يا
+
+307
+00:18:56,040 --> 00:18:59,560
+شيخ أنا عندي وجع في صدري، بس أنا ذاكر اليومين أو
+
+308
+00:18:59,560 --> 00:19:03,560
+تلاتة، بسهذه chief complaint لكن لو كان ليه old
+
+309
+00:19:03,560 --> 00:19:07,060
+problem بعتبرهاش chief complaint لأ خلاص بعتبرها
+
+310
+00:19:07,060 --> 00:19:11,180
+old history واحد بيقول لي في عن مثلا هنا swelling
+
+311
+00:19:11,180 --> 00:19:14,560
+ankles for two weeks طب ليش؟ بقول والله كنت ألعب
+
+312
+00:19:14,560 --> 00:19:17,200
+كورة اتفجأت اني مرة و جاعت و انا مااخدتش فيه ولا
+
+313
+00:19:17,200 --> 00:19:21,140
+اعطيت وانتفخت ال ankles عندي تحت وانا المرفق هذا
+
+314
+00:19:21,140 --> 00:19:24,920
+مش عارف صار عندي ال joint متعبني و صار انا منتفق
+
+315
+00:19:24,920 --> 00:19:27,860
+okay هذا برضه chief complaint اجت على المستشفى
+
+316
+00:19:27,860 --> 00:19:31,630
+fever قداش ال fever عندك headache؟والله حوالي الى
+
+317
+00:19:31,630 --> 00:19:35,130
+يمكن 12 الى 24 ساعة، يمكن يعني اليوم، دغري من
+
+318
+00:19:35,130 --> 00:19:38,270
+جيبه، باب سمير needed، في بعض الحالات كلمة باب
+
+319
+00:19:38,270 --> 00:19:41,190
+سمير هذه هي ال screening نعملها لل female خاصة
+
+320
+00:19:41,190 --> 00:19:45,930
+يعني من ال cervix يعني بناخده من ال cervix of the
+
+321
+00:19:45,930 --> 00:19:48,590
+uterus عشان لما نبدأ نعمل بعض الفحص، يعني بتيجي ال
+
+322
+00:19:48,590 --> 00:19:51,430
+set بتقول أنا جاية عشان أعمل هذا الفحص، هو فحص
+
+323
+00:19:51,430 --> 00:19:55,050
+عالمي ومعروف عشان يكتشف whether في لا سمح الله أي
+
+324
+00:19:55,050 --> 00:19:58,650
+carcinogenic somethingاللي بعد بيجي بعض الناس
+
+325
+00:19:58,650 --> 00:20:00,230
+بيقولك انا جاي لأ انا جاي عشان physical
+
+326
+00:20:00,230 --> 00:20:03,770
+examination ليه for مثلا بكتاب ليه needed for camp
+
+327
+00:20:03,770 --> 00:20:07,090
+مش شرط يكون camp ممكن واحد يقولك لأ انا جاي اعمل
+
+328
+00:20:07,090 --> 00:20:10,950
+فحص كامل لياقى لإن انا بده التحق بده .. ب ..
+
+329
+00:20:10,950 --> 00:20:14,430
+deploy شرطة او انا بده اتوظف او انا بده كده ايا
+
+330
+00:20:14,430 --> 00:20:16,930
+كان هذه كلها ايش اسمها chief complaint شكوهة
+
+331
+00:20:16,930 --> 00:20:21,830
+رئيسية طيب رقم تلاتة بيقوللي ايش هنا history of
+
+332
+00:20:21,830 --> 00:20:26,160
+present illness خلصناالشكوة تبعته باجي أول سؤال
+
+333
+00:20:26,160 --> 00:20:31,080
+باسأله بقوله لو سمحت هذا اللي صار عندك باسأله عن
+
+334
+00:20:31,080 --> 00:20:34,640
+المشكلة اللي موجودة ايش معنى فيها بجمع المعلومات
+
+335
+00:20:34,640 --> 00:20:39,080
+المتعلقة المجموعات المتعلقة بالشكوة اللي هو شكاها
+
+336
+00:20:39,080 --> 00:20:42,440
+المريض الشكوهالة زي ايش مثلا بيجي يقولك انا والله
+
+337
+00:20:42,440 --> 00:20:46,200
+عندي swollen ankles او عندي انا والله في في عندي
+
+338
+00:20:46,200 --> 00:20:49,620
+fever او عندي headache باجي المعلومات اللي بحكي
+
+339
+00:20:49,620 --> 00:20:54,400
+عنها باجي بسأله بقوله لو سمحت كيف صار عندكإيش اللي
+
+340
+00:20:54,400 --> 00:20:57,740
+خلّى القلمة دي زيد عندك؟ شو اللي نجسه؟ طب إيش أنت
+
+341
+00:20:57,740 --> 00:21:01,820
+بالظبط كيف يعني بداية الوجع صار؟ كله إيش اسمه إما
+
+342
+00:21:01,820 --> 00:21:05,360
+essential أو إما relevant؟ إيش يعني essential؟ إيش
+
+343
+00:21:05,360 --> 00:21:09,800
+معنى relevant؟ الآن في معلومات أساسية وفي معلومات
+
+344
+00:21:09,800 --> 00:21:15,840
+متعلقة بالمرضة أعطيكم مثال، الآن هو بيحكيلي، بيقول
+
+345
+00:21:15,840 --> 00:21:21,480
+أنا أول ما حاولت أحمل شيء صار دهري جوعني، هذا اسمه
+
+346
+00:21:21,480 --> 00:21:27,320
+essential، essential إيه؟problem بعد شوية بقول حتى
+
+347
+00:21:27,320 --> 00:21:31,480
+انا و انا ماشي صرت أتعب شوية هذا اسمه relevant ال
+
+348
+00:21:31,480 --> 00:21:35,660
+essential معلومة أساسية علاقة بالإيه؟ علاقة بالمرض
+
+349
+00:21:35,660 --> 00:21:40,240
+ال relevant معلومات متعلقة بالمرض يمكن يكون عنده
+
+350
+00:21:40,240 --> 00:21:44,360
+medical treatment بدي أشوف يعني ممكن يقول لحاله
+
+351
+00:21:44,360 --> 00:21:48,950
+والله أنا روحت شريت diclofene واشربتصح نفسي ان شاء
+
+352
+00:21:48,950 --> 00:21:51,330
+الله لكن لأ ماقدرش أقول هي سبب في المشكلة هي
+
+353
+00:21:51,330 --> 00:21:54,250
+relevant بدونها و بكتبها عشان أحكيها لمين؟ أحكيها
+
+354
+00:21:54,250 --> 00:21:57,770
+للطبيب المعالج يبقى أنا أخدت المعلومات طيب بعديها
+
+355
+00:21:57,770 --> 00:22:02,110
+ال components of present illness ال components of
+
+356
+00:22:02,110 --> 00:22:05,670
+present illness أول عجة introduction طبعا أخدنا
+
+357
+00:22:05,670 --> 00:22:08,090
+عملنا class summary و ال usual health أخدنا
+
+358
+00:22:08,090 --> 00:22:11,030
+المعلومات الكاملة و ال investigation of symptoms
+
+359
+00:22:11,030 --> 00:22:15,190
+أنا قاعد بتفحص الأيش الأعراض قاعد أنا بسألهيعني
+
+360
+00:22:15,190 --> 00:22:18,890
+وقت إيش صارت و وديت و ال gradual هى هل ده الألم
+
+361
+00:22:18,890 --> 00:22:22,490
+أجى عندك عمهل gradual و لا صدل يعني واحد بيجيني و
+
+362
+00:22:22,490 --> 00:22:25,210
+بيقولي والله صدر بجعني بقولش بقولي والله إيه تلت
+
+363
+00:22:25,210 --> 00:22:28,250
+أيام بس كل ماله بزيت شوية اسمه gradual لكن لو واحد
+
+364
+00:22:28,250 --> 00:22:31,290
+أجي قاللي أنا فجأة صار زي السكين لأ او صار burning
+
+365
+00:22:31,290 --> 00:22:34,310
+sensation بقوله تعال أكتر ال duration بتطول ولا
+
+366
+00:22:34,310 --> 00:22:37,570
+بتطورش ال frequency كم مرة بيجي ال location وينما
+
+367
+00:22:37,570 --> 00:22:41,370
+كان و ال quality ال quality ايش جودته يعني حدته
+
+368
+00:22:41,370 --> 00:22:44,700
+قوي ولا مش قويايش ال alleviating و أيش ال
+
+369
+00:22:44,700 --> 00:22:48,700
+aggravating factors ما هي الأشياء التي تزيد القلم
+
+370
+00:22:48,700 --> 00:22:52,360
+و ما هي الأشياء اللي بتجلل القلم alleviating تقلل
+
+371
+00:22:52,360 --> 00:22:56,020
+الأعراض aggravating تزيد الأعراض يعني ممكن يقولي
+
+372
+00:22:56,020 --> 00:22:59,200
+والله يا أستاذ لما بعمل واحد اتنين تلاتة بزيد عندي
+
+373
+00:22:59,200 --> 00:23:01,860
+القلم و لما بعمل واحد اتنين تلاتة بجلي القلم
+
+374
+00:23:01,860 --> 00:23:05,820
+بكتبها و بقول عنها alleviating factors و بقول عنها
+
+375
+00:23:05,820 --> 00:23:08,620
+أيش aggravating factors سامحوني لو أنا كنت سريع
+
+376
+00:23:08,620 --> 00:23:11,560
+شوية بتعيدوا الفيديو مرة و مرتين ان شاء الله بتكون
+
+377
+00:23:11,560 --> 00:23:14,390
+أمور واضحة عنكمبدي أسأل إن الـ negative
+
+378
+00:23:14,390 --> 00:23:17,510
+information معلومات سلبية ممكن يعطيني معلومات
+
+379
+00:23:17,510 --> 00:23:20,730
+مالهاش علاقة مضللة ما بكتبها بس أنا بتكون واضح و
+
+380
+00:23:20,730 --> 00:23:23,310
+أعرف إيش اللي بيحكي ليها و بصنف إن هذه negative
+
+381
+00:23:23,310 --> 00:23:26,430
+information أو positive relevant family
+
+382
+00:23:26,430 --> 00:23:29,250
+information إذا والله في معلومات في العائلة اللي
+
+383
+00:23:29,250 --> 00:23:32,970
+لها علاقة يعني ممكن ييجي يقول أنا صدري بجوعني بس
+
+384
+00:23:32,970 --> 00:23:35,650
+الله أنا خايف ليه؟ لأنه عندنا تاريخ في العائلة
+
+385
+00:23:35,650 --> 00:23:39,510
+بيصير معنى .. هو بيقول تاريخ في العائلة بيصير معنى
+
+386
+00:23:39,510 --> 00:23:43,210
+جلطة هذا باخده على محمل جد اسم relevant familyطيب
+
+387
+00:23:43,210 --> 00:23:46,450
+ممكن يكون في عنده disability affected the clients
+
+388
+00:23:46,450 --> 00:23:50,250
+total life يمكن اللي صار عنده واحد أكل هوايا في
+
+389
+00:23:50,250 --> 00:23:53,850
+راسه فلا سمح الله ان ضرب صار عنده شوية bleeding
+
+390
+00:23:53,850 --> 00:23:56,790
+subdural bleeding او مثلا diural bleeding او brain
+
+391
+00:23:56,790 --> 00:24:00,250
+hematoma صار عنده disability يعني هذا النظيف اللي
+
+392
+00:24:00,250 --> 00:24:03,370
+في المخ صار ايش صار عنده إعاقة كله بدونه و بكتبه
+
+393
+00:24:03,370 --> 00:24:10,190
+كله هاد اسم component of present illness طيب ال
+
+394
+00:24:10,190 --> 00:24:14,980
+past health historyPast يعني الشكل التاريخي القديم
+
+395
+00:24:14,980 --> 00:24:18,140
+بيربوس ايش أنا بتكلم ال major past health problems
+
+396
+00:24:18,140 --> 00:24:21,700
+بسأله عن المشكلات الصحية الموجودة عنده بس ايش هي
+
+397
+00:24:21,700 --> 00:24:25,980
+اللي كانت في حياته تعتبر زي major problem احنا
+
+398
+00:24:25,980 --> 00:24:30,080
+ممكن اسأله هل في حياتك انت صار عندك حادث سير او
+
+399
+00:24:30,080 --> 00:24:33,000
+عندك سبحان الله دخلت مستشفى صار عندك عملية جراحية
+
+400
+00:24:33,000 --> 00:24:36,760
+اي شيء طبعا اول سؤال بنسأله في ال childhood
+
+401
+00:24:36,760 --> 00:24:42,360
+illness بنسأله في الطفولة كيف كانت طفولتك كويسةولا
+
+402
+00:24:42,360 --> 00:24:45,500
+مش كويسة؟ هل كان عندك rheumatic fever؟ عمره صار
+
+403
+00:24:45,500 --> 00:24:48,660
+عندك حمض رheumatism؟ أسخنت وانت صغير؟ صار عندك
+
+404
+00:24:48,660 --> 00:24:53,920
+مثلا meningitis؟ التهاب صحيح؟ أي شيء كله باسأله
+
+405
+00:24:53,920 --> 00:24:57,340
+التطعمات كويسة كانت عندك ولا لأ؟ history of
+
+406
+00:24:57,340 --> 00:25:01,200
+accidents؟ هل في عندك يعني اتعرضت لأي .. مش شرط
+
+407
+00:25:01,200 --> 00:25:04,020
+يكون حادث لما نقول accidents يعني حادث سيارة جبان؟
+
+408
+00:25:04,020 --> 00:25:08,500
+لأ أوجعت، انصبت بشيص، اتسوابت ارصاص، أي شيء
+
+409
+00:25:08,500 --> 00:25:12,930
+history of hospitalization؟عمرك دخلت المستشفى؟ إذا
+
+410
+00:25:12,930 --> 00:25:16,310
+دخلت يا ريت تقولنا متى؟ وإيش اللي كان موجود؟ ولمّا
+
+411
+00:25:16,310 --> 00:25:19,110
+أنت دخلت إيش كان ال complaint؟ إيش الشكوى؟ وإيش ال
+
+412
+00:25:19,110 --> 00:25:22,570
+discharge diagnosis؟ وإيش التشخيص كان؟ وهل ضلتك
+
+413
+00:25:22,570 --> 00:25:26,330
+عامل follow-up؟ يعني كأنه بدنا نربط ما بين مشكلات
+
+414
+00:25:26,330 --> 00:25:29,890
+المريض اللي في السابق وما بين المشكلة اللي موجودة
+
+415
+00:25:29,890 --> 00:25:34,450
+الآن حاليًا ال history of operations بسأله إذا في
+
+416
+00:25:34,450 --> 00:25:37,950
+عندك عمليات عملتها في حياتك وهل العمليات كانت هذه
+
+417
+00:25:37,950 --> 00:25:42,340
+تعتبرعملية كبيرة ولا .. يعني minor ولا major؟ يعني
+
+418
+00:25:42,340 --> 00:25:44,860
+يمكن يقول أه والله مرة جراحت و بنجون و عملوله
+
+419
+00:25:44,860 --> 00:25:47,820
+غراز، هذه تعتبر minor لكن ممكن يقول اللي عملت
+
+420
+00:25:47,820 --> 00:25:52,640
+عملية إزالة المرارة، لأ هذه اسمها major operation.
+
+421
+00:25:53,180 --> 00:25:56,440
+History of immunizations، إذا عندك أي شيء أطعمتله
+
+422
+00:25:56,440 --> 00:25:59,860
+أو لا سمح الله عندك حسية عشان أنا أعرف، يمكن يجي
+
+423
+00:25:59,860 --> 00:26:03,130
+يقولي والله أه أنا زمانحاول و أنا صغير كان عندى
+
+424
+00:26:03,130 --> 00:26:05,810
+سخونة و حاول يعطونى إبره اسم البنسالين كتير من
+
+425
+00:26:05,810 --> 00:26:08,670
+الحلات هيقولك زي هيك فمجرد ماجوا يعطونى البنسالين
+
+426
+00:26:08,670 --> 00:26:13,070
+اللى انا اتفاجأت انه ايش و عندي حسيسية و منعونى
+
+427
+00:26:13,070 --> 00:26:15,950
+الأطباء و قالوا بعدين اقعد تاخد إبره هه بيعطينى
+
+428
+00:26:15,950 --> 00:26:20,610
+ايش alarm انه انتبه ال physical examinations و ال
+
+429
+00:26:20,610 --> 00:26:23,410
+diagnostic test برضه بتطلع الطبيب اعمله physical
+
+430
+00:26:23,410 --> 00:26:27,130
+examination ايش هو الادات اللى عملها و ال
+
+431
+00:26:27,130 --> 00:26:31,880
+information اللى كتبها عشان انا اكمل على المعمولو
+
+432
+00:26:31,880 --> 00:26:35,300
+بتطلع على الفحوصات اللي هو عملها عامل CPC عامل
+
+433
+00:26:35,300 --> 00:26:39,060
+Chemistry عامل Serology عامل Urinalysis باجراهم و
+
+434
+00:26:39,060 --> 00:26:42,640
+اليوم الحمد لله صاروا معظم المختبرات بتكتبلكوا ال
+
+435
+00:26:42,640 --> 00:26:45,820
+normal و ال abnormal عشان نقدر نفسر لو الناس مش
+
+436
+00:26:45,820 --> 00:26:50,520
+عارفين Family History ال family history كتير في
+
+437
+00:26:50,520 --> 00:26:54,280
+بعض الحلات بيسألونا بيقولناإنه إيش داخله؟ بنيجي
+
+438
+00:26:54,280 --> 00:26:57,520
+بنسأل إنه البربوس ليه؟ أول حاجة عشان نشوف ال
+
+439
+00:26:57,520 --> 00:27:00,260
+general health تبعت إيه، خاصة في ال blood
+
+440
+00:27:00,260 --> 00:27:04,800
+relatives، يعني بدنا نسأله في أقاربه، يمكن عنده
+
+441
+00:27:04,800 --> 00:27:09,200
+مشكلة نادرة، باجي بسأله في حد في البيت، هاي
+
+442
+00:27:09,200 --> 00:27:12,000
+الموضوع ال family، زيك، بقولك أه، يعني زي حالات
+
+443
+00:27:12,000 --> 00:27:15,900
+الثلاثيميا أو يعني في حالات كتيرة بتتصل عليه بعض
+
+444
+00:27:15,900 --> 00:27:18,960
+الناس، باجي بسأل، باجي بتصير عندهم حالة
+
+445
+00:27:18,960 --> 00:27:21,990
+schizophrenia، باجي بسأل السؤالبقول له طيب عمره حد
+
+446
+00:27:21,990 --> 00:27:25,710
+صار؟ قال اه والله عم كان عنده وحتى انا سيدي قبل
+
+447
+00:27:25,710 --> 00:27:29,230
+هيكة بقوله انه يعني كائن عنده اعراض زيك، اذا انا
+
+448
+00:27:29,230 --> 00:27:32,750
+بشوف هل صارت عنده مشكلة؟ و هو كمان في مرحلة
+
+449
+00:27:32,750 --> 00:27:36,070
+الطفولة، healthy كان عنده مشكلة او environmental
+
+450
+00:27:36,070 --> 00:27:40,470
+او genetic؟ يعني اقصدإذا كانت في مشكلة لبيئتهم
+
+451
+00:27:40,470 --> 00:27:43,310
+الموجودة في بعض الناس، بيجيب و بيقولّك احنا والله
+
+452
+00:27:43,310 --> 00:27:46,410
+عيلتنا فيها مرض سكري أكتر، احنا ساكنين في مكان
+
+453
+00:27:46,410 --> 00:27:50,270
+معين، ضارين على طقوس معينة، بناكل أكلات خاصة،
+
+454
+00:27:50,270 --> 00:27:54,510
+بنربط المرض اللي موجود الآن بأي إيش familiar
+
+455
+00:27:54,510 --> 00:27:57,910
+نتيريان في الطبيعة العائلية، هذا كله عشان إيش؟
+
+456
+00:27:57,910 --> 00:28:01,350
+عشان نسأل على clients health problems، يعني
+
+457
+00:28:01,350 --> 00:28:04,830
+بينجوسين كل هذا المكتوب و كأنه بيقولّي نسأل عن
+
+458
+00:28:04,830 --> 00:28:08,550
+تاريخ العائلةهل هناك ارتباط بين المرض الموجود عند
+
+459
+00:28:08,550 --> 00:28:11,870
+المريض الآن الحالي وبين الأمراض الموجودة في
+
+460
+00:28:11,870 --> 00:28:15,410
+العائلة؟ وهل هذا مرض ساري؟ عشان اشوف اذا الموضوع
+
+461
+00:28:15,410 --> 00:28:18,770
+genetic فيه ولا لا؟ وهل له علاقة بزواج أقارب او
+
+462
+00:28:18,770 --> 00:28:23,940
+زواج يعني ناس يعني كتير في بعض الناس؟من شدة يعني
+
+463
+00:28:23,940 --> 00:28:27,100
+بتلاقي ابن عمه و هو ابنت عمه و بيزوجوا بعض و
+
+464
+00:28:27,100 --> 00:28:31,520
+النساء برضه بنت عم و قريبات لبعض يعني بتكون ال
+
+465
+00:28:31,520 --> 00:28:35,020
+close relatives فيها problems عشان نقدر نعرف و نحط
+
+466
+00:28:35,020 --> 00:28:40,510
+ايدنا وين بالظبط ال source of problemال family
+
+467
+00:28:40,510 --> 00:28:44,490
+history of communicable disease برضه سؤال العائلة
+
+468
+00:28:44,490 --> 00:28:47,170
+عن المرضى السارية لما نقول كلمة communicable
+
+469
+00:28:47,170 --> 00:28:50,810
+disease هي ايش؟ يعني في عندهم بعض العائلات مرض
+
+470
+00:28:50,810 --> 00:28:54,050
+معين مستوطن يعني مرض شكر موجود عندهم هذول الناس
+
+471
+00:28:54,050 --> 00:28:56,950
+بصير عندهم جلطات في القلب هذه العائلة المعينة في
+
+472
+00:28:56,950 --> 00:29:01,010
+بعض العائلات بالمناسبة يعني عندهم بموتوا بدري مثلا
+
+473
+00:29:01,010 --> 00:29:05,790
+فهم عندهم مشكلة ال source مثلا of problem الموجودة
+
+474
+00:29:05,790 --> 00:29:09,050
+في ال family كله بسجلههل في عندهم مشكلات في ال
+
+475
+00:29:09,050 --> 00:29:12,690
+hereditary يعني مثلا في ال genetic يعني ورثية خاصة
+
+476
+00:29:12,690 --> 00:29:15,210
+العلاقة بال disease كله بكتبه يعني انا ممكن ييجي
+
+477
+00:29:15,210 --> 00:29:19,050
+يقولي هو لحالي يقولي احنا عيلتنا فيها مرض كده
+
+478
+00:29:19,050 --> 00:29:23,190
+بدونه هل في عنده strong family history of certain
+
+479
+00:29:23,190 --> 00:29:26,550
+problem هل في مشكلة في العيلة يعني الكلام بعيد
+
+480
+00:29:26,550 --> 00:29:31,990
+نفسه اذا في مشكلة حقيقية في العيلة بكتبها بتطلع
+
+481
+00:29:31,990 --> 00:29:34,810
+خاصة في موضوع ال maternal وال parents موضوع
+
+482
+00:29:34,810 --> 00:29:40,220
+الأمهات والآباءالأقارب والعمات والخالات يعني أنا
+
+483
+00:29:40,220 --> 00:29:44,200
+بسأل بشكل عام انه اتذكر يا أستاذ او اتذكر يا حجة
+
+484
+00:29:44,200 --> 00:29:48,080
+او اتذكر يا حجة اذا في حد زي هي كان عنده يعني في
+
+485
+00:29:48,080 --> 00:29:52,280
+نفس غيلتكم عشان هذا كله بفيدكم عشان احنا بدنا
+
+486
+00:29:52,280 --> 00:29:56,600
+نستفيد ومابدناش احنا نستعجل في انه نحكم عليكم ان
+
+487
+00:29:56,600 --> 00:30:00,660
+هذا السبب من كده او من كده في بعض الحالات بيجي
+
+488
+00:30:00,660 --> 00:30:02,940
+نسأل ال cause of death of the family members
+
+489
+00:30:03,500 --> 00:30:06,120
+immediate and extended family طبعا لما نقول كلمة
+
+490
+00:30:06,120 --> 00:30:09,120
+immediate العائلة القريبة العائلة البسيطة العائلة
+
+491
+00:30:09,120 --> 00:30:12,060
+النووية الأب و الأم و الأولاد لما نقول extended
+
+492
+00:30:12,060 --> 00:30:16,420
+يعني اللي هو الأعمام و الجد و البني العمومة هذا
+
+493
+00:30:16,420 --> 00:30:19,880
+كله إيه؟ يسموه العائلة الممتدة ده طب ليش بتسأل؟
+
+494
+00:30:19,880 --> 00:30:23,860
+الجد بقى بتبسأل لأن أنا مرت عليه حالات أنه مثلا
+
+495
+00:30:23,860 --> 00:30:29,560
+بيجي مريض صار عمره مش كبير خمسين سنة صار أدوكادك
+
+496
+00:30:29,560 --> 00:30:33,510
+أرسله ماتكمان مرة، نفس .. نفس العمر كاردك أرسته
+
+497
+00:30:33,510 --> 00:30:36,590
+مات، ابليش بنسأل بيقول طب ليش مرتين كاردك أرسته؟
+
+498
+00:30:36,590 --> 00:30:39,210
+وين المشكلة اللي موجودة؟ عشان أنا أقدر أعرف وين
+
+499
+00:30:39,210 --> 00:30:41,830
+المشكلة الموجودة، بيجيب ويقولي والله لأ احنا في
+
+500
+00:30:41,830 --> 00:30:45,210
+العائلة في عندنا cause of death، على عمر محدد
+
+501
+00:30:45,210 --> 00:30:49,270
+بيصير كاردك أرسته، ليش؟ لأن كل عيلتنا عندنا ال
+
+502
+00:30:49,270 --> 00:30:53,660
+cholesterol دايما عاليواحد من مرة يعني لجاني وقال
+
+503
+00:30:53,660 --> 00:30:55,880
+لي انا فحصت ال cholesterol بقوله ليش انتوا
+
+504
+00:30:55,880 --> 00:30:58,880
+مشكلتكوا زي هيك معظمكوا فاتفاجأت ال cholesterol
+
+505
+00:30:58,880 --> 00:31:02,820
+يعني up to 200 يعني ممكن يكون يصل ل 200 وهذا
+
+506
+00:31:02,820 --> 00:31:07,760
+normal بطل اللي هو عنده 570 انا انساقت فبس انه
+
+507
+00:31:07,760 --> 00:31:10,360
+بقوله ليش قاللي احنا هيك بطلع انه يعني مش شرط
+
+508
+00:31:10,360 --> 00:31:12,800
+بتقولولي ان هو من ال sedentary life عشان هو جاعد
+
+509
+00:31:12,800 --> 00:31:16,840
+او كزلاءلا ممكن ماعيش .. خلاص هم أيه كده، هذول
+
+510
+00:31:16,840 --> 00:31:19,500
+الناس العيلة تقول بإننا نهتم لهم و نسير نعطيهم
+
+511
+00:31:19,500 --> 00:31:23,960
+دائما أولى الاهتمام في موضوع العلاجات و موضوع ال
+
+512
+00:31:23,960 --> 00:31:26,380
+future خليني أقول health عشان يقدر .. يعني ممكن
+
+513
+00:31:26,380 --> 00:31:29,440
+نعطيهم علاجات خافقة لكوليسترول و دائما متابعة لمرض
+
+514
+00:31:29,440 --> 00:31:32,300
+القلب عشان مايجعش في أي إشكالية خليني نجح لعند
+
+515
+00:31:32,300 --> 00:31:37,100
+environmental history عشان الآن صار عن .. يعني 31
+
+516
+00:31:37,100 --> 00:31:39,960
+دقيقة يكفي ذلك والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..89947bd9cf5ea817ce43826d93d49b502a62b396
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw.srt
@@ -0,0 +1,1298 @@
+1
+00:00:00,890 --> 00:00:03,250
+اقعدوا بالله مش طالعين بسم الله الرحمن الرحيم
+
+2
+00:00:03,250 --> 00:00:07,190
+خلينا نكمل .. معلش سامحونا يعني كنت في المحاضرة
+
+3
+00:00:07,190 --> 00:00:13,490
+السابقة يمكن شوية مستعجل في الكلام مش لغرض
+
+4
+00:00:13,490 --> 00:00:18,190
+الاستعجال كم هو لغرض إن كنت بس بتخلص يعني وأنهي
+
+5
+00:00:18,190 --> 00:00:21,270
+اللي هو الـ assessment of the year عشان ما بديش أقطع
+
+6
+00:00:21,270 --> 00:00:25,570
+الخاصة لما تكون المحاضرة مزدحمة في نفس اليوم بيكون
+
+7
+00:00:25,570 --> 00:00:28,870
+أفضل يعني وإحنا بنعمل assessment of
+
+8
+00:00:28,870 --> 00:00:32,620
+the nose الآن كيف بتعمل assessment للأنف؟
+
+9
+00:00:32,620 --> 00:00:36,580
+خلصنا لإيه؟ لأن الأنف؟ أول حاجة بتذكر الـ functions
+
+10
+00:00:36,580 --> 00:00:40,880
+of the nose، ليش؟ الله سبحانه وتعالى يعني أوجد لنا
+
+11
+00:00:40,880 --> 00:00:43,920
+هذا الأنف، يمكن بعض الناس بيجي ببالنا إنه دغري
+
+12
+00:00:43,920 --> 00:00:50,260
+مباشرة، إنه إحنا بس بنا نتنفس أو نشم مباشرة،
+
+13
+00:00:50,260 --> 00:00:55,920
+سوء في طبعا بوسطيته، سبحان الله الآن بيقول لي أول
+
+14
+00:00:55,920 --> 00:00:59,060
+حاجة الـ functions and knows إن إحنا نحدد
+
+15
+00:00:59,060 --> 00:01:03,500
+odors بيحدد إيش الروائح من قدرة الله إنه خلقنا
+
+16
+00:01:03,500 --> 00:01:07,600
+نقدر نميز بين الرائحة الفلانية عن الرائحة العلانية و
+
+17
+00:01:07,600 --> 00:01:11,840
+هكذا طب وين هذا؟ من وين بنشم إحنا؟ بيقول لي في الـ
+
+18
+00:01:11,840 --> 00:01:15,440
+upper one third of the system سبحان الله القدرة على
+
+19
+00:01:15,440 --> 00:01:19,320
+الشم بس في أعلى الأنف علشان هيك الإنسان لما بده
+
+20
+00:01:19,320 --> 00:01:24,700
+يشم شيء بتلاقي الإنسان بيجرب أنفه للشيء بس تقريب مش
+
+21
+00:01:24,700 --> 00:01:29,100
+بتضغط بكل أنفه عشان يشم الشيء طيب مش بس هيك الـ
+
+22
+00:01:29,100 --> 00:01:33,700
+function التانية air passageway كمان هو يعتبر
+
+23
+00:01:33,700 --> 00:01:39,340
+عضو من أعضاء الجهاز التنفسي لمرور الهواء خاصة إيش
+
+24
+00:01:39,340 --> 00:01:42,460
+أنا في الـ new born بكون إجباري air conditioning
+
+25
+00:01:42,460 --> 00:01:47,860
+كمان هو مش بس هيك هو يعتبر إيش ملطف اللي هو بيعمل لنا
+
+26
+00:01:47,860 --> 00:01:52,640
+humidify و warm إذا كان يعني والله الهواء بارد
+
+27
+00:01:52,640 --> 00:01:57,660
+بيحاول يدفيه ويعني سبحان الله وبيعمل لنا كمان
+
+28
+00:01:57,660 --> 00:02:00,540
+cleans يعني كمان إيش؟ بنظف من الشوائب زي filter
+
+29
+00:02:00,540 --> 00:02:05,400
+خاصة لما يكون فيه dust يعني شوائب غبار خاصة في بعض
+
+30
+00:02:05,400 --> 00:02:09,160
+الحالات كمان البكتيريا والفيروسات ومش بس هي كمان هو
+
+31
+00:02:09,160 --> 00:02:12,600
+سبحان الله بيساعدنا ومسؤول كمان على الـ voice
+
+32
+00:02:12,600 --> 00:02:15,750
+resonance اللي وراه اللي هو الرنين الصوت أو بيسموه
+
+33
+00:02:15,750 --> 00:02:21,450
+يعني الصوت الرنان، يعني هو اللي بيعطي الرنين للصوت زي
+
+34
+00:02:21,450 --> 00:02:25,310
+بعض الناس اللي هم المغنيين وناس المنشدين و
+
+35
+00:02:25,310 --> 00:02:28,650
+الناس اللي .. اللي سبحان الله اللي .. اللي بيقرأوا
+
+36
+00:02:28,650 --> 00:02:32,530
+القرآن بصوت جميل لما بنسمع كلمة غنة و .. و .. و
+
+37
+00:02:32,530 --> 00:02:35,610
+غير غنة طبعا بكون مسؤول عن أكتر شيء اللي هو الـ
+
+38
+00:02:35,610 --> 00:02:39,610
+nose في هذه الحالة طبعا سبحان الله يعني كيف هذا الـ
+
+39
+00:02:39,610 --> 00:02:43,130
+nose هذا التركيب البسيط لكن قد إيش هو
+
+40
+00:02:43,130 --> 00:02:47,510
+قوي الآن بيجي بيقول لي في حاجة تانية لو طلعنا في
+
+41
+00:02:47,510 --> 00:02:50,650
+الصورة اللي أمامكم هنا بيقول لي inspect and palpate
+
+42
+00:02:50,650 --> 00:02:54,750
+مش بس هيك بدي أنا أمد إيدي وأشوف الـ nose أسس
+
+43
+00:02:54,750 --> 00:02:58,050
+symmetry  يعني شوف إيش .. كيف فتحات
+
+44
+00:02:58,050 --> 00:03:02,410
+الأنف اللي على الجهتين الفتحات الأنف .. الأنف من
+
+45
+00:03:02,410 --> 00:03:06,170
+الأمام اسمها nostril  فتحات الأنف و skin
+
+46
+00:03:06,170 --> 00:03:10,670
+lesion شوف ليش أي ضرر أو ألم أو أذى حوالين إيش
+
+47
+00:03:10,670 --> 00:03:15,310
+فتحات الأنف وخاصة بكرة لما نروح نتدرب هنلاقي بعض
+
+48
+00:03:15,310 --> 00:03:18,410
+المرضى مركبينهم NG tube اللي هو nasogastric tube
+
+49
+00:03:18,410 --> 00:03:23,010
+بتلاقي حواليها في زي sloughing التقشر للأنف حوالين
+
+50
+00:03:23,010 --> 00:03:27,130
+اللي هو الـ tube اللي داخلة في جسم الإنسان الـ
+
+51
+00:03:27,130 --> 00:03:31,450
+patency يعني فتحة الأنف هل هي طبيعية؟ هل فتحتين زي
+
+52
+00:03:31,450 --> 00:03:35,390
+بعض؟ ولازم مش بقول أنا بقول لازم تعمل test one
+
+53
+00:03:35,390 --> 00:03:38,850
+side إيش زي ما عملنا في العين إن مرة فحصنا العين
+
+54
+00:03:38,850 --> 00:03:43,150
+اليمنى وبعدين العين اليسرى كذلك في الـ nose لازم
+
+55
+00:03:43,150 --> 00:03:47,630
+نفحص مرة الأنف الأيمن مرة الأنف الأيسر الفتحة
+
+56
+00:03:47,630 --> 00:03:51,570
+اليسرى ومرة الفتحة اليمنى طب ليش؟ لأن في بعض
+
+57
+00:03:51,570 --> 00:03:55,920
+الحالات بيصير عندهم حاجة بيسموها deviation، إيش
+
+58
+00:03:55,920 --> 00:03:59,540
+يعني deviation؟ لو لاحظنا يعني معلش أمام إن إحنا
+
+59
+00:03:59,540 --> 00:04:04,180
+بنطلع، هنلاقي هذا فيه nose وهنا فيه nose يعني
+
+60
+00:04:04,180 --> 00:04:08,020
+أكيد في منكم شاطر لو أنا سألتكم مين الـ nose اللي
+
+61
+00:04:08,020 --> 00:04:12,330
+هنا يعني يعتبر فيه مشكلة؟ هنا ولا هنا؟ طبعا الشاطر
+
+62
+00:04:12,330 --> 00:04:15,390
+هيقول لي هنا المشكلة، إذا بتلاحظوا فيه حاجة
+
+63
+00:04:15,390 --> 00:04:19,210
+بيسموها انحراف، شايفين؟ لما أقول كلمة انحراف اسمه
+
+64
+00:04:19,210 --> 00:04:23,930
+deviation of nasal septum اسمه deviation of nasal
+
+65
+00:04:23,930 --> 00:04:26,990
+septum، هذا اللي بيسموه انحراف في الأنف، بعض الناس
+
+66
+00:04:26,990 --> 00:04:30,690
+بيقول طب ليه، هل الانحراف بضر؟ اه بضر لأن الإنسان
+
+67
+00:04:30,690 --> 00:04:35,050
+بيبطل يقدر يتنفس كويس و مرات بنيجي بنركب NG tube يعني
+
+68
+00:04:35,050 --> 00:04:39,090
+لو بنتخيل بنركب NG tube لو بنركب NG tube في هذا
+
+69
+00:04:39,090 --> 00:04:42,330
+المكان أو في هذا المكان الاتنين صح لكن لو بنركب NG
+
+70
+00:04:42,330 --> 00:04:45,010
+tube في هذا المكان بيمشي لكن في هذا المكان مش
+
+71
+00:04:45,010 --> 00:04:48,710
+هيمشي طبعا كيف؟ فيه انحناء علشان هيك بيبين لما أنا
+
+72
+00:04:48,710 --> 00:04:52,410
+بتطلع في الواحد يعني النظرة كويسة بقدر أعرف إنه
+
+73
+00:04:52,410 --> 00:04:56,230
+عنده deviation أو لا طيب بقول inspect and observe
+
+74
+00:04:56,230 --> 00:05:00,010
+لاحظ الـ symmetry إذا في inflammation إذا في
+
+75
+00:05:00,010 --> 00:05:04,230
+deformity أي تشوهات طب في حالة ما يكون في swelling
+
+76
+00:05:04,230 --> 00:05:07,550
+أو deformities of the nose لو لجينا الأنف شوية
+
+77
+00:05:07,550 --> 00:05:13,670
+متضخم دغري مباشرة بدي أعمله palpation وأشوف هل في
+
+78
+00:05:13,670 --> 00:05:18,570
+tenderness يعني في ألم هل في swelling هل في
+
+79
+00:05:18,570 --> 00:05:22,190
+deviations زي ما إحنا قلنا short deviation يعني هل
+
+80
+00:05:22,190 --> 00:05:26,850
+فيه رايح لليمين أو رايح للشمال بشكل مش طبيعي أهم شيء
+
+81
+00:05:26,850 --> 00:05:30,580
+إيش بقول؟ إن الـ normal of the external nose لازم يكون
+
+82
+00:05:30,580 --> 00:05:34,420
+symmetrical يعني لازم الأنف الأيمن والأنف الأيسر
+
+83
+00:05:34,420 --> 00:05:39,760
+الفتحتين والشكل والتضاريس واللون وكل الملمس بشكل
+
+84
+00:05:39,760 --> 00:05:45,020
+عام يكون الاتنين the same زي بعض بقول هنا non
+
+85
+00:05:45,020 --> 00:05:48,200
+tender مش مؤلم بدون discharge إيش يعني بدون
+
+86
+00:05:48,200 --> 00:05:52,380
+discharge يعني دقر مستقيم straight طيب بدون يعني
+
+87
+00:05:52,380 --> 00:05:56,280
+يطلع أي إفرازات الـ mucosa إذا شوف الـ mucosa
+
+88
+00:05:57,130 --> 00:06:00,970
+المكوزا اللي هي طبعا اللي هي داخل البطانة لداخل
+
+89
+00:06:00,970 --> 00:06:04,030
+الأنف بيقول لي لازم تكون normal pink بتكون لونها
+
+90
+00:06:04,030 --> 00:06:08,010
+زي orange  لو صار لونها إيش هنا خاصة الـ
+
+91
+00:06:08,010 --> 00:06:11,490
+discharge لو صار فيه discharge أصفر أو أخضر عمال
+
+92
+00:06:11,490 --> 00:06:15,990
+بيطلع هنا إيش بدنا نشك إنه في عنده sinusitis لو
+
+93
+00:06:15,990 --> 00:06:19,010
+أجابه وقعد بيقول لي والله أنا حاسس إنه في صداع من
+
+94
+00:06:19,010 --> 00:06:22,530
+الأمام يا أستاذ وبيطلع مني discharge لونه أصفر
+
+95
+00:06:22,530 --> 00:06:26,150
+غامق أو كده بنقول إنه عنده sinusitis طيب الـ pale
+
+96
+00:06:26,150 --> 00:06:30,230
+mucosa إيش يعني الـ pale mucosa الـ pale mucosa
+
+97
+00:06:30,230 --> 00:06:35,920
+بيقصد هنا بشكل واضح وصريح لو أنا أطلعت شوية شوية في
+
+98
+00:06:35,920 --> 00:06:39,520
+داخل الأنف لقيت لون إيش؟ فيه شاحب أو اللون ما
+
+99
+00:06:39,520 --> 00:06:43,580
+إلا الأبيض أكتر، إيش بيكون هذا؟ يعني أنا بيقعد
+
+100
+00:06:43,580 --> 00:06:47,280
+بيطلع كتير this discharge، هذا allergy، إيش يعني؟
+
+101
+00:06:47,280 --> 00:06:49,640
+اللي بعض بيسموه running nose، إيش يعني running
+
+102
+00:06:49,640 --> 00:06:53,280
+nose؟ بتلاقي بيقول لك الصبح أنا بيسير معي سيلان في
+
+103
+00:06:53,280 --> 00:06:55,740
+الأنف، لما يجي يقول لنا سيلان في الأنف لونه أبيض
+
+104
+00:06:55,740 --> 00:06:59,040
+أو clear، يعني ما لوش لون، إيش بقول عنه؟ هذا عنده
+
+105
+00:06:59,040 --> 00:07:01,860
+allergy، ما عندهوش infection، كتير في حالات زي ذلك،
+
+106
+00:07:01,860 --> 00:07:05,380
+لما بطلع عليه الشمس، بكون مرتاح الآن وكتير بنقول
+
+107
+00:07:05,380 --> 00:07:09,160
+إحنا .. طبعا أنا حكيت .. بدنا نأكد إنه في حالة الـ
+
+108
+00:07:09,160 --> 00:07:13,440
+NG tube الـ nasogastric tube لو كانت مركبة بده
+
+109
+00:07:13,440 --> 00:07:19,030
+نتطلع على اللي هو الجلد حوالين حوالين الـ tube نفسها
+
+110
+00:07:19,030 --> 00:07:22,430
+ليش؟ لأنه سبحان الله من رحمة ربنا لما الإنسان
+
+111
+00:07:22,430 --> 00:07:27,550
+بيتنفس من الأنف وبيطلع النفس برضه دخول وخروج النفس
+
+112
+00:07:27,550 --> 00:07:31,710
+في أطراف الأنف بيعمل نوع من الترطيب سبحان الله و
+
+113
+00:07:31,710 --> 00:07:35,730
+خروج النفس برضه بيعمل نوع من الترطيب وبيخلي الـ
+
+114
+00:07:35,730 --> 00:07:39,710
+skin soft تخيلوا معايا إنه صار في tube فبطل فصار
+
+115
+00:07:39,710 --> 00:07:42,830
+النفس من طريق الـ mouth فبيخلي إيش؟ هنا صار في
+
+116
+00:07:42,830 --> 00:07:46,650
+sloughing عشان هيك بقول check for إيش breakdown للـ
+
+117
+00:07:46,650 --> 00:07:50,610
+skin أو excoriation تقرحات أو redness أو sloughing
+
+118
+00:07:50,610 --> 00:07:55,290
+يعني صار فيه إيش؟ إنزلاق إنزلاق في إيش؟ في الجلد
+
+119
+00:07:55,290 --> 00:07:58,990
+اللي حوالين الـ tube طيب nasal assessment of
+
+120
+00:07:58,990 --> 00:08:02,210
+sinuses هذه أخذناها في إيش؟ في التشريح بس من باب
+
+121
+00:08:02,210 --> 00:08:06,450
+معرفة عامة بشكل عام إحنا نأكد إنه بس على الأقل على
+
+122
+00:08:06,450 --> 00:08:10,760
+الأقل على الأقل إنه فيه جيب أمامنا هنا فوق
+
+123
+00:08:10,760 --> 00:08:15,020
+موجودة فوق محجر العين أيمن وأيسر اسمها frontal
+
+124
+00:08:15,020 --> 00:08:19,600
+sinus وفي هنا منطقتين اللي هو الـ nose على الجهتين
+
+125
+00:08:19,600 --> 00:08:24,420
+اسمها ethmoid sinus وفي هنا إيه؟ هنا منطقة إيش؟
+
+126
+00:08:24,420 --> 00:08:29,520
+الخدة اسمها maxillary maxillary sinuses يعني
+
+127
+00:08:29,520 --> 00:08:35,580
+جيوب أنفية في منطقة الخد منطقة الخد طيب الآن
+
+128
+00:08:35,580 --> 00:08:39,040
+عشان نشوف إحنا بدنا نعمل assessment للـ sinus بشكل
+
+129
+00:08:39,040 --> 00:08:44,500
+عام أهم شيء بيقول لي أول حاجة الـ frontal sinus اللي
+
+130
+00:08:44,500 --> 00:08:48,580
+موجودة تحت الـ eyebrows زي ما أنتم شفتوها في الصورة
+
+131
+00:08:48,580 --> 00:08:52,120
+و الـ maxillary sinus اللي هي below cheek تحت الخد
+
+132
+00:08:52,120 --> 00:08:57,480
+مباشرة في فحص اسمه transillumination إيش يعني
+
+133
+00:08:57,480 --> 00:09:00,500
+transillumination الآن هوريكم الصورة وهتفهموها
+
+134
+00:09:00,500 --> 00:09:04,440
+لحالكم إيش يعني transillumination إنهم بيسموه الفحص
+
+135
+00:09:04,440 --> 00:09:07,940
+بالضوء، إيش يعني الفحص بالضوء؟ الآن هقول لكم الآن
+
+136
+00:09:07,940 --> 00:09:12,160
+هو إيش معناه جيوب؟ شو يعني الجيوب؟ يعني لما أقول
+
+137
+00:09:12,160 --> 00:09:17,000
+جيوب أنفية، إيه جيوب؟ جيوب من اسمه إنه في شيء جوا
+
+138
+00:09:17,000 --> 00:09:22,280
+في الداخل في جوف العظم مفتوح وله زي إيش؟ تجويف
+
+139
+00:09:22,280 --> 00:09:26,680
+داخلي كأنه زي عامل سبحان الله زي أخدود هيك هذا
+
+140
+00:09:26,680 --> 00:09:31,800
+علشان يعمل في عملية التوازن وعملية الرنين في الصوت
+
+141
+00:09:31,800 --> 00:09:36,200
+وعملية التوازن عشان سبحان الله لما الـ skull تكون
+
+142
+00:09:36,200 --> 00:09:40,980
+كلها عظم مصمت بيصير الأمر مش كتير سبحان الله يعني
+
+143
+00:09:40,980 --> 00:09:44,140
+ثقيل وبيصعب على الإنسان يقدر يتعامل مع الناس لكن
+
+144
+00:09:44,140 --> 00:09:48,800
+الـ resonance هذه ورنين الصوت وخفة الحركة في الـ
+
+145
+00:09:48,800 --> 00:09:52,740
+skull هذه اللي جعلتها هي الـ sinuses وأنتم قدروا هذا
+
+146
+00:09:52,740 --> 00:09:57,200
+الكلام في الـ Anatomy الـ frontal sinus اللي موجودة
+
+147
+00:09:57,200 --> 00:10:01,900
+والمجزلة أفحصهم بالـ transillumination كيف يعني؟ أنا
+
+148
+00:10:01,900 --> 00:10:06,020
+هأقول لكم كيف نعملها بيقول لي الطبيعي إن الـ light
+
+149
+00:10:06,020 --> 00:10:08,720
+الضوء لازم يكون symmetrically إيش يعني
+
+150
+00:10:08,720 --> 00:10:12,420
+symmetrically يعني لازم الضوء يطلع مباشرة طيب أنا
+
+151
+00:10:12,420 --> 00:10:16,500
+بدي أقرأ المصطلح تبع transillumination وبعدين
+
+152
+00:10:16,500 --> 00:10:19,380
+الشريحة التانية فيها الصورة شو يعني
+
+153
+00:10:19,380 --> 00:10:23,420
+transillumination بيقول لي عبارة عن إيش؟ اللي هو
+
+154
+00:10:23,420 --> 00:10:29,330
+انتشار الضوء في الخلايا في جسم الإنسان زي إيه؟ زي
+
+155
+00:10:29,330 --> 00:10:32,830
+موضوع الأصابع مثلا لو إحنا جبنا كل واحد فيكم
+
+156
+00:10:32,830 --> 00:10:37,270
+ممكن يجرب نفس التجربة اللي بدي أحكيها لأن سبحان
+
+157
+00:10:37,270 --> 00:10:42,950
+الله رحمة ربنا إنه إحنا الضوء برضه بنستخدمه مرات
+
+158
+00:10:42,950 --> 00:10:46,670
+للـ examination بيقدر يكشف لي إنه في مشكلة حتى
+
+159
+00:10:46,670 --> 00:10:51,270
+الإشعاع بيعتمد مرات على الضوء لما بتصور الأشعة زي
+
+160
+00:10:51,270 --> 00:10:54,550
+كيف؟ لأن لو مسكنا الإبهام أصبع الإبهام
+
+161
+00:10:54,880 --> 00:10:58,120
+الكبير، الإصبع الكبير، الإصبع
+
+162
+00:10:58,120 --> 00:11:01,520
+الكبير، لو جينا مسكنا الضوء، يعني زي إيش
+
+163
+00:11:01,520 --> 00:11:05,360
+الضوء؟ مثلا لو أنا معايا pin light، لو ما معيش pin
+
+164
+00:11:05,360 --> 00:11:09,260
+light، بدي أمسك الجوال تبعي، فتحت الـ flash، الضوء
+
+165
+00:11:09,260 --> 00:11:14,560
+تبعه وحطيت الإضاءة مباشرة يعني لاصقتها للإصبع من
+
+166
+00:11:14,560 --> 00:11:17,640
+الأمام .. لاصقتها للإصبع من الأمام .. إصبع الإبهام
+
+167
+00:11:17,640 --> 00:11:21,140
+أمامنا .. أنت ماسكه بيدك اليسرى أو بيدك اليسرى وجبت
+
+168
+00:11:21,140 --> 00:11:25,540
+الجوال بيدك اليمنى و خلت الضوء يلاصق مباشرة للإبهام
+
+169
+00:11:25,540 --> 00:11:29,080
+.. لأن لو طلعنا على الإبهام من فوق من جهة الأظافر
+
+170
+00:11:29,080 --> 00:11:32,540
+.. لو طلعنا على الإبهام من جهة الأظافر .. هنلاقي
+
+171
+00:11:32,540 --> 00:11:36,120
+سبحان الله لون أحمر .. لون أحمر .. مع إن الطول تبع
+
+172
+00:11:36,120 --> 00:11:41,040
+الجوال مع إن ضوء الجوال لونه أبيض أو يعني لون ..
+
+173
+00:11:41,040 --> 00:11:44,800
+يعني ممكن يكون إيش؟ يعني لون أي لون لكن ليش
+
+174
+00:11:44,800 --> 00:
+
+223
+00:15:02,670 --> 00:15:05,350
+بالأسبوع زي الـ direct percussion إذا صار فيه ألم
+
+224
+00:15:05,350 --> 00:15:09,550
+بيقول لي آه والله أنا تألمت، ما فيش طبيعي، عامل حاجة
+
+225
+00:15:09,550 --> 00:15:13,170
+بيسموها hollow، إيش hollow؟ كأنك بتسمع يعني كأنك
+
+226
+00:15:13,170 --> 00:15:17,640
+بتضرب على شيء أجوف، زي صوت الطبلة شوية، لكن إذا..
+
+227
+00:15:17,640 --> 00:15:23,240
+إذا لا سمح الله حسينا إنه فيه flat، إيش يعني flat؟
+
+228
+00:15:23,240 --> 00:15:26,320
+flat tone أو dull tone، يعني حسينا الصوت جامد أو
+
+229
+00:15:26,320 --> 00:15:30,480
+غامض، أو الصوت يعني زي لوح، معناته فورًا بنقول لأ
+
+230
+00:15:30,480 --> 00:15:34,120
+هذا ممكن إيش يكون؟ عنده severe sinusitis، عشان هيك
+
+231
+00:15:34,120 --> 00:15:38,470
+بنسمع بعض الناس أن عنده التهاب جيوب أنفية حاد أو
+
+232
+00:15:38,470 --> 00:15:42,490
+مزمن، واضطروا يعملوا له غسيل للجيوب عشان يحاولوا
+
+233
+00:15:42,490 --> 00:15:47,310
+ينظفوا الجيوب من اللي موجود فيها، واللي أثر على
+
+234
+00:15:47,310 --> 00:15:52,350
+المريض بشكل عام. طيب، assessment of، إيه assessment
+
+235
+00:15:52,350 --> 00:15:57,650
+of mouth and pharynx. بنعمل الآن، روحنا للـ mouth
+
+236
+00:15:57,650 --> 00:16:01,510
+اللي أمامي، واحنا الآن نتواصف، من ذكر، أنا مش كل
+
+237
+00:16:01,510 --> 00:16:05,020
+شيء بيهمني، أنا بيهمني اللي هو على هيئة الـ mouth
+
+238
+00:16:05,020 --> 00:16:09,100
+اللبس بيهمني، طيب، وبيهمني الـ teeth، والـ tonsils اللي
+
+239
+00:16:09,100 --> 00:16:12,560
+هاشوفها، زي ما تشوفينها، اللي هزل على الجنبين، الـ UV
+
+240
+00:16:12,560 --> 00:16:15,820
+اللي هدا، اللي هه، اللي لورا، وبيهمني الـ tongue، كلكم
+
+241
+00:16:15,820 --> 00:16:20,960
+عارفينه، بيهمني، إيش كمان هنا؟ اللي هو الجنجيفا، اللي هي اللثة،
+
+242
+00:16:20,960 --> 00:16:25,600
+الأسنان، اللثة. طيب، الآن assessment of oral cavity.
+
+243
+00:16:25,600 --> 00:16:29,260
+أول حاجة عشان أعمل assessment كويسة للـ oral cavity
+
+244
+00:16:29,700 --> 00:16:32,900
+can be made during a administration of oral
+
+245
+00:16:32,900 --> 00:16:36,940
+hygiene. الآن كتير بعض الناس، باجي بشوف الـ oral
+
+246
+00:16:36,940 --> 00:16:39,720
+cavity، باجي بقول له، طبعًا في بعض الحالات الصعبة زي في
+
+247
+00:16:39,720 --> 00:16:43,740
+حالات الـ .. يعني اللي هو complete paralysis، بقدرش
+
+248
+00:16:43,740 --> 00:16:46,320
+يعمل شيء، وأنا بدي أساعده في الـ oral hygiene، زي ما
+
+249
+00:16:46,320 --> 00:16:49,120
+علمونا في الـ fundamental، مباشرة بقدر أعرف إن في
+
+250
+00:16:49,120 --> 00:16:52,360
+عنده مشكلة ولا لأ في الـ oral cavity. الأمر التالي،
+
+251
+00:16:52,360 --> 00:16:56,840
+بتشوف الـ lips، شفافه، هل الـ color تبعها كويس؟ الـ
+
+252
+00:16:56,840 --> 00:17:03,650
+texture، hydration، فين يعني؟ يعني فين رطبة ولا
+
+253
+00:17:03,650 --> 00:17:08,050
+جافة، الـ contour شكلها كيف؟ شكلها العام، الـ lesions في
+
+254
+00:17:08,050 --> 00:17:12,450
+أي ضرر أو أي أذى. الـ inner، inner and buccal mucosa.
+
+255
+00:17:12,450 --> 00:17:16,970
+الـ inner الداخلي، buccal mucosa، من جوا يعني، الخد
+
+256
+00:17:16,970 --> 00:17:21,510
+من جوا، اللي هو الـ gums كمان بنشوفها، والـ teeth، كل هذه
+
+257
+00:17:21,510 --> 00:17:25,840
+inspected، لإيه؟ لبطلع على الـ color، hydration، الـ
+
+258
+00:17:25,840 --> 00:17:29,740
+texture. أنا اللي حاجات اللي أنا كتير شرحتها واللي
+
+259
+00:17:29,740 --> 00:17:32,760
+اتكررت، دي شغلنا، أترجم، لأن الحمد لله صرنا فاهمين
+
+260
+00:17:32,760 --> 00:17:35,740
+إيش اللي بنقصده؟ بدنا نطلع إذا في الـ SARS، في
+
+261
+00:17:35,740 --> 00:17:40,440
+abrasions، مكحوتات، حاجات، أي شيء، crust، أي حاجة خاصة الـ
+
+262
+00:17:40,440 --> 00:17:43,320
+crust اللي بتكره الحقل الأسنان، اللي زي اللي
+
+263
+00:17:43,320 --> 00:17:49,540
+بيسموها يعني، الترسبات الجيرية على الأسنان. الـ
+
+264
+00:17:49,540 --> 00:17:53,420
+tongue، بتطلع الـ tongue، خاصة اللي في floor of the
+
+265
+00:17:53,420 --> 00:17:57,420
+mouth، يعني أرض الـ.. أرضية الـ.. الـ mouth. بتطلع إذا
+
+266
+00:17:57,420 --> 00:18:01,520
+في، لا سمح الله، خاصة إذا في abnormalities، أو أي
+
+267
+00:18:01,520 --> 00:18:06,260
+مثلا لا سمح الله، مدناش نقول مثلا injury، أو حتى الـ
+
+268
+00:18:06,260 --> 00:18:10,080
+ulcer، إذا في أي شيء مختلف، أو بقول لا قدر الله، اللي
+
+269
+00:18:10,080 --> 00:18:14,080
+بيجي بعض الناس بيقول لك أنا في عندي دائمًا يعني..
+
+270
+00:18:14,080 --> 00:18:16,700
+دائمًا infection chronically، زي الـ  coating اللي بيصير
+
+271
+00:18:16,700 --> 00:18:19,340
+حوالين اللي هو الـ tongue. ممكن كمان هذا نعمله إيش
+
+272
+00:18:19,340 --> 00:18:23,800
+assessment، ونحكي للطبيب. الآن إيش بقول لي؟ أنا، Palpate
+
+273
+00:18:23,800 --> 00:18:27,300
+soft and hard palate، الشيء اللي بيلاقيه سقف الحلق
+
+274
+00:18:27,300 --> 00:18:31,100
+لو حطينا لساننا لفوق، بنلاقي سقف الحلق، سقف الحلق
+
+275
+00:18:31,100 --> 00:18:35,000
+هذا اللي قدام بنلاقيه، مكان شوية، اسمه hard palate، واللي
+
+276
+00:18:35,000 --> 00:18:39,000
+اللي ورا اسمه soft palate. طبعًا بنطلع، بنعمل
+
+277
+00:18:39,000 --> 00:18:42,900
+assessment، نشوف الـ color، الـ shape، الـ texture، إذا
+
+278
+00:18:42,900 --> 00:18:46,660
+فيه لا قدر الله، extra bony prominences، يعني عنده
+
+279
+00:18:46,660 --> 00:18:51,880
+نتوئات عظمية زائدة، أو فيه defects، يعني أي تشوهات. كل
+
+280
+00:18:51,880 --> 00:18:58,060
+هذا بندونه، وبحكي لمين؟ وبحكي للطبيب.. assessment
+
+281
+00:18:58,060 --> 00:19:00,800
+of pharynx.. pharynx معناته إيش؟  حلق.. شو
+
+282
+00:19:00,800 --> 00:19:05,190
+يعني؟ بقول لك بتطلع في الـ pharynx، كيف بتشوفهم؟ دائمًا
+
+283
+00:19:05,190 --> 00:19:09,070
+بدنا نستخدم الـ tongue depressors، اللي هو خافض
+
+284
+00:19:09,070 --> 00:19:12,730
+اللسان، الطبيب دائمًا بشوفه، دائمًا بتلاقي مسك خافض
+
+285
+00:19:12,730 --> 00:19:16,410
+اللسان، اللي زي عود الأسكيمو، بس بتكون عريضة شوية
+
+286
+00:19:16,410 --> 00:19:20,330
+وبقول له افتح الفم، وبضغط على اللسان، فمجرد ما يضغط
+
+287
+00:19:20,330 --> 00:19:23,990
+الطبيب على لسان المريض، بتلاقي دغري الأنسجة
+
+288
+00:19:23,990 --> 00:19:27,110
+الداخلية بتاعة الـ mouth، سبحان الله، طلعت لبرا، و
+
+289
+00:19:27,110 --> 00:19:30,270
+بيان، فهذه الـ pharyngeal tissues، بيسموها إيش احنا
+
+290
+00:19:30,270 --> 00:19:33,460
+بنسميها pharyngeal tissues، يعني اللي هو الخلايا
+
+291
+00:19:33,460 --> 00:19:37,560
+كلها الممثلة بالحلق من ورا، normally، بشكل طبيعي
+
+292
+00:19:37,560 --> 00:19:40,680
+تكون، لازم تكون pink and smooth، إذا في abnormality
+
+293
+00:19:40,680 --> 00:19:43,860
+بنكون عنده infection، سواء كانت pharyngitis أو أي
+
+294
+00:19:43,860 --> 00:19:47,360
+كانت، أو لا قدر الله في tumor، أو لا قدر الله في
+
+295
+00:19:47,360 --> 00:19:51,480
+lacerations، أو abrasions. بنكتبها إيه؟ بنسأل إذا في
+
+296
+00:19:51,480 --> 00:19:56,220
+وذمة؟ هل في laceration؟ نشوف إذا في inflammation؟
+
+297
+00:19:57,280 --> 00:20:00,060
+نشوف كل هذا، إذا فيه، والله سبحانه وتعالى، abnormal
+
+298
+00:20:00,060 --> 00:20:04,500
+lesions، وكله بندونه، وبنحكيه لمين؟ وبنحكيه للطبيب
+
+299
+00:20:04,500 --> 00:20:08,640
+على حسب ما احنا قدرنا نعرف، إذا فيه أي مشكلة صحية.
+
+300
+00:20:08,640 --> 00:20:14,820
+assessment of the neck، assessment of the neck، هنا
+
+301
+00:20:14,820 --> 00:20:20,740
+إيش بقول لك؟ بدنا نعمل هاي، الرقبة قدامي، أفضل شيء
+
+302
+00:20:20,740 --> 00:20:24,960
+يكون المريض قاعد، وأنت بتعمل assessment للرقبة، خليه
+
+303
+00:20:24,960 --> 00:20:30,120
+قاعد، اتطلع. بعدين إيش؟ أحاول تمد إيدك، وتعمل احساس،
+
+304
+00:20:30,120 --> 00:20:33,520
+لما قال لي inspection، يعني، الآن إيش بقول لي
+
+305
+00:20:33,520 --> 00:20:39,340
+palpation، بدك تشوف الـ neck muscles، عضلات الرقبة،
+
+306
+00:20:39,340 --> 00:20:45,340
+trachea، القصبة، طيب، thyroid gland، الغدة الدرقية،
+
+307
+00:20:45,340 --> 00:20:49,620
+carotid arteries، اللي هو إيش هنا؟ الشريان السباتي
+
+308
+00:20:49,620 --> 00:20:53,240
+اللي على الجنبين، الـ jugular veins، كل هذا أخدناه
+
+309
+00:20:53,240 --> 00:20:56,110
+في الـ anatomy، اللي على اليمين وعلى الشمال. Cervical
+
+310
+00:20:56,110 --> 00:20:59,430
+lymph node، إذا في لا سمح الله، lymph node واضحات
+
+311
+00:20:59,430 --> 00:21:04,130
+ومبيّنات، حوالين الرقبة، أو حوالين خلينا نقول الـ
+
+312
+00:21:04,130 --> 00:21:08,790
+cervical نفسه، اللي هو الحبل الشوكي، أو حوالين
+
+313
+00:21:08,790 --> 00:21:13,390
+الفقرات. نشوف الـ cervical كمان vertebrae، اللي هو
+
+314
+00:21:13,390 --> 00:21:18,510
+الفقرات العنقية، نشوفه، نعمل assessment كويس، assessment neck
+
+315
+00:21:18,510 --> 00:21:22,650
+size، حجم الرقبة، نشوف الـ position of trachea، هل
+
+316
+00:21:22,650 --> 00:21:27,510
+القصبة يعني جاي center، بالضبط، وكويسة، ومتوسطة، ولا في
+
+317
+00:21:27,510 --> 00:21:30,850
+في problem. منشوف الـ thyroid، يعني لا سمح الله
+
+318
+00:21:30,850 --> 00:21:34,090
+الـ thyroid gland، لازم تكون حواليها بالضبط، وجاي في
+
+319
+00:21:34,090 --> 00:21:37,410
+الـ center، في الوسط. هل الـ thyroid gland كبيرة وكده
+
+320
+00:21:37,410 --> 00:21:40,790
+تحسها؟ هو حد يفكر أن الـ thyroid gland، بقدر أحسها
+
+321
+00:21:40,790 --> 00:21:44,450
+مباشرة؟ لأ، إذا حسيناها، معناته في abnormality في
+
+322
+00:21:44,450 --> 00:21:48,150
+abnormal enlargement، normally not palpable، خليكم
+
+323
+00:21:48,150 --> 00:21:52,250
+تذكرّوا، normally not palpable، إذا كان في abnormal
+
+324
+00:21:52,250 --> 00:21:56,220
+lesion، وصار فينا يعني abnormal enlargement، ممكن إيش
+
+325
+00:21:56,220 --> 00:22:01,840
+نقدر نحسها. طيب، assess range of motion، بنتشوف كده
+
+326
+00:22:01,840 --> 00:22:05,720
+حركتها بتاعت إيه؟ الرقبة، كيف؟ على طريق أنه نسأل
+
+327
+00:22:05,720 --> 00:22:08,920
+المريض، ask the client to، إيش؟ tilt the head
+
+328
+00:22:08,920 --> 00:22:12,340
+backward، إيش يعني؟ tilt head backward and side to
+
+329
+00:22:12,340 --> 00:22:16,440
+side؟ بنقول له لو سمحت، رجع رأسك لورا على آخر، وبعدين
+
+330
+00:22:16,440 --> 00:22:22,110
+دير رأسك يمين ويسار. احنا الآن بنراقب قوة العضلات
+
+331
+00:22:22,110 --> 00:22:25,450
+اللي عاملة، بقدر يحرك فيها الرقبة، عشان أقدر أثبت
+
+332
+00:22:25,450 --> 00:22:30,190
+أنه فيه، أنه muscle weakness or not. طيب، assess
+
+333
+00:22:30,190 --> 00:22:34,670
+lymph node، لتشوف إذا فيه الأنسجة أو الخلايا
+
+334
+00:22:34,670 --> 00:22:38,410
+اللمفاوية، أو لا قدر الله، الـ venous distention.
+
+335
+00:22:38,410 --> 00:22:41,820
+إيش يعني venous distention؟ اللي هو زي ما بيقولوا له
+
+336
+00:22:41,820 --> 00:22:46,320
+دم، إيش اللي هو؟ بناجي انتفاخ في إيش؟ انتفاخ في الـ
+
+337
+00:22:46,320 --> 00:22:50,680
+veins اللي حوالين الرقبة، ومبيّنات، يعني حتى
+
+338
+00:22:50,680 --> 00:22:56,220
+بيقولوها بالعامية، شرايين رقبة مبيّنات، خاصة بعض الناس
+
+339
+00:22:56,220 --> 00:22:58,620
+اللي بيكونوا بيعصبوا كتير، أو عندهم severe
+
+340
+00:22:58,620 --> 00:23:02,060
+hypertension، أو الناس الـ very thin، ضعاف كتير، بيبين
+
+341
+00:23:02,060 --> 00:23:07,450
+عندهم distention. بقول إنك should be symmetrical.
+
+342
+00:23:07,450 --> 00:23:11,270
+لازم تكون إنك الرقبة إيش؟ symmetrical، يعني جاي
+
+343
+00:23:11,270 --> 00:23:16,710
+متوسطة، تكون full range of motion، تتحرك بسهولة، و
+
+344
+00:23:16,710 --> 00:23:21,610
+بكل أريحية في كافة الاتجاهات، يمين ويسار، وأمام، و
+
+345
+00:23:21,610 --> 00:23:26,670
+خلف، هذه الطبيعي، ما أقدرش أقول لك تبقى بدون، وين المشكلة
+
+346
+00:23:26,670 --> 00:23:31,140
+اللي واجهة فيها. بعدين، ما فيش حاجة بيسموها.. الواحد
+
+347
+00:23:31,140 --> 00:23:34,260
+يجي يقول لي هل ضروري نلاقي venous distention، سواء
+
+348
+00:23:34,260 --> 00:23:38,620
+كان arthritis، أو في venous؟ لأ، أنا ببدأ أقول لكم مش
+
+349
+00:23:38,620 --> 00:23:40,820
+لازم يكون venous distention، اللي أنا ذكرته هنا في
+
+350
+00:23:40,820 --> 00:23:44,440
+الـ distention، كله هذا abnormal thing، يبقى الطبيعي
+
+351
+00:23:44,440 --> 00:23:47,040
+ما يكونش فيه distention، لو كان فيه distention
+
+352
+00:23:47,040 --> 00:23:51,990
+معناته abnormal events. inspect، بتأكد، بتطلع، بتعمل
+
+353
+00:23:51,990 --> 00:23:57,110
+إيش؟ palpate، للـ cervical vertebrae، إيش يعني؟ فقرات عنقها
+
+354
+00:23:57,110 --> 00:24:01,330
+فقرات، الفقرات العنقية اللي احنا خدناها لما علّمونا
+
+355
+00:24:01,330 --> 00:24:04,390
+في الـ anatomy، اللي فقرات السبعة في cervical
+
+356
+00:24:04,390 --> 00:24:08,690
+vertebrae، سبعة، بدنا نحاول بس نعملها إيش؟ palpation.
+
+357
+00:24:08,690 --> 00:24:12,990
+نعمل بس إيش؟ نحط إصبعينا حوالين اللي هو النخاع
+
+358
+00:24:12,990 --> 00:24:18,510
+الشوكي، ونقعد نعصر شوية شوية لما ننزل لتحت، بس نشوف
+
+359
+00:24:18,510 --> 00:24:21,090
+بشكل عام، هل هي الـ symmetry؟ هل في abnormal
+
+360
+00:24:21,090 --> 00:24:24,370
+enlargement؟ هل لا سمح الله في bone prominence ولا
+
+361
+00:24:24,370 --> 00:24:27,730
+لأ. بنشوف، أنا طبعًا أكيد في الـ posterior aspect، و
+
+362
+00:24:27,730 --> 00:24:30,850
+تاني، أكيد طبعًا، مش معقول فقرات تكون في أمام الرقبة،
+
+363
+00:24:30,850 --> 00:24:35,550
+لأن في trachea، في يعني في vessels، فمش معقول. بنشوف
+
+364
+00:24:35,550 --> 00:24:39,970
+الـ symmetry، بنشوف الـ tenderness، الألم، بنشوف الـ
+
+365
+00:24:39,970 --> 00:24:43,650
+masses، لا قدر الله، بنشوف إذا في swelling كمان، و
+
+366
+00:24:43,650 --> 00:24:47,050
+إذا في swelling، ممكن إيش كمان؟ أنا أصفه، وأعرف إيش
+
+367
+00:24:47,050 --> 00:24:51,270
+بالضبط اللي موجود، بالضبط، أو طبيعته. طيب، احنا الآن
+
+368
+00:24:51,270 --> 00:24:54,450
+بقول لكم كمان، مش بس، بدك تشوف إيش؟ أنا، thyroid gland
+
+369
+00:24:55,870 --> 00:24:59,230
+يعني خليني أنا، حتى لو كانت قصيرة شوية المحاضرة
+
+370
+00:24:59,230 --> 00:25:02,930
+عشان احنا، لإنه صار في بعض المحاضرات تفوت الثلاثين
+
+371
+00:25:02,930 --> 00:25:06,390
+خليني أوقف هنا، وإن شاء الله المحاضرة القادمة أكمل
+
+372
+00:25:06,390 --> 00:25:09,570
+الحديث عن الـ thyroid gland. والسلام عليكم ورحمة
+
+373
+00:25:09,570 --> 00:25:10,330
+الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2efead62884e90e66886f5637749bb350c748076
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_postprocess.srt
@@ -0,0 +1,1492 @@
+1
+00:00:00,890 --> 00:00:03,250
+اقعدوا بالله مش طالجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,250 --> 00:00:07,190
+خلينا نكمل .. معلش سامحونا يعني كنت في المحاضرة
+
+3
+00:00:07,190 --> 00:00:13,490
+السابقة يمكن شوية مستعجل في الكلام مش لغرض
+
+4
+00:00:13,490 --> 00:00:18,190
+الاستعجال كم هو لغرض ان كنت بس بتخلص يعني وانهي
+
+5
+00:00:18,190 --> 00:00:21,270
+اللي هو ال assessment of the year عشان مابديش اقطع
+
+6
+00:00:21,270 --> 00:00:25,570
+الخاصة لما تكون المحاضرة مزجمة في نفس العضو بيكون
+
+7
+00:00:25,570 --> 00:00:28,870
+أفضل يعني و احنا بنعمل assessment assessment of
+
+8
+00:00:28,870 --> 00:00:32,620
+the noseالان كيف بتعمل assessment للنوز الأنف؟
+
+9
+00:00:32,620 --> 00:00:36,580
+خلصتي لإيه لآن النوز؟ أول حاجة بتذكر ال functions
+
+10
+00:00:36,580 --> 00:00:40,880
+of the nose، ليش؟ الله سبحانه وتعالى يعني أوجد لنا
+
+11
+00:00:40,880 --> 00:00:43,920
+هذا الأنف، يمكن بعض الناس بيجي ببالنا انه دغري
+
+12
+00:00:43,920 --> 00:00:50,260
+مباشرة، انه احنا بس بنا ان نتنفس أو نشمش مباشرة،
+
+13
+00:00:50,260 --> 00:00:55,920
+سوء في طبعا بوسطته، سبحان اللهالانش بيقولي اول
+
+14
+00:00:55,920 --> 00:00:59,060
+حاجة ال functions and knows ان احنا identify
+
+15
+00:00:59,060 --> 00:01:03,500
+orders بيحدد ايش الرواقع من قدرت الله انه خلانا
+
+16
+00:01:03,500 --> 00:01:07,600
+نقدر نميز بين الرائحة الفلاني عن الرائحة العلاني و
+
+17
+00:01:07,600 --> 00:01:11,840
+هكذا طب وين هذا؟ من وين بنشم احنا؟ بيقولي في ال
+
+18
+00:01:11,840 --> 00:01:15,440
+upper one third of the system سبحان اللهالقدرة على
+
+19
+00:01:15,440 --> 00:01:19,320
+الشم بس في أعلى الأنف علشان هيك الإنسان لما بده
+
+20
+00:01:19,320 --> 00:01:24,700
+يشم شيء بتلاقي الإنسان بيجرب أنفه لشيء بس تقريب مش
+
+21
+00:01:24,700 --> 00:01:29,100
+بتضغط بكل أنفه عشان يشم الشيء طيب مش بس هيك ال
+
+22
+00:01:29,100 --> 00:01:33,700
+function كمان التانية air passageway كمان هو يعتبر
+
+23
+00:01:33,700 --> 00:01:39,340
+عضوم الأعضاء الجهاز التنفسي لمرور الهواء خاصة إيش
+
+24
+00:01:39,340 --> 00:01:42,460
+أنا في ال new board بكون إجباري air conditioning
+
+25
+00:01:42,460 --> 00:01:47,860
+كمان هو مش بس هيكهو يعتبر إيش ملطف اللي هو بيعملنا
+
+26
+00:01:47,860 --> 00:01:52,640
+humidify و warm إذا كان يعني والله الهواء بارد
+
+27
+00:01:52,640 --> 00:01:57,660
+بيحاول يدفيه و يعني سبحان الله و بيعملنا كمان
+
+28
+00:01:57,660 --> 00:02:00,540
+cleans يعني كمان إيش بنظف من الشوائب زي filter
+
+29
+00:02:00,540 --> 00:02:05,400
+خاصة لما يكون فيه dust يعني شوائب غبار خاصة في بعض
+
+30
+00:02:05,400 --> 00:02:09,160
+الحالات كمان البكتيريا الدارة و مش بس هي كمان هو
+
+31
+00:02:09,160 --> 00:02:12,600
+سبحان الله بيساعدنا و مسئول كمان على ال voice
+
+32
+00:02:12,600 --> 00:02:15,750
+resonance اللي وراهاللي هو run الصوت أو بيسموه
+
+33
+00:02:15,750 --> 00:02:21,450
+يعني الصوت الرنان، يعني هو اللي بيعطي run للصوت زي
+
+34
+00:02:21,450 --> 00:02:25,310
+بعض الناس اللي هم المغنيين و الناس المنشدين و
+
+35
+00:02:25,310 --> 00:02:28,650
+الناس اللي .. اللي سبحان الله اللي .. اللي بيقرأوا
+
+36
+00:02:28,650 --> 00:02:32,530
+القرآن بصوت جميل لما بنسمع كلمة غنة و .. و .. و
+
+37
+00:02:32,530 --> 00:02:35,610
+غير غنة طبعا بكون مسئول عن أكتر شيء اللي هو ال
+
+38
+00:02:35,610 --> 00:02:39,610
+nose في هذه الحالة طبعا سبحان الله يعني كيف هذا ال
+
+39
+00:02:39,610 --> 00:02:43,130
+nose هذا التركيب البسيط لكن اللي قدامنا لكن قداشه
+
+40
+00:02:43,130 --> 00:02:47,510
+ضعيفالان بيجي بقولي في حاجة تانية لو طلعنا في
+
+41
+00:02:47,510 --> 00:02:50,650
+الصورة اللي أمامكم هان بقولي inspect and palpate
+
+42
+00:02:50,650 --> 00:02:54,750
+مش بس هيك بدي أنا أمد إيده و أشوف ال nose أسس
+
+43
+00:02:54,750 --> 00:02:58,050
+symmetry .. symmetry يعني شوف ايش .. كيف فتحات
+
+44
+00:02:58,050 --> 00:03:02,410
+الأنف اللي على الجهتين الفتحات الأنف .. الأنف من
+
+45
+00:03:02,410 --> 00:03:06,170
+الأمام اسمها nostril .. nostril فتحات الأنفو skin
+
+46
+00:03:06,170 --> 00:03:10,670
+lesion شوف ليش أي ضرر أو ألم أو أذى حوالين إيش
+
+47
+00:03:10,670 --> 00:03:15,310
+فتحات الأنف و خاصة بكرا لما نروح نتدرب هنلاقي بعض
+
+48
+00:03:15,310 --> 00:03:18,410
+المرضى مركبينهم NG تيوب اللي هو نازيو كاسترك تيوب
+
+49
+00:03:18,410 --> 00:03:23,010
+بتلاقي حواليها في زي sloughing التقشر للأنف حوالين
+
+50
+00:03:23,010 --> 00:03:27,130
+اللي هو ال tube اللي داخله في جسم الإنسانالـ
+
+51
+00:03:27,130 --> 00:03:31,450
+Patency يعني فتحة الأنف هل هي طبيعية؟ هل فتحتين زي
+
+52
+00:03:31,450 --> 00:03:35,390
+بعض؟ و لازم مش بقولي أنا بقولي لازم تعمل test one
+
+53
+00:03:35,390 --> 00:03:38,850
+side ايش زي ما عملنا في العين ان مرة فحصنا العين
+
+54
+00:03:38,850 --> 00:03:43,150
+اليمنى و بعدين العين اليسرى كذلك في ال nose لازم
+
+55
+00:03:43,150 --> 00:03:47,630
+نفحص مرة العين اليمنى مرة الأنف الأيسر الفتحة
+
+56
+00:03:47,630 --> 00:03:51,570
+اليسرى و مرة الفتحة اليمنى طب ليش؟ لأن في بعض
+
+57
+00:03:51,570 --> 00:03:55,920
+الحالاتبيصير عندهم حاجة بيسموها deviation، إيش
+
+58
+00:03:55,920 --> 00:03:59,540
+يعني deviation؟ لو لاحظنا يعني ماعليش أمام أن احنا
+
+59
+00:03:59,540 --> 00:04:04,180
+بنطلع، هلاقيت هاي فيه nose و هنا فيه nose يعني
+
+60
+00:04:04,180 --> 00:04:08,020
+أكيد في منكم شاطر لو أنا سألتكم مين ال nose اللي
+
+61
+00:04:08,020 --> 00:04:12,330
+هنا يعني يعتبر فيه مشكلة؟ هنا ولا هنا؟طبعا الشاطر
+
+62
+00:04:12,330 --> 00:04:15,390
+هيقول ليه هاي المشكلة، اذا بتلاحظوا فيه حاجة
+
+63
+00:04:15,390 --> 00:04:19,210
+بيسموها انحراف، شايفين؟ لما اقول كلمة انحراف اسمه
+
+64
+00:04:19,210 --> 00:04:23,930
+deviation of nasal septum اسمه deviation of nasal
+
+65
+00:04:23,930 --> 00:04:26,990
+septum، هذا اللي بيسموه انحراف في الانف، بعض الناس
+
+66
+00:04:26,990 --> 00:04:30,690
+بيقول طب ليه، هل الانحراف بدر؟ اه بدر لإن الإنسان
+
+67
+00:04:30,690 --> 00:04:35,050
+بيبطل يقدر يتنفس كويس و مرات بنيجي بنركب NGTO يعني
+
+68
+00:04:35,050 --> 00:04:39,090
+لو بنتخيلبنركب ng-tube لو بنركب ng-tube في هذا
+
+69
+00:04:39,090 --> 00:04:42,330
+المكان أو في هذا المكان الاتنين صح لكن لو بنركب ng
+
+70
+00:04:42,330 --> 00:04:45,010
+-tube في هذا المكان بيمشي لكن في هذا المكان مش
+
+71
+00:04:45,010 --> 00:04:48,710
+هيمشي طبعا كيف؟ فيه انحناء علشان هيك بيبين لما أنا
+
+72
+00:04:48,710 --> 00:04:52,410
+بتطلع في الواحد يعني النظرة كويسة بقدر أعرف إنه
+
+73
+00:04:52,410 --> 00:04:56,230
+عنده deviation أو لا طيب بقول inspect and observe
+
+74
+00:04:56,230 --> 00:05:00,010
+لاحظ ال symmetry إذا في inflammation إذا في
+
+75
+00:05:00,010 --> 00:05:04,230
+deformityأي تشوقهات طب في حالة ما يكون في swelling
+
+76
+00:05:04,230 --> 00:05:07,550
+او deformities of the nose لو لجينا الانف شويه
+
+77
+00:05:07,550 --> 00:05:13,670
+متضخم دغري مباشرة بدي اعمله palpation واشوف هل في
+
+78
+00:05:13,670 --> 00:05:18,570
+tenderness يعني في ألم هل في swelling هل في
+
+79
+00:05:18,570 --> 00:05:22,190
+deviations زي ما احنا قلنا short deviation يعني هل
+
+80
+00:05:22,190 --> 00:05:26,850
+في رايح لليمين او رايح للشمال بشكل مش طبيعي اهم شي
+
+81
+00:05:26,850 --> 00:05:30,580
+اش بقول ان ال normalof the external nose لازم يكون
+
+82
+00:05:30,580 --> 00:05:34,420
+symmetrical يعني لازم الأنف الأيمن والأنف الأيسر
+
+83
+00:05:34,420 --> 00:05:39,760
+الفاتحتين والشكل والتضاريس واللون وكل الملمس بشكل
+
+84
+00:05:39,760 --> 00:05:45,020
+عام يكون الاتنين the same زي بعض بقول هنا non
+
+85
+00:05:45,020 --> 00:05:48,200
+tender مش مؤلمات بدون discharge ايش يعني بدون
+
+86
+00:05:48,200 --> 00:05:52,380
+discharge يعني دقر مستقيم straight طيب بدون يعني
+
+87
+00:05:52,380 --> 00:05:56,280
+يطلع اي افرازات السس ميكوزا إذا شوف الميكوزا
+
+88
+00:05:57,130 --> 00:06:00,970
+الميكوزة اللي هي طبعا اللي هي داخل البطانة لداخل
+
+89
+00:06:00,970 --> 00:06:04,030
+الأنفة بقول لي لازم تكون normal pink بتكون لونها
+
+90
+00:06:04,030 --> 00:06:08,010
+زي orange يلوش لو صار لونها ايش هنا خاصة ال
+
+91
+00:06:08,010 --> 00:06:11,490
+discharge لو صار فيه discharge أصفر أو أخضر عمال
+
+92
+00:06:11,490 --> 00:06:15,990
+بيطلع هنا إيش بدنا نشك أنه في عنده sinusitis لو
+
+93
+00:06:15,990 --> 00:06:19,010
+أجاب و قعدش كيلي والله أنا حاسس أنه في صداع من
+
+94
+00:06:19,010 --> 00:06:22,530
+الأمام يا أستاذ وبيطلع مني discharge لونه أصفر
+
+95
+00:06:22,530 --> 00:06:26,150
+غامق أو كده بنقول أنه عنده sinusitisطيب ال pale
+
+96
+00:06:26,150 --> 00:06:30,230
+mucosa ايش يعني ال pale mucosa ال pale mucosa
+
+97
+00:06:30,230 --> 00:06:35,920
+بيقصد هنا بشكل واضح وصريح لو انا اطلعت شوية شويةفي
+
+98
+00:06:35,920 --> 00:06:39,520
+داخل الأنفة اللي جيت لون إيش؟ فيه شاحب أو اللون ما
+
+99
+00:06:39,520 --> 00:06:43,580
+إلا الأبيض أكتر، إيش بيكون هذا؟ يعني أنا بيقعد
+
+100
+00:06:43,580 --> 00:06:47,280
+بيطلع كتير this charge، هذا allergy، إيش يعني؟
+
+101
+00:06:47,280 --> 00:06:49,640
+اللي بعض بيسموه running nose، إيش يعني running
+
+102
+00:06:49,640 --> 00:06:53,280
+nose؟ بتلاقي بيقولك الصبح أنا بيسير معاه سيلان في
+
+103
+00:06:53,280 --> 00:06:55,740
+الأنفة، لما نجي يقولنا سيلان في الأنفة لونه أبيض
+
+104
+00:06:55,740 --> 00:06:59,040
+أو clear، يعني مالوش لون، إيش بقول عنه؟ هذا عنده
+
+105
+00:06:59,040 --> 00:07:01,860
+allergy، ماعندهوش infection، كتير في حالات زي ذلك،
+
+106
+00:07:01,860 --> 00:07:05,380
+لما بطلع عليه الشمس، بكون مرتاحالان و كتير بنقول
+
+107
+00:07:05,380 --> 00:07:09,160
+احنا .. طبعا انا حكيت .. بدنا نأكد انه في حالة ال
+
+108
+00:07:09,160 --> 00:07:13,440
+NG tube الـ nasogastric tube لو كانت مركبة بده
+
+109
+00:07:13,440 --> 00:07:19,030
+تطلع على اللي هو الجلد حوالينحوالين ال tube نفسها
+
+110
+00:07:19,030 --> 00:07:22,430
+ليه؟ لأنه سبحان الله من رحمة ربنا لما الإنسان
+
+111
+00:07:22,430 --> 00:07:27,550
+بتنفس من الأنف و بطلع النفس برضه دخول و ضرب النفس
+
+112
+00:07:27,550 --> 00:07:31,710
+في أطراف الأنف بيعمل نوع من الترطيب سبحان الله و
+
+113
+00:07:31,710 --> 00:07:35,730
+خروج النفس برضه بيعمل نوع من الترطيب و بيخلي ال
+
+114
+00:07:35,730 --> 00:07:39,710
+skin soft تخيلوا معايا أنه صار في tube فبطل فصار
+
+115
+00:07:39,710 --> 00:07:42,830
+النفس من طريق ال mouth فبيخلي إيش هنا صار في
+
+116
+00:07:42,830 --> 00:07:46,650
+sloughing عشان هيك بقول check for إيش breakdown لل
+
+117
+00:07:46,650 --> 00:07:50,610
+skinأو execution تقرحات أو readiness أو sloughing
+
+118
+00:07:50,610 --> 00:07:55,290
+يعني صار فيه إيش انزلاع انزلاع في إيش في الجلد
+
+119
+00:07:55,290 --> 00:07:58,990
+اللي حوالين اللي ديوم طيب nasal assessment of
+
+120
+00:07:58,990 --> 00:08:02,210
+sinuses هذه أخدناها في إيش في الاناطميا بس من باب
+
+121
+00:08:02,210 --> 00:08:06,450
+معرفة عامة بشكل عام إحنا نأكد إنه بس على الأقل على
+
+122
+00:08:06,450 --> 00:08:10,760
+الأقل على الأقل إنه فيه انهانة أمامنافي هنا فوق
+
+123
+00:08:10,760 --> 00:08:15,020
+موجودة فوق محجر العين أيمن و أيصر اسمها frontal
+
+124
+00:08:15,020 --> 00:08:19,600
+sinus وفي هنا منطقات اللي هو ال nose على الجهتين
+
+125
+00:08:19,600 --> 00:08:24,420
+اسمها ethmoid sinus وفي هنا ايه هنا منطقة ايش
+
+126
+00:08:24,420 --> 00:08:29,520
+المجزلة اسمها maxillary maxillary sinuses يعني
+
+127
+00:08:29,520 --> 00:08:35,580
+جيوب انفية في منطقة المجزلة منطقة المجزلة طيب الآن
+
+128
+00:08:35,580 --> 00:08:39,040
+عشان تشوفاحنا بدنا نعمل assessment لل sinus بشكل
+
+129
+00:08:39,040 --> 00:08:44,500
+عام اهم اشي بقوللي اول حاجة ال frontal sinus اللي
+
+130
+00:08:44,500 --> 00:08:48,580
+موجودة تحت ال eyebrows زي ما انتوا شوفته في الصورة
+
+131
+00:08:48,580 --> 00:08:52,120
+و ال maxillary sinus اللي هي below cheek تحت الخد
+
+132
+00:08:52,120 --> 00:08:57,480
+مباشرة في فحص اسمه transillumination ايش يعني
+
+133
+00:08:57,480 --> 00:09:00,500
+transillumination الان هوريكم الصورة و هتفهموها
+
+134
+00:09:00,500 --> 00:09:04,440
+لحالكم ايش يعني transillumination انهم بيسموهالفحص
+
+135
+00:09:04,440 --> 00:09:07,940
+بالضوء، ايش يعني الفحص بالضوء؟ الان هقولكوا الان
+
+136
+00:09:07,940 --> 00:09:12,160
+هو ايش معناه جيوب؟ شو يعني الجيوب؟ يعني لما اقول
+
+137
+00:09:12,160 --> 00:09:17,000
+جيوب انفيه، ايه جيوب؟ جيوب من اسمه انه في اشي جوا
+
+138
+00:09:17,000 --> 00:09:22,280
+في الداخل في جلب العضم مفتوح ويله زي ايش تجويف
+
+139
+00:09:22,280 --> 00:09:26,680
+داخلي كأنه زي عامل سبحان الله زي أخدود هيك هذا
+
+140
+00:09:26,680 --> 00:09:31,800
+علشان يعمل في عملية التوازنوعملية الرنة في الصوت
+
+141
+00:09:31,800 --> 00:09:36,200
+وعملية التوازن عشان سبحان الله لما ال skull تكون
+
+142
+00:09:36,200 --> 00:09:40,980
+كلها عضم مصمت بيصير الأمر مش كتير سبحان الله يعني
+
+143
+00:09:40,980 --> 00:09:44,140
+ثقيل وبيصعب على الإنسان يقدر يتعامل مع الناس لكن
+
+144
+00:09:44,140 --> 00:09:48,800
+ال resonance هذه ورنانة الصوت وخفة الحركة في ال
+
+145
+00:09:48,800 --> 00:09:52,740
+skull هذه اللي جعلتها هي ال sinuses وانت قدتوا هذا
+
+146
+00:09:52,740 --> 00:09:57,200
+الكلام في ال Anatomy ال frontal sinusاللي موجودة
+
+147
+00:09:57,200 --> 00:10:01,900
+والمقزلر افحصهم بال transillumination كيف يعني انا
+
+148
+00:10:01,900 --> 00:10:06,020
+هقولكوا كيف نعملها بقوللي الطبيعي ان ال light
+
+149
+00:10:06,020 --> 00:10:08,720
+الضوء لازم يكون symmetrically ايش يعني
+
+150
+00:10:08,720 --> 00:10:12,420
+symmetrically يعني لازم الضوء يطلع مباشرة طيب انا
+
+151
+00:10:12,420 --> 00:10:16,500
+بدي اقرأ المصطلح تبع transillumination و بعدين
+
+152
+00:10:16,500 --> 00:10:19,380
+الشريحة التانية فيها الصورة شو يعني
+
+153
+00:10:19,380 --> 00:10:23,420
+transillumination بقوللي عبارة عن إيش اللي هو
+
+154
+00:10:23,420 --> 00:10:29,330
+انتشار الضوءفي الخلايا في جسم الإنسان زى ايه زى
+
+155
+00:10:29,330 --> 00:10:32,830
+موضوع ال fingers مثلا لو احنا جبنا كل واحد فيكم
+
+156
+00:10:32,830 --> 00:10:37,270
+ممكن يجرب نفس التجربة اللى بده احكيها لان سبحان
+
+157
+00:10:37,270 --> 00:10:42,950
+الله رحمة ربنا انه احنا الضوء برضه بنستخدمه مرات
+
+158
+00:10:42,950 --> 00:10:46,670
+لل examination بيقدر يكشفلي انه في مشكلة حتى
+
+159
+00:10:46,670 --> 00:10:51,270
+الإشعاع بعتمد مرات على الضوء لما بتصور الإشعاع زى
+
+160
+00:10:51,270 --> 00:10:54,550
+كيف لان لو مساكن الأصبع الإبهام أصبع الإبهام
+
+161
+00:10:54,880 --> 00:10:58,120
+الكبير، الإصبع اللي بيهام الكبير، الإصبع اللي
+
+162
+00:10:58,120 --> 00:11:01,520
+بيهام الكبير، لو جينا مساكنة الضوء، يعني زي ايش
+
+163
+00:11:01,520 --> 00:11:05,360
+الضوء؟ مثلا لو أنا معايا pin light، لو ماعيش pin
+
+164
+00:11:05,360 --> 00:11:09,260
+light، بدي أمسك الجوال تبعي، فتحت ال flash، الضوء
+
+165
+00:11:09,260 --> 00:11:14,560
+تبعهو حطيت الإضاءة مباشرة يعني لاصقتها للإصبع من
+
+166
+00:11:14,560 --> 00:11:17,640
+الأمام .. لاصقتها للإصبع من الأمام .. إصبع الإبهام
+
+167
+00:11:17,640 --> 00:11:21,140
+أمامنا .. انت ماسكة بيدك الشمال أو بيدك شمال و جبت
+
+168
+00:11:21,140 --> 00:11:25,540
+الجوال بيدك لمين و خلت الضوء يلاصق مباشرة للإبهام
+
+169
+00:11:25,540 --> 00:11:29,080
+.. لأن لو طلعنا على الإبهام من فوق من جهة الإظفار
+
+170
+00:11:29,080 --> 00:11:32,540
+.. لو طلعنا على الإبهام من جهة الإظفار .. هنلاقي
+
+171
+00:11:32,540 --> 00:11:36,120
+سبحان الله لون أحمر .. لون أحمر .. مع إن الطول تبع
+
+172
+00:11:36,120 --> 00:11:41,040
+الجوالمع ان ضوء الجوال لونه أبيض أو يعني لون ..
+
+173
+00:11:41,040 --> 00:11:44,800
+يعني ممكن يكون ايش .. يعني لون اي لون لكن ليش
+
+174
+00:11:44,800 --> 00:11:48,860
+طريقه لونه أحمر؟ ليش طريقه لون أحمر؟ هلجت هنعرف؟
+
+175
+00:11:48,860 --> 00:11:53,740
+سبحان الله اش بقوللي هنا بقوللي السبب ان ال red
+
+176
+00:11:53,740 --> 00:11:57,440
+blood cells كوريات الدم الحمراء تم تص .. انتوا
+
+177
+00:11:57,440 --> 00:12:00,800
+عارفين ان الضوء يحتوي .. يعني انتوا عارفين في سبع
+
+178
+00:12:00,800 --> 00:12:05,180
+ألوان في مجال الطيف سبع ألوان لكن اش بقوللي هنالو
+
+179
+00:12:05,180 --> 00:12:09,180
+احنا حطينا ضوء بيمطص اللي هو كوريات الدم الحمراء
+
+180
+00:12:09,180 --> 00:12:14,340
+جميع الألوان و بس بتطلع اللون اللي بيشبهها، ايش هو
+
+181
+00:12:14,340 --> 00:12:18,500
+اللي هو اللون الأحمر، علشانك لو تطلعنا على الأدفر
+
+182
+00:12:18,500 --> 00:12:22,940
+من فوق، هنلاقي لون أحمر طالع، لون أحمر غامق، و هذا
+
+183
+00:12:22,940 --> 00:12:26,990
+اللي اكتر بعض الحالات لما نبنيجيزي ال pulse
+
+184
+00:12:26,990 --> 00:12:29,990
+oximeter زي حد شافه عمره شافه يبنيجي من جسم ال
+
+185
+00:12:29,990 --> 00:12:35,310
+pulse في إضاءة يعني زي في instrument صغيرة بتركب
+
+186
+00:12:35,310 --> 00:12:38,930
+فيها الأصبع لو طلعنا الأصبع من فوق بنلاقي الضوء
+
+187
+00:12:38,930 --> 00:12:43,930
+اللي جاي من تحت مخترق الأصبع و طالع لفوق لون أحمر
+
+188
+00:12:43,930 --> 00:12:47,630
+هذا ليش شرحت هذا الكلام كله؟ أول إشي هذا ال
+
+189
+00:12:47,630 --> 00:12:51,480
+examination اسمه Transluminationلما نقول كلمة
+
+190
+00:12:51,480 --> 00:12:55,940
+transillumination يعني فحص نفاذية الضوء، نفاذية
+
+191
+00:12:55,940 --> 00:12:59,300
+الضوء، طب ليش كل هذا يا أستاذ؟ عشان نعرف إن ال
+
+192
+00:12:59,300 --> 00:13:03,100
+sinuses في مشكلة أو لأ و لا لأ، طبعا الآن هنا
+
+193
+00:13:03,100 --> 00:13:08,300
+بنعمل إحساس لل sinusesعن طريق الاش أصابع بنضغط في
+
+194
+00:13:08,300 --> 00:13:12,840
+ألم ولا مافيش لو روحنا هنا هذا اللي قدامكم هو اللي
+
+195
+00:13:12,840 --> 00:13:16,280
+باسمه Translumination كيف هي Translumination لو
+
+196
+00:13:16,280 --> 00:13:19,460
+جينا حطينا لو هذا اعتبرنا ضوء انا مابعيش هذا
+
+197
+00:13:19,460 --> 00:13:23,100
+الجهاز لو اي ضوء حطينا خاصة sharp light يعني الضوء
+
+198
+00:13:23,100 --> 00:13:26,000
+المباشر مش ضوء laser مابدهاش ضوء laser ضوء عادي
+
+199
+00:13:26,000 --> 00:13:29,600
+يكون قوى جدالو حطنا فى ده المكان و خلّينا المريض
+
+200
+00:13:29,600 --> 00:13:33,680
+يفتح الفم و جى نطلعنا فى الفم من جوا هنلاقي الضوء
+
+201
+00:13:33,680 --> 00:13:36,600
+طالع هنلاقي الضوء و ينطلع هنا هذا بنقول
+
+202
+00:13:36,600 --> 00:13:40,580
+Translumination God لو طلعنا هنا برضه مش احنا
+
+203
+00:13:40,580 --> 00:13:45,110
+قولنا فى frontal sinusلو حطينا الضوء فى هذا المكان
+
+204
+00:13:45,110 --> 00:13:49,010
+و هنا فى منطقة اللى هو ال forehead جبهة اللى هو
+
+205
+00:13:49,010 --> 00:13:53,530
+الرأس هنلاقي الضوء طالع طبعا هو صحيح مش تخصصنا لكن
+
+206
+00:13:53,530 --> 00:13:58,830
+عشان نعرف ان هذا الفحص اسمه Translumination طيب
+
+207
+00:13:58,830 --> 00:14:03,170
+assessment of the sinus في ال frontal and
+
+208
+00:14:03,170 --> 00:14:07,230
+maxillary examined by pain and edema هل عنده ألم
+
+209
+00:14:07,230 --> 00:14:13,550
+هل عنده أديمة طيب بالبيت sinusحاولت تحس ال sinuses
+
+210
+00:14:13,550 --> 00:14:18,930
+من برا خاصة ال frontal و ال maxilla إذا فيه ألم
+
+211
+00:14:18,930 --> 00:14:22,230
+تنجرس عشان يمكن يكون عنده sinusitis، في بعض
+
+212
+00:14:22,230 --> 00:14:25,290
+الحالات كيف بنعمل؟ ممكن verbalize by the client،
+
+213
+00:14:25,290 --> 00:14:28,950
+يعني ممكن يقولك هوالمريض مجرد ما نحط انت .. يعني
+
+214
+00:14:28,950 --> 00:14:31,850
+انت ممكن لحالك تكشف انه يمكن ان انت عندك نفسك
+
+215
+00:14:31,850 --> 00:14:35,190
+sinusitis، حاول انت تضغط بإصبعك فوق ال .. ال
+
+216
+00:14:35,190 --> 00:14:39,830
+eyebrow، فوق الحاجب، اليمين والأيسر، لو ضغط شوية
+
+217
+00:14:39,830 --> 00:14:44,350
+عليه هيك شوية، لو ضغط شوية عليه، وصار فيه ألم،
+
+218
+00:14:44,350 --> 00:14:49,210
+بنعرف انه ممكن يكون sinusitisلو احنا كيف كنا
+
+219
+00:14:49,210 --> 00:14:51,830
+نستخدم كمان فحص تاني ال percussion اللي احنا
+
+220
+00:14:51,830 --> 00:14:55,250
+اتعلمنا زمان ال percussion ال percussion لزن
+
+221
+00:14:55,250 --> 00:14:59,350
+العملية الطرق على منطقة ال stylus لو طرقنا عليه زي
+
+222
+00:14:59,350 --> 00:15:02,670
+ما نيجي مثلا عند منطقة ال ال forehead و طرقنا
+
+223
+00:15:02,670 --> 00:15:05,350
+بالاسبوع زي ال direct percussion اذا صار فيه ألم
+
+224
+00:15:05,350 --> 00:15:09,550
+بيقولي اه والله انا اتألمت مافيش الطبيعي عامل حاجة
+
+225
+00:15:09,550 --> 00:15:13,170
+بيسموها hollow ايش hollow كأنك بتسمع يعني كأنك
+
+226
+00:15:13,170 --> 00:15:17,640
+بتضرب على شيء أجوف زي صوت الطابلة شويةلكن إذا ..
+
+227
+00:15:17,640 --> 00:15:23,240
+إذا لا سمح الله حسينا إنه فيه flat، إيش يعني flat؟
+
+228
+00:15:23,240 --> 00:15:26,320
+flat tone أو dull tone، يعني حسينا الصوت جامد أو
+
+229
+00:15:26,320 --> 00:15:30,480
+غامض أو الصوت يعني زي لوح، معناته فورا بنقول لأ
+
+230
+00:15:30,480 --> 00:15:34,120
+هذا ممكن إيش يكون عنده severe sinusitis عشان هيك
+
+231
+00:15:34,120 --> 00:15:38,470
+بنسمعبعض الناس ان عنده اتهاب جيوب انفية حاد او
+
+232
+00:15:38,470 --> 00:15:42,490
+مزمن و اضطروا يعملوله غسيل للجيوب عشان يحاولوا
+
+233
+00:15:42,490 --> 00:15:47,310
+ينظفوا الجيوب من اللي موجود فيها و اللي أثر على
+
+234
+00:15:47,310 --> 00:15:52,350
+المريض بشكل عام طيب assessment of ايه assessment
+
+235
+00:15:52,350 --> 00:15:57,650
+of mouth and pharynx بنعمل الان روحنا لل mouth
+
+236
+00:15:57,650 --> 00:16:01,510
+اللي أمامي و احنا بالان نتواصف من الذكر انا مش كل
+
+237
+00:16:01,510 --> 00:16:05,020
+شيء بهمنيبس انا بهمنى اللى هو على هى ال mouth
+
+238
+00:16:05,020 --> 00:16:09,100
+اللبس بتهمنى طيب و بتهمنى ال teeth و التونس اللى
+
+239
+00:16:09,100 --> 00:16:12,560
+هشوفهى زى ما تشوفينه اللى هزل على الجنبين ال UV
+
+240
+00:16:12,560 --> 00:16:15,820
+اللى هدا اللى هه اللى لورا و بهمنى ال tongue كلكوا
+
+241
+00:16:15,820 --> 00:16:20,960
+عارفينه بهمنى اش كمان هنا اللى ه جنجفة اللى هلثة
+
+242
+00:16:20,960 --> 00:16:25,600
+الاسنان اللثة طيب الان assessment of oral cavity
+
+243
+00:16:25,600 --> 00:16:29,260
+اول حاجة عشان اعمل assessment كويسة ل oral cavity
+
+244
+00:16:29,700 --> 00:16:32,900
+can be made during a administration of oral
+
+245
+00:16:32,900 --> 00:16:36,940
+hygiene الان كتير بعض الناس باجي بتشوف ال oral
+
+246
+00:16:36,940 --> 00:16:39,720
+cavity باجي بقوله طبعا في بعض الحالات الصعبة زي في
+
+247
+00:16:39,720 --> 00:16:43,740
+حالات ال .. يعني اللي هو complete paralysis بقدرش
+
+248
+00:16:43,740 --> 00:16:46,320
+يعمل شيء و أنا بدي أساعده في ال oral hygiene زي ما
+
+249
+00:16:46,320 --> 00:16:49,120
+علمونا في ال fundamental مباشرة بقدر أعرف إن في
+
+250
+00:16:49,120 --> 00:16:52,360
+عنده مشكلة ولا لأ في ال oral cavity الأمر التالي
+
+251
+00:16:52,360 --> 00:16:56,840
+بتشوف ال lips شفافه هل ال color تبع كويس ال
+
+252
+00:16:56,840 --> 00:17:03,650
+texture hydrationفين يعني .. يعني فين رطبات ولا
+
+253
+00:17:03,650 --> 00:17:08,050
+جفات ال contour شكلها كيف شكلها عام ال legions في
+
+254
+00:17:08,050 --> 00:17:12,450
+اي ضرر او اي اذى ال inner inner and baculum mucosa
+
+255
+00:17:12,450 --> 00:17:16,970
+ال inner الداخلي baculum mucosa من جوا يعني الخد
+
+256
+00:17:16,970 --> 00:17:21,510
+من جوا اللي ال gums كمان بنشوفها و ال teeth كل هذه
+
+257
+00:17:21,510 --> 00:17:25,840
+inspected لإيه لبطلع على ال colorhydration ال
+
+258
+00:17:25,840 --> 00:17:29,740
+texture انا اللي حاجات اللي انا كتير شرحتها و اللي
+
+259
+00:17:29,740 --> 00:17:32,760
+اتكررت دي شغلنا اترجم لأن الحمد لله صرنا فاهمين
+
+260
+00:17:32,760 --> 00:17:35,740
+ايش اللي بنقصدهم بدنا نطلع اذا في ال SARS في
+
+261
+00:17:35,740 --> 00:17:40,440
+abrasions مكحوتس حاجات اي شي crust اي حاجة خاصة ال
+
+262
+00:17:40,440 --> 00:17:43,320
+crust اللي بتكره الحقل الاسنان اللي زي اللي
+
+263
+00:17:43,320 --> 00:17:49,540
+بيسموها يعني الترسيبات الجيرية على الأسنان ال
+
+264
+00:17:49,540 --> 00:17:53,420
+tongue بتطلع ال tongue خاصة اللي في floor of the
+
+265
+00:17:53,420 --> 00:17:57,420
+mouthيعني أرض ال .. أرضية ال .. ال mouth بتطلع إذا
+
+266
+00:17:57,420 --> 00:18:01,520
+في لا سمح الله خاصة إذا في abnormalities أو أي
+
+267
+00:18:01,520 --> 00:18:06,260
+مثلا لا سمح الله مدناش نقول مثلا injury أو حتى ال
+
+268
+00:18:06,260 --> 00:18:10,080
+killer إذا في أي شي مختلف أو بقول لا قدر الله اللي
+
+269
+00:18:10,080 --> 00:18:14,080
+بيجي بعض الناس بقولك أنا في عندي دايما يعني ..
+
+270
+00:18:14,080 --> 00:18:16,700
+دايما infection chronically زي الحم اللي بيصير
+
+271
+00:18:16,700 --> 00:18:19,340
+حوالين اللي هو ال tongue ممكن كمان هذا نعمله إيش
+
+272
+00:18:19,340 --> 00:18:23,800
+assessment و نحكي للطبيب الآن إيش بقولي أناPulpate
+
+273
+00:18:23,800 --> 00:18:27,300
+soft and hard palate الشيء اللى بيلاقيه سقف الحلق
+
+274
+00:18:27,300 --> 00:18:31,100
+لو حطينا لساننا لفوق بنلاقي سقف الحلق سقف الحلق
+
+275
+00:18:31,100 --> 00:18:35,000
+هذا اللى قدام بنلاقيه ماكن شوية اسمه hard palate و
+
+276
+00:18:35,000 --> 00:18:39,000
+اللى لورا اسمه soft palate طبعا بنطلع بنعمل
+
+277
+00:18:39,000 --> 00:18:42,900
+assessment نشوف ال color ال shape ال texture إذا
+
+278
+00:18:42,900 --> 00:18:46,660
+فيه لقدر الله extra bony prominences يعني عنده
+
+279
+00:18:46,660 --> 00:18:51,880
+نتوئات عضمية زائدة أو فيه defects يعني أي تشوهاتكل
+
+280
+00:18:51,880 --> 00:18:58,060
+هذا بدونه و بحكي لمن و بحكي للطبيب .. assessment
+
+281
+00:18:58,060 --> 00:19:00,800
+of pharynx .. pharynx معناته ايش؟ قلب العوم .. شو
+
+282
+00:19:00,800 --> 00:19:05,190
+يعني؟ بقولي بتطلع في ال pharynx كيف بتشوفهم؟دايما
+
+283
+00:19:05,190 --> 00:19:09,070
+بدنا نستخدم ال tongue depressors اللي هو خافض
+
+284
+00:19:09,070 --> 00:19:12,730
+اللسان الطبيب دايما بتشوفه دايما بتلاقي مسك خافض
+
+285
+00:19:12,730 --> 00:19:16,410
+اللسان اللي زي عودة ال اسكيمو بس بتكون عريضة شوية
+
+286
+00:19:16,410 --> 00:19:20,330
+و بقوله افتح الفم و بضغط على اللسان فمجرد ما يضغط
+
+287
+00:19:20,330 --> 00:19:23,990
+الطبيب على لسان المريض بتلاقي دغري الانسجة
+
+288
+00:19:23,990 --> 00:19:27,110
+الداخلية بتاعة ال mouth سبحان الله طلعت لبرا و
+
+289
+00:19:27,110 --> 00:19:30,270
+بيانت فهذه ال pharyngeal tissues بيسموها ايش احنا
+
+290
+00:19:30,270 --> 00:19:33,460
+بنسميها pharyngeal tissuesيعني اللي هو الخلايا
+
+291
+00:19:33,460 --> 00:19:37,560
+كلها الممثلة بالعوم من ورا normally بشكل طبيعي
+
+292
+00:19:37,560 --> 00:19:40,680
+تكون لازم تكون pink and smooth إذا في abnormality
+
+293
+00:19:40,680 --> 00:19:43,860
+بنكون عنده infection سواء كانت pharyngitis أو أي
+
+294
+00:19:43,860 --> 00:19:47,360
+كان أو لا قدر الله في tumor أو لا قدر الله في
+
+295
+00:19:47,360 --> 00:19:51,480
+lacerations أو abrasions بنكتبها إيه بنسأل إذا في
+
+296
+00:19:51,480 --> 00:19:56,220
+إديمة هل في الaceration شوف إذا في inflammation
+
+297
+00:19:57,280 --> 00:20:00,060
+نشوف كل هذا إذا فيه الله سبحانه و تعالى abnormal
+
+298
+00:20:00,060 --> 00:20:04,500
+lesions و كله بندونه و بنحكيه لمين و بنحكيه للطبيب
+
+299
+00:20:04,500 --> 00:20:08,640
+على حسب ما احنا قدرنا نعرف إذا فيه اي مشكلة صحية
+
+300
+00:20:08,640 --> 00:20:14,820
+assessment of the neck assessment of the neck هنا
+
+301
+00:20:14,820 --> 00:20:20,740
+إيش بقوليه؟ بدنا نعمل هاي الرقبة قدامي أفضل شيء
+
+302
+00:20:20,740 --> 00:20:24,960
+يكون المريض قاعد و أنت بتعمل assessment لرقبة خليه
+
+303
+00:20:24,960 --> 00:20:30,120
+قاعد اتطلعبعدين ايش؟ احاول تمد ايدك و تعمل احساس،
+
+304
+00:20:30,120 --> 00:20:33,520
+لما قال لي inspection يعني، الآن اش بقوللي
+
+305
+00:20:33,520 --> 00:20:39,340
+palpation، بدك تشوف ال neck muscles، عضلات الرقبة،
+
+306
+00:20:39,340 --> 00:20:45,340
+trachea، قصبة، طيب، thyroid gland، الغد الدراقية،
+
+307
+00:20:45,340 --> 00:20:49,620
+carotid arteries اللي هو ايش هنا الشريان التاجي
+
+308
+00:20:49,620 --> 00:20:53,240
+اللي على الجنبين، ال jugular veins، كل كهو أخدته
+
+309
+00:20:53,240 --> 00:20:56,110
+في ال anatomy اللي على اليمين و على الشمالcervical
+
+310
+00:20:56,110 --> 00:20:59,430
+lymph node اذا في الله سمح الله lymph node واضحات
+
+311
+00:20:59,430 --> 00:21:04,130
+وامبينات حوالين الرقبة او حوالين خلينا نقول ال
+
+312
+00:21:04,130 --> 00:21:08,790
+cervical نفسه اللي هو الحبل الشوكي او حوالين
+
+313
+00:21:08,790 --> 00:21:13,390
+الفقرات نشوف ال cervical كمان vertebra اللي هو
+
+314
+00:21:13,390 --> 00:21:18,510
+الفقرات الظهر نشوفه نعمل أسس منتج كويس أسس neck
+
+315
+00:21:18,510 --> 00:21:22,650
+size حجم الرقبة نشوف ال position of التراكي هل
+
+316
+00:21:22,650 --> 00:21:27,510
+القصبةيعني جاي center و بالظبط و كويسة و متوسطة و
+
+317
+00:21:27,510 --> 00:21:30,850
+لا في problem منشوف ال thyroid يعني الله سمح الله
+
+318
+00:21:30,850 --> 00:21:34,090
+ال thyroid gland يازم تكون حواليها بالضبط و جاي في
+
+319
+00:21:34,090 --> 00:21:37,410
+ال center في الوسط هل ال thyroid gland كبيرة و كده
+
+320
+00:21:37,410 --> 00:21:40,790
+تحسها هو حد يفكر أن ال thyroid gland بقدر أحسها
+
+321
+00:21:40,790 --> 00:21:44,450
+مباشرة لأ إذا حسناها معناته في abnormality في
+
+322
+00:21:44,450 --> 00:21:48,150
+abnormal enlargement normally not palpable خليكم
+
+323
+00:21:48,150 --> 00:21:52,250
+تاكرين normally not palpable إذا كان في abnormal
+
+324
+00:21:52,250 --> 00:21:56,220
+lesionوصار فينا يعني abnormal enlargement ممكن إيش
+
+325
+00:21:56,220 --> 00:22:01,840
+نقدر نحسها طيب assist range of motion بنتشوف كدهش
+
+326
+00:22:01,840 --> 00:22:05,720
+حركتها تبعت إيه الرقبة كيف؟ على طريق أنه نسأل
+
+327
+00:22:05,720 --> 00:22:08,920
+المريض ask the client to إيش tilt the head
+
+328
+00:22:08,920 --> 00:22:12,340
+backward إيش يعني tilt head backward and side to
+
+329
+00:22:12,340 --> 00:22:16,440
+side؟ بنقوله لو سمحت رجع رأسك لورا على آخر و بعدين
+
+330
+00:22:16,440 --> 00:22:22,110
+دير رأسك يمين و يسارو احنا الان بنراقب قوة العضلات
+
+331
+00:22:22,110 --> 00:22:25,450
+اللى عاملا بقدر يحرك فيها الرقبة عشان اقدر اثبت
+
+332
+00:22:25,450 --> 00:22:30,190
+انه فيه انه muscle weakness or not طيب assist
+
+333
+00:22:30,190 --> 00:22:34,670
+lymph node لتشوف اذا فيه الانسجة او الخلايا
+
+334
+00:22:34,670 --> 00:22:38,410
+اللينفاوية او لا قدر الله ال venous distinction
+
+335
+00:22:38,410 --> 00:22:41,820
+ايش يعني venous distinctionاللي هو زي ما بيقولوله
+
+336
+00:22:41,820 --> 00:22:46,320
+دم إيش اللي هو بناجي انتفاخ في إيش؟ انتفاخ في ال
+
+337
+00:22:46,320 --> 00:22:50,680
+veins اللي حوالين الرقبة و مبينات يعني حتى
+
+338
+00:22:50,680 --> 00:22:56,220
+بيقولوها بالعامية شروش رقبة مبينات خاصة بعض الناس
+
+339
+00:22:56,220 --> 00:22:58,620
+اللي بيكونوا بعصبوا كتير أو عندهم severe
+
+340
+00:22:58,620 --> 00:23:02,060
+hypertension أو الناس ال very thin ضعاف كتير بيبين
+
+341
+00:23:02,060 --> 00:23:07,450
+عندهم distentionبقول انك should be symmetrical
+
+342
+00:23:07,450 --> 00:23:11,270
+لازم تكون انك الرقبة اشمنت symmetrical يعني جاي
+
+343
+00:23:11,270 --> 00:23:16,710
+متوسطة تكون full range of motion تتحرك بسهولة و
+
+344
+00:23:16,710 --> 00:23:21,610
+بكل اريحية في كافة الاتجاهات يمين و يسار و امام و
+
+345
+00:23:21,610 --> 00:23:26,670
+خلف هذه الطبيعي ماقدرش ابنك تبقى بندون وين المشكلة
+
+346
+00:23:26,670 --> 00:23:31,140
+اللي وجه فيهابعدين مافيش حاجة بيسموها .. الواحد
+
+347
+00:23:31,140 --> 00:23:34,260
+ييجي يقول لي هل ضروري نلاقي vain distinction سواء
+
+348
+00:23:34,260 --> 00:23:38,620
+كان arthritis او في venous لأ انا بدأ أقولكوا مش
+
+349
+00:23:38,620 --> 00:23:40,820
+لازم يكون vain distinction اللي انا ذكرته هنا في
+
+350
+00:23:40,820 --> 00:23:44,440
+ال distinction كله هذا abnormal thing يبقى الطبيعي
+
+351
+00:23:44,440 --> 00:23:47,040
+مايكونش فيه distinction لو كان فيه distinction
+
+352
+00:23:47,040 --> 00:23:51,990
+معناته abnormal events inspect بتاكد تطلعبتعمل
+
+353
+00:23:51,990 --> 00:23:57,110
+ايش؟ pulpate لل cervical vertebraيش ان فقرات عنقها
+
+354
+00:23:57,110 --> 00:24:01,330
+فرقات الفقرات العنق اللي احنا خدناها لما نعلمونا
+
+355
+00:24:01,330 --> 00:24:04,390
+في ال anatomy اللي فقرات السبعة في cervical
+
+356
+00:24:04,390 --> 00:24:08,690
+vertebra سبعة بدنا نحاول بس نعملها ايش؟Palpation
+
+357
+00:24:08,690 --> 00:24:12,990
+نعمل بس إيش نحط إصبعيننا حوالين اللي هو النخاع
+
+358
+00:24:12,990 --> 00:24:18,510
+الشوكي و نقعد نعص شوية شوية لما ننزل لتحت بس نشوف
+
+359
+00:24:18,510 --> 00:24:21,090
+بشكل عام هل هي ال symmetry هل في abnormal
+
+360
+00:24:21,090 --> 00:24:24,370
+enlargement هل لا سمح الله في bone prominance ولا
+
+361
+00:24:24,370 --> 00:24:27,730
+لأ بنشوف أنا طبعا أكيد في ال posterior aspect و
+
+362
+00:24:27,730 --> 00:24:30,850
+تاني أكيد طبعا مش معقول فقراطة تكون في أمام الرقبة
+
+363
+00:24:30,850 --> 00:24:35,550
+لأن في track يو في يعني في vessels فمش معقول بنشوف
+
+364
+00:24:35,550 --> 00:24:39,970
+ال symmetryبنشوف ال tenderness الألم بنشوف ال
+
+365
+00:24:39,970 --> 00:24:43,650
+masses اللي قدر الله بنشوف إذا في swelling كمان و
+
+366
+00:24:43,650 --> 00:24:47,050
+إذا في swelling ممكن أيش كمان أنا أداءه و أعرف أيش
+
+367
+00:24:47,050 --> 00:24:51,270
+بالظبط اللي موجود بالظبط أو طبيعته طيب احنا الآن
+
+368
+00:24:51,270 --> 00:24:54,450
+بقولك كمان مش بس يك بدك تشوف ايش أنا thyroid gland
+
+369
+00:24:55,870 --> 00:24:59,230
+يعني خليني انا حتى لو كانت قصيرة شوية المحاضرة
+
+370
+00:24:59,230 --> 00:25:02,930
+علشان احنا لانه صار في بعض المحاضرات تفوت التلاتين
+
+371
+00:25:02,930 --> 00:25:06,390
+خليني اتوقف هنا وان شاء الله المحاضرة القادمة اكمل
+
+372
+00:25:06,390 --> 00:25:09,570
+الحديث عن ال thyroid gland والسلام عليكم ورحمة
+
+373
+00:25:09,570 --> 00:25:10,330
+الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2efead62884e90e66886f5637749bb350c748076
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/Ur94Fn4cgWw_raw.srt
@@ -0,0 +1,1492 @@
+1
+00:00:00,890 --> 00:00:03,250
+اقعدوا بالله مش طالجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,250 --> 00:00:07,190
+خلينا نكمل .. معلش سامحونا يعني كنت في المحاضرة
+
+3
+00:00:07,190 --> 00:00:13,490
+السابقة يمكن شوية مستعجل في الكلام مش لغرض
+
+4
+00:00:13,490 --> 00:00:18,190
+الاستعجال كم هو لغرض ان كنت بس بتخلص يعني وانهي
+
+5
+00:00:18,190 --> 00:00:21,270
+اللي هو ال assessment of the year عشان مابديش اقطع
+
+6
+00:00:21,270 --> 00:00:25,570
+الخاصة لما تكون المحاضرة مزجمة في نفس العضو بيكون
+
+7
+00:00:25,570 --> 00:00:28,870
+أفضل يعني و احنا بنعمل assessment assessment of
+
+8
+00:00:28,870 --> 00:00:32,620
+the noseالان كيف بتعمل assessment للنوز الأنف؟
+
+9
+00:00:32,620 --> 00:00:36,580
+خلصتي لإيه لآن النوز؟ أول حاجة بتذكر ال functions
+
+10
+00:00:36,580 --> 00:00:40,880
+of the nose، ليش؟ الله سبحانه وتعالى يعني أوجد لنا
+
+11
+00:00:40,880 --> 00:00:43,920
+هذا الأنف، يمكن بعض الناس بيجي ببالنا انه دغري
+
+12
+00:00:43,920 --> 00:00:50,260
+مباشرة، انه احنا بس بنا ان نتنفس أو نشمش مباشرة،
+
+13
+00:00:50,260 --> 00:00:55,920
+سوء في طبعا بوسطته، سبحان اللهالانش بيقولي اول
+
+14
+00:00:55,920 --> 00:00:59,060
+حاجة ال functions and knows ان احنا identify
+
+15
+00:00:59,060 --> 00:01:03,500
+orders بيحدد ايش الرواقع من قدرت الله انه خلانا
+
+16
+00:01:03,500 --> 00:01:07,600
+نقدر نميز بين الرائحة الفلاني عن الرائحة العلاني و
+
+17
+00:01:07,600 --> 00:01:11,840
+هكذا طب وين هذا؟ من وين بنشم احنا؟ بيقولي في ال
+
+18
+00:01:11,840 --> 00:01:15,440
+upper one third of the system سبحان اللهالقدرة على
+
+19
+00:01:15,440 --> 00:01:19,320
+الشم بس في أعلى الأنف علشان هيك الإنسان لما بده
+
+20
+00:01:19,320 --> 00:01:24,700
+يشم شيء بتلاقي الإنسان بيجرب أنفه لشيء بس تقريب مش
+
+21
+00:01:24,700 --> 00:01:29,100
+بتضغط بكل أنفه عشان يشم الشيء طيب مش بس هيك ال
+
+22
+00:01:29,100 --> 00:01:33,700
+function كمان التانية air passageway كمان هو يعتبر
+
+23
+00:01:33,700 --> 00:01:39,340
+عضوم الأعضاء الجهاز التنفسي لمرور الهواء خاصة إيش
+
+24
+00:01:39,340 --> 00:01:42,460
+أنا في ال new board بكون إجباري air conditioning
+
+25
+00:01:42,460 --> 00:01:47,860
+كمان هو مش بس هيكهو يعتبر إيش ملطف اللي هو بيعملنا
+
+26
+00:01:47,860 --> 00:01:52,640
+humidify و warm إذا كان يعني والله الهواء بارد
+
+27
+00:01:52,640 --> 00:01:57,660
+بيحاول يدفيه و يعني سبحان الله و بيعملنا كمان
+
+28
+00:01:57,660 --> 00:02:00,540
+cleans يعني كمان إيش بنظف من الشوائب زي filter
+
+29
+00:02:00,540 --> 00:02:05,400
+خاصة لما يكون فيه dust يعني شوائب غبار خاصة في بعض
+
+30
+00:02:05,400 --> 00:02:09,160
+الحالات كمان البكتيريا الدارة و مش بس هي كمان هو
+
+31
+00:02:09,160 --> 00:02:12,600
+سبحان الله بيساعدنا و مسئول كمان على ال voice
+
+32
+00:02:12,600 --> 00:02:15,750
+resonance اللي وراهاللي هو run الصوت أو بيسموه
+
+33
+00:02:15,750 --> 00:02:21,450
+يعني الصوت الرنان، يعني هو اللي بيعطي run للصوت زي
+
+34
+00:02:21,450 --> 00:02:25,310
+بعض الناس اللي هم المغنيين و الناس المنشدين و
+
+35
+00:02:25,310 --> 00:02:28,650
+الناس اللي .. اللي سبحان الله اللي .. اللي بيقرأوا
+
+36
+00:02:28,650 --> 00:02:32,530
+القرآن بصوت جميل لما بنسمع كلمة غنة و .. و .. و
+
+37
+00:02:32,530 --> 00:02:35,610
+غير غنة طبعا بكون مسئول عن أكتر شيء اللي هو ال
+
+38
+00:02:35,610 --> 00:02:39,610
+nose في هذه الحالة طبعا سبحان الله يعني كيف هذا ال
+
+39
+00:02:39,610 --> 00:02:43,130
+nose هذا التركيب البسيط لكن اللي قدامنا لكن قداشه
+
+40
+00:02:43,130 --> 00:02:47,510
+ضعيفالان بيجي بقولي في حاجة تانية لو طلعنا في
+
+41
+00:02:47,510 --> 00:02:50,650
+الصورة اللي أمامكم هان بقولي inspect and palpate
+
+42
+00:02:50,650 --> 00:02:54,750
+مش بس هيك بدي أنا أمد إيده و أشوف ال nose أسس
+
+43
+00:02:54,750 --> 00:02:58,050
+symmetry .. symmetry يعني شوف ايش .. كيف فتحات
+
+44
+00:02:58,050 --> 00:03:02,410
+الأنف اللي على الجهتين الفتحات الأنف .. الأنف من
+
+45
+00:03:02,410 --> 00:03:06,170
+الأمام اسمها nostril .. nostril فتحات الأنفو skin
+
+46
+00:03:06,170 --> 00:03:10,670
+lesion شوف ليش أي ضرر أو ألم أو أذى حوالين إيش
+
+47
+00:03:10,670 --> 00:03:15,310
+فتحات الأنف و خاصة بكرا لما نروح نتدرب هنلاقي بعض
+
+48
+00:03:15,310 --> 00:03:18,410
+المرضى مركبينهم NG تيوب اللي هو نازيو كاسترك تيوب
+
+49
+00:03:18,410 --> 00:03:23,010
+بتلاقي حواليها في زي sloughing التقشر للأنف حوالين
+
+50
+00:03:23,010 --> 00:03:27,130
+اللي هو ال tube اللي داخله في جسم الإنسانالـ
+
+51
+00:03:27,130 --> 00:03:31,450
+Patency يعني فتحة الأنف هل هي طبيعية؟ هل فتحتين زي
+
+52
+00:03:31,450 --> 00:03:35,390
+بعض؟ و لازم مش بقولي أنا بقولي لازم تعمل test one
+
+53
+00:03:35,390 --> 00:03:38,850
+side ايش زي ما عملنا في العين ان مرة فحصنا العين
+
+54
+00:03:38,850 --> 00:03:43,150
+اليمنى و بعدين العين اليسرى كذلك في ال nose لازم
+
+55
+00:03:43,150 --> 00:03:47,630
+نفحص مرة العين اليمنى مرة الأنف الأيسر الفتحة
+
+56
+00:03:47,630 --> 00:03:51,570
+اليسرى و مرة الفتحة اليمنى طب ليش؟ لأن في بعض
+
+57
+00:03:51,570 --> 00:03:55,920
+الحالاتبيصير عندهم حاجة بيسموها deviation، إيش
+
+58
+00:03:55,920 --> 00:03:59,540
+يعني deviation؟ لو لاحظنا يعني ماعليش أمام أن احنا
+
+59
+00:03:59,540 --> 00:04:04,180
+بنطلع، هلاقيت هاي فيه nose و هنا فيه nose يعني
+
+60
+00:04:04,180 --> 00:04:08,020
+أكيد في منكم شاطر لو أنا سألتكم مين ال nose اللي
+
+61
+00:04:08,020 --> 00:04:12,330
+هنا يعني يعتبر فيه مشكلة؟ هنا ولا هنا؟طبعا الشاطر
+
+62
+00:04:12,330 --> 00:04:15,390
+هيقول ليه هاي المشكلة، اذا بتلاحظوا فيه حاجة
+
+63
+00:04:15,390 --> 00:04:19,210
+بيسموها انحراف، شايفين؟ لما اقول كلمة انحراف اسمه
+
+64
+00:04:19,210 --> 00:04:23,930
+deviation of nasal septum اسمه deviation of nasal
+
+65
+00:04:23,930 --> 00:04:26,990
+septum، هذا اللي بيسموه انحراف في الانف، بعض الناس
+
+66
+00:04:26,990 --> 00:04:30,690
+بيقول طب ليه، هل الانحراف بدر؟ اه بدر لإن الإنسان
+
+67
+00:04:30,690 --> 00:04:35,050
+بيبطل يقدر يتنفس كويس و مرات بنيجي بنركب NGTO يعني
+
+68
+00:04:35,050 --> 00:04:39,090
+لو بنتخيلبنركب ng-tube لو بنركب ng-tube في هذا
+
+69
+00:04:39,090 --> 00:04:42,330
+المكان أو في هذا المكان الاتنين صح لكن لو بنركب ng
+
+70
+00:04:42,330 --> 00:04:45,010
+-tube في هذا المكان بيمشي لكن في هذا المكان مش
+
+71
+00:04:45,010 --> 00:04:48,710
+هيمشي طبعا كيف؟ فيه انحناء علشان هيك بيبين لما أنا
+
+72
+00:04:48,710 --> 00:04:52,410
+بتطلع في الواحد يعني النظرة كويسة بقدر أعرف إنه
+
+73
+00:04:52,410 --> 00:04:56,230
+عنده deviation أو لا طيب بقول inspect and observe
+
+74
+00:04:56,230 --> 00:05:00,010
+لاحظ ال symmetry إذا في inflammation إذا في
+
+75
+00:05:00,010 --> 00:05:04,230
+deformityأي تشوقهات طب في حالة ما يكون في swelling
+
+76
+00:05:04,230 --> 00:05:07,550
+او deformities of the nose لو لجينا الانف شويه
+
+77
+00:05:07,550 --> 00:05:13,670
+متضخم دغري مباشرة بدي اعمله palpation واشوف هل في
+
+78
+00:05:13,670 --> 00:05:18,570
+tenderness يعني في ألم هل في swelling هل في
+
+79
+00:05:18,570 --> 00:05:22,190
+deviations زي ما احنا قلنا short deviation يعني هل
+
+80
+00:05:22,190 --> 00:05:26,850
+في رايح لليمين او رايح للشمال بشكل مش طبيعي اهم شي
+
+81
+00:05:26,850 --> 00:05:30,580
+اش بقول ان ال normalof the external nose لازم يكون
+
+82
+00:05:30,580 --> 00:05:34,420
+symmetrical يعني لازم الأنف الأيمن والأنف الأيسر
+
+83
+00:05:34,420 --> 00:05:39,760
+الفاتحتين والشكل والتضاريس واللون وكل الملمس بشكل
+
+84
+00:05:39,760 --> 00:05:45,020
+عام يكون الاتنين the same زي بعض بقول هنا non
+
+85
+00:05:45,020 --> 00:05:48,200
+tender مش مؤلمات بدون discharge ايش يعني بدون
+
+86
+00:05:48,200 --> 00:05:52,380
+discharge يعني دقر مستقيم straight طيب بدون يعني
+
+87
+00:05:52,380 --> 00:05:56,280
+يطلع اي افرازات السس ميكوزا إذا شوف الميكوزا
+
+88
+00:05:57,130 --> 00:06:00,970
+الميكوزة اللي هي طبعا اللي هي داخل البطانة لداخل
+
+89
+00:06:00,970 --> 00:06:04,030
+الأنفة بقول لي لازم تكون normal pink بتكون لونها
+
+90
+00:06:04,030 --> 00:06:08,010
+زي orange يلوش لو صار لونها ايش هنا خاصة ال
+
+91
+00:06:08,010 --> 00:06:11,490
+discharge لو صار فيه discharge أصفر أو أخضر عمال
+
+92
+00:06:11,490 --> 00:06:15,990
+بيطلع هنا إيش بدنا نشك أنه في عنده sinusitis لو
+
+93
+00:06:15,990 --> 00:06:19,010
+أجاب و قعدش كيلي والله أنا حاسس أنه في صداع من
+
+94
+00:06:19,010 --> 00:06:22,530
+الأمام يا أستاذ وبيطلع مني discharge لونه أصفر
+
+95
+00:06:22,530 --> 00:06:26,150
+غامق أو كده بنقول أنه عنده sinusitisطيب ال pale
+
+96
+00:06:26,150 --> 00:06:30,230
+mucosa ايش يعني ال pale mucosa ال pale mucosa
+
+97
+00:06:30,230 --> 00:06:35,920
+بيقصد هنا بشكل واضح وصريح لو انا اطلعت شوية شويةفي
+
+98
+00:06:35,920 --> 00:06:39,520
+داخل الأنفة اللي جيت لون إيش؟ فيه شاحب أو اللون ما
+
+99
+00:06:39,520 --> 00:06:43,580
+إلا الأبيض أكتر، إيش بيكون هذا؟ يعني أنا بيقعد
+
+100
+00:06:43,580 --> 00:06:47,280
+بيطلع كتير this charge، هذا allergy، إيش يعني؟
+
+101
+00:06:47,280 --> 00:06:49,640
+اللي بعض بيسموه running nose، إيش يعني running
+
+102
+00:06:49,640 --> 00:06:53,280
+nose؟ بتلاقي بيقولك الصبح أنا بيسير معاه سيلان في
+
+103
+00:06:53,280 --> 00:06:55,740
+الأنفة، لما نجي يقولنا سيلان في الأنفة لونه أبيض
+
+104
+00:06:55,740 --> 00:06:59,040
+أو clear، يعني مالوش لون، إيش بقول عنه؟ هذا عنده
+
+105
+00:06:59,040 --> 00:07:01,860
+allergy، ماعندهوش infection، كتير في حالات زي ذلك،
+
+106
+00:07:01,860 --> 00:07:05,380
+لما بطلع عليه الشمس، بكون مرتاحالان و كتير بنقول
+
+107
+00:07:05,380 --> 00:07:09,160
+احنا .. طبعا انا حكيت .. بدنا نأكد انه في حالة ال
+
+108
+00:07:09,160 --> 00:07:13,440
+NG tube الـ nasogastric tube لو كانت مركبة بده
+
+109
+00:07:13,440 --> 00:07:19,030
+تطلع على اللي هو الجلد حوالينحوالين ال tube نفسها
+
+110
+00:07:19,030 --> 00:07:22,430
+ليه؟ لأنه سبحان الله من رحمة ربنا لما الإنسان
+
+111
+00:07:22,430 --> 00:07:27,550
+بتنفس من الأنف و بطلع النفس برضه دخول و ضرب النفس
+
+112
+00:07:27,550 --> 00:07:31,710
+في أطراف الأنف بيعمل نوع من الترطيب سبحان الله و
+
+113
+00:07:31,710 --> 00:07:35,730
+خروج النفس برضه بيعمل نوع من الترطيب و بيخلي ال
+
+114
+00:07:35,730 --> 00:07:39,710
+skin soft تخيلوا معايا أنه صار في tube فبطل فصار
+
+115
+00:07:39,710 --> 00:07:42,830
+النفس من طريق ال mouth فبيخلي إيش هنا صار في
+
+116
+00:07:42,830 --> 00:07:46,650
+sloughing عشان هيك بقول check for إيش breakdown لل
+
+117
+00:07:46,650 --> 00:07:50,610
+skinأو execution تقرحات أو readiness أو sloughing
+
+118
+00:07:50,610 --> 00:07:55,290
+يعني صار فيه إيش انزلاع انزلاع في إيش في الجلد
+
+119
+00:07:55,290 --> 00:07:58,990
+اللي حوالين اللي ديوم طيب nasal assessment of
+
+120
+00:07:58,990 --> 00:08:02,210
+sinuses هذه أخدناها في إيش في الاناطميا بس من باب
+
+121
+00:08:02,210 --> 00:08:06,450
+معرفة عامة بشكل عام إحنا نأكد إنه بس على الأقل على
+
+122
+00:08:06,450 --> 00:08:10,760
+الأقل على الأقل إنه فيه انهانة أمامنافي هنا فوق
+
+123
+00:08:10,760 --> 00:08:15,020
+موجودة فوق محجر العين أيمن و أيصر اسمها frontal
+
+124
+00:08:15,020 --> 00:08:19,600
+sinus وفي هنا منطقات اللي هو ال nose على الجهتين
+
+125
+00:08:19,600 --> 00:08:24,420
+اسمها ethmoid sinus وفي هنا ايه هنا منطقة ايش
+
+126
+00:08:24,420 --> 00:08:29,520
+المجزلة اسمها maxillary maxillary sinuses يعني
+
+127
+00:08:29,520 --> 00:08:35,580
+جيوب انفية في منطقة المجزلة منطقة المجزلة طيب الآن
+
+128
+00:08:35,580 --> 00:08:39,040
+عشان تشوفاحنا بدنا نعمل assessment لل sinus بشكل
+
+129
+00:08:39,040 --> 00:08:44,500
+عام اهم اشي بقوللي اول حاجة ال frontal sinus اللي
+
+130
+00:08:44,500 --> 00:08:48,580
+موجودة تحت ال eyebrows زي ما انتوا شوفته في الصورة
+
+131
+00:08:48,580 --> 00:08:52,120
+و ال maxillary sinus اللي هي below cheek تحت الخد
+
+132
+00:08:52,120 --> 00:08:57,480
+مباشرة في فحص اسمه transillumination ايش يعني
+
+133
+00:08:57,480 --> 00:09:00,500
+transillumination الان هوريكم الصورة و هتفهموها
+
+134
+00:09:00,500 --> 00:09:04,440
+لحالكم ايش يعني transillumination انهم بيسموهالفحص
+
+135
+00:09:04,440 --> 00:09:07,940
+بالضوء، ايش يعني الفحص بالضوء؟ الان هقولكوا الان
+
+136
+00:09:07,940 --> 00:09:12,160
+هو ايش معناه جيوب؟ شو يعني الجيوب؟ يعني لما اقول
+
+137
+00:09:12,160 --> 00:09:17,000
+جيوب انفيه، ايه جيوب؟ جيوب من اسمه انه في اشي جوا
+
+138
+00:09:17,000 --> 00:09:22,280
+في الداخل في جلب العضم مفتوح ويله زي ايش تجويف
+
+139
+00:09:22,280 --> 00:09:26,680
+داخلي كأنه زي عامل سبحان الله زي أخدود هيك هذا
+
+140
+00:09:26,680 --> 00:09:31,800
+علشان يعمل في عملية التوازنوعملية الرنة في الصوت
+
+141
+00:09:31,800 --> 00:09:36,200
+وعملية التوازن عشان سبحان الله لما ال skull تكون
+
+142
+00:09:36,200 --> 00:09:40,980
+كلها عضم مصمت بيصير الأمر مش كتير سبحان الله يعني
+
+143
+00:09:40,980 --> 00:09:44,140
+ثقيل وبيصعب على الإنسان يقدر يتعامل مع الناس لكن
+
+144
+00:09:44,140 --> 00:09:48,800
+ال resonance هذه ورنانة الصوت وخفة الحركة في ال
+
+145
+00:09:48,800 --> 00:09:52,740
+skull هذه اللي جعلتها هي ال sinuses وانت قدتوا هذا
+
+146
+00:09:52,740 --> 00:09:57,200
+الكلام في ال Anatomy ال frontal sinusاللي موجودة
+
+147
+00:09:57,200 --> 00:10:01,900
+والمقزلر افحصهم بال transillumination كيف يعني انا
+
+148
+00:10:01,900 --> 00:10:06,020
+هقولكوا كيف نعملها بقوللي الطبيعي ان ال light
+
+149
+00:10:06,020 --> 00:10:08,720
+الضوء لازم يكون symmetrically ايش يعني
+
+150
+00:10:08,720 --> 00:10:12,420
+symmetrically يعني لازم الضوء يطلع مباشرة طيب انا
+
+151
+00:10:12,420 --> 00:10:16,500
+بدي اقرأ المصطلح تبع transillumination و بعدين
+
+152
+00:10:16,500 --> 00:10:19,380
+الشريحة التانية فيها الصورة شو يعني
+
+153
+00:10:19,380 --> 00:10:23,420
+transillumination بقوللي عبارة عن إيش اللي هو
+
+154
+00:10:23,420 --> 00:10:29,330
+انتشار الضوءفي الخلايا في جسم الإنسان زى ايه زى
+
+155
+00:10:29,330 --> 00:10:32,830
+موضوع ال fingers مثلا لو احنا جبنا كل واحد فيكم
+
+156
+00:10:32,830 --> 00:10:37,270
+ممكن يجرب نفس التجربة اللى بده احكيها لان سبحان
+
+157
+00:10:37,270 --> 00:10:42,950
+الله رحمة ربنا انه احنا الضوء برضه بنستخدمه مرات
+
+158
+00:10:42,950 --> 00:10:46,670
+لل examination بيقدر يكشفلي انه في مشكلة حتى
+
+159
+00:10:46,670 --> 00:10:51,270
+الإشعاع بعتمد مرات على الضوء لما بتصور الإشعاع زى
+
+160
+00:10:51,270 --> 00:10:54,550
+كيف لان لو مساكن الأصبع الإبهام أصبع الإبهام
+
+161
+00:10:54,880 --> 00:10:58,120
+الكبير، الإصبع اللي بيهام الكبير، الإصبع اللي
+
+162
+00:10:58,120 --> 00:11:01,520
+بيهام الكبير، لو جينا مساكنة الضوء، يعني زي ايش
+
+163
+00:11:01,520 --> 00:11:05,360
+الضوء؟ مثلا لو أنا معايا pin light، لو ماعيش pin
+
+164
+00:11:05,360 --> 00:11:09,260
+light، بدي أمسك الجوال تبعي، فتحت ال flash، الضوء
+
+165
+00:11:09,260 --> 00:11:14,560
+تبعهو حطيت الإضاءة مباشرة يعني لاصقتها للإصبع من
+
+166
+00:11:14,560 --> 00:11:17,640
+الأمام .. لاصقتها للإصبع من الأمام .. إصبع الإبهام
+
+167
+00:11:17,640 --> 00:11:21,140
+أمامنا .. انت ماسكة بيدك الشمال أو بيدك شمال و جبت
+
+168
+00:11:21,140 --> 00:11:25,540
+الجوال بيدك لمين و خلت الضوء يلاصق مباشرة للإبهام
+
+169
+00:11:25,540 --> 00:11:29,080
+.. لأن لو طلعنا على الإبهام من فوق من جهة الإظفار
+
+170
+00:11:29,080 --> 00:11:32,540
+.. لو طلعنا على الإبهام من جهة الإظفار .. هنلاقي
+
+171
+00:11:32,540 --> 00:11:36,120
+سبحان الله لون أحمر .. لون أحمر .. مع إن الطول تبع
+
+172
+00:11:36,120 --> 00:11:41,040
+الجوالمع ان ضوء الجوال لونه أبيض أو يعني لون ..
+
+173
+00:11:41,040 --> 00:11:44,800
+يعني ممكن يكون ايش .. يعني لون اي لون لكن ليش
+
+174
+00:11:44,800 --> 00:11:48,860
+طريقه لونه أحمر؟ ليش طريقه لون أحمر؟ هلجت هنعرف؟
+
+175
+00:11:48,860 --> 00:11:53,740
+سبحان الله اش بقوللي هنا بقوللي السبب ان ال red
+
+176
+00:11:53,740 --> 00:11:57,440
+blood cells كوريات الدم الحمراء تم تص .. انتوا
+
+177
+00:11:57,440 --> 00:12:00,800
+عارفين ان الضوء يحتوي .. يعني انتوا عارفين في سبع
+
+178
+00:12:00,800 --> 00:12:05,180
+ألوان في مجال الطيف سبع ألوان لكن اش بقوللي هنالو
+
+179
+00:12:05,180 --> 00:12:09,180
+احنا حطينا ضوء بيمطص اللي هو كوريات الدم الحمراء
+
+180
+00:12:09,180 --> 00:12:14,340
+جميع الألوان و بس بتطلع اللون اللي بيشبهها، ايش هو
+
+181
+00:12:14,340 --> 00:12:18,500
+اللي هو اللون الأحمر، علشانك لو تطلعنا على الأدفر
+
+182
+00:12:18,500 --> 00:12:22,940
+من فوق، هنلاقي لون أحمر طالع، لون أحمر غامق، و هذا
+
+183
+00:12:22,940 --> 00:12:26,990
+اللي اكتر بعض الحالات لما نبنيجيزي ال pulse
+
+184
+00:12:26,990 --> 00:12:29,990
+oximeter زي حد شافه عمره شافه يبنيجي من جسم ال
+
+185
+00:12:29,990 --> 00:12:35,310
+pulse في إضاءة يعني زي في instrument صغيرة بتركب
+
+186
+00:12:35,310 --> 00:12:38,930
+فيها الأصبع لو طلعنا الأصبع من فوق بنلاقي الضوء
+
+187
+00:12:38,930 --> 00:12:43,930
+اللي جاي من تحت مخترق الأصبع و طالع لفوق لون أحمر
+
+188
+00:12:43,930 --> 00:12:47,630
+هذا ليش شرحت هذا الكلام كله؟ أول إشي هذا ال
+
+189
+00:12:47,630 --> 00:12:51,480
+examination اسمه Transluminationلما نقول كلمة
+
+190
+00:12:51,480 --> 00:12:55,940
+transillumination يعني فحص نفاذية الضوء، نفاذية
+
+191
+00:12:55,940 --> 00:12:59,300
+الضوء، طب ليش كل هذا يا أستاذ؟ عشان نعرف إن ال
+
+192
+00:12:59,300 --> 00:13:03,100
+sinuses في مشكلة أو لأ و لا لأ، طبعا الآن هنا
+
+193
+00:13:03,100 --> 00:13:08,300
+بنعمل إحساس لل sinusesعن طريق الاش أصابع بنضغط في
+
+194
+00:13:08,300 --> 00:13:12,840
+ألم ولا مافيش لو روحنا هنا هذا اللي قدامكم هو اللي
+
+195
+00:13:12,840 --> 00:13:16,280
+باسمه Translumination كيف هي Translumination لو
+
+196
+00:13:16,280 --> 00:13:19,460
+جينا حطينا لو هذا اعتبرنا ضوء انا مابعيش هذا
+
+197
+00:13:19,460 --> 00:13:23,100
+الجهاز لو اي ضوء حطينا خاصة sharp light يعني الضوء
+
+198
+00:13:23,100 --> 00:13:26,000
+المباشر مش ضوء laser مابدهاش ضوء laser ضوء عادي
+
+199
+00:13:26,000 --> 00:13:29,600
+يكون قوى جدالو حطنا فى ده المكان و خلّينا المريض
+
+200
+00:13:29,600 --> 00:13:33,680
+يفتح الفم و جى نطلعنا فى الفم من جوا هنلاقي الضوء
+
+201
+00:13:33,680 --> 00:13:36,600
+طالع هنلاقي الضوء و ينطلع هنا هذا بنقول
+
+202
+00:13:36,600 --> 00:13:40,580
+Translumination God لو طلعنا هنا برضه مش احنا
+
+203
+00:13:40,580 --> 00:13:45,110
+قولنا فى frontal sinusلو حطينا الضوء فى هذا المكان
+
+204
+00:13:45,110 --> 00:13:49,010
+و هنا فى منطقة اللى هو ال forehead جبهة اللى هو
+
+205
+00:13:49,010 --> 00:13:53,530
+الرأس هنلاقي الضوء طالع طبعا هو صحيح مش تخصصنا لكن
+
+206
+00:13:53,530 --> 00:13:58,830
+عشان نعرف ان هذا الفحص اسمه Translumination طيب
+
+207
+00:13:58,830 --> 00:14:03,170
+assessment of the sinus في ال frontal and
+
+208
+00:14:03,170 --> 00:14:07,230
+maxillary examined by pain and edema هل عنده ألم
+
+209
+00:14:07,230 --> 00:14:13,550
+هل عنده أديمة طيب بالبيت sinusحاولت تحس ال sinuses
+
+210
+00:14:13,550 --> 00:14:18,930
+من برا خاصة ال frontal و ال maxilla إذا فيه ألم
+
+211
+00:14:18,930 --> 00:14:22,230
+تنجرس عشان يمكن يكون عنده sinusitis، في بعض
+
+212
+00:14:22,230 --> 00:14:25,290
+الحالات كيف بنعمل؟ ممكن verbalize by the client،
+
+213
+00:14:25,290 --> 00:14:28,950
+يعني ممكن يقولك هوالمريض مجرد ما نحط انت .. يعني
+
+214
+00:14:28,950 --> 00:14:31,850
+انت ممكن لحالك تكشف انه يمكن ان انت عندك نفسك
+
+215
+00:14:31,850 --> 00:14:35,190
+sinusitis، حاول انت تضغط بإصبعك فوق ال .. ال
+
+216
+00:14:35,190 --> 00:14:39,830
+eyebrow، فوق الحاجب، اليمين والأيسر، لو ضغط شوية
+
+217
+00:14:39,830 --> 00:14:44,350
+عليه هيك شوية، لو ضغط شوية عليه، وصار فيه ألم،
+
+218
+00:14:44,350 --> 00:14:49,210
+بنعرف انه ممكن يكون sinusitisلو احنا كيف كنا
+
+219
+00:14:49,210 --> 00:14:51,830
+نستخدم كمان فحص تاني ال percussion اللي احنا
+
+220
+00:14:51,830 --> 00:14:55,250
+اتعلمنا زمان ال percussion ال percussion لزن
+
+221
+00:14:55,250 --> 00:14:59,350
+العملية الطرق على منطقة ال stylus لو طرقنا عليه زي
+
+222
+00:14:59,350 --> 00:15:02,670
+ما نيجي مثلا عند منطقة ال ال forehead و طرقنا
+
+223
+00:15:02,670 --> 00:15:05,350
+بالاسبوع زي ال direct percussion اذا صار فيه ألم
+
+224
+00:15:05,350 --> 00:15:09,550
+بيقولي اه والله انا اتألمت مافيش الطبيعي عامل حاجة
+
+225
+00:15:09,550 --> 00:15:13,170
+بيسموها hollow ايش hollow كأنك بتسمع يعني كأنك
+
+226
+00:15:13,170 --> 00:15:17,640
+بتضرب على شيء أجوف زي صوت الطابلة شويةلكن إذا ..
+
+227
+00:15:17,640 --> 00:15:23,240
+إذا لا سمح الله حسينا إنه فيه flat، إيش يعني flat؟
+
+228
+00:15:23,240 --> 00:15:26,320
+flat tone أو dull tone، يعني حسينا الصوت جامد أو
+
+229
+00:15:26,320 --> 00:15:30,480
+غامض أو الصوت يعني زي لوح، معناته فورا بنقول لأ
+
+230
+00:15:30,480 --> 00:15:34,120
+هذا ممكن إيش يكون عنده severe sinusitis عشان هيك
+
+231
+00:15:34,120 --> 00:15:38,470
+بنسمعبعض الناس ان عنده اتهاب جيوب انفية حاد او
+
+232
+00:15:38,470 --> 00:15:42,490
+مزمن و اضطروا يعملوله غسيل للجيوب عشان يحاولوا
+
+233
+00:15:42,490 --> 00:15:47,310
+ينظفوا الجيوب من اللي موجود فيها و اللي أثر على
+
+234
+00:15:47,310 --> 00:15:52,350
+المريض بشكل عام طيب assessment of ايه assessment
+
+235
+00:15:52,350 --> 00:15:57,650
+of mouth and pharynx بنعمل الان روحنا لل mouth
+
+236
+00:15:57,650 --> 00:16:01,510
+اللي أمامي و احنا بالان نتواصف من الذكر انا مش كل
+
+237
+00:16:01,510 --> 00:16:05,020
+شيء بهمنيبس انا بهمنى اللى هو على هى ال mouth
+
+238
+00:16:05,020 --> 00:16:09,100
+اللبس بتهمنى طيب و بتهمنى ال teeth و التونس اللى
+
+239
+00:16:09,100 --> 00:16:12,560
+هشوفهى زى ما تشوفينه اللى هزل على الجنبين ال UV
+
+240
+00:16:12,560 --> 00:16:15,820
+اللى هدا اللى هه اللى لورا و بهمنى ال tongue كلكوا
+
+241
+00:16:15,820 --> 00:16:20,960
+عارفينه بهمنى اش كمان هنا اللى ه جنجفة اللى هلثة
+
+242
+00:16:20,960 --> 00:16:25,600
+الاسنان اللثة طيب الان assessment of oral cavity
+
+243
+00:16:25,600 --> 00:16:29,260
+اول حاجة عشان اعمل assessment كويسة ل oral cavity
+
+244
+00:16:29,700 --> 00:16:32,900
+can be made during a administration of oral
+
+245
+00:16:32,900 --> 00:16:36,940
+hygiene الان كتير بعض الناس باجي بتشوف ال oral
+
+246
+00:16:36,940 --> 00:16:39,720
+cavity باجي بقوله طبعا في بعض الحالات الصعبة زي في
+
+247
+00:16:39,720 --> 00:16:43,740
+حالات ال .. يعني اللي هو complete paralysis بقدرش
+
+248
+00:16:43,740 --> 00:16:46,320
+يعمل شيء و أنا بدي أساعده في ال oral hygiene زي ما
+
+249
+00:16:46,320 --> 00:16:49,120
+علمونا في ال fundamental مباشرة بقدر أعرف إن في
+
+250
+00:16:49,120 --> 00:16:52,360
+عنده مشكلة ولا لأ في ال oral cavity الأمر التالي
+
+251
+00:16:52,360 --> 00:16:56,840
+بتشوف ال lips شفافه هل ال color تبع كويس ال
+
+252
+00:16:56,840 --> 00:17:03,650
+texture hydrationفين يعني .. يعني فين رطبات ولا
+
+253
+00:17:03,650 --> 00:17:08,050
+جفات ال contour شكلها كيف شكلها عام ال legions في
+
+254
+00:17:08,050 --> 00:17:12,450
+اي ضرر او اي اذى ال inner inner and baculum mucosa
+
+255
+00:17:12,450 --> 00:17:16,970
+ال inner الداخلي baculum mucosa من جوا يعني الخد
+
+256
+00:17:16,970 --> 00:17:21,510
+من جوا اللي ال gums كمان بنشوفها و ال teeth كل هذه
+
+257
+00:17:21,510 --> 00:17:25,840
+inspected لإيه لبطلع على ال colorhydration ال
+
+258
+00:17:25,840 --> 00:17:29,740
+texture انا اللي حاجات اللي انا كتير شرحتها و اللي
+
+259
+00:17:29,740 --> 00:17:32,760
+اتكررت دي شغلنا اترجم لأن الحمد لله صرنا فاهمين
+
+260
+00:17:32,760 --> 00:17:35,740
+ايش اللي بنقصدهم بدنا نطلع اذا في ال SARS في
+
+261
+00:17:35,740 --> 00:17:40,440
+abrasions مكحوتس حاجات اي شي crust اي حاجة خاصة ال
+
+262
+00:17:40,440 --> 00:17:43,320
+crust اللي بتكره الحقل الاسنان اللي زي اللي
+
+263
+00:17:43,320 --> 00:17:49,540
+بيسموها يعني الترسيبات الجيرية على الأسنان ال
+
+264
+00:17:49,540 --> 00:17:53,420
+tongue بتطلع ال tongue خاصة اللي في floor of the
+
+265
+00:17:53,420 --> 00:17:57,420
+mouthيعني أرض ال .. أرضية ال .. ال mouth بتطلع إذا
+
+266
+00:17:57,420 --> 00:18:01,520
+في لا سمح الله خاصة إذا في abnormalities أو أي
+
+267
+00:18:01,520 --> 00:18:06,260
+مثلا لا سمح الله مدناش نقول مثلا injury أو حتى ال
+
+268
+00:18:06,260 --> 00:18:10,080
+killer إذا في أي شي مختلف أو بقول لا قدر الله اللي
+
+269
+00:18:10,080 --> 00:18:14,080
+بيجي بعض الناس بقولك أنا في عندي دايما يعني ..
+
+270
+00:18:14,080 --> 00:18:16,700
+دايما infection chronically زي الحم اللي بيصير
+
+271
+00:18:16,700 --> 00:18:19,340
+حوالين اللي هو ال tongue ممكن كمان هذا نعمله إيش
+
+272
+00:18:19,340 --> 00:18:23,800
+assessment و نحكي للطبيب الآن إيش بقولي أناPulpate
+
+273
+00:18:23,800 --> 00:18:27,300
+soft and hard palate الشيء اللى بيلاقيه سقف الحلق
+
+274
+00:18:27,300 --> 00:18:31,100
+لو حطينا لساننا لفوق بنلاقي سقف الحلق سقف الحلق
+
+275
+00:18:31,100 --> 00:18:35,000
+هذا اللى قدام بنلاقيه ماكن شوية اسمه hard palate و
+
+276
+00:18:35,000 --> 00:18:39,000
+اللى لورا اسمه soft palate طبعا بنطلع بنعمل
+
+277
+00:18:39,000 --> 00:18:42,900
+assessment نشوف ال color ال shape ال texture إذا
+
+278
+00:18:42,900 --> 00:18:46,660
+فيه لقدر الله extra bony prominences يعني عنده
+
+279
+00:18:46,660 --> 00:18:51,880
+نتوئات عضمية زائدة أو فيه defects يعني أي تشوهاتكل
+
+280
+00:18:51,880 --> 00:18:58,060
+هذا بدونه و بحكي لمن و بحكي للطبيب .. assessment
+
+281
+00:18:58,060 --> 00:19:00,800
+of pharynx .. pharynx معناته ايش؟ قلب العوم .. شو
+
+282
+00:19:00,800 --> 00:19:05,190
+يعني؟ بقولي بتطلع في ال pharynx كيف بتشوفهم؟دايما
+
+283
+00:19:05,190 --> 00:19:09,070
+بدنا نستخدم ال tongue depressors اللي هو خافض
+
+284
+00:19:09,070 --> 00:19:12,730
+اللسان الطبيب دايما بتشوفه دايما بتلاقي مسك خافض
+
+285
+00:19:12,730 --> 00:19:16,410
+اللسان اللي زي عودة ال اسكيمو بس بتكون عريضة شوية
+
+286
+00:19:16,410 --> 00:19:20,330
+و بقوله افتح الفم و بضغط على اللسان فمجرد ما يضغط
+
+287
+00:19:20,330 --> 00:19:23,990
+الطبيب على لسان المريض بتلاقي دغري الانسجة
+
+288
+00:19:23,990 --> 00:19:27,110
+الداخلية بتاعة ال mouth سبحان الله طلعت لبرا و
+
+289
+00:19:27,110 --> 00:19:30,270
+بيانت فهذه ال pharyngeal tissues بيسموها ايش احنا
+
+290
+00:19:30,270 --> 00:19:33,460
+بنسميها pharyngeal tissuesيعني اللي هو الخلايا
+
+291
+00:19:33,460 --> 00:19:37,560
+كلها الممثلة بالعوم من ورا normally بشكل طبيعي
+
+292
+00:19:37,560 --> 00:19:40,680
+تكون لازم تكون pink and smooth إذا في abnormality
+
+293
+00:19:40,680 --> 00:19:43,860
+بنكون عنده infection سواء كانت pharyngitis أو أي
+
+294
+00:19:43,860 --> 00:19:47,360
+كان أو لا قدر الله في tumor أو لا قدر الله في
+
+295
+00:19:47,360 --> 00:19:51,480
+lacerations أو abrasions بنكتبها إيه بنسأل إذا في
+
+296
+00:19:51,480 --> 00:19:56,220
+إديمة هل في الaceration شوف إذا في inflammation
+
+297
+00:19:57,280 --> 00:20:00,060
+نشوف كل هذا إذا فيه الله سبحانه و تعالى abnormal
+
+298
+00:20:00,060 --> 00:20:04,500
+lesions و كله بندونه و بنحكيه لمين و بنحكيه للطبيب
+
+299
+00:20:04,500 --> 00:20:08,640
+على حسب ما احنا قدرنا نعرف إذا فيه اي مشكلة صحية
+
+300
+00:20:08,640 --> 00:20:14,820
+assessment of the neck assessment of the neck هنا
+
+301
+00:20:14,820 --> 00:20:20,740
+إيش بقوليه؟ بدنا نعمل هاي الرقبة قدامي أفضل شيء
+
+302
+00:20:20,740 --> 00:20:24,960
+يكون المريض قاعد و أنت بتعمل assessment لرقبة خليه
+
+303
+00:20:24,960 --> 00:20:30,120
+قاعد اتطلعبعدين ايش؟ احاول تمد ايدك و تعمل احساس،
+
+304
+00:20:30,120 --> 00:20:33,520
+لما قال لي inspection يعني، الآن اش بقوللي
+
+305
+00:20:33,520 --> 00:20:39,340
+palpation، بدك تشوف ال neck muscles، عضلات الرقبة،
+
+306
+00:20:39,340 --> 00:20:45,340
+trachea، قصبة، طيب، thyroid gland، الغد الدراقية،
+
+307
+00:20:45,340 --> 00:20:49,620
+carotid arteries اللي هو ايش هنا الشريان التاجي
+
+308
+00:20:49,620 --> 00:20:53,240
+اللي على الجنبين، ال jugular veins، كل كهو أخدته
+
+309
+00:20:53,240 --> 00:20:56,110
+في ال anatomy اللي على اليمين و على الشمالcervical
+
+310
+00:20:56,110 --> 00:20:59,430
+lymph node اذا في الله سمح الله lymph node واضحات
+
+311
+00:20:59,430 --> 00:21:04,130
+وامبينات حوالين الرقبة او حوالين خلينا نقول ال
+
+312
+00:21:04,130 --> 00:21:08,790
+cervical نفسه اللي هو الحبل الشوكي او حوالين
+
+313
+00:21:08,790 --> 00:21:13,390
+الفقرات نشوف ال cervical كمان vertebra اللي هو
+
+314
+00:21:13,390 --> 00:21:18,510
+الفقرات الظهر نشوفه نعمل أسس منتج كويس أسس neck
+
+315
+00:21:18,510 --> 00:21:22,650
+size حجم الرقبة نشوف ال position of التراكي هل
+
+316
+00:21:22,650 --> 00:21:27,510
+القصبةيعني جاي center و بالظبط و كويسة و متوسطة و
+
+317
+00:21:27,510 --> 00:21:30,850
+لا في problem منشوف ال thyroid يعني الله سمح الله
+
+318
+00:21:30,850 --> 00:21:34,090
+ال thyroid gland يازم تكون حواليها بالضبط و جاي في
+
+319
+00:21:34,090 --> 00:21:37,410
+ال center في الوسط هل ال thyroid gland كبيرة و كده
+
+320
+00:21:37,410 --> 00:21:40,790
+تحسها هو حد يفكر أن ال thyroid gland بقدر أحسها
+
+321
+00:21:40,790 --> 00:21:44,450
+مباشرة لأ إذا حسناها معناته في abnormality في
+
+322
+00:21:44,450 --> 00:21:48,150
+abnormal enlargement normally not palpable خليكم
+
+323
+00:21:48,150 --> 00:21:52,250
+تاكرين normally not palpable إذا كان في abnormal
+
+324
+00:21:52,250 --> 00:21:56,220
+lesionوصار فينا يعني abnormal enlargement ممكن إيش
+
+325
+00:21:56,220 --> 00:22:01,840
+نقدر نحسها طيب assist range of motion بنتشوف كدهش
+
+326
+00:22:01,840 --> 00:22:05,720
+حركتها تبعت إيه الرقبة كيف؟ على طريق أنه نسأل
+
+327
+00:22:05,720 --> 00:22:08,920
+المريض ask the client to إيش tilt the head
+
+328
+00:22:08,920 --> 00:22:12,340
+backward إيش يعني tilt head backward and side to
+
+329
+00:22:12,340 --> 00:22:16,440
+side؟ بنقوله لو سمحت رجع رأسك لورا على آخر و بعدين
+
+330
+00:22:16,440 --> 00:22:22,110
+دير رأسك يمين و يسارو احنا الان بنراقب قوة العضلات
+
+331
+00:22:22,110 --> 00:22:25,450
+اللى عاملا بقدر يحرك فيها الرقبة عشان اقدر اثبت
+
+332
+00:22:25,450 --> 00:22:30,190
+انه فيه انه muscle weakness or not طيب assist
+
+333
+00:22:30,190 --> 00:22:34,670
+lymph node لتشوف اذا فيه الانسجة او الخلايا
+
+334
+00:22:34,670 --> 00:22:38,410
+اللينفاوية او لا قدر الله ال venous distinction
+
+335
+00:22:38,410 --> 00:22:41,820
+ايش يعني venous distinctionاللي هو زي ما بيقولوله
+
+336
+00:22:41,820 --> 00:22:46,320
+دم إيش اللي هو بناجي انتفاخ في إيش؟ انتفاخ في ال
+
+337
+00:22:46,320 --> 00:22:50,680
+veins اللي حوالين الرقبة و مبينات يعني حتى
+
+338
+00:22:50,680 --> 00:22:56,220
+بيقولوها بالعامية شروش رقبة مبينات خاصة بعض الناس
+
+339
+00:22:56,220 --> 00:22:58,620
+اللي بيكونوا بعصبوا كتير أو عندهم severe
+
+340
+00:22:58,620 --> 00:23:02,060
+hypertension أو الناس ال very thin ضعاف كتير بيبين
+
+341
+00:23:02,060 --> 00:23:07,450
+عندهم distentionبقول انك should be symmetrical
+
+342
+00:23:07,450 --> 00:23:11,270
+لازم تكون انك الرقبة اشمنت symmetrical يعني جاي
+
+343
+00:23:11,270 --> 00:23:16,710
+متوسطة تكون full range of motion تتحرك بسهولة و
+
+344
+00:23:16,710 --> 00:23:21,610
+بكل اريحية في كافة الاتجاهات يمين و يسار و امام و
+
+345
+00:23:21,610 --> 00:23:26,670
+خلف هذه الطبيعي ماقدرش ابنك تبقى بندون وين المشكلة
+
+346
+00:23:26,670 --> 00:23:31,140
+اللي وجه فيهابعدين مافيش حاجة بيسموها .. الواحد
+
+347
+00:23:31,140 --> 00:23:34,260
+ييجي يقول لي هل ضروري نلاقي vain distinction سواء
+
+348
+00:23:34,260 --> 00:23:38,620
+كان arthritis او في venous لأ انا بدأ أقولكوا مش
+
+349
+00:23:38,620 --> 00:23:40,820
+لازم يكون vain distinction اللي انا ذكرته هنا في
+
+350
+00:23:40,820 --> 00:23:44,440
+ال distinction كله هذا abnormal thing يبقى الطبيعي
+
+351
+00:23:44,440 --> 00:23:47,040
+مايكونش فيه distinction لو كان فيه distinction
+
+352
+00:23:47,040 --> 00:23:51,990
+معناته abnormal events inspect بتاكد تطلعبتعمل
+
+353
+00:23:51,990 --> 00:23:57,110
+ايش؟ pulpate لل cervical vertebraيش ان فقرات عنقها
+
+354
+00:23:57,110 --> 00:24:01,330
+فرقات الفقرات العنق اللي احنا خدناها لما نعلمونا
+
+355
+00:24:01,330 --> 00:24:04,390
+في ال anatomy اللي فقرات السبعة في cervical
+
+356
+00:24:04,390 --> 00:24:08,690
+vertebra سبعة بدنا نحاول بس نعملها ايش؟Palpation
+
+357
+00:24:08,690 --> 00:24:12,990
+نعمل بس إيش نحط إصبعيننا حوالين اللي هو النخاع
+
+358
+00:24:12,990 --> 00:24:18,510
+الشوكي و نقعد نعص شوية شوية لما ننزل لتحت بس نشوف
+
+359
+00:24:18,510 --> 00:24:21,090
+بشكل عام هل هي ال symmetry هل في abnormal
+
+360
+00:24:21,090 --> 00:24:24,370
+enlargement هل لا سمح الله في bone prominance ولا
+
+361
+00:24:24,370 --> 00:24:27,730
+لأ بنشوف أنا طبعا أكيد في ال posterior aspect و
+
+362
+00:24:27,730 --> 00:24:30,850
+تاني أكيد طبعا مش معقول فقراطة تكون في أمام الرقبة
+
+363
+00:24:30,850 --> 00:24:35,550
+لأن في track يو في يعني في vessels فمش معقول بنشوف
+
+364
+00:24:35,550 --> 00:24:39,970
+ال symmetryبنشوف ال tenderness الألم بنشوف ال
+
+365
+00:24:39,970 --> 00:24:43,650
+masses اللي قدر الله بنشوف إذا في swelling كمان و
+
+366
+00:24:43,650 --> 00:24:47,050
+إذا في swelling ممكن أيش كمان أنا أداءه و أعرف أيش
+
+367
+00:24:47,050 --> 00:24:51,270
+بالظبط اللي موجود بالظبط أو طبيعته طيب احنا الآن
+
+368
+00:24:51,270 --> 00:24:54,450
+بقولك كمان مش بس يك بدك تشوف ايش أنا thyroid gland
+
+369
+00:24:55,870 --> 00:24:59,230
+يعني خليني انا حتى لو كانت قصيرة شوية المحاضرة
+
+370
+00:24:59,230 --> 00:25:02,930
+علشان احنا لانه صار في بعض المحاضرات تفوت التلاتين
+
+371
+00:25:02,930 --> 00:25:06,390
+خليني اتوقف هنا وان شاء الله المحاضرة القادمة اكمل
+
+372
+00:25:06,390 --> 00:25:09,570
+الحديث عن ال thyroid gland والسلام عليكم ورحمة
+
+373
+00:25:09,570 --> 00:25:10,330
+الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1415370a5e919d2dd32b45872b8af0720dfcc6c4
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8.srt
@@ -0,0 +1,1360 @@
+1
+00:00:01,080 --> 00:00:03,400
+اقعدوا بالله مش تراجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,400 --> 00:00:07,080
+الصلاة والسلام علي أشرف المرسلين سيدنا محمد وعليه
+
+3
+00:00:07,080 --> 00:00:11,960
+وصحبه وسلم أما بعد، اليوم هنكمل إن شاء الله معاكم
+
+4
+00:00:11,960 --> 00:00:16,840
+في مساق التقييم الصحي، التمريديين، طبعا احنا في
+
+5
+00:00:16,840 --> 00:00:21,000
+المحاضرة السابقة، زي ما أنا حكيت لكم، كنا شوية يمكن
+
+6
+00:00:21,000 --> 00:00:26,900
+عجلنا في الطرح اللي هو الـ chapter لأنه كان مراجعة
+
+7
+00:00:26,900 --> 00:00:30,180
+كاملة لكثير من الأشياء اللي كانت ماخذينها احنا في
+
+8
+00:00:30,180 --> 00:00:33,620
+وسط عمل التمريض في المستوى الأول، خلينا اليوم ندخل
+
+9
+00:00:33,620 --> 00:00:37,220
+في بدايات اللي هو التقييم الصحي، التمريضي، وما ننساش
+
+10
+00:00:37,220 --> 00:00:41,220
+قبل ما ندخل، أن احنا قلنا أن التقييم الصحي مش تقييم
+
+11
+00:00:41,220 --> 00:00:44,220
+biology فقط، زي ما زمان كان يسموه physical، وإنما
+
+12
+00:00:44,220 --> 00:00:46,860
+health assessment اللي هي bio psychosocial and
+
+13
+00:00:46,860 --> 00:00:50,380
+spiritual، طبعا دي بس من باب التذكير، احنا أخدناه في
+
+14
+00:00:50,380 --> 00:00:53,780
+المحاضرة السابقة، عشان تذكرنا في عملية الـ nursing
+
+15
+00:00:53,780 --> 00:00:57,420
+care اللي هو plan بشكل عام، اللي بتبدأ من عند الـ
+
+16
+00:00:57,420 --> 00:01:00,060
+assessment، تنتهي من عند الـ evaluation، طيب خلينا
+
+17
+00:01:00,060 --> 00:01:04,960
+نكمل شوية، أول حاجة بدنا نفهم أنه متى بدأ الـ
+
+18
+00:01:04,960 --> 00:01:08,440
+assessment في العالم كله، طبعا زمان ما كان موجود في
+
+19
+00:01:08,440 --> 00:01:12,160
+حاجة اسمها health assessment، صحيح كانوا في بعض
+
+20
+00:01:12,160 --> 00:01:17,000
+الناس يشاركوا في زي تضميد جراح في حروب، أو كانوا في
+
+21
+00:01:17,000 --> 00:01:23,720
+بعض الناس يقيموا حالات في في دول، في مؤسسات، بس دون
+
+22
+00:01:23,720 --> 00:01:26,800
+أن يكون هناك شيء منظم لهذا الموضوع، يعني مافيش
+
+23
+00:01:26,800 --> 00:01:30,340
+شيء كان، يعني زي ما نقول والله مثلا جمعية القلب
+
+24
+00:01:30,340 --> 00:01:34,980
+العالمية، جمعية الأطباء العالمية، ما كانش حاجة زي هي
+
+25
+00:01:34,980 --> 00:01:39,290
+كان، أو جمعية التقييم، أو مؤسسات التقييم، فأول تقييم
+
+26
+00:01:39,290 --> 00:01:43,490
+بدأ في سنة 1998، إذا بتلاحظوا معه، مش كتير، يعني مش
+
+27
+00:01:43,490 --> 00:01:48,170
+… مش بعيد كتير، 1998، الكلام يعني… يعني بدايات، أو في
+
+28
+00:01:48,170 --> 00:01:53,490
+… قبل ما… حتى يعني قبل الألفين، مش كتير يعني، طب
+
+29
+00:01:53,490 --> 00:01:55,470
+عن طريق مين؟ عن طريق الـ American Medical
+
+30
+00:01:55,470 --> 00:01:59,070
+Association، طبعا إيش الـ medical association دي؟
+
+31
+00:01:59,070 --> 00:02:03,810
+كانت عبارة عن مؤسسة أمريكية طبية، لأنه لسه ما كانش
+
+32
+00:02:03,810 --> 00:02:08,730
+الـ nursing يعني طالع على سطحه، على فكرة 1998 بتذكرني
+
+33
+00:02:08,730 --> 00:02:12,350
+بهذا التاريخ، أن هو بداية تأسيس كلية التمريض
+
+34
+00:02:12,350 --> 00:02:16,390
+بالجامعة الإسلامية، هذا معروف، علامة ش… يعني، فبدأ اللي
+
+35
+00:02:16,390 --> 00:02:21,050
+هو الـ assessment في سنة 1995، أصبح في health
+
+36
+00:02:21,050 --> 00:02:24,550
+assessment، صارت تعتبر basic human right، إيش يعني
+
+37
+00:02:24,550 --> 00:02:28,110
+الـ basic human right؟ تعتبر حق من الحقوق الأساسية
+
+38
+00:02:28,110 --> 00:02:32,130
+لكل إنسان، يعني أصبح في سنة 1995، كل واحد من حقه أن
+
+39
+00:02:32,130 --> 00:02:35,550
+يعمل assessment، وطبعا احنا قلنا في الـ preventive
+
+40
+00:02:35,550 --> 00:02:39,270
+إذا بنذكر، لما ذكرنا في المحاضرة السابقة، الـ
+
+41
+00:02:39,270 --> 00:02:41,970
+preventive، هي التذكير مقسم لتلاتة، بس من باب
+
+42
+00:02:41,970 --> 00:02:45,030
+التذكير، لما قلنا primary و secondary أو tertiary، و
+
+43
+00:02:45,030 --> 00:02:48,950
+نفس القضية، هم الآن بيعملوا فيها كيف؟ يعني اللي قبل
+
+44
+00:02:48,950 --> 00:02:52,210
+المرض بنسميها primary prevention، أثناء حدوث المرض
+
+45
+00:02:52,210 --> 00:02:55,830
+secondary prevention، واللي بعد حدوث المرض وحدوث
+
+46
+00:02:55,830 --> 00:02:59,790
+المضاعفة tertiary prevention، طيب هل الـ assessment
+
+47
+00:02:59,790 --> 00:03:03,570
+عمل مرة واحدة، ولا مرتين، ولا كام، ولا هي لعدد
+
+48
+00:03:03,570 --> 00:03:06,970
+معين؟ بقول هنا periodic health assessment needed to
+
+49
+00:03:06,970 --> 00:03:10,550
+be often performed by a physician or nurses، بقول
+
+50
+00:03:10,550 --> 00:03:14,550
+الصحيح، أن الواحد يعمل periodic، لازم يعمل اللي بدأ
+
+51
+00:03:14,550 --> 00:03:17,610
+يعمل assessment، يعني مثلا افترضنا فلان عمل
+
+52
+00:03:17,610 --> 00:03:20,510
+assessment وطلع عنده شغلة، أو احنا شكينا في شغلة
+
+53
+00:03:20,510 --> 00:03:25,030
+أو متحسبين لشغلة معينة، لازم نضل نتابع طبيا و
+
+54
+00:03:25,030 --> 00:03:30,200
+تمريضيا، نضل نتابع إيه؟ طبيا وتمريضيا، طيب objectives
+
+55
+00:03:30,200 --> 00:03:34,620
+and types of assessment، طيب شو الـ objectives وإيش
+
+56
+00:03:34,620 --> 00:03:37,020
+الـ types بتاعة الـ assessment، أول حاجة من الـ
+
+57
+00:03:37,020 --> 00:03:39,540
+objectives المهمة للـ assessment، بيقول لي
+
+58
+00:03:39,540 --> 00:03:41,300
+surveillance، من وين أجت الـ surveillance وده
+
+59
+00:03:41,300 --> 00:03:44,380
+البقاء، يبقى معناته بيقول surveillance of health
+
+60
+00:03:44,380 --> 00:03:48,040
+status، سبحان الله، ده كل ما بتقدم العلم أكتر، طبعا
+
+61
+00:03:48,040 --> 00:03:51,540
+هي ليس تدخلا في أعمار البشر، وإنما الله سبحانه
+
+62
+00:03:51,540 --> 00:03:54,400
+وتعالى هو اللي يقدر الأسباب، لكن لازم ألاحظ احنا
+
+63
+00:03:54,400 --> 00:03:57,810
+الدول الفقيرة اللي لا يوجد فيها علم ولا طب ولا
+
+64
+00:03:57,810 --> 00:04:02,570
+تمريض ولا غيره، وبنلاقي يعني كتير أمراض انتقالية و
+
+65
+00:04:02,570 --> 00:04:06,290
+معدية، وربما تؤدي للوفاة، بكتير من الحالات، الآن
+
+66
+00:04:06,290 --> 00:04:09,590
+احنا في assessment بشكل علمي ومنطقي، في بقاء
+
+67
+00:04:09,590 --> 00:04:13,510
+للبشرية، identification of occult disease، كلمة
+
+68
+00:04:13,510 --> 00:04:17,430
+occult، أخدناها قبل كده، أيه كل ما اسمعها، معناته يعني
+
+69
+00:04:17,430 --> 00:04:21,770
+مخفي، زي ما أقول مثلا occult blood، يعني الدم المخفي
+
+70
+00:04:21,770 --> 00:04:25,230
+لما بيجي في بعض الحالات، بيجي واحد من ضمن الفحوصات
+
+71
+00:04:25,530 --> 00:04:28,250
+بنعملها stool، إن ناس بتطلع عندها blood، مش مبين أنه
+
+72
+00:04:28,250 --> 00:04:32,230
+فيه blood، لكن مبين أنه عامل الـ tarry، الـ tarry، الـ
+
+73
+00:04:32,230 --> 00:04:35,310
+stool، يعني عامل زي الزفتة وزي الشحمة، فاللون
+
+74
+00:04:35,310 --> 00:04:40,570
+بيخلّينا نشك أنه فيه إيه؟ أنه فيه دم، طيب لحالات الـ
+
+75
+00:04:40,570 --> 00:04:43,890
+screening كمان، عشان نقدر نعمل screening، نشوف الناس
+
+76
+00:04:43,890 --> 00:04:46,090
+مين عنده مشكلة، ومين ما عنده مشكلة، زي في حالات
+
+77
+00:04:46,090 --> 00:04:48,870
+اليوم في الكورونا، لما بيعملوا screening لكثير من
+
+78
+00:04:48,870 --> 00:04:52,750
+الناس، برضه، بالزمن، الـ follow up، عشان أقدر أتابع
+
+79
+00:04:52,750 --> 00:04:56,540
+الحالة، طيب periodic assessment at regular intervals،
+
+80
+00:04:56,540 --> 00:05:00,240
+إيش يعني؟ بقول الـ periodic، بقول يعني يفضل أنك تعمل
+
+81
+00:05:00,240 --> 00:05:04,980
+دايما assessment على فترات محددة، والصحيح تكون في
+
+82
+00:05:04,980 --> 00:05:08,780
+فترات منتظمة، يعني أنت عملت كل سنة، تعال كل سنة، عملت
+
+83
+00:05:08,780 --> 00:05:11,820
+كل ست شهور، تعال كل ست شهور، في بعض الحالات بيجي
+
+84
+00:05:11,820 --> 00:05:15,940
+الطبيب بقول أفضل أنه لازم أنت، المرض، الفرنسيين كل
+
+85
+00:05:15,940 --> 00:05:18,980
+ست شهور، اعمله، واحد، اتنين، تلاتة، صحيح ما ينفعش مرة
+
+86
+00:05:18,980 --> 00:05:23,850
+ستة، مرة تمانية، مرة، وهكذا، أكتر أو أقل، برنامج
+
+87
+00:05:23,850 --> 00:05:26,570
+الخاص، بيسميها increasing client participation،
+
+88
+00:05:26,570 --> 00:05:29,830
+ماذا يعني participation؟ Participation، مشاركة في
+
+89
+00:05:29,830 --> 00:05:33,610
+الـ health care، لما احنا بنعمل assessment للمريض، هو
+
+90
+00:05:33,610 --> 00:05:36,730
+نفسه بيتقبل وبيسير ويساعدنا كمان، عشان يعالج نفسه،
+
+91
+00:05:36,730 --> 00:05:39,710
+أكيد أنتم عارفين، بكرة إن شاء الله، لما ترجع الأمور
+
+92
+00:05:39,710 --> 00:05:43,010
+لطبيعتها، ونرجع للمستشفى، هتشوف أن المريض، وتشوف أن
+
+93
+00:05:43,010 --> 00:05:47,250
+المريض لما يكون مستوعب معانا، وماشي معنا، هيحب أنه
+
+94
+00:05:47,250 --> 00:05:50,770
+يعني حتى يساعد نفسه، يشعر مني أن أنا مستعد أساعد
+
+95
+00:05:50,770 --> 00:05:55,110
+مش هكون أنا عبء عليكم، وإنما هساعدكم في رعايتكم،
+
+96
+00:05:55,110 --> 00:06:00,260
+I can define the health and risk care needs for
+
+97
+00:06:00,260 --> 00:06:03,220
+individuals، health and risk، شو يعني health and
+
+98
+00:06:03,220 --> 00:06:07,680
+risk؟ بقول لي هذا كمان، بحدد لي بدقة، شو معايير الصحة
+
+99
+00:06:07,680 --> 00:06:10,540
+اللي موجودة عند المريض، وشو معايير الخطر اللي
+
+100
+00:06:10,540 --> 00:06:14,520
+موجودة عند المريض، لأن لما نعمل assessment، نقدر
+
+101
+00:06:14,520 --> 00:06:16,680
+لحالة، نكشف إيش الـ normal وإيش الـ abnormal، عشان
+
+102
+00:06:16,680 --> 00:06:20,200
+هيك بقول لي أنا، ياريت تعمل assessment، عشان تعرفي أن
+
+103
+00:06:20,200 --> 00:06:23,100
+بعض الناس بيجي وبيقول لك، أنا رأسي بيوجعني، طيب رأسي
+
+104
+00:06:23,100 --> 00:06:25,280
+بيوجعني، بيجي واحد ثاني بيقول، آه أنت… أنت كمان ضغطك
+
+105
+00:06:25,280 --> 00:06:28,540
+مرتفع، عشان أقطع الشك باليقين، بروح بعمل assessment،
+
+106
+00:06:29,140 --> 00:06:32,920
+إذا ما عندوش بقول healthy، إذا عنده بقول risky، و
+
+107
+00:06:32,920 --> 00:06:36,160
+هكذا، health assessment، النقطة الثانية اللي في النص
+
+108
+00:06:36,160 --> 00:06:40,540
+اللي موجودة قدامكم، health assessment shared، و
+
+109
+00:06:40,540 --> 00:06:44,320
+الدخلة، إيش عن shared؟ يجب أن يشارك بها، إيش اللي
+
+110
+00:06:44,320 --> 00:06:51,480
+هو المريض، أن clearly and understandably، لازم يكون
+
+111
+00:06:51,480 --> 00:06:55,430
+مفهوم، بسيط، مفهوم للمريض، إيش اللي بتقوله هنا؟ أنا مش
+
+112
+00:06:55,430 --> 00:06:59,210
+كل شيء هترجم، لأنه أنا متأكد يعني، سنة ولا أخذته، كام
+
+113
+00:06:59,210 --> 00:07:02,970
+كبير من المعلومات، خلّاني أمشي، عشان المادة شوية مش
+
+114
+00:07:02,970 --> 00:07:08,330
+صغيرة، كبيرة شوية، فبقول لي لازم يشارك المريض في عملية
+
+115
+00:07:08,330 --> 00:07:12,710
+الرعاية الصحية له، كيف؟ لكن بقول لي، بسلوب مفهوم، يعني
+
+116
+00:07:12,710 --> 00:07:16,410
+ما ينفعش نيجي، بعض الحالات بنقول له، اسمع أنت عشان تتحسن
+
+117
+00:07:16,410 --> 00:07:22,280
+مثلا بدنا يجيب شرب ميه، الميه تكون سائلة، الآن
+
+118
+00:07:22,280 --> 00:07:25,940
+المريض ده، فيهم بيشرب ميه، لو أعطيناه وقلنا له كلمة
+
+119
+00:07:25,940 --> 00:07:29,620
+غامضة، أشرب سوائل، ممكن يفهم المريض كلمة أشرب سوائل
+
+120
+00:07:29,620 --> 00:07:34,030
+عشان تتحسن، يروح يجيب مثلا بطاطا ويطحنها ويعملها
+
+121
+00:07:34,030 --> 00:07:38,770
+سائل، يمكن يجيب مرقة ويحط عليها لحمة وكذا، فبيصير
+
+122
+00:07:38,770 --> 00:07:42,230
+هنا للأسف، الـ understandable، ما راحت، يعني مش مفهوم
+
+123
+00:07:42,230 --> 00:07:45,330
+صراحة جدا، بيصير حاجة اسمها vague، vague يعني غامض،
+
+124
+00:07:45,330 --> 00:07:49,010
+فالصحيح أن المريض لما يساعدنا يكون فاهم إيش اللي
+
+125
+00:07:49,010 --> 00:07:51,850
+احنا مطلوب منه، عشان الساعة في الـ care، النقطة
+
+126
+00:07:51,850 --> 00:07:55,010
+الأخيرة اللي أقولها هنا، the client must share in
+
+127
+00:07:55,010 --> 00:07:58,450
+decision making، شو يعني decision making؟ صناعة
+
+128
+00:07:58,450 --> 00:08:03,200
+القرار، ليش يشارك، إن أنت صناعة القرار إيه؟ المريض
+
+129
+00:08:03,200 --> 00:08:07,100
+المريض ممكن يساعدنا في صناعة القرار الخاص في الـ
+
+130
+00:08:07,100 --> 00:08:10,880
+all care، لو حد سألني، طب كيف يا أستاذ المريض بدي
+
+131
+00:08:10,880 --> 00:08:14,920
+أساعد… كيف بدي أساعد المريض إنه يعني بصناعة القرار
+
+132
+00:08:14,920 --> 00:08:18,640
+الخاص بيه؟ أنا أعطيكم مثل… مثل بسيط من الأمثلة
+
+133
+00:08:18,640 --> 00:08:22,980
+البسيطة، بيجي… الآن المريض بيجي ويقول لك أنا تعبان،
+
+134
+00:08:22,980 --> 00:08:25,380
+ويقول لك والله عندك أنفلونزا، أو عندك التهابات أو كده،
+
+135
+00:08:25,380 --> 00:08:28,940
+الصحيح، تاخد مضادات حيوية، الآن إيش بيقولوا… بيقولوا
+
+136
+00:08:28,940 --> 00:08:32,420
+بدنا نعطيك مضاد حيوي عن طريق الوريد، بيقولوا، الطبيب، يا
+
+137
+00:08:32,420 --> 00:08:35,400
+دكتور، ما ينفعش آخذ حبوب، بيروحوا بيقولوا والله في حبوب،
+
+138
+00:08:35,400 --> 00:08:38,500
+وفي كبسولات، بس غالية شوية، بيروح المريض بيقولوا لأ،
+
+139
+00:08:38,500 --> 00:08:41,160
+مش… مشكلة، آخذها، لأ، إني أنا ال… ال… ال…
+
+140
+00:08:41,160 --> 00:08:45,140
+الوريد بتعبني، الآن الطبيب بيقولوا okay، زي ما بدك،
+
+141
+00:08:45,140 --> 00:08:49,420
+هذا إيش اسمه؟ ساعد في الرعاية، صنع القرار، طب نعطيه
+
+142
+00:08:49,420 --> 00:08:53,140
+مثال صغير، مثال ثاني، أنه جاء أحد الأشخاص، وهذا
+
+143
+00:08:53,140 --> 00:08:56,430
+حقيقة كتير حصلت معانا واحنا كنا في المستشفيات، يجي
+
+144
+00:08:56,430 --> 00:08:59,050
+الدكتور ويقول له عندك hernia، هيرنيا، عندك إيش؟ فتق،
+
+145
+00:08:59,050 --> 00:09:02,270
+الفتاق اللي موجودة في البطن، بدنا نعملها عملية،
+
+146
+00:09:02,270 --> 00:09:05,630
+فبيقول له… بيقول للدكتور، ينفع أجل يا دكتور، لأني أنا
+
+147
+00:09:05,630 --> 00:09:08,970
+الآن في الجامعة، أو أنا الآن في التوجيهي، أجل لبعض
+
+148
+00:09:08,970 --> 00:09:12,610
+الامتحانات، قال له ما فيش مشكلة، أجل، ما فيش… ما بيصير
+
+149
+00:09:12,610 --> 00:09:16,770
+شارك، حاجة، إذا شارك المريض، آه، طبعا شارك، مش كل شيء،
+
+150
+00:09:16,770 --> 00:09:20,450
+لازم المريض يتلقى بالإجبار، بدون ما إيه؟ مشاركته في
+
+151
+00:09:20,450 --> 00:09:23,990
+بعض الشغلات اللي بتهمّه، لكن الشغلات اللي هي الـ
+
+152
+00:09:23,990 --> 00:09:28,580
+urgent أو الـ emergency، أو الشغلات اللي فيها نتكلم
+
+153
+00:09:28,580 --> 00:09:32,440
+على حاجة فيها يعني، شيء بيخوف، يعني فيها bad
+
+154
+00:09:32,440 --> 00:09:34,780
+complications، أو لأ، سبحان الله، abnormal
+
+155
+00:09:34,780 --> 00:09:38,100
+complications، أو abnormal case، فإيش فيها، أن نشاور
+
+156
+00:09:38,100 --> 00:09:42,080
+المريض، زي في حالة الـ acute appendicitis، اللي هو
+
+157
+00:09:42,080 --> 00:09:44,640
+التهاب الزائدة، اللي دي الحياة، frequency of
+
+158
+00:09:44,640 --> 00:09:48,500
+assessment، متى
+
+159
+00:09:48,500 --> 00:09:52,320
+بعمل assessment؟ هل بعمل assessment يعني على كيفّي،
+
+160
+00:09:52,320 --> 00:09:56,040
+كل يوم، كل سنة، كل سنتين؟ هذا القاعدة اللي قدامنا، بدأ
+
+161
+00:09:56,040 --> 00:10:00,120
+إن شاء الله نحفظها ونفهمها، الناس اللي تحت الخمسة
+
+162
+00:10:00,120 --> 00:10:02,800
+وتلاتين سنة، اللي زي حضراتكم، اللي تحت الخمسة و
+
+163
+00:10:02,800 --> 00:10:05,600
+تلاتين سنة، ما يجي واحد يقول لهم لأ، أنا شاب صغير، أو
+
+164
+00:10:05,600 --> 00:10:08,600
+بنت تقول لي أنا لسه صغيرة يا أستاذ، ما بعانيش من حاجة،
+
+165
+00:10:08,600 --> 00:10:12,320
+أنا زي الحديد، زي البومب، ما فيش كلمة زي الحديد، احنا
+
+166
+00:10:12,320 --> 00:10:17,180
+هذا، صحة الإنسان كلها متراكبة على بعض، وإذا اختل
+
+167
+00:10:17,180 --> 00:10:21,200
+جزء من الجسم، كل الجسم بيختل، اللي تحت الخمسة وتلاتين
+
+168
+00:10:21,200 --> 00:10:25,880
+سنة، بيعمل كل أربع إلى خمس سنوات مرة، health
+
+169
+00:10:25,880 --> 00:10:31,120
+assessment، طبعا بعض الناس فيه، بيسموه، عشان تعرفوا
+
+170
+00:10:31,120 --> 00:10:34,320
+لما بيجي بتوظف الإنسان، يعني مثلا إن شاء الله ربنا
+
+1
+
+223
+00:14:10,180 --> 00:14:12,920
+client response ال to healthy problems
+
+224
+00:14:12,920 --> 00:14:15,960
+احنا عارفين وقلنا أني أنا بركز على healthy
+
+225
+00:14:15,960 --> 00:14:20,300
+problems اللي هي مرتبطة بالـ medical diagnosis زي
+
+226
+00:14:20,300 --> 00:14:23,500
+ما قلنا hypertension، أنا بشوف إيش الأشياء المرتبطة
+
+227
+00:14:23,500 --> 00:14:26,920
+بالـ hypertension، فهي بتركز على استجابة المريض، طيب
+
+228
+00:14:26,920 --> 00:14:30,860
+ثلاثة مقولي إيش هنا؟ ثلاثة قدامي مقولي the nurse
+
+229
+00:14:30,860 --> 00:14:34,700
+carefully examine the client's body parts، كمان لازم
+
+230
+00:14:34,700 --> 00:14:39,640
+يفحص الممرض الشاطر، لازم يفحص الـ body parts اللي هو
+
+231
+00:14:39,640 --> 00:14:42,980
+أعضاء الجسد اللي موجودة عند اللي هو المريض
+
+232
+00:14:42,980 --> 00:14:47,960
+لِيعرف إيش هو الـ normal وإيش هو الـ abnormal عشان
+
+233
+00:14:47,960 --> 00:14:51,710
+يجيء to determine abnormalities of the client عشان
+
+234
+00:14:51,710 --> 00:14:54,630
+هيك مرات الواحد ما يستعجلش، يعني بعض الحالات بيجي
+
+235
+00:14:54,630 --> 00:14:58,430
+بيقول لي يا أستاذ أنا شوفت في مشكلة عنده في الـ
+
+236
+00:14:58,430 --> 00:15:01,490
+right hand، بقوله استنى شوية، يمكن الـ right والـ
+
+237
+00:15:01,490 --> 00:15:07,110
+left هم هيك، عشان هيك السؤال ما يستعجلش، طيب أربعة the
+
+238
+00:15:07,110 --> 00:15:11,610
+nurse relies on data from different sources، واحنا
+
+239
+00:15:11,610 --> 00:15:14,880
+قلنا قبل هيك، الـ sources بتبعث الـ data اللي هي
+
+240
+00:15:14,880 --> 00:15:17,840
+عشان تصل للمشاكل اللي بتجيها في direct وفي
+
+241
+00:15:17,840 --> 00:15:20,720
+indirect، واحنا قلنا direct أخذنا من المريض، أنا
+
+242
+00:15:20,720 --> 00:15:23,560
+ممكن آخذ معلومات من المريض، لكن هو كاتب لي هنا في
+
+243
+00:15:23,560 --> 00:15:26,520
+different sources، لو ما قدرت أأخذ، أفرض المريض عنده
+
+244
+00:15:26,520 --> 00:15:30,720
+coma يعني مغيب، أفرض المريض طفل، أفرض المريض اختيار
+
+245
+00:15:30,720 --> 00:15:35,420
+Geriatric، أفرض المريض refused، رفض، فبآخذ من إيش؟ في
+
+246
+00:15:35,420 --> 00:15:39,740
+file، في طبيب، في أقارب، في ناس حواليه، في أستاذ، في
+
+247
+00:15:39,740 --> 00:15:44,170
+حكيم، خامسة بقول الـ health assessment provides a
+
+248
+00:15:44,170 --> 00:15:49,530
+baseline، زي الـ خط الأساسي، ليش خط أساسي؟ أوي يعني
+
+249
+00:15:49,530 --> 00:15:52,350
+زي ما بقولها يعني، زي القاعدة الأساسية اللي
+
+250
+00:15:52,350 --> 00:15:56,470
+بستخدمها لإيش؟ to plan the client's care، ما ينفع من
+
+251
+00:15:56,470 --> 00:16:01,750
+عندي أنا مستعجل وأروح أخطط، ما ينفع مباشرة لحالي
+
+252
+00:16:01,750 --> 00:16:07,610
+أنا أعمل care plan مباشرة، لازم آخذ معلومات كاملة
+
+253
+00:16:07,610 --> 00:16:10,770
+عن طريق الـ health assessment عشان أقدر أعمل .. عشان
+
+254
+00:16:10,770 --> 00:16:14,270
+أقدر أعمل إيش؟ plan، يمكن دائماً بقول هنا
+
+255
+00:16:14,270 --> 00:16:19,630
+لا تستعجل، هي الحكمة وأنت الطالب، فعمل care plan إلى
+
+256
+00:16:19,630 --> 00:16:23,110
+لما تأخذ علامات كاملة، ستة health assessment helps
+
+257
+00:16:23,110 --> 00:16:26,850
+planners to diagnose a client's problem، أكيد بساعدك
+
+258
+00:16:26,850 --> 00:16:30,750
+عشان تقدر تشخص إيش مشكلات اللي هو المريض، and
+
+259
+00:16:30,750 --> 00:16:35,110
+intervention، ما ينفعش يجي الممرض يقول أنا حاسس عنده
+
+260
+00:16:35,110 --> 00:16:37,950
+واحد اثنين ثلاثة، ما تفتش كلمة أنا حاسس أو بتوقع عنده كده
+
+261
+00:16:37,950 --> 00:16:41,530
+كده، لا تتوقع، تعال كل ما تأخذ معلومات أكثر، كل ما يصير
+
+262
+00:16:41,530 --> 00:16:46,490
+عندك إيش؟ كمية أقوى، تقدر إيش أنت تصيغ بيها مشكلات
+
+263
+00:16:46,490 --> 00:16:50,910
+على المريض، سبعة complete health assessment، الـ
+
+264
+00:16:50,910 --> 00:16:52,670
+complete health assessment إيش بيقول؟ ي involve
+
+265
+00:16:52,670 --> 00:16:57,970
+more detailed review of a client's conditions، كل ما
+
+266
+00:16:57,970 --> 00:17:02,780
+بنأخذ معلومات صحية أكثر، الـ health assessment أقوى وأكثر،
+
+267
+00:17:02,780 --> 00:17:07,100
+أكثر، إيش بقول لي هنا؟ بقول لي كلمة detail، يعني أنا مش
+
+268
+00:17:07,100 --> 00:17:11,740
+هكون كأني بسأل واحد زائد واحد يساوي اثنين، ولا بدي
+
+269
+00:17:11,740 --> 00:17:14,620
+أحاول كل شيء yes or no question .. لا، لكن قدامي
+
+270
+00:17:14,620 --> 00:17:18,900
+شوية، سنُصرح لكم أن في عظم open question، في عظم
+
+271
+00:17:18,900 --> 00:17:22,340
+closed question، وفي عظم list question، فأنا كل ما
+
+272
+00:17:22,340 --> 00:17:25,860
+بآخذ معلومات واسعة أكثر، كل ما بقدر إيه؟ أنا كل ما
+
+273
+00:17:25,860 --> 00:17:28,680
+بآخذ معلومات، كل ما أقدر أحدد إيش الـ condition
+
+274
+00:17:28,680 --> 00:17:33,260
+بتاعة المريض، ما عنديش معلومات، ما ينفعش، ما يجيء
+
+275
+00:17:33,260 --> 00:17:36,920
+الواحد يعني يستعجل، حتى الطبيب ما ينفعش يجيء يشخص
+
+276
+00:17:36,920 --> 00:17:40,740
+من أول كلمة أو من شكوى بسيطة واحدة، وإنما لازم يجلس
+
+277
+00:17:40,740 --> 00:17:44,860
+مع المريض ويفهم كل شكوى، ثمانية health assessment
+
+278
+00:17:44,860 --> 00:17:48,340
+influences the choice of therapies، أكيد بقول لي لما
+
+279
+00:17:48,340 --> 00:17:52,180
+نعمل تقييم صحي، بساعدني باختيار العلاج، عندي clinical
+
+280
+00:17:52,180 --> 00:17:55,240
+response، واختيار كمان إيش؟ استجابة المرضى، أعطيكم
+
+281
+00:17:55,240 --> 00:17:59,640
+مثال، وأنا بعمل assessment، جاني إنه لازم يعني أنا
+
+282
+00:17:59,640 --> 00:18:03,920
+جاني عند المريض مثلاً، وقع، شريط، في الدرج مثلاً، بغض
+
+283
+00:18:03,920 --> 00:18:06,900
+النظر falling down، عنده desk، بغض النظر لما نعمله
+
+284
+00:18:06,900 --> 00:18:10,660
+assessment، إيش بقول لي؟ قال إنه لازم تأخذ مسكنات، آجي
+
+285
+00:18:10,660 --> 00:18:14,220
+أقول له، بدي أعطيك، ممكن تأخذه في pharmacology، في
+
+286
+00:18:14,220 --> 00:18:18,560
+أدوية، من ضمن الأدوية، في مجموعة اسمها non-steroidal
+
+287
+00:18:18,560 --> 00:18:22,350
+anti-inflammatory drugs، المجموعة زي مجموعة
+
+288
+00:18:22,350 --> 00:18:25,710
+.. زي مجموعة الـ Antibiotic، هذه المجموعة بتشتغل
+
+289
+00:18:25,710 --> 00:18:30,050
+يعني على اللي هو ألم الأعصاب أو ألم العضلات اللي
+
+290
+00:18:30,050 --> 00:18:32,030
+موجودة عنده، وفي نفس الوقت، يعني هي مضادة
+
+291
+00:18:32,030 --> 00:18:35,590
+للالالتهابات، لكن فيها مشكلة، زي الدواء اسمه Diclofenac
+
+292
+00:18:35,590 --> 00:18:39,550
+منها، الـ Diclofenac هذا لو أخذه الإنسان مباشرة على
+
+293
+00:18:39,550 --> 00:18:42,770
+المعدة، ممكن يحرج معدته، الآن بنقوله لو سمحت،
+
+294
+00:18:42,770 --> 00:18:46,670
+احنا قاعدين نعملها استثمار، خذ هذا الدواء مثلاً ثلاث
+
+295
+00:18:46,670 --> 00:18:49,570
+مرات في اليوم، بروح بس بقوله در بالك يا ريت تأخذه
+
+296
+00:18:49,570 --> 00:18:52,530
+على معدة مليانة عشان إيه؟ ما يأثرش على المعدة، بروحش
+
+297
+00:18:52,530 --> 00:18:56,210
+بقول له؟ بقول له، لأ أنا لأ والله أنا در بالي، أنا
+
+298
+00:18:56,210 --> 00:18:58,910
+عندي مشكلة في المعدة، إيش هي؟ إني أنا عندي ألم
+
+299
+00:18:58,910 --> 00:19:02,030
+كثير، بصير و براط كذا، بصير عندك تقرح في المعدة،
+
+300
+00:19:02,030 --> 00:19:05,550
+الآن مجرد ما حكالي زي هي غيرت كل الـ therapy، غيرت
+
+301
+00:19:05,550 --> 00:19:09,190
+كل العلاج، أو بدأت أعطي، أما أعطي يعني دواء يكون
+
+302
+00:19:09,190 --> 00:19:12,770
+للمعدة زيادة مع العلاج أو بغير الدواء كله من أصله،
+
+303
+00:19:12,770 --> 00:19:16,480
+مين اللي خَلّاني؟ هذا أغيره هو لما عملت assessment
+
+304
+00:19:16,480 --> 00:19:20,820
+قدر يجعلنا نغير العلاج اللي يكون مفيد للمريض، طيب
+
+305
+00:19:20,820 --> 00:19:23,760
+purposes of health assessment، شو أغراض الـ health
+
+306
+00:19:23,760 --> 00:19:26,820
+assessment؟ أول حاجة gathering data، جمع المعلومات،
+
+307
+00:19:26,820 --> 00:19:33,080
+جمعها، اثنين confirm or refuse، إيش دخل confirm؟ أثبت
+
+308
+00:19:33,080 --> 00:19:36,640
+طب refuse؟ ليش قلت refuse هنا؟ refuse معناته هنا
+
+309
+00:19:36,640 --> 00:19:40,090
+ارفض، بقول لك أنت يا بتأكد المعلومات يا بترفض
+
+310
+00:19:40,090 --> 00:19:43,170
+المعلومات، مش احنا قلنا أن في direct وفي indirect
+
+311
+00:19:43,170 --> 00:19:46,110
+أخذنا المعلومات، يمكن أنا أخذت معلومات من الـ health
+
+312
+00:19:46,110 --> 00:19:49,530
+history، مش كلها تكون صحيحة، يمكن المريض ضلّلني شوية،
+
+313
+00:19:49,530 --> 00:19:53,250
+يمكن ما أعطانيش المعلومات عشان ما يخاف على نفسه من
+
+314
+00:19:53,250 --> 00:19:56,830
+بعض الأشياء، بدون ما حدا يشكّله في شغله أو يقول له بنعمل لك
+
+315
+00:19:56,830 --> 00:20:01,610
+عملية، فأنا بعمل assessment بشكل كامل، يا إما بأكد
+
+316
+00:20:01,610 --> 00:20:04,410
+المعلومات اللي عندي، يا إما برفض المعلومات اللي
+
+317
+00:20:04,410 --> 00:20:08,800
+عندي، وبحاول أغيرها، ثلاثة confirm and identify
+
+318
+00:20:08,800 --> 00:20:12,400
+nursing diagnosis، أنا حطيت عندي nursing diagnosis
+
+319
+00:20:12,400 --> 00:20:15,540
+عشان أكد أن الـ nursing diagnosis صحيحة، بعمل
+
+320
+00:20:15,540 --> 00:20:18,180
+assessment، احنا أخذنا سنة أولى لما كانوا يقولوا لنا
+
+321
+00:20:18,180 --> 00:20:23,000
+قبل ما نعمل الـ nursing problems، قبل ما بدنا نصيغها
+
+322
+00:20:23,000 --> 00:20:27,160
+بقول لك اعمل assessment كويسة عشان نقدر نعرف أن هل الـ
+
+323
+00:20:27,160 --> 00:20:30,720
+nursing diagnosis بينفع ولا ما بينفعش، إذا بينفع
+
+324
+00:20:30,720 --> 00:20:35,700
+بكمل، ما بينفعش بنقل الـ assessment، بغير، طيب أربعة
+
+325
+00:20:36,750 --> 00:20:42,310
+make clinical judgments، حكم كلينيكي، هذا كلينيكي وهذا
+
+326
+00:20:42,310 --> 00:20:46,450
+judgment، حكم about the client's changing health، لما
+
+327
+00:20:46,450 --> 00:20:50,230
+الإنسان يكون عنده، بتابع المريض ألاقي فيه
+
+328
+00:20:50,230 --> 00:20:53,610
+تغييرات في صحته، هو اللي بيكون الفيصل أمام الطبيب
+
+329
+00:20:53,610 --> 00:20:59,410
+بالمناسبة، كثير من الممرضين والحكماء الشاطرين وأنا
+
+330
+00:20:59,410 --> 00:21:03,340
+تابعت نفسي، هذا الكلام هو اللي خلى الطبيب يغير
+
+331
+00:21:03,340 --> 00:21:06,720
+علاجات معينة أو هو اللي خلى يغير مسار حتى الرعاية
+
+332
+00:21:06,720 --> 00:21:10,120
+للمريض، فدائماً احنا بنساعد في الـ clinical judgment
+
+333
+00:21:10,120 --> 00:21:14,580
+كيف بنساعد؟ بنعطيك مثال، دائماً بحب أضرب أمثلة عشان
+
+334
+00:21:14,580 --> 00:21:18,840
+نستفيد أكثر، كيف يعني؟ بيجيء الآن واحد بيقول له اليوم
+
+335
+00:21:18,840 --> 00:21:23,040
+أنت خرجت من الطبيب وأنا شفتك كويس، بيقول المريض، بروح
+
+336
+00:21:23,040 --> 00:21:26,960
+بقول الممرض، لأ أنا كنت سهران الليلة للأسف، صار عنده
+
+337
+00:21:26,960 --> 00:21:30,720
+vomiting الساعة 12 في الليل، ودخل الحمام شوية واحنا
+
+338
+00:21:31,190 --> 00:21:35,250
+عطينا يعني حب الدواء، واجىء الطبيب في الليل وقال
+
+339
+00:21:35,250 --> 00:21:38,310
+إذا وأنا تعبان أعطيه محلول، الآن الكلام اللي حكاه
+
+340
+00:21:38,310 --> 00:21:43,890
+هذا الحكيم صح، اتنكد المريض لكن هذا غير مسار كل هي
+
+341
+00:21:43,890 --> 00:21:46,590
+الرعاية، اجىء الطبيب بيقولوا له، لأ بنقدرش بناء على
+
+342
+00:21:46,590 --> 00:21:49,530
+التغييرات اللي صارت، إيش اسمها؟ clinical judgment
+
+343
+00:21:49,530 --> 00:21:54,010
+بيقولوا بناء على التغييرات، معلش سامحنا بنخليك
+
+344
+00:21:54,010 --> 00:21:59,350
+يبقى احنا بنشارك بالتغييرات اللي بتصير في الرعاية
+
+345
+00:21:59,350 --> 00:22:02,980
+للمريض، بناء على متابعتنا الدائمة، وأنت لا تنسى أن
+
+346
+00:22:02,980 --> 00:22:08,640
+الممرض يتابع المريض 24 ساعة، الطبيب ليس قليل من
+
+347
+00:22:08,640 --> 00:22:13,360
+قيمته وإنما هو يعني الله يعينه، بيجيء يتابع الحالات
+
+348
+00:22:13,360 --> 00:22:17,080
+بشكل كامل، بحالات كثيرة جداً، برة، وجوبات، وعيادات وغيره
+
+349
+00:22:17,080 --> 00:22:21,180
+لكن احنا ملزمين نكون في المستشفى مع المرضى ونتابع
+
+350
+00:22:21,180 --> 00:22:25,380
+كل التغييرات اللي بتصير، خمسة to evaluate، بنقيم bio
+
+351
+00:22:25,380 --> 00:22:27,820
+psychosocial اللي احنا حكيناه، and spiritual
+
+352
+00:22:27,820 --> 00:22:31,830
+outcomes of care، طبعاً اللي هو أي تطورات بتصير، بدنا
+
+353
+00:22:31,830 --> 00:22:35,730
+نتابعها من كل الجوانب اللي هو الحيوية والنفسية والـ
+
+354
+00:22:35,730 --> 00:22:39,410
+اجتماعية والروحانية، طيب nursing and medical
+
+355
+00:22:39,410 --> 00:22:44,650
+diagnosis، كثير من الناس للأسف بيكون عنده مشكلة
+
+356
+00:22:44,650 --> 00:22:48,790
+إيش المشكلة دي؟ إنه بيفكر الاثنين نفس التشخيص، لأ أنا
+
+357
+00:22:48,790 --> 00:22:53,510
+كمان مرة بدي أقول فرق كبير جداً، هو المكتب ليه؟ أنا
+
+358
+00:22:53,510 --> 00:22:55,730
+big difference، هي كانت بيشوف كان من الخط المعين
+
+359
+00:22:56,140 --> 00:22:59,120
+للأسف، بنقول big difference لأن في ناس بيخلطوا بين
+
+360
+00:22:59,120 --> 00:23:03,460
+الاثنين، الـ nursing diagnosis، independent role of
+
+361
+00:23:03,460 --> 00:23:06,300
+the nurse، لما نقول كلمة independent، يا ريتوا ضايقوا
+
+362
+00:23:06,300 --> 00:23:09,640
+الذاكرين، هذه الكلمة independent، مستقل، dependent
+
+363
+00:23:09,640 --> 00:23:13,580
+يعني معتمد، لما نيجي نقول الطفل dependent on his
+
+364
+00:23:13,580 --> 00:23:17,000
+mother، يعني معتمد على أمه، أنت الآن، وأنت الآن ما شاء
+
+365
+00:23:17,000 --> 00:23:20,160
+الله كبرت في عييتك، بنقول you are independent، أنت
+
+366
+00:23:20,160 --> 00:23:24,220
+الآن ما شاء الله عليك، يعني بتقدر تكون معتمد على
+
+367
+00:23:24,220 --> 00:23:28,250
+نفسك، وأنت الآن، الـ nursing diagnosis لازم يكون إيش؟
+
+368
+00:23:28,250 --> 00:23:30,890
+independent، طب يعتمد على إيش؟ depends on the
+
+369
+00:23:30,890 --> 00:23:34,090
+client's problems، شو الـ client's problems associated
+
+370
+00:23:34,090 --> 00:23:39,470
+with a specific disorder؟ أنا كحكيم لما بدي أصيغ
+
+371
+00:23:39,470 --> 00:23:43,150
+.. لما بدي أصيغ مش .. بدي أعمل diagnosis، بدي أصيغ
+
+372
+00:23:43,150 --> 00:23:47,170
+يعني هذا التشخيص، بصيغه بناء على إيه؟ بناء على
+
+373
+00:23:47,170 --> 00:23:51,410
+استجابة المريض، لا هو من رأسي ولا له علاقة
+
+374
+00:23:51,410 --> 00:23:55,930
+بالـ تحاليل الطبية ولا له علاقة بواحد بيجيء يأمرني
+
+375
+00:23:55,930 --> 00:23:59,190
+يقول كذا، يمكن الطبيب مختلف، الآن احنا هنعرف كيف
+
+376
+00:23:59,190 --> 00:24:04,510
+مختلف، نيجيء هنا شوية، الآن any problems must be noticed
+
+377
+00:24:04,510 --> 00:24:07,290
+from a holistic، ما احنا قلنا، إيش holistic؟
+
+378
+00:24:07,290 --> 00:24:11,740
+biopsychosocial and spiritual relations، بقول لك أنتَ
+
+379
+00:24:11,740 --> 00:24:16,920
+يا حكيم لازم تشوف أي مشكلة موجودة عند المريض وتـ
+
+380
+00:24:16,920 --> 00:24:20,220
+تتطلع من أربعة جوانب عشان تقدر تعمل diagnostic
+
+381
+00:24:20,220 --> 00:24:24,380
+diagnosis، يبقى أنت كحكيم بدك تتابع بيوسوسيوسي
+
+382
+00:24:24,380 --> 00:24:28,840
+social and spiritual، لكن الطبيب لحظة، بقول لي لأ،
+
+383
+00:24:28,840 --> 00:24:32,740
+أنا depends on the clinical picture and laboratory
+
+384
+00:24:32,740 --> 00:24:36,980
+findings، الطبيب ما احترمنا وتقدرنا، لما بده يجيء
+
+385
+00:24:36,980 --> 00:24:39,920
+يصيغ الـ diagnosis، كيف يصيغه؟ يعني ممكن يجيء يقوله
+
+386
+00:24:39,920 --> 00:24:46,580
+تعال falling down، يعني واحد، واحد هو مثلاً كاتب إنه
+
+387
+00:24:46,580 --> 00:24:50,480
+عنده vomiting، وقال خلاص falling down، التشخيص، لما
+
+388
+00:24:50,480 --> 00:24:55,260
+دخله على القسم راح عمل له CT عشان يشوف الراس فيه شيء
+
+389
+00:24:55,260 --> 00:25:00,360
+لما عملنا له CT، اتفاجأنا وسُعق الطبيب، لقى إنه في
+
+390
+00:25:00,360 --> 00:25:04,740
+عنده brain tumor، صح واجع، لكن لما صورنا الـ CT كشفت
+
+391
+00:25:04,740 --> 00:25:07,680
+شيء ثاني، إيش الـ medical diagnosis صار بناء على
+
+392
+00:25:07,680 --> 00:25
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..dd1457d128810fbd446f94f32facb0cd277ebd45
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.json
@@ -0,0 +1 @@
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falling down التشريس لما دخله على القسم راح عمله CT عشان يشوف الراس فيه اشي لما عملنا له CT اتفاجأناه و سُعق الطبيب لقى انه في عنده brain tumor", "tokens": [6027, 9566, 21292, 3555, 19446, 1975, 33753, 2288, 2304, 8315, 4032, 6055, 28543, 2288, 8315, 26895, 3224, 5296, 15042, 47525, 3224, 7251, 7435, 1829, 7251, 9381, 1829, 17082, 2423, 15217, 9122, 33911, 7251, 9381, 1829, 17082, 3224, 37495, 22653, 3714, 43020, 7251, 1829, 7435, 1829, 7251, 39648, 3224, 37279, 6027, 1829, 7440, 760, 37495, 22653, 36764, 24401, 36764, 24401, 31439, 50113, 15040, 9122, 9307, 3555, 16472, 3224, 43242, 3224, 46234, 4032, 50239, 16490, 1211, 33546, 7440, 760, 16712, 8592, 16572, 3794, 5296, 15042, 11778, 9778, 43761, 15844, 25062, 38251, 12602, 39319, 6225, 42213, 3224, 19529, 6225, 8592, 7649, 7251, 8592, 38688, 34892, 32277, 8978, 3224, 1975, 8592, 1829, 5296, 15042, 6225, 42213, 8315, 46740, 19529, 1975, 2655, 5172, 26108, 10721, 8315, 3224, 4032, 8608, 10859, 3615, 4587, 41950, 21292, 3555, 5296, 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0.8916015625}, {"start": 1654.77, "end": 1654.97, "word": " DM", "probability": 0.9482421875}, {"start": 1654.97, "end": 1655.51, "word": " كلمة", "probability": 0.8782552083333334}, {"start": 1655.51, "end": 1655.81, "word": " واحدة", "probability": 0.9444986979166666}, {"start": 1655.81, "end": 1655.89, "word": " او", "probability": 0.939453125}, {"start": 1655.89, "end": 1656.41, "word": " كلمتين", "probability": 0.9466552734375}, {"start": 1656.41, "end": 1657.07, "word": " لكن", "probability": 0.72314453125}, {"start": 1657.07, "end": 1657.47, "word": " لاحظين", "probability": 0.9300537109375}, {"start": 1657.47, "end": 1657.65, "word": " احنا", "probability": 0.9236653645833334}, {"start": 1657.65, "end": 1658.07, "word": " بنصيغ", "probability": 0.797607421875}, {"start": 1658.07, "end": 1658.35, "word": " نرسم", "probability": 0.5533040364583334}, {"start": 1658.35, "end": 1658.45, "word": " ال", "probability": 0.72998046875}, {"start": 1658.45, "end": 1658.83, "word": " diagnosis", "probability": 0.7490234375}, {"start": 1658.83, "end": 1659.67, "word": " هنصيغ", "probability": 0.88857421875}, {"start": 1659.67, "end": 1660.03, "word": " تلاتة", "probability": 0.8912353515625}, {"start": 1660.03, "end": 1660.37, "word": " واربعة", "probability": 0.751708984375}, {"start": 1660.37, "end": 1660.69, "word": " بناء", "probability": 0.979248046875}, {"start": 1660.69, "end": 1660.97, "word": " على", "probability": 0.73388671875}, {"start": 1660.97, "end": 1661.89, "word": " نفس", "probability": 0.920654296875}, {"start": 1661.89, "end": 1662.11, "word": " اللي", "probability": 0.840087890625}, {"start": 1662.11, "end": 1662.43, "word": " هو", "probability": 0.85400390625}, {"start": 1662.43, "end": 1663.19, "word": " التشخيص", "probability": 0.96513671875}, {"start": 1663.19, "end": 1663.69, "word": " زي", "probability": 0.782470703125}, {"start": 1663.69, "end": 1663.81, "word": " ما", "probability": 0.958984375}, {"start": 1663.81, "end": 1663.97, "word": " اقول", "probability": 0.896728515625}, {"start": 1663.97, "end": 1664.23, "word": " بكرا", "probability": 0.8299153645833334}, {"start": 1664.23, "end": 1664.61, "word": " hypertension", "probability": 0.89111328125}, {"start": 1664.61, "end": 1665.65, "word": " تشخيص", "probability": 0.85556640625}, {"start": 1665.65, "end": 1666.25, "word": " انا", "probability": 0.916015625}, {"start": 1666.25, "end": 1666.45, "word": " اروح", "probability": 0.8800455729166666}, {"start": 1666.45, "end": 1666.85, "word": " اتكلم", "probability": 0.954345703125}, {"start": 1666.85, "end": 1667.03, "word": " على", "probability": 0.475830078125}, {"start": 1667.03, "end": 1667.13, "word": " ال", "probability": 0.96533203125}, {"start": 1667.13, "end": 1667.51, "word": " problems", "probability": 0.890625}, {"start": 1667.51, "end": 1667.77, "word": " اللي", "probability": 0.962646484375}, {"start": 1667.77, "end": 1667.93, "word": " له", "probability": 0.2362060546875}, {"start": 1667.93, "end": 1668.23, "word": " علاقة", "probability": 0.9777018229166666}, {"start": 1668.23, "end": 1668.55, "word": " مثلا", "probability": 0.6942138671875}, {"start": 1668.55, "end": 1668.73, "word": " بال", "probability": 0.796875}, {"start": 1668.73, "end": 1669.31, "word": " retrimors", "probability": 0.4204915364583333}, {"start": 1669.31, "end": 1669.77, "word": " بردج", "probability": 0.5809326171875}, {"start": 1669.77, "end": 1670.35, "word": " اللي", "probability": 0.785400390625}, {"start": 1670.35, "end": 1670.47, "word": " له", "probability": 0.2890625}, {"start": 1670.47, "end": 1670.65, "word": " علاقة", "probability": 0.9886067708333334}, {"start": 1670.65, "end": 1670.79, "word": " بال", "probability": 0.92431640625}, {"start": 1670.79, "end": 1671.27, "word": " sensation", "probability": 0.9208984375}, {"start": 1671.27, "end": 1671.95, "word": " بالاحساس", "probability": 0.8568115234375}, {"start": 1671.95, "end": 1672.45, "word": " اللي", "probability": 0.953857421875}, {"start": 1672.45, "end": 1672.49, "word": " له", "probability": 0.7587890625}, {"start": 1672.49, "end": 1672.77, "word": " علاقة", "probability": 0.9856770833333334}, {"start": 1672.77, "end": 1672.97, "word": " بال", "probability": 0.96435546875}, {"start": 1672.97, "end": 1673.27, "word": " headache", "probability": 0.9130859375}, {"start": 1673.27, "end": 1673.45, "word": " و", "probability": 0.86083984375}, {"start": 1673.45, "end": 1673.87, "word": " هكذا", "probability": 0.86181640625}, {"start": 1673.87, "end": 1674.45, "word": " يبقى", "probability": 0.84722900390625}, {"start": 1674.45, "end": 1674.91, "word": " معناته", "probability": 0.98486328125}, {"start": 1674.91, "end": 1675.67, "word": " تتعدد", "probability": 0.9468994140625}, {"start": 1675.67, "end": 1675.87, "word": " ال", "probability": 0.9853515625}, {"start": 1675.87, "end": 1676.17, "word": " nursing", "probability": 0.93701171875}, {"start": 1676.17, "end": 1676.85, "word": " diagnosis", "probability": 0.90185546875}, {"start": 1676.85, "end": 1677.49, "word": " ل", "probability": 0.37548828125}, {"start": 1677.49, "end": 1677.79, "word": " medical", "probability": 0.93017578125}, {"start": 1677.79, "end": 1678.35, "word": " diagnosis", "probability": 0.9287109375}, {"start": 1678.35, "end": 1678.75, "word": " واحد", "probability": 0.990966796875}], "temperature": 1.0}, {"id": 65, "seek": 169366, "start": 1680.58, "end": 1693.66, "text": "أنا بقول اللي خاطر عشان احنا مضلنا مدناش ناخد وقت كتير في المحاضرات خلينا نكتفل هنا هي 28 دقيقة ان شاء الله في المحاضرة القادمة بنكمل ال health history بإذن الله والسلام عليكم ورحمة الله وبركاته", "tokens": [10721, 8315, 4724, 39648, 13672, 1829, 16490, 41193, 2288, 6225, 8592, 7649, 1975, 5016, 8315, 3714, 11242, 1211, 8315, 3714, 3215, 1863, 33599, 8717, 47283, 3215, 4032, 38149, 9122, 2655, 13546, 8978, 9673, 5016, 46958, 2288, 9307, 16490, 20292, 8315, 8717, 4117, 2655, 5172, 1211, 34105, 39896, 7562, 11778, 38436, 28671, 16472, 13412, 16606, 21984, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 44945, 24793, 1211, 2423, 1585, 2503, 4724, 28814, 8848, 1863, 21984, 16070, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.1632812571194437, "compression_ratio": 1.6568627450980393, "no_speech_prob": 8.940696716308594e-07, "words": [{"start": 1680.58, "end": 1681.24, "word": "أنا", "probability": 0.8193359375}, {"start": 1681.24, "end": 1681.9, "word": " بقول", "probability": 0.97900390625}, {"start": 1681.9, "end": 1682.04, "word": " اللي", "probability": 0.56396484375}, {"start": 1682.04, "end": 1682.38, "word": " خاطر", "probability": 0.904296875}, {"start": 1682.38, "end": 1682.7, "word": " عشان", "probability": 0.9454752604166666}, {"start": 1682.7, "end": 1682.88, "word": " احنا", "probability": 0.8859049479166666}, {"start": 1682.88, "end": 1683.3, "word": " مضلنا", "probability": 0.81475830078125}, {"start": 1683.3, "end": 1684.16, "word": " مدناش", "probability": 0.68438720703125}, {"start": 1684.16, "end": 1684.66, "word": " ناخد", "probability": 0.9392903645833334}, {"start": 1684.66, "end": 1684.98, "word": " وقت", "probability": 0.944580078125}, {"start": 1684.98, "end": 1685.2, "word": " كتير", "probability": 0.9938151041666666}, {"start": 1685.2, "end": 1685.3, "word": " في", "probability": 0.7763671875}, {"start": 1685.3, "end": 1685.82, "word": " المحاضرات", "probability": 0.9853515625}, {"start": 1685.82, "end": 1686.42, "word": " خلينا", "probability": 0.7450358072916666}, {"start": 1686.42, "end": 1686.78, "word": " نكتفل", "probability": 0.9033203125}, {"start": 1686.78, "end": 1686.9, "word": " هنا", "probability": 0.69921875}, {"start": 1686.9, "end": 1687.02, "word": " هي", "probability": 0.40966796875}, {"start": 1687.02, "end": 1687.34, "word": " 28", "probability": 0.86083984375}, {"start": 1687.34, "end": 1687.68, "word": " دقيقة", "probability": 0.9041341145833334}, {"start": 1687.68, "end": 1687.8, "word": " ان", "probability": 0.548828125}, {"start": 1687.8, "end": 1687.94, "word": " شاء", "probability": 0.97314453125}, {"start": 1687.94, "end": 1688.04, "word": " الله", "probability": 0.95166015625}, {"start": 1688.04, "end": 1688.48, "word": " في", "probability": 0.75439453125}, {"start": 1688.48, "end": 1688.86, "word": " المحاضرة", "probability": 0.9830322265625}, {"start": 1688.86, "end": 1689.26, "word": " القادمة", "probability": 0.9931640625}, {"start": 1689.26, "end": 1689.78, "word": " بنكمل", "probability": 0.8065592447916666}, {"start": 1689.78, "end": 1689.88, "word": " ال", "probability": 0.810546875}, {"start": 1689.88, "end": 1690.16, "word": " health", "probability": 0.89892578125}, {"start": 1690.16, "end": 1691.0, "word": " history", "probability": 0.86572265625}, {"start": 1691.0, "end": 1691.3, "word": " بإذن", "probability": 0.8831787109375}, {"start": 1691.3, "end": 1691.48, "word": " الله", "probability": 0.94873046875}, {"start": 1691.48, "end": 1691.78, "word": " والسلام", "probability": 0.7481282552083334}, {"start": 1691.78, "end": 1692.24, "word": " عليكم", "probability": 0.968017578125}, {"start": 1692.24, "end": 1692.76, "word": " ورحمة", "probability": 0.9874267578125}, {"start": 1692.76, "end": 1693.0, "word": " الله", "probability": 0.978515625}, {"start": 1693.0, "end": 1693.66, "word": " وبركاته", "probability": 0.96630859375}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1699.8168125, "duration_after_vad": 1671.6268749999965}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1e0fb7b409befcbdcf4a779856d4c32236997f95
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/_9vY9OCPfu8_raw.srt
@@ -0,0 +1,1760 @@
+1
+00:00:01,080 --> 00:00:03,400
+اقعدوا بالله مش تراجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,400 --> 00:00:07,080
+الصلاة والسلام علي أشرف المرسلين سيدنا محمد وعليه
+
+3
+00:00:07,080 --> 00:00:11,960
+وصحبه وسلم اما بعد اليوم هنكمل ان شاء الله معاكم
+
+4
+00:00:11,960 --> 00:00:16,840
+في مسابق التقييم الصحي التمريدين طبعا احنا في
+
+5
+00:00:16,840 --> 00:00:21,000
+المحاضرة السابقة زي ما انا حكيتلكوا كنا شوية يمكن
+
+6
+00:00:21,000 --> 00:00:26,900
+عجلنا فيالطرح اللى هو ال chapter لإنه كان مراجعة
+
+7
+00:00:26,900 --> 00:00:30,180
+كاملة لكثير من الأشياء اللى كانت ماخدينها احنا في
+
+8
+00:00:30,180 --> 00:00:33,620
+وسط عمل التمريد في المستوى الأول خلينا اليوم ندخل
+
+9
+00:00:33,620 --> 00:00:37,220
+في بدايات اللى هو التقييم الصحي التمريد وما ننساش
+
+10
+00:00:37,220 --> 00:00:41,220
+قبل ندخل ان احنا قلنا ان التقييم الصحي مش تقييم
+
+11
+00:00:41,220 --> 00:00:44,220
+biology فقط زى ما زمان كان يسموه physical وانما
+
+12
+00:00:44,220 --> 00:00:46,860
+health assessment اللى هي bio psychosocial and
+
+13
+00:00:46,860 --> 00:00:50,380
+spiritual طبعا دى بس من باب التذكير احنا أخدناه في
+
+14
+00:00:50,380 --> 00:00:53,780
+المحاضرة السابقةعشان تذكرنا في عملية ال nursing
+
+15
+00:00:53,780 --> 00:00:57,420
+care اللى هو plan بشكل عام اللى بتبدأ من عند ال
+
+16
+00:00:57,420 --> 00:01:00,060
+assessment تنتهي من عند ال evaluation طيب خلنا
+
+17
+00:01:00,060 --> 00:01:04,960
+نكمل شوية اول حاجة بدنا نفهم انه متى بدأ ال
+
+18
+00:01:04,960 --> 00:01:08,440
+assessment في العالم كله طبعا زمان ماكان موجود في
+
+19
+00:01:08,440 --> 00:01:12,160
+حاجة اسمها health assessment صحيح كانوا في بعض
+
+20
+00:01:12,160 --> 00:01:17,000
+الناس يشاركوا في زي تضميد جراح في حروب او كانوا في
+
+21
+00:01:17,000 --> 00:01:23,720
+بعض الناس يقيموا حالات فيفي دول في مؤسسات بس دون
+
+22
+00:01:23,720 --> 00:01:26,800
+انه مايكون هناك شيء ناضم لهذا الموضوع يعني مافيش
+
+23
+00:01:26,800 --> 00:01:30,340
+اشي كان يعني زي ما نقول والله مثلا جمعية القلب
+
+24
+00:01:30,340 --> 00:01:34,980
+العالمية جمعية الأطباء العالم ماكانش حاجة زي هي
+
+25
+00:01:34,980 --> 00:01:39,290
+كان او جمعية التقييم او مؤسسات التقييمفأول تقييم
+
+26
+00:01:39,290 --> 00:01:43,490
+بدأ في سنة 1998 إذا بتلاحظوا معاه مش كتير يعني مش
+
+27
+00:01:43,490 --> 00:01:48,170
+.. مش بعيد كتير 1998 تكلمه يعني يعني بدايات أو في
+
+28
+00:01:48,170 --> 00:01:53,490
+.. قبل ما .. حتى يعني قبل الألفين مش بكتير يعني طب
+
+29
+00:01:53,490 --> 00:01:55,470
+عن طريق مين؟ عن طريق ال American Medical
+
+30
+00:01:55,470 --> 00:01:59,070
+Association طبعا إيش ال medical association دي؟
+
+31
+00:01:59,070 --> 00:02:03,810
+كانت عبارة عن مؤسسة أمريكية طبية لأنه لسه ماكانش
+
+32
+00:02:03,810 --> 00:02:08,730
+ال nursing يعني طالع على سطحه على فكرة1998 بتذكرني
+
+33
+00:02:08,730 --> 00:02:12,350
+بهذا التاريخ أن هو بداية تأسيس كلية التمريد
+
+34
+00:02:12,350 --> 00:02:16,390
+بالجامعة الإسلامية، هذا معروف علامش يعني فبدأ اللي
+
+35
+00:02:16,390 --> 00:02:21,050
+هو ال assessment في سنة 1995 أصبح في health
+
+36
+00:02:21,050 --> 00:02:24,550
+assessment صارت تعتبر basic human right، إيش يعني
+
+37
+00:02:24,550 --> 00:02:28,110
+ال basic human right؟ تعتبر حق من الحقوق الأساسية
+
+38
+00:02:28,110 --> 00:02:32,130
+لكل إنسان، يعني أصبح في سنة 1995 كل واحد من حقه أن
+
+39
+00:02:32,130 --> 00:02:35,550
+يعمل assessmentو طبعا احنا قلنا في ال preventive
+
+40
+00:02:35,550 --> 00:02:39,270
+إذا بنذكر لما ذكرنا في المحاضرة السابقة ال
+
+41
+00:02:39,270 --> 00:02:41,970
+preventive هي التذكير مقسم لتلاتة بس من باب
+
+42
+00:02:41,970 --> 00:02:45,030
+التذكير لما قلنا primary و secondary أو tertiary و
+
+43
+00:02:45,030 --> 00:02:48,950
+نفس القضية هم الآن بيعملوا فيها كيف يعني اللي قبل
+
+44
+00:02:48,950 --> 00:02:52,210
+المرض بنسميها primary prevention أثناء حدوث المرض
+
+45
+00:02:52,210 --> 00:02:55,830
+secondary prevention و اللي بعد حدوث المرض و حدوث
+
+46
+00:02:55,830 --> 00:02:59,790
+المضاعفة tertiary preventionطيب هل ال assessment
+
+47
+00:02:59,790 --> 00:03:03,570
+عمل مرة واحدة و لا مرتين و لا كام و لا هي لعداد
+
+48
+00:03:03,570 --> 00:03:06,970
+معين بقول هنا periodic health assessment needed to
+
+49
+00:03:06,970 --> 00:03:10,550
+be اشهد performed by a physician or nurses بقول
+
+50
+00:03:10,550 --> 00:03:14,550
+الصح ان الواحد يعمل periodic لازم يعمل اللي بدأ
+
+51
+00:03:14,550 --> 00:03:17,610
+يعمل assessment يعني مثلا افترضنا فلان عمل
+
+52
+00:03:17,610 --> 00:03:20,510
+assessment و طلع عنده شغلة او احنا شكينا في شغلة
+
+53
+00:03:20,510 --> 00:03:25,030
+او متحسبين لشغلة معينة لازم نضل نتعب طبيا و
+
+54
+00:03:25,030 --> 00:03:30,200
+تمريضيا نضل نتعب ايه طبيا و تمريضياطيب objectives
+
+55
+00:03:30,200 --> 00:03:34,620
+and types of assessment طيب شو ال objectives و إيش
+
+56
+00:03:34,620 --> 00:03:37,020
+ال types بتاعة ال assessment أول حاجة من ال
+
+57
+00:03:37,020 --> 00:03:39,540
+objectives المهمة لل assessment بيقولي
+
+58
+00:03:39,540 --> 00:03:41,300
+surveillance من وين أجت ال surveillance و ده
+
+59
+00:03:41,300 --> 00:03:44,380
+البقاء يبقى معناته بيقول surveillance of health
+
+60
+00:03:44,380 --> 00:03:48,040
+status سبحان الله ده كل ما بتقدم العلم أكتر طبعا
+
+61
+00:03:48,040 --> 00:03:51,540
+هي ليس تدخلا في أعمار البشر وإنما الله سبحانه
+
+62
+00:03:51,540 --> 00:03:54,400
+وتعالى هو اللي يقدر الأسباب لكن لازم ألاحظ احنا
+
+63
+00:03:54,400 --> 00:03:57,810
+الدول الفقيرة اللي لايوجد فيهالا علم ولا طب ولا
+
+64
+00:03:57,810 --> 00:04:02,570
+تمريض ولا غير و بنلاقي يعني كتير أمراض تنتسارية و
+
+65
+00:04:02,570 --> 00:04:06,290
+معدية و ربما تؤدي للوفاة بكتير من الحالات الأن
+
+66
+00:04:06,290 --> 00:04:09,590
+احنا في assessment بشكل علمي و منطقي في بقاء
+
+67
+00:04:09,590 --> 00:04:13,510
+للبشرية identification of occult disease كلمة
+
+68
+00:04:13,510 --> 00:04:17,430
+occult أخدناها قبل أيه كل ما سمعهاش معناتها يعني
+
+69
+00:04:17,430 --> 00:04:21,770
+مخفي زي ما اقول مثلا occult blood يعني الدم المخفي
+
+70
+00:04:21,770 --> 00:04:25,230
+لما بيجي في بعض الحالات بيجي واحد من المعلن فحصات
+
+71
+00:04:25,530 --> 00:04:28,250
+بنعمله stool انه ناسس بطلع عنده blood مش مبين انه
+
+72
+00:04:28,250 --> 00:04:32,230
+فيه blood لكن مبين انه عامل ال tarry ال tarry ال
+
+73
+00:04:32,230 --> 00:04:35,310
+stool يعني عامل زي الزفتة و زي الشحمة فاللون
+
+74
+00:04:35,310 --> 00:04:40,570
+بيخلنا نشك انه فيه ايه انه فيه دم طيب لحالات ال
+
+75
+00:04:40,570 --> 00:04:43,890
+screening كمان عشان نقدر نعمل screening نشوف الناس
+
+76
+00:04:43,890 --> 00:04:46,090
+مين عنده مشكلة و مين ماعنده مشكلة زي في حالات
+
+77
+00:04:46,090 --> 00:04:48,870
+اليوم في الكورونا لما بعملوا screening لكثير من
+
+78
+00:04:48,870 --> 00:04:52,750
+الناس برضه بالزمن ال follow up عشان أضن أتابع
+
+79
+00:04:52,750 --> 00:04:56,540
+الحلقة طيبperiodic assessment at regular interval
+
+80
+00:04:56,540 --> 00:05:00,240
+ايش يعني؟ بقول ال periodic بقول يعني يفضل انك تعمل
+
+81
+00:05:00,240 --> 00:05:04,980
+دايما assessment على فترات محددة و الصحيح تكون في
+
+82
+00:05:04,980 --> 00:05:08,780
+فترات منتظمة يعني انت عملت كل سنة تعال كل سنة عملت
+
+83
+00:05:08,780 --> 00:05:11,820
+كل ست شهور تعال كل ست شهور في بعض الحالات بيجي
+
+84
+00:05:11,820 --> 00:05:15,940
+الطبيب بقول افضل انه لازم انت المرض الفرنسيين كل
+
+85
+00:05:15,940 --> 00:05:18,980
+ست شهور اعمله واحد اتنين تلاتة صحيح مابينفعش مرة
+
+86
+00:05:18,980 --> 00:05:23,850
+ستة مرة تمانية مرة و هكذا اكتر او اقلالبرنامج
+
+87
+00:05:23,850 --> 00:05:26,570
+الخاص بيسميها increasing client participation،
+
+88
+00:05:26,570 --> 00:05:29,830
+ماذا يعني participation؟ Participation مشاركة في
+
+89
+00:05:29,830 --> 00:05:33,610
+ال health careلما نحنا بنعمل assessment للمريض هو
+
+90
+00:05:33,610 --> 00:05:36,730
+نفسه بيتقبل و بيسير و يساعدنا كمان عشان يعالج نفسه
+
+91
+00:05:36,730 --> 00:05:39,710
+أكيد انتوا عارفين بكرا ان شاء الله لما ترجع الأمور
+
+92
+00:05:39,710 --> 00:05:43,010
+لطبيعتها و نرجع المستشفى هتشوف ان المريض و تشوف ان
+
+93
+00:05:43,010 --> 00:05:47,250
+المريض لما يكون مستوعب علينا و ماشي معناه هيحب انه
+
+94
+00:05:47,250 --> 00:05:50,770
+يعني حتى يساعد نفسه يشبكوا مني ان انا مستعد اساعد
+
+95
+00:05:50,770 --> 00:05:55,110
+مش هكون انا عبق كلي عليكم و انما هساعدكم في رعايتى
+
+96
+00:05:55,110 --> 00:06:00,260
+I cannot define the health and riskCare needs for
+
+97
+00:06:00,260 --> 00:06:03,220
+individuals health and risk شو يعني health and
+
+98
+00:06:03,220 --> 00:06:07,680
+risk بقوللي هذا كمان بحددلي بدقة شو معايير الصحة
+
+99
+00:06:07,680 --> 00:06:10,540
+اللي موجودة عند المريض وشو معايير الخطر اللي
+
+100
+00:06:10,540 --> 00:06:14,520
+موجودة عند المريض لان لما نعمل assessment نقدر
+
+101
+00:06:14,520 --> 00:06:16,680
+لحالة نكشف ايش ال normal و ايش ال abnormal عشان
+
+102
+00:06:16,680 --> 00:06:20,200
+هيك بقوللي انا ياريت تعمل assessment عشان تعرفي ان
+
+103
+00:06:20,200 --> 00:06:23,100
+بعض الناس بيجي و بيقولك انا راسي بيجعوني طيب راسي
+
+104
+00:06:23,100 --> 00:06:25,280
+بيجعوني بيجي لوحد تاني بيقول اه انت انت كمان ضغطك
+
+105
+00:06:25,280 --> 00:06:28,540
+مرتفع عشان اقطع الشك باليقين بروح بعمل assessment
+
+106
+00:06:29,140 --> 00:06:32,920
+إذا ما عندهوش بقول healthy إذا عنده بقول risky و
+
+107
+00:06:32,920 --> 00:06:36,160
+هكذا health assessment النقطة التانية اللى فى النص
+
+108
+00:06:36,160 --> 00:06:40,540
+اللى موجودة قدامكوا health assessment shared و
+
+109
+00:06:40,540 --> 00:06:44,320
+الدخلانة ايش عن shared يجب ان يشارك بيها ايش اللى
+
+110
+00:06:44,320 --> 00:06:51,480
+هو المريض ان clearly and understandable لازم يكون
+
+111
+00:06:51,480 --> 00:06:55,430
+مفهوم سلوب مفهوم للمريض ايش اللى بتقوله هناأنا مش
+
+112
+00:06:55,430 --> 00:06:59,210
+كل إشي هترجم لأنه أنا متأكد يعني سنة ولا أخدته كام
+
+113
+00:06:59,210 --> 00:07:02,970
+كبير من المعلومات خلاني أمشي عشان المادة شوية مش
+
+114
+00:07:02,970 --> 00:07:08,330
+صغيرة كبيرة شوية فبقولي لازم يشارك المريض في عملية
+
+115
+00:07:08,330 --> 00:07:12,710
+الرعاية الصحية له كيف لكن بقولي بسلوب مفهوم يعني
+
+116
+00:07:12,710 --> 00:07:16,410
+مانفعش نيجي بعض الحالات بنقوله اسمع انت عشان تتحسن
+
+117
+00:07:16,410 --> 00:07:22,280
+مثلا بدنا يجتش شرب ميهها ميه تكون سائلة، الآن
+
+118
+00:07:22,280 --> 00:07:25,940
+المريض ده فيهم بشرب ميه، لو أعطناه وقلناله كلمه
+
+119
+00:07:25,940 --> 00:07:29,620
+غامضه أشرب سوائل، ممكن يفهم المريض كلمه أشرب سوائل
+
+120
+00:07:29,620 --> 00:07:34,030
+عشان تتحسنيروح يجيب مثلا بطاطا و يطحنها و يعملها
+
+121
+00:07:34,030 --> 00:07:38,770
+سائل يمكن يجيب مرقة و يحط عليها لحمة و كذا فبصير
+
+122
+00:07:38,770 --> 00:07:42,230
+هنا للأسف ال understander مراحت يعني مش مفهوم
+
+123
+00:07:42,230 --> 00:07:45,330
+صراحة جدا بصير حاجة اسمها vague، vague يعني غامض
+
+124
+00:07:45,330 --> 00:07:49,010
+فالصح ان المريض لما يساعدنا يكون فاهم ايش اللي
+
+125
+00:07:49,010 --> 00:07:51,850
+احنا مطلوب منه عشان الساعة في ال care النقطة
+
+126
+00:07:51,850 --> 00:07:55,010
+الأخيرة اللي اقول هنا the client must share in
+
+127
+00:07:55,010 --> 00:07:58,450
+decision making شو يعني decision making صناعة
+
+128
+00:07:58,450 --> 00:08:03,200
+القرارليش تشارك ان انت صناعة القرار ايه المريض؟
+
+129
+00:08:03,200 --> 00:08:07,100
+المريض ممكن يساعدها في صناعة القرار الخاص في ال
+
+130
+00:08:07,100 --> 00:08:10,880
+all care لو حد سألني طب كيف يا أستاذ المريض بدي
+
+131
+00:08:10,880 --> 00:08:14,920
+ساعد .. كيف بدي ساعد المريض انه يعني بصناعة القرار
+
+132
+00:08:14,920 --> 00:08:18,640
+الخاص بيه؟ انا اعطيكم مثل .. مثل بسيط من الأمثلة
+
+133
+00:08:18,640 --> 00:08:22,980
+البسيطة بيجي .. الان المريض بيجي ويقوله انا تعبان
+
+134
+00:08:22,980 --> 00:08:25,380
+ويقوله والله عندك فلونزا او عندك التهابات او كده
+
+135
+00:08:25,380 --> 00:08:28,940
+الصح تاخد مضار حياتهالان ايش بيقولوا .. بيقولوا
+
+136
+00:08:28,940 --> 00:08:32,420
+بدنا نعطيك مضاهض عن طريق الوريد، بيقولوا الطبيب يا
+
+137
+00:08:32,420 --> 00:08:35,400
+دكتور مينفعش اخد حبوب، بروح بيقولوا والله في حبوب
+
+138
+00:08:35,400 --> 00:08:38,500
+وفي كابسولات بس غالية شوية، بروح لمرض بيقولوا لأ
+
+139
+00:08:38,500 --> 00:08:41,160
+مش مشكلة باخدها لأ انه انا ال .. ال .. ال ..
+
+140
+00:08:41,160 --> 00:08:45,140
+الوريد بتعبني، الان الطبيب بيقولوا okay زي ما بدك،
+
+141
+00:08:45,140 --> 00:08:49,420
+هذا ايش اسمه؟ ساعد في رعاية، صنع القرار طب نعطيه
+
+142
+00:08:49,420 --> 00:08:53,140
+مثال صغير، مثال تاني انه أجى أحد الأشخاص و هذا
+
+143
+00:08:53,140 --> 00:08:56,430
+حقيقة كتير حصلت معانا و احنا كنا في مستشفياتيجي
+
+144
+00:08:56,430 --> 00:08:59,050
+الدكتور يقوله عندك hernia هيرنية عندك إيش فتق
+
+145
+00:08:59,050 --> 00:09:02,270
+الفتقات اللي موجودة في التاج بدنا نعملها عمليا
+
+146
+00:09:02,270 --> 00:09:05,630
+فبقوله .. بقول الدكتور بنفع أجل يا دكتور لإن أنا
+
+147
+00:09:05,630 --> 00:09:08,970
+الآن في الجامعة أو أنا الآن في التوجيهي أجل لبعض
+
+148
+00:09:08,970 --> 00:09:12,610
+الامتحانات قال له مافي مشكلة أجل مافيش .. مابصير
+
+149
+00:09:12,610 --> 00:09:16,770
+شارك حاجة إذا شارك المريض أه طبعا شارك مش كل إشي
+
+150
+00:09:16,770 --> 00:09:20,450
+لازم المريض يتلقى بالإجبار بدون ما إيه انشاره في
+
+151
+00:09:20,450 --> 00:09:23,990
+بعض الشغلات اللي دهمه لكن الشغلات اللي هي ال
+
+152
+00:09:23,990 --> 00:09:28,580
+urgent أو ال emergencyأو الشغلات اللي فيها نتكلم
+
+153
+00:09:28,580 --> 00:09:32,440
+على حاجة فيها يعني اشي بيخوفله يعني فيها bad
+
+154
+00:09:32,440 --> 00:09:34,780
+complications او لأ سبحان الله abnormal
+
+155
+00:09:34,780 --> 00:09:38,100
+complications او abnormal case فاش فيها انه نشاور
+
+156
+00:09:38,100 --> 00:09:42,080
+المريض زي في حالة ال acute appendicitis اللي هو
+
+157
+00:09:42,080 --> 00:09:44,640
+التهاب الزائد اللي دي الحياة frequency of
+
+158
+00:09:44,640 --> 00:09:48,500
+assessment متى
+
+159
+00:09:48,500 --> 00:09:52,320
+بأعمل assessment هل بعمل assessment يعني على كيفي
+
+160
+00:09:52,320 --> 00:09:56,040
+كل يوم كل سنة كل سنتينهذا القاعدة اللى قدامنا بدأ
+
+161
+00:09:56,040 --> 00:10:00,120
+ان شاء الله نحفظها و نفهمها الناس اللى تحت الخمسة
+
+162
+00:10:00,120 --> 00:10:02,800
+و تلاتين سنة اللى زى حضراتكم اللى تحت الخمسة و
+
+163
+00:10:02,800 --> 00:10:05,600
+تلاتين سنة مايجيش واحد يقول لهم لأ انا شاب صغير او
+
+164
+00:10:05,600 --> 00:10:08,600
+بنت تقوللي انا لسه صغير يا استاذ مابعانيش من حاجة
+
+165
+00:10:08,600 --> 00:10:12,320
+انا زى الحديد زى البومب مافي كلمة زى الحديد احنا
+
+166
+00:10:12,320 --> 00:10:17,180
+هذا صحة الإنسان كلها متراكبة على بعض و اذا اختل
+
+167
+00:10:17,180 --> 00:10:21,200
+جزء من الجسم كل جسم بختلاللي تحت الخمسة و تلاتين
+
+168
+00:10:21,200 --> 00:10:25,880
+سنة بيعمل كل اربع الى خمس سنوات مرة health
+
+169
+00:10:25,880 --> 00:10:31,120
+assessment طبعا بعض الناس فيه بيسموه عشان تعرفوا
+
+170
+00:10:31,120 --> 00:10:34,320
+لما بيجي بتوظف الانسان يعني مثلا ان شاء الله ربنا
+
+171
+00:10:34,320 --> 00:10:38,900
+يقدر و لما نخلص و الحياة هادت كمان تتحسن و أيامكوا
+
+172
+00:10:38,900 --> 00:10:41,700
+تكون أحلى من هذه الأيام و نيجي نقدمنا وظيفة اي
+
+173
+00:10:41,700 --> 00:10:44,920
+وظيفة مرة ما رحتوا بيعملوا حاجة بيسموها تقييم صحي
+
+174
+00:10:44,920 --> 00:10:51,190
+بيسموها بالوزارة الصحةالكميسيون الطبي و بيسموها
+
+175
+00:10:51,190 --> 00:10:55,770
+بالرياضة اللياقة البدنية و بيسموها بالداخلية
+
+176
+00:10:55,770 --> 00:11:00,430
+اللياقة الصحية طبعا كلها تعددت الأسماء لكن في
+
+177
+00:11:00,430 --> 00:11:04,430
+الآخر هدف واحد فهم يشبعوا علشان يشوف ناقط الإنسان
+
+178
+00:11:04,430 --> 00:11:07,950
+من كل أربع لخمس سنوات يعني لازم يعمل مرة حتى يصل
+
+179
+00:11:07,950 --> 00:11:10,830
+لخمس و تلاتين الان وصل لخمس و تلاتين من خمس و
+
+180
+00:11:10,830 --> 00:11:13,870
+تلاتين لخمس و أربعين سنة اللي عمرهيعني في العشر
+
+181
+00:11:13,870 --> 00:11:18,150
+سنوات هذه بيعمل كل سنتين لدالت سنين لاحظوا ان كل
+
+182
+00:11:18,150 --> 00:11:21,650
+ما بيكبر الإنسان بيصير يعمل في ايه؟ بيصير يعمل
+
+183
+00:11:21,650 --> 00:11:26,010
+assessment في فترات أقل شوية طيب نيجي لبعده هان من
+
+184
+00:11:26,010 --> 00:11:29,810
+خمسة و أربعين لخمسة و خمسين صار لخمسة و خمسين سنة
+
+185
+00:11:29,810 --> 00:11:34,550
+لازم يعمل ايش هنا؟ هو يمكن هنا مش موضح لي لكن هنا
+
+186
+00:11:34,550 --> 00:11:38,010
+بيقولي every year ايش يعني every year؟ كل سنة
+
+187
+00:11:38,010 --> 00:11:41,490
+هيكتبها في الآخر سوري بقى أنا ماكناش حاطينا ورا
+
+188
+00:11:41,490 --> 00:11:46,060
+القوس مباشرةevery يعني كل سنة لازم يعمل اللى عمره
+
+189
+00:11:46,060 --> 00:11:51,940
+من 45 ل 55 سنة طيب اللى بعد ال 55 لاحظوا هنا ماتنش
+
+190
+00:11:51,940 --> 00:11:55,520
+60 ماتنش اكتر مع انه فيه اكتر و في عندهم يعني ممكن
+
+191
+00:11:55,520 --> 00:12:00,220
+الشباب يضلوا شاعري و مستمر بيه لبعد ال 60 كمان ال
+
+192
+00:12:00,220 --> 00:12:05,440
+persons اللى هم فوق ال 55 الصح ينعمل كل 6 شهور او
+
+193
+00:12:05,440 --> 00:12:10,020
+اقل or less ليش؟ هعطيكم مثال صغير، الآن هذا اللى
+
+194
+00:12:10,020 --> 00:12:13,510
+انا حكيته هو حكومة عالميةالحكم العالمي لل healthy
+
+195
+00:12:13,510 --> 00:12:17,470
+persons، للأشخاص اللي هم كويسين وماعندهمش أمراض،
+
+196
+00:12:17,470 --> 00:12:22,630
+طيب فرضا جينا .. لجينا واحد عمره 25 سنة وعنده سكر
+
+197
+00:12:22,630 --> 00:12:26,610
+وعنده ضغط، كداش عمره؟ 25 سنة يعني، أقل من 35، هل
+
+198
+00:12:26,610 --> 00:12:29,230
+قاد أعمله assessment كل 4 على 5 سنوات؟ أبدا لا
+
+199
+00:12:29,230 --> 00:12:32,650
+والله، مابقدر، هذا بدي أعمله مش كل 6 شهر كمان، كل
+
+200
+00:12:32,650 --> 00:12:37,380
+3 شهرويمكن أقل بدي أقوله تعال بدي أعملك فحص و أشوف
+
+201
+00:12:37,380 --> 00:12:40,740
+مخزون السكر و أضل نجيسك الضغط و أعطيك علاجة إذا
+
+202
+00:12:40,740 --> 00:12:43,980
+على حسب الحالة اللي موجودة أمامي لكن المريض ماعنده
+
+203
+00:12:43,980 --> 00:12:47,700
+شيء أو ال client ماعنده أي شيء ماشي بمشي معاه انه
+
+204
+00:12:47,700 --> 00:12:51,100
+على حسب اللي هو السنوات اللي موجودة أمامي حتى
+
+205
+00:12:51,100 --> 00:12:54,520
+الفقر ال 55 لو أجى زي اليوم هو موجود في العيادات
+
+206
+00:12:54,520 --> 00:12:58,220
+الوكالة و الحكومة بيسير مع سكر و ضغط أو مرض قلبش
+
+207
+00:12:58,220 --> 00:13:02,870
+بيقولوله كل شهر تعال إنه عشان تاخد الدواءنعملك
+
+208
+00:13:02,870 --> 00:13:06,090
+تقييم و نعملك فحصة إذا حسب الحال اللي موجودة أمامي
+
+209
+00:13:06,090 --> 00:13:11,890
+تنسوش أنه كمان مرة بنقول أنه اللي تحت اللي هو 35
+
+210
+00:13:11,890 --> 00:13:17,250
+سنة من 4 إلى 5 سنوات و اللي من 35 إلى 45 من سنتين
+
+211
+00:13:17,250 --> 00:13:23,310
+إلى تلتة و اللي من 45 إلى 55 كمان مرة بنقول كل سنة
+
+212
+00:13:23,310 --> 00:13:28,010
+و اللي فوق ال 55 سنة هذا بينعمله concentration أو
+
+213
+00:13:28,010 --> 00:13:34,990
+أقل على حسب حالته الصحيةImportance of health
+
+214
+00:13:34,990 --> 00:13:38,470
+assessment اول حاجة Systematic and continuous
+
+215
+00:13:38,470 --> 00:13:41,930
+collection of client data اللي كويس فيها ان
+
+216
+00:13:41,930 --> 00:13:45,990
+بتعطيني جمع معلومات منتظم ومستمر لما بعمل
+
+217
+00:13:45,990 --> 00:13:51,350
+assessment وانا بكمل زميلي وزميلي بيكمل شغلي بنظل
+
+218
+00:13:51,350 --> 00:13:55,840
+دائما فيه حاجة كويسة ايش هي الحاجة كويسة؟إنه احنا
+
+219
+00:13:55,840 --> 00:14:00,040
+عملنا انا أخدت معلومات و زميلي كمان ما أخد معلومات
+
+220
+00:14:00,040 --> 00:14:03,280
+بنكمل بعض فبتضلوا عندنا continuous و ال continuous
+
+221
+00:14:03,280 --> 00:14:07,300
+هي systematic بنظام مش كإنه واحد بيشتغل في واد و
+
+222
+00:14:07,300 --> 00:14:10,180
+انا بشتغل في واد اتنين focus on the client
+
+223
+00:14:10,180 --> 00:14:12,920
+response ال client response to healthy problems
+
+224
+00:14:12,920 --> 00:14:15,960
+احنا عارفين و قولنا انه انا بركز على healthy
+
+225
+00:14:15,960 --> 00:14:20,300
+problems اللي هي مرتبطة بال medical diagnosis زي
+
+226
+00:14:20,300 --> 00:14:23,500
+ما قلنا hypertension انا بشوف ايش الأشياء المرتبطة
+
+227
+00:14:23,500 --> 00:14:26,920
+بال hypertensionفهي بتركز على استجابة المريض طيب
+
+228
+00:14:26,920 --> 00:14:30,860
+تلاتة مقولي ايش هنا تلاتة قدامي مقولي the nurse
+
+229
+00:14:30,860 --> 00:14:34,700
+carefully examine the clients body parts كمان لازم
+
+230
+00:14:34,700 --> 00:14:39,640
+يفحص الممرض الشاطر لازم يفحص ال body parts اللي هو
+
+231
+00:14:39,640 --> 00:14:42,980
+أعضاء الجسد اللي موجود عند اللي اللي هو المريض
+
+232
+00:14:42,980 --> 00:14:47,960
+ليعرف ايش هو ال normal و ايش هو ال abnormal عشان
+
+233
+00:14:47,960 --> 00:14:51,710
+يجيلي to determineabnormalities of the client عشان
+
+234
+00:14:51,710 --> 00:14:54,630
+هيك مرات الواحد مايستعجلش يعني بعض الحالات بيجي
+
+235
+00:14:54,630 --> 00:14:58,430
+بيقول لي يا أستاذ أنا شوفت في مشكلة عنده في ال
+
+236
+00:14:58,430 --> 00:15:01,490
+right hand بقوله استنى شوية يمكن ال right و ال
+
+237
+00:15:01,490 --> 00:15:07,110
+left هم هيك عشان هيك السؤال مايستعجلش طيب أربع the
+
+238
+00:15:07,110 --> 00:15:11,610
+nurse relies on data from different sources و احنا
+
+239
+00:15:11,610 --> 00:15:14,880
+قلنا قبل هيكةالـ sources بتبعت ال data اللي هي
+
+240
+00:15:14,880 --> 00:15:17,840
+عشان تصل للمشاكل اللي بتجيهها في direct و في
+
+241
+00:15:17,840 --> 00:15:20,720
+indirect و احنا قلنا direct أخدنا من المريض انا
+
+242
+00:15:20,720 --> 00:15:23,560
+ممكن اخد معلومات من المريض لكن هو كاتب لي هنا في
+
+243
+00:15:23,560 --> 00:15:26,520
+different sources لو ماقدرتش اخد افرض المريض عنده
+
+244
+00:15:26,520 --> 00:15:30,720
+coma يعني مغيب افرض المريض طفل افرض المريض اختيار
+
+245
+00:15:30,720 --> 00:15:35,420
+Geriatric افرض المريض refused رفض فباخد من ايش في
+
+246
+00:15:35,420 --> 00:15:39,740
+file في طبيب في أقارب في ناس حواليه في استاذ في
+
+247
+00:15:39,740 --> 00:15:44,170
+حكيم خامسةبقول ال health assessment provides a
+
+248
+00:15:44,170 --> 00:15:49,530
+baseline زي ال خط الأساسي ليش خط الأساسي أوي يعني
+
+249
+00:15:49,530 --> 00:15:52,350
+زي ما بقولها يعني زي القاعدة الأساسية اللي
+
+250
+00:15:52,350 --> 00:15:56,470
+بستخدمها لإيش to plan the clients care مابينفع من
+
+251
+00:15:56,470 --> 00:16:01,750
+عندي أنا مستعجل و بروح أخطط مابينفع مباشرة لحالي
+
+252
+00:16:01,750 --> 00:16:07,610
+أنا أعمل care plan مباشرة لازم أخد معلومات كاملة
+
+253
+00:16:07,610 --> 00:16:10,770
+عن طريق ال health assessmentعشان اقدر اعمل .. عشان
+
+254
+00:16:10,770 --> 00:16:14,270
+اقدر اعمل ايش .. plan يمكن دائماش بقولي هنا
+
+255
+00:16:14,270 --> 00:16:19,630
+تستعجلش هي الحكيم وانت الطالب فعمل care plan الى
+
+256
+00:16:19,630 --> 00:16:23,110
+لما تاخد علامات كاملة ستة health assessment helps
+
+257
+00:16:23,110 --> 00:16:26,850
+planners to diagnose a clients problem اكيد بساعدك
+
+258
+00:16:26,850 --> 00:16:30,750
+عشان تقدر تجخص ايش مشكلات اللي هو المريض and
+
+259
+00:16:30,750 --> 00:16:35,110
+intervention مينفعش ييجي الممرضيقول انا حاسس عنده
+
+260
+00:16:35,110 --> 00:16:37,950
+واحد اتنين تلتفتش كلمة انا حاسس او بتوقع عنده كده
+
+261
+00:16:37,950 --> 00:16:41,530
+كده بتوقعش تعال كل ما تاخد معلومات اكتر كل ما يصير
+
+262
+00:16:41,530 --> 00:16:46,490
+عندك ايش كمية اقوى تقدر ايش انت تصيغ بيها مشكلات
+
+263
+00:16:46,490 --> 00:16:50,910
+على المريض سبعة complete health assessment ال
+
+264
+00:16:50,910 --> 00:16:52,670
+complete health assessment ايش بيقول ي involve
+
+265
+00:16:52,670 --> 00:16:57,970
+more detailed review of a clients conditions كل ما
+
+266
+00:16:57,970 --> 00:17:02,780
+بناخد معلومات صحية اكترو health assessment اقوى و
+
+267
+00:17:02,780 --> 00:17:07,100
+اكتر ايش بقولي هنا بقولي كلمة detail يعني انا مش
+
+268
+00:17:07,100 --> 00:17:11,740
+هكون كإني بسأل واحد زاد واحد سوى اتنين ولا بدي
+
+269
+00:17:11,740 --> 00:17:14,620
+احاول كل شي yes or no question .. no لكن قدامي
+
+270
+00:17:14,620 --> 00:17:18,900
+شوية هنصرحلكم انه في عظم open question في عظم
+
+271
+00:17:18,900 --> 00:17:22,340
+closed question وفي عظم list question فانا كل ما
+
+272
+00:17:22,340 --> 00:17:25,860
+باخد معلومات واسعة اكتركل ما بقدر ايه انا كل ما
+
+273
+00:17:25,860 --> 00:17:28,680
+باخد معلومات كل ما بقدر احدد ايش ال condition
+
+274
+00:17:28,680 --> 00:17:33,260
+بتاعة المريض ماعنديش معلومات مابينفعش مابيجيش
+
+275
+00:17:33,260 --> 00:17:36,920
+الواحد يعني يستعجل حتى الطبيب مابينفعش ييجي يشخص
+
+276
+00:17:36,920 --> 00:17:40,740
+من اول كلمة او من شكوة بسيطة واحدة وانما لازم يجلس
+
+277
+00:17:40,740 --> 00:17:44,860
+مع المريض ويفهم كل شكوه تمانية health assessment
+
+278
+00:17:44,860 --> 00:17:48,340
+influenced the choice of therapists اكيد بقولي لما
+
+279
+00:17:48,340 --> 00:17:52,180
+نعمل تقييم صحي بساعدني باختيار العلاجعندى clinical
+
+280
+00:17:52,180 --> 00:17:55,240
+response واختي كمان ايش انا استجابة المرضى اعطيكوا
+
+281
+00:17:55,240 --> 00:17:59,640
+مثال وانا بعمل assessment لجيت انه لازم يعني انا
+
+282
+00:17:59,640 --> 00:18:03,920
+لجينا عند المرض مثلا قلم شريط فى دهره مثلا بغض
+
+283
+00:18:03,920 --> 00:18:06,900
+النظر falling down عنده desk بغض النظر لما نعمله
+
+284
+00:18:06,900 --> 00:18:10,660
+assessment ايش بقولى قال انه لازم تاخد مساكله اجى
+
+285
+00:18:10,660 --> 00:18:14,220
+حكاله بدى اعطيك ممكن هتاخده فى pharmacology فى
+
+286
+00:18:14,220 --> 00:18:18,560
+أدوية من ضمن الأدوية فى مجموعة اسمها non-steroidal
+
+287
+00:18:18,560 --> 00:18:22,350
+anti-inflammatory drugs مجموعةالمجموعة زي مجموعة
+
+288
+00:18:22,350 --> 00:18:25,710
+.. زي مجموعة ال Antibiotic، هذه المجموعة بتشتغل
+
+289
+00:18:25,710 --> 00:18:30,050
+يعني على اللي هو ألم الأعصاب أو ألم العضلات اللي
+
+290
+00:18:30,050 --> 00:18:32,030
+موجودة عنها وفي نفس الوقت، يعني هي مضادة
+
+291
+00:18:32,030 --> 00:18:35,590
+للاتهابات، لكن فيها مشكلة زي الدواء اسمه Diclofene
+
+292
+00:18:35,590 --> 00:18:39,550
+منها، ال Diclofene هذا لو أخده الإنسان مباشرة على
+
+293
+00:18:39,550 --> 00:18:42,770
+المعدة، ممكن تحرجوا معدته، الآن بنقوله لو سمحت،
+
+294
+00:18:42,770 --> 00:18:46,670
+احنا قاعدين نعملها استثمار، خد هذا الدواء مثلا تلت
+
+295
+00:18:46,670 --> 00:18:49,570
+مرات في اليومبروح بس بقوله در بالك يا ريت تاخده
+
+296
+00:18:49,570 --> 00:18:52,530
+على معدة مليانة عشان ايه مايأثرش على المعدة، بروحش
+
+297
+00:18:52,530 --> 00:18:56,210
+بقول ليه؟ بقول لأ انا لأ والله انا در بالك انا
+
+298
+00:18:56,210 --> 00:18:58,910
+عندي مشكلة في المعدة، ايش هي؟ انه انا عندي ألم
+
+299
+00:18:58,910 --> 00:19:02,030
+كتير بصير و برات كذا، بصير عندك تقرح في المعدة،
+
+300
+00:19:02,030 --> 00:19:05,550
+الان مجرد ما حكالي زي هي غيرت كل ال therapy، غيرت
+
+301
+00:19:05,550 --> 00:19:09,190
+كل العلاج، او بديت اعطي اما اعطي يعني دوة يكون
+
+302
+00:19:09,190 --> 00:19:12,770
+للمعدة زيادة مع العلاج او بغير الدوة كلها من أصله،
+
+303
+00:19:12,770 --> 00:19:16,480
+مين اللي خلاني؟هذا أغيره هو لما عملت assessment
+
+304
+00:19:16,480 --> 00:19:20,820
+قدر يجعلنا نغير العلاج اللى يكون مفيد للمريض طيب
+
+305
+00:19:20,820 --> 00:19:23,760
+purposes of health assessment شو أغراض ال health
+
+306
+00:19:23,760 --> 00:19:26,820
+assessment أول حاجة gathering data جمع المعلومات
+
+307
+00:19:26,820 --> 00:19:33,080
+جمعها اتنين confirm or refuse ايش دخل confirm اثبت
+
+308
+00:19:33,080 --> 00:19:36,640
+طب refuse ليش قلت refuse هنا refuse معناته هنا
+
+309
+00:19:36,640 --> 00:19:40,090
+ارفضبقولي انت يا بتأكد المعلومات يا بترفض
+
+310
+00:19:40,090 --> 00:19:43,170
+المعلومات مش احنا قلنا ان في direct و في indirect
+
+311
+00:19:43,170 --> 00:19:46,110
+اخدنا المعلومات يمكن انا اخدت معلومات من ال health
+
+312
+00:19:46,110 --> 00:19:49,530
+history مش كلها تكون صحيحة يمكن المريض ضللني شوية
+
+313
+00:19:49,530 --> 00:19:53,250
+يمكن ماعطانيش المعلومات عشان ما خايف على نفسه من
+
+314
+00:19:53,250 --> 00:19:56,830
+بعض الأشياء بدونش حدا يشكله في شغل او يقوله بنعملك
+
+315
+00:19:56,830 --> 00:20:01,610
+عملية فو أنا بعمل assessment بشكل كامل يا اما بأكد
+
+316
+00:20:01,610 --> 00:20:04,410
+المعلومات اللي عندي يا اما برفض المعلومات اللي
+
+317
+00:20:04,410 --> 00:20:08,800
+عندي و بحاول اغيرهاتلاتة confirm and identify
+
+318
+00:20:08,800 --> 00:20:12,400
+nursing diagnosis انا حطيت عندى nursing diagnosis
+
+319
+00:20:12,400 --> 00:20:15,540
+عشان اكد ان ال nursing diagnosis صحيحة بعمل
+
+320
+00:20:15,540 --> 00:20:18,180
+assessment احنا خدنا سنة اولى لما كانوا يقولوا لنا
+
+321
+00:20:18,180 --> 00:20:23,000
+قبل ما نعمل ال nursing problems قبل ما بدنا نصيغها
+
+322
+00:20:23,000 --> 00:20:27,160
+بقول اعمل assessment كويسة عشان نقدر نعرف ان هل ال
+
+323
+00:20:27,160 --> 00:20:30,720
+nursing diagnosis بينفع ولا مابينفعش اذا بينفع
+
+324
+00:20:30,720 --> 00:20:35,700
+بكمل مابينفعش بنقل ال assessment بغير طيب اربعة
+
+325
+00:20:36,750 --> 00:20:42,310
+make clinical judgments حكم كليكي هذا كليك وهذا
+
+326
+00:20:42,310 --> 00:20:46,450
+judgment حكم about the clients changing health لما
+
+327
+00:20:46,450 --> 00:20:50,230
+الإنسان يكون في عنده بتابع المريض يلاقي فيه
+
+328
+00:20:50,230 --> 00:20:53,610
+تغييرات في صحته هو اللي بيكون فيصل أمام الطبيب
+
+329
+00:20:53,610 --> 00:20:59,410
+بالمناسبة كتير من الممرضين والحكماء الشطرين وانا
+
+330
+00:20:59,410 --> 00:21:03,340
+تابعت نفسي هذا الكلامهو اللي خلى الطبيب يغير
+
+331
+00:21:03,340 --> 00:21:06,720
+علاجات معينة او هو اللي خلى يغير مسار حتى الرعاية
+
+332
+00:21:06,720 --> 00:21:10,120
+للمريض فدائما احنا بنساعد في ال clinical judgment
+
+333
+00:21:10,120 --> 00:21:14,580
+كيف بنساعد؟ بنعطيك مثال دائما بحب اضرب امثلة عشان
+
+334
+00:21:14,580 --> 00:21:18,840
+نستفيد اكتر كيف يعني بيجي الان واحد بيقوله اليوم
+
+335
+00:21:18,840 --> 00:21:23,040
+انت خرج من الطبيب وانا شافك كويس بيقول المريض بروح
+
+336
+00:21:23,040 --> 00:21:26,960
+بقول الممرض لأ انا كنت سهران الليلة للأسف صار عنده
+
+337
+00:21:26,960 --> 00:21:30,720
+vomiting الساعة 12 في الليل وداخل حمام شوية واحنا
+
+338
+00:21:31,190 --> 00:21:35,250
+عطينا يعني حب الدواء و اجى الطبيب فى الليل و قال
+
+339
+00:21:35,250 --> 00:21:38,310
+اذا وانا تعبان اعطيه محلول الآن الكلام اللى حكاه
+
+340
+00:21:38,310 --> 00:21:43,890
+هذا الحكيم صح اتنكد المريض لكن هذا غير مصار كل هى
+
+341
+00:21:43,890 --> 00:21:46,590
+الرعاية اجى الطبيب بيقولوا لأ بنقدرش بناء على
+
+342
+00:21:46,590 --> 00:21:49,530
+التغييرات اللى صارت ايش اسمها clinical judgment
+
+343
+00:21:49,530 --> 00:21:54,010
+بيقولوا بناء على التغييرات ماعليش سامحنا بنخليك
+
+344
+00:21:54,010 --> 00:21:59,350
+يبقى احنا بنشارك بالتغييرات اللى بتصير فى الرعاية
+
+345
+00:21:59,350 --> 00:22:02,980
+للمريضبناء على متابعتنا الدائمة وانت لا تنسى ان
+
+346
+00:22:02,980 --> 00:22:08,640
+الممرض يتابع المريض 24 ساعة الطبيب ليس قليل من
+
+347
+00:22:08,640 --> 00:22:13,360
+قيمته وانما هو يعني الله يعينه بيجي يتابع الحالات
+
+348
+00:22:13,360 --> 00:22:17,080
+بشكل كامل بحالات كتيرة جدا برة وجوبة وعيادات وغيره
+
+349
+00:22:17,080 --> 00:22:21,180
+لكن احنا ملزمين نكون في المستشفى مع المرضى ونتابع
+
+350
+00:22:21,180 --> 00:22:25,380
+كل التغييرات اللي بتسير خمسة to evaluate بنقيم bio
+
+351
+00:22:25,380 --> 00:22:27,820
+psychosocial اللي احنا حاكيناها and spiritual
+
+352
+00:22:27,820 --> 00:22:31,830
+outcomes of careطبعا اللى هو اى تطورات بتسير بدنا
+
+353
+00:22:31,830 --> 00:22:35,730
+نتبعها من كل الجوانب اللى هو الحيوية و النفسية و
+
+354
+00:22:35,730 --> 00:22:39,410
+الاجتماعية و الروحانية طيب nursing and medical
+
+355
+00:22:39,410 --> 00:22:44,650
+diagnosis كتير من الناس للأسف بكون في عنده مشكلة
+
+356
+00:22:44,650 --> 00:22:48,790
+ايش المشكلة دى انه بفكر الاتنين نفس التشخيص لأ انا
+
+357
+00:22:48,790 --> 00:22:53,510
+كمان مرة بدي اقول فرق كبير جدا هو المكتب ليه انا
+
+358
+00:22:53,510 --> 00:22:55,730
+big difference هي كنت بيشوف كان من الخط المعين
+
+359
+00:22:56,140 --> 00:22:59,120
+للأسف بنقول big difference لإن في ناس بيخلطوا بين
+
+360
+00:22:59,120 --> 00:23:03,460
+الاتنين ال nursing diagnosis independent role of
+
+361
+00:23:03,460 --> 00:23:06,300
+the nurse لما نقول كلمة independent يا ريتو ضايقوا
+
+362
+00:23:06,300 --> 00:23:09,640
+الذاكرين هذه الكلمة independent مستقل dependent
+
+363
+00:23:09,640 --> 00:23:13,580
+يعني معتمد لما نأتي أقول الطفل dependent on his
+
+364
+00:23:13,580 --> 00:23:17,000
+mother يعني تمد على أمه انت الآن وانت الآن ما شاء
+
+365
+00:23:17,000 --> 00:23:20,160
+الله كبرت في معيتي بنقول you are independent انت
+
+366
+00:23:20,160 --> 00:23:24,220
+الآن ما شاء الله عليك يعني بتقدر تكون معتمد على
+
+367
+00:23:24,220 --> 00:23:28,250
+نفسك وانت الآنال nursing diagnosis لازم يكون ايش؟
+
+368
+00:23:28,250 --> 00:23:30,890
+independent طب يعتمد على ايش؟ depends on the
+
+369
+00:23:30,890 --> 00:23:34,090
+clients problems شو ال clients problems associated
+
+370
+00:23:34,090 --> 00:23:39,470
+with a specific disorder؟ انا كحكيم لما بده أصيغ
+
+371
+00:23:39,470 --> 00:23:43,150
+.. لما بده أصيغ مش .. بده اعمل diagnosis، بده أصيغ
+
+372
+00:23:43,150 --> 00:23:47,170
+يعني هذا التشخيص، بصيغه بناء على ايه؟بناء على
+
+373
+00:23:47,170 --> 00:23:51,410
+استجابة المريض، لا هو من راسي ولا له علاقة
+
+374
+00:23:51,410 --> 00:23:55,930
+بالتحاليل الطبية ولا له علاقة بواحد بيجي بأمرني
+
+375
+00:23:55,930 --> 00:23:59,190
+يقول كذا، يمكن الطبيب مختلف، الان احنا هنعرف كيف
+
+376
+00:23:59,190 --> 00:24:04,510
+مختلف، نيجي هنا شوية الان any problems must notice
+
+377
+00:24:04,510 --> 00:24:07,290
+from a holistic ما احنا قلنا، ايش holistic؟
+
+378
+00:24:07,290 --> 00:24:11,740
+biopsychosocial and spiritual relationsبقول لي أنت
+
+379
+00:24:11,740 --> 00:24:16,920
+يا حكيم لازم تشوف أي مشكلة موجودة عند المريض و
+
+380
+00:24:16,920 --> 00:24:20,220
+تتطلع من أربع جوانب عشان تقدر تعمل diagnostic
+
+381
+00:24:20,220 --> 00:24:24,380
+diagnosis يبقى أنت كحكيم بدك تتابع بيوسيقى ال
+
+382
+00:24:24,380 --> 00:24:28,840
+social and spiritual لكن الطبيب لحظة بقول لي لأ
+
+383
+00:24:28,840 --> 00:24:32,740
+أنا depends on the clinical picture and laboratory
+
+384
+00:24:32,740 --> 00:24:36,980
+findingsالطبيب ما احترمنا و تقدرنايله لما بده يجي
+
+385
+00:24:36,980 --> 00:24:39,920
+يصيغ ال diagnosis كيف يصيغه يعني ممكن ييجي يقوله
+
+386
+00:24:39,920 --> 00:24:46,580
+تعالي falling down يعني واحد واحد هو مثلا كاتب انه
+
+387
+00:24:46,580 --> 00:24:50,480
+عنده vomiting و قال خلاص falling down التشريس لما
+
+388
+00:24:50,480 --> 00:24:55,260
+دخله على القسم راح عمله CT عشان يشوف الراس فيه اشي
+
+389
+00:24:55,260 --> 00:25:00,360
+لما عملنا له CT اتفاجأناه و سُعق الطبيب لقى انه في
+
+390
+00:25:00,360 --> 00:25:04,740
+عنده brain tumorصح واجع لكن لما صورنا ال CT كشفت
+
+391
+00:25:04,740 --> 00:25:07,680
+شيء تاني، إيش ال medical diagnosis صار بناء على
+
+392
+00:25:07,680 --> 00:25:09,920
+التحليل الطبي اللي صار وبناء على التحليل
+
+393
+00:25:09,920 --> 00:25:14,460
+الكلينيكي، اتغير جدريا 100% أصبح من falling down ل
+
+394
+00:25:14,460 --> 00:25:18,500
+brain tumor، الآن احنا مابنقدرش نغير الاستجابة
+
+395
+00:25:18,500 --> 00:25:21,640
+اللي موجودة vomiting دلت زي ما هي، والاستجابة اللي
+
+396
+00:25:21,640 --> 00:25:24,580
+صار عنده drowsiness زي ما هي كتمريضعشان هيك ال
+
+397
+00:25:24,580 --> 00:25:28,600
+medical بيعتمد على التحليل، التحليل بيوديه شمال أو
+
+398
+00:25:28,600 --> 00:25:31,820
+بيوديه يمين، لكن احنا بنتكلم على استجابة ..
+
+399
+00:25:31,820 --> 00:25:38,420
+استجابة المريض ل ال medical diagnosis طيب،
+
+400
+00:25:38,420 --> 00:25:43,860
+the specific specialist doctor has a right to
+
+401
+00:25:43,860 --> 00:25:48,210
+diagnose not else، ركزوا الكلمات مهمةبقول لي ان
+
+402
+00:25:48,210 --> 00:25:52,390
+الطبيب الأخصائي هو فقط اللي ايه اللي بشخص يبقى
+
+403
+00:25:52,390 --> 00:25:55,970
+لابد ان انا اقول medical diagnosis for whom مين هو
+
+404
+00:25:55,970 --> 00:25:59,910
+اللي بتشخص الطبيب الأخصائي يعني ده واحد بده يخصص
+
+405
+00:25:59,910 --> 00:26:05,070
+مريض قلب بده يكون طبيب قلب زي cardiologist واحد
+
+406
+00:26:05,070 --> 00:26:08,930
+بده يخصصها واحد بده يخصص ان فلان عنده سكر ولا
+
+407
+00:26:08,930 --> 00:26:13,610
+ماعندهوش بده نجيب طبيب endocrinologist يعني مخصائي
+
+408
+00:26:13,610 --> 00:26:18,190
+اللي هو ايش هنا غدط صماءأما التمريد بيختلف يعني
+
+409
+00:26:18,190 --> 00:26:21,730
+بيجيش طبيب عام يشخص ممنوع الطبيب العام بيعمل
+
+410
+00:26:21,730 --> 00:26:25,950
+assessment فقط الآن اعطاني مثال example جالي ال
+
+411
+00:26:25,950 --> 00:26:28,650
+diabetes طبعا كلك عارفين ايش معنى ال DM اخدناها في
+
+412
+00:26:28,650 --> 00:26:32,010
+ترمينولوجيا ال diabetes mellitus يعني السكر اجهزش
+
+413
+00:26:32,010 --> 00:26:33,810
+بيقولي ال medical diagnosis ده medical diagnosis
+
+414
+00:26:33,810 --> 00:26:38,270
+الآن ال diabetes mellitus ماهي واحدة من تنتين يا
+
+415
+00:26:38,270 --> 00:26:42,750
+hypoglycemia يا hyperglycemia يا اما سكر واطي يا
+
+416
+00:26:42,750 --> 00:26:46,170
+اما سكر وعليطب ال nursing diagnosis اللي له علاقة
+
+417
+00:26:46,170 --> 00:26:49,730
+بالديابتز انا بقدرش اقول ديابتز مليتز، علمونا في
+
+418
+00:26:49,730 --> 00:26:52,570
+السنة الأولى، ممنوع اقول كلمة ديابتز، مانفعش اكتب
+
+419
+00:26:52,570 --> 00:26:57,730
+المشكلة اللي حكاها التشخيصية، اكتبها نفس الشيء،
+
+420
+00:26:57,730 --> 00:27:00,810
+انا إيش بقول؟ بكتب أشياء اللي لها علاقة بالديابتز،
+
+421
+00:27:00,810 --> 00:27:04,550
+إيش بقول؟ impaired skin integrity، اه اه انا بدأ
+
+422
+00:27:04,550 --> 00:27:09,320
+أدوك على skin integrity، سلامة الجلداللي تهتكت
+
+423
+00:27:09,320 --> 00:27:13,240
+وقربت زي حكاية ال .. مثلا اللي هو diabetic food
+
+424
+00:27:13,240 --> 00:27:17,900
+اللي صارت، إلي علاقة بالإيش؟ بال poor مثلا sugar
+
+425
+00:27:17,900 --> 00:27:20,580
+أو ال poor nutrition، اللي إلي علاقة بالdiabetes،
+
+426
+00:27:20,580 --> 00:27:23,840
+طب مش بس أيه؟ أو بال poor circulation، الدم لمش
+
+427
+00:27:23,840 --> 00:27:26,100
+واصل، طب في حاجة مشكلة تانية، بقول knowledge
+
+428
+00:27:26,100 --> 00:27:31,280
+deficit related to مثلا disease مثلا the changes،
+
+429
+00:27:31,280 --> 00:27:35,810
+أنا قصدي هناانه احنا لاحظين الان ال DM كلمة واحدة
+
+430
+00:27:35,810 --> 00:27:38,830
+او كلمتين لكن لاحظين احنا بنصيغ نرسم ال diagnosis
+
+431
+00:27:38,830 --> 00:27:43,690
+هنصيغ تلاتة واربعة بناء على نفس اللي هو التشخيص زي
+
+432
+00:27:43,690 --> 00:27:47,030
+ما اقول بكرا hypertension تشخيص انا اروح اتكلم على
+
+433
+00:27:47,030 --> 00:27:49,770
+ال problems اللي له علاقة مثلا بال retrimors بردج
+
+434
+00:27:49,770 --> 00:27:52,770
+اللي له علاقة بال sensation بالاحساس اللي له علاقة
+
+435
+00:27:52,770 --> 00:27:56,170
+بال headache و هكذا يبقى معناته تتعدد ال nursing
+
+436
+00:27:56,170 --> 00:28:02,040
+diagnosis ل medical diagnosis واحدأنا بقول اللي
+
+437
+00:28:02,040 --> 00:28:05,300
+خاطر عشان احنا مضلنا مدناش ناخد وقت كتير في
+
+438
+00:28:05,300 --> 00:28:08,040
+المحاضرات خلينا نكتفل هنا هي 28 دقيقة ان شاء الله
+
+439
+00:28:08,040 --> 00:28:11,300
+في المحاضرة القادمة بنكمل ال health history بإذن
+
+440
+00:28:11,300 --> 00:28:13,660
+الله والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1ec58f752330a9f19bf413925cc31c60816c8f12
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_postprocess.srt
@@ -0,0 +1,1788 @@
+1
+00:00:01,420 --> 00:00:03,900
+أعوذ بالله من الشتارجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,900 --> 00:00:07,540
+طبعا توقفنا في المحاضرة السابقة عن ال health
+
+3
+00:00:07,540 --> 00:00:11,060
+history و الأن ان شاء الله بدنا نكمل احنا وياكم
+
+4
+00:00:11,060 --> 00:00:14,700
+طبعا health history زى ما انتوا شايفين تحتوي على
+
+5
+00:00:14,700 --> 00:00:19,100
+خمس بند البند الأول interview المقابلة و أنا
+
+6
+00:00:19,100 --> 00:00:22,840
+هتتكلم في موضوع ال interview طبعا اللى صحيح أنا
+
+7
+00:00:22,840 --> 00:00:26,220
+بتتكلم هنا على ال clinical interview لكنى ممكن
+
+8
+00:00:26,220 --> 00:00:30,290
+تكون هي تفيدنا كمان في حياتنافعليات المقابلة و
+
+9
+00:00:30,290 --> 00:00:33,650
+أنواع المقابلة و كيف الأسئلة المقابلة عشان احنا لو
+
+10
+00:00:33,650 --> 00:00:36,850
+في اي فترة اتعرضنا لهذا المقابلة ان شاء الله نكون
+
+11
+00:00:36,850 --> 00:00:40,870
+احنا جادها اتنين psycho social assessment بناخد
+
+12
+00:00:40,870 --> 00:00:44,390
+طبعا history كامل مش بس القصة ال .. الناحية
+
+13
+00:00:44,390 --> 00:00:47,390
+المرضية او الناحية الصحية بنسأله برضه من الناحية
+
+14
+00:00:47,390 --> 00:00:50,690
+النفسية من الناحية الاجتماعية من الناحية التالتة
+
+15
+00:00:50,690 --> 00:00:52,310
+اللي هو ال nutritional assessment زي ما انتوا
+
+16
+00:00:52,310 --> 00:00:55,190
+عارفين شوف التغيرات اللي صارت في ال diet او كيف
+
+17
+00:00:55,190 --> 00:00:57,570
+وضع او لسه weight او high of weight و هكذا
+
+18
+00:00:58,340 --> 00:01:01,040
+assessment of sleep weakfulness patterns كمان
+
+19
+00:01:01,040 --> 00:01:05,320
+طبيعة النوم هل كيف كان وضعه الصحي قبل ما ييجي او
+
+20
+00:01:05,320 --> 00:01:09,560
+في القديم او هل كان عنده مشاكل يعني صحية مرتبطة
+
+21
+00:01:09,560 --> 00:01:12,460
+بالنوم و هكذا اخر حاجة بنتكلم على ال health
+
+22
+00:01:12,460 --> 00:01:15,420
+history ك health history يعني كيف بنبدأ ناخدها
+
+23
+00:01:15,420 --> 00:01:20,200
+يعني كبنود نيجي نتكلم هنا اول حاجة ال interview ال
+
+24
+00:01:20,200 --> 00:01:24,040
+interview هنا definition زي ما تشوفين عبارة عن
+
+25
+00:01:24,040 --> 00:01:26,800
+communication process focus on ايه communication
+
+26
+00:01:26,800 --> 00:01:31,960
+processيبقى هي معناته هي التواصل هي طريقة التواصل
+
+27
+00:01:31,960 --> 00:01:35,480
+وقالية التواصل بين ال clients development معلش
+
+28
+00:01:35,480 --> 00:01:38,820
+بضله بس شوية بين ال clients development
+
+29
+00:01:38,820 --> 00:01:45,300
+psychological physiological socio cultural and
+
+30
+00:01:45,300 --> 00:01:49,420
+spiritual لو لاحظنا الكلمات واضحة يعني قصة ال
+
+31
+00:01:49,420 --> 00:01:53,300
+interview مش بس كيف حالك او ايش أخبارك لأ في أسئلة
+
+32
+00:01:53,300 --> 00:01:56,920
+بتتكلم عن development تطور المريض كيف حياته كيف
+
+33
+00:01:56,920 --> 00:01:59,320
+كانت ماشيةو من ناحية النفسية و من ناحية
+
+34
+00:01:59,320 --> 00:02:02,660
+الفيسيولوجية و من ناحية الاجتماعية و الثقافة و
+
+35
+00:02:02,660 --> 00:02:07,040
+الثقافية و حتى من ناحية الروحانية هذا تقريبا يمكن
+
+36
+00:02:07,040 --> 00:02:10,280
+من أفضل التعريفات لل interview لأنه شامل اكتر من
+
+37
+00:02:10,280 --> 00:02:14,460
+البرود و ان كان مختصر بالكلمات طب ال major purpose
+
+38
+00:02:14,460 --> 00:02:18,980
+ليش انا بعمل interview بعمل interview to obtain
+
+39
+00:02:18,980 --> 00:02:22,630
+health history عشان اخدالتاريخ الصحي و التاريخ
+
+40
+00:02:22,630 --> 00:02:27,790
+المرضي و اي شي معلومات موجودة عند المرض طب ليه and
+
+41
+00:02:27,790 --> 00:02:31,450
+to identify development of the symptoms لأنه انا
+
+42
+00:02:31,450 --> 00:02:34,990
+لما اخد المعلومات الكاملة بعرف ان الأعراض هل تطورت
+
+43
+00:02:34,990 --> 00:02:38,010
+و لا ماتطورتش يبقى ال major paradox تبعي ان اخد ال
+
+44
+00:02:38,010 --> 00:02:40,310
+testosterone من هذا المرض اللي أمامي و في نفس
+
+45
+00:02:40,310 --> 00:02:44,030
+الوقت اعرف انه هل الأعراض اللي موجودة عنده زادت و
+
+46
+00:02:44,030 --> 00:02:48,030
+لا جلت و لا في إمكانية للتدخل و لا لأ طيب
+
+47
+00:02:48,030 --> 00:02:52,600
+components of nursing interviewال nursing
+
+48
+00:02:52,600 --> 00:02:55,480
+interview فيها تلاتة components خلينا نذاكرينها
+
+49
+00:02:55,480 --> 00:02:59,500
+عشان ما ننساش هذا شيء مهم introductory, working,
+
+50
+00:03:00,460 --> 00:03:04,020
+termination يبقى ملاته ال interview في أي مجال في
+
+51
+00:03:04,020 --> 00:03:07,600
+العالم بس احنا بنخصصها نقول nursing عشان بنتكلم عن
+
+52
+00:03:07,600 --> 00:03:11,360
+عبارات تخص ال nursing يبقى أول حاجة introductory
+
+53
+00:03:11,360 --> 00:03:18,760
+تقديم working عمل termination انهاء طبعا كل واحدة
+
+54
+00:03:18,760 --> 00:03:23,270
+اللي هي بنودها وليها خصائصها نيجي نتكلمأول حاجة
+
+55
+00:03:23,270 --> 00:03:28,310
+introductory phase طبعا اتعلمنا في ال fundamental
+
+56
+00:03:28,310 --> 00:03:31,390
+و كمان مرة بنهيد انه دايما you must introduce
+
+57
+00:03:31,390 --> 00:03:34,450
+yourself and explains the purpose of the interview
+
+58
+00:03:34,450 --> 00:03:37,970
+to the client مش معقول انا اجي للمريض السلام عليكم
+
+59
+00:03:37,970 --> 00:03:40,950
+لو سمحت بده اخدك ال vital signs او لو سمحت يا حاجة
+
+60
+00:03:40,950 --> 00:03:44,510
+معلش بده اخدك الحرارة و كده بده يقولك يا ابن انت
+
+61
+00:03:44,510 --> 00:03:48,210
+مين انت طبعا او مين انت يا ابني فاحنا أول حاجة
+
+62
+00:03:48,210 --> 00:03:52,530
+لازم ايش يكون عندنا اقدم نفسي مخجلش انا فلان فلاني
+
+63
+00:03:53,080 --> 00:03:55,800
+أنا طالب سنة تانية من كلية التمرض في الجامعة
+
+64
+00:03:55,800 --> 00:04:00,180
+الإسلامية و احنا بنتدرب مايقوللي حد انه والله طب
+
+65
+00:04:00,180 --> 00:04:02,900
+ايش يقولوا يصير يقولوا بعض المرضى اه انتوا جيه
+
+66
+00:04:02,900 --> 00:04:05,940
+انتوا اتعلموا فينا او زي .. لا لا لا الحمد لله
+
+67
+00:04:05,940 --> 00:04:09,560
+اللي سابقوكوا من الطلاب بيعملوا قرص طيب و بيعملوا
+
+68
+00:04:09,560 --> 00:04:13,040
+سيرة طيبة بالعكس هم بينتظروكوا لما انتوا تروحوا
+
+69
+00:04:13,040 --> 00:04:15,580
+تشتغلوا معاهم بينتظروكوا و تزاروا و هم يحبوا طلبة
+
+70
+00:04:15,580 --> 00:04:18,360
+الجامعة الإسلامية مش من بدا بتحفظهم يحبوا الطلاب
+
+71
+00:04:18,360 --> 00:04:23,170
+بشكل عام لأنه انتوا ناس مؤدبين و الا هنثجل دمنا
+
+72
+00:04:23,170 --> 00:04:26,810
+ولا هن .. احنا رايحين بدنا يعني نخدم هذا المريض،
+
+73
+00:04:26,810 --> 00:04:30,390
+نحاول يعني مساعدته في هذا العلاج، لذلك ما نخجل من
+
+74
+00:04:30,390 --> 00:04:33,670
+تعريف أنفسنا و احنا كل واحد حتى مطلوب مننا نحط ال
+
+75
+00:04:33,670 --> 00:04:36,590
+tag name بس ان شاء الله الظروف ترجع لطبيعتها و
+
+76
+00:04:36,590 --> 00:04:39,430
+نرجع نحط ال tag name و نكون احنا رافعين رأسنا و
+
+77
+00:04:39,430 --> 00:04:43,490
+احنا عاملنا بالتعامل مع المرضى في داخل المستشفيات
+
+78
+00:04:43,490 --> 00:04:46,690
+before asking questions البندق التاني before
+
+79
+00:04:46,690 --> 00:04:50,290
+asking questions بقولي هنقلتك لا انتوا في ليهاش
+
+80
+00:04:50,290 --> 00:04:56,030
+comfortخل المريض يشعر براحة privacy و بعدين
+
+81
+00:04:56,030 --> 00:04:59,470
+confidentiality شو يعني؟ يعني هو جاء و بيقول لي
+
+82
+00:04:59,470 --> 00:05:05,790
+معلش و انت عمالك بنتك تسأل لسه بدك تسأل المريض خل
+
+83
+00:05:05,790 --> 00:05:10,270
+المريض يرتاح لك خليه يشعر ان انت هتكتم أسراره خليه
+
+84
+00:05:10,270 --> 00:05:13,810
+يشعر انه في ثقة لما يشعر المريض انه في ثقة و انك
+
+85
+00:05:13,810 --> 00:05:17,810
+هتكتم أسراره هيعطيك المعلومات لو شعر انه في مشكلة
+
+86
+00:05:17,810 --> 00:05:21,290
+انه من كلماته اللي هيحكيهاو احنا يعني هاللي هيطلع
+
+87
+00:05:21,290 --> 00:05:26,770
+أسراره برا مش هيقدر يعطينا طيب working phase مرحلة
+
+88
+00:05:26,770 --> 00:05:29,930
+ال working phase اللي the nurse ايه هنا must
+
+89
+00:05:29,930 --> 00:05:35,470
+listen and observe cues cues معناة التلميحات شو
+
+90
+00:05:35,470 --> 00:05:38,750
+يعني يعني in addition to using critical thinking
+
+91
+00:05:38,750 --> 00:05:42,710
+يعني يستخدم التفكير العميق التفكير اللي هو احنا
+
+92
+00:05:42,710 --> 00:05:47,670
+بنقول عالم العصف الديني تتخلى عندك يعني أفق واسع
+
+93
+00:05:47,670 --> 00:05:51,520
+في التفكيرand to validate يعني بقولك validate عشان
+
+94
+00:05:51,520 --> 00:05:54,160
+تتحقق من ال information received from the client
+
+95
+00:05:54,160 --> 00:05:57,800
+شو صار معنى هذا الكلام؟ معنى هذه الفقرة كلها اللي
+
+96
+00:05:57,800 --> 00:06:00,820
+قدامكوا بتقول ماعنش هو ال mouse ما بعرف أشي
+
+97
+00:06:00,820 --> 00:06:06,280
+المشكلة بقوللي هنا أن أثناء ال working phase دائما
+
+98
+00:06:06,280 --> 00:06:12,360
+الممرض أو الطالب لازم يسمع و في نفس الوقت يلاحظ
+
+99
+00:06:12,360 --> 00:06:15,660
+التلميحات اللي موجودة على جسد المريض و يستخدم
+
+100
+00:06:15,660 --> 00:06:18,400
+الفكر المنطقي عنده عشان يحكم على المعلومات كيف
+
+101
+00:06:18,400 --> 00:06:22,810
+يعني؟افرط المريض يقعد بتكلم بيقول لأ انا ما .. انت
+
+102
+00:06:22,810 --> 00:06:26,470
+بتقوله طب هل في عندك وجع؟ هو خايف يحكي انه عنده
+
+103
+00:06:26,470 --> 00:06:30,730
+وجع عشان مايروحش على العمليات فهو بتقوله في عندك
+
+104
+00:06:30,730 --> 00:06:34,330
+ألم؟ يقول لأ انا ماعنديش ألم لكن قصامات وجهه وجسمه
+
+105
+00:06:34,330 --> 00:06:38,090
+إيديه وحركته كلها بتدل انه في ألم طيب أصدق هنا
+
+106
+00:06:38,090 --> 00:06:41,270
+مين؟ أصدق الكلام اللي سمعته؟ ولا أصدق ال body
+
+107
+00:06:41,270 --> 00:06:44,730
+language؟ لأ ال body language more accurate than
+
+108
+00:06:44,730 --> 00:06:47,970
+verbal languageدائما اذكر هذا الكلمة ال body
+
+109
+00:06:47,970 --> 00:06:52,390
+language more accurate than verbal language انا
+
+110
+00:06:52,390 --> 00:06:56,110
+بصدق التلميحات حتى لما احنا نتكلم مع بعض احنا
+
+111
+00:06:56,110 --> 00:07:00,150
+انتوا كطلاب و زملاء مع بعض او حتى في البيوت يعني
+
+112
+00:07:00,150 --> 00:07:05,530
+ممكن الواحد يتكلم كلمة مع الآخر لكن يروح يعطي يعني
+
+113
+00:07:05,530 --> 00:07:11,750
+حركات او كده تغير المسار تبع الكلام فبخلنا لأ نصدق
+
+114
+00:07:11,750 --> 00:07:15,430
+الحركات وهذا خدناه في ال psychology لما ايام احنا
+
+115
+00:07:15,430 --> 00:07:20,200
+طرحناموضوع الطفل لما الوالد كان يحكيله شيء و يعمله
+
+116
+00:07:20,200 --> 00:07:25,600
+إيماءات بشيء تاني فبنفعش لازم احنا نقرن و نعرف أيش
+
+117
+00:07:25,600 --> 00:07:29,660
+اللي بيصير موجود قدام المريض قدامنا طيب the nurse
+
+118
+00:07:29,660 --> 00:07:33,180
+identify clients problems and goals لازم و احنا
+
+119
+00:07:33,180 --> 00:07:37,360
+بنسمع في البداية نحدد ال clients problems ايش
+
+120
+00:07:37,360 --> 00:07:40,580
+مشكلات المريض اللي موجود عندهوش الأهداف اللي بدي
+
+121
+00:07:40,580 --> 00:07:43,860
+أعملها يعني و أنا قاعد بسمع في ال interview بيجيني
+
+122
+00:07:43,860 --> 00:07:46,460
+دغري في ذهني ان انا اه في مشكلة مهمة زي ما بيجي
+
+123
+00:07:46,460 --> 00:07:49,940
+الطبيب الآن بيجي بقوله ايش أخبارك اتفضل بقعد يحكي
+
+124
+00:07:49,940 --> 00:07:54,500
+فالطبيب الشاطر و الأخصائي هو عماله بيحكي المريض
+
+125
+00:07:54,500 --> 00:07:57,420
+بيبقى على شجة كاتب يعني هو قاعد بقوله مثلا بقوله
+
+126
+00:07:57,420 --> 00:08:00,380
+انا الي اربع أيام بروح على الحمام يبقى
+
+127
+00:08:00,380 --> 00:08:03,800
+constipation بكتب مش عارف مرات انا بدوخ بكتب كلمة
+
+128
+00:08:03,800 --> 00:08:08,540
+مثلا cinco او بكتب مثلا كلمة vertigo او اي شيءعشان
+
+129
+00:08:08,540 --> 00:08:11,920
+يعرف انه ايش عشان بعدين نعود نرجع لها طيب
+
+130
+00:08:11,920 --> 00:08:16,060
+termination phase ال termination phase هنا ايش
+
+131
+00:08:16,060 --> 00:08:21,420
+يعني انا خلصت جيت اول حاجة introductory قدمت نفسي
+
+132
+00:08:21,420 --> 00:08:26,240
+working بدت اشتغل و لسه احنا كمان هنشرحه اكتر في
+
+133
+00:08:26,240 --> 00:08:31,320
+القادم يعني طب termination كيف بدني انا خلصت الان
+
+134
+00:08:31,320 --> 00:08:34,080
+اخدت معلومات كتيرة اول حاجة اللي بيقوللي nurse
+
+135
+00:08:34,080 --> 00:08:36,760
+summarizes information obtained during the working
+
+136
+00:08:36,760 --> 00:08:41,070
+phaseSamarais يعني اختصر، يلخص على الطالب الشاطر
+
+137
+00:08:41,070 --> 00:08:44,670
+انه بعد ما ياخد المعلومات، المريض بيعطيك معلومات
+
+138
+00:08:44,670 --> 00:08:48,090
+كبيرة وكتيرة لازم انت تلخص، مانفعش عشان ايه لما
+
+139
+00:08:48,090 --> 00:08:51,270
+كان يطلب منك الأستاذ مرات في .. في بداية السنة
+
+140
+00:08:51,270 --> 00:08:54,350
+الأولى، كان يقولك ايه بتقدر تعملي تقرير عن مريض
+
+141
+00:08:54,350 --> 00:08:58,630
+معين؟ طبعا كل يوم لما نروح نتدرب، هينطلب منه في
+
+142
+00:08:58,630 --> 00:09:01,730
+سنة تانية نعمل حاجة daily اسمه daily clients
+
+143
+00:09:01,730 --> 00:09:06,480
+report يعني تقرير يومي عن حالة المريضبتبدأ مثلا my
+
+144
+00:09:06,480 --> 00:09:10,420
+patients او my clients name كده و كده مش بزيك
+
+145
+00:09:10,420 --> 00:09:13,560
+admitted since كده diagnosed as كده treatment
+
+146
+00:09:13,560 --> 00:09:17,480
+بتتكلم على انه حاجات كتيرة لان مابتروح على المريض
+
+147
+00:09:17,480 --> 00:09:22,080
+بتلاقي بيحكي كتير الحاجة الكتيرة ده مش شرط ناخده
+
+148
+00:09:22,080 --> 00:09:25,260
+كل كلامه انا اللي بيهمني في الآخر حاجة بيسموها
+
+149
+00:09:25,260 --> 00:09:28,560
+scientific information المعلومات العلمية and its
+
+150
+00:09:28,560 --> 00:09:31,720
+relation و المتعلقات بيها يعني ده لاجينا في حاجة
+
+151
+00:09:31,720 --> 00:09:36,320
+مهمة متعلقةحتى لو كانت مش علمية لو ناجينا معلومة
+
+152
+00:09:36,320 --> 00:09:39,580
+متعلقة بشي علمي بحطها يبقى معناته في ال
+
+153
+00:09:39,580 --> 00:09:43,880
+termination أول حاجة بلخص اللي أنا أخدته من المريض
+
+154
+00:09:43,880 --> 00:09:47,920
+اتنين validate problems and goals with the client
+
+155
+00:09:47,920 --> 00:09:52,600
+validية هنا معناته التحق يعني فيها مصداقية بتأكد
+
+156
+00:09:52,600 --> 00:09:55,540
+مش احنا كنا و احنا بنسمع بنحط مشاكل و بنحط أهداف
+
+157
+00:09:55,540 --> 00:10:00,220
+جينا بنخلصه ابنعرف هل المشاكل كلها بتديها هل
+
+158
+00:10:00,220 --> 00:10:04,300
+الأهداف كلها بتديها ولا بتختصربنقر على قبل ما اقوم
+
+159
+00:10:04,300 --> 00:10:07,700
+من عند المريض عشان انا اتأكد عشان اقعد اصيغن في ال
+
+160
+00:10:07,700 --> 00:10:11,720
+care plan تلاتة making plans يبقى بعدها ايش بروحنا
+
+161
+00:10:11,720 --> 00:10:15,420
+بنعمل الخطة ليش بنعمل خطة to resolve the problems
+
+162
+00:10:15,420 --> 00:10:20,220
+شوفت لاحظته انا بعملش الخطة مباشرة اول ما اسمع عن
+
+163
+00:10:20,220 --> 00:10:24,580
+المريض وهذا باكد دائما انه دائما ال plan بتيجي بعد
+
+164
+00:10:24,580 --> 00:10:28,240
+ما يصير عندك معلومات وافية وكافية بعد ما نعمل ال
+
+165
+00:10:28,240 --> 00:10:31,020
+plan بنخش شوية بيصير عندنا ال science و ال
+
+166
+00:10:31,020 --> 00:10:33,640
+symptomsو ال nursing diagnosis و ال problem و
+
+167
+00:10:33,640 --> 00:10:37,780
+بعدين بنخش ال action لما نصل ال evaluation طيب
+
+168
+00:10:37,780 --> 00:10:43,840
+communication techniques during interview ايش
+
+169
+00:10:43,840 --> 00:10:47,820
+الطرق او الطرق او القاليات او التقنيات اللى بدي
+
+170
+00:10:47,820 --> 00:10:51,340
+استخدمها في ال interview اول حاجة بدي استخدمها بدي
+
+171
+00:10:51,340 --> 00:10:54,320
+اركز على ال types of questions types of questions
+
+172
+00:10:54,320 --> 00:10:58,870
+انواع ايه انواع الاسئلةأنواع الأسئلة إذا بتلاحظوا
+
+173
+00:10:58,870 --> 00:11:01,310
+في تلات أنواع إذا بتلاحظوا معايا في تلات أنواع
+
+174
+00:11:01,310 --> 00:11:05,330
+خلينا نمشي شوية شوية أول حاجة النوع الأول اسمه
+
+175
+00:11:05,330 --> 00:11:10,210
+open إيش يعني open؟ open ended questions فيه سموها
+
+176
+00:11:10,210 --> 00:11:13,530
+أسئلة مفتوحة يبقى معناته أن في أسئلة مفتوحة بدي
+
+177
+00:11:13,530 --> 00:11:16,370
+أسألها للمريض to assess the client's feelings يبقى
+
+178
+00:11:16,370 --> 00:11:21,110
+الأسئلة المفتوحة لمن أسأل عن المشاعر زي ال what؟
+
+179
+00:11:21,110 --> 00:11:28,400
+what you know about كده what about your health؟how
+
+180
+00:11:28,400 --> 00:11:32,800
+is your health? how are كده؟ طيب which يعني أنا
+
+181
+00:11:32,800 --> 00:11:38,920
+بسأل أسئلة وباستنى زي إيش مثلا كيف أنت حاسس الألم؟
+
+182
+00:11:38,920 --> 00:11:42,780
+كيف أنت حاسس صحتك؟ كيف شعر وضعك؟ لما بدأ أسأل عن
+
+183
+00:11:42,780 --> 00:11:47,920
+أي شيء في feelings بروح باخد open question يعني له
+
+184
+00:11:47,920 --> 00:11:53,800
+نهايات يعني مستمرة ما بده أوقفها اتنين النقطة
+
+185
+00:11:53,800 --> 00:11:58,120
+التانية use closed ended questions متى؟لما بدأ
+
+186
+00:11:58,120 --> 00:12:02,220
+أسأل عن facts عن حقائق زي إيش يعني بيجي بقولي
+
+187
+00:12:02,220 --> 00:12:06,320
+القلم موجود في بطني بقوله when this pain occurred
+
+188
+00:12:06,320 --> 00:12:11,380
+أه did you مثلا والله suffer from كده لاحظين معايا
+
+189
+00:12:11,380 --> 00:12:16,700
+is there كده يعني احنا قاعدين نسأله على حقائق لما
+
+190
+00:12:16,700 --> 00:12:19,800
+بدأ أسأل على حقائق باخد closed ended questions
+
+191
+00:12:19,800 --> 00:12:25,210
+طبعا ال closed مش list لأ مش سؤال yes or no لأالـ
+
+192
+00:12:25,210 --> 00:12:28,390
+closed يعني بيعطيني جواب جملة و خلاص الجملة ده
+
+193
+00:12:28,390 --> 00:12:31,930
+بتكفيني كيف كده؟ والله واحد اتنين تلاتة لكن اذا
+
+194
+00:12:31,930 --> 00:12:35,390
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+195
+00:12:35,390 --> 00:12:39,130
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+196
+00:12:39,130 --> 00:12:40,110
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+197
+00:12:40,110 --> 00:12:40,170
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+198
+00:12:40,170 --> 00:12:40,290
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+199
+00:12:40,290 --> 00:12:53,910
+مابتدش .. مابتدش .. مابتدش .. مابتدش
+
+200
+00:12:53,910 --> 00:13:00,530
+..does your smoke yes or no لما اقوله والله is
+
+201
+00:13:00,530 --> 00:13:04,550
+there a change in your weight yes or no هلجيت
+
+202
+00:13:04,550 --> 00:13:08,110
+بيجيب اعطاني مثال زي ما انتوا شايفين بقول is pain
+
+203
+00:13:08,110 --> 00:13:13,350
+severe هل القلم عندك حد ولا dull ولا حاسب ثقل ولا
+
+204
+00:13:13,350 --> 00:13:17,650
+sharp حاسس اشي كأنه بيطعن ان احنا بنسألهان سؤال
+
+205
+00:13:17,650 --> 00:13:21,190
+yes or no يعني كلمة بيعلمليها زي موضوع ال list
+
+206
+00:13:21,190 --> 00:13:24,990
+بيذكرنا بايش موضوع الاستبانات اللي مرات بنقدمهاإنه
+
+207
+00:13:24,990 --> 00:13:29,050
+بيجيب يعطينا أسئلة و احنا بنختار مالناش يعني احنا
+
+208
+00:13:29,050 --> 00:13:34,170
+رأي نقعد نناقش فقط أنا بختار من الموجود يعني إما
+
+209
+00:13:34,170 --> 00:13:39,010
+إجابة من متغيرين أو من إجابتين أو من تلاتة أو يعني
+
+210
+00:13:39,010 --> 00:13:42,890
+شيء يختار المريض مباشرة explore all data deviated
+
+211
+00:13:42,890 --> 00:13:46,110
+from normal إيش يعني explore اكتشف أي معلومات
+
+212
+00:13:46,110 --> 00:13:49,930
+deviated جاء من كلمة deviation اللي هو كون شاذ إيش
+
+213
+00:13:49,930 --> 00:13:54,130
+يعني يعني بعيد عن الطبيعيأقصد و إحنا عمالنا قاعد
+
+214
+00:13:54,130 --> 00:13:58,770
+بنسأله أي شيء حسينا معلومة غريبة قاعد بيحكيلي إشي
+
+215
+00:13:58,770 --> 00:14:02,290
+مؤلم أو محزن يعني زي increase or decrease the
+
+216
+00:14:02,290 --> 00:14:05,950
+problem يعني افرض و هو قاعد بيحكيلينا بنقوله مثلا
+
+217
+00:14:05,950 --> 00:14:12,150
+does you smoke أنت بتدخن؟ قال yes لحاله حكالي بدخن
+
+218
+00:14:12,150 --> 00:14:18,710
+لأن والدي بدخن أعطاني معلومة أو بدخن لأن أنا عندي
+
+219
+00:14:18,710 --> 00:14:22,420
+واحد اتنين تلاتةإذا لاجينا شيء مرتبط بهذا الجواب
+
+220
+00:14:22,420 --> 00:14:27,600
+بحطه في حاجة بسموها يعني miscellaneous notes كلمة
+
+221
+00:14:27,600 --> 00:14:30,840
+miscellaneous notes يعني إيش؟ يعني إحنا بنتكلم على
+
+222
+00:14:30,840 --> 00:14:35,520
+ملاحظات إضافية بنكتبها عشان يعرف الطبيب إن المشكلة
+
+223
+00:14:35,520 --> 00:14:38,540
+اللي موجودة عند المريض مش إنها أجت هيك من راسه، لأ
+
+224
+00:14:38,540 --> 00:14:43,860
+في إيش بنكد عليه types of statements to use أنواع
+
+225
+00:14:43,860 --> 00:14:47,340
+الجمال اللي بنستخدمها أول حاجة clarify information
+
+226
+00:14:47,340 --> 00:14:51,010
+and encourage verbalizationواضح المعلومات للمريض
+
+227
+00:14:51,010 --> 00:14:55,770
+clarify ما تحطش معلومات don't use vague .. اه
+
+228
+00:14:55,770 --> 00:15:02,730
+don't use vague terms لا تستخدم مصطلحات غامضة and
+
+229
+00:15:02,730 --> 00:15:05,630
+don't use scientific terms و لا تستخدم مصطلحات
+
+230
+00:15:05,630 --> 00:15:09,190
+علمية بنفعش و احنا عاملنا نيجي عن المريض و هذا
+
+231
+00:15:09,190 --> 00:15:13,990
+حصلت من باب الطرفة بيجي بيقول للمريض معلش والله
+
+232
+00:15:13,990 --> 00:15:16,590
+انا بدي اخدك ال vital signs يا ساتر يا رب ايش
+
+233
+00:15:16,590 --> 00:15:20,900
+تاخدني؟ انا كبريش فين؟فهو بيكون انا مش فاهم فاحنا
+
+234
+00:15:20,900 --> 00:15:24,240
+دائما بدنا نستخدم normal words يعني الكلمات اللي
+
+235
+00:15:24,240 --> 00:15:27,900
+بيفهمها المريض and encourage verbalization شجع
+
+236
+00:15:27,900 --> 00:15:32,100
+المريض انه يتكلم خليه يحكي طيب accept the client
+
+237
+00:15:32,100 --> 00:15:36,100
+use silence to recognize thoughts ايش يعني هنا
+
+238
+00:15:36,100 --> 00:15:42,740
+accept هو بيقولي خلي المريض يهدا شوية و ينظم
+
+239
+00:15:42,740 --> 00:15:45,720
+أفكاره يعني افرضوا احنا مانا قاعدين نحكي المريض
+
+240
+00:15:45,720 --> 00:15:50,750
+شوية راح بعيدفانت بتقول لأ انا سألتك عن مثلا الألم
+
+241
+00:15:50,750 --> 00:15:55,590
+الفلاني انت على مهل بس انت ركز و جاوبني لما تقوله
+
+242
+00:15:55,590 --> 00:15:59,290
+ركز و جاوبني بروح المرض بستجمع كل أفكاره بيعطيه
+
+243
+00:15:59,290 --> 00:16:02,270
+كيش بداية الكلام طبعا انا اللي بدي اقوله في هذا ال
+
+244
+00:16:02,270 --> 00:16:05,550
+band انه مانضلناش نقاطع المريض و احنا بقاعدين نسأل
+
+245
+00:16:05,550 --> 00:16:08,610
+في ال interview و هذا يمكن احسن ميزة موجودة عند
+
+246
+00:16:08,610 --> 00:16:11,330
+التمريد اللي بيفهم انه دايما مايقاطعش يعني بدأ
+
+247
+00:16:11,330 --> 00:16:15,720
+المريض يحكيما نستناشي انا مش جاي انا احسب على نفسي
+
+248
+00:16:15,720 --> 00:16:19,100
+هو يحكي اكتر ولا انا احكي لأ انا جاي لمساعدة
+
+249
+00:16:19,100 --> 00:16:22,880
+المريض خليه يتكلم و انا بسجل لما هو ينتهي انا ببدأ
+
+250
+00:16:22,880 --> 00:16:28,120
+اربعة avoid some communication styles ابعد عن
+
+251
+00:16:28,120 --> 00:16:34,020
+نماذج في آليات التواصل و في آليات المقابلة و آليات
+
+252
+00:16:34,020 --> 00:16:38,720
+التعامل مع المريض حسب التالي اش اول حاجة excessive
+
+253
+00:16:38,720 --> 00:16:43,260
+or not enough eye contactيعني انا مابدي اتطالب لمن
+
+254
+00:16:43,260 --> 00:16:47,400
+ياخد يعني عماله بتطلع في المريض و بسمعله مابدي
+
+255
+00:16:47,400 --> 00:16:51,540
+يعني لا يتطلع زيادة عن اللزوم ولا .. اه ولا
+
+256
+00:16:51,540 --> 00:16:55,440
+مايتطلعش بالمرة كيف يعني؟ يعني افرض المريض قاعد
+
+257
+00:16:55,440 --> 00:16:59,160
+عمالي بيحكي و احنا بيحكي مركزين فيه فجأة لجيت حاجة
+
+258
+00:16:59,160 --> 00:17:02,480
+سارحان انا و انا قاعد نركز فيه ففجأة هو المريض
+
+259
+00:17:02,480 --> 00:17:06,360
+بيقوللي مالك بتطلع فيه زي هيك اتخاف المريض او
+
+260
+00:17:06,360 --> 00:17:11,100
+عمالك هو قاعد بيحكي انت مطمن راسك في الجوالأو حاطض
+
+261
+00:17:11,100 --> 00:17:15,080
+معاك ويا جلام ايوة ايوة فاهم عليك و بتهز راسك حتما
+
+262
+00:17:15,080 --> 00:17:18,140
+هيقولك يا عم مالك انت يعني انت بتسمعليش انت بتنشني
+
+263
+00:17:18,140 --> 00:17:21,080
+حتى احنا لما نحكي مع بعض بنقول للواحد اتطلع فيه
+
+264
+00:17:21,080 --> 00:17:24,640
+يركز معاه اللي بده اقول هنا يعني لا .. يعني احنا
+
+265
+00:17:24,640 --> 00:17:29,720
+لا بدناش يزيد يخل يعني ولا قليل مل يعني اللي بده
+
+266
+00:17:29,720 --> 00:17:34,080
+اقوله باختصار انه نتطلع لما يحكي المريض و لما يبطل
+
+267
+00:17:34,080 --> 00:17:37,860
+يحكي خلاص برفع عينيطبعا و خاصة بدناش لأن بعض
+
+268
+00:17:37,860 --> 00:17:41,720
+المرضى يفهمها خاطئ كأنه التحديق بالعين كأنه أنت
+
+269
+00:17:41,720 --> 00:17:45,980
+يعني عمالك يعني منبهر بكلامه أو بتسمع أو مستغرب أو
+
+270
+00:17:45,980 --> 00:17:50,620
+مستهجر فبدناش يصل لهيك مرحلة المريض النجمة ال ..
+
+271
+00:17:50,620 --> 00:17:54,180
+ال .. الاخر شيء هذه النقطة بتقوللي إيش هنا؟ بقوللي
+
+272
+00:17:54,180 --> 00:17:57,900
+حاول تبعد عن إيش doing .. doing anything during
+
+273
+00:17:57,900 --> 00:18:01,160
+إيش history during getting history بقوللي يعني
+
+274
+00:18:01,160 --> 00:18:05,460
+يريد تبعد عن أنك تعمل أي شيء و أنت بتاخد إيشيعني
+
+275
+00:18:05,460 --> 00:18:08,640
+بتاخد معلومات من المريض، زي كيف، يعني مانفعش ان
+
+276
+00:18:08,640 --> 00:18:11,860
+انا قاعد باسأله او كيف انت امرك و ان شاء الله يعني
+
+277
+00:18:11,860 --> 00:18:15,480
+ربني ايش فيك و ماسك الجوال و عمالي بلعب حي و سلم و
+
+278
+00:18:15,480 --> 00:18:19,220
+لا عمالي .. اصلا في مثلا لاجيت نت و عمالي فتحتلي
+
+279
+00:18:19,220 --> 00:18:22,220
+اي game و لا عمالي براجع الواتس أو براجع الفيس أو
+
+280
+00:18:22,220 --> 00:18:28,400
+..هذا الوقت مخصص للمريض مجرد ما انت تبدأ حاول انت
+
+281
+00:18:28,400 --> 00:18:32,360
+تحط الجوار تحط كل أغراضك في جيبتك عشان تبدأ تركز
+
+282
+00:18:32,360 --> 00:18:37,540
+مع المريض و هو يحس انه انت منتبهله كويس طيب based
+
+283
+00:18:37,540 --> 00:18:41,420
+يعني biased او biased يعني منحاز او leading
+
+284
+00:18:41,420 --> 00:18:45,720
+questions او السؤال اللي بيقود للإجابة بقول ابعد
+
+285
+00:18:45,720 --> 00:18:50,160
+عنه يعني انا بقول ما تستخدم don't use biased or
+
+286
+00:18:50,160 --> 00:18:54,570
+leading questions ما تستخدم الأسئلةاللي بتأدي
+
+287
+00:18:54,570 --> 00:18:59,350
+للجواب، ايش قصدك يا أستاذ؟ اعطيك مثال، الان مانفعش
+
+288
+00:18:59,350 --> 00:19:02,750
+تيجي تقول المريض you don't feel bad، انت اكيد مش
+
+289
+00:19:02,750 --> 00:19:07,690
+يعني .. انت مش شعر انك سيء، انت كويس، لأ مانفعش،
+
+290
+00:19:07,690 --> 00:19:12,670
+او اجي اقوله اكيد بتحب انت أكل المطبخ صح؟ لأ
+
+291
+00:19:12,670 --> 00:19:16,770
+مانفعش، افرض انا جاعة بسأله عن ال psycho، انا واحد
+
+292
+00:19:16,770 --> 00:19:20,870
+من الناس مثلا شاب زهجان من غزة و نفسيتي متعبة،
+
+293
+00:19:20,870 --> 00:19:23,980
+مانفعش اسقطه على المريضأجى أقوله يقوله كيف أنت
+
+294
+00:19:23,980 --> 00:19:28,320
+حاسس الأمور؟ أكيد أزاي حالاتي، بنفعش هذا اسمه
+
+295
+00:19:28,320 --> 00:19:32,320
+biased and leading سؤال بيعمل تحيز و بقدر الجواب
+
+296
+00:19:32,320 --> 00:19:36,720
+هذا بدنا نكون حاذرين منه، تمام؟ اللي بعده don't
+
+297
+00:19:36,720 --> 00:19:40,620
+relying on memory to recall information relying
+
+298
+00:19:40,620 --> 00:19:44,360
+تعتمد، لا تعتمد على الذاكر عشان تتذكر المعلومات
+
+299
+00:19:44,360 --> 00:19:47,520
+يعني أتمنى على الجميع و أنت بتاخد .. احنا يمكن
+
+300
+00:19:47,520 --> 00:19:52,320
+نختلف على طبها على طبها، بمر على خمس، ست مرضىويمكن
+
+301
+00:19:52,320 --> 00:19:55,260
+مرات بينسى لدرجة انه حتى ممكن بعد ما يخلص المرور
+
+302
+00:19:55,260 --> 00:19:58,480
+هتتذكره معاه لما تروح المستشفى تتذكر الكلمات هذه
+
+303
+00:19:58,480 --> 00:20:04,800
+بيبدأ يكتب بعض العلاجات لمريض فلاني وخروج للمريض
+
+304
+00:20:04,800 --> 00:20:09,200
+العلاني ممكن ينسى بيصير يقول للحكيم طيب المريض
+
+305
+00:20:09,200 --> 00:20:12,140
+اللي احنا شكى من كده بيصير يقوله اه اه اللي كان
+
+306
+00:20:12,140 --> 00:20:15,180
+جنب الشباك او اللي كان في المصر احنا ممكنش نكون
+
+307
+00:20:15,180 --> 00:20:19,220
+صحيحاحنا أول بول دائما علمونا و هنروح المستشفى
+
+308
+00:20:19,220 --> 00:20:22,520
+نشوف أنه أول بول كل ما تصير معلومة عن المريض
+
+309
+00:20:22,520 --> 00:20:26,000
+بكتبها ليه؟ ماعتمدش على الذاكرة لأنه أنا طول
+
+310
+00:20:26,000 --> 00:20:30,220
+النهار هكون مع مرضاه هنسأت عملت مع هانا و مع هانا
+
+311
+00:20:30,220 --> 00:20:33,980
+أستاذ اتكلم معايا و طالب زميل يتكلم فالإنسان سبحان
+
+312
+00:20:33,980 --> 00:20:39,340
+الله بينسى خمسة specific age variations بدنا نكون
+
+313
+00:20:39,340 --> 00:20:44,500
+حارسين جدا في التغييرات اللي بتصيريعني أمامي من
+
+314
+00:20:44,500 --> 00:20:46,840
+المرضى مش كل المرضى بده استخدم نفس الطريقة
+
+315
+00:20:46,840 --> 00:20:50,020
+بالأسئلة ولا نفس الطريقة بالتلميحات ولا نفسي يعني
+
+316
+00:20:50,020 --> 00:20:53,700
+مش معقول يعني معقول الصغير زي الكبير لأ طبعا يعني
+
+317
+00:20:53,700 --> 00:20:57,280
+معقول واحد بده يختلف في يعني مثلا ما بيصير عندي او
+
+318
+00:20:57,280 --> 00:21:00,520
+male زي ال female لأ يمكن انا اكون male و بده اخد
+
+319
+00:21:00,520 --> 00:21:03,380
+مثلا history من female و ال female مش ستة كبيرة
+
+320
+00:21:03,380 --> 00:21:06,920
+يعني انا صغيرة في السن في أسئلة مابقدرش اسألها و
+
+321
+00:21:06,920 --> 00:21:10,160
+كذلك نعكسها يمكن انا female و راحت الطالبة بده
+
+322
+00:21:10,160 --> 00:21:12,910
+تاخد مثلا historyواللي قدامي مش كبير في الأعمار
+
+323
+00:21:12,910 --> 00:21:16,450
+يعني صغير برضه في أسئلة مابتنساه يبقى احنا بنكون
+
+324
+00:21:16,450 --> 00:21:20,570
+حاذرين هذه بيسموها variation culture وفي variation
+
+325
+00:21:20,570 --> 00:21:23,350
+age يعني كمان اختلاف في ال age و الأعمار خليني
+
+326
+00:21:23,350 --> 00:21:26,370
+أشوف أول حاجة ال pediatric clients ال pediatric
+
+327
+00:21:26,370 --> 00:21:30,810
+clients الآن في الأطفال ايش بينام طب أخدنا معلومات
+
+328
+00:21:30,810 --> 00:21:34,210
+هل دائما الطفل صادق طب في مرات الطفل مش عارف أسأله
+
+329
+00:21:34,210 --> 00:21:37,630
+يمكن الطفل عمره سنتين يمكن عمره تلاتة يمكن عمره
+
+330
+00:21:37,630 --> 00:21:41,820
+أربعة بيكلمني هل كل معلوماته صادقة؟ لأانا حاجة
+
+331
+00:21:41,820 --> 00:21:45,400
+بدنا نقولكن دايما نذكركن ان في ال pediatric يعني
+
+332
+00:21:45,400 --> 00:21:51,360
+دايما ال clients بتلاقي بطبيعتهم يكذبوا، يعني ال
+
+333
+00:21:51,360 --> 00:21:54,300
+lying هذا او الكذب ما بقدر اعتبره يعني شغل مرضى،
+
+334
+00:21:54,300 --> 00:21:58,000
+لأ الولد الطفل دايما خياله واسع، يمكن بكذب عشان
+
+335
+00:21:58,000 --> 00:22:01,020
+خايف من الإبرة، يمكن بكذب عشان ماتعطوهش يعني
+
+336
+00:22:01,020 --> 00:22:05,040
+علاجات معينةلكن احنا بناخد عشان احنا نكبر شأن
+
+337
+00:22:05,040 --> 00:22:08,660
+الطفل و نبسط منه لما خاصة نروح نتدرب و نلاقي
+
+338
+00:22:08,660 --> 00:22:12,440
+قدامنا طفل بسأله لكن لو بدي اتأكد من المعلومات
+
+339
+00:22:12,440 --> 00:22:16,200
+منهم باتأكد منها باتأكد من ال parents اللي موجودين
+
+340
+00:22:16,200 --> 00:22:19,740
+معاه زي الأم اذا كانت موجودة او زي الأب ليه لا
+
+341
+00:22:19,740 --> 00:22:23,280
+يمكن الأم او الأب يكذبوا او مثلا مايحكوش الحقيقة
+
+342
+00:22:23,280 --> 00:22:27,020
+لإن هم جايين ليش و هي جاية تعالج ابنها ليش فاحنا
+
+343
+00:22:27,020 --> 00:22:29,920
+بنأكد المعلومات منها أخدنا معلومات من الطفل
+
+344
+00:22:29,920 --> 00:22:33,830
+بنأكدها من الأم او من اللي حواليهمن العائلة طب في
+
+345
+00:22:33,830 --> 00:22:37,930
+ال geriatric مش معقول اروح اكل زي الأطفال ال
+
+346
+00:22:37,930 --> 00:22:41,930
+geriatric يعني راجل اختيار او ست عجوز طالع نفس
+
+347
+00:22:41,930 --> 00:22:45,110
+السن بنفع نقوله معلش ولا بتتأكد ما هو برضه نفس
+
+348
+00:22:45,110 --> 00:22:49,550
+القضية الانسان ممكن صار عنده Alzheimer يمكن صار
+
+349
+00:22:49,550 --> 00:22:54,470
+عنده frequent forgetting يعني بضل ينسى بضل ينسى طب
+
+350
+00:22:54,470 --> 00:22:56,930
+ايش بده اعمل؟ بده نستخدم هنا simple words كلمات
+
+351
+00:22:56,930 --> 00:23:00,730
+بسيطة and assess hearing equity equity يعني ايش
+
+352
+00:23:00,730 --> 00:23:03,560
+هنا؟حدة السماعة زي ما نقول visual equity يعني لما
+
+353
+00:23:03,560 --> 00:23:06,820
+كنا ناخدها نقول visual equity يعني حدة إيش النظر
+
+354
+00:23:06,820 --> 00:23:10,880
+طب hearing equity حدة السماعة بدنا نتأكد أنه
+
+355
+00:23:10,880 --> 00:23:15,120
+سامعني الحاج ولا لأ مانفعش نتكلم معاه بنفس النبرة
+
+356
+00:23:15,120 --> 00:23:17,960
+اللي كنا نتكلم بيها مع اللي أصغر في بعض العجاز
+
+357
+00:23:17,960 --> 00:23:21,840
+بتيجي تقولهم كيف حالك يا حاجة بقولك أنا عارف والله
+
+358
+00:23:21,840 --> 00:23:25,780
+امبارح لما أجوا ناس علي مش فاهم أيه السؤالك كتير
+
+359
+00:23:25,780 --> 00:23:29,750
+من الناس خاصة الأكبار السن لما نبطل يسمعبيخجل
+
+360
+00:23:29,750 --> 00:23:33,510
+يقولك انا مسمعش، بيصير يعطيك جواب تاني، يعني انت
+
+361
+00:23:33,510 --> 00:23:36,530
+ممكن تسأله ممكن حتى تضحك انت، ليه؟ انت بتسأله في
+
+362
+00:23:36,530 --> 00:23:41,150
+شيء هو عامله ايش، يعني انت بتقوله مثلا كيف ان شاء
+
+363
+00:23:41,150 --> 00:23:44,870
+الله أمورك كويسة، روح يفهمها كأنه انت بتقوله يعني
+
+364
+00:23:44,870 --> 00:23:48,830
+حاجة تانية، يعني بيصير جوابك في أمور تانية، فعشان
+
+365
+00:23:48,830 --> 00:23:51,950
+هيك بدنا نتأكد انه بيسمع كويس و في نفس الوقت
+
+366
+00:23:51,950 --> 00:23:57,090
+نستخدم كلمات بسيطة هو يفهمهامش تنيجة .. معلش يا
+
+367
+00:23:57,090 --> 00:23:59,470
+حاجة احنا جايين من كلية التمريد بالجامعة الإسلامية
+
+368
+00:23:59,470 --> 00:24:03,630
+نريد أن ناخد منها كده، هيقولك في الآخر معلش والله
+
+369
+00:24:03,630 --> 00:24:07,010
+أنا مش سامعك يا ابني و ترجملييفكر انك بتحكي ايش
+
+370
+00:24:07,010 --> 00:24:11,490
+لغة ايش هنا كأنك بتحكي لغة يعني مش عربية علشان هيك
+
+371
+00:24:11,490 --> 00:24:14,810
+لأ الحج بده لغة تانية اه يا حج الله يعطيك الصحة
+
+372
+00:24:14,810 --> 00:24:17,850
+كيف أمورك ان شاء الله انت كويس ما تقلق يا والدي ما
+
+373
+00:24:17,850 --> 00:24:20,450
+تقلق يا أمي و ما تقلق يا كلمات ما تقلق يا ماما
+
+374
+00:24:20,450 --> 00:24:24,130
+يعني الأمر هذا بيعطيه نوع من الاش القريحية يعني
+
+375
+00:24:24,130 --> 00:24:29,090
+حتى هو بيصير يقدر يعطيك المعلومات طيب emotional
+
+376
+00:24:29,090 --> 00:24:32,270
+variations شو يعني emotional variations اللي هي
+
+377
+00:24:32,270 --> 00:24:36,780
+اختلافات العواطف كيف يعنيالان مش كل مرضى زي بعض
+
+378
+00:24:36,780 --> 00:24:39,620
+لازم نحترم العواطف اللى موجودة عند المرضى اللى
+
+379
+00:24:39,620 --> 00:24:42,820
+أمامنا افرض المرضى اللى قدامنا angry يعني جينا
+
+380
+00:24:42,820 --> 00:24:47,600
+جينا لجينا مرض لحاله بقول انا عارف المستشفى و
+
+381
+00:24:47,600 --> 00:24:50,940
+حاسبي الله عليه و حاسبي على الطب يعني هنا ايش بقول
+
+382
+00:24:50,940 --> 00:24:54,660
+you must be calm ايش يعني calm؟ خليك عطوف خليك
+
+383
+00:24:54,660 --> 00:24:59,220
+هادي انت خليك عندك نوع من دفء المشاعر عندك ايه
+
+384
+00:24:59,220 --> 00:25:01,980
+يعني ماتجيش واحد قاعد بقولحاسس بيه الله على
+
+385
+00:25:01,980 --> 00:25:05,560
+المستشفى و الله يجعله مثلا يتدمر تقول الله لا يرده
+
+386
+00:25:05,560 --> 00:25:10,280
+و ينحرق كمان للأسف في بعض الطلاب أنا سمعت شغلات
+
+387
+00:25:10,280 --> 00:25:14,160
+زيك أمر غريب انت قاعد بتنجل إحباطك على المرضى حتى
+
+388
+00:25:14,160 --> 00:25:17,800
+لو عندك مئة إحباط مهنتك إنسانية مهنتك اللي انت جيت
+
+389
+00:25:17,800 --> 00:25:20,700
+عليها هادف فيها يعني الله سبحانه وتعالى بتبركلك
+
+390
+00:25:20,700 --> 00:25:24,760
+فيها فما بينفع دغري هيك مباشرة كأننا نساعد يبقى
+
+391
+00:25:24,760 --> 00:25:27,800
+نكون اللي ماناشي نساعد المرضى على الشر ولا على
+
+392
+00:25:27,800 --> 00:25:32,420
+الغضب طب مش بس هيك افرض اناواحد anxious يعني جلجان
+
+393
+00:25:32,420 --> 00:25:35,620
+طبعا ايش جلجان؟ والله خايف من العمليات والله حاسس
+
+394
+00:25:35,620 --> 00:25:38,200
+حالي مش حاجة بيقولوا انه الواحد بصحاش من ال bench
+
+395
+00:25:38,200 --> 00:25:40,800
+لما تقعد بحكيلي بيقولوا ان فلان والله انا جاري عمل
+
+396
+00:25:40,800 --> 00:25:44,440
+كذا او هي بتقول والله جارتي او والله جريبتي بنجوها
+
+397
+00:25:44,440 --> 00:25:47,920
+وصخيت تاني يوم هرقش من كل you must be simply شو
+
+398
+00:25:47,920 --> 00:25:52,260
+يعني simply؟ simply يعني خليك بسيط يعني لأ معلش مش
+
+399
+00:25:52,260 --> 00:25:55,220
+لها الدرجة و العلم اتطور مش لها الدرجة لأ الواحد
+
+400
+00:25:55,220 --> 00:25:58,480
+بعدين مش اول الناس انتي ولا اخها بنعطي كلمة بس
+
+401
+00:25:58,480 --> 00:26:03,090
+ماينفعش اكون simplyمع ال angry لأ يعني مانفعش واحد
+
+402
+00:26:03,090 --> 00:26:06,150
+معصب و nervous و قاعد بيقول حاسبي الله على
+
+403
+00:26:06,150 --> 00:26:10,750
+المستشفى و الله تروح تقوله والله شكلك معصب طب
+
+404
+00:26:10,750 --> 00:26:13,770
+ماحنا حاجة من جد من حد ما نحكي نقول شكلك معصب
+
+405
+00:26:13,770 --> 00:26:18,650
+هيصير يكسر الدنيا يمكن احنا نستخدم الهدوء مع الغضب
+
+406
+00:26:18,650 --> 00:26:23,470
+و البساطة مع القلق و ال interest التشوق مع المكتئب
+
+407
+00:26:23,470 --> 00:26:27,810
+كيف يعني لجينا مريض حزين و بسرعة جاوبنا هذا مكتئب
+
+408
+00:26:27,810 --> 00:26:32,140
+فهيش انا اقوله لأتجلجش و أنت كويس و ان شاء الله
+
+409
+00:26:32,140 --> 00:26:37,560
+بإذن الله حطيب و تصير تمنح و ما تخاف طيب culture
+
+410
+00:26:37,560 --> 00:26:41,640
+variations يعني اختلافات الاشي الثقافة لازم نكون
+
+411
+00:26:41,640 --> 00:26:44,240
+احنا انا the communication of self and clients اش
+
+412
+00:26:44,240 --> 00:26:47,460
+يعني في مرات بتصير اختلافات ثقافية اللي بدأوا
+
+413
+00:26:47,460 --> 00:26:53,290
+بقولكواأنا فلاح، هو مدني، أنا بدوي، هو فلاح، أنا
+
+414
+00:26:53,290 --> 00:26:56,350
+مثلا مدني، هو بدوي، بغض النظر، احنا موجودين في
+
+415
+00:26:56,350 --> 00:26:59,890
+غزة، في اختلافات ثقافية، لكن احترمين احترم ال
+
+416
+00:26:59,890 --> 00:27:03,190
+culture تبعتهم، عشان ايه دائما لاختلافات ثقافية
+
+417
+00:27:03,190 --> 00:27:07,330
+نكون حارسين و نتخيل الكلمات الواضحة اللي بيفهمها
+
+418
+00:27:07,330 --> 00:27:11,610
+المريض تمانية، you can use culture broker، اشارة
+
+419
+00:27:11,610 --> 00:27:15,520
+culture broker زي بسموها مترجمطبعا ليش مترجم؟ في
+
+420
+00:27:15,520 --> 00:27:18,940
+مرات بعض الكلمات شوية ممكن تكون احنا مافهمهاش يعني
+
+421
+00:27:18,940 --> 00:27:22,680
+مثلا أهلنا و أحبابنا مرة كان عندي .. يعني زمان كان
+
+422
+00:27:22,680 --> 00:27:26,820
+احده عند طالب بدوي قاعد بعالج .. بتعالج عنا فبقوله
+
+423
+00:27:26,820 --> 00:27:31,740
+.. كان فيه واجهة اندرسه فبقوله الطالب من إيش؟ ألف
+
+424
+00:27:31,740 --> 00:27:35,800
+سلام عليك يا حاجة من إيش الحجر هذا؟ قالله من
+
+425
+00:27:35,800 --> 00:27:41,370
+الطنيات .. من الطنيات ضربوني و عجدواالان انا فاهم
+
+426
+00:27:41,370 --> 00:27:43,810
+ايش جزده هو الطنيات يعني الأولاد الصغار و ضربوني
+
+427
+00:27:43,810 --> 00:27:48,550
+يعني ضربوني و عجدوا يعني شردوا فالان فالطالب للأسف
+
+428
+00:27:48,550 --> 00:27:51,270
+بيقوله ماعليش حاجة أنا بسألك جاوبني قاله ما أنا
+
+429
+00:27:51,270 --> 00:27:54,270
+قلتلك الطنيات ضربه قاله انا بسألك ايش صار معاك و
+
+430
+00:27:54,270 --> 00:27:56,950
+قعدت انا بقعدت ده تصير مشكلة جاء من اختيار و غضب
+
+431
+00:27:56,950 --> 00:28:00,930
+طبعا مش بحكي و كأن انا مستغرب من لغة لأ احنا كلنا
+
+432
+00:28:00,930 --> 00:28:05,010
+أهل في لغهان و في لغان .. كلنا أهل كلنا أحباب كلنا
+
+433
+00:28:05,010 --> 00:28:09,420
+مصدرنا واحد لكن سبحان الله طبيعةاللغة مراتي شويه
+
+434
+00:28:09,420 --> 00:28:12,120
+زي الموضوع اللاكنة الإنجليزية يعني الأمريكي غير
+
+435
+00:28:12,120 --> 00:28:15,640
+البريطاني غير الاندونيزي بأي غض النظر فهنا بدنا
+
+436
+00:28:15,640 --> 00:28:18,620
+نستخدم إيش هنا في بعض الحالات ممكن نلجأ نستخدم ل
+
+437
+00:28:18,620 --> 00:28:22,520
+pictures يعني صور أو reading يعني مرات او لمن هدول
+
+438
+00:28:22,520 --> 00:28:25,600
+ل non reading clients افرض يعني المريض الأمامي مش
+
+439
+00:28:25,600 --> 00:28:28,540
+فاهمني بالمرة مش قادر احنا مرات بنقوله طبعا أنا
+
+440
+00:28:28,540 --> 00:28:31,540
+بسألك عن هيك يعني كأنك بجيب غرقه أو فيها صورة أو
+
+441
+00:28:31,540 --> 00:28:35,180
+بقوله عن هيك بسألك علشان هيك لو حسنا أن المريض
+
+442
+00:28:35,180 --> 00:28:38,580
+اللي أمامي مش قادر أفهمه مش عيبه مش غلطأسهل أسأل
+
+443
+00:28:38,580 --> 00:28:42,880
+instructor أو أسأل الحكيم عن هذه طبيعة الكلام اللي
+
+444
+00:28:42,880 --> 00:28:47,220
+مش قادر يفهمني فيه خلينا نقف عند الشابتر اللي بكون
+
+445
+00:28:47,220 --> 00:28:50,100
+خلصته ان شاء الله و الدور الجاي ان شاء الله بنكمل
+
+446
+00:28:50,100 --> 00:28:54,540
+في الشابتر القادم يعني هيك عشان نلتزم في حدود
+
+447
+00:28:54,540 --> 00:28:58,780
+التلاتين دقيقة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1ec58f752330a9f19bf413925cc31c60816c8f12
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/dRO_2hc1kpI_raw.srt
@@ -0,0 +1,1788 @@
+1
+00:00:01,420 --> 00:00:03,900
+أعوذ بالله من الشتارجين بسم الله الرحمن الرحيم
+
+2
+00:00:03,900 --> 00:00:07,540
+طبعا توقفنا في المحاضرة السابقة عن ال health
+
+3
+00:00:07,540 --> 00:00:11,060
+history و الأن ان شاء الله بدنا نكمل احنا وياكم
+
+4
+00:00:11,060 --> 00:00:14,700
+طبعا health history زى ما انتوا شايفين تحتوي على
+
+5
+00:00:14,700 --> 00:00:19,100
+خمس بند البند الأول interview المقابلة و أنا
+
+6
+00:00:19,100 --> 00:00:22,840
+هتتكلم في موضوع ال interview طبعا اللى صحيح أنا
+
+7
+00:00:22,840 --> 00:00:26,220
+بتتكلم هنا على ال clinical interview لكنى ممكن
+
+8
+00:00:26,220 --> 00:00:30,290
+تكون هي تفيدنا كمان في حياتنافعليات المقابلة و
+
+9
+00:00:30,290 --> 00:00:33,650
+أنواع المقابلة و كيف الأسئلة المقابلة عشان احنا لو
+
+10
+00:00:33,650 --> 00:00:36,850
+في اي فترة اتعرضنا لهذا المقابلة ان شاء الله نكون
+
+11
+00:00:36,850 --> 00:00:40,870
+احنا جادها اتنين psycho social assessment بناخد
+
+12
+00:00:40,870 --> 00:00:44,390
+طبعا history كامل مش بس القصة ال .. الناحية
+
+13
+00:00:44,390 --> 00:00:47,390
+المرضية او الناحية الصحية بنسأله برضه من الناحية
+
+14
+00:00:47,390 --> 00:00:50,690
+النفسية من الناحية الاجتماعية من الناحية التالتة
+
+15
+00:00:50,690 --> 00:00:52,310
+اللي هو ال nutritional assessment زي ما انتوا
+
+16
+00:00:52,310 --> 00:00:55,190
+عارفين شوف التغيرات اللي صارت في ال diet او كيف
+
+17
+00:00:55,190 --> 00:00:57,570
+وضع او لسه weight او high of weight و هكذا
+
+18
+00:00:58,340 --> 00:01:01,040
+assessment of sleep weakfulness patterns كمان
+
+19
+00:01:01,040 --> 00:01:05,320
+طبيعة النوم هل كيف كان وضعه الصحي قبل ما ييجي او
+
+20
+00:01:05,320 --> 00:01:09,560
+في القديم او هل كان عنده مشاكل يعني صحية مرتبطة
+
+21
+00:01:09,560 --> 00:01:12,460
+بالنوم و هكذا اخر حاجة بنتكلم على ال health
+
+22
+00:01:12,460 --> 00:01:15,420
+history ك health history يعني كيف بنبدأ ناخدها
+
+23
+00:01:15,420 --> 00:01:20,200
+يعني كبنود نيجي نتكلم هنا اول حاجة ال interview ال
+
+24
+00:01:20,200 --> 00:01:24,040
+interview هنا definition زي ما تشوفين عبارة عن
+
+25
+00:01:24,040 --> 00:01:26,800
+communication process focus on ايه communication
+
+26
+00:01:26,800 --> 00:01:31,960
+processيبقى هي معناته هي التواصل هي طريقة التواصل
+
+27
+00:01:31,960 --> 00:01:35,480
+وقالية التواصل بين ال clients development معلش
+
+28
+00:01:35,480 --> 00:01:38,820
+بضله بس شوية بين ال clients development
+
+29
+00:01:38,820 --> 00:01:45,300
+psychological physiological socio cultural and
+
+30
+00:01:45,300 --> 00:01:49,420
+spiritual لو لاحظنا الكلمات واضحة يعني قصة ال
+
+31
+00:01:49,420 --> 00:01:53,300
+interview مش بس كيف حالك او ايش أخبارك لأ في أسئلة
+
+32
+00:01:53,300 --> 00:01:56,920
+بتتكلم عن development تطور المريض كيف حياته كيف
+
+33
+00:01:56,920 --> 00:01:59,320
+كانت ماشيةو من ناحية النفسية و من ناحية
+
+34
+00:01:59,320 --> 00:02:02,660
+الفيسيولوجية و من ناحية الاجتماعية و الثقافة و
+
+35
+00:02:02,660 --> 00:02:07,040
+الثقافية و حتى من ناحية الروحانية هذا تقريبا يمكن
+
+36
+00:02:07,040 --> 00:02:10,280
+من أفضل التعريفات لل interview لأنه شامل اكتر من
+
+37
+00:02:10,280 --> 00:02:14,460
+البرود و ان كان مختصر بالكلمات طب ال major purpose
+
+38
+00:02:14,460 --> 00:02:18,980
+ليش انا بعمل interview بعمل interview to obtain
+
+39
+00:02:18,980 --> 00:02:22,630
+health history عشان اخدالتاريخ الصحي و التاريخ
+
+40
+00:02:22,630 --> 00:02:27,790
+المرضي و اي شي معلومات موجودة عند المرض طب ليه and
+
+41
+00:02:27,790 --> 00:02:31,450
+to identify development of the symptoms لأنه انا
+
+42
+00:02:31,450 --> 00:02:34,990
+لما اخد المعلومات الكاملة بعرف ان الأعراض هل تطورت
+
+43
+00:02:34,990 --> 00:02:38,010
+و لا ماتطورتش يبقى ال major paradox تبعي ان اخد ال
+
+44
+00:02:38,010 --> 00:02:40,310
+testosterone من هذا المرض اللي أمامي و في نفس
+
+45
+00:02:40,310 --> 00:02:44,030
+الوقت اعرف انه هل الأعراض اللي موجودة عنده زادت و
+
+46
+00:02:44,030 --> 00:02:48,030
+لا جلت و لا في إمكانية للتدخل و لا لأ طيب
+
+47
+00:02:48,030 --> 00:02:52,600
+components of nursing interviewال nursing
+
+48
+00:02:52,600 --> 00:02:55,480
+interview فيها تلاتة components خلينا نذاكرينها
+
+49
+00:02:55,480 --> 00:02:59,500
+عشان ما ننساش هذا شيء مهم introductory, working,
+
+50
+00:03:00,460 --> 00:03:04,020
+termination يبقى ملاته ال interview في أي مجال في
+
+51
+00:03:04,020 --> 00:03:07,600
+العالم بس احنا بنخصصها نقول nursing عشان بنتكلم عن
+
+52
+00:03:07,600 --> 00:03:11,360
+عبارات تخص ال nursing يبقى أول حاجة introductory
+
+53
+00:03:11,360 --> 00:03:18,760
+تقديم working عمل termination انهاء طبعا كل واحدة
+
+54
+00:03:18,760 --> 00:03:23,270
+اللي هي بنودها وليها خصائصها نيجي نتكلمأول حاجة
+
+55
+00:03:23,270 --> 00:03:28,310
+introductory phase طبعا اتعلمنا في ال fundamental
+
+56
+00:03:28,310 --> 00:03:31,390
+و كمان مرة بنهيد انه دايما you must introduce
+
+57
+00:03:31,390 --> 00:03:34,450
+yourself and explains the purpose of the interview
+
+58
+00:03:34,450 --> 00:03:37,970
+to the client مش معقول انا اجي للمريض السلام عليكم
+
+59
+00:03:37,970 --> 00:03:40,950
+لو سمحت بده اخدك ال vital signs او لو سمحت يا حاجة
+
+60
+00:03:40,950 --> 00:03:44,510
+معلش بده اخدك الحرارة و كده بده يقولك يا ابن انت
+
+61
+00:03:44,510 --> 00:03:48,210
+مين انت طبعا او مين انت يا ابني فاحنا أول حاجة
+
+62
+00:03:48,210 --> 00:03:52,530
+لازم ايش يكون عندنا اقدم نفسي مخجلش انا فلان فلاني
+
+63
+00:03:53,080 --> 00:03:55,800
+أنا طالب سنة تانية من كلية التمرض في الجامعة
+
+64
+00:03:55,800 --> 00:04:00,180
+الإسلامية و احنا بنتدرب مايقوللي حد انه والله طب
+
+65
+00:04:00,180 --> 00:04:02,900
+ايش يقولوا يصير يقولوا بعض المرضى اه انتوا جيه
+
+66
+00:04:02,900 --> 00:04:05,940
+انتوا اتعلموا فينا او زي .. لا لا لا الحمد لله
+
+67
+00:04:05,940 --> 00:04:09,560
+اللي سابقوكوا من الطلاب بيعملوا قرص طيب و بيعملوا
+
+68
+00:04:09,560 --> 00:04:13,040
+سيرة طيبة بالعكس هم بينتظروكوا لما انتوا تروحوا
+
+69
+00:04:13,040 --> 00:04:15,580
+تشتغلوا معاهم بينتظروكوا و تزاروا و هم يحبوا طلبة
+
+70
+00:04:15,580 --> 00:04:18,360
+الجامعة الإسلامية مش من بدا بتحفظهم يحبوا الطلاب
+
+71
+00:04:18,360 --> 00:04:23,170
+بشكل عام لأنه انتوا ناس مؤدبين و الا هنثجل دمنا
+
+72
+00:04:23,170 --> 00:04:26,810
+ولا هن .. احنا رايحين بدنا يعني نخدم هذا المريض،
+
+73
+00:04:26,810 --> 00:04:30,390
+نحاول يعني مساعدته في هذا العلاج، لذلك ما نخجل من
+
+74
+00:04:30,390 --> 00:04:33,670
+تعريف أنفسنا و احنا كل واحد حتى مطلوب مننا نحط ال
+
+75
+00:04:33,670 --> 00:04:36,590
+tag name بس ان شاء الله الظروف ترجع لطبيعتها و
+
+76
+00:04:36,590 --> 00:04:39,430
+نرجع نحط ال tag name و نكون احنا رافعين رأسنا و
+
+77
+00:04:39,430 --> 00:04:43,490
+احنا عاملنا بالتعامل مع المرضى في داخل المستشفيات
+
+78
+00:04:43,490 --> 00:04:46,690
+before asking questions البندق التاني before
+
+79
+00:04:46,690 --> 00:04:50,290
+asking questions بقولي هنقلتك لا انتوا في ليهاش
+
+80
+00:04:50,290 --> 00:04:56,030
+comfortخل المريض يشعر براحة privacy و بعدين
+
+81
+00:04:56,030 --> 00:04:59,470
+confidentiality شو يعني؟ يعني هو جاء و بيقول لي
+
+82
+00:04:59,470 --> 00:05:05,790
+معلش و انت عمالك بنتك تسأل لسه بدك تسأل المريض خل
+
+83
+00:05:05,790 --> 00:05:10,270
+المريض يرتاح لك خليه يشعر ان انت هتكتم أسراره خليه
+
+84
+00:05:10,270 --> 00:05:13,810
+يشعر انه في ثقة لما يشعر المريض انه في ثقة و انك
+
+85
+00:05:13,810 --> 00:05:17,810
+هتكتم أسراره هيعطيك المعلومات لو شعر انه في مشكلة
+
+86
+00:05:17,810 --> 00:05:21,290
+انه من كلماته اللي هيحكيهاو احنا يعني هاللي هيطلع
+
+87
+00:05:21,290 --> 00:05:26,770
+أسراره برا مش هيقدر يعطينا طيب working phase مرحلة
+
+88
+00:05:26,770 --> 00:05:29,930
+ال working phase اللي the nurse ايه هنا must
+
+89
+00:05:29,930 --> 00:05:35,470
+listen and observe cues cues معناة التلميحات شو
+
+90
+00:05:35,470 --> 00:05:38,750
+يعني يعني in addition to using critical thinking
+
+91
+00:05:38,750 --> 00:05:42,710
+يعني يستخدم التفكير العميق التفكير اللي هو احنا
+
+92
+00:05:42,710 --> 00:05:47,670
+بنقول عالم العصف الديني تتخلى عندك يعني أفق واسع
+
+93
+00:05:47,670 --> 00:05:51,520
+في التفكيرand to validate يعني بقولك validate عشان
+
+94
+00:05:51,520 --> 00:05:54,160
+تتحقق من ال information received from the client
+
+95
+00:05:54,160 --> 00:05:57,800
+شو صار معنى هذا الكلام؟ معنى هذه الفقرة كلها اللي
+
+96
+00:05:57,800 --> 00:06:00,820
+قدامكوا بتقول ماعنش هو ال mouse ما بعرف أشي
+
+97
+00:06:00,820 --> 00:06:06,280
+المشكلة بقوللي هنا أن أثناء ال working phase دائما
+
+98
+00:06:06,280 --> 00:06:12,360
+الممرض أو الطالب لازم يسمع و في نفس الوقت يلاحظ
+
+99
+00:06:12,360 --> 00:06:15,660
+التلميحات اللي موجودة على جسد المريض و يستخدم
+
+100
+00:06:15,660 --> 00:06:18,400
+الفكر المنطقي عنده عشان يحكم على المعلومات كيف
+
+101
+00:06:18,400 --> 00:06:22,810
+يعني؟افرط المريض يقعد بتكلم بيقول لأ انا ما .. انت
+
+102
+00:06:22,810 --> 00:06:26,470
+بتقوله طب هل في عندك وجع؟ هو خايف يحكي انه عنده
+
+103
+00:06:26,470 --> 00:06:30,730
+وجع عشان مايروحش على العمليات فهو بتقوله في عندك
+
+104
+00:06:30,730 --> 00:06:34,330
+ألم؟ يقول لأ انا ماعنديش ألم لكن قصامات وجهه وجسمه
+
+105
+00:06:34,330 --> 00:06:38,090
+إيديه وحركته كلها بتدل انه في ألم طيب أصدق هنا
+
+106
+00:06:38,090 --> 00:06:41,270
+مين؟ أصدق الكلام اللي سمعته؟ ولا أصدق ال body
+
+107
+00:06:41,270 --> 00:06:44,730
+language؟ لأ ال body language more accurate than
+
+108
+00:06:44,730 --> 00:06:47,970
+verbal languageدائما اذكر هذا الكلمة ال body
+
+109
+00:06:47,970 --> 00:06:52,390
+language more accurate than verbal language انا
+
+110
+00:06:52,390 --> 00:06:56,110
+بصدق التلميحات حتى لما احنا نتكلم مع بعض احنا
+
+111
+00:06:56,110 --> 00:07:00,150
+انتوا كطلاب و زملاء مع بعض او حتى في البيوت يعني
+
+112
+00:07:00,150 --> 00:07:05,530
+ممكن الواحد يتكلم كلمة مع الآخر لكن يروح يعطي يعني
+
+113
+00:07:05,530 --> 00:07:11,750
+حركات او كده تغير المسار تبع الكلام فبخلنا لأ نصدق
+
+114
+00:07:11,750 --> 00:07:15,430
+الحركات وهذا خدناه في ال psychology لما ايام احنا
+
+115
+00:07:15,430 --> 00:07:20,200
+طرحناموضوع الطفل لما الوالد كان يحكيله شيء و يعمله
+
+116
+00:07:20,200 --> 00:07:25,600
+إيماءات بشيء تاني فبنفعش لازم احنا نقرن و نعرف أيش
+
+117
+00:07:25,600 --> 00:07:29,660
+اللي بيصير موجود قدام المريض قدامنا طيب the nurse
+
+118
+00:07:29,660 --> 00:07:33,180
+identify clients problems and goals لازم و احنا
+
+119
+00:07:33,180 --> 00:07:37,360
+بنسمع في البداية نحدد ال clients problems ايش
+
+120
+00:07:37,360 --> 00:07:40,580
+مشكلات المريض اللي موجود عندهوش الأهداف اللي بدي
+
+121
+00:07:40,580 --> 00:07:43,860
+أعملها يعني و أنا قاعد بسمع في ال interview بيجيني
+
+122
+00:07:43,860 --> 00:07:46,460
+دغري في ذهني ان انا اه في مشكلة مهمة زي ما بيجي
+
+123
+00:07:46,460 --> 00:07:49,940
+الطبيب الآن بيجي بقوله ايش أخبارك اتفضل بقعد يحكي
+
+124
+00:07:49,940 --> 00:07:54,500
+فالطبيب الشاطر و الأخصائي هو عماله بيحكي المريض
+
+125
+00:07:54,500 --> 00:07:57,420
+بيبقى على شجة كاتب يعني هو قاعد بقوله مثلا بقوله
+
+126
+00:07:57,420 --> 00:08:00,380
+انا الي اربع أيام بروح على الحمام يبقى
+
+127
+00:08:00,380 --> 00:08:03,800
+constipation بكتب مش عارف مرات انا بدوخ بكتب كلمة
+
+128
+00:08:03,800 --> 00:08:08,540
+مثلا cinco او بكتب مثلا كلمة vertigo او اي شيءعشان
+
+129
+00:08:08,540 --> 00:08:11,920
+يعرف انه ايش عشان بعدين نعود نرجع لها طيب
+
+130
+00:08:11,920 --> 00:08:16,060
+termination phase ال termination phase هنا ايش
+
+131
+00:08:16,060 --> 00:08:21,420
+يعني انا خلصت جيت اول حاجة introductory قدمت نفسي
+
+132
+00:08:21,420 --> 00:08:26,240
+working بدت اشتغل و لسه احنا كمان هنشرحه اكتر في
+
+133
+00:08:26,240 --> 00:08:31,320
+القادم يعني طب termination كيف بدني انا خلصت الان
+
+134
+00:08:31,320 --> 00:08:34,080
+اخدت معلومات كتيرة اول حاجة اللي بيقوللي nurse
+
+135
+00:08:34,080 --> 00:08:36,760
+summarizes information obtained during the working
+
+136
+00:08:36,760 --> 00:08:41,070
+phaseSamarais يعني اختصر، يلخص على الطالب الشاطر
+
+137
+00:08:41,070 --> 00:08:44,670
+انه بعد ما ياخد المعلومات، المريض بيعطيك معلومات
+
+138
+00:08:44,670 --> 00:08:48,090
+كبيرة وكتيرة لازم انت تلخص، مانفعش عشان ايه لما
+
+139
+00:08:48,090 --> 00:08:51,270
+كان يطلب منك الأستاذ مرات في .. في بداية السنة
+
+140
+00:08:51,270 --> 00:08:54,350
+الأولى، كان يقولك ايه بتقدر تعملي تقرير عن مريض
+
+141
+00:08:54,350 --> 00:08:58,630
+معين؟ طبعا كل يوم لما نروح نتدرب، هينطلب منه في
+
+142
+00:08:58,630 --> 00:09:01,730
+سنة تانية نعمل حاجة daily اسمه daily clients
+
+143
+00:09:01,730 --> 00:09:06,480
+report يعني تقرير يومي عن حالة المريضبتبدأ مثلا my
+
+144
+00:09:06,480 --> 00:09:10,420
+patients او my clients name كده و كده مش بزيك
+
+145
+00:09:10,420 --> 00:09:13,560
+admitted since كده diagnosed as كده treatment
+
+146
+00:09:13,560 --> 00:09:17,480
+بتتكلم على انه حاجات كتيرة لان مابتروح على المريض
+
+147
+00:09:17,480 --> 00:09:22,080
+بتلاقي بيحكي كتير الحاجة الكتيرة ده مش شرط ناخده
+
+148
+00:09:22,080 --> 00:09:25,260
+كل كلامه انا اللي بيهمني في الآخر حاجة بيسموها
+
+149
+00:09:25,260 --> 00:09:28,560
+scientific information المعلومات العلمية and its
+
+150
+00:09:28,560 --> 00:09:31,720
+relation و المتعلقات بيها يعني ده لاجينا في حاجة
+
+151
+00:09:31,720 --> 00:09:36,320
+مهمة متعلقةحتى لو كانت مش علمية لو ناجينا معلومة
+
+152
+00:09:36,320 --> 00:09:39,580
+متعلقة بشي علمي بحطها يبقى معناته في ال
+
+153
+00:09:39,580 --> 00:09:43,880
+termination أول حاجة بلخص اللي أنا أخدته من المريض
+
+154
+00:09:43,880 --> 00:09:47,920
+اتنين validate problems and goals with the client
+
+155
+00:09:47,920 --> 00:09:52,600
+validية هنا معناته التحق يعني فيها مصداقية بتأكد
+
+156
+00:09:52,600 --> 00:09:55,540
+مش احنا كنا و احنا بنسمع بنحط مشاكل و بنحط أهداف
+
+157
+00:09:55,540 --> 00:10:00,220
+جينا بنخلصه ابنعرف هل المشاكل كلها بتديها هل
+
+158
+00:10:00,220 --> 00:10:04,300
+الأهداف كلها بتديها ولا بتختصربنقر على قبل ما اقوم
+
+159
+00:10:04,300 --> 00:10:07,700
+من عند المريض عشان انا اتأكد عشان اقعد اصيغن في ال
+
+160
+00:10:07,700 --> 00:10:11,720
+care plan تلاتة making plans يبقى بعدها ايش بروحنا
+
+161
+00:10:11,720 --> 00:10:15,420
+بنعمل الخطة ليش بنعمل خطة to resolve the problems
+
+162
+00:10:15,420 --> 00:10:20,220
+شوفت لاحظته انا بعملش الخطة مباشرة اول ما اسمع عن
+
+163
+00:10:20,220 --> 00:10:24,580
+المريض وهذا باكد دائما انه دائما ال plan بتيجي بعد
+
+164
+00:10:24,580 --> 00:10:28,240
+ما يصير عندك معلومات وافية وكافية بعد ما نعمل ال
+
+165
+00:10:28,240 --> 00:10:31,020
+plan بنخش شوية بيصير عندنا ال science و ال
+
+166
+00:10:31,020 --> 00:10:33,640
+symptomsو ال nursing diagnosis و ال problem و
+
+167
+00:10:33,640 --> 00:10:37,780
+بعدين بنخش ال action لما نصل ال evaluation طيب
+
+168
+00:10:37,780 --> 00:10:43,840
+communication techniques during interview ايش
+
+169
+00:10:43,840 --> 00:10:47,820
+الطرق او الطرق او القاليات او التقنيات اللى بدي
+
+170
+00:10:47,820 --> 00:10:51,340
+استخدمها في ال interview اول حاجة بدي استخدمها بدي
+
+171
+00:10:51,340 --> 00:10:54,320
+اركز على ال types of questions types of questions
+
+172
+00:10:54,320 --> 00:10:58,870
+انواع ايه انواع الاسئلةأنواع الأسئلة إذا بتلاحظوا
+
+173
+00:10:58,870 --> 00:11:01,310
+في تلات أنواع إذا بتلاحظوا معايا في تلات أنواع
+
+174
+00:11:01,310 --> 00:11:05,330
+خلينا نمشي شوية شوية أول حاجة النوع الأول اسمه
+
+175
+00:11:05,330 --> 00:11:10,210
+open إيش يعني open؟ open ended questions فيه سموها
+
+176
+00:11:10,210 --> 00:11:13,530
+أسئلة مفتوحة يبقى معناته أن في أسئلة مفتوحة بدي
+
+177
+00:11:13,530 --> 00:11:16,370
+أسألها للمريض to assess the client's feelings يبقى
+
+178
+00:11:16,370 --> 00:11:21,110
+الأسئلة المفتوحة لمن أسأل عن المشاعر زي ال what؟
+
+179
+00:11:21,110 --> 00:11:28,400
+what you know about كده what about your health؟how
+
+180
+00:11:28,400 --> 00:11:32,800
+is your health? how are كده؟ طيب which يعني أنا
+
+181
+00:11:32,800 --> 00:11:38,920
+بسأل أسئلة وباستنى زي إيش مثلا كيف أنت حاسس الألم؟
+
+182
+00:11:38,920 --> 00:11:42,780
+كيف أنت حاسس صحتك؟ كيف شعر وضعك؟ لما بدأ أسأل عن
+
+183
+00:11:42,780 --> 00:11:47,920
+أي شيء في feelings بروح باخد open question يعني له
+
+184
+00:11:47,920 --> 00:11:53,800
+نهايات يعني مستمرة ما بده أوقفها اتنين النقطة
+
+185
+00:11:53,800 --> 00:11:58,120
+التانية use closed ended questions متى؟لما بدأ
+
+186
+00:11:58,120 --> 00:12:02,220
+أسأل عن facts عن حقائق زي إيش يعني بيجي بقولي
+
+187
+00:12:02,220 --> 00:12:06,320
+القلم موجود في بطني بقوله when this pain occurred
+
+188
+00:12:06,320 --> 00:12:11,380
+أه did you مثلا والله suffer from كده لاحظين معايا
+
+189
+00:12:11,380 --> 00:12:16,700
+is there كده يعني احنا قاعدين نسأله على حقائق لما
+
+190
+00:12:16,700 --> 00:12:19,800
+بدأ أسأل على حقائق باخد closed ended questions
+
+191
+00:12:19,800 --> 00:12:25,210
+طبعا ال closed مش list لأ مش سؤال yes or no لأالـ
+
+192
+00:12:25,210 --> 00:12:28,390
+closed يعني بيعطيني جواب جملة و خلاص الجملة ده
+
+193
+00:12:28,390 --> 00:12:31,930
+بتكفيني كيف كده؟ والله واحد اتنين تلاتة لكن اذا
+
+194
+00:12:31,930 --> 00:12:35,390
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+195
+00:12:35,390 --> 00:12:39,130
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+196
+00:12:39,130 --> 00:12:40,110
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+197
+00:12:40,110 --> 00:12:40,170
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+198
+00:12:40,170 --> 00:12:40,290
+مابتدش .. مابتدش .. مابتدش .. مابتدش .. مابتدش ..
+
+199
+00:12:40,290 --> 00:12:53,910
+مابتدش .. مابتدش .. مابتدش .. مابتدش
+
+200
+00:12:53,910 --> 00:13:00,530
+..does your smoke yes or no لما اقوله والله is
+
+201
+00:13:00,530 --> 00:13:04,550
+there a change in your weight yes or no هلجيت
+
+202
+00:13:04,550 --> 00:13:08,110
+بيجيب اعطاني مثال زي ما انتوا شايفين بقول is pain
+
+203
+00:13:08,110 --> 00:13:13,350
+severe هل القلم عندك حد ولا dull ولا حاسب ثقل ولا
+
+204
+00:13:13,350 --> 00:13:17,650
+sharp حاسس اشي كأنه بيطعن ان احنا بنسألهان سؤال
+
+205
+00:13:17,650 --> 00:13:21,190
+yes or no يعني كلمة بيعلمليها زي موضوع ال list
+
+206
+00:13:21,190 --> 00:13:24,990
+بيذكرنا بايش موضوع الاستبانات اللي مرات بنقدمهاإنه
+
+207
+00:13:24,990 --> 00:13:29,050
+بيجيب يعطينا أسئلة و احنا بنختار مالناش يعني احنا
+
+208
+00:13:29,050 --> 00:13:34,170
+رأي نقعد نناقش فقط أنا بختار من الموجود يعني إما
+
+209
+00:13:34,170 --> 00:13:39,010
+إجابة من متغيرين أو من إجابتين أو من تلاتة أو يعني
+
+210
+00:13:39,010 --> 00:13:42,890
+شيء يختار المريض مباشرة explore all data deviated
+
+211
+00:13:42,890 --> 00:13:46,110
+from normal إيش يعني explore اكتشف أي معلومات
+
+212
+00:13:46,110 --> 00:13:49,930
+deviated جاء من كلمة deviation اللي هو كون شاذ إيش
+
+213
+00:13:49,930 --> 00:13:54,130
+يعني يعني بعيد عن الطبيعيأقصد و إحنا عمالنا قاعد
+
+214
+00:13:54,130 --> 00:13:58,770
+بنسأله أي شيء حسينا معلومة غريبة قاعد بيحكيلي إشي
+
+215
+00:13:58,770 --> 00:14:02,290
+مؤلم أو محزن يعني زي increase or decrease the
+
+216
+00:14:02,290 --> 00:14:05,950
+problem يعني افرض و هو قاعد بيحكيلينا بنقوله مثلا
+
+217
+00:14:05,950 --> 00:14:12,150
+does you smoke أنت بتدخن؟ قال yes لحاله حكالي بدخن
+
+218
+00:14:12,150 --> 00:14:18,710
+لأن والدي بدخن أعطاني معلومة أو بدخن لأن أنا عندي
+
+219
+00:14:18,710 --> 00:14:22,420
+واحد اتنين تلاتةإذا لاجينا شيء مرتبط بهذا الجواب
+
+220
+00:14:22,420 --> 00:14:27,600
+بحطه في حاجة بسموها يعني miscellaneous notes كلمة
+
+221
+00:14:27,600 --> 00:14:30,840
+miscellaneous notes يعني إيش؟ يعني إحنا بنتكلم على
+
+222
+00:14:30,840 --> 00:14:35,520
+ملاحظات إضافية بنكتبها عشان يعرف الطبيب إن المشكلة
+
+223
+00:14:35,520 --> 00:14:38,540
+اللي موجودة عند المريض مش إنها أجت هيك من راسه، لأ
+
+224
+00:14:38,540 --> 00:14:43,860
+في إيش بنكد عليه types of statements to use أنواع
+
+225
+00:14:43,860 --> 00:14:47,340
+الجمال اللي بنستخدمها أول حاجة clarify information
+
+226
+00:14:47,340 --> 00:14:51,010
+and encourage verbalizationواضح المعلومات للمريض
+
+227
+00:14:51,010 --> 00:14:55,770
+clarify ما تحطش معلومات don't use vague .. اه
+
+228
+00:14:55,770 --> 00:15:02,730
+don't use vague terms لا تستخدم مصطلحات غامضة and
+
+229
+00:15:02,730 --> 00:15:05,630
+don't use scientific terms و لا تستخدم مصطلحات
+
+230
+00:15:05,630 --> 00:15:09,190
+علمية بنفعش و احنا عاملنا نيجي عن المريض و هذا
+
+231
+00:15:09,190 --> 00:15:13,990
+حصلت من باب الطرفة بيجي بيقول للمريض معلش والله
+
+232
+00:15:13,990 --> 00:15:16,590
+انا بدي اخدك ال vital signs يا ساتر يا رب ايش
+
+233
+00:15:16,590 --> 00:15:20,900
+تاخدني؟ انا كبريش فين؟فهو بيكون انا مش فاهم فاحنا
+
+234
+00:15:20,900 --> 00:15:24,240
+دائما بدنا نستخدم normal words يعني الكلمات اللي
+
+235
+00:15:24,240 --> 00:15:27,900
+بيفهمها المريض and encourage verbalization شجع
+
+236
+00:15:27,900 --> 00:15:32,100
+المريض انه يتكلم خليه يحكي طيب accept the client
+
+237
+00:15:32,100 --> 00:15:36,100
+use silence to recognize thoughts ايش يعني هنا
+
+238
+00:15:36,100 --> 00:15:42,740
+accept هو بيقولي خلي المريض يهدا شوية و ينظم
+
+239
+00:15:42,740 --> 00:15:45,720
+أفكاره يعني افرضوا احنا مانا قاعدين نحكي المريض
+
+240
+00:15:45,720 --> 00:15:50,750
+شوية راح بعيدفانت بتقول لأ انا سألتك عن مثلا الألم
+
+241
+00:15:50,750 --> 00:15:55,590
+الفلاني انت على مهل بس انت ركز و جاوبني لما تقوله
+
+242
+00:15:55,590 --> 00:15:59,290
+ركز و جاوبني بروح المرض بستجمع كل أفكاره بيعطيه
+
+243
+00:15:59,290 --> 00:16:02,270
+كيش بداية الكلام طبعا انا اللي بدي اقوله في هذا ال
+
+244
+00:16:02,270 --> 00:16:05,550
+band انه مانضلناش نقاطع المريض و احنا بقاعدين نسأل
+
+245
+00:16:05,550 --> 00:16:08,610
+في ال interview و هذا يمكن احسن ميزة موجودة عند
+
+246
+00:16:08,610 --> 00:16:11,330
+التمريد اللي بيفهم انه دايما مايقاطعش يعني بدأ
+
+247
+00:16:11,330 --> 00:16:15,720
+المريض يحكيما نستناشي انا مش جاي انا احسب على نفسي
+
+248
+00:16:15,720 --> 00:16:19,100
+هو يحكي اكتر ولا انا احكي لأ انا جاي لمساعدة
+
+249
+00:16:19,100 --> 00:16:22,880
+المريض خليه يتكلم و انا بسجل لما هو ينتهي انا ببدأ
+
+250
+00:16:22,880 --> 00:16:28,120
+اربعة avoid some communication styles ابعد عن
+
+251
+00:16:28,120 --> 00:16:34,020
+نماذج في آليات التواصل و في آليات المقابلة و آليات
+
+252
+00:16:34,020 --> 00:16:38,720
+التعامل مع المريض حسب التالي اش اول حاجة excessive
+
+253
+00:16:38,720 --> 00:16:43,260
+or not enough eye contactيعني انا مابدي اتطالب لمن
+
+254
+00:16:43,260 --> 00:16:47,400
+ياخد يعني عماله بتطلع في المريض و بسمعله مابدي
+
+255
+00:16:47,400 --> 00:16:51,540
+يعني لا يتطلع زيادة عن اللزوم ولا .. اه ولا
+
+256
+00:16:51,540 --> 00:16:55,440
+مايتطلعش بالمرة كيف يعني؟ يعني افرض المريض قاعد
+
+257
+00:16:55,440 --> 00:16:59,160
+عمالي بيحكي و احنا بيحكي مركزين فيه فجأة لجيت حاجة
+
+258
+00:16:59,160 --> 00:17:02,480
+سارحان انا و انا قاعد نركز فيه ففجأة هو المريض
+
+259
+00:17:02,480 --> 00:17:06,360
+بيقوللي مالك بتطلع فيه زي هيك اتخاف المريض او
+
+260
+00:17:06,360 --> 00:17:11,100
+عمالك هو قاعد بيحكي انت مطمن راسك في الجوالأو حاطض
+
+261
+00:17:11,100 --> 00:17:15,080
+معاك ويا جلام ايوة ايوة فاهم عليك و بتهز راسك حتما
+
+262
+00:17:15,080 --> 00:17:18,140
+هيقولك يا عم مالك انت يعني انت بتسمعليش انت بتنشني
+
+263
+00:17:18,140 --> 00:17:21,080
+حتى احنا لما نحكي مع بعض بنقول للواحد اتطلع فيه
+
+264
+00:17:21,080 --> 00:17:24,640
+يركز معاه اللي بده اقول هنا يعني لا .. يعني احنا
+
+265
+00:17:24,640 --> 00:17:29,720
+لا بدناش يزيد يخل يعني ولا قليل مل يعني اللي بده
+
+266
+00:17:29,720 --> 00:17:34,080
+اقوله باختصار انه نتطلع لما يحكي المريض و لما يبطل
+
+267
+00:17:34,080 --> 00:17:37,860
+يحكي خلاص برفع عينيطبعا و خاصة بدناش لأن بعض
+
+268
+00:17:37,860 --> 00:17:41,720
+المرضى يفهمها خاطئ كأنه التحديق بالعين كأنه أنت
+
+269
+00:17:41,720 --> 00:17:45,980
+يعني عمالك يعني منبهر بكلامه أو بتسمع أو مستغرب أو
+
+270
+00:17:45,980 --> 00:17:50,620
+مستهجر فبدناش يصل لهيك مرحلة المريض النجمة ال ..
+
+271
+00:17:50,620 --> 00:17:54,180
+ال .. الاخر شيء هذه النقطة بتقوللي إيش هنا؟ بقوللي
+
+272
+00:17:54,180 --> 00:17:57,900
+حاول تبعد عن إيش doing .. doing anything during
+
+273
+00:17:57,900 --> 00:18:01,160
+إيش history during getting history بقوللي يعني
+
+274
+00:18:01,160 --> 00:18:05,460
+يريد تبعد عن أنك تعمل أي شيء و أنت بتاخد إيشيعني
+
+275
+00:18:05,460 --> 00:18:08,640
+بتاخد معلومات من المريض، زي كيف، يعني مانفعش ان
+
+276
+00:18:08,640 --> 00:18:11,860
+انا قاعد باسأله او كيف انت امرك و ان شاء الله يعني
+
+277
+00:18:11,860 --> 00:18:15,480
+ربني ايش فيك و ماسك الجوال و عمالي بلعب حي و سلم و
+
+278
+00:18:15,480 --> 00:18:19,220
+لا عمالي .. اصلا في مثلا لاجيت نت و عمالي فتحتلي
+
+279
+00:18:19,220 --> 00:18:22,220
+اي game و لا عمالي براجع الواتس أو براجع الفيس أو
+
+280
+00:18:22,220 --> 00:18:28,400
+..هذا الوقت مخصص للمريض مجرد ما انت تبدأ حاول انت
+
+281
+00:18:28,400 --> 00:18:32,360
+تحط الجوار تحط كل أغراضك في جيبتك عشان تبدأ تركز
+
+282
+00:18:32,360 --> 00:18:37,540
+مع المريض و هو يحس انه انت منتبهله كويس طيب based
+
+283
+00:18:37,540 --> 00:18:41,420
+يعني biased او biased يعني منحاز او leading
+
+284
+00:18:41,420 --> 00:18:45,720
+questions او السؤال اللي بيقود للإجابة بقول ابعد
+
+285
+00:18:45,720 --> 00:18:50,160
+عنه يعني انا بقول ما تستخدم don't use biased or
+
+286
+00:18:50,160 --> 00:18:54,570
+leading questions ما تستخدم الأسئلةاللي بتأدي
+
+287
+00:18:54,570 --> 00:18:59,350
+للجواب، ايش قصدك يا أستاذ؟ اعطيك مثال، الان مانفعش
+
+288
+00:18:59,350 --> 00:19:02,750
+تيجي تقول المريض you don't feel bad، انت اكيد مش
+
+289
+00:19:02,750 --> 00:19:07,690
+يعني .. انت مش شعر انك سيء، انت كويس، لأ مانفعش،
+
+290
+00:19:07,690 --> 00:19:12,670
+او اجي اقوله اكيد بتحب انت أكل المطبخ صح؟ لأ
+
+291
+00:19:12,670 --> 00:19:16,770
+مانفعش، افرض انا جاعة بسأله عن ال psycho، انا واحد
+
+292
+00:19:16,770 --> 00:19:20,870
+من الناس مثلا شاب زهجان من غزة و نفسيتي متعبة،
+
+293
+00:19:20,870 --> 00:19:23,980
+مانفعش اسقطه على المريضأجى أقوله يقوله كيف أنت
+
+294
+00:19:23,980 --> 00:19:28,320
+حاسس الأمور؟ أكيد أزاي حالاتي، بنفعش هذا اسمه
+
+295
+00:19:28,320 --> 00:19:32,320
+biased and leading سؤال بيعمل تحيز و بقدر الجواب
+
+296
+00:19:32,320 --> 00:19:36,720
+هذا بدنا نكون حاذرين منه، تمام؟ اللي بعده don't
+
+297
+00:19:36,720 --> 00:19:40,620
+relying on memory to recall information relying
+
+298
+00:19:40,620 --> 00:19:44,360
+تعتمد، لا تعتمد على الذاكر عشان تتذكر المعلومات
+
+299
+00:19:44,360 --> 00:19:47,520
+يعني أتمنى على الجميع و أنت بتاخد .. احنا يمكن
+
+300
+00:19:47,520 --> 00:19:52,320
+نختلف على طبها على طبها، بمر على خمس، ست مرضىويمكن
+
+301
+00:19:52,320 --> 00:19:55,260
+مرات بينسى لدرجة انه حتى ممكن بعد ما يخلص المرور
+
+302
+00:19:55,260 --> 00:19:58,480
+هتتذكره معاه لما تروح المستشفى تتذكر الكلمات هذه
+
+303
+00:19:58,480 --> 00:20:04,800
+بيبدأ يكتب بعض العلاجات لمريض فلاني وخروج للمريض
+
+304
+00:20:04,800 --> 00:20:09,200
+العلاني ممكن ينسى بيصير يقول للحكيم طيب المريض
+
+305
+00:20:09,200 --> 00:20:12,140
+اللي احنا شكى من كده بيصير يقوله اه اه اللي كان
+
+306
+00:20:12,140 --> 00:20:15,180
+جنب الشباك او اللي كان في المصر احنا ممكنش نكون
+
+307
+00:20:15,180 --> 00:20:19,220
+صحيحاحنا أول بول دائما علمونا و هنروح المستشفى
+
+308
+00:20:19,220 --> 00:20:22,520
+نشوف أنه أول بول كل ما تصير معلومة عن المريض
+
+309
+00:20:22,520 --> 00:20:26,000
+بكتبها ليه؟ ماعتمدش على الذاكرة لأنه أنا طول
+
+310
+00:20:26,000 --> 00:20:30,220
+النهار هكون مع مرضاه هنسأت عملت مع هانا و مع هانا
+
+311
+00:20:30,220 --> 00:20:33,980
+أستاذ اتكلم معايا و طالب زميل يتكلم فالإنسان سبحان
+
+312
+00:20:33,980 --> 00:20:39,340
+الله بينسى خمسة specific age variations بدنا نكون
+
+313
+00:20:39,340 --> 00:20:44,500
+حارسين جدا في التغييرات اللي بتصيريعني أمامي من
+
+314
+00:20:44,500 --> 00:20:46,840
+المرضى مش كل المرضى بده استخدم نفس الطريقة
+
+315
+00:20:46,840 --> 00:20:50,020
+بالأسئلة ولا نفس الطريقة بالتلميحات ولا نفسي يعني
+
+316
+00:20:50,020 --> 00:20:53,700
+مش معقول يعني معقول الصغير زي الكبير لأ طبعا يعني
+
+317
+00:20:53,700 --> 00:20:57,280
+معقول واحد بده يختلف في يعني مثلا ما بيصير عندي او
+
+318
+00:20:57,280 --> 00:21:00,520
+male زي ال female لأ يمكن انا اكون male و بده اخد
+
+319
+00:21:00,520 --> 00:21:03,380
+مثلا history من female و ال female مش ستة كبيرة
+
+320
+00:21:03,380 --> 00:21:06,920
+يعني انا صغيرة في السن في أسئلة مابقدرش اسألها و
+
+321
+00:21:06,920 --> 00:21:10,160
+كذلك نعكسها يمكن انا female و راحت الطالبة بده
+
+322
+00:21:10,160 --> 00:21:12,910
+تاخد مثلا historyواللي قدامي مش كبير في الأعمار
+
+323
+00:21:12,910 --> 00:21:16,450
+يعني صغير برضه في أسئلة مابتنساه يبقى احنا بنكون
+
+324
+00:21:16,450 --> 00:21:20,570
+حاذرين هذه بيسموها variation culture وفي variation
+
+325
+00:21:20,570 --> 00:21:23,350
+age يعني كمان اختلاف في ال age و الأعمار خليني
+
+326
+00:21:23,350 --> 00:21:26,370
+أشوف أول حاجة ال pediatric clients ال pediatric
+
+327
+00:21:26,370 --> 00:21:30,810
+clients الآن في الأطفال ايش بينام طب أخدنا معلومات
+
+328
+00:21:30,810 --> 00:21:34,210
+هل دائما الطفل صادق طب في مرات الطفل مش عارف أسأله
+
+329
+00:21:34,210 --> 00:21:37,630
+يمكن الطفل عمره سنتين يمكن عمره تلاتة يمكن عمره
+
+330
+00:21:37,630 --> 00:21:41,820
+أربعة بيكلمني هل كل معلوماته صادقة؟ لأانا حاجة
+
+331
+00:21:41,820 --> 00:21:45,400
+بدنا نقولكن دايما نذكركن ان في ال pediatric يعني
+
+332
+00:21:45,400 --> 00:21:51,360
+دايما ال clients بتلاقي بطبيعتهم يكذبوا، يعني ال
+
+333
+00:21:51,360 --> 00:21:54,300
+lying هذا او الكذب ما بقدر اعتبره يعني شغل مرضى،
+
+334
+00:21:54,300 --> 00:21:58,000
+لأ الولد الطفل دايما خياله واسع، يمكن بكذب عشان
+
+335
+00:21:58,000 --> 00:22:01,020
+خايف من الإبرة، يمكن بكذب عشان ماتعطوهش يعني
+
+336
+00:22:01,020 --> 00:22:05,040
+علاجات معينةلكن احنا بناخد عشان احنا نكبر شأن
+
+337
+00:22:05,040 --> 00:22:08,660
+الطفل و نبسط منه لما خاصة نروح نتدرب و نلاقي
+
+338
+00:22:08,660 --> 00:22:12,440
+قدامنا طفل بسأله لكن لو بدي اتأكد من المعلومات
+
+339
+00:22:12,440 --> 00:22:16,200
+منهم باتأكد منها باتأكد من ال parents اللي موجودين
+
+340
+00:22:16,200 --> 00:22:19,740
+معاه زي الأم اذا كانت موجودة او زي الأب ليه لا
+
+341
+00:22:19,740 --> 00:22:23,280
+يمكن الأم او الأب يكذبوا او مثلا مايحكوش الحقيقة
+
+342
+00:22:23,280 --> 00:22:27,020
+لإن هم جايين ليش و هي جاية تعالج ابنها ليش فاحنا
+
+343
+00:22:27,020 --> 00:22:29,920
+بنأكد المعلومات منها أخدنا معلومات من الطفل
+
+344
+00:22:29,920 --> 00:22:33,830
+بنأكدها من الأم او من اللي حواليهمن العائلة طب في
+
+345
+00:22:33,830 --> 00:22:37,930
+ال geriatric مش معقول اروح اكل زي الأطفال ال
+
+346
+00:22:37,930 --> 00:22:41,930
+geriatric يعني راجل اختيار او ست عجوز طالع نفس
+
+347
+00:22:41,930 --> 00:22:45,110
+السن بنفع نقوله معلش ولا بتتأكد ما هو برضه نفس
+
+348
+00:22:45,110 --> 00:22:49,550
+القضية الانسان ممكن صار عنده Alzheimer يمكن صار
+
+349
+00:22:49,550 --> 00:22:54,470
+عنده frequent forgetting يعني بضل ينسى بضل ينسى طب
+
+350
+00:22:54,470 --> 00:22:56,930
+ايش بده اعمل؟ بده نستخدم هنا simple words كلمات
+
+351
+00:22:56,930 --> 00:23:00,730
+بسيطة and assess hearing equity equity يعني ايش
+
+352
+00:23:00,730 --> 00:23:03,560
+هنا؟حدة السماعة زي ما نقول visual equity يعني لما
+
+353
+00:23:03,560 --> 00:23:06,820
+كنا ناخدها نقول visual equity يعني حدة إيش النظر
+
+354
+00:23:06,820 --> 00:23:10,880
+طب hearing equity حدة السماعة بدنا نتأكد أنه
+
+355
+00:23:10,880 --> 00:23:15,120
+سامعني الحاج ولا لأ مانفعش نتكلم معاه بنفس النبرة
+
+356
+00:23:15,120 --> 00:23:17,960
+اللي كنا نتكلم بيها مع اللي أصغر في بعض العجاز
+
+357
+00:23:17,960 --> 00:23:21,840
+بتيجي تقولهم كيف حالك يا حاجة بقولك أنا عارف والله
+
+358
+00:23:21,840 --> 00:23:25,780
+امبارح لما أجوا ناس علي مش فاهم أيه السؤالك كتير
+
+359
+00:23:25,780 --> 00:23:29,750
+من الناس خاصة الأكبار السن لما نبطل يسمعبيخجل
+
+360
+00:23:29,750 --> 00:23:33,510
+يقولك انا مسمعش، بيصير يعطيك جواب تاني، يعني انت
+
+361
+00:23:33,510 --> 00:23:36,530
+ممكن تسأله ممكن حتى تضحك انت، ليه؟ انت بتسأله في
+
+362
+00:23:36,530 --> 00:23:41,150
+شيء هو عامله ايش، يعني انت بتقوله مثلا كيف ان شاء
+
+363
+00:23:41,150 --> 00:23:44,870
+الله أمورك كويسة، روح يفهمها كأنه انت بتقوله يعني
+
+364
+00:23:44,870 --> 00:23:48,830
+حاجة تانية، يعني بيصير جوابك في أمور تانية، فعشان
+
+365
+00:23:48,830 --> 00:23:51,950
+هيك بدنا نتأكد انه بيسمع كويس و في نفس الوقت
+
+366
+00:23:51,950 --> 00:23:57,090
+نستخدم كلمات بسيطة هو يفهمهامش تنيجة .. معلش يا
+
+367
+00:23:57,090 --> 00:23:59,470
+حاجة احنا جايين من كلية التمريد بالجامعة الإسلامية
+
+368
+00:23:59,470 --> 00:24:03,630
+نريد أن ناخد منها كده، هيقولك في الآخر معلش والله
+
+369
+00:24:03,630 --> 00:24:07,010
+أنا مش سامعك يا ابني و ترجملييفكر انك بتحكي ايش
+
+370
+00:24:07,010 --> 00:24:11,490
+لغة ايش هنا كأنك بتحكي لغة يعني مش عربية علشان هيك
+
+371
+00:24:11,490 --> 00:24:14,810
+لأ الحج بده لغة تانية اه يا حج الله يعطيك الصحة
+
+372
+00:24:14,810 --> 00:24:17,850
+كيف أمورك ان شاء الله انت كويس ما تقلق يا والدي ما
+
+373
+00:24:17,850 --> 00:24:20,450
+تقلق يا أمي و ما تقلق يا كلمات ما تقلق يا ماما
+
+374
+00:24:20,450 --> 00:24:24,130
+يعني الأمر هذا بيعطيه نوع من الاش القريحية يعني
+
+375
+00:24:24,130 --> 00:24:29,090
+حتى هو بيصير يقدر يعطيك المعلومات طيب emotional
+
+376
+00:24:29,090 --> 00:24:32,270
+variations شو يعني emotional variations اللي هي
+
+377
+00:24:32,270 --> 00:24:36,780
+اختلافات العواطف كيف يعنيالان مش كل مرضى زي بعض
+
+378
+00:24:36,780 --> 00:24:39,620
+لازم نحترم العواطف اللى موجودة عند المرضى اللى
+
+379
+00:24:39,620 --> 00:24:42,820
+أمامنا افرض المرضى اللى قدامنا angry يعني جينا
+
+380
+00:24:42,820 --> 00:24:47,600
+جينا لجينا مرض لحاله بقول انا عارف المستشفى و
+
+381
+00:24:47,600 --> 00:24:50,940
+حاسبي الله عليه و حاسبي على الطب يعني هنا ايش بقول
+
+382
+00:24:50,940 --> 00:24:54,660
+you must be calm ايش يعني calm؟ خليك عطوف خليك
+
+383
+00:24:54,660 --> 00:24:59,220
+هادي انت خليك عندك نوع من دفء المشاعر عندك ايه
+
+384
+00:24:59,220 --> 00:25:01,980
+يعني ماتجيش واحد قاعد بقولحاسس بيه الله على
+
+385
+00:25:01,980 --> 00:25:05,560
+المستشفى و الله يجعله مثلا يتدمر تقول الله لا يرده
+
+386
+00:25:05,560 --> 00:25:10,280
+و ينحرق كمان للأسف في بعض الطلاب أنا سمعت شغلات
+
+387
+00:25:10,280 --> 00:25:14,160
+زيك أمر غريب انت قاعد بتنجل إحباطك على المرضى حتى
+
+388
+00:25:14,160 --> 00:25:17,800
+لو عندك مئة إحباط مهنتك إنسانية مهنتك اللي انت جيت
+
+389
+00:25:17,800 --> 00:25:20,700
+عليها هادف فيها يعني الله سبحانه وتعالى بتبركلك
+
+390
+00:25:20,700 --> 00:25:24,760
+فيها فما بينفع دغري هيك مباشرة كأننا نساعد يبقى
+
+391
+00:25:24,760 --> 00:25:27,800
+نكون اللي ماناشي نساعد المرضى على الشر ولا على
+
+392
+00:25:27,800 --> 00:25:32,420
+الغضب طب مش بس هيك افرض اناواحد anxious يعني جلجان
+
+393
+00:25:32,420 --> 00:25:35,620
+طبعا ايش جلجان؟ والله خايف من العمليات والله حاسس
+
+394
+00:25:35,620 --> 00:25:38,200
+حالي مش حاجة بيقولوا انه الواحد بصحاش من ال bench
+
+395
+00:25:38,200 --> 00:25:40,800
+لما تقعد بحكيلي بيقولوا ان فلان والله انا جاري عمل
+
+396
+00:25:40,800 --> 00:25:44,440
+كذا او هي بتقول والله جارتي او والله جريبتي بنجوها
+
+397
+00:25:44,440 --> 00:25:47,920
+وصخيت تاني يوم هرقش من كل you must be simply شو
+
+398
+00:25:47,920 --> 00:25:52,260
+يعني simply؟ simply يعني خليك بسيط يعني لأ معلش مش
+
+399
+00:25:52,260 --> 00:25:55,220
+لها الدرجة و العلم اتطور مش لها الدرجة لأ الواحد
+
+400
+00:25:55,220 --> 00:25:58,480
+بعدين مش اول الناس انتي ولا اخها بنعطي كلمة بس
+
+401
+00:25:58,480 --> 00:26:03,090
+ماينفعش اكون simplyمع ال angry لأ يعني مانفعش واحد
+
+402
+00:26:03,090 --> 00:26:06,150
+معصب و nervous و قاعد بيقول حاسبي الله على
+
+403
+00:26:06,150 --> 00:26:10,750
+المستشفى و الله تروح تقوله والله شكلك معصب طب
+
+404
+00:26:10,750 --> 00:26:13,770
+ماحنا حاجة من جد من حد ما نحكي نقول شكلك معصب
+
+405
+00:26:13,770 --> 00:26:18,650
+هيصير يكسر الدنيا يمكن احنا نستخدم الهدوء مع الغضب
+
+406
+00:26:18,650 --> 00:26:23,470
+و البساطة مع القلق و ال interest التشوق مع المكتئب
+
+407
+00:26:23,470 --> 00:26:27,810
+كيف يعني لجينا مريض حزين و بسرعة جاوبنا هذا مكتئب
+
+408
+00:26:27,810 --> 00:26:32,140
+فهيش انا اقوله لأتجلجش و أنت كويس و ان شاء الله
+
+409
+00:26:32,140 --> 00:26:37,560
+بإذن الله حطيب و تصير تمنح و ما تخاف طيب culture
+
+410
+00:26:37,560 --> 00:26:41,640
+variations يعني اختلافات الاشي الثقافة لازم نكون
+
+411
+00:26:41,640 --> 00:26:44,240
+احنا انا the communication of self and clients اش
+
+412
+00:26:44,240 --> 00:26:47,460
+يعني في مرات بتصير اختلافات ثقافية اللي بدأوا
+
+413
+00:26:47,460 --> 00:26:53,290
+بقولكواأنا فلاح، هو مدني، أنا بدوي، هو فلاح، أنا
+
+414
+00:26:53,290 --> 00:26:56,350
+مثلا مدني، هو بدوي، بغض النظر، احنا موجودين في
+
+415
+00:26:56,350 --> 00:26:59,890
+غزة، في اختلافات ثقافية، لكن احترمين احترم ال
+
+416
+00:26:59,890 --> 00:27:03,190
+culture تبعتهم، عشان ايه دائما لاختلافات ثقافية
+
+417
+00:27:03,190 --> 00:27:07,330
+نكون حارسين و نتخيل الكلمات الواضحة اللي بيفهمها
+
+418
+00:27:07,330 --> 00:27:11,610
+المريض تمانية، you can use culture broker، اشارة
+
+419
+00:27:11,610 --> 00:27:15,520
+culture broker زي بسموها مترجمطبعا ليش مترجم؟ في
+
+420
+00:27:15,520 --> 00:27:18,940
+مرات بعض الكلمات شوية ممكن تكون احنا مافهمهاش يعني
+
+421
+00:27:18,940 --> 00:27:22,680
+مثلا أهلنا و أحبابنا مرة كان عندي .. يعني زمان كان
+
+422
+00:27:22,680 --> 00:27:26,820
+احده عند طالب بدوي قاعد بعالج .. بتعالج عنا فبقوله
+
+423
+00:27:26,820 --> 00:27:31,740
+.. كان فيه واجهة اندرسه فبقوله الطالب من إيش؟ ألف
+
+424
+00:27:31,740 --> 00:27:35,800
+سلام عليك يا حاجة من إيش الحجر هذا؟ قالله من
+
+425
+00:27:35,800 --> 00:27:41,370
+الطنيات .. من الطنيات ضربوني و عجدواالان انا فاهم
+
+426
+00:27:41,370 --> 00:27:43,810
+ايش جزده هو الطنيات يعني الأولاد الصغار و ضربوني
+
+427
+00:27:43,810 --> 00:27:48,550
+يعني ضربوني و عجدوا يعني شردوا فالان فالطالب للأسف
+
+428
+00:27:48,550 --> 00:27:51,270
+بيقوله ماعليش حاجة أنا بسألك جاوبني قاله ما أنا
+
+429
+00:27:51,270 --> 00:27:54,270
+قلتلك الطنيات ضربه قاله انا بسألك ايش صار معاك و
+
+430
+00:27:54,270 --> 00:27:56,950
+قعدت انا بقعدت ده تصير مشكلة جاء من اختيار و غضب
+
+431
+00:27:56,950 --> 00:28:00,930
+طبعا مش بحكي و كأن انا مستغرب من لغة لأ احنا كلنا
+
+432
+00:28:00,930 --> 00:28:05,010
+أهل في لغهان و في لغان .. كلنا أهل كلنا أحباب كلنا
+
+433
+00:28:05,010 --> 00:28:09,420
+مصدرنا واحد لكن سبحان الله طبيعةاللغة مراتي شويه
+
+434
+00:28:09,420 --> 00:28:12,120
+زي الموضوع اللاكنة الإنجليزية يعني الأمريكي غير
+
+435
+00:28:12,120 --> 00:28:15,640
+البريطاني غير الاندونيزي بأي غض النظر فهنا بدنا
+
+436
+00:28:15,640 --> 00:28:18,620
+نستخدم إيش هنا في بعض الحالات ممكن نلجأ نستخدم ل
+
+437
+00:28:18,620 --> 00:28:22,520
+pictures يعني صور أو reading يعني مرات او لمن هدول
+
+438
+00:28:22,520 --> 00:28:25,600
+ل non reading clients افرض يعني المريض الأمامي مش
+
+439
+00:28:25,600 --> 00:28:28,540
+فاهمني بالمرة مش قادر احنا مرات بنقوله طبعا أنا
+
+440
+00:28:28,540 --> 00:28:31,540
+بسألك عن هيك يعني كأنك بجيب غرقه أو فيها صورة أو
+
+441
+00:28:31,540 --> 00:28:35,180
+بقوله عن هيك بسألك علشان هيك لو حسنا أن المريض
+
+442
+00:28:35,180 --> 00:28:38,580
+اللي أمامي مش قادر أفهمه مش عيبه مش غلطأسهل أسأل
+
+443
+00:28:38,580 --> 00:28:42,880
+instructor أو أسأل الحكيم عن هذه طبيعة الكلام اللي
+
+444
+00:28:42,880 --> 00:28:47,220
+مش قادر يفهمني فيه خلينا نقف عند الشابتر اللي بكون
+
+445
+00:28:47,220 --> 00:28:50,100
+خلصته ان شاء الله و الدور الجاي ان شاء الله بنكمل
+
+446
+00:28:50,100 --> 00:28:54,540
+في الشابتر القادم يعني هيك عشان نلتزم في حدود
+
+447
+00:28:54,540 --> 00:28:58,780
+التلاتين دقيقة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s.srt
new file mode 100644
index 0000000000000000000000000000000000000000..52a7f7747e126c66fdacb40518e80c2808630f1c
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s.srt
@@ -0,0 +1,1941 @@
+1
+00:00:00,440 --> 00:00:04,380
+بسم الله الرحمن الرحيم اليوم إن شاء الله بدنا نبدأ
+
+2
+00:00:04,380 --> 00:00:08,160
+في الشكتر الثامن اللي هو assessment of ماذا؟
+
+3
+00:00:08,160 --> 00:00:12,200
+cardiovascular system يعني تقييم .. خلصنا التقييم
+
+4
+00:00:12,200 --> 00:00:15,260
+للجهاز التنفسي، اليوم بدنا نأخذ اللي هو التقييم
+
+5
+00:00:15,260 --> 00:00:19,300
+للجهاز الدوري اللي هو القلب والأوعية الدموية، طيب
+
+6
+00:00:19,300 --> 00:00:23,600
+أول حاجة assessment of cardiovascular system يبدأ
+
+7
+00:00:23,600 --> 00:00:26,380
+بإيه؟ بالـ objective data، زي كل مرة، إيش هي الـ
+
+8
+00:00:26,380 --> 00:00:30,470
+objective data؟ أول حاجة بدنا نسأل المريض، أسئلة أول
+
+9
+00:00:30,470 --> 00:00:32,910
+سؤال بدنا نسأله: chief complaint، شو الشكوى
+
+10
+00:00:32,910 --> 00:00:37,670
+الأساسية اللي هو بيشكيها؟ عنده chest pain؟ حاضر،
+
+11
+00:00:37,670 --> 00:00:41,670
+نيجي بنقول له: طيب وين بالظبط مكانه؟ الـ quality؟ كيف
+
+12
+00:00:41,670 --> 00:00:45,530
+كيفيته؟ duration؟  متى بدأ الألم؟ مستمر عندك؟ associated
+
+13
+00:00:45,530 --> 00:00:48,150
+symptoms؟ أيش الأعراض المتعلقة كمان معاه؟ يعني
+
+14
+00:00:48,150 --> 00:00:52,650
+أقصد هنا لما يجينا المريض،  الأساسيات للـ
+
+15
+00:00:52,650 --> 00:00:55,690
+cardiovascular system، بشكل عام، أجي أتألم من منطقة
+
+16
+00:00:55,690 --> 00:00:59,350
+صدره، وبديت أشك أنه العلاقة… الوجع هذا بقلبه،
+
+17
+00:01:00,150 --> 00:01:03,890
+بنسأله كل شيء عن هذا الألم، و هذا الوجع، وقت إيش
+
+18
+00:01:03,890 --> 00:01:05,930
+بيروح، ووقت إيش بيجي، إيش اللي بيخليه يزيد، إيش اللي
+
+19
+00:01:05,930 --> 00:01:09,570
+بيخليه… وهكذا، بعدين بشوف إيش الـ regular heart
+
+20
+00:01:09,570 --> 00:01:14,150
+beat، هل عنده عدم انتظام في دقات القلب، pounding، إيش
+
+21
+00:01:14,150 --> 00:01:18,370
+زي إيش؟ بمعنى يعني زي إيش؟ زي… زي… لما أقول كلمة
+
+22
+00:01:18,370 --> 00:01:24,620
+pounding يعني شيء زي بتjump، يعني bound، بتضرب كأنه
+
+23
+00:01:24,620 --> 00:01:29,200
+حاجة بتضغط عليه، يعني أنا أحس شيء هو بيضرب، أنا أحس
+
+24
+00:01:29,200 --> 00:01:33,480
+دقات قلبي بتضرب عليّ، كيف بتضرب عليك؟ سواء أنا
+
+25
+00:01:33,480 --> 00:01:39,260
+يعني بتحاول أقربها وأبسطها، زي أنه دقات القلب كأنه
+
+26
+00:01:39,260 --> 00:01:43,340
+زي حلقات بتحاول تضغط، حلقات بتحاول تضغط، في منها نوع
+
+27
+00:01:43,340 --> 00:01:45,480
+ثاني بيسموه too fast، بيقول لك: لأ، أنا عندي سريع في
+
+28
+00:01:45,480 --> 00:01:49,230
+الـ jumping، إيه الـ jumping؟ يعني بقول لك: أنا بحس إيه دقات قلبي
+
+29
+00:01:49,230 --> 00:01:52,830
+بنط، بنط، بحس قلبي تبعي زي اللي بفط فط هيك، و etc.
+
+30
+00:01:52,830 --> 00:01:56,750
+الآخرين: assessment of risk factors، بنسأله عن إيه
+
+31
+00:01:56,750 --> 00:02:00,870
+الـ risk factors؟ شو الـ risk factors اللي ممكن نسأل
+
+32
+00:02:00,870 --> 00:02:04,250
+عنها؟ أول حاجة عن history of hypertension، لأن مرتبط
+
+33
+00:02:04,250 --> 00:02:07,850
+ارتباط وثيق جداً بالـ cardiac problems، على اعتبار
+
+34
+00:02:07,850 --> 00:02:11,550
+أنه لما نقول كلمة ضغط الدم، يعني أوعية دموية
+
+35
+00:02:11,550 --> 00:02:17,030
+مرتبط ارتباط شامل وكامل  مع  القلب، diabetes،
+
+36
+00:02:17,030 --> 00:02:20,330
+على اعتبار أن معظم الناس اللي عندهم diabetes بيروحوا
+
+37
+00:02:20,330 --> 00:02:23,390
+إيش بتجرى معاه الـ hypertension، وممكن يصير عندها
+
+38
+00:02:23,390 --> 00:02:27,910
+secondary hypertension، بعدين نقول إيش كمان نسأل
+
+39
+00:02:27,910 --> 00:02:30,670
+عن الـ rheumatic fever، خاصة حمى الروماتيزم، لأنه
+
+40
+00:02:30,670 --> 00:02:34,430
+لُقِيَ الارتباط برضه في الـ valves، يعني لو صار عند
+
+41
+00:02:34,430 --> 00:02:38,510
+واحد حمى في بداية صغره، ولُقِيَ بعض الحالات بتتأثر
+
+42
+00:02:38,510 --> 00:02:41,390
+اللي هو الـ valves تبع الـ heart، اللي هو في داخل
+
+43
+00:02:41,390 --> 00:02:46,140
+القلب، بين الـ ventricle والـ atrium، علشان بتصير فيها
+
+44
+00:02:46,140 --> 00:02:50,300
+إشكالية، طبعاً الإشكالية لأنه لُقِيَ أن نفس البكتيريا
+
+45
+00:02:50,300 --> 00:02:54,020
+اللي بتسبب الـ rheumatic fever، streptococci، برضه بتأثر
+
+46
+00:02:54,020 --> 00:02:56,980
+على… على منطقة اللي هو الـ valves، عشان بتصير
+
+47
+00:02:56,980 --> 00:03:00,900
+عندهم endocarditis، طيب، ask about، اسأل عن إيش؟ الـ
+
+48
+00:03:00,900 --> 00:03:04,280
+family history، اسأل: هل في تاريخ  heart attack؟ هل صار
+
+49
+00:03:04,280 --> 00:03:08,820
+عندكم في عيلتكم myocardial infarction، angina، كله
+
+50
+00:03:08,820 --> 00:03:11,580
+اللي بتتكلم عن heart attack، طيب، صار في
+
+51
+00:03:11,580 --> 00:03:15,960
+hypertension، في جلطات، في عندكم diabetes، هذه
+
+52
+00:03:15,960 --> 00:03:18,820
+تعتبر من الـ history المهمة جداً، وأنا قاعد بعمل في
+
+53
+00:03:18,820 --> 00:03:22,740
+بداية الـ assessment للـ cardiovascular system، طيب
+
+54
+00:03:22,740 --> 00:03:26,860
+ثاني أمر مهم جداً، وإحنا أخذناه في الـ
+
+55
+00:03:26,860 --> 00:03:30,800
+nutrition assessment، أن نسأل: أول حاجة كيف الأكل
+
+56
+00:03:30,800 --> 00:03:34,460
+اللي أنت بتاكله؟ طبعاً لو حد ما يجيب  فالو أنه كان
+
+57
+00:03:34,460 --> 00:03:37,480
+بيسأل عن طبيعة الأكل، كم يأكل، وكم يشرب، لأ، أنا
+
+58
+00:03:37,480 --> 00:03:39,940
+بتكلم في نوعية، ممكن يكون فيها ملح، ممكن يكون
+
+59
+00:03:39,940 --> 00:03:43,270
+فيها قلة، ممكن يكون ما فيها minerals، وهكذا، ما فيها
+
+60
+00:03:43,270 --> 00:03:47,610
+protein، فبنسأله: nutrition intake كيف؟ هل في عند
+
+61
+00:03:47,610 --> 00:03:51,750
+عندك مشكلة؟ طب عمرك حسيت… بنسأل السؤال: عمرك حسيت
+
+62
+00:03:51,750 --> 00:03:56,050
+بالكوليسترول، triglyceride، level of protein، liver
+
+63
+00:03:56,050 --> 00:03:58,470
+function test بشكل عام؟ عمرك حسيت بكل اللي علاقة
+
+64
+00:03:58,470 --> 00:04:01,870
+بإيه؟ nutrition intake، إذا في مشكلة، عشان نبدأ
+
+65
+00:04:01,870 --> 00:04:03,950
+نعالج، لأنه نقص خطر، الكوليسترول عالي، الـ
+
+66
+00:04:03,950 --> 00:04:06,430
+triglyceride عالي، والـ diabetes عالي، معناته
+
+67
+00:04:06,430 --> 00:04:09,170
+رايحين على إشكالية ممكن تصير في الـ cardiovascular
+
+68
+00:04:09,170 --> 00:04:13,040
+system،  هل كنت تدخن كثيراً؟ لُقِيَ في الدراسات أنه في
+
+69
+00:04:13,040 --> 00:04:17,960
+ارتباط وثيق مع التدخين، كم سيجارة كنت تدخن، ومتى أقلعت؟
+
+70
+00:04:17,960 --> 00:04:22,820
+قريباً، وهكذا، how do you view yourself؟
+
+71
+00:04:22,820 --> 00:04:26,620
+إيش يعني؟ كيف بنسأل سؤال:  أنت كيف شايف حالك؟ يعني
+
+72
+00:04:26,620 --> 00:04:30,620
+أنا ببسطها للطبيب اللي بيجي، المريض بيقول له: أنا قبل
+
+73
+00:04:30,620 --> 00:04:33,480
+ما يحكم عليك، أنت كيف شايف حالك؟ بيجي المريض بيقول
+
+74
+00:04:33,480 --> 00:04:35,580
+والله أنا حاسس حالي تعبان، والله حاسس حالي مرهق،
+
+75
+00:04:35,580 --> 00:04:39,630
+والله حاسس… يعني هذا إيش اسمه؟ I view myself from my
+
+76
+00:04:39,630 --> 00:04:43,010
+view، أنا بشوف حالي من وجهة نظري، وفي نفس الوقت
+
+77
+00:04:43,010 --> 00:04:46,650
+بيقولوا: what you do is to relax، إيش أنت بتعمل
+
+78
+00:04:46,650 --> 00:04:50,250
+عشان ترتاح لما تكون تعبان؟ هذا إيه المعنى؟  لقادم
+
+79
+00:04:50,250 --> 00:04:53,190
+شوية، هنفهم إيش… إيش اللي نقصد، How many hours؟
+
+80
+00:04:53,190 --> 00:04:57,510
+كم ساعة أنت، كم ساعة في اليوم بتشتغل؟  ما زال، كم ساعة في
+
+81
+00:04:57,510 --> 00:05:00,050
+اليوم بتشتغل؟ كم دقيقة  تلقائياً كم ساعة في اليوم
+
+82
+00:05:00,050 --> 00:05:03,870
+بترتاح؟ الأمر اللي بعده، بدنا نسأله على موضوع الـ
+
+83
+00:05:03,870 --> 00:05:07,510
+stress، لأنه مرتبط ارتباط وثيق جداً في الـ
+
+84
+00:05:07,510 --> 00:05:10,810
+cardiovascular system، ما أثر الـ stress للأسف
+
+85
+00:05:10,810 --> 00:05:13,750
+على القلب، لأنه من كثرة ما الإنسان بيحط في قلبه مشكلة
+
+86
+00:05:13,750 --> 00:05:17,990
+طبعاً، نسأله: how to cope؟ كيف أنت بتتأقلم مع التوتر في
+
+87
+00:05:17,990 --> 00:05:21,490
+حياتك؟ بده يخبرنا: هل بالـ aggressive؟ هل بالـ anxiety؟
+
+88
+00:05:21,490 --> 00:05:24,170
+بده يحكي لنا الشيء اللي موجود عنده، نسأل على الـ
+
+89
+00:05:24,170 --> 00:05:29,140
+exercise، أنت بالنسبة لك بتعمل تمارين رياضية؟ مش شرط أنك
+
+90
+00:05:29,140 --> 00:05:32,000
+قاعد بتلعب مثلاً ماراثون وغيرها، لأ، بتعمل تمارين في
+
+91
+00:05:32,000 --> 00:05:35,720
+حياتك ولا لأ؟ إذا قال: آه، بتقول له: إيش نوعها؟  كم مرة؟
+
+92
+00:05:35,720 --> 00:05:39,320
+كل يومين، كل يوم، كل أسبوع، وكيف قوتها، بتمشي…
+
+93
+00:05:39,320 --> 00:05:42,120
+إيش اللي بتعمله؟ طيب، في عندنا،  بدنا ندخل في
+
+94
+00:05:42,120 --> 00:05:45,920
+التفاصيل الأدق شوية، نسأل عن الألم الآن، الألم
+
+95
+00:05:45,920 --> 00:05:48,420
+ما بنسأله في منطقة الـ heart مباشرة، لأ، بيجي بيسأله
+
+96
+00:05:48,420 --> 00:05:51,480
+في منطقة إيش؟ الـ calves، الـ calves يا جماعة، عشان
+
+97
+00:05:51,480 --> 00:05:55,130
+كنّا عارفين، بيسموها عضلات الرجل، و الـ calves
+
+98
+00:05:55,130 --> 00:05:58,530
+بيسموها العلماء the second heart of the body، إيش
+
+99
+00:05:58,530 --> 00:06:02,050
+يعني؟ يعني تعتبر اسمها القلب الثاني للجسم، على اعتبار
+
+100
+00:06:02,050 --> 00:06:07,340
+أنها بعد ما الدم كله ينزل للأطراف السفلى، بنضغط
+
+101
+00:06:07,340 --> 00:06:10,220
+بالـ calves muscle… سبحان الله، الـ calves muscle
+
+102
+00:06:10,220 --> 00:06:13,800
+وين بروح وبرجع، يعني على الطريق اللي فيه كذا،
+
+103
+00:06:13,800 --> 00:06:16,160
+بيروح، بيجي، برجع على القلب، وهذا ميزة حلوة كثيراً
+
+104
+00:06:16,160 --> 00:06:19,540
+الله حطها يعني في جسم الإنسان، عشان ما يصيرش، قلنا
+
+105
+00:06:19,540 --> 00:06:23,520
+دواري، وإحنا واقفين، وإحنا عمالنا بنطول وقفتنا،
+
+106
+00:06:23,520 --> 00:06:27,320
+نسأل على الـ feet، الأقدام كيف؟ الـ legs، ما حد يقول
+
+107
+00:06:27,320 --> 00:06:30,780
+لي إيش دخلها؟ لأ، كلها لها دخل، أي arterial problems
+
+108
+00:06:30,780 --> 00:06:33,220
+بالعكس، أي arterial… الـ arterial problems
+
+109
+00:06:33,220 --> 00:06:36,520
+من هون جاية الـ arterial problems جاية من الـ heart،
+
+110
+00:06:36,520 --> 00:06:41,220
+عشان هيك، لأنها بتأثر أوعية القلب، أوعية، بعدين بنسأله
+
+111
+00:06:41,220 --> 00:06:43,860
+إيش اللي بيجي… لما أقول كلمة… كلمة aggravates،
+
+112
+00:06:43,860 --> 00:06:47,580
+شو اللي بيخلي الألم عندك يزيد؟ ما زال، في كلمة
+
+113
+00:06:47,580 --> 00:06:50,580
+aggravate، لازم يكون العكس فيه، كلمة relief، يبقى لازم
+
+114
+00:06:50,580 --> 00:06:53,680
+نسأله، لو قال لي: آه والله أنا عندي مشكلة، عندي ألم
+
+115
+00:06:53,680 --> 00:06:57,050
+في رجليّ، عندي رجليّ ألم في منطقة… والله الكلاليب
+
+116
+00:06:57,050 --> 00:07:00,010
+اللي في مصر، عندي ألم، بس أسأله: شو اللي ممكن
+
+117
+00:07:00,010 --> 00:07:03,530
+يعمل aggravation؟ زي الـ walking، أو الـ sitting،
+
+118
+00:07:03,530 --> 00:07:07,230
+long period، زي الـ standing، long period، زي الـ
+
+119
+00:07:07,230 --> 00:07:09,530
+sleep، في مرات بيقول لك: لأ، في بعض الناس بيقول لك: أنا
+
+120
+00:07:09,530 --> 00:07:12,870
+في الليل بتألم، بيصير معي stiffness، لازم نأخذ الكلام
+
+121
+00:07:12,870 --> 00:07:16,430
+بعين الاعتبار، أو بتشد عضلاتي، وما أقدرش أ… يعني أ…
+
+122
+00:07:16,430 --> 00:07:20,590
+… أفرد نفسي، طيب، ما زال، سألنا إيش اللي بيشجع الألم،
+
+123
+00:07:20,590 --> 00:07:25,280
+بدنا نسأل السؤال: إيش اللي بيخفف الألم؟ بنسأله: إيش
+
+124
+00:07:25,280 --> 00:07:27,660
+اللي ممكن يخفف الألم؟ elevated legs، يعني هل أنت
+
+125
+00:07:27,660 --> 00:07:33,380
+لما ترفع رجليك مثلاً على المخدة، بتحس براحة؟ طيب، هل
+
+126
+00:07:33,380 --> 00:07:37,700
+أنت بتستخدم هنا، constructing، هنا حاجة اسمها
+
+127
+00:07:37,700 --> 00:07:40,900
+garments or hosiery، garments or hosiery، يعني
+
+128
+00:07:40,900 --> 00:07:45,920
+الجوارب، وخاصة للأسف في بعضهم بيصير عندهم مشكلة أنه
+
+129
+00:07:45,920 --> 00:07:49,300
+خاصة اللي بيلبسوا الضغط الشديد، ضغط عالي على رجليهم
+
+130
+00:07:49,300 --> 00:07:54,720
+عشان بدهم رقم أصغر، أو بيلبس جوارب يعني ضغط كثير، أو
+
+131
+00:07:54,720 --> 00:07:58,700
+الجوارب الطويلة، يعني بتعرفوهم أنتم هذول، برضه
+
+132
+00:07:58,700 --> 00:08:01,940
+اللي  معلقة، عشان نعرف أن اللي قدامي شوية من هذول
+
+133
+00:08:01,940 --> 00:08:06,280
+مرات بساعد في رفع ضغط الدم، ومرات بضر، إذا كان
+
+134
+00:08:06,280 --> 00:08:10,980
+زيادة، زي الـ bandage، أو الشاش، لما بنلف على يد
+
+135
+00:08:10,980 --> 00:08:14,300
+المريض، لما بيكون بحدوده الطبيعية، مقبول، لما بيزيد
+
+136
+00:08:14,300 --> 00:08:19,000
+مشكلة، ولما بيقل برضه مشكلة، طيب، in what type of
+
+137
+00:08:19,000 --> 00:08:22,880
+chair does the client usually sit؟ بنسأله سؤال: إيش
+
+138
+00:08:22,880 --> 00:08:26,240
+أنت، أحسن كرسي بتحب تقعد عليه؟ برضه هذا إيه المهم،
+
+139
+00:08:26,240 --> 00:08:29,440
+كيف قعدته؟ كيف هي جلسته؟ عشان نعرف أنه هل بيحب
+
+140
+00:08:29,440 --> 00:08:33,060
+يخفف عن نفسه؟ هل بيحب يحط وراه مثلاً مسند، مخدة، عشان
+
+141
+00:08:33,060 --> 00:08:36,700
+نعرف أنه فيه مشكلة؟ هل بيحب يخفف عن الـ pressure من
+
+142
+00:08:36,700 --> 00:08:39,860
+الـ abdomen جاي على الـ heart ولا لأ؟ بعدين بنسأله،
+
+143
+00:08:39,860 --> 00:08:44,860
+هل أنت من الناس اللي بيحبوا يعني يعملوا cross legs؟
+
+144
+00:08:44,860 --> 00:08:48,210
+cross legs، الكل عارفين يعني: بيحط رجل على رجل، يعني، طبعاً
+
+145
+00:08:48,210 --> 00:08:51,050
+ما بتعتبر حاجة صحيحة، الناس بتعتبرها ربما
+
+146
+00:08:51,050 --> 00:08:55,410
+prestige، أو كذا، لكن أنا هنا صراحة، أنصح، مش
+
+147
+00:08:55,410 --> 00:08:59,130
+كثير كويسة صحياً، ولو زادت ممكن يعني تعمل مصيبة،
+
+148
+00:08:59,130 --> 00:09:02,330
+خاصة في بعض الناس اللي عندهم أصلاً arterial
+
+149
+00:09:02,330 --> 00:09:08,790
+problems، اللي هو يعني وضع رجل على رجل أكثر من وقت
+
+150
+00:09:08,790 --> 00:09:13,370
+كثير، ممكن يصير للأسف DVT في بعض الحالات، assessment،
+
+151
+00:09:13,370 --> 00:09:16,590
+نشوف إيش هنا، لازم يكون إيش؟ المريض مش sitting، لما
+
+152
+00:09:16,590 --> 00:09:20,850
+قلنا هناك في الـ assessment للـ respiratory system،
+
+153
+00:09:20,850 --> 00:09:23,970
+كنا sitting، ولما نتعَب ممكن إيش؟ نايم على جنبه، هنا
+
+154
+00:09:23,970 --> 00:09:27,570
+لأ، عشان الـ heart جاي على الـ subile، لكن إيش يعني subile؟
+
+155
+00:09:27,570 --> 00:09:31,190
+subile، ممكن يكون sitting، لكن هو subile بيكون أريح
+
+156
+00:09:31,190 --> 00:09:34,550
+للمريض، ليش؟ على اعتبار أنه ما فيش pressure على الـ
+
+157
+00:09:34,550 --> 00:09:39,770
+heart،  لكي أُذكّرُكم  بموضوع هام according to، إيش توزيع
+
+158
+00:09:39,770 --> 00:09:44,390
+يعني أنت، تابع  صحة المريض؟  بعض
+
+159
+00:09:44,390 --> 00:09:48,150
+المرضى بيقولوا لك: ما أقدرش أنا مع ظهري، خاصة الناس الـ obese
+
+160
+00:09:48,150 --> 00:09:50,130
+والـ heavy smokers، ما أقدرش، أو اللي عنده أزمة، بيقول لك
+
+161
+00:09:50,130 --> 00:09:53,610
+ما أقدرش، هذا ممكن، على راحتُه، نخليه sitting، طيب،
+
+162
+00:09:53,610 --> 00:09:56,810
+inspection and palpation، أول حاجة بدنا نعمل
+
+163
+00:09:56,810 --> 00:10:00,450
+inspection، بعدين بدنا نمد يدنا، نعمل palpation،
+
+164
+00:10:00,450 --> 00:10:03,910
+عشان إذا فيه، لا سمح الله، ventricular hypertrophy،
+
+165
+00:10:03,910 --> 00:10:07,950
+في بعض الناس بنسمع بيقولوا: عنده تضخم في عضلة القلب،
+
+166
+00:10:08,480 --> 00:10:11,000
+لما تسمع تضخم في عضلة القلب، هذا المقصود،
+
+167
+00:10:11,000 --> 00:10:14,520
+ventricular hypertrophy، من إيش؟ لقدام شوية أشرح
+
+168
+00:10:14,520 --> 00:10:18,340
+من إيش بتكون، لازم نستخدم source of light، لازم يكون
+
+1
+
+223
+00:13:32,570 --> 00:13:38,450
+في المنطقة هذه في حجز ما هيفز الثقل over lifts يعني
+
+224
+00:13:38,450 --> 00:13:42,070
+و احنا قاعدين بنعمل assessment  لل pulse بنحس إشي
+
+225
+00:13:42,070 --> 00:13:45,610
+قاعد برفع إيدنا و برفعها لفوق زي اللي بيطلع الإيد
+
+226
+00:13:45,610 --> 00:13:50,210
+لفوق يعني في إشي بيجبرنا نرفعها لفوق إيش هذا بيقول لي
+
+227
+00:13:50,210 --> 00:13:53,650
+هذا دقيق بدنا ن check إيش اللي فيه، صح؟
+
+228
+00:13:53,650 --> 00:13:59,030
+ventricular work increase بيكون في زيادة load كبير
+
+229
+00:13:59,030 --> 00:14:04,250
+على وين؟ على ال right ventricle على ال right إيه ال
+
+230
+00:14:04,250 --> 00:14:12,960
+ventricle اللي هو البطين الأيمن، طيب الآن
+
+231
+00:14:12,960 --> 00:14:17,160
+بعض الناس طبعاً هنا اللي بيجي بعدها بيصير حاجة
+
+232
+00:14:17,160 --> 00:14:21,380
+تسموها إيش؟ اللي هو ال congestive heart failure عشان
+
+233
+00:14:21,380 --> 00:14:24,160
+هيك ال congestive heart failure بنلاقي في كثير من
+
+234
+00:14:24,160 --> 00:14:26,780
+الحالات، المصدر الأساسي اللي جاي من وين؟ من ال right
+
+235
+00:14:26,780 --> 00:14:33,040
+ventricle، طيب الآن
+
+236
+00:14:34,150 --> 00:14:37,930
+خلصنا موضوع البطين و .. اللي .. اللي صار و عملنا
+
+237
+00:14:37,930 --> 00:14:39,970
+ال assessment، جينا كمان عملنا palpation و سمعناها
+
+238
+00:14:39,970 --> 00:14:43,330
+كويسة، شو؟ palpation في palpation برضه في sublime
+
+239
+00:14:43,330 --> 00:14:46,590
+position، إيش بقولوا؟ أول حاجة بدك تعمل palpation
+
+240
+00:14:46,590 --> 00:14:51,050
+ابدأ من ال apex لوين؟ to the external border to
+
+241
+00:14:51,050 --> 00:14:56,560
+base، يعني في palpation بقولوا يعني العلماء أنه أفضل
+
+242
+00:14:56,560 --> 00:15:01,700
+أنك تبدأ من رأس المخروط أو رأس القلب و احنا قلنا
+
+243
+00:15:01,700 --> 00:15:05,140
+الرأس تحت و القاعدة وين؟ فوق، فبيقولوا ابدأ من الرأس
+
+244
+00:15:05,140 --> 00:15:08,480
+من تحت و حط .. ضلك إيش تعمل assessment شوي شوي في
+
+245
+00:15:08,480 --> 00:15:12,740
+إصبعك لما تصل إيش؟ لحدود ال base اللي هو of the
+
+246
+00:15:12,740 --> 00:15:17,380
+heart، و قولي detect abnormalities حاولي تحدد إذا في
+
+247
+00:15:17,380 --> 00:15:21,320
+أي شيء مش طبيعي في إيش؟ في ال site of palpation
+
+248
+00:15:21,320 --> 00:15:23,740
+يعني، و إحنا قاعدين نعمل palpation اعرف لي إذا في
+
+249
+00:15:23,740 --> 00:15:27,880
+أي مشكلة، صار فيه صوت معين و إحنا قاعدين بنحط
+
+250
+00:15:27,880 --> 00:15:31,860
+إيدينا، حاسين فيه صوت تحت أصابع إيدينا غريب، هذا
+
+251
+00:15:31,860 --> 00:15:36,220
+الصوت لما نسمعه، abnormal flow of blood بأي منطقة كان
+
+252
+00:15:36,220 --> 00:15:39,980
+يعني عشان نختصر، يكفينا أي صوت تحت أصابع
+
+253
+00:15:39,980 --> 00:15:42,980
+أيدينا و احنا بنعمل assessment، إجينا صوت غريب
+
+254
+00:15:42,980 --> 00:15:47,100
+يعني عامله بي .. زي .. زي مجرى معين هيك بينزل لكن
+
+255
+00:15:47,100 --> 00:15:50,740
+غريب الصوت، إيش اسمه هنا؟ thrill، يبقى إيش اسمه؟ thrill
+
+256
+00:15:50,740 --> 00:15:55,280
+abnormal flow of blood، يبقى إنسداد بالدم غير طبيعي
+
+257
+00:15:55,280 --> 00:15:59,080
+أو اللي هو صوت يعني شوية عامله عامل يعني مش الصوت
+
+258
+00:15:59,080 --> 00:16:03,760
+اللي أنا بعتبره طبيعي، إيش بتسميه؟ thrill، بقول لك أن
+
+259
+00:16:03,760 --> 00:16:08,680
+تِرْتَقي بالك، مهم كتير أنك تصف ال palpation إيش
+
+260
+00:16:08,680 --> 00:16:13,260
+توصفها؟ اوصف لي إياها مع علاقتها مع إيش؟ مع ال time لل
+
+261
+00:16:13,260 --> 00:16:16,840
+cardiac cycle، يعني إنت وإنت قاعد عمالك بتعمل
+
+262
+00:16:16,840 --> 00:16:21,080
+assessment لل pulse، شوف ال pulse بتسبق ال cardiac cycle
+
+263
+00:16:21,080 --> 00:16:26,100
+بتسبقها، ولا لا؟ هل في تسارع في التقلص؟ هل بتحس أنه لا بطيء
+
+264
+00:16:26,100 --> 00:16:30,040
+هل بتحس كل شوية بتطلع لك يعني pulse حالة زي ال extra
+
+265
+00:16:30,040 --> 00:16:33,740
+systoles، هذا كله بدنا نعمله assessment عشان نُدوّنه و
+
+266
+00:16:33,740 --> 00:16:37,800
+نحكي للطبيب اللي بعده، بقول describe in terms، أوصف
+
+267
+00:16:37,800 --> 00:16:43,600
+بمصطلحات ال location، وين ما كان ال pulse يعني نكون
+
+268
+00:16:43,600 --> 00:16:47,000
+دقيقين لما نقول ال pulse موجود، قول لي في ال right
+
+269
+00:16:47,000 --> 00:16:50,140
+مثلاً، في مثلاً أو في ال left مثلاً، intercostal or
+
+270
+00:16:50,140 --> 00:16:53,560
+space اللي جاي في ال fifth مثلاً، sixth أي كان
+
+271
+00:16:53,560 --> 00:16:57,220
+طيب، in relation to mid sternum، عارفين وين ال mid
+
+272
+00:16:57,220 --> 00:17:01,460
+sternum؟ هي ال sternum، بقول ال mid sternum، يعني في
+
+273
+00:17:01,460 --> 00:17:05,140
+بُرَات ال pulse، مش قادر أنا أشوفه في ال sixth أو في
+
+274
+00:17:05,140 --> 00:17:09,680
+ال fifth، ها إيش أعمل؟ لقيته جنب ال midsternal، بقول
+
+275
+00:17:09,680 --> 00:17:13,400
+والله nearly midsternal، يمكن بعضهم اللي لقيته تحت ال
+
+276
+00:17:13,400 --> 00:17:16,160
+clavicle، كلكم عارفين عظمة الترقوة اللي هي ال
+
+277
+00:17:16,160 --> 00:17:19,890
+clavicle، ممكن أنا أجي تحت إيش؟ لك ده في كلّه تحت أنا
+
+278
+00:17:19,890 --> 00:17:23,230
+بقول والله لا أنا سمعت الصوت أو حسيت بالصوت في ال
+
+279
+00:17:23,230 --> 00:17:26,010
+mid-clavicular، في بعضهم بيقول لك لا والله أنا حسيتُه
+
+280
+00:17:26,010 --> 00:17:28,030
+شوية في ال axillary، واحد يجي يقول لي axillary
+
+281
+00:17:28,030 --> 00:17:30,730
+طبعاً تحت الإبط، واحد يجي يقول لي طبعاً هذا طبيعي؟ لا
+
+282
+00:17:30,730 --> 00:17:34,710
+هذا مش طبيعي، بس أنا أقصد أنه لازم إحنا نصف لما
+
+283
+00:17:34,710 --> 00:17:38,370
+بدنا نحكي بالمصطلحات الطبية للطبيب أو للمعالج
+
+284
+00:17:38,370 --> 00:17:42,940
+نقول له بالظبط وين شعرنا بال pulsation موجودة، بيوصفها
+
+285
+00:17:42,940 --> 00:17:46,440
+هل هي جنب ال sternum ولا جنب ال clavicle ولا جنب ال
+
+286
+00:17:46,440 --> 00:17:51,820
+axillary وهكذا، طيب palpation of apical pulse
+
+287
+00:17:51,820 --> 00:17:55,240
+يعني وإحنا بنعمل كده palpation لل apical pulse
+
+288
+00:17:55,240 --> 00:18:00,560
+بدك تشوف إيش هنا؟ ال strength، القوة بتختلف، تختلف من
+
+289
+00:18:00,560 --> 00:18:06,160
+الضعيف للسمين، دائماً هي من thin to obese، ما بدي أقول أن
+
+290
+00:18:06,160 --> 00:18:09,890
+بتكون عند ال obese أعلى، ووجدوا في اختلافهم
+
+291
+00:18:09,890 --> 00:18:13,350
+وجدوا أن ال obese بتكون عنده أكثر على اعتبار أن
+
+292
+00:18:13,350 --> 00:18:19,950
+القلب بيبقى بيجاهد عشان يوصل للأطراف يعني لأطراف الجسم
+
+293
+00:18:19,950 --> 00:18:23,850
+والـ thin بيعتبروا يعني .. يعني لأن ال body خليني أقول
+
+294
+00:18:23,850 --> 00:18:27,570
+built بالشكل العام يعني بتكون شوية أخف من ال obesity
+
+295
+00:18:27,570 --> 00:18:30,990
+وممكن الدم يصل بسهولة، عشان هيك بتكون ال pulse أهون
+
+296
+00:18:30,990 --> 00:18:35,760
+شوية، طيب ال conditions زي إيش؟ اللي ممكن إيش هذا
+
+297
+00:18:35,760 --> 00:18:39,260
+اللي ممكن تزيد ال duration ها تبع ال apical pulse
+
+298
+00:18:39,260 --> 00:18:42,400
+أنا لحد الآن بتكلم ع ال apical، إحنا في نوعين في
+
+299
+00:18:42,400 --> 00:18:44,280
+apical و في base pulse، خلينا نتكلم ع ال apical
+
+300
+00:18:44,280 --> 00:18:49,340
+نكمل، فبقول لي إيش الأشياء اللي ممكن تزيد القوة و
+
+301
+00:18:49,340 --> 00:18:54,300
+المدة تبع ال apical pulse؟ بقول لي زي ال anxiety أكيد
+
+302
+00:18:54,300 --> 00:18:57,400
+طبعاً أنيميا، ما حد يقول طب أنيميا يا أستاذ، في فقر
+
+303
+00:18:57,400 --> 00:19:00,320
+دم، آه compensatory mechanism بيصير القلب بيسرع
+
+304
+00:19:00,320 --> 00:19:04,580
+أكثر عشان يقدر يعوض، fever، hyperthyroidism طبعاً
+
+305
+00:19:04,580 --> 00:19:08,740
+كلهم عارفين إيش معناتهم الآن، وخاصة غضب ال thyroid
+
+306
+00:19:08,740 --> 00:19:11,760
+كمان تلاقيه أنه إيش؟ غضب الغدة الدرقية عامة، زاد نشاطها فبيصير
+
+307
+00:19:11,760 --> 00:19:16,570
+مشكلة، طيب بقول you feel lifting، كيف بتعرف lifting
+
+308
+00:19:16,570 --> 00:19:19,550
+sensation؟ أما إحنا قلنا كلمة lifting، بتشعر أن تحت
+
+309
+00:19:19,550 --> 00:19:23,890
+أصابعك إشي عماله بيرفع أصابعك لفوق، يعني وإنت بتعمل
+
+310
+00:19:23,890 --> 00:19:28,830
+assessment لنفس ال apical pulse، بتحس كأنه .. كأنه
+
+311
+00:19:28,830 --> 00:19:34,630
+النبض بيرفع إيدك لفوق، هذا بيدل أنه عماله بيزيد أكثر
+
+312
+00:19:34,630 --> 00:19:37,870
+اللي هو ال apical pulse و بيزيد ال duration و بيزيد
+
+313
+00:19:37,870 --> 00:19:43,370
+ال strength بتاعته، الآن بال palpation of the pulse اللي هو
+
+314
+00:19:43,370 --> 00:19:48,390
+اسمه إيه؟ base pulse، الآن طب إنت عرفنا يا أستاذ وين
+
+315
+00:19:48,390 --> 00:19:51,510
+ال apex وعرفناها في ال fifth intercostal space
+
+316
+00:19:51,510 --> 00:19:53,530
+و قلنا زي فيه مشكلة وفيه enlargement بنروح على ال
+
+317
+00:19:53,530 --> 00:20:00,630
+sixth، طب هنا أمّا ال base، لا بيقول لي حط إيدك على where
+
+318
+00:20:00,630 --> 00:20:06,230
+second left or right intercostal space، بيقول لي
+
+319
+00:20:06,230 --> 00:20:08,330
+روح على ال intercostal space، اطلع لفوق شوية
+
+320
+00:20:08,830 --> 00:20:11,430
+روح لي على ال second يعني على إيش؟ على اللي هو
+
+321
+00:20:11,430 --> 00:20:13,870
+الفراغ الثاني .. بين ال .. ليش؟ بين ال ribs، يا
+
+322
+00:20:13,870 --> 00:20:17,070
+بتحط إيدك على الشمال يا على اليمين، طبعاً مش هقدر
+
+323
+00:20:17,070 --> 00:20:20,030
+أحطها في النص لأنه في عظمة في النص، طب ليش يمين أو
+
+324
+00:20:20,030 --> 00:20:24,970
+شمال؟ على الاثنين بظبط؟ لأن ال base شمال عريضة، ما
+
+325
+00:20:24,970 --> 00:20:27,950
+إحنا قلنا بيكون ال apex تحت و ال base فوق عريضة،
+
+326
+00:20:27,950 --> 00:20:31,330
+فهي ممتدة على جنب اليمين وعلى جنب اليسار تبع إيه؟
+
+327
+00:20:31,740 --> 00:20:35,360
+تبع اللي هو ال external، فبقدر أعمل assessment، يبقى
+
+328
+00:20:35,360 --> 00:20:38,040
+ال intercostal space الثاني بقدر أحس عليه إيش
+
+329
+00:20:38,040 --> 00:20:42,040
+هنا اللي هو حوالين ال external borders، عامة القصة
+
+330
+00:20:42,040 --> 00:20:45,900
+اللي حوالينا بقدر أشوف و أحس اللي هو إيش؟ ال
+
+331
+00:20:45,900 --> 00:20:49,510
+base pulse، ما بدي أشرح كثير عن ال base pulse ولا بدي
+
+332
+00:20:49,510 --> 00:20:51,990
+أشرح ولا بدي أقارنه، أنا فقط بس بدي أعرف أن هاي
+
+333
+00:20:51,990 --> 00:20:55,030
+المكان عرفناه ليه؟ لأنه إحنا حن .. لما بدنا
+
+334
+00:20:55,030 --> 00:20:57,230
+يشرحوا لنا بكرا في ال medical surgical و بدنا
+
+335
+00:20:57,230 --> 00:21:00,490
+نشرحها في كل إشي، مش هينذكر، اللي هينذكر apical
+
+336
+00:21:00,490 --> 00:21:02,710
+radial .. apical radial وهكذا، بس إحنا من باب
+
+337
+00:21:02,710 --> 00:21:05,810
+زيادة في المعرفة، أنه نعرف أنه في حاجة برضه في
+
+338
+00:21:05,810 --> 00:21:10,640
+الجهة اللي هو ال base pulse، طبعاً ال percussion مهم
+
+339
+00:21:10,640 --> 00:21:13,500
+كثير على الموضوع اللي بالأحمر، not used in cardiac
+
+340
+00:21:13,500 --> 00:21:17,040
+assessment، لو حد سألنا هو بقدر أستخدم percussion؟
+
+341
+00:21:17,040 --> 00:21:20,400
+وين بدك تستخدم percussion؟ يعني هل بنقدر نستخدم
+
+342
+00:21:20,400 --> 00:21:23,820
+percussion؟ و إحنا بنعمل assessment على عضلة القلب،
+
+343
+00:21:23,820 --> 00:21:27,160
+طب القلب نفسه مش هنقدر نطوله ولا نصل له، ولا نصل له،
+
+344
+00:21:27,160 --> 00:21:30,820
+في .. في .. في ribs و في muscles و في skin يعني
+
+345
+00:21:30,820 --> 00:21:34,400
+اللي فوقه،  داخل كتير، سواء كان بعيد عن ال ..
+
+346
+00:21:34,400 --> 00:21:37,720
+ال .. ال .. ال back و بعيد عن .. و بعيد عن إيش؟ ال
+
+347
+00:21:37,720 --> 00:21:40,880
+chest، يعني على الاثنين، يعني الظهر و الصدر، طيب،
+
+348
+00:21:41,200 --> 00:21:45,580
+auscultation, all heart sounds، كل اللي هو أصوات القلب
+
+349
+00:21:45,580 --> 00:21:50,590
+إستماعها بتكون low pitched، low ماحدش يجي يقول لي هو صوت
+
+350
+00:21:50,590 --> 00:21:54,550
+القلب نسمعه من بعيد، أعوذ بالله صعب كتير، ما عمرناش
+
+351
+00:21:54,550 --> 00:21:58,230
+نسمعه من بعيد، أمّا ممكن إذا حطينا الأذن مباشرة على
+
+352
+00:21:58,230 --> 00:22:01,510
+الصدر زي ما نحط الأذن على صدر الطفل، ممكن نسمع،
+
+353
+00:22:01,510 --> 00:22:03,910
+لكن ماحدش يقول لي والله أنا سامع دقات قلبك و أنا قاعد
+
+354
+00:22:03,910 --> 00:22:07,210
+هنا، لا طبعاً مش لهذه الدرجة، فبقول لي low pitched و
+
+355
+00:22:07,210 --> 00:22:09,370
+low frequency و difficult to hear، يبقى معناته
+
+356
+00:22:09,370 --> 00:22:13,570
+ما أقدرش أسمعها عن طريق الأذن، عشان هيك لازم أنا أستخدم
+
+357
+00:22:13,570 --> 00:22:17,350
+ال stethoscope، طب لو سألنا حد، ابدأ في ال stethoscope
+
+358
+00:22:17,350 --> 00:22:19,970
+من ال apex لل base ولا ال base لل apex زي
+
+359
+00:22:19,970 --> 00:22:23,450
+ما بدك؟ إيش قالوا العلماء؟ قالوا من ال base لل apex
+
+360
+00:22:23,450 --> 00:22:26,190
+أو من ال apex لل base، نفس الشيء ما في مشكلة، لأنك في
+
+361
+00:22:26,190 --> 00:22:28,970
+الآخر إنت .. قلنا في الآخر إحنا في الآخر apex ال
+
+362
+00:22:28,970 --> 00:22:31,150
+radial، لكن إحنا حاطين ال base بس من باب المعرفة و
+
+363
+00:22:31,150 --> 00:22:34,930
+أينما كان ال pulse، طيب بقول، assess rate and rhythm
+
+364
+00:22:34,930 --> 00:22:39,590
+بتروح تشوف ال rate، تشوف ال rhythm of the beat، بتشوف
+
+365
+00:22:39,590 --> 00:22:43,570
+يعني كيف النبض، ال concentration، بينركز على ال
+
+366
+00:22:43,570 --> 00:22:46,470
+sound one، بعدين إيش ال sound one وإيش ال sound
+
+367
+00:22:46,470 --> 00:22:49,670
+two، sound one يعني بدك تشوف كده حدته و ال
+
+368
+00:22:49,670 --> 00:22:52,250
+vibrations اللي جات، أنا هشرح شو أقصد في ال sound
+
+369
+00:22:52,250 --> 00:22:54,750
+one و شو أقصد في ال sound two عشان تكون الأمور أوضح
+
+370
+00:22:54,750 --> 00:22:58,350
+أكثر، بعدين بيقول لي هنا اسمع لل sound two نفس الشيء
+
+371
+00:22:58,350 --> 00:23:02,890
+اللي هو حدته و اهتزازه، و هل في duplication يعني
+
+372
+00:23:02,890 --> 00:23:07,420
+ازدواجية ولا لا؟ طيب، اللي بعده، أنا إيش بقول لي كمان؟ بدك
+
+373
+00:23:07,420 --> 00:23:12,360
+تشوف ال extra sounds، إيه extra sound؟ أي صوت زي
+
+374
+00:23:12,360 --> 00:23:17,360
+ما علمونا في السنة الأولى، زي دوب دوب دوب دوب، زي دقات
+
+375
+00:23:17,360 --> 00:23:20,840
+لكل إنسان، و إحنا بنعمل لما علمونا كيف نأخذ ال
+
+376
+00:23:20,840 --> 00:23:25,270
+pulse و نعده، أي شيء حسيتُه مش طبيعي بيكفيني أنا
+
+377
+00:23:25,270 --> 00:23:31,110
+كممرضة ويعني تمريض، بيكفيني أسميه بس إيه murmurs، لأن
+
+378
+00:23:31,110 --> 00:23:33,790
+الطبيب المتخصص، cardiologist، هو اللي بيعرف إيش
+
+379
+00:23:33,790 --> 00:23:37,450
+أنواع ال murmurs، مش موضوعنا دلوقت، لكن يهمني نعرف ال
+
+380
+00:23:37,450 --> 00:23:40,530
+sound one وإيش ال sound two، متى بيصير ال sound
+
+381
+00:23:40,530 --> 00:23:42,970
+one ومتى بيصير ال sound two، ال sound one سهل كتير
+
+382
+00:23:42,970 --> 00:23:47,310
+أول حاجة من إيش بيجي؟ لما بيغلق .. إيش هنا .. بيغلق
+
+383
+00:23:47,310 --> 00:23:49,990
+ال tricuspid و ال mitral valves، اللي هو ال بين ..
+
+384
+00:23:49,990 --> 00:23:53,070
+اللي هو ال ventricle و بين الأذينين، لما بيغلق
+
+385
+00:23:53,070 --> 00:23:56,070
+الصمام، الدم فوق القطة، إجه على الأذينين و انضغط
+
+386
+00:23:56,070 --> 00:23:58,990
+نزل على ال ventricle، أول ما ينضغط و ينزل هو، بتبدأ
+
+387
+00:23:58,990 --> 00:24:01,790
+ال sound 1، وبيظل الصوت ماشي لعند ما يصل لوين؟ ..
+
+388
+00:24:01,790 --> 00:24:05,950
+extend، لما يصل لل sound 2، يبقى معناته .. يبقى
+
+389
+00:24:05,950 --> 00:24:09,530
+معناته .. الآن ال sound 1 من وين؟ أول ما بيغلق
+
+390
+00:24:09,530 --> 00:24:12,950
+ال .. ال tricuspid و ال mitral بيطلع الصوت، طيب ..
+
+391
+00:24:13,160 --> 00:24:16,020
+الآن
+
+445
+00:27:48,150 --> 00:27:51,850
+كتير أنه نفهم الـ sound one و الـ sound two بشكل عام
+
+446
+00:27:51,850 --> 00:27:55,930
+نكفزلز طبعا، خلنا أسرع شوية، معلش، عشان نلحق نخلص الـ
+
+447
+00:27:55,930 --> 00:27:59,970
+chapter لأنه الوقت بدأ يأخذنا و يدهمنا شوية، بدنا
+
+448
+00:27:59,970 --> 00:28:02,930
+نشوف طبعا، نكفزلز، نعمل assessment، الـ assessment للـ
+
+449
+00:28:02,930 --> 00:28:09,030
+نكفزلز، بنحاول أن نطلع بشكل عام على حوالين الرقبة
+
+450
+00:28:11,480 --> 00:28:15,180
+خاصة يعني الـ .. الـ distinction اللي بيصير موجود
+
+451
+00:28:15,180 --> 00:28:18,700
+حوالين الرقبة لما نصير فيه مشكلة في الـ right side
+
+452
+00:28:18,700 --> 00:28:21,960
+الـ heart، يعني لما نصير congestive heart failure و
+
+453
+00:28:21,960 --> 00:28:25,500
+بيصير عملية ضغط على عضلة القلب في تصريف اللي هو
+
+454
+00:28:25,500 --> 00:28:28,920
+الدم اللي مليان بالسائل، فبتلاقي صار إيش هنا
+
+455
+00:28:28,920 --> 00:28:31,860
+extension، بتلاقي سبحان الله حوالينا، حتى بقولك في
+
+456
+00:28:31,860 --> 00:28:34,900
+بعض الحالات بكون ضعيف و بتنتفخ، كأنه
+
+457
+00:28:34,900 --> 00:28:39,320
+الشرايين بيناتها على جنب .. على جنب الرقبة طبعا
+
+458
+00:28:39,320 --> 00:28:42,130
+لازم المريض عشان نقدر نعمله assessment اللي عنده
+
+459
+00:28:42,130 --> 00:28:46,370
+هذا congenital heart failure يكون في position يعني
+
+460
+00:28:46,370 --> 00:28:49,570
+يكون كويس، فهو لو الـ position 45 درجة، وبنشوف الـ
+
+461
+00:28:49,570 --> 00:28:53,910
+jugular pulse، برضه خاصة اللي هو الـ Venus، بعض الناس
+
+462
+00:28:53,910 --> 00:28:56,430
+بيقولوا هو الـ Venus فيه Venus pulse؟ أه، فيه Venus
+
+463
+00:28:56,430 --> 00:29:00,430
+pulse، لما أقول Venus يعني هو الـ waves زي موجات
+
+464
+00:29:00,430 --> 00:29:05,600
+بيعمل، أما الـ .. الـ .. الـ .. الـ arterial pulse لأ
+
+465
+00:29:05,600 --> 00:29:08,360
+نقر تك تك تك، يعني أو double up double up، يعني أما
+
+466
+00:29:08,360 --> 00:29:12,260
+هنا waves بيعمل و بيقاس، على فكرة بجهاز دوبلر ..
+
+467
+00:29:12,260 --> 00:29:16,720
+دوبلر machine، يبقى بنشوف الـ wave اللي هي خاصة بعد
+
+468
+00:29:16,720 --> 00:29:20,740
+ما الدم ينضخ .. ينضخ على الـ right ventricle، هلجيت
+
+469
+00:29:20,740 --> 00:29:22,640
+الدم اتجمع على الـ right ventricle، إنتوا في الـ
+
+470
+00:29:22,640 --> 00:29:25,720
+Anatomy اشتروا مني؟ هلجيت الدم اللي راجع شوية
+
+471
+00:29:25,720 --> 00:29:31,310
+بيعمل حاجة بسموها إيش هنا jugular pulse، نشوف الـ
+
+472
+00:29:31,310 --> 00:29:34,350
+character pulse، الـ character pulse طبعا وين بتكون
+
+473
+00:29:34,350 --> 00:29:38,390
+موجود، خاصة برضه حوالين الرقبة، لو حد سألنا بالظبط
+
+474
+00:29:38,390 --> 00:29:41,290
+وين موجود؟ على الـ media to the angle of the jaw
+
+475
+00:29:41,290 --> 00:29:44,130
+يعني بدنا نعمل أولا inspection and palpation، طب
+
+476
+00:29:44,130 --> 00:29:46,330
+وين هو موجود؟ inspection، وعرفنا، طلعنا حوالين
+
+477
+00:29:46,330 --> 00:29:50,290
+الرقبة، طب وين palpation؟ بنحط إصبعين .. إصبعين
+
+478
+00:29:50,290 --> 00:29:53,510
+اللي هو تبعت إيدي مثلا عند المريض، بنروح على الـ
+
+479
+00:29:53,510 --> 00:29:56,620
+angle of the jaw، اللي هو الزاوية تبعت اللي هو تحت
+
+480
+00:29:56,620 --> 00:30:00,960
+الـ .. الـ mandible، و بنروح قدام شوية، يعني بننزل
+
+481
+00:30:00,960 --> 00:30:05,040
+لتحت شوية، هي مثلا آخر الفك اللي ورا، بننزل لتحت
+
+482
+00:30:05,040 --> 00:30:09,880
+شوية و لأمام شوية، بنحس إيه؟ بنحس أنه في هنا عمله
+
+483
+00:30:09,880 --> 00:30:13,680
+فيه بينبض تحت أصابعنا، فبنعرف أنه هذا اللي هو الـ
+
+484
+00:30:13,680 --> 00:30:17,060
+carotid artery، و بعدين بنحط اللي هو الـ bell مش ..
+
+485
+00:30:17,060 --> 00:30:20,260
+مش الـ diaphragm، بنحط يعني اللي هو مش اللي هو
+
+486
+00:30:20,260 --> 00:30:23,620
+السماعة، اللي هو الشق الصغير، لأ، الشق الصغير اللي هو
+
+487
+00:30:23,620 --> 00:30:26,900
+عشان نقدر نسمع، لأنه إحنا قاعدين بنسمع pulse، مانعش
+
+488
+00:30:26,900 --> 00:30:30,900
+نسمع حاجة كبيرة. الـ carotid arteries، بدك تشوف
+
+489
+00:30:30,900 --> 00:30:35,720
+الـ pulsation، هل هي strong، هل هي weak، rise،
+
+490
+00:30:35,720 --> 00:30:41,200
+يعني بتشد فوق، collapse، يعني منكمشة، سريعة، ولا
+
+491
+00:30:41,200 --> 00:30:46,880
+بطيئة، double؟ هل هي متحسس دواجية في الأصوات ولا
+
+492
+00:30:46,880 --> 00:30:50,940
+single، يعني تك تك تك، ولا أصوات متداخلة، كله
+
+493
+00:30:50,940 --> 00:30:54,620
+متداخلة طبعا، وإحنا قلنا أي صوت متداخل إيش بيعني؟
+
+494
+00:30:54,620 --> 00:30:58,160
+اسمه murmur، دي بجمعها، لا تقلق، ما تنسى إذا سمعنا
+
+495
+00:30:58,160 --> 00:31:00,680
+أصوات غريبة وإحنا بنعمل assessment في الـ carotid
+
+496
+00:31:00,680 --> 00:31:03,520
+الـ carotid artery و الـ carotid muscle و الـ carotid
+
+497
+00:31:03,520 --> 00:31:07,720
+pulse، دغري بقول، بقول فيه murmurs، و الـ murmurs هذا
+
+498
+00:31:09,210 --> 00:31:13,690
+في بعض الحالات يعني إحنا ما نقدرش نشخصه بالنسبة لنا
+
+499
+00:31:13,690 --> 00:31:18,170
+لكن هو الطبيب، لأنه هو تشخيصه مش سهل، لازم يكون
+
+500
+00:31:18,170 --> 00:31:20,790
+cardiologist، لأنه هو vibrations، عبارة عن اهتزازات
+
+501
+00:31:20,790 --> 00:31:23,950
+و أنا ما أقدرش ولا إنتوا بتقدروا تعرفوا إيش طبيعتها، لأنه
+
+502
+00:31:23,950 --> 00:31:28,360
+هو مدارس ومتخصص في الأمر هذا، طبعا بدنا نعرف إن هي هل
+
+503
+00:31:28,360 --> 00:31:32,080
+هي كانت في الـ systole ولا في الـ diastole، برضه خاصة
+
+504
+00:31:32,080 --> 00:31:35,380
+لما نسمع مرات وإحنا بنجيز الضغط، هل بنحس الخربطة
+
+505
+00:31:35,380 --> 00:31:38,900
+هذه، وإحنا قاعدين في منطقة الـ systole فوق ولا
+
+506
+00:31:38,900 --> 00:31:42,980
+تحت في منطقة الـ diastole، طبعا هي، نعرفنا بس، بيعدلنا
+
+507
+00:31:42,980 --> 00:31:45,640
+الكلام، نفس الكلام، بعيد، أنه بيقول أنه فيه defects
+
+508
+00:31:45,640 --> 00:31:49,080
+بيصير في الـ ash، في الـ valve، فبتعمل murmur زي ما بعض
+
+509
+00:31:49,080 --> 00:31:52,780
+الناس بيقول لك إذا عنده خلل في القلب أو عنده يعني
+
+510
+00:31:52,780 --> 00:31:57,480
+خلل شوية في الدم، أي defects موجود في داخل القلب
+
+511
+00:31:57,480 --> 00:32:01,240
+أو في الـ .. في الـ valves، أو في تصريف الدم، وفي نفس
+
+512
+00:32:01,240 --> 00:32:05,320
+الوقت بيعمل لي يعني شوية خربطة وأصوات غريبة، بده
+
+513
+00:32:05,320 --> 00:32:08,900
+يسميها إيش يعني؟ murmurs، الـ murmurs زي ما إحنا قلنا
+
+514
+00:32:08,900 --> 00:32:13,870
+abnormal sound of the heart، آخر شيء بدنا نقارن على
+
+515
+00:32:13,870 --> 00:32:16,390
+السريع بين arterial و الـ venous insufficiency
+
+516
+00:32:16,390 --> 00:32:21,090
+القصور أو الفشل اللي بيصيب، يا إنسان عنده مثلا يعني
+
+517
+00:32:21,090 --> 00:32:26,210
+فشل في الـ .. خليني أقول الجسم الشرياني أو فشل في
+
+518
+00:32:26,210 --> 00:32:31,530
+الجسم الوريدي، طبعا الاختصارات بسيطة سهلة ومش غالب
+
+519
+00:32:31,530 --> 00:32:34,350
+أكثر عليكم، أول حاجة من ناحية الـ pulse في الـ
+
+520
+00:32:34,350 --> 00:32:37,090
+artery، بنلاقي decrease or absence، إذا كان فيه قصور
+
+521
+00:32:37,090 --> 00:32:40,310
+أو فشل في artery، أكيد هيكون قليل أو قليل الـ pulse
+
+522
+00:32:40,310 --> 00:32:43,850
+هنا، لأ، الـ venous بيكون موجود، على حد يعني بتلاقيه
+
+523
+00:32:43,850 --> 00:32:46,390
+ممكن يكون الـ waves أعلى، على اعتبار أنه صار فيه
+
+524
+00:32:46,390 --> 00:32:50,930
+مشكلة، فالدم بيحاول يدخل بكل قوة، الـ color لو طلعنا
+
+525
+00:32:50,930 --> 00:32:53,770
+على الجلد حوالين الـ artery اللي فيه المشكلة
+
+526
+00:32:53,770 --> 00:32:58,410
+بيلاقيه pale، شاحب، و بعدين إيش هنا؟ elevation and
+
+527
+00:32:58,410 --> 00:33:03,030
+إيش؟ on and cold، إيش يعني؟ يعني لو .. لو رفع
+
+528
+00:33:03,030 --> 00:33:06,090
+رجله شوية صغيرة، بتلاقي شاحب، وحتى في بعض الحالات
+
+529
+00:33:06,090 --> 00:33:09,390
+لو ما رفعش رجله، بنلاقي شحوب مع وجهه كمان، بنلاقي
+
+530
+00:33:09,390 --> 00:33:13,150
+شحوب، وفي نفس الوقت إيش بتكون رجله؟ باردة شوية، لكن
+
+531
+00:33:13,150 --> 00:33:15,570
+لو طلعنا على الـ venous، لأ، بنلاقي pink، يعني لأ، اللون
+
+532
+00:33:15,570 --> 00:33:18,550
+طبيعي، بس مئة المرات يكون للسينوز، يعني ممكن يكون
+
+533
+00:33:18,550 --> 00:33:22,210
+لأزرق أو فيه لون بني، على اعتبار أنه إيش؟ بدأ
+
+534
+00:33:22,210 --> 00:33:28,350
+يتحشر الدم، الـ temperature لو حسينا الجلد في منطقة
+
+535
+00:33:28,350 --> 00:33:31,750
+الـ arterial insufficiency، هنلاقيه بارد، عشان هيك لما
+
+536
+00:33:31,750 --> 00:33:35,230
+بنسأل .. بنقوله إيده باردة، إذا يعني لو واحد مركب
+
+537
+00:33:35,230 --> 00:33:38,350
+لو مثلا جبس، إذا لاجينا قدام الجبس، إيده باردة
+
+538
+00:33:38,350 --> 00:33:41,690
+فورا بدنا نشيل الجبس، لكن لو لاجينا إيده دافية، بدنا
+
+539
+00:33:41,690 --> 00:33:44,650
+نعطيه علاج، بدنا نعرف إن المشكلة وين موجودة يعني
+
+540
+00:33:44,650 --> 00:33:49,880
+السخونة وريدي والبرودة شرياني، إِدِيمَة، طالع في الإِدِيمَة
+
+541
+00:33:49,880 --> 00:33:52,300
+بنلاقيها مش موجودة، فش في الـ arterial، لسه فش لسه
+
+542
+00:33:52,300 --> 00:33:55,120
+إِدِيمَة، لكن أي venous، لسه فش، لسه، عشان يكتب عني الـ
+
+543
+00:33:55,120 --> 00:34:00,480
+DVT، بقولك أنا صار عندي، حاسس أنه أنا صار عندي إِدِيمَة
+
+544
+00:34:00,480 --> 00:34:02,920
+مش جادة، يعني هي ليه؟ استسقاء، يعني المية عاملة بتزيد
+
+545
+00:34:02,920 --> 00:34:06,360
+فبيجي بقولك، طب تعال نشوف، نعمل لك فحص عشان نعرف
+
+546
+00:34:06,360 --> 00:34:11,280
+إيش هذا اللي موجود عندك، Skin، بنطلع الجلد حوالين
+
+547
+00:34:11,280 --> 00:34:15,260
+الـ artery اللي هو فيه المشكلة، بنشوف لامع،
+
+548
+00:34:15,260 --> 00:34:18,320
+الأضافر بدأت تصير فيها thickness، لأنه بطل يصلها
+
+549
+00:34:18,320 --> 00:34:23,940
+الدم و الأكسجين كويس، صار الـ hair كمان يتقصف، فصار
+
+550
+00:34:23,940 --> 00:34:26,760
+عنده تقرحات، يعني شغلات كلها متعلقة بإيه؟
+
+551
+00:34:26,760 --> 00:34:30,540
+gangrene، كل هذا متعلق بأنه مش الدم، بطل يوصل وبطل
+
+552
+00:34:30,540 --> 00:34:34,540
+وصار فيه قصور في الشريان، أما القصور في الوريد،
+
+553
+00:34:34,540 --> 00:34:38,820
+هنا لأ، بيصير إِدِيمَة، بس أكترش على الـ ankles، خاصة
+
+554
+00:34:38,820 --> 00:34:42,440
+و بيصير discolored، وبيصير scaly، يعني بتلون منطقة
+
+555
+00:34:42,440 --> 00:34:46,080
+الـ ankles خاصة، هذا يعني الـ joint بالذات، علشان
+
+556
+00:34:46,080 --> 00:34:48,940
+الضغط، الـ pressure اللي عليه، وبيصير زي قشور بتطلع
+
+557
+00:34:48,940 --> 00:34:53,400
+على .. على رجله من هذا المكان، طبعا الـ sensation
+
+558
+00:34:53,400 --> 00:34:57,080
+الإحساس، الـ leg pain، طبعا فيه ألم شديد بيكون في
+
+559
+00:34:57,080 --> 00:34:59,720
+منطقة الـ leg، لكن بيزيد إيش؟ مع الـ standing، يعني
+
+560
+00:34:59,720 --> 00:35:02,740
+بدنا نعرف إنه عنده مشكلة في artery ولا في venous، مجرد
+
+561
+00:35:02,740 --> 00:35:05,480
+ما يوقف، مجرد ما يوقف، إيش بيصير؟ عنده ألم شديد، لكن
+
+562
+00:35:05,480 --> 00:35:10,070
+لو ارتاح، relieved، بتلاقي أول ما يرتاح بيخف الألم، و
+
+563
+00:35:10,070 --> 00:35:12,470
+في مرات فيه pressure بيحس، يعني بتغطي على الـ
+
+564
+00:35:12,470 --> 00:35:16,170
+blotches، وبيحس مرات بألم في الـ calves، كل هذا بيسموه
+
+565
+00:35:16,170 --> 00:35:20,330
+cramp، كلمة cramp يعني زي إشي بعصل، زي إشي بيدغط
+
+566
+00:35:20,330 --> 00:35:24,370
+عليه، زي إشي بيشده، هذا الـ sensation مرتبط أكتر شي
+
+567
+00:35:24,370 --> 00:35:27,270
+بالـ arterial insufficiency، أما في الـ venous
+
+568
+00:35:27,270 --> 00:35:30,490
+insufficiency، إيش بيقول لي صحيح؟ الـ leg pain موجود
+
+569
+00:35:30,490 --> 00:35:34,570
+لكن و aggravated by standing، ها لاحظين كمان
+
+570
+00:35:34,570 --> 00:35:37,430
+بيقول لي بيزيد في إيش؟ بالوقوف، على اعتبار أن الوقوف
+
+571
+00:35:37,430 --> 00:35:41,490
+بتغطي على الشريان والوريد، أو في الـ sitting كمان
+
+572
+00:35:41,490 --> 00:35:45,470
+and relieved by إيش؟ elevation of legs، هنا .. هنا
+
+573
+00:35:45,470 --> 00:35:53,020
+elevation by legs، طيب لو لاحظنا، قال لي بدك ترفع
+
+574
+00:35:53,020 --> 00:35:56,860
+هنا عشان بدك تحسّنهم، حتى لو نام ما يرتاحش، لكن لو
+
+575
+00:35:56,860 --> 00:36:00,060
+رفعنا الرجلين، لو رفعنا رجلينا شوية، ارتاح هنا،
+
+576
+00:36:00,060 --> 00:36:03,520
+لأ، ما لوش علاقة، لأن المشكلة جونا في الشريان، مش
+
+577
+00:36:03,520 --> 00:36:08,190
+في الوريد، الآن بقول الـ lying down، لو نام كمان أو
+
+578
+00:36:08,190 --> 00:36:12,830
+استلقى عادي، حتى لو ماشي .. ها تلاحظوا، لو ماشي ممكن
+
+579
+00:36:12,830 --> 00:36:16,470
+يتحسن في الـ venous في الأول، لكن ممكن يكون ممنوع
+
+580
+00:36:16,470 --> 00:36:19,890
+فيما بعدها .. ممكن يكون .. لكن أنت سِمِح للطبيب يا
+
+581
+00:36:19,890 --> 00:36:23,130
+أنا، ممكن يقولك شوية تقلصات بتمشي هنا، ممنوع، لأ، لأنه
+
+582
+00:36:23,130 --> 00:36:26,410
+مع المشي هيتألم كتير .. برضه relieved by إيش هنا؟
+
+583
+00:36:26,410 --> 00:36:30,580
+use of إيش؟ support، هو زي، إحنا بدأنا نستخدم بعض
+
+584
+00:36:30,580 --> 00:36:33,900
+الجوارب الضاغطة، أو الجوارب، فيه جوارب بيسموها
+
+585
+00:36:33,900 --> 00:36:36,980
+الجوارب الطبية، بيستخدموها، زي الجوارب اللي لها
+
+586
+00:36:36,980 --> 00:36:40,860
+علاقة، أو حتى اليوم صار يصنع زي روابط، مشدات معينة
+
+587
+00:36:40,860 --> 00:36:44,560
+بتضغط على الرجل وبتحاول إنها إيش؟ عشان تساعد في
+
+588
+00:36:44,560 --> 00:36:47,900
+ضغط الدم في اتجاه القلب بشكل أوسع أو أقوى، بإذن
+
+589
+00:36:47,900 --> 00:36:52,930
+الله، طبعا هي خلصنا chapter الـ cardiocardiac
+
+590
+00:36:52,930 --> 00:36:56,150
+assessment و cardiovascular، والحمد لله، إن شاء الله
+
+591
+00:36:56,150 --> 00:36:59,530
+المحاضرة القادمة ندخل في الـ chapter القادم، السلام
+
+592
+00:36:59,530 --> 00:37:01,410
+عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c14eeed9214aaf2037f2100cf5063ee80a512d60
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_postprocess.srt
@@ -0,0 +1,2368 @@
+1
+00:00:00,440 --> 00:00:04,380
+بسم الله الرحمن الرحيم اليوم ان شاء الله بدنا نبدأ
+
+2
+00:00:04,380 --> 00:00:08,160
+في الشكتر الثامن اللي هو assessment of ايه؟
+
+3
+00:00:08,160 --> 00:00:12,200
+cardiovascular system يعني تقييم .. خلصتنا التقييم
+
+4
+00:00:12,200 --> 00:00:15,260
+للجهاز التنفسي اليوم بدنا ناخد اللي هو التقييم
+
+5
+00:00:15,260 --> 00:00:19,300
+للجهاز الدوري اللي هو القلب والأوعية الدموية طيب
+
+6
+00:00:19,300 --> 00:00:23,600
+أول حاجة assessment of cardiovascular system يبدأ
+
+7
+00:00:23,600 --> 00:00:26,380
+بإيه؟ بال objective data زي كل مرة إيش هي ال
+
+8
+00:00:26,380 --> 00:00:30,470
+objective data؟ أول حاجة بدنا نسأل المرض كسؤالأول
+
+9
+00:00:30,470 --> 00:00:32,910
+سؤال بدنا نسأله chief complaint، شو الشكوه
+
+10
+00:00:32,910 --> 00:00:37,670
+الأساسية اللي هو بيشكيها؟ عنده chest pain؟ حاضر،
+
+11
+00:00:37,670 --> 00:00:41,670
+نيجي بنقوله طيب وين بالظبط مكانه؟ ال quality؟ كيف
+
+12
+00:00:41,670 --> 00:00:45,530
+كيفيته؟ duration؟ كدهش مستمر عندك؟ associated
+
+13
+00:00:45,530 --> 00:00:48,150
+symptoms؟ أيش الأعراض المتعلقة كمان معاه؟ يعني
+
+14
+00:00:48,150 --> 00:00:52,650
+أقصد هنا لما يجينا المريض للعمل اللي أسسه لل
+
+15
+00:00:52,650 --> 00:00:55,690
+cardiovascular system بشكل عام أجي أتألم من منطقة
+
+16
+00:00:55,690 --> 00:00:59,350
+صدره و بديت أشك أنه العلاقة .. الوجع هذا بقلبه
+
+17
+00:01:00,150 --> 00:01:03,890
+بنسألك كل إشي عن هذا القلم و هذا الوجع، وقت إيش
+
+18
+00:01:03,890 --> 00:01:05,930
+بروح و وقت إيش بيجي، إيش اللي بيخليه زيد، إيش اللي
+
+19
+00:01:05,930 --> 00:01:09,570
+بيخليه .. و هكذا، بعدين بشوف إيش ال regular heart
+
+20
+00:01:09,570 --> 00:01:14,150
+beat، هل عنده عدم انتظام في دقات القلب، pound، إيش
+
+21
+00:01:14,150 --> 00:01:18,370
+زي إيش بغم يعني زي إيش زي .. زي .. لما أقول كلمة
+
+22
+00:01:18,370 --> 00:01:24,620
+بغم يعنيأشي حاجة زي بت jump يعني bound بتجمع كأنه
+
+23
+00:01:24,620 --> 00:01:29,200
+حاجة بتضغط عليه يعني اما احس اشي هو بيجبول انا بحس
+
+24
+00:01:29,200 --> 00:01:33,480
+الدجاج تبعتي بتغم عليكيف بتغم عليك زي سواء انا
+
+25
+00:01:33,480 --> 00:01:39,260
+يعني بتحاول اقربها و بسطها زي انه دقات القلب كأنا
+
+26
+00:01:39,260 --> 00:01:43,340
+زي حلقات بتحاول تضغط حلقات بتحاول تضغط في منها نوع
+
+27
+00:01:43,340 --> 00:01:45,480
+تاني بيسموه too fast بيقولك لأ انا عندك سريع في
+
+28
+00:01:45,480 --> 00:01:49,230
+jumpإيه ال jump يعني بقولك أنا بحس إيه دجات جلبي
+
+29
+00:01:49,230 --> 00:01:52,830
+بنط النط بحس الجلب تبعي زي اللي بفط فط هيك و etc
+
+30
+00:01:52,830 --> 00:01:56,750
+الاخرين assessment of risk factors بنسأله عن إيه
+
+31
+00:01:56,750 --> 00:02:00,870
+ال risk factors شو ال risk factors اللي ممكن نسأل
+
+32
+00:02:00,870 --> 00:02:04,250
+عنها أول حاجة عن history of hypertension لإن مرتبط
+
+33
+00:02:04,250 --> 00:02:07,850
+ارتباط وثيق جدا بال cardiac problems على اعتبار
+
+34
+00:02:07,850 --> 00:02:11,550
+انه لما نقول كلمة طاقة الدم يعني أوعية دم أويا
+
+35
+00:02:11,550 --> 00:02:17,030
+مرتبط ارتباط شامل و كامل معايش مع القلبdiabetes
+
+36
+00:02:17,030 --> 00:02:20,330
+على اعتبار ان معظم الناس اللي عندهم diabetes بيروح
+
+37
+00:02:20,330 --> 00:02:23,390
+ايش بتجرب معاه ال hypertension و ممكن يصير عندها
+
+38
+00:02:23,390 --> 00:02:27,910
+secondary hypertension في بعدين نقول ايش كان نسأل
+
+39
+00:02:27,910 --> 00:02:30,670
+عن ال rheumatic fever خاصة بحما ال rheumatism لأنه
+
+40
+00:02:30,670 --> 00:02:34,430
+لقوا الارتباط برضه في ال valves يعني لو صار عند
+
+41
+00:02:34,430 --> 00:02:38,510
+واحد حمه في بداية صغره و لقوا بعض الحالات بيتأثر
+
+42
+00:02:38,510 --> 00:02:41,390
+اللي هو ال valves تبع ال heart اللي هو في داخل
+
+43
+00:02:41,390 --> 00:02:46,140
+القلببين ال ventricle و ال atrium علشان بتصير فيها
+
+44
+00:02:46,140 --> 00:02:50,300
+إشكالية طبعا الإشكالية لأنه لجوا أنه نفس البكتيريا
+
+45
+00:02:50,300 --> 00:02:54,020
+اللى تسبب ال erotic fever streptococci برضه بتأثر
+
+46
+00:02:54,020 --> 00:02:56,980
+على .. على منطقة اللي هو ال valves عشان بتصير
+
+47
+00:02:56,980 --> 00:03:00,900
+عندهم endocarditis طيب ask about اسأل عن إيش ال
+
+48
+00:03:00,900 --> 00:03:04,280
+family history اسأل هل نقاش heart attack هل صار
+
+49
+00:03:04,280 --> 00:03:08,820
+عندكم في عيلتكم myocardial infarction angina كله
+
+50
+00:03:08,820 --> 00:03:11,580
+اللي بتتكلم عن heart attack طيب صار في
+
+51
+00:03:11,580 --> 00:03:15,960
+hypertensionفي جلطات، في عندكوا diabetes، هذه
+
+52
+00:03:15,960 --> 00:03:18,820
+تعتبر من ال history المهمة جدا و انا قاعد بعمل في
+
+53
+00:03:18,820 --> 00:03:22,740
+بداية ال assessment لcardiovascular system طيب
+
+54
+00:03:22,740 --> 00:03:26,860
+التاني الأمر المهم جدا و احنا خدناه في ال
+
+55
+00:03:26,860 --> 00:03:30,800
+nutrition assessment أن نسأل أول حاجة كيف الأكل
+
+56
+00:03:30,800 --> 00:03:34,460
+اللي أنت بتاكله طبعا لو حد مايجيب فالو أنه كان
+
+57
+00:03:34,460 --> 00:03:37,480
+بيسأل عن طبيعة الأكل، كم يأكل و كم ملال، لأ أنا
+
+58
+00:03:37,480 --> 00:03:39,940
+بتكلم في نوعية، ممكن يكون فيها ملاح، ممكن يكون
+
+59
+00:03:39,940 --> 00:03:43,270
+فيها قلة، ممكن يكون فيش فيها mineralsهكذا مش فيها
+
+60
+00:03:43,270 --> 00:03:47,610
+protein، فبنسأله nutrition intake كيف؟ هل في انت
+
+61
+00:03:47,610 --> 00:03:51,750
+عندك مشكلة؟ طب عمرك فحست .. بنسأل السؤال عمرك فحست
+
+62
+00:03:51,750 --> 00:03:56,050
+الكوليسترول، triglyceride، level of protein، liver
+
+63
+00:03:56,050 --> 00:03:58,470
+function test بشكل عام؟ عمرك فحستهم كله اللي علاقة
+
+64
+00:03:58,470 --> 00:04:01,870
+بالإيه nutrition intake إذا في مشكلة عشان نبدأ
+
+65
+00:04:01,870 --> 00:04:03,950
+يعيش لإنه نقص خطر، الكوليسترول عالي، ال
+
+66
+00:04:03,950 --> 00:04:06,430
+triglyceride عالي و ال diabetes عالي، معناته
+
+67
+00:04:06,430 --> 00:04:09,170
+رايحين على أشكالية ممكن تصير في ال cardiovascular
+
+68
+00:04:09,170 --> 00:04:13,040
+systemدى اسمه كانت تدخن كتير لجوه الدراسات انه في
+
+69
+00:04:13,040 --> 00:04:17,960
+ارتباط وثيق مع التدخين كدهش بتدخل و زمان إلك ولا
+
+70
+00:04:17,960 --> 00:04:22,820
+قرية يعني من قريب و هكذا how do you view yourself
+
+71
+00:04:22,820 --> 00:04:26,620
+ايش يعني كي بنسأل سؤال كويس انت كيف شايف حالك يعني
+
+72
+00:04:26,620 --> 00:04:30,620
+انا بنبسط من الطبيب اللى بيجي المرض بيقوله انا قبل
+
+73
+00:04:30,620 --> 00:04:33,480
+ما حكم عليك انت كيف شايف حالك بيجي المرض بيقول
+
+74
+00:04:33,480 --> 00:04:35,580
+والله انا حاسس حالة تعبان والله حاسس حالة مرهقة
+
+75
+00:04:35,580 --> 00:04:39,630
+والله حاسس يعني هذا ايش اسمهI view myself from my
+
+76
+00:04:39,630 --> 00:04:43,010
+view. أنا بشوف حالي من وجهة نظري. و في نفس الوقت
+
+77
+00:04:43,010 --> 00:04:46,650
+بيقولوا what you do is to relax. إيش أنت بتعمل
+
+78
+00:04:46,650 --> 00:04:50,250
+عشان ترتاح لما تكون تعبال؟ هذا إيه المعنى؟ لقدام
+
+79
+00:04:50,250 --> 00:04:53,190
+شوية هنفهم إيش .. إيش اللي نقصد. How many hours؟
+
+80
+00:04:53,190 --> 00:04:57,510
+جديش أنت جديش في اليوم بتشتغل. ما زال جديش في
+
+81
+00:04:57,510 --> 00:05:00,050
+اليوم تشتغل كم هيكون دُغر تلقايا جديش في اليوم
+
+82
+00:05:00,050 --> 00:05:03,870
+بترتاح.الأمر اللي أختار بده نسأله على موضوع ال
+
+83
+00:05:03,870 --> 00:05:07,510
+stress لإنه مرتبط ارتباط وثيق جدا في ال
+
+84
+00:05:07,510 --> 00:05:10,810
+cardiovascular system ما حلله ال stress للأسف
+
+85
+00:05:10,810 --> 00:05:13,750
+القلب لإنه من كتر من الإنسان بحط في قلبه مشكلة
+
+86
+00:05:13,750 --> 00:05:17,990
+طبعا نسألك how to cope كيف أنت بتتأقلم بالتوتر في
+
+87
+00:05:17,990 --> 00:05:21,490
+حياتك بده يقولنا هل بال aggressive هل بال anxiety
+
+88
+00:05:21,490 --> 00:05:24,170
+بده يحكينا الشيء اللي موجود عنده نسأل على ال
+
+89
+00:05:24,170 --> 00:05:29,140
+exerciseانت بالنسبة لك بتعمل تمارين مش شرط انك
+
+90
+00:05:29,140 --> 00:05:32,000
+قاعد بلعب مثلا مارثونة وغيرها، لأ، بتعمل تمارين في
+
+91
+00:05:32,000 --> 00:05:35,720
+حياتك ولا لأ؟ إذا قال أه، بتقوله أيش هوفر، جد إيش؟
+
+92
+00:05:35,720 --> 00:05:39,320
+كل يومين، كل يوم، كل أسبوع، وكيف قليتك، بتمشي ..
+
+93
+00:05:39,320 --> 00:05:42,120
+إيش اللي بتعمله؟ طيب، في عندك الجد بدأنا ندخل في
+
+94
+00:05:42,120 --> 00:05:45,920
+التفصيل الأدق شوية، نسأل عن الألم الآن، الألم
+
+95
+00:05:45,920 --> 00:05:48,420
+مابيسأله في منطقة ال heart مباشرة، لأ، بيجي بيسأله
+
+96
+00:05:48,420 --> 00:05:51,480
+في منطقة إيش؟ ال calves، ال calves يا جماعة عشان
+
+97
+00:05:51,480 --> 00:05:55,130
+كنا عندكوا علمبيسموها لبطة الرجل وال curves
+
+98
+00:05:55,130 --> 00:05:58,530
+بيسموها العلماء the second heart of the body، ايش
+
+99
+00:05:58,530 --> 00:06:02,050
+يعني؟ يعني تعتبر اسم القلب الثاني للجسم على اعتبار
+
+100
+00:06:02,050 --> 00:06:07,340
+انها بعد ما الدم كله ينزل ال extremities تحتبينضغط
+
+101
+00:06:07,340 --> 00:06:10,220
+بال calves muscle .. سبحان الله ال calves muscle
+
+102
+00:06:10,220 --> 00:06:13,800
+وين بروح و برجع يعني على الطريق اللي فينا كذا،
+
+103
+00:06:13,800 --> 00:06:16,160
+بروح اياش، برجع على القلب، وهذا ميزة حلوة كتير
+
+104
+00:06:16,160 --> 00:06:19,540
+الله حطها يعني في جسم الإنسان عشان ما يصيرش قلنا
+
+105
+00:06:19,540 --> 00:06:23,520
+دوالي و احنا واقفين و احنا عمالنا بنطول واقفتنا،
+
+106
+00:06:23,520 --> 00:06:27,320
+نسأل على ال feet، الأقدام كيف؟الـ legs ماحدى يقول
+
+107
+00:06:27,320 --> 00:06:30,780
+لي إيش دخلهم، لأ كله اللي دخل أي arterial problems
+
+108
+00:06:30,780 --> 00:06:33,220
+بالعكس على دول أي arterial .. ال arterial problems
+
+109
+00:06:33,220 --> 00:06:36,520
+من هون جاية ال arterial problems جاية من ال heart
+
+110
+00:06:36,520 --> 00:06:41,220
+عشان هيك لإنها يتوع طبع قلبه أوعيا بعدين بنسأله
+
+111
+00:06:41,220 --> 00:06:43,860
+إيش اللي بيجي .. لما أقول كلمة .. كلمة aggravates
+
+112
+00:06:43,860 --> 00:06:47,580
+شو اللي بيخلي القلم عندك زيت؟ مزال في كلمة
+
+113
+00:06:47,580 --> 00:06:50,580
+aggravate لازم يكون العكس فيه عسم relief يبقى لازم
+
+114
+00:06:50,580 --> 00:06:53,680
+نسأله، لو قاللي أه والله أنا عندي مشكلة، عندي قلم
+
+115
+00:06:53,680 --> 00:06:57,050
+في رجليا، عندي رجليا قلم في منطقة الوالله الكلال
+
+116
+00:06:57,050 --> 00:07:00,010
+اللي في مصر عندي ألم باتش بسأله، شهو اللي ممكن
+
+117
+00:07:00,010 --> 00:07:03,530
+يعمل ا aggravation زي ال walking أو ال sitting،
+
+118
+00:07:03,530 --> 00:07:07,230
+long period، زي ال standing، long period، زي ال
+
+119
+00:07:07,230 --> 00:07:09,530
+sleep، في مرات بيقولك لأ، في بعض الناس بيقولك أنا
+
+120
+00:07:09,530 --> 00:07:12,870
+في الليل بتقلم، بيصير معي stiff، لازم ناخد الكلام
+
+121
+00:07:12,870 --> 00:07:16,430
+بعين الاعتبار، أو بتشد عضلاتي وماقدرش ا .. يعني ا
+
+122
+00:07:16,430 --> 00:07:20,590
+.. افرد نفسي طيب ما زال سألنا إيش اللي بشجع الألم،
+
+123
+00:07:20,590 --> 00:07:25,280
+بدنا نسأل السؤال إيش اللي بخفف الألم؟بنسأله ايش
+
+124
+00:07:25,280 --> 00:07:27,660
+اللي ممكن يخفف القمزايا elevated legs يعني هل انت
+
+125
+00:07:27,660 --> 00:07:33,380
+لما ترفع رجليك مثلا عن خد على كده بترتاح طيب هل
+
+126
+00:07:33,380 --> 00:07:37,700
+انت بتستخدم هنا constructing هنا حاجة سمها
+
+127
+00:07:37,700 --> 00:07:40,900
+garments or hosiery garments or hosiery يعني
+
+128
+00:07:40,900 --> 00:07:45,920
+الجوارب وخاصة للأسف في بعضهم بيصير عندهم مشكلة انه
+
+129
+00:07:45,920 --> 00:07:49,300
+خاصة اللي بيلبسوا الأحتياج شديدة شويه ضغط ع رجليهم
+
+130
+00:07:49,300 --> 00:07:54,720
+عشان بدهوا نمر أصغر أو بيلبس جوارب يعني ضغط كتيرأو
+
+131
+00:07:54,720 --> 00:07:58,700
+الجوارب الطويلة يعني بتعرفوهم انتوا هذولة برضه
+
+132
+00:07:58,700 --> 00:08:01,940
+اللي معلاقة عشان نعرف ان اللي قدامي شوية ان هذول
+
+133
+00:08:01,940 --> 00:08:06,280
+مرات بساعد في رأي يعني ضغط الدم و مرات بضر ان اذا
+
+134
+00:08:06,280 --> 00:08:10,980
+كان زيادة زي ال bandage او الشاشة لما بنلف على ايد
+
+135
+00:08:10,980 --> 00:08:14,300
+المريض لما بيكون بحدوده الطبيعي مقبول لما بزيد
+
+136
+00:08:14,300 --> 00:08:19,000
+مشكلة و لما بجلد برضه مشكلة طيب in what type of
+
+137
+00:08:19,000 --> 00:08:22,880
+chair does the client usually sit؟ بنسأله سؤاليإيش
+
+138
+00:08:22,880 --> 00:08:26,240
+أنت أحسن كرسي بتحب تقعد عليه؟ برضه هذا إيه المهم،
+
+139
+00:08:26,240 --> 00:08:29,440
+كيف قعدتك؟ كيف قليت الجلوس عشان نعرف أنه هل بيحب
+
+140
+00:08:29,440 --> 00:08:33,060
+يخفف عن نفسه؟ هل بيحب يحط ورا مثلا مسند، مخدة عشان
+
+141
+00:08:33,060 --> 00:08:36,700
+نعرف أنه فيه مشكلة؟ هل بيحب يخفف عن ال pressure من
+
+142
+00:08:36,700 --> 00:08:39,860
+ال abdomen جاى على ال heart ولا لأ؟ بعدين بنسأله،
+
+143
+00:08:39,860 --> 00:08:44,860
+هل أنت من الناس اللي بيحبوا يعني يعمل cross legs؟
+
+144
+00:08:44,860 --> 00:08:48,210
+cross legs كلهم عارفين يعني بيحط رجل عرجل يعنيطبعا
+
+145
+00:08:48,210 --> 00:08:51,050
+ما تعتبروها نحاجة صحيح الناس بيعتبرها ربما
+
+146
+00:08:51,050 --> 00:08:55,410
+prestige أو كده لكن أنا هنا صراحة أنصحت جميع مش
+
+147
+00:08:55,410 --> 00:08:59,130
+كتير كويسة صحية و لو زادت ممكن يعني تعمل مصيبة
+
+148
+00:08:59,130 --> 00:09:02,330
+خاصة في بعض الناس اللي عندهم أصلا arterial
+
+149
+00:09:02,330 --> 00:09:08,790
+problems اللي هو يعني وضع رجل على رجل أكتر من وقت
+
+150
+00:09:08,790 --> 00:09:13,370
+كتير ممكن يصير للأسف DVT في بعض الحالاتassessment
+
+151
+00:09:13,370 --> 00:09:16,590
+نشوف إيش هنا لازم يكون إيش المريض مش sitting لما
+
+152
+00:09:16,590 --> 00:09:20,850
+قلنا هناك في ال assessment لل respiratory system
+
+153
+00:09:20,850 --> 00:09:23,970
+كنا sitting و لما نيتعب ممكن إيش نايم على دهره هنا
+
+154
+00:09:23,970 --> 00:09:27,570
+لأ عشان heart جلي على ال subile لكن إيش جلي إيه
+
+155
+00:09:27,570 --> 00:09:31,190
+subile ممكن يكون sitting لكن هو subile بيكون أريح
+
+156
+00:09:31,190 --> 00:09:34,550
+للمريض ليش على اعتبار أن مافيش pressure على ال
+
+157
+00:09:34,550 --> 00:09:39,770
+heart كتب لي لحظة كلام حلو according to إيش توزيت
+
+158
+00:09:39,770 --> 00:09:44,390
+يعني أنت تابعليش بقول انت تابع صحة المريض؟ بعض
+
+159
+00:09:44,390 --> 00:09:48,150
+المرضى بقولك بقدرش انا مع ظهري خاصة الناس ال obese
+
+160
+00:09:48,150 --> 00:09:50,130
+و ال heavy smokers بقدرش او اللي عنده أزمة بقولك
+
+161
+00:09:50,130 --> 00:09:53,610
+بقدرش هذا ممكن على راحته نخليه setting طيب
+
+162
+00:09:53,610 --> 00:09:56,810
+inspection and pulpation أول حاجة بدنا نطلع
+
+163
+00:09:56,810 --> 00:10:00,450
+inspection بعدين بدنا نمد دي أنه نعمل pulpation
+
+164
+00:10:00,450 --> 00:10:03,910
+عشان إذا فيه لا سمح الله ventricular hypertrophy
+
+165
+00:10:03,910 --> 00:10:07,950
+في بعض الناس نسمع بيقولوا عنده تضخم في عضلة القلب
+
+166
+00:10:08,480 --> 00:10:11,000
+لما تسمع تضخم في عدوة القلب هذا المقصود
+
+167
+00:10:11,000 --> 00:10:14,520
+ventricular hypertrophy من إيش؟ لقدام شويحة أشرح
+
+168
+00:10:14,520 --> 00:10:18,340
+من إيش بتكون لازم نستخدم source of light لازم يكون
+
+169
+00:10:18,340 --> 00:10:22,480
+مصدر ضوء قوي جدا طب ليش؟ عشان في بعض الحركات مش
+
+170
+00:10:22,480 --> 00:10:25,440
+كذا اسمها subtil movement subtil يعني المنطقة
+
+171
+00:10:25,440 --> 00:10:29,000
+المخفية الحركات المخفية in the chest يعني ممكن أنت
+
+172
+00:10:29,000 --> 00:10:33,640
+تتطلع في ال chest ممكن الجلب نفسه في دقاته في
+
+173
+00:10:33,640 --> 00:10:37,220
+مشكلةومبينة على الجسم من برا لكن مش قادر اشوفها
+
+174
+00:10:37,220 --> 00:10:41,220
+انا ممكن تكون حركات مخفية خاصة لما بيكون obese
+
+175
+00:10:41,220 --> 00:10:46,420
+المريض وفي القلب مع دقاته فيه خربطة شوية مش قادرين
+
+176
+00:10:46,420 --> 00:10:50,000
+نعرف هذه الخربطات زي ايش خربطة يا أستاذ زي حاجة ال
+
+177
+00:10:50,000 --> 00:10:52,960
+pulsation لو حطينا ضوء ممكن انا ماشوفش الجسم
+
+178
+00:10:52,960 --> 00:10:56,940
+بالعين مجرد لو حطت ضوء قوي بنسير نتطلع بنشوف تطلع
+
+179
+00:10:56,940 --> 00:11:00,000
+وع الطفل لو عندكوا طفل ع مطقة الصدر وحطيتوا ضوء
+
+180
+00:11:00,000 --> 00:11:04,360
+هتلاقيوا إيش النبضات مبينة جدا و واضحة زي الشمسفي
+
+181
+00:11:04,360 --> 00:11:07,600
+بعض الناس عندهم Retraction Retraction زي ليش بطلع
+
+182
+00:11:07,600 --> 00:11:10,940
+و بنزل Retraction هاسمه إيش Retraction زي حكاية ال
+
+183
+00:11:10,940 --> 00:11:13,100
+.. ال .. ال .. إيش .. زي إيش بروح و برجع .. بروح و
+
+184
+00:11:13,100 --> 00:11:17,360
+برجع .. بروح و برجع .. هاسمه إيه Retraction طيب في
+
+185
+00:11:17,360 --> 00:11:21,240
+عندنا من ال pulse اللي بدنا نعمله assessment في
+
+186
+00:11:21,240 --> 00:11:26,240
+منطقة ال heart نوعين في نوع اسمه Apical pulse و في
+
+187
+00:11:26,240 --> 00:11:30,610
+نوع اسمه Base pulse مش Apical و Radialانا عارف ايش
+
+188
+00:11:30,610 --> 00:11:32,990
+قصدكم apical و radial طبعا فى فرق بينهم و شوية
+
+189
+00:11:32,990 --> 00:11:37,150
+هكمل يعنى فى اعتبروا انه one to two to three pulse
+
+190
+00:11:37,150 --> 00:11:40,930
+زي الفرق بينهم اللى ما بين ال apical و ال radial
+
+191
+00:11:40,930 --> 00:11:44,430
+لكن هنا اقصد ال apical و ال basic اتنين heart طيب
+
+192
+00:11:44,430 --> 00:11:46,310
+احنا فى البداية وان ال heart موجود ما انت خدتوا فى
+
+193
+00:11:46,310 --> 00:11:49,910
+التشريح و نذكركوا ال heart زى سبحان الله زى
+
+194
+00:11:49,910 --> 00:11:54,170
+المخلوط الشكلالرأس تبع المخروط لتحته و القاعدة تبع
+
+195
+00:11:54,170 --> 00:11:58,530
+المخروط لفوق يبقى أعلى الصدر فوق هو قاعدة القلب
+
+196
+00:11:58,530 --> 00:12:01,690
+لإنه بيطلع منها ال vessels و هو أدنها من تحت اللي
+
+197
+00:12:01,690 --> 00:12:05,570
+هو رأس إيه اللي هو ال apical pulse وين موجود؟ عشان
+
+198
+00:12:05,570 --> 00:12:08,070
+أعرف بالظبط، بقوللي في ال lift، ها fifth
+
+199
+00:12:08,070 --> 00:12:11,890
+intercoastal space، بدك تسمع كويس ال apical pulse،
+
+200
+00:12:11,890 --> 00:12:14,750
+روح على إيش؟ ال lift، ها fifth intercoastal space،
+
+201
+00:12:14,750 --> 00:12:18,580
+روح على منطقة الشمال، يعني شمال استيرناو عند اللي
+
+202
+00:12:18,580 --> 00:12:21,600
+هو .. اللي هو الفراغ الخامس ما بين ال intercostal
+
+203
+00:12:21,600 --> 00:12:24,560
+اللي هو الفراغات بين ال cartilage و عنده في هذا
+
+204
+00:12:24,560 --> 00:12:27,500
+المكان أسمع كويس .. ممكن تلاقي deviation اشعر ال
+
+205
+00:12:27,500 --> 00:12:30,720
+deviation انحراف يعني ماسمعتش كويس او لجيت الصوت
+
+206
+00:12:30,720 --> 00:12:34,120
+اللي انا بده اسمعه في مكان تاني مازال في مكان تاني
+
+207
+00:12:34,120 --> 00:12:39,100
+فورا ايش بتشيك cardiac enlargement تمام؟ زي ايه؟
+
+208
+00:12:39,100 --> 00:12:42,940
+زي بدل ما سمعته في الخامس اسمعته في السادس يعني
+
+209
+00:12:42,940 --> 00:12:45,460
+بدل ما سمعته في فراغ الخامس اسمعته في فراغ السادس
+
+210
+00:12:45,740 --> 00:12:49,260
+هذا يدل على أنه فيه تضخم في عضلة القلب، شغلات
+
+211
+00:12:49,260 --> 00:12:52,080
+بسيطة تدل أنه في مشكلة خطيرة و أنت بتعمل
+
+212
+00:12:52,080 --> 00:12:54,920
+assessment ال retractions زي ما قلنا إيش بطلع و
+
+213
+00:12:54,920 --> 00:12:58,800
+بنزل ممكن يكون هذا إيش هنا around the site of the
+
+214
+00:12:58,800 --> 00:13:01,540
+apical bus إيش يعني؟ ممكن يكون حوالين ال apical
+
+215
+00:13:01,540 --> 00:13:04,520
+bus يعني أنا عرفت إنه في ال fifth و حطيت السماعة
+
+216
+00:13:04,520 --> 00:13:08,800
+لكن أنا شايف حوالينه في حاجة اسمها retraction عامة
+
+217
+00:13:08,800 --> 00:13:12,430
+بقى الجلد بطلع و بنزل، طب إيش هذا بدل ليه؟بدل انه
+
+218
+00:13:12,430 --> 00:13:15,970
+في عنده مشكلة ايش هي المشكلة هذه اسمها pericardial
+
+219
+00:13:15,970 --> 00:13:20,650
+disease لما نسمع كلمة pericardial disease يعني مرض
+
+220
+00:13:20,650 --> 00:13:25,150
+حوالين جدار القلب endocardial disease يعني مرض
+
+221
+00:13:25,150 --> 00:13:28,710
+داخل القلب يبقى pericardial حوالين endocardial
+
+222
+00:13:28,710 --> 00:13:32,570
+تباركاردير يعني جيران القلب يعني مثل في ال plural
+
+223
+00:13:32,570 --> 00:13:38,450
+في المنطقة هذه في حجز ماهيفز الثقلover lifts يعني
+
+224
+00:13:38,450 --> 00:13:42,070
+و احنا قاعدين بنعمل assessment ال pulse بنحس اشي
+
+225
+00:13:42,070 --> 00:13:45,610
+قاعد برفع ايدنا و برفعها لفوق زي اللي بطلع الايد
+
+226
+00:13:45,610 --> 00:13:50,210
+لفوق يعني في اشي فجيل برفعنا لفوق اش هذا بقوللي
+
+227
+00:13:50,210 --> 00:13:53,650
+هذا دقري بدنا ن check ايش انه في عنده right
+
+228
+00:13:53,650 --> 00:13:59,030
+ventricular work increase بكون في زيادة load كبير
+
+229
+00:13:59,030 --> 00:14:04,250
+على وين على ال right ventricle على ال right ايه ال
+
+230
+00:14:04,250 --> 00:14:12,960
+ventricle اللي هوالبطين الأيمن طيب الآن
+
+231
+00:14:12,960 --> 00:14:17,160
+بعض الناس طبعا هنا اللي بيجي بعدها بيصير حاجة
+
+232
+00:14:17,160 --> 00:14:21,380
+تسموه إيش اللي هو ال congestive heart failure عشان
+
+233
+00:14:21,380 --> 00:14:24,160
+هيك ال congestive heart failure بنلاقي في كتير من
+
+234
+00:14:24,160 --> 00:14:26,780
+الحالات المصدر الأساسي اللي جاي من وين من ال right
+
+235
+00:14:26,780 --> 00:14:33,040
+ventricle طيب الآن
+
+236
+00:14:34,150 --> 00:14:37,930
+خلصوا موضوع البطاين و .. اللي .. اللي صار و عملنا
+
+237
+00:14:37,930 --> 00:14:39,970
+ال assessment نجري جدا نعمل palpation و سمعناها
+
+238
+00:14:39,970 --> 00:14:43,330
+كويسة شو؟ palpation في palpation برضه في sublime
+
+239
+00:14:43,330 --> 00:14:46,590
+position ايش بقولين؟ اول حاجة بدك تعمل palpation
+
+240
+00:14:46,590 --> 00:14:51,050
+ابدأ من ال apex لوين؟ to the external border to
+
+241
+00:14:51,050 --> 00:14:56,560
+base يعني في palpationبقولوا يعني العلماء أنه أفضل
+
+242
+00:14:56,560 --> 00:15:01,700
+أنك تبدأ من رأس المخروط أو رأس القلب و احنا قولنا
+
+243
+00:15:01,700 --> 00:15:05,140
+الرأس تحت و القاعدة وين فوق فبيقولوا ابدأ من الرأس
+
+244
+00:15:05,140 --> 00:15:08,480
+من تحت و حط .. ضلك إيش تعمل assessment شوي شوي في
+
+245
+00:15:08,480 --> 00:15:12,740
+صبيعك لما تصل إيش لحدود ال base اللي هو of the
+
+246
+00:15:12,740 --> 00:15:17,380
+heartو قولي detect abnormalities حاولي تحدد إذا في
+
+247
+00:15:17,380 --> 00:15:21,320
+أي شيء مش طبيعي في إيش في ال sight of palpation
+
+248
+00:15:21,320 --> 00:15:23,740
+يعني و إحنا قاعدين نعمل palpation اعرف لي إذا في
+
+249
+00:15:23,740 --> 00:15:27,880
+أي مشكلة صار فيه صوت معين و إحنا قاعدين بنحط
+
+250
+00:15:27,880 --> 00:15:31,860
+إيدينا حاسين فيه صوت تحت أصابع إيدينا غريب هذا
+
+251
+00:15:31,860 --> 00:15:36,220
+الصوت لما نسمع abnormal flow of blood بأي نقية كان
+
+252
+00:15:36,220 --> 00:15:39,980
+يعني عشان نتمرد بكفينا داليأي صوت تحت أصابيه
+
+253
+00:15:39,980 --> 00:15:42,980
+اديانة و احنا بنعمل assessment لاجينا صوت غريب
+
+254
+00:15:42,980 --> 00:15:47,100
+يعني عامله بي .. زي .. زي مجر معين هيك بينزله لكن
+
+255
+00:15:47,100 --> 00:15:50,740
+غريب الصوت ايش اسمه هنا thrill يبقى اشمت thrill
+
+256
+00:15:50,740 --> 00:15:55,280
+abnormal flow of blood يبقى انسية بالدم غير طبيعي
+
+257
+00:15:55,280 --> 00:15:59,080
+او اللي صوت يعني شوية عامله عامل يعني مش الصوت
+
+258
+00:15:59,080 --> 00:16:03,760
+اللي انا بعتبره طبيعي اش بتسمي thrill بقوللي لك ان
+
+259
+00:16:03,760 --> 00:16:08,680
+ترى بالك من المهم كتير ان انتتوصف الbarcession ايش
+
+260
+00:16:08,680 --> 00:16:13,260
+توصفها؟ اوصفليها مع علاقتها معيش مع ال time لل
+
+261
+00:16:13,260 --> 00:16:16,840
+cardiac cycle يعني انت وانت قاعد عمالك بتعمل
+
+262
+00:16:16,840 --> 00:16:21,080
+assessment للبرس شوف البرس بتسبق ال cardiac cycle
+
+263
+00:16:21,080 --> 00:16:26,100
+بتسبقهاش هل في تسارع في تقابض هل بتحس انه لأ بطيء
+
+264
+00:16:26,100 --> 00:16:30,040
+هل بتحس كل شوية بتطلعلك يعني برس لحالة زي ال extra
+
+265
+00:16:30,040 --> 00:16:33,740
+system هذا كله بدنا نعمله assessment عشان ندونه و
+
+266
+00:16:33,740 --> 00:16:37,800
+نحكي للطبيباللي بعد بقول describe in terms أوصف
+
+267
+00:16:37,800 --> 00:16:43,600
+بمصطلحات ال location وين ما كان ال pulse يعني نكون
+
+268
+00:16:43,600 --> 00:16:47,000
+دقيقين لما نقول ال pulse موجود قوللي فى ال right
+
+269
+00:16:47,000 --> 00:16:50,140
+مثلا فأ مثلا او فى ال left مثلا intercourse or
+
+270
+00:16:50,140 --> 00:16:53,560
+space اللى جاي فى ال fifth مثلا sixth اي ان كان
+
+271
+00:16:53,560 --> 00:16:57,220
+طيب in relation to mid sternum عارفين وين ال mid
+
+272
+00:16:57,220 --> 00:17:01,460
+sternum هى ال sternum بقول ال mid sternum يعنيفي
+
+273
+00:17:01,460 --> 00:17:05,140
+برات ال pulse مش قادر انا اشوفه في ال sixth او في
+
+274
+00:17:05,140 --> 00:17:09,680
+ال fifth ها ايش اعمل لجيته جنب ال medestinal بقول
+
+275
+00:17:09,680 --> 00:17:13,400
+والله nearly medestinal يمكن بعضهم اللي جيت تحت ال
+
+276
+00:17:13,400 --> 00:17:16,160
+clavicle كلكم عارفين عضمة الترقوة اللي هي ال
+
+277
+00:17:16,160 --> 00:17:19,890
+clavicleممكن انا اجي تحت ايش لك ده في كله تحت انا
+
+278
+00:17:19,890 --> 00:17:23,230
+بقول والله لأ انا سمعت الصوت او حاسيت الصوت في ال
+
+279
+00:17:23,230 --> 00:17:26,010
+mid-clavicular في بعضهم بيقولك لأ والله انا حاسيته
+
+280
+00:17:26,010 --> 00:17:28,030
+شوية في ال auxiliary ماحدة ييجي يقولي auxiliary
+
+281
+00:17:28,030 --> 00:17:30,730
+طبعا تحت القبط ماحدة ييجي يقولي طبعا هذا طبيعي لأ
+
+282
+00:17:30,730 --> 00:17:34,710
+هذا مش طبيعي بس انا اقصد انه لازم احنا نوصف لما
+
+283
+00:17:34,710 --> 00:17:38,370
+بدنا نحكي بالاساسمة الطبيعية للطبيب او للمعالج
+
+284
+00:17:38,370 --> 00:17:42,940
+نقوله بالظبط وين شعرنا ال pulsation موجودةبيوصفها
+
+285
+00:17:42,940 --> 00:17:46,440
+هل هي جنب السترنم و لا جنب ال clavicle و لا جنب ال
+
+286
+00:17:46,440 --> 00:17:51,820
+auxiliary و هكذا طيب palpation of apical pulse
+
+287
+00:17:51,820 --> 00:17:55,240
+يعني و احنا بنعمل كده palpation لل apical pulse
+
+288
+00:17:55,240 --> 00:18:00,560
+بدك تشوف ايش هنا ال strength القوة بتختلف تختلف من
+
+289
+00:18:00,560 --> 00:18:06,160
+الناصح للضعيف دايما هي thin to obese مابدأ اقول ان
+
+290
+00:18:06,160 --> 00:18:09,890
+بتكون عند ال obese اعلى و اوطانهم في اختلافهم
+
+291
+00:18:09,890 --> 00:18:13,350
+وجدوا أن ال obese بتكون عنده أكتر على اعتبار أن
+
+292
+00:18:13,350 --> 00:18:19,950
+القلب بيبقى كافح عشان بيوصل لأخر يعني أطراف الجسم
+
+293
+00:18:19,950 --> 00:18:23,850
+والثن بيعتبروا يعني .. يعني لأن ال body خليني أقول
+
+294
+00:18:23,850 --> 00:18:27,570
+built بالشكل عام يعني بتكون شوية أخف من ال obesity
+
+295
+00:18:27,570 --> 00:18:30,990
+وممكن الدم يصل بسهولة عشانك تكون ال pulse أهون
+
+296
+00:18:30,990 --> 00:18:35,760
+شويةطيب ال conditions زي إيش اللي ممكن إيش هذا
+
+297
+00:18:35,760 --> 00:18:39,260
+اللي ممكن تزيد ال duration ها تبع ال apical pulse
+
+298
+00:18:39,260 --> 00:18:42,400
+أنا لحد الآن بتكلم ع ال apical احنا كل نوعين في
+
+299
+00:18:42,400 --> 00:18:44,280
+apical و في base pulse خلينا نتكلم ع ال apical
+
+300
+00:18:44,280 --> 00:18:49,340
+نكمل فبقولي إيش الأشياء اللي ممكن تزيد القوة و
+
+301
+00:18:49,340 --> 00:18:54,300
+المدة تبع ال apical pulse بقولي زي ال anxietyأكيد
+
+302
+00:18:54,300 --> 00:18:57,400
+طبعا أنيميا ما حد يقول طب أنيميا يا أستاذ فى فقر
+
+303
+00:18:57,400 --> 00:19:00,320
+دم اه compensatory mechanism بيصير الجالب بيسرع
+
+304
+00:19:00,320 --> 00:19:04,580
+أكتر عشان يقدر يعوض fever hyperthyroidism طبعا
+
+305
+00:19:04,580 --> 00:19:08,740
+كلهم عارفين إيش معناتهم الآن وخاصة غضب الthyroid
+
+306
+00:19:08,740 --> 00:19:11,760
+كمان تلاقيها أنهيش غضب دراقية عامة زاد نشاطة فبصير
+
+307
+00:19:11,760 --> 00:19:16,570
+مشكلةطيب بقول you feel lifting كيف بتعرف lifting
+
+308
+00:19:16,570 --> 00:19:19,550
+sensation اما احنا قولنا كلمة lifting بتشعر ان تحت
+
+309
+00:19:19,550 --> 00:19:23,890
+أصابعك اشي عماله بيحمل أصابعك لفوق يعني وانت بتعمل
+
+310
+00:19:23,890 --> 00:19:28,830
+assessment لنفس ال apical pulse بتحس كأنه .. كأنه
+
+311
+00:19:28,830 --> 00:19:34,630
+النبض بيرفع ايدك لفوق هذا بيدل انه عماله بزيد اكتر
+
+312
+00:19:34,630 --> 00:19:37,870
+اللي هو ال apical pulse و بزيد ال duration و بزيد
+
+313
+00:19:37,870 --> 00:19:43,370
+ال strength بتبعتهالان بالبيشن of the bars اللي هو
+
+314
+00:19:43,370 --> 00:19:48,390
+اسمه ايه base bars الان طب انت عرفنا يا أستاذ وين
+
+315
+00:19:48,390 --> 00:19:51,510
+ال apex وعرفناها في ال fifth inter coastal space
+
+316
+00:19:51,510 --> 00:19:53,530
+وقلنا زي فيه مشكلة وفيه enlargement بنروح على ال
+
+317
+00:19:53,530 --> 00:20:00,630
+six طب هنا أم ال base لأ بيقوللي حط إيدك على where
+
+318
+00:20:00,630 --> 00:20:06,230
+second left or right inter coastal space بيقوللي
+
+319
+00:20:06,230 --> 00:20:08,330
+روح على ال inter coastal space اطلع لفوق شوية
+
+320
+00:20:08,830 --> 00:20:11,430
+اروحلي على ال second يعني على ايش .. على اللي هو
+
+321
+00:20:11,430 --> 00:20:13,870
+الفراغ التاني .. بين ال .. ليش؟ بين ال ribs، يا
+
+322
+00:20:13,870 --> 00:20:17,070
+بتحط إيدك على الشمال يا على اليمين، طبعا مش هقدر
+
+323
+00:20:17,070 --> 00:20:20,030
+أحطها في النص لإنه في عضمة في النص، طب ليش يمين أو
+
+324
+00:20:20,030 --> 00:20:24,970
+شمال؟ على التنين بظبط؟ لإن ال base شمال عريضة، ما
+
+325
+00:20:24,970 --> 00:20:27,950
+احنا قلنا بكون ال apex تحت و ال base فوق عريضة،
+
+326
+00:20:27,950 --> 00:20:31,330
+فهي ممتدة على جنب اليمين و على جنب اليسار تبع إيه؟
+
+327
+00:20:31,740 --> 00:20:35,360
+طبع اللي هو ال external فبقدر أعمل assessment يبقى
+
+328
+00:20:35,360 --> 00:20:38,040
+ال inter coastal space الثاني بقدر أحس عليه إيش
+
+329
+00:20:38,040 --> 00:20:42,040
+هنا اللي هو حوالين ال external borders عامة القصة
+
+330
+00:20:42,040 --> 00:20:45,900
+اللي حوالينا بقدر أشوف و أحس اللي هو إيش ال
+
+331
+00:20:45,900 --> 00:20:49,510
+baseballsما بدي أشرح كتير عن ال base pulse ولا بدي
+
+332
+00:20:49,510 --> 00:20:51,990
+أشرح ولا بدي أقارنه أنا فقط بس بدي أعرف أن هاي
+
+333
+00:20:51,990 --> 00:20:55,030
+المكان عرفناه ليه؟ لأنه إحنا حنش .. لما بدنا
+
+334
+00:20:55,030 --> 00:20:57,230
+يشرحونا أبوكرا في ال medical surgical و بدنا
+
+335
+00:20:57,230 --> 00:21:00,490
+نشرحنا في كل إشي مش هينذكر، اللي هينذكر Epical
+
+336
+00:21:00,490 --> 00:21:02,710
+radial .. Epical radial و هكذا، بس إحنا من باب
+
+337
+00:21:02,710 --> 00:21:05,810
+زيادة في المعرفة أنه نعرف أنه في حاجة برضه في
+
+338
+00:21:05,810 --> 00:21:10,640
+إجماعة اللي هو ال base pulseطبعا ال percussion مهم
+
+339
+00:21:10,640 --> 00:21:13,500
+كتير على الموضوع اللي بالأحمر not used in cardiac
+
+340
+00:21:13,500 --> 00:21:17,040
+assessment لو حد سألنا هو بقدر استخدم percussion؟
+
+341
+00:21:17,040 --> 00:21:20,400
+وين بدك تستخدم percussion؟ يعني هل بنقدر نستخدم
+
+342
+00:21:20,400 --> 00:21:23,820
+percussion؟و احنا بنعمل assessment على عضلة القلب،
+
+343
+00:21:23,820 --> 00:21:27,160
+طب القلب نفسه مش هنقدر ينطوله ولا نظر .. ولا نظر،
+
+344
+00:21:27,160 --> 00:21:30,820
+في .. في .. في ribs و في muscles و في skin يعني
+
+345
+00:21:30,820 --> 00:21:34,400
+اللي وجوه وجوه داخل كتير، سواء كان بعيد عن ال ..
+
+346
+00:21:34,400 --> 00:21:37,720
+ال .. ال .. ال back و بعيد عن .. و بعيد عن إيش؟ ال
+
+347
+00:21:37,720 --> 00:21:40,880
+chest، يعني على التنين، يعني الدهر والصدر. طيب,
+
+348
+00:21:41,200 --> 00:21:45,580
+escalation, all heart sound كل اللي هو أصوات القلب
+
+349
+00:21:45,580 --> 00:21:50,590
+إشهانةبتكون low Asian low ماحدش يجي يقولي هو صوت
+
+350
+00:21:50,590 --> 00:21:54,550
+القلب نسمعه من بعيد، أعوذ بالله صعب كتير، ماعمرش
+
+351
+00:21:54,550 --> 00:21:58,230
+نسمع لحدها، أما ممكن إذا حطينا الأذن مباشرة على
+
+352
+00:21:58,230 --> 00:22:01,510
+الصدر زي ما نحط الأذن على صدر الطفل، ممكن نسمع،
+
+353
+00:22:01,510 --> 00:22:03,910
+لكن ماحدش يقولي والله أنا سامع دجج قلبك و أنا قاعد
+
+354
+00:22:03,910 --> 00:22:07,210
+هنا، لأ طبعا مش لها الدرجة، فبقولي low pitched و
+
+355
+00:22:07,210 --> 00:22:09,370
+low frequency و difficult to hear، يبقى معناته
+
+356
+00:22:09,370 --> 00:22:13,570
+مقدرش أسمعها عن طريق الأذنعشان هيك لازم انا استخدم
+
+357
+00:22:13,570 --> 00:22:17,350
+ال status scope طب لو سألنا حد ابدأ في ال status
+
+358
+00:22:17,350 --> 00:22:19,970
+scope من ال apex لل base و لا ال base لل apex زي
+
+359
+00:22:19,970 --> 00:22:23,450
+ما بدك ايش جالوا العلماء جالوا من ال base لل apex
+
+360
+00:22:23,450 --> 00:22:26,190
+او من ال apex للbase نفس الشيء مافي مشكلة لأنك في
+
+361
+00:22:26,190 --> 00:22:28,970
+الآخر انت .. قولنا في الآخر احنا في الآخر apex ال
+
+362
+00:22:28,970 --> 00:22:31,150
+radial لكن احنا حاطين ال base بس من باب المعرفة و
+
+363
+00:22:31,150 --> 00:22:34,930
+اين ماكانه ال pulse طيب بقول يأسس rate and rhythm
+
+364
+00:22:34,930 --> 00:22:39,590
+بتاكي تشوف ال rate تشوف ال rhythm of the beatبتشوف
+
+365
+00:22:39,590 --> 00:22:43,570
+يعني كيف النقطة ال concentration بيناركز على ال
+
+366
+00:22:43,570 --> 00:22:46,470
+sound one بعدين ايش ال sound one و ايش ال sound
+
+367
+00:22:46,470 --> 00:22:49,670
+two sound one يعني بيدك تشوف كده حدته و ال
+
+368
+00:22:49,670 --> 00:22:52,250
+vibrations اللي جت انا هشرح شو اقصد في ال sound
+
+369
+00:22:52,250 --> 00:22:54,750
+one و شو اقصد في ال sound two عشان تكون أموره أوضح
+
+370
+00:22:54,750 --> 00:22:58,350
+اكتر بعدين بيقولي هنا اسمع لل sound two نفس الشي
+
+371
+00:22:58,350 --> 00:23:02,890
+اللي هو حدته واهتزازه و هل في duplication يعني
+
+372
+00:23:02,890 --> 00:23:07,420
+ازدواجية ولا لأ طيبالنيجا انا اش بقوللي كمان، بدك
+
+373
+00:23:07,420 --> 00:23:12,360
+تشوف ال extra sounds، ايه extra sound؟ اي صوت زي
+
+374
+00:23:12,360 --> 00:23:17,360
+ما علمونا في السنة الأولى زي دب لاب دب لاب زي دجات
+
+375
+00:23:17,360 --> 00:23:20,840
+لكل إنسان و احنا بنعمل لما علمونا كيف ناخد ال
+
+376
+00:23:20,840 --> 00:23:25,270
+pulse و نعده، اي شيءحاسيته مش طبيعي بيكفيني انا
+
+377
+00:23:25,270 --> 00:23:31,110
+كحكيم ويعني تمريض بيكفيني اسميه بس ايه ميرمارز لأن
+
+378
+00:23:31,110 --> 00:23:33,790
+الطبيب المتخصص كارديولوجيست هو اللي بيعرف ايش
+
+379
+00:23:33,790 --> 00:23:37,450
+أنواع الميرمارز مش موضوعنا دلوقت لكن بهمنا نعرف ال
+
+380
+00:23:37,450 --> 00:23:40,530
+sound one و ايش ال sound two متى بيصير ال sound
+
+381
+00:23:40,530 --> 00:23:42,970
+one و متى بيصير ال sound two ال sound one سهل كتير
+
+382
+00:23:42,970 --> 00:23:47,310
+اول حاجة من ايش بيجيلما بيغلق .. ايش هنا .. بيغلق
+
+383
+00:23:47,310 --> 00:23:49,990
+الـ tricusp و ال mitral valves اللي هو ال بين ..
+
+384
+00:23:49,990 --> 00:23:53,070
+اللي هو ال ventricle و بين الأتريام لما بيغلق
+
+385
+00:23:53,070 --> 00:23:56,070
+المشكلة الدم فوق القطة أجى على الأتريام و انضغط
+
+386
+00:23:56,070 --> 00:23:58,990
+نزل على ال ventricle أول ما ينضغط و ينزل هو بتبدأ
+
+387
+00:23:58,990 --> 00:24:01,790
+ال sound 1 و بيظل الصوت ماشي لعند ما يصل لوين ..
+
+388
+00:24:01,790 --> 00:24:05,950
+extend لما نيصل لل sound 2 يبقى معناته .. يبقى
+
+389
+00:24:05,950 --> 00:24:09,530
+معناته .. الآن ال sound 1 من وين .. أول ما بيغلق
+
+390
+00:24:09,530 --> 00:24:12,950
+ال .. ال tricusp و الم mitral بيطلع الصوت طيب ..
+
+391
+00:24:13,160 --> 00:24:16,020
+الان في حاجة مش في سيستور و في داستور و احنا بنجيز
+
+392
+00:24:16,020 --> 00:24:19,500
+البلد برا شرط السيستور اللي هو الضغط العالي اللي
+
+393
+00:24:19,500 --> 00:24:23,140
+زي ما نقول 120 ع 80، 130 ع 70 هذا السيستور اللي
+
+394
+00:24:23,140 --> 00:24:27,180
+بيبدأ من ال sound 1 و بيمدق و لا نويل لل sound 2
+
+395
+00:24:27,180 --> 00:24:30,880
+طب ايش هو ال sound 2 يا ترى؟ ال sound 2 بعد ما
+
+396
+00:24:30,880 --> 00:24:35,580
+الدم نزل، راح الفنتريجل، وين الضخ؟ راح ايش؟ ال
+
+397
+00:24:35,580 --> 00:24:39,800
+aortic، ها ال aortic و البلمونريإيش راح على
+
+398
+00:24:39,800 --> 00:24:42,920
+الأورطة عشان يروح على الجسم كله؟ وإيش راح على
+
+399
+00:24:42,920 --> 00:24:46,120
+البلمون عشان إيه؟ عشان يتنقق ويصير مليان أكسجين.
+
+400
+00:24:46,580 --> 00:24:50,920
+هذه الضغطة هي sound 2. طيب ال diastole بيقول بيبدأ
+
+401
+00:24:50,920 --> 00:24:55,500
+من sound 2 وبيمتد على sound 1 عشان هيك. بنلاقي ال
+
+402
+00:24:55,500 --> 00:24:59,760
+systole دايما أعلى من ال diastole. ليه؟ على اعتبار
+
+403
+00:24:59,760 --> 00:25:04,360
+أنه شوفوا لحظة أنتوا كيف.الان اغلاق الـ Trigaspid
+
+404
+00:25:04,360 --> 00:25:08,740
+والميترال بدي يكون قوي عشان يقدر ضخ الدم على وين؟
+
+405
+00:25:08,740 --> 00:25:11,520
+على الاورتك وعلى ال بالمونري اللي هو ال sound 2
+
+406
+00:25:11,520 --> 00:25:15,960
+يبقى عرفنا الستول بيبدأ من sound 1 بنتهي ل 2 و
+
+407
+00:25:15,960 --> 00:25:19,680
+sound 2 الدياسترول بيبدأ من sound 2 بيمتد ل sound
+
+408
+00:25:19,680 --> 00:25:25,520
+1 طبعا في حاجة كويسة هنا طريفة لجوا ان ال sound 2
+
+409
+00:25:25,520 --> 00:25:30,310
+أعلى .. ها ال sound .. sound 2أعلى من ال sound 1
+
+410
+00:25:30,310 --> 00:25:34,870
+في منطقة ال base سبحان الله يعني في منطقة ايش؟
+
+411
+00:25:34,870 --> 00:25:38,730
+base في أعلى القلب لكن لجوها أهدا شوية .. أهدا
+
+412
+00:25:38,730 --> 00:25:43,170
+شوية من ال sound 1 في ال apex يعني لجوا أن الصوت
+
+413
+00:25:43,170 --> 00:25:47,490
+الصوت ال sound .. نعيد كمان مرة لجوا صوت ال sound
+
+414
+00:25:47,490 --> 00:25:51,350
+2 اللي هو الصوت الثاني أعلى من الصوت الأول في
+
+415
+00:25:51,350 --> 00:25:54,910
+منطقة ال baseولاجوا أن ال sound .. اللي هو ..
+
+416
+00:25:54,910 --> 00:25:59,270
+نرجعكم كام مرة أن ال sound 2 لاجوا أهدا من ال
+
+417
+00:25:59,270 --> 00:26:03,950
+sound 1 في منطقة ال apex هذي بس يعني للمتخصصين
+
+418
+00:26:03,950 --> 00:26:06,870
+عشان يعرفوهم في عندنا ال sound 3 و ال sound 4 أنا
+
+419
+00:26:06,870 --> 00:26:09,530
+بتشرحهم بشكل عام و أنتوا فاهمهم لحالكم على السريع
+
+420
+00:26:09,530 --> 00:26:12,930
+لإنه مش كتير أنا مهمات عندي تعرفهم أنا بهموني اللي
+
+421
+00:26:12,930 --> 00:26:16,890
+هو sound 1 و sound 2طبعا ال sound 3 هي عبارة عن
+
+422
+00:26:16,890 --> 00:26:20,130
+إيش الاهتزاز الزائد اللي بيصير الاهتزاز الزائد
+
+423
+00:26:20,130 --> 00:26:23,670
+اللي بيصير في ال ventricular walls لما الدم بنزل ع
+
+424
+00:26:23,670 --> 00:26:26,890
+ال ventricle تحت أو مش بنزل من ال .. من الأتريا من
+
+425
+00:26:26,890 --> 00:26:30,950
+ال ventricle لما بنزل بسرعة الصوت هذا بيعمل wave
+
+426
+00:26:30,950 --> 00:26:34,870
+كيف يعني؟ بيعمل زي احتزاز هذا الاهتزاز اسمه sound
+
+427
+00:26:34,870 --> 00:26:40,230
+3 إذا كان سريع اسمه sound 3 بعد ما بينزل الدم بعد
+
+428
+00:26:40,230 --> 00:26:43,560
+ما بينزل الدمإيش بيقولي أنا late؟ إيش يعني late؟
+
+429
+00:26:43,560 --> 00:26:47,600
+بعد ما بينزل الدم يستقر شوية بعدها بعد ال death to
+
+430
+00:26:47,600 --> 00:26:52,220
+the killing بتلع لل sound four يعني بيصير احتزازات
+
+431
+00:26:52,220 --> 00:26:55,420
+في ال ventricle نفس القضية في ال ventricular wall
+
+432
+00:26:55,420 --> 00:27:00,100
+و بيصير عندنا vibrations برضه في ال valves في نفس
+
+433
+00:27:00,100 --> 00:27:04,400
+الصممات اللي موجودة في داخل القلب بس ايه تيجي بعد
+
+434
+00:27:04,400 --> 00:27:09,520
+ال sound three طبعا أنا هي عبارة اتنين سواء كانت
+
+435
+00:27:09,520 --> 00:27:14,580
+تلاتة أو اربعةهو صحيح مايبيننش للطبيب هو بده يقعد
+
+436
+00:27:14,580 --> 00:27:18,140
+اذا بين انه يعني انه يكشف انه فيه مشكلة عشان هيك
+
+437
+00:27:18,140 --> 00:27:21,100
+ده لجأ مشكلة في مصطلح اسمه summation gallop ايش
+
+438
+00:27:21,100 --> 00:27:24,700
+يعني summation gallop مصطلح يعني ده لجينا انه فيه
+
+439
+00:27:24,700 --> 00:27:28,760
+بدل ما يطلع صوتين فيه تالت صوت عند البناء ده صوت
+
+440
+00:27:28,760 --> 00:27:31,560
+الأول واضح و الصوت التاني واضح اما التلاتة والاربع
+
+441
+00:27:31,560 --> 00:27:35,880
+مدمجات مع بعض فسموه ايش summation of sound three
+
+442
+00:27:35,880 --> 00:27:39,640
+and sound four فايش صموه هذا التشخيص summation
+
+443
+00:27:39,640 --> 00:27:43,690
+gallopيبقى ال summation جاله تلت أصوات ال sound
+
+444
+00:27:43,690 --> 00:27:48,150
+one و ال sound two و التلت و أربع مع بعض أنا بهمني
+
+445
+00:27:48,150 --> 00:27:51,850
+كتير أنه نفهم ال sound one و ال sound two بشكل عام
+
+446
+00:27:51,850 --> 00:27:55,930
+نكفزلز طبعا خلنا أسرع شوية معلش عشان نلحق نخلص ال
+
+447
+00:27:55,930 --> 00:27:59,970
+chapter لأنه الوقت بدأ يأخذنا و يدهمنا شوية بدنا
+
+448
+00:27:59,970 --> 00:28:02,930
+نشوف طبعا نكفزلز نعمل assessment ال assessment لل
+
+449
+00:28:02,930 --> 00:28:09,030
+نكفزلز بنحاول أن نطلع بشكل عام على حوالين الرقبة
+
+450
+00:28:11,480 --> 00:28:15,180
+خاصة يعني ال .. ال distinction اللي بيصير موجود
+
+451
+00:28:15,180 --> 00:28:18,700
+حوالينا الرقبة لما نصير فيه مشكلة في ال right side
+
+452
+00:28:18,700 --> 00:28:21,960
+ال heart يعني لما نصير congestive heart failure و
+
+453
+00:28:21,960 --> 00:28:25,500
+بيصير عملية ضغط على عضلة القلب في تصريف اللي هو
+
+454
+00:28:25,500 --> 00:28:28,920
+الدم اللي مليان بالسائل فبتلاقي صار إيش هنا
+
+455
+00:28:28,920 --> 00:28:31,860
+extension بتلاقي سبحان الله حوالينا حتى بقولك في
+
+456
+00:28:31,860 --> 00:28:34,900
+بعض الحالات بكون ضعيف و بتبتطلع عليها كإنه
+
+457
+00:28:34,900 --> 00:28:39,320
+الشرايين بيناتها على جنب .. على جنب الرقبة طبعا
+
+458
+00:28:39,320 --> 00:28:42,130
+لازم المريض عشان نقدر نعمله assessmentاللي عنده
+
+459
+00:28:42,130 --> 00:28:46,370
+هذا congenital heart failure يكون في position يعني
+
+460
+00:28:46,370 --> 00:28:49,570
+يكون كويس فهو لو ال position 45 درجة وبنشوف ال
+
+461
+00:28:49,570 --> 00:28:53,910
+jugular pulse برضه خاصة اللي هو ال Venus بعض الناس
+
+462
+00:28:53,910 --> 00:28:56,430
+بيقولوا هو ال Venus فيه Venus pulse؟ أه فيه Venus
+
+463
+00:28:56,430 --> 00:29:00,430
+pulse لما أقول Venus يعني هو ال waves زي موجات
+
+464
+00:29:00,430 --> 00:29:05,600
+بيعملأما ال .. ال .. ال .. ال arterial pulse لأ
+
+465
+00:29:05,600 --> 00:29:08,360
+نقر تك تك تك يعني او double up double up يعني أما
+
+466
+00:29:08,360 --> 00:29:12,260
+هنا waves بيعمل و بيقسوه على فكرة بجهاز مدبلر ..
+
+467
+00:29:12,260 --> 00:29:16,720
+مدبلر machine يبقى بنشوف ال wave اللي هي خاصة بعد
+
+468
+00:29:16,720 --> 00:29:20,740
+ما الدم ينضخ .. ينضخ على ال right ventricle هلجيت
+
+469
+00:29:20,740 --> 00:29:22,640
+الدم اتجمع على ال right ventricle انتوا في ال
+
+470
+00:29:22,640 --> 00:29:25,720
+Anatomy اشتروا مني؟ هلجيت الدم اللي راجع شوية
+
+471
+00:29:25,720 --> 00:29:31,310
+بيعمل حاجة بسموها إيش هنا jugular pulseنشوف ال
+
+472
+00:29:31,310 --> 00:29:34,350
+character pulse ال character pulse طبعا وين بتكون
+
+473
+00:29:34,350 --> 00:29:38,390
+موجود خاصة برضه حوالين الرقبة لو حد سألنا بالظبط
+
+474
+00:29:38,390 --> 00:29:41,290
+وين موجود على ال media to the angle of the jaw
+
+475
+00:29:41,290 --> 00:29:44,130
+يعني بدنا نعمل أولا inspection and palpation طب
+
+476
+00:29:44,130 --> 00:29:46,330
+وين هو موجود؟ inspection وعرفنا طلعنا حوالين
+
+477
+00:29:46,330 --> 00:29:50,290
+الرقبة طب وين palpation؟ بنحط إصبعين .. إصبعين
+
+478
+00:29:50,290 --> 00:29:53,510
+اللي هو تبعت إيدي مثلا عند المريض بنروح على ال
+
+479
+00:29:53,510 --> 00:29:56,620
+angle of the jaw اللي هو الزاوية تبعت اللي هوتحت
+
+480
+00:29:56,620 --> 00:30:00,960
+ال .. ال mandible و بنوله قدام شويه يعني بننزل
+
+481
+00:30:00,960 --> 00:30:05,040
+لتحت صنطي هي مثلا أخر الفك اللي ورا بننزل لتحت
+
+482
+00:30:05,040 --> 00:30:09,880
+شوية و لأمام صنطي بنحس ايه؟ بنحس أنه في هنا عمله
+
+483
+00:30:09,880 --> 00:30:13,680
+فيه بينبض تحت أصابعنا فبنعرف أنه هذا اللي هو ال
+
+484
+00:30:13,680 --> 00:30:17,060
+carotid artery و بعدين بنحط اللي هو ال bell مش ..
+
+485
+00:30:17,060 --> 00:30:20,260
+مش ال diaphragm بنحط يعني اللي هو مش اللي هو
+
+486
+00:30:20,260 --> 00:30:23,620
+السماعة اللي هو الشق الكبير لأ الشق الصغير اللي هو
+
+487
+00:30:23,620 --> 00:30:26,900
+عشان نقدر نسمعلأنه إحنا قاعدين بنسمع بلس، مانعش
+
+488
+00:30:26,900 --> 00:30:30,900
+نسمع حاجة كبيرة. الـ Cascaded arteries، بدك تشوف
+
+489
+00:30:30,900 --> 00:30:35,720
+الـ pulsation، هل هي strong، هل هي weak، rise،
+
+490
+00:30:35,720 --> 00:30:41,200
+يعني بتشد فوق، collapse، يعني منكمشة، سريعة، ولا
+
+491
+00:30:41,200 --> 00:30:46,880
+بطيقة، double؟هل هي متحسس دواجية في الأصوات و لا
+
+492
+00:30:46,880 --> 00:30:50,940
+single يعني تك تك تك و لا أصوات متداخلة كله
+
+493
+00:30:50,940 --> 00:30:54,620
+متداخلة طبعا و احنا قلنا أي صوت متداخل إيش بيعني
+
+494
+00:30:54,620 --> 00:30:58,160
+اسمه murmur دي بجمعة لا تقلناش تنسى إذا سمعنا
+
+495
+00:30:58,160 --> 00:31:00,680
+أصوات غريبة و احنا بنعمل assessment في ال carotid
+
+496
+00:31:00,680 --> 00:31:03,520
+ال carotid artery و ال carotid muscle و ال carotid
+
+497
+00:31:03,520 --> 00:31:07,720
+pulse دغنش بقول بقول فيه murmurs و ال murmurs هذا
+
+498
+00:31:09,210 --> 00:31:13,690
+في بعض الحالات يعني احنا مانقدرش نشخصه بالنسبة لنا
+
+499
+00:31:13,690 --> 00:31:18,170
+لكن هو الطبيب لإن هو تشخيصه مش سهل لازم يكون
+
+500
+00:31:18,170 --> 00:31:20,790
+cardiologist لإن هو vibrations عبارة عن اهتزازات
+
+501
+00:31:20,790 --> 00:31:23,950
+وانا مابقدر ولا انتوا بنقدر نعرف ايش طبيعتها لإن
+
+502
+00:31:23,950 --> 00:31:28,360
+هو مدارس ومتخصص في الأمر هذاطبعا بدنا نعرف انها هل
+
+503
+00:31:28,360 --> 00:31:32,080
+هي كانت في ال cystole ولا في الdiastole برضه لخاصة
+
+504
+00:31:32,080 --> 00:31:35,380
+لما نسمع مرات و احنا بنجيز الضغط هل بنحس الخربط
+
+505
+00:31:35,380 --> 00:31:38,900
+هذي و هو احنا قاعدين في منطقة ال cystole فوق ولا
+
+506
+00:31:38,900 --> 00:31:42,980
+تحت في منطقة الdiastole طبعا هي نعرفنا بس بيعدلنا
+
+507
+00:31:42,980 --> 00:31:45,640
+الكلام نفس الكلام بعيد انه بيقول انه في defects
+
+508
+00:31:45,640 --> 00:31:49,080
+بيصير في ال ash في ال valve فبتعمل مرمر زي ما بعض
+
+509
+00:31:49,080 --> 00:31:52,780
+الناس بيقول لك اذا عنده ثقة في القلب او عنده يعني
+
+510
+00:31:52,780 --> 00:31:57,480
+تصريف شوية في الدم اي defectsموجود في داخل القلب
+
+511
+00:31:57,480 --> 00:32:01,240
+او في ال .. في ال valves او في تصريف الدم و في نفس
+
+512
+00:32:01,240 --> 00:32:05,320
+الوقت بيعمللي يعني شوية خربطة و صوات غريبة بده
+
+513
+00:32:05,320 --> 00:32:08,900
+يسميها ايش يعني مرمرز المرمرز زي ما احنا قلنا
+
+514
+00:32:08,900 --> 00:32:13,870
+abnormal sound of the heartآخر شيء بدنا نقارن على
+
+515
+00:32:13,870 --> 00:32:16,390
+السريع بين arterial و ال violence insufficiency
+
+516
+00:32:16,390 --> 00:32:21,090
+القصور أو الفشل اللي بيصيب يا إنسان عنده مثلا يعني
+
+517
+00:32:21,090 --> 00:32:26,210
+فشل في ال .. خليني أقول الجسم الشرياني أو فشل في
+
+518
+00:32:26,210 --> 00:32:31,530
+الجسم الوريدي طبعا الإختصارات بسيطة سهلة و مش غالب
+
+519
+00:32:31,530 --> 00:32:34,350
+أكتر عليكمأول حاجة من ناحية الـ pulse في الـ
+
+520
+00:32:34,350 --> 00:32:37,090
+artery بنلاقي decrease or absence إذا كان فيه قصور
+
+521
+00:32:37,090 --> 00:32:40,310
+أو فشل في الارض أكيد هيكون فشي أو قليل ال pulse
+
+522
+00:32:40,310 --> 00:32:43,850
+هنا لأ ال venous بيكون موجود على حد يعني بتلاقيه
+
+523
+00:32:43,850 --> 00:32:46,390
+ممكن يكون ال waves أعلى على اعتبار أنه صار فيه
+
+524
+00:32:46,390 --> 00:32:50,930
+مشكلة فالدم بيحاول يدخل بكل قوة ال color لو طلعنا
+
+525
+00:32:50,930 --> 00:32:53,770
+على الجلد حوالين ال artery اللي فيه المشكلة
+
+526
+00:32:53,770 --> 00:32:58,410
+بيلاقيه pale شاحب و بعدين إيش هنا elevation إيش
+
+527
+00:32:58,410 --> 00:33:03,030
+and إيشon and cold ايش يعني؟ يعني لو .. لو رفع
+
+528
+00:33:03,030 --> 00:33:06,090
+رجله شوية صغيرة بتلاقي شاحب و حتى في بعض الحالات
+
+529
+00:33:06,090 --> 00:33:09,390
+لو مارفعش رجله بنلاقي شحوب مع وجوفه كمان بنلاقي
+
+530
+00:33:09,390 --> 00:33:13,150
+شحوب و في نفس الوقت ايش بتكون رجله باردة شوية لكن
+
+531
+00:33:13,150 --> 00:33:15,570
+لو طلعنا على ال فيناس لأ بنلاقي pink يعني لأ اللون
+
+532
+00:33:15,570 --> 00:33:18,550
+طبيعي بس مائة المرات يكون للسينوز يعني ممكن يكون
+
+533
+00:33:18,550 --> 00:33:22,210
+للازرقاء او فيه لون بنى على اعتبار انه ايش بدأ
+
+534
+00:33:22,210 --> 00:33:28,350
+يتحشر الدمال temperature لو حسينا الجلد في منطقة
+
+535
+00:33:28,350 --> 00:33:31,750
+ال arterial efficiency هنلاقيه بارد عشان هيك لما
+
+536
+00:33:31,750 --> 00:33:35,230
+بنسأل .. بنقوله إيده باردة إذا يعني لو واحد مركب
+
+537
+00:33:35,230 --> 00:33:38,350
+لو مثلا جيبس إذا لاجينا قدام الجيبس إيده باردة
+
+538
+00:33:38,350 --> 00:33:41,690
+فورا بدنا نقص الجيبس لكن لو لاجينا إيده دافية بدنا
+
+539
+00:33:41,690 --> 00:33:44,650
+نعطيه علاج بدنا نعرف إن المشكلة وين موجودة يعني
+
+540
+00:33:44,650 --> 00:33:49,880
+السخونة وريد والبرودة شريانإديمة طالع في الإديمة
+
+541
+00:33:49,880 --> 00:33:52,300
+بنلاقيها مش موجودة، فش في الارتيلة لسه فش لسه
+
+542
+00:33:52,300 --> 00:33:55,120
+إديمة، لكن أي فيناس لسه فش لسه عشان يكتب عني ال
+
+543
+00:33:55,120 --> 00:34:00,480
+DVT بقولك أنا صار عندي حاسس انه انا صار عندي إديمة
+
+544
+00:34:00,480 --> 00:34:02,920
+مش جادة يعني هي ليه استثقاء يعني الميه عاملا بتزيد
+
+545
+00:34:02,920 --> 00:34:06,360
+فبيجي بقولك طب تعال تنشوف نعمل لك فحص عشان نعرف
+
+546
+00:34:06,360 --> 00:34:11,280
+إيش هذا اللي موجود عندكSkin، بنطلع الجلد حوالين
+
+547
+00:34:11,280 --> 00:34:15,260
+الـ artery اللي هو فيه المشكلة، بنشوف لامع،
+
+548
+00:34:15,260 --> 00:34:18,320
+الأضافر بدأت تصير فيها thickness لأنه بطل يصلها
+
+549
+00:34:18,320 --> 00:34:23,940
+الدم و الاكسجين كويس، صار ال hair كمان يتقصف، فصار
+
+550
+00:34:23,940 --> 00:34:26,760
+عنده تقرحات، يعني شغلات كلها متعلقة بإيه،
+
+551
+00:34:26,760 --> 00:34:30,540
+gangrene، كل هذا متعلق بإنه مش الدم بطل يوصل و بطل
+
+552
+00:34:30,540 --> 00:34:34,540
+و صار فيه قصور في الشريان. أما القصور في الوريد،
+
+553
+00:34:34,540 --> 00:34:38,820
+هنا لأ، بيصير ألزارز، بس أكترش على ال ankles.خاصة
+
+554
+00:34:38,820 --> 00:34:42,440
+و بيصير discolored و بيصير scaly يعني بتلون منطقة
+
+555
+00:34:42,440 --> 00:34:46,080
+ال ankles خاصة هذا يعني ال joint بالذات علشان
+
+556
+00:34:46,080 --> 00:34:48,940
+الضغط ال pressure اللي عليه و بيصير زي قشور بتطلع
+
+557
+00:34:48,940 --> 00:34:53,400
+على .. على رجله من هذا المكان طبعا ال sensation
+
+558
+00:34:53,400 --> 00:34:57,080
+الإحساس ال leg pain طبعا فيه ألم شديد بيكون في
+
+559
+00:34:57,080 --> 00:34:59,720
+منطقة ال leg لكن بيزيد أيش مع ال standing يعني
+
+560
+00:34:59,720 --> 00:35:02,740
+بدنا نعرف إنه عنده مشكلة في الأرض ولا في ناس مجرد
+
+561
+00:35:02,740 --> 00:35:05,480
+ما يجاف مجرد ما يجاف إيش بيصير عنده ألم شديد لكن
+
+562
+00:35:05,480 --> 00:35:10,070
+لو ارتاح relievedبتلاقي أول ما يرتاح بيخف الألم و
+
+563
+00:35:10,070 --> 00:35:12,470
+في مرات في عنده pressure بيحس يعني بتغطي على ال
+
+564
+00:35:12,470 --> 00:35:16,170
+batox و بيحس مرات بألم في ال calves كل هذا بيسموه
+
+565
+00:35:16,170 --> 00:35:20,330
+cramp كلمة cramp يعني زي إشي بعصل زي إشي بيدغط
+
+566
+00:35:20,330 --> 00:35:24,370
+عليه زي إشي بيشده هذا ال sensation مرتبط أكتر شي
+
+567
+00:35:24,370 --> 00:35:27,270
+بال arterial insufficiency أما في ال venous
+
+568
+00:35:27,270 --> 00:35:30,490
+insufficiencyايش بيقوللي صحيح ال leg veil موجود
+
+569
+00:35:30,490 --> 00:35:34,570
+لكن و aggravated by standing ها لاحظين كمان
+
+570
+00:35:34,570 --> 00:35:37,430
+بيقوللي بزيد في أيش بالوقوف على اعتباره الوقوف
+
+571
+00:35:37,430 --> 00:35:41,490
+بتغطي على الشريان و الوريد و او في ال sitting كمان
+
+572
+00:35:41,490 --> 00:35:45,470
+and relieved by أيش elevated of legs هنا .. هنا
+
+573
+00:35:45,470 --> 00:35:53,020
+elevated أيش by legs طيب لو لاحظناقال لي بدك ترفع
+
+574
+00:35:53,020 --> 00:35:56,860
+هنا عشان بدك تحسنهم، حتى لو نيمنها مارتاحش، لكن لو
+
+575
+00:35:56,860 --> 00:36:00,060
+رفعنا الرجلين، لو رفعنا رجلينا شوية، ارتاح هنا،
+
+576
+00:36:00,060 --> 00:36:03,520
+لأ، مالوش علاقة، لأن المشكلة جونا في الشريان، مش
+
+577
+00:36:03,520 --> 00:36:08,190
+في الوريدالان بقول ال lying down لو نام كمان أو
+
+578
+00:36:08,190 --> 00:36:12,830
+استلقى عادي حتى لو ماشى .. ها تحظى لو ماشى ممكن
+
+579
+00:36:12,830 --> 00:36:16,470
+يتحسن في ال Venus في الأول لكن ممكن يكون ممنوع
+
+580
+00:36:16,470 --> 00:36:19,890
+فيما بعدها .. ممكن يكون .. لكن انت سمح للطبيب يا
+
+581
+00:36:19,890 --> 00:36:23,130
+انا ممكن يقولك شوية تقلصات بتمشي هنا ممنوع لأ لأنه
+
+582
+00:36:23,130 --> 00:36:26,410
+مع المشي هيتألم كتير .. برضه relieved by ايش هنا
+
+583
+00:36:26,410 --> 00:36:30,580
+use of ايشال support هو زي انا بدأنا نستخدم بعض
+
+584
+00:36:30,580 --> 00:36:33,900
+الجوارب الضاغطة او الجوارب فيه جوارب بيسموها
+
+585
+00:36:33,900 --> 00:36:36,980
+الجوارب الطبية بيستخدموها زي الجوارب اللي لها
+
+586
+00:36:36,980 --> 00:36:40,860
+علاقة او حتى اليوم صار يصنع زي روابط مشدات معينة
+
+587
+00:36:40,860 --> 00:36:44,560
+بتضغط على الرجل و بتحاول انها ايش عشان تساعد في
+
+588
+00:36:44,560 --> 00:36:47,900
+ضغط الدم في اتجاه القلب بشكل اوسع او اقوى بإذن
+
+589
+00:36:47,900 --> 00:36:52,930
+الله طبعا هي خلصنا chapter ال cardiocardiac
+
+590
+00:36:52,930 --> 00:36:56,150
+assessment وcardiovascular والحمد لله ان شاء الله
+
+591
+00:36:56,150 --> 00:36:59,530
+المحاضرة القادمة ندخل في الشكتر القادم السلام
+
+592
+00:36:59,530 --> 00:37:01,410
+عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c14eeed9214aaf2037f2100cf5063ee80a512d60
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/gBD1qCWIg2s_raw.srt
@@ -0,0 +1,2368 @@
+1
+00:00:00,440 --> 00:00:04,380
+بسم الله الرحمن الرحيم اليوم ان شاء الله بدنا نبدأ
+
+2
+00:00:04,380 --> 00:00:08,160
+في الشكتر الثامن اللي هو assessment of ايه؟
+
+3
+00:00:08,160 --> 00:00:12,200
+cardiovascular system يعني تقييم .. خلصتنا التقييم
+
+4
+00:00:12,200 --> 00:00:15,260
+للجهاز التنفسي اليوم بدنا ناخد اللي هو التقييم
+
+5
+00:00:15,260 --> 00:00:19,300
+للجهاز الدوري اللي هو القلب والأوعية الدموية طيب
+
+6
+00:00:19,300 --> 00:00:23,600
+أول حاجة assessment of cardiovascular system يبدأ
+
+7
+00:00:23,600 --> 00:00:26,380
+بإيه؟ بال objective data زي كل مرة إيش هي ال
+
+8
+00:00:26,380 --> 00:00:30,470
+objective data؟ أول حاجة بدنا نسأل المرض كسؤالأول
+
+9
+00:00:30,470 --> 00:00:32,910
+سؤال بدنا نسأله chief complaint، شو الشكوه
+
+10
+00:00:32,910 --> 00:00:37,670
+الأساسية اللي هو بيشكيها؟ عنده chest pain؟ حاضر،
+
+11
+00:00:37,670 --> 00:00:41,670
+نيجي بنقوله طيب وين بالظبط مكانه؟ ال quality؟ كيف
+
+12
+00:00:41,670 --> 00:00:45,530
+كيفيته؟ duration؟ كدهش مستمر عندك؟ associated
+
+13
+00:00:45,530 --> 00:00:48,150
+symptoms؟ أيش الأعراض المتعلقة كمان معاه؟ يعني
+
+14
+00:00:48,150 --> 00:00:52,650
+أقصد هنا لما يجينا المريض للعمل اللي أسسه لل
+
+15
+00:00:52,650 --> 00:00:55,690
+cardiovascular system بشكل عام أجي أتألم من منطقة
+
+16
+00:00:55,690 --> 00:00:59,350
+صدره و بديت أشك أنه العلاقة .. الوجع هذا بقلبه
+
+17
+00:01:00,150 --> 00:01:03,890
+بنسألك كل إشي عن هذا القلم و هذا الوجع، وقت إيش
+
+18
+00:01:03,890 --> 00:01:05,930
+بروح و وقت إيش بيجي، إيش اللي بيخليه زيد، إيش اللي
+
+19
+00:01:05,930 --> 00:01:09,570
+بيخليه .. و هكذا، بعدين بشوف إيش ال regular heart
+
+20
+00:01:09,570 --> 00:01:14,150
+beat، هل عنده عدم انتظام في دقات القلب، pound، إيش
+
+21
+00:01:14,150 --> 00:01:18,370
+زي إيش بغم يعني زي إيش زي .. زي .. لما أقول كلمة
+
+22
+00:01:18,370 --> 00:01:24,620
+بغم يعنيأشي حاجة زي بت jump يعني bound بتجمع كأنه
+
+23
+00:01:24,620 --> 00:01:29,200
+حاجة بتضغط عليه يعني اما احس اشي هو بيجبول انا بحس
+
+24
+00:01:29,200 --> 00:01:33,480
+الدجاج تبعتي بتغم عليكيف بتغم عليك زي سواء انا
+
+25
+00:01:33,480 --> 00:01:39,260
+يعني بتحاول اقربها و بسطها زي انه دقات القلب كأنا
+
+26
+00:01:39,260 --> 00:01:43,340
+زي حلقات بتحاول تضغط حلقات بتحاول تضغط في منها نوع
+
+27
+00:01:43,340 --> 00:01:45,480
+تاني بيسموه too fast بيقولك لأ انا عندك سريع في
+
+28
+00:01:45,480 --> 00:01:49,230
+jumpإيه ال jump يعني بقولك أنا بحس إيه دجات جلبي
+
+29
+00:01:49,230 --> 00:01:52,830
+بنط النط بحس الجلب تبعي زي اللي بفط فط هيك و etc
+
+30
+00:01:52,830 --> 00:01:56,750
+الاخرين assessment of risk factors بنسأله عن إيه
+
+31
+00:01:56,750 --> 00:02:00,870
+ال risk factors شو ال risk factors اللي ممكن نسأل
+
+32
+00:02:00,870 --> 00:02:04,250
+عنها أول حاجة عن history of hypertension لإن مرتبط
+
+33
+00:02:04,250 --> 00:02:07,850
+ارتباط وثيق جدا بال cardiac problems على اعتبار
+
+34
+00:02:07,850 --> 00:02:11,550
+انه لما نقول كلمة طاقة الدم يعني أوعية دم أويا
+
+35
+00:02:11,550 --> 00:02:17,030
+مرتبط ارتباط شامل و كامل معايش مع القلبdiabetes
+
+36
+00:02:17,030 --> 00:02:20,330
+على اعتبار ان معظم الناس اللي عندهم diabetes بيروح
+
+37
+00:02:20,330 --> 00:02:23,390
+ايش بتجرب معاه ال hypertension و ممكن يصير عندها
+
+38
+00:02:23,390 --> 00:02:27,910
+secondary hypertension في بعدين نقول ايش كان نسأل
+
+39
+00:02:27,910 --> 00:02:30,670
+عن ال rheumatic fever خاصة بحما ال rheumatism لأنه
+
+40
+00:02:30,670 --> 00:02:34,430
+لقوا الارتباط برضه في ال valves يعني لو صار عند
+
+41
+00:02:34,430 --> 00:02:38,510
+واحد حمه في بداية صغره و لقوا بعض الحالات بيتأثر
+
+42
+00:02:38,510 --> 00:02:41,390
+اللي هو ال valves تبع ال heart اللي هو في داخل
+
+43
+00:02:41,390 --> 00:02:46,140
+القلببين ال ventricle و ال atrium علشان بتصير فيها
+
+44
+00:02:46,140 --> 00:02:50,300
+إشكالية طبعا الإشكالية لأنه لجوا أنه نفس البكتيريا
+
+45
+00:02:50,300 --> 00:02:54,020
+اللى تسبب ال erotic fever streptococci برضه بتأثر
+
+46
+00:02:54,020 --> 00:02:56,980
+على .. على منطقة اللي هو ال valves عشان بتصير
+
+47
+00:02:56,980 --> 00:03:00,900
+عندهم endocarditis طيب ask about اسأل عن إيش ال
+
+48
+00:03:00,900 --> 00:03:04,280
+family history اسأل هل نقاش heart attack هل صار
+
+49
+00:03:04,280 --> 00:03:08,820
+عندكم في عيلتكم myocardial infarction angina كله
+
+50
+00:03:08,820 --> 00:03:11,580
+اللي بتتكلم عن heart attack طيب صار في
+
+51
+00:03:11,580 --> 00:03:15,960
+hypertensionفي جلطات، في عندكوا diabetes، هذه
+
+52
+00:03:15,960 --> 00:03:18,820
+تعتبر من ال history المهمة جدا و انا قاعد بعمل في
+
+53
+00:03:18,820 --> 00:03:22,740
+بداية ال assessment لcardiovascular system طيب
+
+54
+00:03:22,740 --> 00:03:26,860
+التاني الأمر المهم جدا و احنا خدناه في ال
+
+55
+00:03:26,860 --> 00:03:30,800
+nutrition assessment أن نسأل أول حاجة كيف الأكل
+
+56
+00:03:30,800 --> 00:03:34,460
+اللي أنت بتاكله طبعا لو حد مايجيب فالو أنه كان
+
+57
+00:03:34,460 --> 00:03:37,480
+بيسأل عن طبيعة الأكل، كم يأكل و كم ملال، لأ أنا
+
+58
+00:03:37,480 --> 00:03:39,940
+بتكلم في نوعية، ممكن يكون فيها ملاح، ممكن يكون
+
+59
+00:03:39,940 --> 00:03:43,270
+فيها قلة، ممكن يكون فيش فيها mineralsهكذا مش فيها
+
+60
+00:03:43,270 --> 00:03:47,610
+protein، فبنسأله nutrition intake كيف؟ هل في انت
+
+61
+00:03:47,610 --> 00:03:51,750
+عندك مشكلة؟ طب عمرك فحست .. بنسأل السؤال عمرك فحست
+
+62
+00:03:51,750 --> 00:03:56,050
+الكوليسترول، triglyceride، level of protein، liver
+
+63
+00:03:56,050 --> 00:03:58,470
+function test بشكل عام؟ عمرك فحستهم كله اللي علاقة
+
+64
+00:03:58,470 --> 00:04:01,870
+بالإيه nutrition intake إذا في مشكلة عشان نبدأ
+
+65
+00:04:01,870 --> 00:04:03,950
+يعيش لإنه نقص خطر، الكوليسترول عالي، ال
+
+66
+00:04:03,950 --> 00:04:06,430
+triglyceride عالي و ال diabetes عالي، معناته
+
+67
+00:04:06,430 --> 00:04:09,170
+رايحين على أشكالية ممكن تصير في ال cardiovascular
+
+68
+00:04:09,170 --> 00:04:13,040
+systemدى اسمه كانت تدخن كتير لجوه الدراسات انه في
+
+69
+00:04:13,040 --> 00:04:17,960
+ارتباط وثيق مع التدخين كدهش بتدخل و زمان إلك ولا
+
+70
+00:04:17,960 --> 00:04:22,820
+قرية يعني من قريب و هكذا how do you view yourself
+
+71
+00:04:22,820 --> 00:04:26,620
+ايش يعني كي بنسأل سؤال كويس انت كيف شايف حالك يعني
+
+72
+00:04:26,620 --> 00:04:30,620
+انا بنبسط من الطبيب اللى بيجي المرض بيقوله انا قبل
+
+73
+00:04:30,620 --> 00:04:33,480
+ما حكم عليك انت كيف شايف حالك بيجي المرض بيقول
+
+74
+00:04:33,480 --> 00:04:35,580
+والله انا حاسس حالة تعبان والله حاسس حالة مرهقة
+
+75
+00:04:35,580 --> 00:04:39,630
+والله حاسس يعني هذا ايش اسمهI view myself from my
+
+76
+00:04:39,630 --> 00:04:43,010
+view. أنا بشوف حالي من وجهة نظري. و في نفس الوقت
+
+77
+00:04:43,010 --> 00:04:46,650
+بيقولوا what you do is to relax. إيش أنت بتعمل
+
+78
+00:04:46,650 --> 00:04:50,250
+عشان ترتاح لما تكون تعبال؟ هذا إيه المعنى؟ لقدام
+
+79
+00:04:50,250 --> 00:04:53,190
+شوية هنفهم إيش .. إيش اللي نقصد. How many hours؟
+
+80
+00:04:53,190 --> 00:04:57,510
+جديش أنت جديش في اليوم بتشتغل. ما زال جديش في
+
+81
+00:04:57,510 --> 00:05:00,050
+اليوم تشتغل كم هيكون دُغر تلقايا جديش في اليوم
+
+82
+00:05:00,050 --> 00:05:03,870
+بترتاح.الأمر اللي أختار بده نسأله على موضوع ال
+
+83
+00:05:03,870 --> 00:05:07,510
+stress لإنه مرتبط ارتباط وثيق جدا في ال
+
+84
+00:05:07,510 --> 00:05:10,810
+cardiovascular system ما حلله ال stress للأسف
+
+85
+00:05:10,810 --> 00:05:13,750
+القلب لإنه من كتر من الإنسان بحط في قلبه مشكلة
+
+86
+00:05:13,750 --> 00:05:17,990
+طبعا نسألك how to cope كيف أنت بتتأقلم بالتوتر في
+
+87
+00:05:17,990 --> 00:05:21,490
+حياتك بده يقولنا هل بال aggressive هل بال anxiety
+
+88
+00:05:21,490 --> 00:05:24,170
+بده يحكينا الشيء اللي موجود عنده نسأل على ال
+
+89
+00:05:24,170 --> 00:05:29,140
+exerciseانت بالنسبة لك بتعمل تمارين مش شرط انك
+
+90
+00:05:29,140 --> 00:05:32,000
+قاعد بلعب مثلا مارثونة وغيرها، لأ، بتعمل تمارين في
+
+91
+00:05:32,000 --> 00:05:35,720
+حياتك ولا لأ؟ إذا قال أه، بتقوله أيش هوفر، جد إيش؟
+
+92
+00:05:35,720 --> 00:05:39,320
+كل يومين، كل يوم، كل أسبوع، وكيف قليتك، بتمشي ..
+
+93
+00:05:39,320 --> 00:05:42,120
+إيش اللي بتعمله؟ طيب، في عندك الجد بدأنا ندخل في
+
+94
+00:05:42,120 --> 00:05:45,920
+التفصيل الأدق شوية، نسأل عن الألم الآن، الألم
+
+95
+00:05:45,920 --> 00:05:48,420
+مابيسأله في منطقة ال heart مباشرة، لأ، بيجي بيسأله
+
+96
+00:05:48,420 --> 00:05:51,480
+في منطقة إيش؟ ال calves، ال calves يا جماعة عشان
+
+97
+00:05:51,480 --> 00:05:55,130
+كنا عندكوا علمبيسموها لبطة الرجل وال curves
+
+98
+00:05:55,130 --> 00:05:58,530
+بيسموها العلماء the second heart of the body، ايش
+
+99
+00:05:58,530 --> 00:06:02,050
+يعني؟ يعني تعتبر اسم القلب الثاني للجسم على اعتبار
+
+100
+00:06:02,050 --> 00:06:07,340
+انها بعد ما الدم كله ينزل ال extremities تحتبينضغط
+
+101
+00:06:07,340 --> 00:06:10,220
+بال calves muscle .. سبحان الله ال calves muscle
+
+102
+00:06:10,220 --> 00:06:13,800
+وين بروح و برجع يعني على الطريق اللي فينا كذا،
+
+103
+00:06:13,800 --> 00:06:16,160
+بروح اياش، برجع على القلب، وهذا ميزة حلوة كتير
+
+104
+00:06:16,160 --> 00:06:19,540
+الله حطها يعني في جسم الإنسان عشان ما يصيرش قلنا
+
+105
+00:06:19,540 --> 00:06:23,520
+دوالي و احنا واقفين و احنا عمالنا بنطول واقفتنا،
+
+106
+00:06:23,520 --> 00:06:27,320
+نسأل على ال feet، الأقدام كيف؟الـ legs ماحدى يقول
+
+107
+00:06:27,320 --> 00:06:30,780
+لي إيش دخلهم، لأ كله اللي دخل أي arterial problems
+
+108
+00:06:30,780 --> 00:06:33,220
+بالعكس على دول أي arterial .. ال arterial problems
+
+109
+00:06:33,220 --> 00:06:36,520
+من هون جاية ال arterial problems جاية من ال heart
+
+110
+00:06:36,520 --> 00:06:41,220
+عشان هيك لإنها يتوع طبع قلبه أوعيا بعدين بنسأله
+
+111
+00:06:41,220 --> 00:06:43,860
+إيش اللي بيجي .. لما أقول كلمة .. كلمة aggravates
+
+112
+00:06:43,860 --> 00:06:47,580
+شو اللي بيخلي القلم عندك زيت؟ مزال في كلمة
+
+113
+00:06:47,580 --> 00:06:50,580
+aggravate لازم يكون العكس فيه عسم relief يبقى لازم
+
+114
+00:06:50,580 --> 00:06:53,680
+نسأله، لو قاللي أه والله أنا عندي مشكلة، عندي قلم
+
+115
+00:06:53,680 --> 00:06:57,050
+في رجليا، عندي رجليا قلم في منطقة الوالله الكلال
+
+116
+00:06:57,050 --> 00:07:00,010
+اللي في مصر عندي ألم باتش بسأله، شهو اللي ممكن
+
+117
+00:07:00,010 --> 00:07:03,530
+يعمل ا aggravation زي ال walking أو ال sitting،
+
+118
+00:07:03,530 --> 00:07:07,230
+long period، زي ال standing، long period، زي ال
+
+119
+00:07:07,230 --> 00:07:09,530
+sleep، في مرات بيقولك لأ، في بعض الناس بيقولك أنا
+
+120
+00:07:09,530 --> 00:07:12,870
+في الليل بتقلم، بيصير معي stiff، لازم ناخد الكلام
+
+121
+00:07:12,870 --> 00:07:16,430
+بعين الاعتبار، أو بتشد عضلاتي وماقدرش ا .. يعني ا
+
+122
+00:07:16,430 --> 00:07:20,590
+.. افرد نفسي طيب ما زال سألنا إيش اللي بشجع الألم،
+
+123
+00:07:20,590 --> 00:07:25,280
+بدنا نسأل السؤال إيش اللي بخفف الألم؟بنسأله ايش
+
+124
+00:07:25,280 --> 00:07:27,660
+اللي ممكن يخفف القمزايا elevated legs يعني هل انت
+
+125
+00:07:27,660 --> 00:07:33,380
+لما ترفع رجليك مثلا عن خد على كده بترتاح طيب هل
+
+126
+00:07:33,380 --> 00:07:37,700
+انت بتستخدم هنا constructing هنا حاجة سمها
+
+127
+00:07:37,700 --> 00:07:40,900
+garments or hosiery garments or hosiery يعني
+
+128
+00:07:40,900 --> 00:07:45,920
+الجوارب وخاصة للأسف في بعضهم بيصير عندهم مشكلة انه
+
+129
+00:07:45,920 --> 00:07:49,300
+خاصة اللي بيلبسوا الأحتياج شديدة شويه ضغط ع رجليهم
+
+130
+00:07:49,300 --> 00:07:54,720
+عشان بدهوا نمر أصغر أو بيلبس جوارب يعني ضغط كتيرأو
+
+131
+00:07:54,720 --> 00:07:58,700
+الجوارب الطويلة يعني بتعرفوهم انتوا هذولة برضه
+
+132
+00:07:58,700 --> 00:08:01,940
+اللي معلاقة عشان نعرف ان اللي قدامي شوية ان هذول
+
+133
+00:08:01,940 --> 00:08:06,280
+مرات بساعد في رأي يعني ضغط الدم و مرات بضر ان اذا
+
+134
+00:08:06,280 --> 00:08:10,980
+كان زيادة زي ال bandage او الشاشة لما بنلف على ايد
+
+135
+00:08:10,980 --> 00:08:14,300
+المريض لما بيكون بحدوده الطبيعي مقبول لما بزيد
+
+136
+00:08:14,300 --> 00:08:19,000
+مشكلة و لما بجلد برضه مشكلة طيب in what type of
+
+137
+00:08:19,000 --> 00:08:22,880
+chair does the client usually sit؟ بنسأله سؤاليإيش
+
+138
+00:08:22,880 --> 00:08:26,240
+أنت أحسن كرسي بتحب تقعد عليه؟ برضه هذا إيه المهم،
+
+139
+00:08:26,240 --> 00:08:29,440
+كيف قعدتك؟ كيف قليت الجلوس عشان نعرف أنه هل بيحب
+
+140
+00:08:29,440 --> 00:08:33,060
+يخفف عن نفسه؟ هل بيحب يحط ورا مثلا مسند، مخدة عشان
+
+141
+00:08:33,060 --> 00:08:36,700
+نعرف أنه فيه مشكلة؟ هل بيحب يخفف عن ال pressure من
+
+142
+00:08:36,700 --> 00:08:39,860
+ال abdomen جاى على ال heart ولا لأ؟ بعدين بنسأله،
+
+143
+00:08:39,860 --> 00:08:44,860
+هل أنت من الناس اللي بيحبوا يعني يعمل cross legs؟
+
+144
+00:08:44,860 --> 00:08:48,210
+cross legs كلهم عارفين يعني بيحط رجل عرجل يعنيطبعا
+
+145
+00:08:48,210 --> 00:08:51,050
+ما تعتبروها نحاجة صحيح الناس بيعتبرها ربما
+
+146
+00:08:51,050 --> 00:08:55,410
+prestige أو كده لكن أنا هنا صراحة أنصحت جميع مش
+
+147
+00:08:55,410 --> 00:08:59,130
+كتير كويسة صحية و لو زادت ممكن يعني تعمل مصيبة
+
+148
+00:08:59,130 --> 00:09:02,330
+خاصة في بعض الناس اللي عندهم أصلا arterial
+
+149
+00:09:02,330 --> 00:09:08,790
+problems اللي هو يعني وضع رجل على رجل أكتر من وقت
+
+150
+00:09:08,790 --> 00:09:13,370
+كتير ممكن يصير للأسف DVT في بعض الحالاتassessment
+
+151
+00:09:13,370 --> 00:09:16,590
+نشوف إيش هنا لازم يكون إيش المريض مش sitting لما
+
+152
+00:09:16,590 --> 00:09:20,850
+قلنا هناك في ال assessment لل respiratory system
+
+153
+00:09:20,850 --> 00:09:23,970
+كنا sitting و لما نيتعب ممكن إيش نايم على دهره هنا
+
+154
+00:09:23,970 --> 00:09:27,570
+لأ عشان heart جلي على ال subile لكن إيش جلي إيه
+
+155
+00:09:27,570 --> 00:09:31,190
+subile ممكن يكون sitting لكن هو subile بيكون أريح
+
+156
+00:09:31,190 --> 00:09:34,550
+للمريض ليش على اعتبار أن مافيش pressure على ال
+
+157
+00:09:34,550 --> 00:09:39,770
+heart كتب لي لحظة كلام حلو according to إيش توزيت
+
+158
+00:09:39,770 --> 00:09:44,390
+يعني أنت تابعليش بقول انت تابع صحة المريض؟ بعض
+
+159
+00:09:44,390 --> 00:09:48,150
+المرضى بقولك بقدرش انا مع ظهري خاصة الناس ال obese
+
+160
+00:09:48,150 --> 00:09:50,130
+و ال heavy smokers بقدرش او اللي عنده أزمة بقولك
+
+161
+00:09:50,130 --> 00:09:53,610
+بقدرش هذا ممكن على راحته نخليه setting طيب
+
+162
+00:09:53,610 --> 00:09:56,810
+inspection and pulpation أول حاجة بدنا نطلع
+
+163
+00:09:56,810 --> 00:10:00,450
+inspection بعدين بدنا نمد دي أنه نعمل pulpation
+
+164
+00:10:00,450 --> 00:10:03,910
+عشان إذا فيه لا سمح الله ventricular hypertrophy
+
+165
+00:10:03,910 --> 00:10:07,950
+في بعض الناس نسمع بيقولوا عنده تضخم في عضلة القلب
+
+166
+00:10:08,480 --> 00:10:11,000
+لما تسمع تضخم في عدوة القلب هذا المقصود
+
+167
+00:10:11,000 --> 00:10:14,520
+ventricular hypertrophy من إيش؟ لقدام شويحة أشرح
+
+168
+00:10:14,520 --> 00:10:18,340
+من إيش بتكون لازم نستخدم source of light لازم يكون
+
+169
+00:10:18,340 --> 00:10:22,480
+مصدر ضوء قوي جدا طب ليش؟ عشان في بعض الحركات مش
+
+170
+00:10:22,480 --> 00:10:25,440
+كذا اسمها subtil movement subtil يعني المنطقة
+
+171
+00:10:25,440 --> 00:10:29,000
+المخفية الحركات المخفية in the chest يعني ممكن أنت
+
+172
+00:10:29,000 --> 00:10:33,640
+تتطلع في ال chest ممكن الجلب نفسه في دقاته في
+
+173
+00:10:33,640 --> 00:10:37,220
+مشكلةومبينة على الجسم من برا لكن مش قادر اشوفها
+
+174
+00:10:37,220 --> 00:10:41,220
+انا ممكن تكون حركات مخفية خاصة لما بيكون obese
+
+175
+00:10:41,220 --> 00:10:46,420
+المريض وفي القلب مع دقاته فيه خربطة شوية مش قادرين
+
+176
+00:10:46,420 --> 00:10:50,000
+نعرف هذه الخربطات زي ايش خربطة يا أستاذ زي حاجة ال
+
+177
+00:10:50,000 --> 00:10:52,960
+pulsation لو حطينا ضوء ممكن انا ماشوفش الجسم
+
+178
+00:10:52,960 --> 00:10:56,940
+بالعين مجرد لو حطت ضوء قوي بنسير نتطلع بنشوف تطلع
+
+179
+00:10:56,940 --> 00:11:00,000
+وع الطفل لو عندكوا طفل ع مطقة الصدر وحطيتوا ضوء
+
+180
+00:11:00,000 --> 00:11:04,360
+هتلاقيوا إيش النبضات مبينة جدا و واضحة زي الشمسفي
+
+181
+00:11:04,360 --> 00:11:07,600
+بعض الناس عندهم Retraction Retraction زي ليش بطلع
+
+182
+00:11:07,600 --> 00:11:10,940
+و بنزل Retraction هاسمه إيش Retraction زي حكاية ال
+
+183
+00:11:10,940 --> 00:11:13,100
+.. ال .. ال .. إيش .. زي إيش بروح و برجع .. بروح و
+
+184
+00:11:13,100 --> 00:11:17,360
+برجع .. بروح و برجع .. هاسمه إيه Retraction طيب في
+
+185
+00:11:17,360 --> 00:11:21,240
+عندنا من ال pulse اللي بدنا نعمله assessment في
+
+186
+00:11:21,240 --> 00:11:26,240
+منطقة ال heart نوعين في نوع اسمه Apical pulse و في
+
+187
+00:11:26,240 --> 00:11:30,610
+نوع اسمه Base pulse مش Apical و Radialانا عارف ايش
+
+188
+00:11:30,610 --> 00:11:32,990
+قصدكم apical و radial طبعا فى فرق بينهم و شوية
+
+189
+00:11:32,990 --> 00:11:37,150
+هكمل يعنى فى اعتبروا انه one to two to three pulse
+
+190
+00:11:37,150 --> 00:11:40,930
+زي الفرق بينهم اللى ما بين ال apical و ال radial
+
+191
+00:11:40,930 --> 00:11:44,430
+لكن هنا اقصد ال apical و ال basic اتنين heart طيب
+
+192
+00:11:44,430 --> 00:11:46,310
+احنا فى البداية وان ال heart موجود ما انت خدتوا فى
+
+193
+00:11:46,310 --> 00:11:49,910
+التشريح و نذكركوا ال heart زى سبحان الله زى
+
+194
+00:11:49,910 --> 00:11:54,170
+المخلوط الشكلالرأس تبع المخروط لتحته و القاعدة تبع
+
+195
+00:11:54,170 --> 00:11:58,530
+المخروط لفوق يبقى أعلى الصدر فوق هو قاعدة القلب
+
+196
+00:11:58,530 --> 00:12:01,690
+لإنه بيطلع منها ال vessels و هو أدنها من تحت اللي
+
+197
+00:12:01,690 --> 00:12:05,570
+هو رأس إيه اللي هو ال apical pulse وين موجود؟ عشان
+
+198
+00:12:05,570 --> 00:12:08,070
+أعرف بالظبط، بقوللي في ال lift، ها fifth
+
+199
+00:12:08,070 --> 00:12:11,890
+intercoastal space، بدك تسمع كويس ال apical pulse،
+
+200
+00:12:11,890 --> 00:12:14,750
+روح على إيش؟ ال lift، ها fifth intercoastal space،
+
+201
+00:12:14,750 --> 00:12:18,580
+روح على منطقة الشمال، يعني شمال استيرناو عند اللي
+
+202
+00:12:18,580 --> 00:12:21,600
+هو .. اللي هو الفراغ الخامس ما بين ال intercostal
+
+203
+00:12:21,600 --> 00:12:24,560
+اللي هو الفراغات بين ال cartilage و عنده في هذا
+
+204
+00:12:24,560 --> 00:12:27,500
+المكان أسمع كويس .. ممكن تلاقي deviation اشعر ال
+
+205
+00:12:27,500 --> 00:12:30,720
+deviation انحراف يعني ماسمعتش كويس او لجيت الصوت
+
+206
+00:12:30,720 --> 00:12:34,120
+اللي انا بده اسمعه في مكان تاني مازال في مكان تاني
+
+207
+00:12:34,120 --> 00:12:39,100
+فورا ايش بتشيك cardiac enlargement تمام؟ زي ايه؟
+
+208
+00:12:39,100 --> 00:12:42,940
+زي بدل ما سمعته في الخامس اسمعته في السادس يعني
+
+209
+00:12:42,940 --> 00:12:45,460
+بدل ما سمعته في فراغ الخامس اسمعته في فراغ السادس
+
+210
+00:12:45,740 --> 00:12:49,260
+هذا يدل على أنه فيه تضخم في عضلة القلب، شغلات
+
+211
+00:12:49,260 --> 00:12:52,080
+بسيطة تدل أنه في مشكلة خطيرة و أنت بتعمل
+
+212
+00:12:52,080 --> 00:12:54,920
+assessment ال retractions زي ما قلنا إيش بطلع و
+
+213
+00:12:54,920 --> 00:12:58,800
+بنزل ممكن يكون هذا إيش هنا around the site of the
+
+214
+00:12:58,800 --> 00:13:01,540
+apical bus إيش يعني؟ ممكن يكون حوالين ال apical
+
+215
+00:13:01,540 --> 00:13:04,520
+bus يعني أنا عرفت إنه في ال fifth و حطيت السماعة
+
+216
+00:13:04,520 --> 00:13:08,800
+لكن أنا شايف حوالينه في حاجة اسمها retraction عامة
+
+217
+00:13:08,800 --> 00:13:12,430
+بقى الجلد بطلع و بنزل، طب إيش هذا بدل ليه؟بدل انه
+
+218
+00:13:12,430 --> 00:13:15,970
+في عنده مشكلة ايش هي المشكلة هذه اسمها pericardial
+
+219
+00:13:15,970 --> 00:13:20,650
+disease لما نسمع كلمة pericardial disease يعني مرض
+
+220
+00:13:20,650 --> 00:13:25,150
+حوالين جدار القلب endocardial disease يعني مرض
+
+221
+00:13:25,150 --> 00:13:28,710
+داخل القلب يبقى pericardial حوالين endocardial
+
+222
+00:13:28,710 --> 00:13:32,570
+تباركاردير يعني جيران القلب يعني مثل في ال plural
+
+223
+00:13:32,570 --> 00:13:38,450
+في المنطقة هذه في حجز ماهيفز الثقلover lifts يعني
+
+224
+00:13:38,450 --> 00:13:42,070
+و احنا قاعدين بنعمل assessment ال pulse بنحس اشي
+
+225
+00:13:42,070 --> 00:13:45,610
+قاعد برفع ايدنا و برفعها لفوق زي اللي بطلع الايد
+
+226
+00:13:45,610 --> 00:13:50,210
+لفوق يعني في اشي فجيل برفعنا لفوق اش هذا بقوللي
+
+227
+00:13:50,210 --> 00:13:53,650
+هذا دقري بدنا ن check ايش انه في عنده right
+
+228
+00:13:53,650 --> 00:13:59,030
+ventricular work increase بكون في زيادة load كبير
+
+229
+00:13:59,030 --> 00:14:04,250
+على وين على ال right ventricle على ال right ايه ال
+
+230
+00:14:04,250 --> 00:14:12,960
+ventricle اللي هوالبطين الأيمن طيب الآن
+
+231
+00:14:12,960 --> 00:14:17,160
+بعض الناس طبعا هنا اللي بيجي بعدها بيصير حاجة
+
+232
+00:14:17,160 --> 00:14:21,380
+تسموه إيش اللي هو ال congestive heart failure عشان
+
+233
+00:14:21,380 --> 00:14:24,160
+هيك ال congestive heart failure بنلاقي في كتير من
+
+234
+00:14:24,160 --> 00:14:26,780
+الحالات المصدر الأساسي اللي جاي من وين من ال right
+
+235
+00:14:26,780 --> 00:14:33,040
+ventricle طيب الآن
+
+236
+00:14:34,150 --> 00:14:37,930
+خلصوا موضوع البطاين و .. اللي .. اللي صار و عملنا
+
+237
+00:14:37,930 --> 00:14:39,970
+ال assessment نجري جدا نعمل palpation و سمعناها
+
+238
+00:14:39,970 --> 00:14:43,330
+كويسة شو؟ palpation في palpation برضه في sublime
+
+239
+00:14:43,330 --> 00:14:46,590
+position ايش بقولين؟ اول حاجة بدك تعمل palpation
+
+240
+00:14:46,590 --> 00:14:51,050
+ابدأ من ال apex لوين؟ to the external border to
+
+241
+00:14:51,050 --> 00:14:56,560
+base يعني في palpationبقولوا يعني العلماء أنه أفضل
+
+242
+00:14:56,560 --> 00:15:01,700
+أنك تبدأ من رأس المخروط أو رأس القلب و احنا قولنا
+
+243
+00:15:01,700 --> 00:15:05,140
+الرأس تحت و القاعدة وين فوق فبيقولوا ابدأ من الرأس
+
+244
+00:15:05,140 --> 00:15:08,480
+من تحت و حط .. ضلك إيش تعمل assessment شوي شوي في
+
+245
+00:15:08,480 --> 00:15:12,740
+صبيعك لما تصل إيش لحدود ال base اللي هو of the
+
+246
+00:15:12,740 --> 00:15:17,380
+heartو قولي detect abnormalities حاولي تحدد إذا في
+
+247
+00:15:17,380 --> 00:15:21,320
+أي شيء مش طبيعي في إيش في ال sight of palpation
+
+248
+00:15:21,320 --> 00:15:23,740
+يعني و إحنا قاعدين نعمل palpation اعرف لي إذا في
+
+249
+00:15:23,740 --> 00:15:27,880
+أي مشكلة صار فيه صوت معين و إحنا قاعدين بنحط
+
+250
+00:15:27,880 --> 00:15:31,860
+إيدينا حاسين فيه صوت تحت أصابع إيدينا غريب هذا
+
+251
+00:15:31,860 --> 00:15:36,220
+الصوت لما نسمع abnormal flow of blood بأي نقية كان
+
+252
+00:15:36,220 --> 00:15:39,980
+يعني عشان نتمرد بكفينا داليأي صوت تحت أصابيه
+
+253
+00:15:39,980 --> 00:15:42,980
+اديانة و احنا بنعمل assessment لاجينا صوت غريب
+
+254
+00:15:42,980 --> 00:15:47,100
+يعني عامله بي .. زي .. زي مجر معين هيك بينزله لكن
+
+255
+00:15:47,100 --> 00:15:50,740
+غريب الصوت ايش اسمه هنا thrill يبقى اشمت thrill
+
+256
+00:15:50,740 --> 00:15:55,280
+abnormal flow of blood يبقى انسية بالدم غير طبيعي
+
+257
+00:15:55,280 --> 00:15:59,080
+او اللي صوت يعني شوية عامله عامل يعني مش الصوت
+
+258
+00:15:59,080 --> 00:16:03,760
+اللي انا بعتبره طبيعي اش بتسمي thrill بقوللي لك ان
+
+259
+00:16:03,760 --> 00:16:08,680
+ترى بالك من المهم كتير ان انتتوصف الbarcession ايش
+
+260
+00:16:08,680 --> 00:16:13,260
+توصفها؟ اوصفليها مع علاقتها معيش مع ال time لل
+
+261
+00:16:13,260 --> 00:16:16,840
+cardiac cycle يعني انت وانت قاعد عمالك بتعمل
+
+262
+00:16:16,840 --> 00:16:21,080
+assessment للبرس شوف البرس بتسبق ال cardiac cycle
+
+263
+00:16:21,080 --> 00:16:26,100
+بتسبقهاش هل في تسارع في تقابض هل بتحس انه لأ بطيء
+
+264
+00:16:26,100 --> 00:16:30,040
+هل بتحس كل شوية بتطلعلك يعني برس لحالة زي ال extra
+
+265
+00:16:30,040 --> 00:16:33,740
+system هذا كله بدنا نعمله assessment عشان ندونه و
+
+266
+00:16:33,740 --> 00:16:37,800
+نحكي للطبيباللي بعد بقول describe in terms أوصف
+
+267
+00:16:37,800 --> 00:16:43,600
+بمصطلحات ال location وين ما كان ال pulse يعني نكون
+
+268
+00:16:43,600 --> 00:16:47,000
+دقيقين لما نقول ال pulse موجود قوللي فى ال right
+
+269
+00:16:47,000 --> 00:16:50,140
+مثلا فأ مثلا او فى ال left مثلا intercourse or
+
+270
+00:16:50,140 --> 00:16:53,560
+space اللى جاي فى ال fifth مثلا sixth اي ان كان
+
+271
+00:16:53,560 --> 00:16:57,220
+طيب in relation to mid sternum عارفين وين ال mid
+
+272
+00:16:57,220 --> 00:17:01,460
+sternum هى ال sternum بقول ال mid sternum يعنيفي
+
+273
+00:17:01,460 --> 00:17:05,140
+برات ال pulse مش قادر انا اشوفه في ال sixth او في
+
+274
+00:17:05,140 --> 00:17:09,680
+ال fifth ها ايش اعمل لجيته جنب ال medestinal بقول
+
+275
+00:17:09,680 --> 00:17:13,400
+والله nearly medestinal يمكن بعضهم اللي جيت تحت ال
+
+276
+00:17:13,400 --> 00:17:16,160
+clavicle كلكم عارفين عضمة الترقوة اللي هي ال
+
+277
+00:17:16,160 --> 00:17:19,890
+clavicleممكن انا اجي تحت ايش لك ده في كله تحت انا
+
+278
+00:17:19,890 --> 00:17:23,230
+بقول والله لأ انا سمعت الصوت او حاسيت الصوت في ال
+
+279
+00:17:23,230 --> 00:17:26,010
+mid-clavicular في بعضهم بيقولك لأ والله انا حاسيته
+
+280
+00:17:26,010 --> 00:17:28,030
+شوية في ال auxiliary ماحدة ييجي يقولي auxiliary
+
+281
+00:17:28,030 --> 00:17:30,730
+طبعا تحت القبط ماحدة ييجي يقولي طبعا هذا طبيعي لأ
+
+282
+00:17:30,730 --> 00:17:34,710
+هذا مش طبيعي بس انا اقصد انه لازم احنا نوصف لما
+
+283
+00:17:34,710 --> 00:17:38,370
+بدنا نحكي بالاساسمة الطبيعية للطبيب او للمعالج
+
+284
+00:17:38,370 --> 00:17:42,940
+نقوله بالظبط وين شعرنا ال pulsation موجودةبيوصفها
+
+285
+00:17:42,940 --> 00:17:46,440
+هل هي جنب السترنم و لا جنب ال clavicle و لا جنب ال
+
+286
+00:17:46,440 --> 00:17:51,820
+auxiliary و هكذا طيب palpation of apical pulse
+
+287
+00:17:51,820 --> 00:17:55,240
+يعني و احنا بنعمل كده palpation لل apical pulse
+
+288
+00:17:55,240 --> 00:18:00,560
+بدك تشوف ايش هنا ال strength القوة بتختلف تختلف من
+
+289
+00:18:00,560 --> 00:18:06,160
+الناصح للضعيف دايما هي thin to obese مابدأ اقول ان
+
+290
+00:18:06,160 --> 00:18:09,890
+بتكون عند ال obese اعلى و اوطانهم في اختلافهم
+
+291
+00:18:09,890 --> 00:18:13,350
+وجدوا أن ال obese بتكون عنده أكتر على اعتبار أن
+
+292
+00:18:13,350 --> 00:18:19,950
+القلب بيبقى كافح عشان بيوصل لأخر يعني أطراف الجسم
+
+293
+00:18:19,950 --> 00:18:23,850
+والثن بيعتبروا يعني .. يعني لأن ال body خليني أقول
+
+294
+00:18:23,850 --> 00:18:27,570
+built بالشكل عام يعني بتكون شوية أخف من ال obesity
+
+295
+00:18:27,570 --> 00:18:30,990
+وممكن الدم يصل بسهولة عشانك تكون ال pulse أهون
+
+296
+00:18:30,990 --> 00:18:35,760
+شويةطيب ال conditions زي إيش اللي ممكن إيش هذا
+
+297
+00:18:35,760 --> 00:18:39,260
+اللي ممكن تزيد ال duration ها تبع ال apical pulse
+
+298
+00:18:39,260 --> 00:18:42,400
+أنا لحد الآن بتكلم ع ال apical احنا كل نوعين في
+
+299
+00:18:42,400 --> 00:18:44,280
+apical و في base pulse خلينا نتكلم ع ال apical
+
+300
+00:18:44,280 --> 00:18:49,340
+نكمل فبقولي إيش الأشياء اللي ممكن تزيد القوة و
+
+301
+00:18:49,340 --> 00:18:54,300
+المدة تبع ال apical pulse بقولي زي ال anxietyأكيد
+
+302
+00:18:54,300 --> 00:18:57,400
+طبعا أنيميا ما حد يقول طب أنيميا يا أستاذ فى فقر
+
+303
+00:18:57,400 --> 00:19:00,320
+دم اه compensatory mechanism بيصير الجالب بيسرع
+
+304
+00:19:00,320 --> 00:19:04,580
+أكتر عشان يقدر يعوض fever hyperthyroidism طبعا
+
+305
+00:19:04,580 --> 00:19:08,740
+كلهم عارفين إيش معناتهم الآن وخاصة غضب الthyroid
+
+306
+00:19:08,740 --> 00:19:11,760
+كمان تلاقيها أنهيش غضب دراقية عامة زاد نشاطة فبصير
+
+307
+00:19:11,760 --> 00:19:16,570
+مشكلةطيب بقول you feel lifting كيف بتعرف lifting
+
+308
+00:19:16,570 --> 00:19:19,550
+sensation اما احنا قولنا كلمة lifting بتشعر ان تحت
+
+309
+00:19:19,550 --> 00:19:23,890
+أصابعك اشي عماله بيحمل أصابعك لفوق يعني وانت بتعمل
+
+310
+00:19:23,890 --> 00:19:28,830
+assessment لنفس ال apical pulse بتحس كأنه .. كأنه
+
+311
+00:19:28,830 --> 00:19:34,630
+النبض بيرفع ايدك لفوق هذا بيدل انه عماله بزيد اكتر
+
+312
+00:19:34,630 --> 00:19:37,870
+اللي هو ال apical pulse و بزيد ال duration و بزيد
+
+313
+00:19:37,870 --> 00:19:43,370
+ال strength بتبعتهالان بالبيشن of the bars اللي هو
+
+314
+00:19:43,370 --> 00:19:48,390
+اسمه ايه base bars الان طب انت عرفنا يا أستاذ وين
+
+315
+00:19:48,390 --> 00:19:51,510
+ال apex وعرفناها في ال fifth inter coastal space
+
+316
+00:19:51,510 --> 00:19:53,530
+وقلنا زي فيه مشكلة وفيه enlargement بنروح على ال
+
+317
+00:19:53,530 --> 00:20:00,630
+six طب هنا أم ال base لأ بيقوللي حط إيدك على where
+
+318
+00:20:00,630 --> 00:20:06,230
+second left or right inter coastal space بيقوللي
+
+319
+00:20:06,230 --> 00:20:08,330
+روح على ال inter coastal space اطلع لفوق شوية
+
+320
+00:20:08,830 --> 00:20:11,430
+اروحلي على ال second يعني على ايش .. على اللي هو
+
+321
+00:20:11,430 --> 00:20:13,870
+الفراغ التاني .. بين ال .. ليش؟ بين ال ribs، يا
+
+322
+00:20:13,870 --> 00:20:17,070
+بتحط إيدك على الشمال يا على اليمين، طبعا مش هقدر
+
+323
+00:20:17,070 --> 00:20:20,030
+أحطها في النص لإنه في عضمة في النص، طب ليش يمين أو
+
+324
+00:20:20,030 --> 00:20:24,970
+شمال؟ على التنين بظبط؟ لإن ال base شمال عريضة، ما
+
+325
+00:20:24,970 --> 00:20:27,950
+احنا قلنا بكون ال apex تحت و ال base فوق عريضة،
+
+326
+00:20:27,950 --> 00:20:31,330
+فهي ممتدة على جنب اليمين و على جنب اليسار تبع إيه؟
+
+327
+00:20:31,740 --> 00:20:35,360
+طبع اللي هو ال external فبقدر أعمل assessment يبقى
+
+328
+00:20:35,360 --> 00:20:38,040
+ال inter coastal space الثاني بقدر أحس عليه إيش
+
+329
+00:20:38,040 --> 00:20:42,040
+هنا اللي هو حوالين ال external borders عامة القصة
+
+330
+00:20:42,040 --> 00:20:45,900
+اللي حوالينا بقدر أشوف و أحس اللي هو إيش ال
+
+331
+00:20:45,900 --> 00:20:49,510
+baseballsما بدي أشرح كتير عن ال base pulse ولا بدي
+
+332
+00:20:49,510 --> 00:20:51,990
+أشرح ولا بدي أقارنه أنا فقط بس بدي أعرف أن هاي
+
+333
+00:20:51,990 --> 00:20:55,030
+المكان عرفناه ليه؟ لأنه إحنا حنش .. لما بدنا
+
+334
+00:20:55,030 --> 00:20:57,230
+يشرحونا أبوكرا في ال medical surgical و بدنا
+
+335
+00:20:57,230 --> 00:21:00,490
+نشرحنا في كل إشي مش هينذكر، اللي هينذكر Epical
+
+336
+00:21:00,490 --> 00:21:02,710
+radial .. Epical radial و هكذا، بس إحنا من باب
+
+337
+00:21:02,710 --> 00:21:05,810
+زيادة في المعرفة أنه نعرف أنه في حاجة برضه في
+
+338
+00:21:05,810 --> 00:21:10,640
+إجماعة اللي هو ال base pulseطبعا ال percussion مهم
+
+339
+00:21:10,640 --> 00:21:13,500
+كتير على الموضوع اللي بالأحمر not used in cardiac
+
+340
+00:21:13,500 --> 00:21:17,040
+assessment لو حد سألنا هو بقدر استخدم percussion؟
+
+341
+00:21:17,040 --> 00:21:20,400
+وين بدك تستخدم percussion؟ يعني هل بنقدر نستخدم
+
+342
+00:21:20,400 --> 00:21:23,820
+percussion؟و احنا بنعمل assessment على عضلة القلب،
+
+343
+00:21:23,820 --> 00:21:27,160
+طب القلب نفسه مش هنقدر ينطوله ولا نظر .. ولا نظر،
+
+344
+00:21:27,160 --> 00:21:30,820
+في .. في .. في ribs و في muscles و في skin يعني
+
+345
+00:21:30,820 --> 00:21:34,400
+اللي وجوه وجوه داخل كتير، سواء كان بعيد عن ال ..
+
+346
+00:21:34,400 --> 00:21:37,720
+ال .. ال .. ال back و بعيد عن .. و بعيد عن إيش؟ ال
+
+347
+00:21:37,720 --> 00:21:40,880
+chest، يعني على التنين، يعني الدهر والصدر. طيب,
+
+348
+00:21:41,200 --> 00:21:45,580
+escalation, all heart sound كل اللي هو أصوات القلب
+
+349
+00:21:45,580 --> 00:21:50,590
+إشهانةبتكون low Asian low ماحدش يجي يقولي هو صوت
+
+350
+00:21:50,590 --> 00:21:54,550
+القلب نسمعه من بعيد، أعوذ بالله صعب كتير، ماعمرش
+
+351
+00:21:54,550 --> 00:21:58,230
+نسمع لحدها، أما ممكن إذا حطينا الأذن مباشرة على
+
+352
+00:21:58,230 --> 00:22:01,510
+الصدر زي ما نحط الأذن على صدر الطفل، ممكن نسمع،
+
+353
+00:22:01,510 --> 00:22:03,910
+لكن ماحدش يقولي والله أنا سامع دجج قلبك و أنا قاعد
+
+354
+00:22:03,910 --> 00:22:07,210
+هنا، لأ طبعا مش لها الدرجة، فبقولي low pitched و
+
+355
+00:22:07,210 --> 00:22:09,370
+low frequency و difficult to hear، يبقى معناته
+
+356
+00:22:09,370 --> 00:22:13,570
+مقدرش أسمعها عن طريق الأذنعشان هيك لازم انا استخدم
+
+357
+00:22:13,570 --> 00:22:17,350
+ال status scope طب لو سألنا حد ابدأ في ال status
+
+358
+00:22:17,350 --> 00:22:19,970
+scope من ال apex لل base و لا ال base لل apex زي
+
+359
+00:22:19,970 --> 00:22:23,450
+ما بدك ايش جالوا العلماء جالوا من ال base لل apex
+
+360
+00:22:23,450 --> 00:22:26,190
+او من ال apex للbase نفس الشيء مافي مشكلة لأنك في
+
+361
+00:22:26,190 --> 00:22:28,970
+الآخر انت .. قولنا في الآخر احنا في الآخر apex ال
+
+362
+00:22:28,970 --> 00:22:31,150
+radial لكن احنا حاطين ال base بس من باب المعرفة و
+
+363
+00:22:31,150 --> 00:22:34,930
+اين ماكانه ال pulse طيب بقول يأسس rate and rhythm
+
+364
+00:22:34,930 --> 00:22:39,590
+بتاكي تشوف ال rate تشوف ال rhythm of the beatبتشوف
+
+365
+00:22:39,590 --> 00:22:43,570
+يعني كيف النقطة ال concentration بيناركز على ال
+
+366
+00:22:43,570 --> 00:22:46,470
+sound one بعدين ايش ال sound one و ايش ال sound
+
+367
+00:22:46,470 --> 00:22:49,670
+two sound one يعني بيدك تشوف كده حدته و ال
+
+368
+00:22:49,670 --> 00:22:52,250
+vibrations اللي جت انا هشرح شو اقصد في ال sound
+
+369
+00:22:52,250 --> 00:22:54,750
+one و شو اقصد في ال sound two عشان تكون أموره أوضح
+
+370
+00:22:54,750 --> 00:22:58,350
+اكتر بعدين بيقولي هنا اسمع لل sound two نفس الشي
+
+371
+00:22:58,350 --> 00:23:02,890
+اللي هو حدته واهتزازه و هل في duplication يعني
+
+372
+00:23:02,890 --> 00:23:07,420
+ازدواجية ولا لأ طيبالنيجا انا اش بقوللي كمان، بدك
+
+373
+00:23:07,420 --> 00:23:12,360
+تشوف ال extra sounds، ايه extra sound؟ اي صوت زي
+
+374
+00:23:12,360 --> 00:23:17,360
+ما علمونا في السنة الأولى زي دب لاب دب لاب زي دجات
+
+375
+00:23:17,360 --> 00:23:20,840
+لكل إنسان و احنا بنعمل لما علمونا كيف ناخد ال
+
+376
+00:23:20,840 --> 00:23:25,270
+pulse و نعده، اي شيءحاسيته مش طبيعي بيكفيني انا
+
+377
+00:23:25,270 --> 00:23:31,110
+كحكيم ويعني تمريض بيكفيني اسميه بس ايه ميرمارز لأن
+
+378
+00:23:31,110 --> 00:23:33,790
+الطبيب المتخصص كارديولوجيست هو اللي بيعرف ايش
+
+379
+00:23:33,790 --> 00:23:37,450
+أنواع الميرمارز مش موضوعنا دلوقت لكن بهمنا نعرف ال
+
+380
+00:23:37,450 --> 00:23:40,530
+sound one و ايش ال sound two متى بيصير ال sound
+
+381
+00:23:40,530 --> 00:23:42,970
+one و متى بيصير ال sound two ال sound one سهل كتير
+
+382
+00:23:42,970 --> 00:23:47,310
+اول حاجة من ايش بيجيلما بيغلق .. ايش هنا .. بيغلق
+
+383
+00:23:47,310 --> 00:23:49,990
+الـ tricusp و ال mitral valves اللي هو ال بين ..
+
+384
+00:23:49,990 --> 00:23:53,070
+اللي هو ال ventricle و بين الأتريام لما بيغلق
+
+385
+00:23:53,070 --> 00:23:56,070
+المشكلة الدم فوق القطة أجى على الأتريام و انضغط
+
+386
+00:23:56,070 --> 00:23:58,990
+نزل على ال ventricle أول ما ينضغط و ينزل هو بتبدأ
+
+387
+00:23:58,990 --> 00:24:01,790
+ال sound 1 و بيظل الصوت ماشي لعند ما يصل لوين ..
+
+388
+00:24:01,790 --> 00:24:05,950
+extend لما نيصل لل sound 2 يبقى معناته .. يبقى
+
+389
+00:24:05,950 --> 00:24:09,530
+معناته .. الآن ال sound 1 من وين .. أول ما بيغلق
+
+390
+00:24:09,530 --> 00:24:12,950
+ال .. ال tricusp و الم mitral بيطلع الصوت طيب ..
+
+391
+00:24:13,160 --> 00:24:16,020
+الان في حاجة مش في سيستور و في داستور و احنا بنجيز
+
+392
+00:24:16,020 --> 00:24:19,500
+البلد برا شرط السيستور اللي هو الضغط العالي اللي
+
+393
+00:24:19,500 --> 00:24:23,140
+زي ما نقول 120 ع 80، 130 ع 70 هذا السيستور اللي
+
+394
+00:24:23,140 --> 00:24:27,180
+بيبدأ من ال sound 1 و بيمدق و لا نويل لل sound 2
+
+395
+00:24:27,180 --> 00:24:30,880
+طب ايش هو ال sound 2 يا ترى؟ ال sound 2 بعد ما
+
+396
+00:24:30,880 --> 00:24:35,580
+الدم نزل، راح الفنتريجل، وين الضخ؟ راح ايش؟ ال
+
+397
+00:24:35,580 --> 00:24:39,800
+aortic، ها ال aortic و البلمونريإيش راح على
+
+398
+00:24:39,800 --> 00:24:42,920
+الأورطة عشان يروح على الجسم كله؟ وإيش راح على
+
+399
+00:24:42,920 --> 00:24:46,120
+البلمون عشان إيه؟ عشان يتنقق ويصير مليان أكسجين.
+
+400
+00:24:46,580 --> 00:24:50,920
+هذه الضغطة هي sound 2. طيب ال diastole بيقول بيبدأ
+
+401
+00:24:50,920 --> 00:24:55,500
+من sound 2 وبيمتد على sound 1 عشان هيك. بنلاقي ال
+
+402
+00:24:55,500 --> 00:24:59,760
+systole دايما أعلى من ال diastole. ليه؟ على اعتبار
+
+403
+00:24:59,760 --> 00:25:04,360
+أنه شوفوا لحظة أنتوا كيف.الان اغلاق الـ Trigaspid
+
+404
+00:25:04,360 --> 00:25:08,740
+والميترال بدي يكون قوي عشان يقدر ضخ الدم على وين؟
+
+405
+00:25:08,740 --> 00:25:11,520
+على الاورتك وعلى ال بالمونري اللي هو ال sound 2
+
+406
+00:25:11,520 --> 00:25:15,960
+يبقى عرفنا الستول بيبدأ من sound 1 بنتهي ل 2 و
+
+407
+00:25:15,960 --> 00:25:19,680
+sound 2 الدياسترول بيبدأ من sound 2 بيمتد ل sound
+
+408
+00:25:19,680 --> 00:25:25,520
+1 طبعا في حاجة كويسة هنا طريفة لجوا ان ال sound 2
+
+409
+00:25:25,520 --> 00:25:30,310
+أعلى .. ها ال sound .. sound 2أعلى من ال sound 1
+
+410
+00:25:30,310 --> 00:25:34,870
+في منطقة ال base سبحان الله يعني في منطقة ايش؟
+
+411
+00:25:34,870 --> 00:25:38,730
+base في أعلى القلب لكن لجوها أهدا شوية .. أهدا
+
+412
+00:25:38,730 --> 00:25:43,170
+شوية من ال sound 1 في ال apex يعني لجوا أن الصوت
+
+413
+00:25:43,170 --> 00:25:47,490
+الصوت ال sound .. نعيد كمان مرة لجوا صوت ال sound
+
+414
+00:25:47,490 --> 00:25:51,350
+2 اللي هو الصوت الثاني أعلى من الصوت الأول في
+
+415
+00:25:51,350 --> 00:25:54,910
+منطقة ال baseولاجوا أن ال sound .. اللي هو ..
+
+416
+00:25:54,910 --> 00:25:59,270
+نرجعكم كام مرة أن ال sound 2 لاجوا أهدا من ال
+
+417
+00:25:59,270 --> 00:26:03,950
+sound 1 في منطقة ال apex هذي بس يعني للمتخصصين
+
+418
+00:26:03,950 --> 00:26:06,870
+عشان يعرفوهم في عندنا ال sound 3 و ال sound 4 أنا
+
+419
+00:26:06,870 --> 00:26:09,530
+بتشرحهم بشكل عام و أنتوا فاهمهم لحالكم على السريع
+
+420
+00:26:09,530 --> 00:26:12,930
+لإنه مش كتير أنا مهمات عندي تعرفهم أنا بهموني اللي
+
+421
+00:26:12,930 --> 00:26:16,890
+هو sound 1 و sound 2طبعا ال sound 3 هي عبارة عن
+
+422
+00:26:16,890 --> 00:26:20,130
+إيش الاهتزاز الزائد اللي بيصير الاهتزاز الزائد
+
+423
+00:26:20,130 --> 00:26:23,670
+اللي بيصير في ال ventricular walls لما الدم بنزل ع
+
+424
+00:26:23,670 --> 00:26:26,890
+ال ventricle تحت أو مش بنزل من ال .. من الأتريا من
+
+425
+00:26:26,890 --> 00:26:30,950
+ال ventricle لما بنزل بسرعة الصوت هذا بيعمل wave
+
+426
+00:26:30,950 --> 00:26:34,870
+كيف يعني؟ بيعمل زي احتزاز هذا الاهتزاز اسمه sound
+
+427
+00:26:34,870 --> 00:26:40,230
+3 إذا كان سريع اسمه sound 3 بعد ما بينزل الدم بعد
+
+428
+00:26:40,230 --> 00:26:43,560
+ما بينزل الدمإيش بيقولي أنا late؟ إيش يعني late؟
+
+429
+00:26:43,560 --> 00:26:47,600
+بعد ما بينزل الدم يستقر شوية بعدها بعد ال death to
+
+430
+00:26:47,600 --> 00:26:52,220
+the killing بتلع لل sound four يعني بيصير احتزازات
+
+431
+00:26:52,220 --> 00:26:55,420
+في ال ventricle نفس القضية في ال ventricular wall
+
+432
+00:26:55,420 --> 00:27:00,100
+و بيصير عندنا vibrations برضه في ال valves في نفس
+
+433
+00:27:00,100 --> 00:27:04,400
+الصممات اللي موجودة في داخل القلب بس ايه تيجي بعد
+
+434
+00:27:04,400 --> 00:27:09,520
+ال sound three طبعا أنا هي عبارة اتنين سواء كانت
+
+435
+00:27:09,520 --> 00:27:14,580
+تلاتة أو اربعةهو صحيح مايبيننش للطبيب هو بده يقعد
+
+436
+00:27:14,580 --> 00:27:18,140
+اذا بين انه يعني انه يكشف انه فيه مشكلة عشان هيك
+
+437
+00:27:18,140 --> 00:27:21,100
+ده لجأ مشكلة في مصطلح اسمه summation gallop ايش
+
+438
+00:27:21,100 --> 00:27:24,700
+يعني summation gallop مصطلح يعني ده لجينا انه فيه
+
+439
+00:27:24,700 --> 00:27:28,760
+بدل ما يطلع صوتين فيه تالت صوت عند البناء ده صوت
+
+440
+00:27:28,760 --> 00:27:31,560
+الأول واضح و الصوت التاني واضح اما التلاتة والاربع
+
+441
+00:27:31,560 --> 00:27:35,880
+مدمجات مع بعض فسموه ايش summation of sound three
+
+442
+00:27:35,880 --> 00:27:39,640
+and sound four فايش صموه هذا التشخيص summation
+
+443
+00:27:39,640 --> 00:27:43,690
+gallopيبقى ال summation جاله تلت أصوات ال sound
+
+444
+00:27:43,690 --> 00:27:48,150
+one و ال sound two و التلت و أربع مع بعض أنا بهمني
+
+445
+00:27:48,150 --> 00:27:51,850
+كتير أنه نفهم ال sound one و ال sound two بشكل عام
+
+446
+00:27:51,850 --> 00:27:55,930
+نكفزلز طبعا خلنا أسرع شوية معلش عشان نلحق نخلص ال
+
+447
+00:27:55,930 --> 00:27:59,970
+chapter لأنه الوقت بدأ يأخذنا و يدهمنا شوية بدنا
+
+448
+00:27:59,970 --> 00:28:02,930
+نشوف طبعا نكفزلز نعمل assessment ال assessment لل
+
+449
+00:28:02,930 --> 00:28:09,030
+نكفزلز بنحاول أن نطلع بشكل عام على حوالين الرقبة
+
+450
+00:28:11,480 --> 00:28:15,180
+خاصة يعني ال .. ال distinction اللي بيصير موجود
+
+451
+00:28:15,180 --> 00:28:18,700
+حوالينا الرقبة لما نصير فيه مشكلة في ال right side
+
+452
+00:28:18,700 --> 00:28:21,960
+ال heart يعني لما نصير congestive heart failure و
+
+453
+00:28:21,960 --> 00:28:25,500
+بيصير عملية ضغط على عضلة القلب في تصريف اللي هو
+
+454
+00:28:25,500 --> 00:28:28,920
+الدم اللي مليان بالسائل فبتلاقي صار إيش هنا
+
+455
+00:28:28,920 --> 00:28:31,860
+extension بتلاقي سبحان الله حوالينا حتى بقولك في
+
+456
+00:28:31,860 --> 00:28:34,900
+بعض الحالات بكون ضعيف و بتبتطلع عليها كإنه
+
+457
+00:28:34,900 --> 00:28:39,320
+الشرايين بيناتها على جنب .. على جنب الرقبة طبعا
+
+458
+00:28:39,320 --> 00:28:42,130
+لازم المريض عشان نقدر نعمله assessmentاللي عنده
+
+459
+00:28:42,130 --> 00:28:46,370
+هذا congenital heart failure يكون في position يعني
+
+460
+00:28:46,370 --> 00:28:49,570
+يكون كويس فهو لو ال position 45 درجة وبنشوف ال
+
+461
+00:28:49,570 --> 00:28:53,910
+jugular pulse برضه خاصة اللي هو ال Venus بعض الناس
+
+462
+00:28:53,910 --> 00:28:56,430
+بيقولوا هو ال Venus فيه Venus pulse؟ أه فيه Venus
+
+463
+00:28:56,430 --> 00:29:00,430
+pulse لما أقول Venus يعني هو ال waves زي موجات
+
+464
+00:29:00,430 --> 00:29:05,600
+بيعملأما ال .. ال .. ال .. ال arterial pulse لأ
+
+465
+00:29:05,600 --> 00:29:08,360
+نقر تك تك تك يعني او double up double up يعني أما
+
+466
+00:29:08,360 --> 00:29:12,260
+هنا waves بيعمل و بيقسوه على فكرة بجهاز مدبلر ..
+
+467
+00:29:12,260 --> 00:29:16,720
+مدبلر machine يبقى بنشوف ال wave اللي هي خاصة بعد
+
+468
+00:29:16,720 --> 00:29:20,740
+ما الدم ينضخ .. ينضخ على ال right ventricle هلجيت
+
+469
+00:29:20,740 --> 00:29:22,640
+الدم اتجمع على ال right ventricle انتوا في ال
+
+470
+00:29:22,640 --> 00:29:25,720
+Anatomy اشتروا مني؟ هلجيت الدم اللي راجع شوية
+
+471
+00:29:25,720 --> 00:29:31,310
+بيعمل حاجة بسموها إيش هنا jugular pulseنشوف ال
+
+472
+00:29:31,310 --> 00:29:34,350
+character pulse ال character pulse طبعا وين بتكون
+
+473
+00:29:34,350 --> 00:29:38,390
+موجود خاصة برضه حوالين الرقبة لو حد سألنا بالظبط
+
+474
+00:29:38,390 --> 00:29:41,290
+وين موجود على ال media to the angle of the jaw
+
+475
+00:29:41,290 --> 00:29:44,130
+يعني بدنا نعمل أولا inspection and palpation طب
+
+476
+00:29:44,130 --> 00:29:46,330
+وين هو موجود؟ inspection وعرفنا طلعنا حوالين
+
+477
+00:29:46,330 --> 00:29:50,290
+الرقبة طب وين palpation؟ بنحط إصبعين .. إصبعين
+
+478
+00:29:50,290 --> 00:29:53,510
+اللي هو تبعت إيدي مثلا عند المريض بنروح على ال
+
+479
+00:29:53,510 --> 00:29:56,620
+angle of the jaw اللي هو الزاوية تبعت اللي هوتحت
+
+480
+00:29:56,620 --> 00:30:00,960
+ال .. ال mandible و بنوله قدام شويه يعني بننزل
+
+481
+00:30:00,960 --> 00:30:05,040
+لتحت صنطي هي مثلا أخر الفك اللي ورا بننزل لتحت
+
+482
+00:30:05,040 --> 00:30:09,880
+شوية و لأمام صنطي بنحس ايه؟ بنحس أنه في هنا عمله
+
+483
+00:30:09,880 --> 00:30:13,680
+فيه بينبض تحت أصابعنا فبنعرف أنه هذا اللي هو ال
+
+484
+00:30:13,680 --> 00:30:17,060
+carotid artery و بعدين بنحط اللي هو ال bell مش ..
+
+485
+00:30:17,060 --> 00:30:20,260
+مش ال diaphragm بنحط يعني اللي هو مش اللي هو
+
+486
+00:30:20,260 --> 00:30:23,620
+السماعة اللي هو الشق الكبير لأ الشق الصغير اللي هو
+
+487
+00:30:23,620 --> 00:30:26,900
+عشان نقدر نسمعلأنه إحنا قاعدين بنسمع بلس، مانعش
+
+488
+00:30:26,900 --> 00:30:30,900
+نسمع حاجة كبيرة. الـ Cascaded arteries، بدك تشوف
+
+489
+00:30:30,900 --> 00:30:35,720
+الـ pulsation، هل هي strong، هل هي weak، rise،
+
+490
+00:30:35,720 --> 00:30:41,200
+يعني بتشد فوق، collapse، يعني منكمشة، سريعة، ولا
+
+491
+00:30:41,200 --> 00:30:46,880
+بطيقة، double؟هل هي متحسس دواجية في الأصوات و لا
+
+492
+00:30:46,880 --> 00:30:50,940
+single يعني تك تك تك و لا أصوات متداخلة كله
+
+493
+00:30:50,940 --> 00:30:54,620
+متداخلة طبعا و احنا قلنا أي صوت متداخل إيش بيعني
+
+494
+00:30:54,620 --> 00:30:58,160
+اسمه murmur دي بجمعة لا تقلناش تنسى إذا سمعنا
+
+495
+00:30:58,160 --> 00:31:00,680
+أصوات غريبة و احنا بنعمل assessment في ال carotid
+
+496
+00:31:00,680 --> 00:31:03,520
+ال carotid artery و ال carotid muscle و ال carotid
+
+497
+00:31:03,520 --> 00:31:07,720
+pulse دغنش بقول بقول فيه murmurs و ال murmurs هذا
+
+498
+00:31:09,210 --> 00:31:13,690
+في بعض الحالات يعني احنا مانقدرش نشخصه بالنسبة لنا
+
+499
+00:31:13,690 --> 00:31:18,170
+لكن هو الطبيب لإن هو تشخيصه مش سهل لازم يكون
+
+500
+00:31:18,170 --> 00:31:20,790
+cardiologist لإن هو vibrations عبارة عن اهتزازات
+
+501
+00:31:20,790 --> 00:31:23,950
+وانا مابقدر ولا انتوا بنقدر نعرف ايش طبيعتها لإن
+
+502
+00:31:23,950 --> 00:31:28,360
+هو مدارس ومتخصص في الأمر هذاطبعا بدنا نعرف انها هل
+
+503
+00:31:28,360 --> 00:31:32,080
+هي كانت في ال cystole ولا في الdiastole برضه لخاصة
+
+504
+00:31:32,080 --> 00:31:35,380
+لما نسمع مرات و احنا بنجيز الضغط هل بنحس الخربط
+
+505
+00:31:35,380 --> 00:31:38,900
+هذي و هو احنا قاعدين في منطقة ال cystole فوق ولا
+
+506
+00:31:38,900 --> 00:31:42,980
+تحت في منطقة الdiastole طبعا هي نعرفنا بس بيعدلنا
+
+507
+00:31:42,980 --> 00:31:45,640
+الكلام نفس الكلام بعيد انه بيقول انه في defects
+
+508
+00:31:45,640 --> 00:31:49,080
+بيصير في ال ash في ال valve فبتعمل مرمر زي ما بعض
+
+509
+00:31:49,080 --> 00:31:52,780
+الناس بيقول لك اذا عنده ثقة في القلب او عنده يعني
+
+510
+00:31:52,780 --> 00:31:57,480
+تصريف شوية في الدم اي defectsموجود في داخل القلب
+
+511
+00:31:57,480 --> 00:32:01,240
+او في ال .. في ال valves او في تصريف الدم و في نفس
+
+512
+00:32:01,240 --> 00:32:05,320
+الوقت بيعمللي يعني شوية خربطة و صوات غريبة بده
+
+513
+00:32:05,320 --> 00:32:08,900
+يسميها ايش يعني مرمرز المرمرز زي ما احنا قلنا
+
+514
+00:32:08,900 --> 00:32:13,870
+abnormal sound of the heartآخر شيء بدنا نقارن على
+
+515
+00:32:13,870 --> 00:32:16,390
+السريع بين arterial و ال violence insufficiency
+
+516
+00:32:16,390 --> 00:32:21,090
+القصور أو الفشل اللي بيصيب يا إنسان عنده مثلا يعني
+
+517
+00:32:21,090 --> 00:32:26,210
+فشل في ال .. خليني أقول الجسم الشرياني أو فشل في
+
+518
+00:32:26,210 --> 00:32:31,530
+الجسم الوريدي طبعا الإختصارات بسيطة سهلة و مش غالب
+
+519
+00:32:31,530 --> 00:32:34,350
+أكتر عليكمأول حاجة من ناحية الـ pulse في الـ
+
+520
+00:32:34,350 --> 00:32:37,090
+artery بنلاقي decrease or absence إذا كان فيه قصور
+
+521
+00:32:37,090 --> 00:32:40,310
+أو فشل في الارض أكيد هيكون فشي أو قليل ال pulse
+
+522
+00:32:40,310 --> 00:32:43,850
+هنا لأ ال venous بيكون موجود على حد يعني بتلاقيه
+
+523
+00:32:43,850 --> 00:32:46,390
+ممكن يكون ال waves أعلى على اعتبار أنه صار فيه
+
+524
+00:32:46,390 --> 00:32:50,930
+مشكلة فالدم بيحاول يدخل بكل قوة ال color لو طلعنا
+
+525
+00:32:50,930 --> 00:32:53,770
+على الجلد حوالين ال artery اللي فيه المشكلة
+
+526
+00:32:53,770 --> 00:32:58,410
+بيلاقيه pale شاحب و بعدين إيش هنا elevation إيش
+
+527
+00:32:58,410 --> 00:33:03,030
+and إيشon and cold ايش يعني؟ يعني لو .. لو رفع
+
+528
+00:33:03,030 --> 00:33:06,090
+رجله شوية صغيرة بتلاقي شاحب و حتى في بعض الحالات
+
+529
+00:33:06,090 --> 00:33:09,390
+لو مارفعش رجله بنلاقي شحوب مع وجوفه كمان بنلاقي
+
+530
+00:33:09,390 --> 00:33:13,150
+شحوب و في نفس الوقت ايش بتكون رجله باردة شوية لكن
+
+531
+00:33:13,150 --> 00:33:15,570
+لو طلعنا على ال فيناس لأ بنلاقي pink يعني لأ اللون
+
+532
+00:33:15,570 --> 00:33:18,550
+طبيعي بس مائة المرات يكون للسينوز يعني ممكن يكون
+
+533
+00:33:18,550 --> 00:33:22,210
+للازرقاء او فيه لون بنى على اعتبار انه ايش بدأ
+
+534
+00:33:22,210 --> 00:33:28,350
+يتحشر الدمال temperature لو حسينا الجلد في منطقة
+
+535
+00:33:28,350 --> 00:33:31,750
+ال arterial efficiency هنلاقيه بارد عشان هيك لما
+
+536
+00:33:31,750 --> 00:33:35,230
+بنسأل .. بنقوله إيده باردة إذا يعني لو واحد مركب
+
+537
+00:33:35,230 --> 00:33:38,350
+لو مثلا جيبس إذا لاجينا قدام الجيبس إيده باردة
+
+538
+00:33:38,350 --> 00:33:41,690
+فورا بدنا نقص الجيبس لكن لو لاجينا إيده دافية بدنا
+
+539
+00:33:41,690 --> 00:33:44,650
+نعطيه علاج بدنا نعرف إن المشكلة وين موجودة يعني
+
+540
+00:33:44,650 --> 00:33:49,880
+السخونة وريد والبرودة شريانإديمة طالع في الإديمة
+
+541
+00:33:49,880 --> 00:33:52,300
+بنلاقيها مش موجودة، فش في الارتيلة لسه فش لسه
+
+542
+00:33:52,300 --> 00:33:55,120
+إديمة، لكن أي فيناس لسه فش لسه عشان يكتب عني ال
+
+543
+00:33:55,120 --> 00:34:00,480
+DVT بقولك أنا صار عندي حاسس انه انا صار عندي إديمة
+
+544
+00:34:00,480 --> 00:34:02,920
+مش جادة يعني هي ليه استثقاء يعني الميه عاملا بتزيد
+
+545
+00:34:02,920 --> 00:34:06,360
+فبيجي بقولك طب تعال تنشوف نعمل لك فحص عشان نعرف
+
+546
+00:34:06,360 --> 00:34:11,280
+إيش هذا اللي موجود عندكSkin، بنطلع الجلد حوالين
+
+547
+00:34:11,280 --> 00:34:15,260
+الـ artery اللي هو فيه المشكلة، بنشوف لامع،
+
+548
+00:34:15,260 --> 00:34:18,320
+الأضافر بدأت تصير فيها thickness لأنه بطل يصلها
+
+549
+00:34:18,320 --> 00:34:23,940
+الدم و الاكسجين كويس، صار ال hair كمان يتقصف، فصار
+
+550
+00:34:23,940 --> 00:34:26,760
+عنده تقرحات، يعني شغلات كلها متعلقة بإيه،
+
+551
+00:34:26,760 --> 00:34:30,540
+gangrene، كل هذا متعلق بإنه مش الدم بطل يوصل و بطل
+
+552
+00:34:30,540 --> 00:34:34,540
+و صار فيه قصور في الشريان. أما القصور في الوريد،
+
+553
+00:34:34,540 --> 00:34:38,820
+هنا لأ، بيصير ألزارز، بس أكترش على ال ankles.خاصة
+
+554
+00:34:38,820 --> 00:34:42,440
+و بيصير discolored و بيصير scaly يعني بتلون منطقة
+
+555
+00:34:42,440 --> 00:34:46,080
+ال ankles خاصة هذا يعني ال joint بالذات علشان
+
+556
+00:34:46,080 --> 00:34:48,940
+الضغط ال pressure اللي عليه و بيصير زي قشور بتطلع
+
+557
+00:34:48,940 --> 00:34:53,400
+على .. على رجله من هذا المكان طبعا ال sensation
+
+558
+00:34:53,400 --> 00:34:57,080
+الإحساس ال leg pain طبعا فيه ألم شديد بيكون في
+
+559
+00:34:57,080 --> 00:34:59,720
+منطقة ال leg لكن بيزيد أيش مع ال standing يعني
+
+560
+00:34:59,720 --> 00:35:02,740
+بدنا نعرف إنه عنده مشكلة في الأرض ولا في ناس مجرد
+
+561
+00:35:02,740 --> 00:35:05,480
+ما يجاف مجرد ما يجاف إيش بيصير عنده ألم شديد لكن
+
+562
+00:35:05,480 --> 00:35:10,070
+لو ارتاح relievedبتلاقي أول ما يرتاح بيخف الألم و
+
+563
+00:35:10,070 --> 00:35:12,470
+في مرات في عنده pressure بيحس يعني بتغطي على ال
+
+564
+00:35:12,470 --> 00:35:16,170
+batox و بيحس مرات بألم في ال calves كل هذا بيسموه
+
+565
+00:35:16,170 --> 00:35:20,330
+cramp كلمة cramp يعني زي إشي بعصل زي إشي بيدغط
+
+566
+00:35:20,330 --> 00:35:24,370
+عليه زي إشي بيشده هذا ال sensation مرتبط أكتر شي
+
+567
+00:35:24,370 --> 00:35:27,270
+بال arterial insufficiency أما في ال venous
+
+568
+00:35:27,270 --> 00:35:30,490
+insufficiencyايش بيقوللي صحيح ال leg veil موجود
+
+569
+00:35:30,490 --> 00:35:34,570
+لكن و aggravated by standing ها لاحظين كمان
+
+570
+00:35:34,570 --> 00:35:37,430
+بيقوللي بزيد في أيش بالوقوف على اعتباره الوقوف
+
+571
+00:35:37,430 --> 00:35:41,490
+بتغطي على الشريان و الوريد و او في ال sitting كمان
+
+572
+00:35:41,490 --> 00:35:45,470
+and relieved by أيش elevated of legs هنا .. هنا
+
+573
+00:35:45,470 --> 00:35:53,020
+elevated أيش by legs طيب لو لاحظناقال لي بدك ترفع
+
+574
+00:35:53,020 --> 00:35:56,860
+هنا عشان بدك تحسنهم، حتى لو نيمنها مارتاحش، لكن لو
+
+575
+00:35:56,860 --> 00:36:00,060
+رفعنا الرجلين، لو رفعنا رجلينا شوية، ارتاح هنا،
+
+576
+00:36:00,060 --> 00:36:03,520
+لأ، مالوش علاقة، لأن المشكلة جونا في الشريان، مش
+
+577
+00:36:03,520 --> 00:36:08,190
+في الوريدالان بقول ال lying down لو نام كمان أو
+
+578
+00:36:08,190 --> 00:36:12,830
+استلقى عادي حتى لو ماشى .. ها تحظى لو ماشى ممكن
+
+579
+00:36:12,830 --> 00:36:16,470
+يتحسن في ال Venus في الأول لكن ممكن يكون ممنوع
+
+580
+00:36:16,470 --> 00:36:19,890
+فيما بعدها .. ممكن يكون .. لكن انت سمح للطبيب يا
+
+581
+00:36:19,890 --> 00:36:23,130
+انا ممكن يقولك شوية تقلصات بتمشي هنا ممنوع لأ لأنه
+
+582
+00:36:23,130 --> 00:36:26,410
+مع المشي هيتألم كتير .. برضه relieved by ايش هنا
+
+583
+00:36:26,410 --> 00:36:30,580
+use of ايشال support هو زي انا بدأنا نستخدم بعض
+
+584
+00:36:30,580 --> 00:36:33,900
+الجوارب الضاغطة او الجوارب فيه جوارب بيسموها
+
+585
+00:36:33,900 --> 00:36:36,980
+الجوارب الطبية بيستخدموها زي الجوارب اللي لها
+
+586
+00:36:36,980 --> 00:36:40,860
+علاقة او حتى اليوم صار يصنع زي روابط مشدات معينة
+
+587
+00:36:40,860 --> 00:36:44,560
+بتضغط على الرجل و بتحاول انها ايش عشان تساعد في
+
+588
+00:36:44,560 --> 00:36:47,900
+ضغط الدم في اتجاه القلب بشكل اوسع او اقوى بإذن
+
+589
+00:36:47,900 --> 00:36:52,930
+الله طبعا هي خلصنا chapter ال cardiocardiac
+
+590
+00:36:52,930 --> 00:36:56,150
+assessment وcardiovascular والحمد لله ان شاء الله
+
+591
+00:36:56,150 --> 00:36:59,530
+المحاضرة القادمة ندخل في الشكتر القادم السلام
+
+592
+00:36:59,530 --> 00:37:01,410
+عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1bdff2c515fde7b96a7c70874aea80d1765c790e
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs.srt
@@ -0,0 +1,1429 @@
+1
+00:00:02,380 --> 00:00:04,160
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,160 --> 00:00:09,140
+الرحيم. طب أعلنه الآن، هتكون المحاضرة الأولى اللي هي
+
+3
+00:00:09,140 --> 00:00:12,000
+الـ chapter اللي مكتوب عليه the nursing process، و
+
+4
+00:00:12,000 --> 00:00:15,280
+هو موجود، زي ما قلت لكم، موجود عندكم على الـ slides
+
+5
+00:00:15,280 --> 00:00:19,020
+اللي حطيتها على الـ model كمان، هو موجود في الكتاب.
+
+6
+00:00:19,020 --> 00:00:24,140
+بالمناسبة، يمكن هذا بالذات chapter أنا همشي فيه
+
+7
+00:00:24,140 --> 00:00:28,970
+شوية بسرعة، مش أنه أنا يعني بدي أسرّع معاكم؟ لأ، لأن
+
+8
+00:00:28,970 --> 00:00:33,550
+هو تقريباً هذا الـ chapter شامل كل المنهج اللي احنا
+
+9
+00:00:33,550 --> 00:00:38,970
+بدنا نشرحه على مدى اللي هو كل الـ chapters، لكن هو يعني
+
+10
+00:00:38,970 --> 00:00:45,310
+خلّنا نقول مدخل عام، مدخل عام بيفهمني إيش بالظبط
+
+11
+00:00:45,310 --> 00:00:49,190
+المقصود، وهنتذكر إن احنا إنشرحنا في الـ process of
+
+12
+00:00:49,190 --> 00:00:53,110
+process،  الزمان العملية اللي هي في الـ fundamental
+
+13
+00:00:53,110 --> 00:00:56,600
+اللي بتبدأ عند الـ assessment والـ planning والـ
+
+14
+00:00:56,600 --> 00:00:59,200
+diagnosis، والـ diagnosis إلى أن تصل لأخر شي الـ
+
+15
+00:00:59,200 --> 00:01:02,040
+evaluation، وانتوا عارفين هذا الكلام. عموماً أنا
+
+16
+00:01:02,040 --> 00:01:07,040
+بالذات هذا الـ chapter هكون شوية يعني بدي أسرّع فيه.
+
+17
+00:01:07,040 --> 00:01:11,880
+مش كمان مرة، مش نوع من إنه أنا بدي يعني، وكأنه أرمي
+
+18
+00:01:11,880 --> 00:01:15,360
+رمي، لأ الأمر بسيط، والكلمات اللي فيه بسيطة كتير، و
+
+19
+00:01:15,360 --> 00:01:18,340
+احنا اللي هنركز عليه في الشرح، واللي هنركز عليه
+
+20
+00:01:18,340 --> 00:01:21,720
+فيما بعد هو اللي دائماً احنا ننتبه له بإذن الله بشكل
+
+21
+00:01:21,720 --> 00:01:27,420
+أكبر. هنا بتكلم بس بذكر هذا اللي عمله يعني ماسك
+
+22
+00:01:27,420 --> 00:01:29,800
+البلدانين يشوفوا كلها، هنا بيذكرني أنه في
+
+23
+00:01:29,800 --> 00:01:32,700
+assessment، وanalyzing، وplanning، وimplementation،
+
+24
+00:01:32,700 --> 00:01:35,840
+evaluation، كله قُشطين فيها، أشطر من يعني بيبدأ ..
+
+25
+00:01:35,840 --> 00:01:39,880
+تبدأ عملية .. العملية التمريضية العامة والشمولية
+
+26
+00:01:39,880 --> 00:01:46,080
+من التقييم للتحليل للتخطيط، بعدين .. بعد .. في
+
+27
+00:01:46,080 --> 00:01:48,300
+التخطيط بنحط كمان nursing diagnosis، وبعدين أروح
+
+28
+00:01:48,300 --> 00:01:50,940
+مين بصير عندنا بنعمل اللي هو nursing curriculum،
+
+29
+00:01:50,940 --> 00:01:53,820
+اللي هو أنتو عملتوها مرة في سنة أولى أو مرتين ما
+
+30
+00:01:53,820 --> 00:01:59,260
+بعرف، لكن هي هتعملوها حقيقةً على المرضى لما تروحوا
+
+31
+00:01:59,260 --> 00:02:03,400
+عليهم، وبعدين في أخر شي evaluation. طيب، الـ nursing
+
+32
+00:02:03,400 --> 00:02:06,440
+process إيش هي يعني؟ هو بيقول لي organizational
+
+33
+00:02:06,440 --> 00:02:10,240
+framework، عبارة عن إطار، إطار يعني بتعمل إيش هنا؟
+
+34
+00:02:10,240 --> 00:02:13,700
+إطار عملي لكل عملي في داخل وين؟ في داخل المستشفى، و
+
+35
+00:02:13,700 --> 00:02:17,410
+في التعامل، أو على فكرة لما نقول إطار عمل، إلي مش شرط
+
+36
+00:02:17,410 --> 00:02:20,370
+يكون دائماً مع الـ patient inside the hospitals، لأ،
+
+37
+00:02:20,370 --> 00:02:23,370
+احنا اتعلّمنا زمان إن احنا دور التمريض مش بس في
+
+38
+00:02:23,370 --> 00:02:26,850
+المستشفى، لأ، دوره في أي مرفق صحي، في المدارس صار
+
+39
+00:02:26,850 --> 00:02:30,210
+فيهم دور التمريض، في المؤسسات دور التمريض، اليوم
+
+40
+00:02:30,210 --> 00:02:33,310
+في مؤسسات المجتمع المدني، في موضوع جائحة كورونا،
+
+41
+00:02:33,310 --> 00:02:36,770
+وموضوع التثقيف الصحي، التمريض في كل مكان هو اللي
+
+42
+00:02:36,770 --> 00:02:40,510
+موجود. عموماً هو بيقول لي إن احنا هذا يعتبر الـ
+
+43
+00:02:40,510 --> 00:02:43,750
+nursing process central، مركز لكل الـ nursing care،
+
+44
+00:02:43,750 --> 00:02:47,540
+طيب، مش موضوعنا اليوم؟ بشكل الأقل الـ definition of
+
+45
+00:02:47,540 --> 00:02:50,340
+nursing process، إيش هنا؟ organized sequence problem
+
+46
+00:02:50,340 --> 00:02:53,440
+solving، هو عبارة عن problem solving steps، يعني
+
+47
+00:02:53,440 --> 00:02:57,660
+خطوات لحل المشكلات التي تواجهينها، بتبدأ من الـ
+
+48
+00:02:57,660 --> 00:03:01,340
+assessment، لما إنتِ تصلِ لوين؟ لما إنتِ تصلِ الـ evaluation.
+
+49
+00:03:01,340 --> 00:03:04,800
+ما ننساش كل اللي بيحكمنا هنا هو الـ NANDA، اللي هو
+
+50
+00:03:04,800 --> 00:03:09,200
+North American Nursing Diagnosis Association. الـ
+
+51
+00:03:09,200 --> 00:03:11,580
+benefits of the nursing process، أخذناها في الـ
+
+52
+00:03:11,580 --> 00:03:15,900
+fundamental، بس هي من باب التذكير، مش اختبار. بتعطيني
+
+53
+00:03:15,900 --> 00:03:18,240
+systematic method، يعني بتعطيني planning،
+
+54
+00:03:18,240 --> 00:03:22,020
+بتشجع عندي إنه كيف يكون عندي standardizing nursing
+
+55
+00:03:22,020 --> 00:03:25,160
+practice، لما أقول كلمة standardizing، يعني هيكون
+
+56
+00:03:25,160 --> 00:03:28,500
+قد إيش أنا بقدر أعمل standard؟ تسمع كلمة كلمة
+
+57
+00:03:28,500 --> 00:03:33,800
+standard، يعني كيف أتعلم أعمل أفضل عمل، وأفضل شيء.
+
+58
+00:03:33,800 --> 00:03:37,100
+كيف أعمل الـ documentation اللي اتعلمناه، كيف، و
+
+59
+00:03:37,100 --> 00:03:41,800
+كانوا يقولون اكتبوه عشان نصلّح لكم، كيف نتعامل مع الـ
+
+60
+00:03:41,800 --> 00:03:45,300
+stress، كيف نتعامل .. نتعامل مع الـ quality، اللي هو
+
+61
+00:03:45,300 --> 00:03:48,880
+يعني جودة العمل. طبعاً ما ننساش إن الـ assessment،
+
+62
+00:03:49,200 --> 00:03:51,320
+diagnosis، planning، implementation، evaluation،
+
+63
+00:03:51,320 --> 00:03:55,020
+الكلام معمول بعيد بعضه. طبعاً أنا مش قاعد بأسرّع، بقول
+
+64
+00:03:55,020 --> 00:03:58,220
+لكم أنا قلت لكم مش كتير حأندمج، لأن أنا جاي في
+
+65
+00:03:58,220 --> 00:04:01,660
+المحاضرات القادمة هيكون فيها كل هذا اللي أنا قاعد
+
+66
+00:04:01,660 --> 00:04:06,160
+بحكيه، زيناً. طب إيش الـ benefits للـ nursing process؟
+
+67
+00:04:06,160 --> 00:04:10,500
+continuity of care، لما نقول continuity of care،
+
+68
+00:04:10,500 --> 00:04:16,030
+يعني استمرارية الرعاية. prevention of duplication،
+
+69
+00:04:16,030 --> 00:04:20,310
+منع الإزدواجية، عشان عمل فلان ما يتعرضش مع عمل فلان،
+
+70
+00:04:20,310 --> 00:04:22,470
+individualized care، لما أقول كلمة individualized
+
+71
+00:04:22,470 --> 00:04:26,390
+care، يعني إنه تخصيص الرعاية لكل إنسان، وstandard،
+
+72
+00:04:26,390 --> 00:04:28,890
+أو يمكننا ننسى كلمة standard، standard يعني إيش
+
+73
+00:04:28,890 --> 00:04:35,150
+هنا؟ يعني احنا بنطمح للـ perfect، لأفضل عمل، طبعاً
+
+74
+00:04:35,150 --> 00:04:38,590
+بالتعاون مع مين؟ collaboration of care، مع اللي هو
+
+75
+00:04:38,590 --> 00:04:43,160
+زملاء المهنة. طبعاً أنا لازم أكون أنا عندي .. أنا
+
+76
+00:04:43,160 --> 00:04:47,680
+accountable، يعني أكون مسؤول وأنا بشتغل مع المرضى،
+
+77
+00:04:47,680 --> 00:04:51,680
+يكون عندي critical thinking، مسؤول عن أعمالي، في
+
+78
+00:04:51,680 --> 00:04:56,800
+عندي تفكير مهني، بقدر أنا أتعامل مع الناس اللي هم
+
+79
+00:04:56,800 --> 00:05:00,760
+زيّي، اللي بيسمّوها level of your peers، يعني سبحان
+
+80
+00:05:00,760 --> 00:05:04,140
+الله، لما يكون عندك زملاء. إنت هذا الـ assessment
+
+81
+00:05:04,140 --> 00:05:08,060
+بيخليك تقدر تتعامل زيك زيهم. هنلاقي حالة لما نروح
+
+82
+00:05:08,060 --> 00:05:11,850
+نتدرب، أنا رايح أُتدرب وأنا لسه سنة ثانية، هتلاقي
+
+83
+00:05:11,850 --> 00:05:16,250
+حالك إنه الحمد لله صار عندك علم تقدر تتعامل مع كل
+
+84
+00:05:16,250 --> 00:05:19,170
+التمريض اللي موجود في المجتمع، رغم إن التمريض في
+
+85
+00:05:19,170 --> 00:05:22,370
+منهم diploma، وفي منهم bachelor، وmagister، وربما
+
+86
+00:05:22,370 --> 00:05:26,650
+أكثر، يمكن دكتوراه، لكن إنت هتصير تقدر تتعامل زيهم،
+
+87
+00:05:26,650 --> 00:05:30,270
+لأنه أخذت قاعدة علمية صحيحة، والقواعد العلمية
+
+88
+00:05:30,270 --> 00:05:33,450
+الصحيحة لا يختلف عليها اثنان، وهنستخدم الـ nursing
+
+89
+00:05:33,450 --> 00:05:36,830
+process هذا. طبعاً بقول أنا something you think
+
+90
+00:05:36,830 --> 00:05:40,390
+about، بدنا نتأكد دائماً إنه يكون في عندنا حاجة بسمها
+
+91
+00:05:40,390 --> 00:05:44,610
+unique .. unique هنا إيش أنا؟ unique dimension of
+
+92
+00:05:44,610 --> 00:05:48,830
+a thing. طب ولما نقول كلمة unique هنا زي ما أقول
+
+93
+00:05:48,830 --> 00:05:53,850
+كلمة يعني .. يعني متكامل، يعني شمولي، يعني كل واحد
+
+94
+00:05:53,850 --> 00:05:57,050
+متفرد، يكون عنده diagnosis، وtreatment، وhuman
+
+95
+00:05:57,050 --> 00:06:00,040
+responses، actual and potential problems. لما نقول
+
+96
+00:06:00,040 --> 00:06:03,620
+كلمة actual، المشكلات اللي موجودة الآن. لما نقول
+
+97
+00:06:03,620 --> 00:06:06,780
+potential، المشكلات اللي موجودة اللي احنا متوقعين
+
+98
+00:06:06,780 --> 00:06:10,980
+تصير، تمام؟ ليه؟ مش كل واحد يعني ممكن واحد يقول لك
+
+99
+00:06:10,980 --> 00:06:16,280
+أنا راسي وجعني، رأسه بيوجعه، لأنه واجع، هذا actual.
+
+100
+00:06:16,280 --> 00:06:20,760
+طب في potential ممكن يصير عنده vomiting، بتوقع يصير
+
+101
+00:06:20,760 --> 00:06:25,910
+عنده vomiting، بتصير potential. طيبة هذه مقولة حلوة،
+
+102
+00:06:25,910 --> 00:06:29,390
+يعني صراحةً يعني اللي حكاها Martha .. طبعاً هذا
+
+103
+00:06:29,390 --> 00:06:32,830
+Martha Rogers، من العلماء الكبار اللي يعني بتكلموا
+
+104
+00:06:32,830 --> 00:06:36,850
+فيها. طبعاً علماء النفس الاجتماعي بيقولوا يعني حتى
+
+105
+00:06:36,850 --> 00:06:41,070
+هدموا النظريات على فكرة التمريض، بيقول when an
+
+106
+00:06:41,070 --> 00:06:44,250
+apple is cut، لما احنا نقطع اللي هو الـ apple، اللي هو
+
+107
+00:06:44,250 --> 00:06:48,490
+التفاحة، others see me seeds. إيش الـ seeds معناته؟
+
+108
+00:06:48,490 --> 00:06:51,750
+البذور، مش لما احنا بنكسر أو بنقطع التفاحة من
+
+109
+00:06:51,750 --> 00:06:56,110
+المصدر، بيطلع بذور صغيرة في النص سوداء، هذا in the
+
+110
+00:06:56,110 --> 00:06:59,530
+apple، يعني الناس بيقولوا لما بيفتحوا التفاحة
+
+111
+00:06:59,530 --> 00:07:04,930
+بيطلعوا على البذور في التفاحة، لكن احنا as nurses،
+
+112
+00:07:04,930 --> 00:07:09,490
+ولكن أنا كتمريض، ننظر apples in the seeds. إيش سعر
+
+113
+00:07:09,490 --> 00:07:13,990
+معناها؟ ولكن أنا ننظر إلى التفاحة في البذور، يعني
+
+114
+00:07:13,990 --> 00:07:17,250
+كأنه .. يعني كأنه إيش بقول له؟ إن احنا نظرتنا مش
+
+115
+00:07:17,250 --> 00:07:21,130
+سطحية. احنا يا تمريض نظرتنا مش سطحية، يمكن واحد
+
+116
+00:07:21,130 --> 00:07:24,370
+يكون ماشي علينا عادي، إيه بينظروا له؟ راح أجن،
+
+117
+00:07:24,370 --> 00:07:27,430
+ما انتبهوا له، احنا بكرا هنتعلم الحاجة اسمها clinical
+
+118
+00:07:27,430 --> 00:07:31,350
+sense، وcritical sense، فهدول الناس لما بفتحوا
+
+119
+00:07:31,350 --> 00:07:34,900
+التفاحة بيطلعوا فيها من جواب، يقول لك هذا خربانة ومش
+
+120
+00:07:34,900 --> 00:07:38,720
+خربانة، احنا كأننا ننظر إلى التفاحة كيف تخرج من
+
+121
+00:07:38,720 --> 00:07:42,720
+هذه البذور، يعني كأننا على إنه كيف نتعامل مع كل
+
+122
+00:07:42,720 --> 00:07:47,200
+طبيعة وإشراعات المجتمع، وننظر بنفس النظرة المتوازنة
+
+123
+00:07:47,200 --> 00:07:51,300
+مع اللي هو الصغير والكبير، واختلاف نوعية المرض.
+
+124
+00:07:52,260 --> 00:07:53,740
+what are the responsibilities؟ الـ responsibility
+
+125
+00:07:53,740 --> 00:07:56,920
+اللي احنا علينا؟ healthy problems، anticipate
+
+126
+00:07:56,920 --> 00:08:00,140
+complications، initiate اللي هو actions، يعني بدي
+
+127
+00:08:00,140 --> 00:08:03,980
+أتأكد أول حاجة، بدي أحدد المشكلات، إيش فيها من
+
+128
+00:08:03,980 --> 00:08:09,470
+مضاعفات؟ كيف بدي أبدأ؟ بقول لحظة، begin to think، إيش
+
+129
+00:08:09,470 --> 00:08:14,590
+critical، يعني ما بدي تفكيرك ولا تفكيرك يكون سطحي.
+
+130
+00:08:14,590 --> 00:08:19,850
+التفكير لازم يكون مُتعمّق عشان نقدر نفهم المريض اللي
+
+131
+00:08:19,850 --> 00:08:23,750
+أمامنا. ما بِدِّي التفكير يكون سطحي، لأنّه هيُضِرّني، لأ،
+
+132
+00:08:23,750 --> 00:08:27,710
+الصح إنه يكون لنا التفكير مُتعمّق عشان أفهم طبيعة
+
+133
+00:08:27,710 --> 00:08:33,210
+اللي أمامي من المرضى. قول لي هنا، لقدام بدنا كمان
+
+134
+00:08:33,210 --> 00:08:35,350
+mental operations، عمليات عقلية، عشان نكون عندك
+
+135
+00:08:35,350 --> 00:08:38,750
+decision making، تقدر إنت إيش تصِل لقرار، ويكون عندك
+
+136
+00:08:38,750 --> 00:08:42,290
+أسباب، reasoning، لذلك القرار، ويكون عندك معرفة، يكون
+
+137
+00:08:42,290 --> 00:08:44,990
+عندك attitudes .. attitudes، طبعاً كيف يكون سلوكك،
+
+138
+00:08:44,990 --> 00:08:50,850
+يعني، وحياتك، ونموذجك في الحياة كيف بتكون؟ هنا بقول
+
+139
+00:08:50,850 --> 00:08:54,530
+لك، الـ critical thinking شغل مهم جداً .. مهم
+
+140
+00:08:54,530 --> 00:08:58,270
+جداً، لأنها هي في الآخر هتودّيك للـ goal directed ..
+
+141
+00:08:58,270 --> 00:09:01,930
+إيش يعني goal directed؟ هتودّيك للهدف، يعني أنا اللي
+
+142
+00:09:01,930 --> 00:09:06,740
+بدي أقوله، لما نحدد هدف، أنا بدي أحسّ إنه زي ما
+
+143
+00:09:06,740 --> 00:09:10,680
+أقول والله بدي أنا أنزّل الحرارة عند المريض، هذا هدف.
+
+144
+00:09:10,680 --> 00:09:14,780
+أو أنا بدي أنا أخلّي المريض ما يعانيش، أو بدي أخلّي
+
+145
+00:09:14,780 --> 00:09:18,820
+المريض ما يبكيش، هذا هدف. بدي أخلّي كل تفكيري مُنصبّ
+
+146
+00:09:18,820 --> 00:09:22,560
+بهاذا الاتجاه. طيب، بدنا نشوف assessment of wellbeing،
+
+147
+00:09:22,560 --> 00:09:25,500
+هنتكلم عن الـ emotional، physical، social،
+
+148
+00:09:25,580 --> 00:09:29,800
+spiritual، كل هذا جاي إن شاء الله، هشرحه كله الآن.
+
+149
+00:09:29,800 --> 00:09:33,660
+بقول، هيا نبدأ. طبعاً مش شرط الـ points الآن كلها نحفظها، و
+
+150
+00:09:33,660 --> 00:09:36,980
+كمان مرة بقول لكم مش كلّه حفظ، هو بيقول لي لأ، بدّك
+
+151
+00:09:36,980 --> 00:09:40,640
+تحدد الأولويات، تكون عندك adequate time، introduce
+
+152
+00:09:40,640 --> 00:09:44,900
+yourself، تقدّم نفسك، خليك عارف إيش .. ليش الـ
+
+153
+00:09:44,900 --> 00:09:47,440
+purpose من الـ interview، إنت مش هتتعرف على المريض،
+
+154
+00:09:47,440 --> 00:09:51,600
+ولا تضرب صحبة معه وأنا هو جارِك، ولكن بدّك إنت ..
+
+155
+00:09:51,600 --> 00:09:54,500
+هذا اسمه professional interview، يعني مقابلة مهنية،
+
+156
+00:09:55,260 --> 00:09:57,860
+عشان تكون في عندك confidentiality، واحنا بكرا
+
+157
+00:09:57,860 --> 00:10:01,620
+عارفين، وهتاخدوا في الـ ethics في أول صفحة في الـ
+
+158
+00:10:01,620 --> 00:10:04,800
+ethics، قسم المهنة اللي هي في القضايا والأخلاقية
+
+159
+00:10:04,800 --> 00:10:08,220
+المهنة، هتلاقي قسم المهنة هتلاقي العبارات مُحدّدة، و
+
+160
+00:10:08,220 --> 00:10:12,540
+مرتّبة، ومنمقة، ومرتبطة بالعقيدة، لأنه هنتعرّف عليها
+
+161
+00:10:12,540 --> 00:10:15,860
+أسرار خطيرة، المريض يمكن ما يحكيش للطبيب بس يحكي لك،
+
+162
+00:10:15,860 --> 00:10:21,030
+فدائماً المريض يحتاج منك إنك تطمئنه، وتكون عندك ..
+
+163
+00:10:21,030 --> 00:10:25,150
+يعني إنت مش هتش .. مش هتنشر معلومته، عشان قبل ما
+
+164
+00:10:25,150 --> 00:10:29,530
+تبدأ تعمله إيش؟ اطمئنه. طيب، الـ types of  إيه
+
+165
+00:10:29,530 --> 00:10:33,830
+interview، نوعية المقابلات؟ في direct، وفي non
+
+166
+00:10:33,830 --> 00:10:37,410
+-direct، مش هشرحها الآن، لأنه لسه جاي شرح كتير عليها.
+
+167
+00:10:37,410 --> 00:10:42,010
+direct، أنا بجيب لك مباشرةً، indirect، بجيب لك من .. مش
+
+168
+00:10:42,010 --> 00:10:45,380
+و أنا واقف قدامك، يمكن على تليفون، يمكن by media، يمكن
+
+169
+00:10:45,380 --> 00:10:52,100
+إنتقلت للمقابلة، يمكن لجانب عن بعد، وهكذا. الـ
+
+170
+00:10:52,100 --> 00:10:56,480
+assessment، كيف تصبح الـ assessment؟ ابتدى لطرق بقيم
+
+171
+00:10:56,480 --> 00:10:59,660
+بالـ observation، ملاحظة، بالـ interview، وكيف الـ
+
+172
+00:10
+
+223
+00:14:12,600 --> 00:14:15,900
+أنا والله بعرفش إلا زيك، لأ مش هيك، طبعا والـ
+
+224
+00:14:15,900 --> 00:14:18,960
+nurse دائما الـ process إيش بتساعد أنا to
+
+225
+00:14:18,960 --> 00:14:23,740
+understand إيش أنا، بقول لي strategy .. استراتيجيات
+
+226
+00:14:24,200 --> 00:14:27,460
+الـ clients used in attempts to coping ذاكرين كلمة
+
+227
+00:14:27,460 --> 00:14:31,120
+coping أعيد لكم إياها coping معناته التأقلم أنا
+
+228
+00:14:31,120 --> 00:14:33,940
+لما نُصبح بتعامل مع المريض و بأخذ منه الـ history و
+
+229
+00:14:33,940 --> 00:14:36,380
+ببدأ أعمله assessment و عشان أعمله examination
+
+230
+00:14:36,380 --> 00:14:41,100
+بعرف طريقته في coping التأقلم اللي بتشمل إثنتين
+
+231
+00:14:41,100 --> 00:14:47,520
+adaptation and adjustment coping يعني التأقلم الـ
+
+232
+00:14:47,520 --> 00:14:50,940
+resources كثير منهم بتجيب معلومات من الـ client و
+
+233
+00:14:50,940 --> 00:14:53,610
+من الـ individuals و من الـ records و من الـ
+
+234
+00:14:53,610 --> 00:14:56,470
+consultations استشارات و من الـ diagnostic studies
+
+235
+00:14:56,470 --> 00:15:00,270
+المختبرات و منها الموجودة من الـ relevant مثلا
+
+236
+00:15:00,270 --> 00:15:03,030
+literature الطبيب ممكن يـ fit لي الـ assessment من
+
+237
+00:15:03,030 --> 00:15:06,070
+وين أجيبها؟ في عندنا database assessment في عندنا
+
+238
+00:15:06,070 --> 00:15:09,030
+comprehensive الـ assessment أول ما ببدأ الـ focus
+
+239
+00:15:09,030 --> 00:15:13,210
+assessment أول حاجة الـ data أول ما بيجي المريض
+
+240
+00:15:13,210 --> 00:15:16,210
+أمامي بيسألني واحد بيقول لي من وين آخذ المعلومات؟
+
+241
+00:15:16,210 --> 00:15:20,960
+هذا قصده مش قادر يأخذ المعلومات في كومة في المريض
+
+242
+00:15:20,960 --> 00:15:25,040
+مش قادر يعطيك المعلومات مش عيب و مش غلط اسأل الطبيب
+
+243
+00:15:25,040 --> 00:15:29,980
+اسأل زملائك اسأل قريبه امسك الـ file تجيب الورقات
+
+244
+00:15:29,980 --> 00:15:32,740
+المختبر بيصير عندك معلومات كاملة يبقى الـ source of
+
+245
+00:15:32,740 --> 00:15:35,180
+data فيه نوعين primary و secondary زي ما أنتم
+
+246
+00:15:35,180 --> 00:15:38,320
+شايفين الـ primary اللي هو الـ client الـ secondary
+
+247
+00:15:38,320 --> 00:15:42,020
+أي حاجة خلاص أي حاجة غير الـ client اعتبرها secondary
+
+248
+00:15:42,020 --> 00:15:45,860
+secondary سواء تقارير أطباء اعتبرها ايه ايه
+
+249
+00:15:45,860 --> 00:15:49,750
+secondary طبعا الـ disease prevention شيء عن disease
+
+250
+00:15:49,750 --> 00:15:54,850
+prevention إحنا شغلنا تلت مستويات في الرعاية واحد
+
+251
+00:15:54,850 --> 00:15:57,810
+بيسموه primary prevention و الثاني اسمه secondary
+
+252
+00:15:57,810 --> 00:16:01,110
+prevention و الثالث اسمه tertiary prevention عشان
+
+253
+00:16:01,110 --> 00:16:07,310
+ما أطيلش كثير primary يعني أنا بمنع حدوث المرض بني
+
+254
+00:16:07,310 --> 00:16:13,350
+آدم طبيعي أبوه عنده سكر و أمه عنده سكر بنقول له دير
+
+255
+00:16:13,350 --> 00:16:17,040
+بالك خليك معانا بنصحصح و نتابع تعليماتنا عشان
+
+256
+00:16:17,040 --> 00:16:21,120
+ما يصيرش عندك سكر هذا اسمه primary طب صار عنده سكر
+
+257
+00:16:21,120 --> 00:16:25,880
+لكن اكتشفناه مبكر صار عنده سكر و اكتشفناه إيش يعني
+
+258
+00:16:25,880 --> 00:16:29,720
+early detection بنقول صار إيش بدنا نتعامل معه
+
+259
+00:16:29,720 --> 00:16:33,420
+secondary prevention صار عنده سكر لكن بدنا نعالجه
+
+260
+00:16:33,420 --> 00:16:36,380
+نعطيه انسلين نعطيه جلوكوفاج نعطيه أدوية أي كان
+
+261
+00:16:36,380 --> 00:16:40,800
+طيب واحد صار معه سكري و هو مش dairy و طول معه
+
+262
+00:16:40,800 --> 00:16:45,310
+السكري فصار عنده قدم سكرية يعني صار عنده شيء اللي
+
+263
+00:16:45,310 --> 00:16:48,230
+جاء complication إذا صار عنده complication و بدنا
+
+264
+00:16:48,230 --> 00:16:52,090
+نتعامل معها إيش صار اسمه tertiary prevention اللي
+
+265
+00:16:52,090 --> 00:16:55,810
+ما بعد تطور المرض يبقى الـ primary قبل حدوث المرض
+
+266
+00:16:55,810 --> 00:16:59,070
+الـ secondary أثناء حدوث المرض الـ tertiary ما بعد
+
+267
+00:16:59,070 --> 00:17:02,690
+حدوث المرض بأيام كثيرة الـ data من وين بدنا نتأكد
+
+268
+00:17:02,690 --> 00:17:06,370
+verifying هيعمل لمبة بيقول لي من وين بدنا نتأكد هل
+
+269
+00:17:06,370 --> 00:17:10,050
+المعلومات كلها بدنا نأخذها 100% مسلم أبدا أول حاجة
+
+270
+00:17:10,050 --> 00:17:13,450
+بيقول لي استخدم عقلها جواها مش كل حاجة يعني مش كل ما
+
+271
+00:17:13,450 --> 00:17:17,550
+يسمع يصدق لكن إحنا هنا معنين أن إحنا المعلومات
+
+272
+00:17:17,550 --> 00:17:21,170
+نفكر فيها كويس مجلة بول دياتا الشغلات اللي يمكن
+
+273
+00:17:21,170 --> 00:17:25,430
+قياسها نصدقها double check لما يكون في عندي أكثر
+
+274
+00:17:25,430 --> 00:17:29,650
+من مصدر معناته صح equipment أنا والله اتخربطت في
+
+275
+00:17:29,650 --> 00:17:33,810
+الـ vital signs خلي إيش واحد ثاني يجيه يقيسه ما فيه
+
+276
+00:17:33,810 --> 00:17:39,070
+مشكلة ما فيهوش عيب علشان إحنا نتأكد أكثر بعدين
+
+277
+00:17:39,070 --> 00:17:42,850
+انشار الخبراء ما فيهوش عيب الـ instructor عندنا فيه
+
+278
+00:17:42,850 --> 00:17:46,610
+دكتور فيه زميل قديم وهكذا re check و compare
+
+279
+00:17:46,610 --> 00:17:53,970
+subjective and objective data طيب planning اللي هو
+
+280
+00:17:53,970 --> 00:17:58,330
+أول شيء التخطيط general guidelines كيف تخطط بدك
+
+281
+00:17:58,330 --> 00:18:01,400
+تنقل immediate issue الـ safety issue و الـ patient
+
+282
+00:18:01,400 --> 00:18:06,180
+identified issues كله في مرحلة تخطيط يعني أنا جئت
+
+283
+00:18:06,180 --> 00:18:09,460
+عن المريض شو هو المريض أخذت عنه المعلومات إيش
+
+284
+00:18:09,460 --> 00:18:13,640
+بيُعاني كده أشغله في المستشفى أهم شيء identify
+
+285
+00:18:13,640 --> 00:18:17,220
+priorities أنا بشرح اللي انشرح في السنة الأولى بس
+
+286
+00:18:17,220 --> 00:18:21,720
+بلمحة سريعة إيش identified priorities بنحدد إيش
+
+287
+00:18:21,720 --> 00:18:25,280
+الأولويات مش كل حاجة بدي أدق عليها يعني أفرض أنا
+
+288
+00:18:25,280 --> 00:18:29,030
+حكالي شغلات قدام المريض و فيه معلومات هامة في
+
+289
+00:18:29,030 --> 00:18:33,410
+الموضوع أن إحنا دغري بدنا نشوف وين نقاط القوة عند
+
+290
+00:18:33,410 --> 00:18:37,090
+المريض و نبتعد عن قضية الـ ethical issue إيش يعني؟
+
+291
+00:18:37,090 --> 00:18:40,750
+يعني أي شيء محرج للمريض نحاول نبدّله أي سؤال ممكن
+
+292
+00:18:40,750 --> 00:18:44,410
+يؤثر على حرج أو يوقف الإجابات واقفة شوية الـ time
+
+293
+00:18:44,410 --> 00:18:46,810
+أحترمه الوقت مش معقول أنا آتي في نص الليل و أعمله
+
+294
+00:18:46,810 --> 00:18:50,670
+history و كده ولا أنا آتي عنده زوار أو أقاربه و
+
+295
+00:18:50,670 --> 00:18:54,070
+أقعد أعمله المشكلة أقول استنى شوية بدنا نتبع الـ
+
+296
+00:18:54,070 --> 00:18:58,020
+hierarchy of needs اللي هو ما بيسموها إحنا الهرم
+
+297
+00:18:58,020 --> 00:19:01,140
+المتطلبات اللي زي هرم اللي هو Maslow يعني ما
+
+298
+00:19:01,140 --> 00:19:06,040
+نبدأش من Z to A وإنما نبدأ من A to Z و نلقى قدام
+
+299
+00:19:06,040 --> 00:19:09,400
+شوية Interdisciplinary بيصير عندنا يعني بنعمل
+
+300
+00:19:09,400 --> 00:19:14,560
+نموذج تقييمي و خطة تقييمية منضبطة بيساعدني فيها
+
+301
+00:19:14,560 --> 00:19:18,480
+اللي هو مش بس المريض موجود أمامك ممكن الأستاذ ممكن
+
+302
+00:19:18,480 --> 00:19:22,580
+زميلي في المهنة يكون برضه قدامي طيب نلقى قدام State of
+
+303
+00:19:22,580 --> 00:19:24,880
+the patient كل هذا بتكلم على وين identifying
+
+304
+00:19:24,880 --> 00:19:29,050
+client الآن أول حاجة client centered بقول لي outcomes
+
+305
+00:19:29,050 --> 00:19:31,010
+إحنا بنتكلم عن outcomes بس إيش أنا بقول centered
+
+306
+00:19:31,010 --> 00:19:35,370
+يعني لازم يكون مركزية التقدم هو المريض تبعي give
+
+307
+00:19:35,370 --> 00:19:38,510
+direction to patients بعدين behavior نشوف السلوكية
+
+308
+00:19:38,510 --> 00:19:42,390
+اللي عنده the patient هنا will be أول حاجة
+
+309
+00:19:42,390 --> 00:19:48,450
+diagnosis أنا بدي ما نستعجل مباشرة بتشخيص المريض
+
+310
+00:19:48,450 --> 00:19:52,190
+لأ شوف إحنا طول حكينا قلنا شوف نقطة القوة نقطة
+
+311
+00:19:52,190 --> 00:19:55,220
+الضعف إيش اللي موجود عنده كيف وضعه هل زمان له
+
+312
+00:19:55,220 --> 00:19:58,720
+نائم؟ إيش اللي مانكد عليه؟ إيش المشكلة؟ أنا قصدي
+
+313
+00:19:58,720 --> 00:20:02,840
+ما نروح مباشرة زي بعض الأطباء و بعض الممرضين
+
+314
+00:20:02,840 --> 00:20:06,220
+القدامى بيقول لك هذا عنده هيك خلاص أنا إحساسي بيقول
+
+315
+00:20:06,220 --> 00:20:09,980
+هيك اوعى ما عندي كلمة إحساسي بيقول هيك لأ إحنا لازم
+
+316
+00:20:09,980 --> 00:20:16,360
+نكون يعني نكون نروح لأبعد من هيك و أطول من هيك أنه
+
+317
+00:20:16,360 --> 00:20:23,840
+لازم نتمرس في فن استخراج التشخيص قبل ما أن نستعجل
+
+318
+00:20:23,840 --> 00:20:27,360
+باستراتيجية التشخيصات ولا قدام هأقول لكم أن ما فيه إيش
+
+319
+00:20:27,360 --> 00:20:28,740
+اختلاف في الـ nursing diagnosis عن medical
+
+320
+00:20:28,740 --> 00:20:31,900
+diagnosis عموما الـ nursing diagnosis فيه actual
+
+321
+00:20:31,900 --> 00:20:35,200
+و فيه potential برضه ولا قدام هشرحها steps of
+
+322
+00:20:35,200 --> 00:20:37,660
+driving outcomes في الـ nursing diagnosis look
+
+323
+00:20:37,660 --> 00:20:41,560
+first دائما look for the risk along type nursing
+
+324
+00:20:41,560 --> 00:20:45,520
+diagnosis and a restate in the statement that
+
+325
+00:20:45,520 --> 00:20:48,800
+describe improvement control absence of the
+
+326
+00:20:48,800 --> 00:20:51,530
+problem كثير من الناس بيجي يسألني الـ nursing
+
+327
+00:20:51,530 --> 00:20:55,870
+diagnosis هل هو كلام بيظل ثابت ولا ممكن يتغير؟ لأ
+
+328
+00:20:55,870 --> 00:20:59,490
+أنا من الآن بقول لك التحكم في الـ nursing diagnosis
+
+329
+00:20:59,490 --> 00:21:02,910
+بناء على تقدم المرحلة يعني أنا يمكن أحط تلاتة
+
+330
+00:21:02,910 --> 00:21:06,310
+أربعة nursing diagnosis تحسن منهم إثنين أو تلاتة
+
+331
+00:21:06,310 --> 00:21:10,050
+تحسن منهم إثنين أو تلاتة تحسن الإثنين أو التلاتة
+
+332
+00:21:10,050 --> 00:21:13,570
+بيخليني أعمل re-plan re-diagnosis إعادة التشخيص
+
+333
+00:21:13,570 --> 00:21:16,970
+يعني مش شرط يكون الـ nursing لكن الطبيب ممكن الـ
+
+334
+00:21:16,970 --> 00:21:20,930
+nursing diagnosis كله يتغير يعني هو دخل مثلا بـ
+
+335
+00:21:20,930 --> 00:21:24,630
+falling down طلع لا سمح الله death مات  يغير كل
+
+336
+00:21:24,630 --> 00:21:28,770
+التشخيص بس إحنا بناء على استجابة المريض و بناء على
+
+337
+00:21:28,770 --> 00:21:33,130
+الـ risk الموجود عنده بتغير أنا و بغير التشخيص تبعي
+
+338
+00:21:33,130 --> 00:21:36,410
+الـ subject طبعا أن هذا كله لازم أحصل على
+
+339
+00:21:36,410 --> 00:21:40,150
+performance مش وقته لأن لأن أحصل على كله إن شاء
+
+340
+00:21:40,150 --> 00:21:43,530
+الله الـ nursing intervention بدنا لأن نشتغل مع
+
+341
+00:21:43,530 --> 00:21:46,870
+المريض أهم شيء أن نلاحظ اللي أمامنا minimize risk
+
+342
+00:21:46,870 --> 00:21:50,790
+resolve minimize  هأركزهمش تروح و تعمل المخاطر على
+
+343
+00:21:50,790 --> 00:21:54,290
+مهل بس this ده إيش هنا ADLs our activity of daily
+
+344
+00:21:54,290 --> 00:21:58,290
+living بقدر بقدرش يعمل يعني بيعمل شعر و حياته بقدر
+
+345
+00:21:58,290 --> 00:22:02,310
+يقوم يقعد optimum health كيف وضعه الـ intervention
+
+346
+00:22:02,310 --> 00:22:05,550
+ده بيقول لي كمان direct intervention و في indirect
+
+347
+00:22:05,550 --> 00:22:08,210
+intervention بقولنا direct أنا بلاحظ المريض قدامي
+
+348
+00:22:08,210 --> 00:22:11,350
+indirect أنا بلاحظ الـ body language و الأشياء اللي
+
+349
+00:22:11,350 --> 00:22:14,750
+حوليه اللي بتخليني أنتبه أن في عنده مشكلة اللي
+
+350
+00:22:14,750 --> 00:22:17,830
+قدام كمان صورة أكثر و أوسع أكثر اللي direct و
+
+351
+00:22:17,830 --> 00:22:21,960
+indirect الـ nursing diagnosis تعلمناها في سنة أولى
+
+352
+00:22:21,960 --> 00:22:26,980
+أن لازم يكون هذا تقييم خاص به أنا اللي هو بيكون
+
+353
+00:22:26,980 --> 00:22:32,080
+يعمد الاش هنا reduced or resolved problems يعني هو
+
+354
+00:22:32,080 --> 00:22:38,100
+بيخليني أنا أُصيغ جملة معينة هذه الجملة قصدنا أن
+
+355
+00:22:38,100 --> 00:22:42,060
+أخفف مشكلة عند المريض في خلال يوم في خلال يومين في
+
+356
+00:22:42,060 --> 00:22:46,060
+خلال خليني أقول مثلا تلت أيام لازم يكون محدود ده
+
+357
+00:22:46,060 --> 00:22:49,670
+مش لازم يكون طويل كثير طبعا الـ document لما أقول
+
+358
+00:22:49,670 --> 00:22:53,330
+كلمة document the most important أهم شيء من كل
+
+359
+00:22:53,330 --> 00:22:56,010
+اللي شرحته الـ documentation إيش هو الـ
+
+360
+00:22:56,010 --> 00:22:59,790
+documentation؟ اللي بيشمل prioritization لما أقول
+
+361
+00:22:59,790 --> 00:23:03,490
+كلمة prioritized .. prioritized يعني أن الأولوية
+
+362
+00:23:03,490 --> 00:23:07,870
+في التمريض ما نكتبش حاجات .. يعني ما أقول المريض
+
+363
+00:23:07,870 --> 00:23:12,710
+طبيعي ساكن في كذا عمره يعني عمل عمليات و كان دار
+
+364
+00:23:12,710 --> 00:23:16,110
+أخوه من دار كذا و عنده دار جيرانه .. لأ أنا بتكلم
+
+365
+00:23:16,110 --> 00:23:17,970
+على الأولويات و إيش الـ outcomes و إيش الـ
+
+366
+00:23:17,970 --> 00:23:20,870
+intervention بالمناسبة لازم الـ documentation يكون
+
+367
+00:23:20,870 --> 00:23:25,430
+إيش؟  clear and concise لازم يكون واضح .. يكون
+
+368
+00:23:25,430 --> 00:23:29,710
+دقيق و يكون appropriate يعني ما نكتبش مصطلحات غريبة
+
+369
+00:23:29,710 --> 00:23:33,710
+مصطلحات غامضة تحتمل أكثر من معنى على فكرة بيذكرني
+
+370
+00:23:33,710 --> 00:23:37,850
+الأمر هنا في الـ documentation مرة أحد الأطباء يعني
+
+371
+00:23:37,850 --> 00:23:40,330
+زمان و شخصيات صدّق أن هذا حقيقي و بإمكانك تسأل عن
+
+372
+00:23:40,330 --> 00:23:43,050
+هذا الموضوع و للأسف درجة أن إحنا فيه في العالم
+
+373
+00:23:43,050 --> 00:23:46,490
+international abbreviation شرحنا إياها الأستاذ في
+
+374
+00:23:46,490 --> 00:23:50,210
+الـ terminology ليه اختصارات عالمية زي ما أقول مثلا
+
+375
+00:23:50,210 --> 00:23:54,950
+MI my card and my fortune مثلا يعني كثير من الشغلات
+
+376
+00:23:54,950 --> 00:23:57,270
+أن خلاص و أنا بقول أن هذا لا يختلف عليه اثنان
+
+377
+00:23:57,270 --> 00:24:02,250
+لكن يقول لي MB طب إيش MB؟ MB قاعد يُعالَج المريض
+
+378
+00:24:02,250 --> 00:24:05,670
+كثير و يُعطَى و gastric lavage و يُغسَل المعدة و
+
+379
+00:24:05,670 --> 00:24:08,670
+يُعطَى في الجيل بقول للطبيب والله أنا معلش أنا
+
+380
+00:24:08,670 --> 00:24:13,130
+خجول من الطلبة مش عارف شو MB لو بيقول لي MB يعني
+
+381
+00:24:13,130 --> 00:24:15,730
+مفتول poisoning لا إله إلا الله إيش مفتول
+
+382
+00:24:15,730 --> 00:24:18,570
+poisoning؟ جاله عنده تسمم المفتول بقوله طب ما فيه
+
+383
+00:24:18,570 --> 00:24:21,930
+مفتول يعني ممكن تجيب .. يعني ممكن تسميها food
+
+384
+00:24:21,930 --> 00:24:27,050
+poisoning قال لأ ما أقدرش أسميها زي كده لأن food تشتمل
+
+385
+00:24:27,050 --> 00:24:30,590
+عدة شغلات، أقنع أن هو منطقيا أنه .. قال لأ أنا قصدي
+
+386
+00:24:30,590 --> 00:24:33,890
+أن المفتول بالذات، أنا ضحكت صراحة، قلت مفتول و
+
+387
+00:24:33,890 --> 00:24:36,950
+سعره بعدها الناس تكتب في الشيفات، فأنا حكيتها عشان
+
+388
+00:24:36,950 --> 00:24:40,410
+بكرا لو شفنا MB ما تقولش مثلا اختصار إيه شعرت، لأ
+
+389
+00:24:40,410 --> 00:24:43,590
+مفتول poisoning و خاصة المفتول لما يبت لثاني يوم
+
+390
+00:24:43,590 --> 00:24:49,610
+بره الثلاجة بيعمل تسمم موية لطيفة فإحنا دائما بقول
+
+391
+00:24:49,610 --> 00:24:52,210
+في الـ documentation دي ربالنا يكون عندنا كلامنا
+
+392
+00:24:52,210 --> 00:24:55,190
+واضح و في الـ physical assessment لما نيجي نصف
+
+393
+00:24:55,190 --> 00:24:58,470
+حالة المريض و الـ vital signs و الـ diet و كله بدنا
+
+394
+00:24:58,470 --> 00:25:02,010
+نكتبه بشغلات واضحة جدا ما .. لا تحتمل اختلاف الـ
+
+395
+00:25:02,010 --> 00:25:05,230
+documentation بيكون كثير كويس لو كان بالـ own words،
+
+396
+00:25:05,230 --> 00:25:09,830
+إيش يعني؟ لو حكالنا شغلة، المريض حكاها حكي معين و
+
+397
+00:25:09,830 --> 00:2
+
+445
+00:28:12,110 --> 00:28:15,390
+نحاول نبعد عنها لأنه مش موضوعنا، ليش؟ لأنه هو المريض
+
+446
+00:28:15,390 --> 00:28:18,290
+مش هيقدر كتير، أنا مش هيقدر طول عمري عشان أحطه
+
+447
+00:28:18,290 --> 00:28:21,990
+للـ long-term goals nursing process كمان مرة بأعيد
+
+448
+00:28:21,990 --> 00:28:25,010
+الكلام بعضه planning, selecting, and intervention
+
+449
+00:28:25,010 --> 00:28:29,190
+تدخل communicating، وبعدين evaluation، والـ nursing
+
+450
+00:28:29,190 --> 00:28:33,430
+process نفس القضية على فكرة، يعني لاحظ أنا بأعيد نفس
+
+451
+00:28:33,430 --> 00:28:36,750
+الـ slides السابقة، ليه؟ من باب إنه يعني كأنه
+
+452
+00:28:36,750 --> 00:28:40,330
+بيختصر لي الشرح اللي كان موجود بشكل كبير، عموما إن
+
+453
+00:28:40,330 --> 00:28:43,290
+شاء الله أنا بأبدأ أنتهي في هذه المحاضرة لهذا القدر
+
+454
+00:28:43,290 --> 00:28:47,410
+وإن شاء الله المحاضرة القادمة بنكمل، والسلام
+
+455
+00:28:47,410 --> 00:28:49,290
+عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..9c00ee1caa4ba278909f6cc12f8c5179685a9b1b
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/hx7ENH6BrYs_postprocess.srt
@@ -0,0 +1,1820 @@
+1
+00:00:02,380 --> 00:00:04,160
+أعوذ بالله من الشيطان الرجيم بسم الله الرحمن
+
+2
+00:00:04,160 --> 00:00:09,140
+الرحيم طب أعلنه الآن هتكون المحاضرة الأولى اللى هى
+
+3
+00:00:09,140 --> 00:00:12,000
+ال chapter اللى مكتوب عليه the nursing process و
+
+4
+00:00:12,000 --> 00:00:15,280
+هو موجود زى ما قلتلكم موجود عندكم على ال slides
+
+5
+00:00:15,280 --> 00:00:19,020
+اللى حطيتها على ال model كمان هو موجود في الكتاب
+
+6
+00:00:19,020 --> 00:00:24,140
+بالمناسبة يمكن هذا بالذات chapter انا همشي فيه
+
+7
+00:00:24,140 --> 00:00:28,970
+شوية بسرعة مش انه انا يعني بدىهسرع معاكم؟ لأ لأن
+
+8
+00:00:28,970 --> 00:00:33,550
+هو تقريبا هذا ال chapter شامل كل المنهج اللي احنا
+
+9
+00:00:33,550 --> 00:00:38,970
+بدنا نشرحه على مدى اللي هو كل الشباتر لكن هو يعني
+
+10
+00:00:38,970 --> 00:00:45,310
+خلنا نقول مدخل عام مدخل عام بيفهمني ايش بالظبط
+
+11
+00:00:45,310 --> 00:00:49,190
+المقصود و هنتذكر ان احنا انشرحنا في ال process of
+
+12
+00:00:49,190 --> 00:00:53,110
+process الزمان العملية اللي هي في ال fundamental
+
+13
+00:00:53,110 --> 00:00:56,600
+اللي بتبدأ عند ال assessment و ال planningو ال
+
+14
+00:00:56,600 --> 00:00:59,200
+diagnosis و ال diagnosis الى أن تصل لأخر شي ال
+
+15
+00:00:59,200 --> 00:01:02,040
+evaluation و انتوا عارفين هذا الكلام عموما انا
+
+16
+00:01:02,040 --> 00:01:07,040
+بالذات هذا ال chapter هكون شوية يعني بده أسرع فيه
+
+17
+00:01:07,040 --> 00:01:11,880
+مش كمان مرة مش نوع من انه انا بدي يعني و كأنه ارمي
+
+18
+00:01:11,880 --> 00:01:15,360
+رمي لأ الأمر بسيط و الكلامات اللي فيه بسيطة كتير و
+
+19
+00:01:15,360 --> 00:01:18,340
+احنا اللي هنركز عليه في الشرح و اللي هنركز عليه
+
+20
+00:01:18,340 --> 00:01:21,720
+فيما بعد هو اللي دايما احنا ننتبهله بإذن الله بشكل
+
+21
+00:01:21,720 --> 00:01:27,420
+أكبر هنا بتكلم بس بذكرنيهذا اللي عمله يعني ماسك
+
+22
+00:01:27,420 --> 00:01:29,800
+البلدانيين يشوفوا كلها هنا بيذكرني أنه في
+
+23
+00:01:29,800 --> 00:01:32,700
+assessment و analyzing و planning و implementation
+
+24
+00:01:32,700 --> 00:01:35,840
+evaluation كله قشطنين فيها أشطر من يعني بيبدأ ..
+
+25
+00:01:35,840 --> 00:01:39,880
+تبدأ عملية .. العملية التمريدية العامة والشمولية
+
+26
+00:01:39,880 --> 00:01:46,080
+من التقييم للتحليل للتخطيط بعدين .. بعد .. في
+
+27
+00:01:46,080 --> 00:01:48,300
+التخطيط بنحط كمان nursing diagnosis و بعدين أروح
+
+28
+00:01:48,300 --> 00:01:50,940
+مينبصير عندنا بنعمل اللي هو nursing curriculum
+
+29
+00:01:50,940 --> 00:01:53,820
+اللي هو أنتوا عملتوها مرة في سنة أولى أو مرتين ما
+
+30
+00:01:53,820 --> 00:01:59,260
+بعرف لكن هي هتعملوها حقيقة على المرض لما تروحوا
+
+31
+00:01:59,260 --> 00:02:03,400
+عليهم و بعدين في أخر شي evaluation طيب ال nursing
+
+32
+00:02:03,400 --> 00:02:06,440
+process إيش هي يعني؟ هو بيقولي organizational
+
+33
+00:02:06,440 --> 00:02:10,240
+framework عبارة عن إطار إطار يعني بتعمل إيش هنا؟
+
+34
+00:02:10,240 --> 00:02:13,700
+إطار عملي لكل عملي في داخل وين؟ في داخل المستشفى و
+
+35
+00:02:13,700 --> 00:02:17,410
+في التعامل أو على فكرةلما نقول إطار عمل إلي مش شرط
+
+36
+00:02:17,410 --> 00:02:20,370
+يكون دايما مع ال patient inside the hospitals، لأ،
+
+37
+00:02:20,370 --> 00:02:23,370
+احنا اتعلمنا زمان أن احنا دور التمريد مش بس في
+
+38
+00:02:23,370 --> 00:02:26,850
+المستشفى، لأ، دوره في أي مرفق صحي، في المدارس صار
+
+39
+00:02:26,850 --> 00:02:30,210
+فيهم دور التمريد، في المؤسسات دور التمريد، اليوم
+
+40
+00:02:30,210 --> 00:02:33,310
+في مؤسسات المجتمع المدني، في موضوع جائحة كورونا
+
+41
+00:02:33,310 --> 00:02:36,770
+وموضوع التفحيف الصحي، التمريد في كل مكان هو اللي
+
+42
+00:02:36,770 --> 00:02:40,510
+موجود عموما هو بيقوللي أن احنا هذا يعتبر ال
+
+43
+00:02:40,510 --> 00:02:43,750
+nursing process central، مركز لكل ال nursing care،
+
+44
+00:02:43,750 --> 00:02:47,540
+طيب، مش موضوعنا اليوم؟بشكل الأقل ال definition of
+
+45
+00:02:47,540 --> 00:02:50,340
+nursing process إيش هنا organized sequence problem
+
+46
+00:02:50,340 --> 00:02:53,440
+solving هو عبارة عن problem solving steps يعني
+
+47
+00:02:53,440 --> 00:02:57,660
+خطوات لحل المشكلات التي تواجهينها بتبدأ من ال
+
+48
+00:02:57,660 --> 00:03:01,340
+assessment لما انتصل لوين لما انتصل ال evaluation
+
+49
+00:03:01,340 --> 00:03:04,800
+ننساش كل اللي بيحكمنا هنا هو ال NANDA اللي هو
+
+50
+00:03:04,800 --> 00:03:09,200
+North American Nursing Diagnosis Association ال
+
+51
+00:03:09,200 --> 00:03:11,580
+benefits of the nursing process أخدناها في ال
+
+52
+00:03:11,580 --> 00:03:15,900
+fundamental بس هي من بابك تذكير مش أختارتعطيني
+
+53
+00:03:15,900 --> 00:03:18,240
+systematic method يعني خليني بتعطيني planning
+
+54
+00:03:18,240 --> 00:03:22,020
+بتشجع عندي انه كيف يكون عندي standardizing nursing
+
+55
+00:03:22,020 --> 00:03:25,160
+practice لما اقول كلمة standardizing يعني هيكون
+
+56
+00:03:25,160 --> 00:03:28,500
+قداش انا بقدر اعمل standard تسمع كلمة كلمة
+
+57
+00:03:28,500 --> 00:03:33,800
+standard يعني كيف اتعلم اعمل افضل العمل و افضل شيء
+
+58
+00:03:33,800 --> 00:03:37,100
+كيف اعمل ال documentation اللي اتعلمناه كيف و
+
+59
+00:03:37,100 --> 00:03:41,800
+كانوا يقولون اكتبوه عشان نصلحلكم كيف نتعامل مع ال
+
+60
+00:03:41,800 --> 00:03:45,300
+stress كيف نتكلم .. نتعامل مع ال equalityاللي هو
+
+61
+00:03:45,300 --> 00:03:48,880
+يعني جودة العمل طبعا ننساش ان ال assessment,
+
+62
+00:03:49,200 --> 00:03:51,320
+diagnosis, planning, implementation, evaluation
+
+63
+00:03:51,320 --> 00:03:55,020
+الكلام معملوا بعيد بعضه طبعا انا مش قاعد بأسر يقول
+
+64
+00:03:55,020 --> 00:03:58,220
+لك انا قولتلكم مش كتير حندق لأنه انا جاي في
+
+65
+00:03:58,220 --> 00:04:01,660
+المحاضرات القادمة هيكون فيها كل هذا اللي انا قاعد
+
+66
+00:04:01,660 --> 00:04:06,160
+بحكيه زيانة طب ايش ال benefits لل nursing process
+
+67
+00:04:06,160 --> 00:04:10,500
+continuity of care لما نقول continuity of care
+
+68
+00:04:10,500 --> 00:04:16,030
+يعني استمرارية الرعايةprevention of duplication،
+
+69
+00:04:16,030 --> 00:04:20,310
+منع الإزدواجية، عشان عمل فلان مايتعرضش مع عمله،
+
+70
+00:04:20,310 --> 00:04:22,470
+individualized care، لما اقول كلمة individualized
+
+71
+00:04:22,470 --> 00:04:26,390
+care يعني انه تخصيص الرعاية لكل إنسان، و standard،
+
+72
+00:04:26,390 --> 00:04:28,890
+او يمكننا ننسى كلمة standard، standard يعني ايش
+
+73
+00:04:28,890 --> 00:04:35,150
+هنا؟ يعني احنا بنطمح لل perfect، لأفضل عمل، طبعا
+
+74
+00:04:35,150 --> 00:04:38,590
+بالتعاون مع مين؟ collaboration of care مع اللي هو
+
+75
+00:04:38,590 --> 00:04:43,160
+زملاء المهنةطبعا انا لازم اكون انا عندى .. انا
+
+76
+00:04:43,160 --> 00:04:47,680
+accountable يعني اكون مسئول و انا بشتغل مع المرضى،
+
+77
+00:04:47,680 --> 00:04:51,680
+يكون عندى critical thinking، مسئول عن أعمالى، في
+
+78
+00:04:51,680 --> 00:04:56,800
+عندى تفكير مهني، بقدر انا اتعامل مع الناس اللي هم
+
+79
+00:04:56,800 --> 00:05:00,760
+زيى، اللي بيسمينها level of your peers يعني سبحان
+
+80
+00:05:00,760 --> 00:05:04,140
+الله لما يكون عندك زملاء انت هذا ال assessment
+
+81
+00:05:04,140 --> 00:05:08,060
+بيخليك تقدر تتعامل زيك زيهم، هنلاقي حالة لما نروح
+
+82
+00:05:08,060 --> 00:05:11,850
+نتدرب، انا رايح اتدرب و انا لسه سنة تانيةهتلاقي
+
+83
+00:05:11,850 --> 00:05:16,250
+حالك انه الحمد لله صار عندك علم تقدر تتعامل مع كل
+
+84
+00:05:16,250 --> 00:05:19,170
+التمريض اللي موجود في المجتمع، رغم ان التمريض في
+
+85
+00:05:19,170 --> 00:05:22,370
+منهم diploma وفي منهم bachelor و magister وربما
+
+86
+00:05:22,370 --> 00:05:26,650
+اكثر، يمكن دكتوراه، لكن انت هتصير تقدر تتعامل زيهم
+
+87
+00:05:26,650 --> 00:05:30,270
+لأنه أخدت قاعدة علمية صحيحة و القواعد العلمية
+
+88
+00:05:30,270 --> 00:05:33,450
+الصحيحة لا يختلف عليها أثنان، و هنستخدم ال nursing
+
+89
+00:05:33,450 --> 00:05:36,830
+process هذاطبعا بقولي أنا something you think
+
+90
+00:05:36,830 --> 00:05:40,390
+about، بدنا نتأكد دايما أنه يكون في عنا حاجة بسمها
+
+91
+00:05:40,390 --> 00:05:44,610
+unique .. unique هنا إيش أنا؟ unique dimension of
+
+92
+00:05:44,610 --> 00:05:48,830
+a thing طب و لما نقول كلمة unique هنا زي ما أقول
+
+93
+00:05:48,830 --> 00:05:53,850
+كلمة يعني .. يعني متكامل، يعني شمولي، يعني كل واحد
+
+94
+00:05:53,850 --> 00:05:57,050
+متفرد، يكون عنده diagnosis و treatment و human
+
+95
+00:05:57,050 --> 00:06:00,040
+responsesactual and potential problems لما نقول
+
+96
+00:06:00,040 --> 00:06:03,620
+كلمة actual المشكلات اللي موجودة الآن لما نقول
+
+97
+00:06:03,620 --> 00:06:06,780
+potential المشكلات اللي موجودة اللي احنا متوقعين
+
+98
+00:06:06,780 --> 00:06:10,980
+تصير تمامك ليه؟ مش كل واحد يعني ممكن واحد يقولك
+
+99
+00:06:10,980 --> 00:06:16,280
+انا راسي وجعني راسه بيوجعوا لأنه واجع هذا actual
+
+100
+00:06:16,280 --> 00:06:20,760
+طب في potential ممكن يصير عنده vomiting بتوقع يصير
+
+101
+00:06:20,760 --> 00:06:25,910
+عنده vomiting بتصير potential طيبهذه مقولة حلوة
+
+102
+00:06:25,910 --> 00:06:29,390
+يعني صراحة يعني اللي حكاها Martha .. طبعا هذا
+
+103
+00:06:29,390 --> 00:06:32,830
+Martha Rogers من العلماء الكبار اللي يعني بتكلموا
+
+104
+00:06:32,830 --> 00:06:36,850
+فيها طبعا علماء النفس الاجتماعي بيقولوا يعني حتى
+
+105
+00:06:36,850 --> 00:06:41,070
+هدموا النظريات على فكرة التمريد بيقول when an
+
+106
+00:06:41,070 --> 00:06:44,250
+apple is cut لما احنا نقطع اللي هو الapple اللي هو
+
+107
+00:06:44,250 --> 00:06:48,490
+التفاحة others see me seeds ايش ال seeds معناته
+
+108
+00:06:48,490 --> 00:06:51,750
+البذور مش لما احنا بنكسر او بنقطع التفاحة من
+
+109
+00:06:51,750 --> 00:06:56,110
+المصدربطلع بذور صغيرة في النص السودة هذا in the
+
+110
+00:06:56,110 --> 00:06:59,530
+apple يعني الناس بيقولوا لما بيفتحوا التفاحة
+
+111
+00:06:59,530 --> 00:07:04,930
+بيتطلعوا على البذور في التفاحة لكن احنا as nurses
+
+112
+00:07:04,930 --> 00:07:09,490
+ولكن انا كتمريض ننظر apples in the seeds ايش سعر
+
+113
+00:07:09,490 --> 00:07:13,990
+معناها؟ ولكن انا ننظر الى التفاحة في البذور يعني
+
+114
+00:07:13,990 --> 00:07:17,250
+كأنه .. يعني كأنه اش بقول ليه؟ ان احنا نظرتنا مش
+
+115
+00:07:17,250 --> 00:07:21,130
+سطحية احنا يا التمريدنظرتنا مش سطحية، يمكن واحد
+
+116
+00:07:21,130 --> 00:07:24,370
+يكون ماشي علينا عادي، ايه بينظروله؟ راح أجن،
+
+117
+00:07:24,370 --> 00:07:27,430
+ماانتبهلوش، احنا بكرا هنتعلم الحاجة اسمها clinical
+
+118
+00:07:27,430 --> 00:07:31,350
+sense و critical sense فهدول الناس لما بفتحوا
+
+119
+00:07:31,350 --> 00:07:34,900
+التفاحة بتطلعوا فيها من جوابقولك هذا خربانة ومش
+
+120
+00:07:34,900 --> 00:07:38,720
+خربانة، احنا كأننا ننظر إلى التفاحة كيف تخرج من
+
+121
+00:07:38,720 --> 00:07:42,720
+هذه البذور، يعني كنات على انه كيف نتعامل مع كل
+
+122
+00:07:42,720 --> 00:07:47,200
+طبيعة واشراع المجتمع وننظر بنفس النظرة المتوازنة
+
+123
+00:07:47,200 --> 00:07:51,300
+مع اللي هو الصغير والكبير واختلاف نوعية المرض.
+
+124
+00:07:52,260 --> 00:07:53,740
+what are the responsibilities؟ ال responsibility
+
+125
+00:07:53,740 --> 00:07:56,920
+اللي احنا علينا healthy problems, anticipate
+
+126
+00:07:56,920 --> 00:08:00,140
+complications, initiateاللي هو actions يعني بدي
+
+127
+00:08:00,140 --> 00:08:03,980
+أتأكد أول حاجة بدي أحدد المشكلات إيش بعضيا في
+
+128
+00:08:03,980 --> 00:08:09,470
+مضاعفات كيف بدي أبدأ بقولي لحظةbegin to think ايش
+
+129
+00:08:09,470 --> 00:08:14,590
+critical يعني مابدي تفكيرك ولا تفكيرك يكون سطحي
+
+130
+00:08:14,590 --> 00:08:19,850
+التفكير لازم يكون متعمق عشان نقدر نفهم المريض اللي
+
+131
+00:08:19,850 --> 00:08:23,750
+أمامنا مابيدفع التفكير يكون سطحي لأنه هي تربني لأ
+
+132
+00:08:23,750 --> 00:08:27,710
+الصح أن يكون لنا التفكير متعمق عشان أفهم طبيبتي
+
+133
+00:08:27,710 --> 00:08:33,210
+اللي أمامي من المرضى قوللي هنا لقدام بدنا كمان
+
+134
+00:08:33,210 --> 00:08:35,350
+mental operations عمليات عقلية عشان نكون عندك
+
+135
+00:08:35,350 --> 00:08:38,750
+decision making تقدر انت ايشتصلح قرار و يكون عندك
+
+136
+00:08:38,750 --> 00:08:42,290
+أسباب reasoning لذلك القرار و يكون عندك معرفة يكون
+
+137
+00:08:42,290 --> 00:08:44,990
+عندك attitudes .. attitudes طبعا كيف يكون سلوكك
+
+138
+00:08:44,990 --> 00:08:50,850
+يعني و حياتك و نموذجك في الحياة كيف بتكون هنا بقول
+
+139
+00:08:50,850 --> 00:08:54,530
+دير بقلك ال critical thinking شغل مهم جدا .. مهم
+
+140
+00:08:54,530 --> 00:08:58,270
+جدا لأنها هي في الآخر هتوديك لل goal directed ..
+
+141
+00:08:58,270 --> 00:09:01,930
+ايش يعني goal directed؟ هتوديك للهدف يعني انا اللي
+
+142
+00:09:01,930 --> 00:09:06,740
+بدي اقوله لما نحدد هدفانه انا بدى حاسس انه زى ما
+
+143
+00:09:06,740 --> 00:09:10,680
+اقول والله بدا انا انزل الحرارة عند المريض هذا هدف
+
+144
+00:09:10,680 --> 00:09:14,780
+او انا بدي انا اخلى المريض مايعانيش او بدي اخلى
+
+145
+00:09:14,780 --> 00:09:18,820
+المريض ماتبكيش هذا هدف بدي اخلى كل تفكيري منصب
+
+146
+00:09:18,820 --> 00:09:22,560
+بهذا الاتجاه طيب بدنا نشوف assessment of wellbeing
+
+147
+00:09:22,560 --> 00:09:25,500
+هنتكلم عن ال emotional, physical, social,
+
+148
+00:09:25,580 --> 00:09:29,800
+spiritual كل هذا جاي ان شاء الله هشرحه كله الان
+
+149
+00:09:29,800 --> 00:09:33,660
+بقول هيا نبدأ طبعا مش شرط البنود الان كلها نحفظهاو
+
+150
+00:09:33,660 --> 00:09:36,980
+كمان مرة بقولكوا مش كله حفظ، هو بيقوللي لأ بدك
+
+151
+00:09:36,980 --> 00:09:40,640
+تحدد الأولويات، تكون عندك adequate time, introduce
+
+152
+00:09:40,640 --> 00:09:44,900
+yourself، تقدم نفسك، خليك عارف ايش .. ليش ال
+
+153
+00:09:44,900 --> 00:09:47,440
+purpose من ال interview، انت مش هتتعرف على المريض
+
+154
+00:09:47,440 --> 00:09:51,600
+ولا تضرب صحبة معاه وانا هو جريبك ولكن بدك انت ..
+
+155
+00:09:51,600 --> 00:09:54,500
+هذا اسمه professional interview يعني مقابلة مهنية
+
+156
+00:09:55,260 --> 00:09:57,860
+عشان تكون في عندك confidentiality و احنا بكرا
+
+157
+00:09:57,860 --> 00:10:01,620
+عارفين و هتاخدوا في ال ethics في أول صفحة في ال
+
+158
+00:10:01,620 --> 00:10:04,800
+ethics قسم المهنة اللي هي في القضايا و أخلاقيا
+
+159
+00:10:04,800 --> 00:10:08,220
+المهنة هتلاقي قسم المهنة هتلاقي العبارات محدودة و
+
+160
+00:10:08,220 --> 00:10:12,540
+مرتبة و منمقة و مرتبطة بالعقيدة لأنه هنتعرفها
+
+161
+00:10:12,540 --> 00:10:15,860
+أسرار خطيرة المريض يمكن مايحكيش للطبيب بس يحكيلك
+
+162
+00:10:15,860 --> 00:10:21,030
+فدائما المريض يحتاج منكانت تتأمنه و تكون عندك ..
+
+163
+00:10:21,030 --> 00:10:25,150
+يعني انت مش هتش .. مش هتنشر معلومته عشان قبل ما
+
+164
+00:10:25,150 --> 00:10:29,530
+تبدأ تعمله ايش اطمئنك طيب ال types of ايه
+
+165
+00:10:29,530 --> 00:10:33,830
+interview نوعية المقابلات في direct و في non
+
+166
+00:10:33,830 --> 00:10:37,410
+-direct مش هشرحها الآن لأنه لسه جاي شرح كتير عليها
+
+167
+00:10:37,410 --> 00:10:42,010
+direct انا بجابلك مباشرة indirect بجابلك من .. مش
+
+168
+00:10:42,010 --> 00:10:45,380
+و انا واقف قدامكيمكن على تليفون يمكن by media يمكن
+
+169
+00:10:45,380 --> 00:10:52,100
+انتقلت الي المقابلة يمكن لجانب عن بعد و هكذا ال
+
+170
+00:10:52,100 --> 00:10:56,480
+assessment كيف تصبح ال assessment ابتدى لطرق بقيم
+
+171
+00:10:56,480 --> 00:10:59,660
+بال observation ملاحظة بال interview و كيف ال
+
+172
+00:10:59,660 --> 00:11:01,380
+interview و انا اقول الحلقة قدام حصلتلكوا و كيف
+
+173
+00:11:01,380 --> 00:11:06,280
+المستشفى كيف انواع الأسئلة و كيف بنلاحظ ال
+
+174
+00:11:06,280 --> 00:11:07,800
+environment اللي حواليها ال physical و ال
+
+175
+00:11:07,800 --> 00:11:11,640
+emotional و في الآخر ايه هنا ال examinationلحظة
+
+176
+00:11:11,640 --> 00:11:14,840
+انه حط ال examination في الآخر يعني انا بدي اتعلم
+
+177
+00:11:14,840 --> 00:11:17,520
+انه انا غير عن الطبيب، الطبيب ممكن يقوله المريض
+
+178
+00:11:17,520 --> 00:11:23,160
+والله انا في عندي مشكلة هي موجودة في وجهي، وين؟
+
+179
+00:11:23,160 --> 00:11:26,860
+قالله جالي هي أنا تحت عينيأجى اجرب المريض اجى اجرب
+
+180
+00:11:26,860 --> 00:11:30,960
+الطبيب على المريض عشان يفحصه فالمريض كان تعبان
+
+181
+00:11:30,960 --> 00:11:34,940
+فعرا عطس او عمل او جح أو سعل وبالتالي يطلع عنده
+
+182
+00:11:34,940 --> 00:11:38,920
+مصيبة احنا لأ قبل ما احنا نسمع الشكوه ليه ال exam
+
+183
+00:11:38,920 --> 00:11:42,840
+مش بالاخر فى ملاحظة انا مافهم ايش المريض عنده قبل
+
+184
+00:11:42,840 --> 00:11:47,480
+ما اجرب منه ال types of data فى انتوا عارفين فى
+
+185
+00:11:47,480 --> 00:11:52,040
+انه objective وفى subjective اختصر عشان مانطولشال
+
+186
+00:11:52,040 --> 00:11:56,640
+objective هي ال signs العلمات ال subjective هي ال
+
+187
+00:11:56,640 --> 00:12:00,260
+symptoms الأعراض هلقيت أنا قولت vital signs ليس
+
+188
+00:12:00,260 --> 00:12:05,000
+منها vital signs شغلة مجربة ممكن قياسها تنسوش يمكن
+
+189
+00:12:05,000 --> 00:12:07,660
+قياسها يمكن الأشياء اللي ممكن قياسها و ممكن
+
+190
+00:12:07,660 --> 00:12:11,000
+ملاحظتها signs الأشياء اللي مش ممكن ألاحظها ولا
+
+191
+00:12:11,000 --> 00:12:16,040
+قيصها symptoms جالي راسي بيجوعني symptoms Gestillo
+
+192
+00:12:16,040 --> 00:12:21,200
+الحرارة اللي جيتها سخنة signs و اكترفي كمان ال
+
+193
+00:12:21,200 --> 00:12:23,660
+cultural، ال cultural اللي هنا يعني من ناحية كمان
+
+194
+00:12:23,660 --> 00:12:29,380
+يعني وين ساكن، ال .. ال .. الارث الثقافي اللي
+
+195
+00:12:29,380 --> 00:12:32,640
+موجود فيه المريض، بده يكون منتبه الإنسان إله، أنا
+
+196
+00:12:32,640 --> 00:12:38,620
+مش شرط يعني هو أنا يعني بيئتي بده أنا أجبر المريض
+
+197
+00:12:38,620 --> 00:12:41,900
+إنه يتحملها معايا، أنا بده اتنازل ل culture تبع
+
+198
+00:12:41,900 --> 00:12:45,060
+المريض، مش أنا اللي بدي .. لازم يكون في عندنا
+
+199
+00:12:45,060 --> 00:12:49,220
+differences أكيدفيش واحد في العالم يطابق الثاني زي
+
+200
+00:12:49,220 --> 00:12:51,660
+ما اتعلمنا زي ما انا في ال psychology احنا هنش
+
+201
+00:12:51,660 --> 00:12:53,760
+بقوله respect ايش يعني respect individual
+
+202
+00:12:53,760 --> 00:12:58,620
+difference احترم الفرقات الفردية انا مدني هو فلاح
+
+203
+00:12:58,620 --> 00:13:02,900
+انا مش عارف ايش هو كده هو بتكلم كلمات لغة تانية اه
+
+204
+00:13:02,900 --> 00:13:07,080
+اللي مش عارف ايش احنا ما نيجي نجبره يتكلم زي احنا
+
+205
+00:13:07,080 --> 00:13:11,660
+اللي بنتكلم زيه عشان في الآخر هذا community و احنا
+
+206
+00:13:11,660 --> 00:13:15,940
+اللي رايحيننساعد المرضى مش نخلى المرضى هم اللى
+
+207
+00:13:15,940 --> 00:13:21,320
+غصبنا عنهم يصيروا زينا طيب ال common challenges
+
+208
+00:13:21,320 --> 00:13:26,060
+فيه تحديات التحديات اللى دائما موجودة عندنا في
+
+209
+00:13:26,060 --> 00:13:29,480
+قضية يعني ممكن يصير في بعض الحالات compensation
+
+210
+00:13:29,480 --> 00:13:31,680
+هذا بتذكرنا في اللى خدناه في ال defense mechanism
+
+211
+00:13:31,680 --> 00:13:34,760
+ممكن يكون في compensation denial displacement
+
+212
+00:13:34,760 --> 00:13:38,310
+rationalizationprojection, repression,
+
+213
+00:13:38,830 --> 00:13:42,670
+suppression، هلاقي، مش كل مرضى دغري مباشرة هيستجيب
+
+214
+00:13:42,670 --> 00:13:48,190
+معانا ويمكن يعرضنا لهيك مجابها، احنا الشطارة انه
+
+215
+00:13:48,190 --> 00:13:51,070
+مانخلي المريض يصل لهيك مرحلة، انا لما باجي بسأل
+
+216
+00:13:51,070 --> 00:13:53,710
+المريض، يعني نبقي بعض الناس بتقول السلام عليكم،
+
+217
+00:13:53,710 --> 00:13:56,430
+بقولك وعليكم السلام، والله انا حابب اسألك عن كذا،
+
+218
+00:13:56,430 --> 00:13:59,760
+اول شي هقولك مين انت عشان تسألنيلكن لو قلتله والله
+
+219
+00:13:59,760 --> 00:14:03,320
+أنا طالب تمريض من الجامعة الإسلامية في غزة، أنا
+
+220
+00:14:03,320 --> 00:14:06,700
+اسمه كده، احنا جاي نترقص، كلماتها دي بسيطة، أعطته
+
+221
+00:14:06,700 --> 00:14:09,860
+أريحية، يقدر يحكي معاك، والمثل بيقول لاجيني ولا
+
+222
+00:14:09,860 --> 00:14:12,600
+تغديني، مايجيش واحد اوب يخمط، مرة واحد يقول انا ..
+
+223
+00:14:12,600 --> 00:14:15,900
+انا والله بعرفش إلا زيك، لأ مش هيك، طبعا و ال
+
+224
+00:14:15,900 --> 00:14:18,960
+nurse دايما ال process إيش بتساعد أنا to
+
+225
+00:14:18,960 --> 00:14:23,740
+understand إيش أنا، بقوللي strategy .. استراتيجيات
+
+226
+00:14:24,200 --> 00:14:27,460
+ال clients used in attempts to coping ذاكرين كلمة
+
+227
+00:14:27,460 --> 00:14:31,120
+coping اعيدلكوا اياها coping معناته التأقلم انا
+
+228
+00:14:31,120 --> 00:14:33,940
+لما نباجي بتعامل مع المريض و باخد منه ال history و
+
+229
+00:14:33,940 --> 00:14:36,380
+ببدأ اعمله assessment و عشان اعمله examination
+
+230
+00:14:36,380 --> 00:14:41,100
+بعرف طريقته في coping التأقلم اللي بتشمل اتنتين
+
+231
+00:14:41,100 --> 00:14:47,520
+adaptation and adjustment coping يعني التأقلم ال
+
+232
+00:14:47,520 --> 00:14:50,940
+resources كتار منهم بتجيب معلومات من ال client و
+
+233
+00:14:50,940 --> 00:14:53,610
+من ال individuals و من ال recordsو من ال
+
+234
+00:14:53,610 --> 00:14:56,470
+consultations استشارات و من ال diagnostic studies
+
+235
+00:14:56,470 --> 00:15:00,270
+المختبرات و منها الموجودة من ال relevant مثلا
+
+236
+00:15:00,270 --> 00:15:03,030
+literature الطبيب ممكن ي fitني ال assessment من
+
+237
+00:15:03,030 --> 00:15:06,070
+وين أجيبها؟ في عندنا database assessment في عندنا
+
+238
+00:15:06,070 --> 00:15:09,030
+comprehensive ال assessment أول ما ببدأ ال focus
+
+239
+00:15:09,030 --> 00:15:13,210
+assessment أول حاجة ال data أول ما بيجي المريض
+
+240
+00:15:13,210 --> 00:15:16,210
+أمامي بيسألني واحد بيقولي من وين أخد المعلومات؟
+
+241
+00:15:16,210 --> 00:15:20,960
+هذا قصدهمش قادر تاخد المعلومات في كومة في المريض
+
+242
+00:15:20,960 --> 00:15:25,040
+مش قادر يعطيك المعلومات مش عيب ومش غلط اسأل الطبيب
+
+243
+00:15:25,040 --> 00:15:29,980
+اسأل زملاءك اسأل قريبه امسك ال file تجيب الورقات
+
+244
+00:15:29,980 --> 00:15:32,740
+المختبر بيصير عندك معلومات كاملة يبقى ال source of
+
+245
+00:15:32,740 --> 00:15:35,180
+data فيه نوعين primary و secondary زي ما انتوا
+
+246
+00:15:35,180 --> 00:15:38,320
+شايفين ال primary اللي هو ال client ال secondary
+
+247
+00:15:38,320 --> 00:15:42,020
+اي حاجة خلاص اي حاجة غير ال client اعتبرها Asian
+
+248
+00:15:42,020 --> 00:15:45,860
+secondary سواء تقارير اطباء اعتبرها ايه ايه
+
+249
+00:15:45,860 --> 00:15:49,750
+secondaryطبعا ال disease prevention اشي عن disease
+
+250
+00:15:49,750 --> 00:15:54,850
+prevention احنا شغلنا تلت مستويات في الرعاية واحد
+
+251
+00:15:54,850 --> 00:15:57,810
+بيسمو primary prevention و التاني اسمه secondary
+
+252
+00:15:57,810 --> 00:16:01,110
+prevention و التالت اسمه tertiary prevention عشان
+
+253
+00:16:01,110 --> 00:16:07,310
+ماتتهوش كتير primary يعني انا بمنع حدوث المرض بني
+
+254
+00:16:07,310 --> 00:16:13,350
+ادم طبيعي ابوه عنده سكر و امه عنده سكر بنقوله دير
+
+255
+00:16:13,350 --> 00:16:17,040
+بالك خليك معانابنصحصح و نتابع تعليماتنا عشان
+
+256
+00:16:17,040 --> 00:16:21,120
+مايصيرش عندك سكر هذا اسمه primary طب صار عنده سكر
+
+257
+00:16:21,120 --> 00:16:25,880
+لكن اكتشفناه مبكر صار عنده سكر و اكتشفناه ايش يعني
+
+258
+00:16:25,880 --> 00:16:29,720
+early detection بنقول صار ايش بدنا نتعامل معاه
+
+259
+00:16:29,720 --> 00:16:33,420
+secondary prevention صار عنده سكر لكن بدنا نعالجه
+
+260
+00:16:33,420 --> 00:16:36,380
+نعطيه انسلين نعطيه جلوكوفاج نعطيه دوانيل ايا كان
+
+261
+00:16:36,380 --> 00:16:40,800
+طيب واحد صار معاه سكري و هو مش dairy و طول معاه
+
+262
+00:16:40,800 --> 00:16:45,310
+السكري فصار عنده قدم سكريةيعني صار عنده اشي اللي
+
+263
+00:16:45,310 --> 00:16:48,230
+جيت complication إذا صار عنده complication و بدنا
+
+264
+00:16:48,230 --> 00:16:52,090
+نتعامل معها إيش صار اسمه tertiary prevention اللي
+
+265
+00:16:52,090 --> 00:16:55,810
+ما بعد تطور المرض يبقى ال primary قبل حدوث المرض
+
+266
+00:16:55,810 --> 00:16:59,070
+ال secondary أثناء حدوث المرض ال tertiary ما بعد
+
+267
+00:16:59,070 --> 00:17:02,690
+حدوث المرض بأيام كثيرة ال data من وين بدنا نتأكد
+
+268
+00:17:02,690 --> 00:17:06,370
+verifying هيعمل لمبة بقولي من وين بدنا نتأكد هل
+
+269
+00:17:06,370 --> 00:17:10,050
+المعلومات كلها بدنا ناخدها 100% مسلم أبداأول حاجة
+
+270
+00:17:10,050 --> 00:17:13,450
+بيقولي استخدم عقلها جواها مش كل حاجة يعني مش كل ما
+
+271
+00:17:13,450 --> 00:17:17,550
+يسمع يصدق لكن احنا هنا معنين انه احنا المعلومات
+
+272
+00:17:17,550 --> 00:17:21,170
+نفكر فيها كويس مجلة بول دياتا الشغلات اللي يمكن
+
+273
+00:17:21,170 --> 00:17:25,430
+قياسها بنصدقها double check لما يكون في عندي اكتر
+
+274
+00:17:25,430 --> 00:17:29,650
+من مصدر معناته صح equipment انا والله اتخربطت في
+
+275
+00:17:29,650 --> 00:17:33,810
+ال vital signs خلي ايش واحد تاني يجيه يجيسه مافيه
+
+276
+00:17:33,810 --> 00:17:39,070
+مشكلة مافيش فيه عيب علشان احنا نتأكد اكتربعدين
+
+277
+00:17:39,070 --> 00:17:42,850
+انشار الخبراء مافي عيب ال instructor عندنا فيه
+
+278
+00:17:42,850 --> 00:17:46,610
+دكتور فيه زميل قديم وهكذا re check و compare
+
+279
+00:17:46,610 --> 00:17:53,970
+subjective and objective data طيب planning اللي هو
+
+280
+00:17:53,970 --> 00:17:58,330
+أول شي التخطيط general guidelines كيف تخطط بدك
+
+281
+00:17:58,330 --> 00:18:01,400
+تنقل immediate issueال safety issue و ال patient
+
+282
+00:18:01,400 --> 00:18:06,180
+identified issues كله في مرحلة تخطيط يعني أنا جيت
+
+283
+00:18:06,180 --> 00:18:09,460
+عن المريض شهو هو المريض أخدت عنه المعلومات إيش
+
+284
+00:18:09,460 --> 00:18:13,640
+بيعاني كده إشقله في المستشفى أهم شي identify
+
+285
+00:18:13,640 --> 00:18:17,220
+priorities أنا بشرح اللي انشرح في السنة الأولى بس
+
+286
+00:18:17,220 --> 00:18:21,720
+بلامحة سريعة إيش identified priorities بنحدد إيش
+
+287
+00:18:21,720 --> 00:18:25,280
+الأولويات مش كل الحاجة بدي أدق عليها يعني افرض أنا
+
+288
+00:18:25,280 --> 00:18:29,030
+حكالي شغلات قدام المريض و فيه مرشداتاهامة في
+
+289
+00:18:29,030 --> 00:18:33,410
+الموضوع ان احنا دغري بدنا نشوف وين نقاط القوة عند
+
+290
+00:18:33,410 --> 00:18:37,090
+المريض ودربالنا من قضية ال ethical issue ايش يعني؟
+
+291
+00:18:37,090 --> 00:18:40,750
+يعني اي شي محرج للمريض نحاول نبدعله اي سؤال ممكن
+
+292
+00:18:40,750 --> 00:18:44,410
+يأثر على حرج او يوقف الإجابات واقفه شوية ال time
+
+293
+00:18:44,410 --> 00:18:46,810
+احترمه الوقت مش معقول انا اجي في نص الليل و اعمله
+
+294
+00:18:46,810 --> 00:18:50,670
+history و كده ولا انا اجي عنده زوار او اقاربه و
+
+295
+00:18:50,670 --> 00:18:54,070
+اقعد اعمله المشكلة اقول استنى شوية بدنا نتبع ال
+
+296
+00:18:54,070 --> 00:18:58,020
+hierarchy of needs اللي هو ما بيسموها اناالهرام
+
+297
+00:18:58,020 --> 00:19:01,140
+المتطلبات اللى زى هرام اللى هو Maslow يعني ما
+
+298
+00:19:01,140 --> 00:19:06,040
+بنبدأش من Z to A وإنما بنبدأ من A to Z ولقى قدام
+
+299
+00:19:06,040 --> 00:19:09,400
+شوية Interdisciplinary بيصير عندنا يعني بنعمل
+
+300
+00:19:09,400 --> 00:19:14,560
+نموذج تقييمى وخطة تقييمية منضبطة بيساعدنى فيها
+
+301
+00:19:14,560 --> 00:19:18,480
+اللى هو مش بس المريض موجود أمامك ممكن الأستاذ ممكن
+
+302
+00:19:18,480 --> 00:19:22,580
+زميلي المهنة يكون برضه قدامى طيب لقى قدام State of
+
+303
+00:19:22,580 --> 00:19:24,880
+the patient كل هذا بتكلم على وين identifying
+
+304
+00:19:24,880 --> 00:19:29,050
+client الآن أول حاجةclient centered بقولي outcomes
+
+305
+00:19:29,050 --> 00:19:31,010
+احنا بنتكلم عن outcomes بس ايش انا بقولي centered
+
+306
+00:19:31,010 --> 00:19:35,370
+يعني لازم يكون مركزية التقدم هو المريض تبعي give
+
+307
+00:19:35,370 --> 00:19:38,510
+direction to patients بعدين behavior نشوف السلوكية
+
+308
+00:19:38,510 --> 00:19:42,390
+اللي عنده the patient a هنا will be اول حاجة
+
+309
+00:19:42,390 --> 00:19:48,450
+diagnosis انا بدي ما نستعجل مباشرة بتشخيص المريض
+
+310
+00:19:48,450 --> 00:19:52,190
+لأ شوف احنا طوا حكينا قولنا شوف نقطة القوة نقطة
+
+311
+00:19:52,190 --> 00:19:55,220
+الضعف ايش اللي موجود عنده كيف وضعههل زمان إله
+
+312
+00:19:55,220 --> 00:19:58,720
+نايم؟ إيش اللي مانكد عليه؟ إيش المشكلة؟ أنا قصدي
+
+313
+00:19:58,720 --> 00:20:02,840
+مانروح مباشرة زي بعض الأطباء و بعض الممرضين
+
+314
+00:20:02,840 --> 00:20:06,220
+القدامى بقولك هذا عنده هيك خلاص أنا إحساسي بقول
+
+315
+00:20:06,220 --> 00:20:09,980
+هيك اوعى ماعندي كلمة إحساسي بقول هيك لأ إحنا لازم
+
+316
+00:20:09,980 --> 00:20:16,360
+نكون يعني نكون نروح لأبعد من هيك و أطول من هيك أنه
+
+317
+00:20:16,360 --> 00:20:23,840
+لازم نتمرس في فن استخراج التشخيص قبل ما أنهبنستعجل
+
+318
+00:20:23,840 --> 00:20:27,360
+باستراتي التشخيصات ولا قدام هقولكوا أن مافي ايش
+
+319
+00:20:27,360 --> 00:20:28,740
+اختلاف في ال nursing diagnosis عن medical
+
+320
+00:20:28,740 --> 00:20:31,900
+diagnosis عموما ال nursing diagnosis فيه actual
+
+321
+00:20:31,900 --> 00:20:35,200
+وفيه potential برضه ولا قدام هشرحها steps of
+
+322
+00:20:35,200 --> 00:20:37,660
+driving outcomes في ال nursing diagnosis look
+
+323
+00:20:37,660 --> 00:20:41,560
+first دايما look for the risk along type nursing
+
+324
+00:20:41,560 --> 00:20:45,520
+diagnosis and a restate in the statement that
+
+325
+00:20:45,520 --> 00:20:48,800
+describe improvement control absence of the
+
+326
+00:20:48,800 --> 00:20:51,530
+problemكتير من الناس بيجيب يسألني ال nursing
+
+327
+00:20:51,530 --> 00:20:55,870
+diagnosis هل هو كلام بيظل مثبت ولا ممكن يتغير؟ لأ
+
+328
+00:20:55,870 --> 00:20:59,490
+أنا من الآن بقول لك التحكم في ال nursing diagnosis
+
+329
+00:20:59,490 --> 00:21:02,910
+بناء على تقدم المرحلة يعني انا يمكن احط تلاتة
+
+330
+00:21:02,910 --> 00:21:06,310
+اربعة nursing diagnosis اتحسن منهم اتنين او تلاتة
+
+331
+00:21:06,310 --> 00:21:10,050
+اتحسن منهم اتنين او تلاتة تحسن الاتنين او تلاتة
+
+332
+00:21:10,050 --> 00:21:13,570
+بيخليني اعمل re-plan re-diagnosis اعادة التشخيص
+
+333
+00:21:13,570 --> 00:21:16,970
+يعني مش شرط يكون ال nursing لكن الطبيب ممكن ال
+
+334
+00:21:16,970 --> 00:21:20,930
+nursing diagnosis كله يتغيريعني هو دخل مثلا ب
+
+335
+00:21:20,930 --> 00:21:24,630
+falling down طلع لا سمح الله death مات تغير كل
+
+336
+00:21:24,630 --> 00:21:28,770
+التشخيص بس احنا بناء على استجابة المريض و بناء على
+
+337
+00:21:28,770 --> 00:21:33,130
+ال risk الموجود عنده بتغير انا و بغير التشخيص تبعي
+
+338
+00:21:33,130 --> 00:21:36,410
+ال subject طبعا ان هذا كله لازم احصل على
+
+339
+00:21:36,410 --> 00:21:40,150
+performance مش وقته لان لان احصل على كله ان شاء
+
+340
+00:21:40,150 --> 00:21:43,530
+الله ال nursing intervention بدنا لان نشتغل مع
+
+341
+00:21:43,530 --> 00:21:46,870
+المريض اهم شي ان لاحظ اللي أمامنا minimize risk
+
+342
+00:21:46,870 --> 00:21:50,790
+resolve minimize هاركزهمش تروح و تعمل المخاطر على
+
+343
+00:21:50,790 --> 00:21:54,290
+مهل بس this ده ايش هنا ADLS our activity of daily
+
+344
+00:21:54,290 --> 00:21:58,290
+living بقدر بقدرش يعمل يعني بيعمل شعر و حياته بقدر
+
+345
+00:21:58,290 --> 00:22:02,310
+يقوم يقعد optimum health كيف وضعه ال intervention
+
+346
+00:22:02,310 --> 00:22:05,550
+ده بيقولي كمان direct intervention و في indirect
+
+347
+00:22:05,550 --> 00:22:08,210
+intervention بقولنا direct انا بلاحظ المريض قدامي
+
+348
+00:22:08,210 --> 00:22:11,350
+indirect انا بلاحظ ال body language و الأشياء اللي
+
+349
+00:22:11,350 --> 00:22:14,750
+حواليه اللي بتخليني أنتبه ان في عنده مشكلة اللي
+
+350
+00:22:14,750 --> 00:22:17,830
+قدام كمان حصحة اكتر و واسعة اكتر اللي direct و
+
+351
+00:22:17,830 --> 00:22:21,960
+indirectال nursing diagnosis اتعلمناها في سنة أولى
+
+352
+00:22:21,960 --> 00:22:26,980
+انه لازم يكون هذا تقييم خاص بيه انا اللي هو بيكون
+
+353
+00:22:26,980 --> 00:22:32,080
+يعمد الاش هنا reduced or resolved problems يعني هو
+
+354
+00:22:32,080 --> 00:22:38,100
+بيخليني انا اصيغ جملة معينة هذه الجملة قصدنا ان
+
+355
+00:22:38,100 --> 00:22:42,060
+اخفف مشكلة عند المريض في خلال يوم في خلال يومين في
+
+356
+00:22:42,060 --> 00:22:46,060
+خلال خليني اقول مثلا تلت أيام لازم يكون محدود ده
+
+357
+00:22:46,060 --> 00:22:49,670
+مش لازم يكون طويل كتيرطبعا ال document لما اقول
+
+358
+00:22:49,670 --> 00:22:53,330
+كلمة document the most important أهم شيء من كل
+
+359
+00:22:53,330 --> 00:22:56,010
+اللي شرحته ال documentation ايش هو ال
+
+360
+00:22:56,010 --> 00:22:59,790
+documentation؟اللي بيشمل prioritization لما اقول
+
+361
+00:22:59,790 --> 00:23:03,490
+كلمة prioritized .. prioritized يعني انه الاولوية
+
+362
+00:23:03,490 --> 00:23:07,870
+في التمريد مانكتبش حاجات .. يعني مالش اقول المريض
+
+363
+00:23:07,870 --> 00:23:12,710
+طبيعي ساكن في كذا عمره يعني عمل عمليات و كان دار
+
+364
+00:23:12,710 --> 00:23:16,110
+أخوه من دار كذا و عنده دار جرايبه .. لأ انا بتكلم
+
+365
+00:23:16,110 --> 00:23:17,970
+على الاولويات و ايش ال outcomes و ايش ال
+
+366
+00:23:17,970 --> 00:23:20,870
+intervention بالمناسبة لازم ال documentation يكون
+
+367
+00:23:20,870 --> 00:23:25,430
+ايش؟ هن clear and concise لازم يكون واضح .. يكون
+
+368
+00:23:25,430 --> 00:23:29,710
+دقيقو يكون appropriate يعني ما نكتبش مصطلحات غريبة
+
+369
+00:23:29,710 --> 00:23:33,710
+مصطلحات غامضة تحتمل أكتر من معنى على فكرة بيذكرني
+
+370
+00:23:33,710 --> 00:23:37,850
+الأمر هنا في ال documentation مرة أحد الأطباء يعني
+
+371
+00:23:37,850 --> 00:23:40,330
+زمان و شخصيات صدقة أن هذا حقيقي و بإمكانك تسأل عن
+
+372
+00:23:40,330 --> 00:23:43,050
+هذا الموضوع و للأسف درجة أن احنا فيه في العالم
+
+373
+00:23:43,050 --> 00:23:46,490
+international abbreviation شرحنا إياها الأستاذ في
+
+374
+00:23:46,490 --> 00:23:50,210
+ال terminology ليه اقتصارات عالمية زي ما أقول مثلا
+
+375
+00:23:50,210 --> 00:23:54,950
+MI my card and my fortune مثلايعني كتير من الشغلات
+
+376
+00:23:54,950 --> 00:23:57,270
+انه خلاص و انا بقول انه هذا لا يختلف عليها اتنين
+
+377
+00:23:57,270 --> 00:24:02,250
+لكن يقوللي MB طب ايش MB؟ MB قاعد يتعالج المريض
+
+378
+00:24:02,250 --> 00:24:05,670
+كتير و يعطوه و gastric lavage و يغسل المعدة و
+
+379
+00:24:05,670 --> 00:24:08,670
+يعطوه في الجيل بقول للطبيب والله انا معلش انا
+
+380
+00:24:08,670 --> 00:24:13,130
+خجلان من الطلبة مش عارف شو MB لو بقوللي MB يعني
+
+381
+00:24:13,130 --> 00:24:15,730
+مفتول poisoning لا اله الا الله ايش مفتول
+
+382
+00:24:15,730 --> 00:24:18,570
+poisoning؟ جال عنده تسمم المفتول بقوله طب مافيش
+
+383
+00:24:18,570 --> 00:24:21,930
+مفتول يعني ممكن تجيب .. يعني ممكن تسميها food
+
+384
+00:24:21,930 --> 00:24:27,050
+poisoningقال لأ مقدرش أسميها زي كده لأن food تشتمل
+
+385
+00:24:27,050 --> 00:24:30,590
+عدة شغلات، أقنع أن هو منطقيا أنه .. قال لأ أنا قصد
+
+386
+00:24:30,590 --> 00:24:33,890
+أنه المفتول بالذات، أنا أضحكت صراحة، قولت مفتول و
+
+387
+00:24:33,890 --> 00:24:36,950
+سعره بعدها الناس تكتب في الشيفات، فأنا حكيتها عشان
+
+388
+00:24:36,950 --> 00:24:40,410
+بكرا لو شوفنا MB ما تقولش مثلا اختصار إيه شعرت، لأ
+
+389
+00:24:40,410 --> 00:24:43,590
+مفتول poisoning و خاصة المفتول لما نبت لتاني يوم
+
+390
+00:24:43,590 --> 00:24:49,610
+برا التلاجة بيعمل تسمه موية لطيفةفاحنا دائما بقول
+
+391
+00:24:49,610 --> 00:24:52,210
+في ال documentation دي ربالنا يكون عندنا كلامنا
+
+392
+00:24:52,210 --> 00:24:55,190
+واضح و في ال physical assessment لما نيجي نوصف
+
+393
+00:24:55,190 --> 00:24:58,470
+حالة المريض و ال vital signs و ال diet و كله بدنا
+
+394
+00:24:58,470 --> 00:25:02,010
+نكتبه بشغلات واضحة جدا ما .. لا تحتمل اختلاف ال
+
+395
+00:25:02,010 --> 00:25:05,230
+documentation بكون كتير كويس لو كان بال own words،
+
+396
+00:25:05,230 --> 00:25:09,830
+اش يعني؟ لو حكالنا شغلة، المريض حكاها حكي معين و
+
+397
+00:25:09,830 --> 00:25:14,390
+انت .. و انت حابب توصل هذه الشغلة لطبيب، لخصائي،
+
+398
+00:25:14,390 --> 00:25:19,200
+اكتبها زي ما هييعني ممكن يقولك انا حاسس صدري او
+
+399
+00:25:19,200 --> 00:25:23,620
+حاسس قلبي كأنه فيه سكين بيتقوله والله مثلا he feel
+
+400
+00:25:23,620 --> 00:25:27,100
+like knife is stamped in her heart ورانيزها ارض
+
+401
+00:25:27,100 --> 00:25:31,940
+بيقول بيشعر كأنه سكينة طبعا هذه لها معنى لأنه لو
+
+402
+00:25:31,940 --> 00:25:34,960
+قال معايا شكاهه تانية لها معاني تانية فبقوليها انا
+
+403
+00:25:34,960 --> 00:25:39,580
+ماتعمليش جمل summative يعني statement ماتعمليش جمل
+
+404
+00:25:39,580 --> 00:25:45,380
+جمعية اتروح انت my patient normalgood feeling اوعى
+
+405
+00:25:45,380 --> 00:25:48,920
+تستخدم و اوعى تستخدم judgemental words في ال
+
+406
+00:25:48,920 --> 00:25:52,800
+documentation ال judgemental معناه الحكم مانستخدم
+
+407
+00:25:52,800 --> 00:25:56,540
+لا good ولا bad ولا normal ولا abnormal يعني زى
+
+408
+00:25:56,540 --> 00:26:00,680
+مرة مانفعش يجيني والله الطالب يقول لي والله my
+
+409
+00:26:00,680 --> 00:26:04,460
+patients health is ايه is so good يا سلام so good
+
+410
+00:26:04,460 --> 00:26:07,480
+طب وليه جاي عندنا وصبحت المريض اللي لو صار معجلطة
+
+411
+00:26:07,480 --> 00:26:10,100
+و لا مات المريض طب من بعد كنتت so good و اليوم
+
+412
+00:26:10,100 --> 00:26:14,460
+رعال بالجبر لأ طبعا ابن أوصف الأمور بإيشبخصوصيتها
+
+413
+00:26:14,460 --> 00:26:17,580
+evaluation عشان ماتطورش في المحاضرة لأنه بدأ الوقت
+
+414
+00:26:17,580 --> 00:26:21,160
+يعني .. نشوف قداش .. الوقت شوية يعني ما بدنا نصل
+
+415
+00:26:21,160 --> 00:26:25,180
+للنصف ساعة نعمل determine ال outcome deciding
+
+416
+00:26:25,180 --> 00:26:28,360
+whether and continue and modify and terminate the
+
+417
+00:26:28,360 --> 00:26:32,120
+plan يعني بقول ال evaluation باختصار اللي انت
+
+418
+00:26:32,120 --> 00:26:36,060
+عملته يمكن يكون صح بقول والله وصلت للي بديها يمكن
+
+419
+00:26:36,060 --> 00:26:40,180
+يكون مش صحبقول معناته انا بدي اعمل replay فاش حاجة
+
+420
+00:26:40,180 --> 00:26:44,080
+اسمها فشل لأ انت ممكن تحط يعني تلاتة اربعة nursing
+
+421
+00:26:44,080 --> 00:26:47,580
+diagnosis وماينجحش الا واحد مافي مشكلة ليه؟ لأن
+
+422
+00:26:47,580 --> 00:26:51,580
+احنا بنحط استجابة لإيه للمريض اللي أمامي فيا بعمل
+
+423
+00:26:51,580 --> 00:26:54,520
+replay يا بشوف معلوماتي صحيحة يا بشوف المريض
+
+424
+00:26:54,520 --> 00:26:58,500
+استجاب و هكذا كيف ال outcomes بيصير أمام المريض
+
+425
+00:26:58,500 --> 00:27:03,080
+بقعد اسأله؟أنا بتطلع فيه بشوف كيف هل هو طبقت اللي
+
+426
+00:27:03,080 --> 00:27:06,320
+أنا عملته complete مت يعني الاختصار اللي هو
+
+427
+00:27:06,320 --> 00:27:10,300
+التصريف التان من الميت هل يعني اللي انت حطيته من
+
+428
+00:27:10,300 --> 00:27:14,160
+ال goals طبقته و الحمد لله حققته مية في المية لأ
+
+429
+00:27:14,160 --> 00:27:19,000
+طبقش جزييا طبق نط مت ماقدرتش على كل الجهات بعود
+
+430
+00:27:19,000 --> 00:27:22,940
+بعمل re planning عشان أقدر أرتب الأمور طيب هنا
+
+431
+00:27:22,940 --> 00:27:26,740
+فينا variable affecting outcomes achievement يحدد
+
+432
+00:27:26,740 --> 00:27:29,690
+لك كيف كمانإنه هل ال plan تبعتيها realistic؟ كانت
+
+433
+00:27:29,690 --> 00:27:34,010
+منطقيا؟ هل هي كانت مناسبة؟ هل في تغيير؟ طب how
+
+434
+00:27:34,010 --> 00:27:36,650
+does .. إيش أنا بدي أعمل في لبنان؟ ممكن يساعدني
+
+435
+00:27:36,650 --> 00:27:38,590
+فيها الأستاذ أو يساعدني فيها المشرف اللي بيكون
+
+436
+00:27:38,590 --> 00:27:42,930
+عندى للمستقبل طب للمستقبل لازم يكون عندى predict
+
+437
+00:27:42,930 --> 00:27:46,550
+prevent and manage focus أنا مابدى يعني أشرح كتير
+
+438
+00:27:46,550 --> 00:27:49,510
+في هذا الموضوع لإن كله جاي طبعا كله هشرحه ال
+
+439
+00:27:49,510 --> 00:27:52,010
+nursing process و ال nursing diagnosis كله أنا
+
+440
+00:27:52,010 --> 00:27:55,570
+هشرحه ان شاء الله و ال NAND ده طبعا هو كمان هي
+
+441
+00:27:55,570 --> 00:27:59,570
+بعيد كده بعيد نفسه planningsetting priorities
+
+442
+00:27:59,570 --> 00:28:03,150
+شرحناها بس هو لحاله يعملوا بعيد short term goals
+
+443
+00:28:03,150 --> 00:28:06,650
+هو زي ما شرحت قبل شوية مانحطش هداف طويلة لما ده
+
+444
+00:28:06,650 --> 00:28:12,110
+هداف بسيطة تكون ليوم ليومين تلاتة long term goals
+
+445
+00:28:12,110 --> 00:28:15,390
+نحاول نبعد عنها لإنه مش موضوعنا ليش لإن هو المريض
+
+446
+00:28:15,390 --> 00:28:18,290
+مش هيقدند كتير أنا مش هيقدند طول العمر عشان أحطه
+
+447
+00:28:18,290 --> 00:28:21,990
+لل long term goals nursing process كمان مرة بعيد
+
+448
+00:28:21,990 --> 00:28:25,010
+الكلام بعضه planning selecting and intervention
+
+449
+00:28:25,010 --> 00:28:29,190
+تدخلcommunicating و بعدين evaluation و ال nursing
+
+450
+00:28:29,190 --> 00:28:33,430
+process نفس القضية على فكرة يعني لاحظ أنا بعيد نفس
+
+451
+00:28:33,430 --> 00:28:36,750
+ال slides السابقة ليه؟ من باب انه يعني كأنه
+
+452
+00:28:36,750 --> 00:28:40,330
+بيختصرلي الشرح اللي كان موجود بشكل كبير عموما ان
+
+453
+00:28:40,330 --> 00:28:43,290
+شاء الله أنا بدأ أنتهي في هذا المحاضرة لهذا القدر
+
+454
+00:28:43,290 --> 00:28:47,410
+و ان شاء الله المحاضرة القادمة بنكمل و السلام
+
+455
+00:28:47,410 --> 00:28:49,290
+عليكم و رحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b7208749e16bbe2b28c4737b2ca6136dd2d71981
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY.srt
@@ -0,0 +1,1633 @@
+1
+00:00:00,810 --> 00:00:04,290
+وبسم الله الرحمن الرحيم خلينا نكمل طبعاً احنا
+
+2
+00:00:04,290 --> 00:00:08,770
+وصلنا لهذه الشريحة في المحاضرة السابقة وإن شاء
+
+3
+00:00:08,770 --> 00:00:13,450
+الله نكمل مع بعض في respiratory assessment طبعاً..
+
+4
+00:00:13,450 --> 00:00:15,210
+طبعاً respiratory system يعني اللي هو الجهاز
+
+5
+00:00:15,210 --> 00:00:19,570
+التنفسي وصلنا لحاجة اسمها الـ pleural friction rub
+
+6
+00:00:19,570 --> 00:00:22,290
+طبعاً خلصنا عندها الـ stridor اللي لما حكينا عنها
+
+7
+00:00:22,290 --> 00:00:26,070
+خاصة في حالة الـ inspiration وكيف تصير musical
+
+8
+00:00:26,070 --> 00:00:29,390
+وwheezing اللي هو الصوت الصفير أثناء النفس أو الزفير
+
+9
+00:00:30,320 --> 00:00:34,800
+طيب إيه pleural friction rub من اسمها؟ pleural..
+
+10
+00:00:34,800 --> 00:00:37,580
+pleural cavity طب friction زي احتكاك.. rub.. rub
+
+11
+00:00:37,580 --> 00:00:40,860
+يعني كأنه بيحك مع بعضه شو يعني دي؟ يعني صار من
+
+12
+00:00:40,860 --> 00:00:45,260
+منطقة الـ pleural صارت فيها جفاف وتحتك مع بعضها
+
+13
+00:00:45,260 --> 00:00:49,500
+ويلها صوت سماها loud dry cracking إيش يعني كأنه هي
+
+14
+00:00:49,500 --> 00:00:53,260
+كإيش بي..بي.. بيعمل صوت وورقتين كانوا بيحكوا مع
+
+15
+00:00:53,260 --> 00:00:57,260
+بعض بيقولوا grating sound indicating pleural
+
+16
+00:00:57,260 --> 00:01:02,360
+friction أو pleural irritation عبارة عن صوت كرَكة أو
+
+17
+00:01:02,360 --> 00:01:07,340
+خرخشة موجودة بتصير زي احتكاك اتنين مع بعض grating
+
+18
+00:01:07,340 --> 00:01:12,160
+زي إشي.. زي إشي بيشحت.. إشي بيعمل صوت زي تشحّت مع
+
+19
+00:01:12,160 --> 00:01:17,740
+بعض وين بيصير هذا؟ بيقول لي بكون على lateral and
+
+20
+00:01:17,740 --> 00:01:21,280
+anterior lung in sitting position مرات بيصير على
+
+21
+00:01:21,280 --> 00:01:24,460
+الجنب اللي هو خارجه.. اللي هو الـ lung على الجنب
+
+22
+00:01:24,460 --> 00:01:27,660
+سواء كان right أو left وبيصير وين كمان في الـ
+
+23
+00:01:27,660 --> 00:01:30,100
+anterior والـ anterior يعني بيصيرش في الـ..في الـ
+
+24
+00:01:30,100 --> 00:01:33,260
+posterior اللي بيكون يعني مش..مش من الظهري
+
+25
+00:01:33,260 --> 00:01:37,200
+بينسمع وإنما.. طبعاً بعض الناس بيقول لك طيب إيش هذا
+
+26
+00:01:37,200 --> 00:01:40,840
+الصوت؟ ما هو يمكن هذا الصوت يكون في secretion أو
+
+27
+00:01:40,840 --> 00:01:44,930
+في شغلات موجودة في الرئتين وخلّيه يجَوْح شوية ممكن
+
+28
+00:01:44,930 --> 00:01:48,770
+تطلع عشان نقدر نفرّج بين الـ pleural الـ friction rub
+
+29
+00:01:48,770 --> 00:01:53,170
+وبين الـ sputum with coughing أو مثلاً.. خليني أقول
+
+30
+00:01:53,170 --> 00:01:57,170
+مثلاً with sputum أو with cough أو زي ما يقولوا يعني
+
+31
+00:01:57,170 --> 00:02:01,570
+اللي هي الـ الكحة اللي بتكون مختلطة بأي.. بأي
+
+32
+00:02:01,570 --> 00:02:06,370
+secretions هذه، لما يجَوْح الإنسان مجرد ما يطلع
+
+33
+00:02:06,370 --> 00:02:09,680
+secretions خلاص بيروح الصوت لكن في الـ pleural الـ
+
+34
+00:02:09,680 --> 00:02:12,900
+friction rub إيش كتبت هنا not clear with coughing
+
+35
+00:02:12,900 --> 00:02:16,800
+يعني لو ظل يجَوْح منها لبكرة بيضل الصوت موجود ليه؟
+
+36
+00:02:16,800 --> 00:02:20,060
+على اعتبار أن الإشي مش موجود في داخل الـ lung وإنما
+
+37
+00:02:20,060 --> 00:02:24,240
+إنما حوالي الـ lung طب خلينا نشوف causes of
+
+38
+00:02:24,240 --> 00:02:27,260
+decreased or absent breath sounds متى الكتب بتتكلم
+
+39
+00:02:27,260 --> 00:02:30,440
+بشكل عام؟ بتتكلمش بشكل خاص بتتكلم بشكل عام أصوات
+
+40
+00:02:30,440 --> 00:02:33,740
+النفس سواء كان في الـ main bronchus والـ bronchi والـ
+
+41
+00:02:33,740 --> 00:02:38,890
+bronchioles بغض النظر متى ممكن الأصوات تبع التنفس
+
+42
+00:02:38,890 --> 00:02:43,370
+بشكل عام ممكن تقل يعني صوتها ما يكونش عالي في حال
+
+43
+00:02:43,370 --> 00:02:46,150
+..هتلاقي في كل اللي..اللي..اللي بدنا نذكره
+
+44
+00:02:46,150 --> 00:02:51,110
+شغلات فيها يعني..يعني إما chronic problem أو إما
+
+45
+00:02:51,110 --> 00:02:54,610
+تكون يعني إيش..يعني خلوني أقول dangerous problem من
+
+46
+00:02:54,610 --> 00:02:58,710
+إيش؟ زي الأزمة اللي بيكون عنده أزمة بشكل دائم و
+
+47
+00:02:58,710 --> 00:03:03,350
+طويل بيكون نفسه أصلاً يعني بيكون ضيق شوية ومرات بيكون
+
+48
+00:03:03,350 --> 00:03:05,950
+الصوت صفير ولما..ما بتكلمش على صوت الصفير هنا
+
+49
+00:03:05,950 --> 00:03:09,810
+بتروح تقول لي ما هو صوت..يعتبر صوت نفس، لأ، هذا
+
+50
+00:03:09,810 --> 00:03:14,430
+بنسمع الصفير بدون سماعات، لكن أنا بتكلم على الصوت
+
+51
+00:03:14,430 --> 00:03:18,550
+اللي ممكن نسمعه بـ stethoscope ونتأكد منه COPD
+
+52
+00:03:18,550 --> 00:03:22,510
+chronic obstructive pulmonary disease المرض اللي
+
+53
+00:03:22,510 --> 00:03:25,990
+خالص هو بيكون معاه bronchitis، مع أزمة، بعضهم بيجِيْ
+
+54
+00:03:25,990 --> 00:03:30,020
+كمان اللي هو bronchiectasis اللي الأخيرة كل هذا إيش
+
+55
+00:03:30,020 --> 00:03:33,240
+يعني بتعتبر من الأمراض اللي إيه اللي بتلازم اللي هو
+
+56
+00:03:33,240 --> 00:03:36,960
+الجهاز التنفسي، pleural effusion لما نقول كلمة pleural
+
+57
+00:03:36,960 --> 00:03:39,740
+effusion معناها أن الـ pleural cavity صار في قلبه،
+
+58
+00:03:39,740 --> 00:03:42,900
+فيه سائل والسائل إيش ممكن يكون؟ ممكن يكون serous
+
+59
+00:03:42,900 --> 00:03:46,480
+fluid، ممكن يكون blood، بغض النظر المهم فيه fluid،
+
+60
+00:03:46,480 --> 00:03:50,590
+الـ pneumothorax هنا طبعاً بعضهم بيقول لك في طبعاً
+
+61
+00:03:50,590 --> 00:03:54,450
+hemothorax بيسموها وهنا إذا كانت blood بيسميها
+
+62
+00:03:54,450 --> 00:03:57,830
+hemothorax لكن pneumothorax كلكم عارفين pneumo جاي من
+
+63
+00:03:57,830 --> 00:04:01,930
+هواء معناته إيش؟ دخول هواء في منطقة الـ pleural cavity
+
+64
+00:04:01,930 --> 00:04:05,590
+وخاصة لما الواحد بيكون واخد stab wound أو لقدر
+
+65
+00:04:05,590 --> 00:04:10,050
+الله قطعنه من شيء أو أكل هواية أو صار عنده fracture في
+
+66
+00:04:10,050 --> 00:04:12,570
+الـ ribs طبعاً أو أوقات الـ  الـ
+
+67
+00:04:12,570 --> 00:04:14,490
+inflammatory process في الـ lung tissue زي ما
+
+68
+00:04:14,490 --> 00:04:18,940
+شرحناها في المحاضرة السابقة طيب Common respiratory
+
+69
+00:04:18,940 --> 00:04:22,340
+disorders، إيش أكثر؟ ما جبتش كل الـ respiratory
+
+70
+00:04:22,340 --> 00:04:26,560
+disorders، no، أنا قُلت common عشان ماحدش يقول أنّه
+
+71
+00:04:26,560 --> 00:04:30,680
+هاد اللي بتصيب فقط الـ respiratory system، لأ،
+
+72
+00:04:30,680 --> 00:04:33,880
+اليوم إحنا في كورونا، respiratory system problems،
+
+73
+00:04:33,880 --> 00:04:37,320
+ممكن يقول TB، respiratory problem، مش عارفين، حتى
+
+74
+00:04:37,320 --> 00:04:42,020
+بس أنا بنجيب بشكل عام إيش الشغلات اللي ممكن تؤثر و
+
+75
+00:04:42,020 --> 00:04:47,200
+تعمل عند المريض إشكالات في الجهاز التنفسي أول حاجة
+
+76
+00:04:47,200 --> 00:04:53,160
+الالتهاب الرئوي، شو الالتهاب الرئوي يعني؟ التهاب في أنسجة
+
+77
+00:04:53,160 --> 00:04:58,400
+وخلايا الرئتين طيب، الالتهاب الرئوي ده هل كل التهاب رئوي زي
+
+78
+00:04:58,400 --> 00:05:02,080
+بعض؟ لأ، في التهاب رئوي سُمّي community acquired
+
+79
+00:05:02,080 --> 00:05:05,120
+pneumonia، يعني جاي من إيش؟ جاي من community، من
+
+80
+00:05:05,120 --> 00:05:08,840
+المجتمع، من سكَنَه في مكان، جنبه في asbestos، جنبه
+
+81
+00:05:08,840 --> 00:05:11,660
+environmental مثلاً إيه الـ pollutants أو شغلات زي
+
+82
+00:05:11,660 --> 00:05:15,320
+ذلك، عملت عنده التهاب رئوي في ناس عندهم صارت للأسف cross
+
+83
+00:05:15,320 --> 00:05:18,300
+infection من وين؟ اللي بيسموها من وين؟ hospital
+
+84
+00:05:18,300 --> 00:05:21,200
+infection اللي هي hospital acquired pneumonia يعني
+
+85
+00:05:21,200 --> 00:05:23,420
+هو وكان كويس لكن اللي حواليه عندهم pneumonia عداه
+
+86
+00:05:23,420 --> 00:05:28,040
+ممكن إيه؟ جاي من بكتيريا ممكن يكون السبب في viruses
+
+87
+00:05:28,040 --> 00:05:31,120
+زي ما الآن موجود في كورونا coronavirus ممكن
+
+88
+00:05:31,120 --> 00:05:34,880
+mycoplasma وأنتم درستوا واحدة في إيه؟ كلكم درستوا
+
+89
+00:05:34,880 --> 00:05:37,540
+في الميكروبيولوجيا كل هذه الأنواع ممكن تكون فنجي
+
+90
+00:05:37,540 --> 00:05:41,760
+فطري ممكن تكون chemical شغل كيماوي زي إيش؟ كيمائي
+
+91
+00:05:41,760 --> 00:05:44,860
+زي بعض الناس اللي شغّالين في الأشياء اللي بتطلع عيش
+
+92
+00:05:44,860 --> 00:05:48,220
+روائح خاصة وفي مش بس كمان بتطلع روائح شديدة، حتى
+
+93
+00:05:48,220 --> 00:05:51,440
+مرات في خطأ، وكويس أني أذكركم في هذه الحلقة،
+
+94
+00:05:51,440 --> 00:05:54,660
+في بعض الستات في البيوت بروحوا مشكلتهم مشكلة،
+
+95
+00:05:54,660 --> 00:05:57,300
+بتروح بتجيب بدأت تنظّف البيت أو الحمام، أكرمكم الله
+
+96
+00:05:57,300 --> 00:06:00,970
+زيادة عن اللزوم، بتروح بتحط مية النار وبتحط معاها
+
+97
+00:06:00,970 --> 00:06:04,870
+كلور، يصير التفاعل بتطلع طبعاً offensive روائح
+
+98
+00:06:04,870 --> 00:06:08,430
+شديدة جداً ومن الحالات في كثير منهم أجوا صار عندهم
+
+99
+00:06:08,430 --> 00:06:12,450
+مش بس التهاب رئوي صار عندهم يعني dangerous خليني أقول مثلاً
+
+100
+00:06:12,450 --> 00:06:16,170
+shortness of breath صار عندهم سبب خطير ومش قادر
+
+101
+00:06:16,170 --> 00:06:18,830
+يتنفس ليش؟ لإنه بقى صار بتصير عندهم إيش حاجة
+
+102
+00:06:18,830 --> 00:06:22,410
+بيسموها air collapse وهذا أمر مش سهل كله من إيش؟
+
+103
+00:06:22,410 --> 00:06:26,590
+من الـ chemical، من التفاعلات اللي بتصير في الحمام
+
+104
+00:06:26,590 --> 00:06:28,850
+بدنا نلقي نظرة على الـ pleural effusion أنا بتكلم عن
+
+105
+00:06:28,850 --> 00:06:31,770
+إيه الـ common respiratory يعني أغلب الحالات اللي
+
+106
+00:06:31,770 --> 00:06:34,610
+بتيجي طبعاً من الحالات التانية اللي هي الـ
+
+107
+00:06:34,610 --> 00:06:38,370
+respiratory disorders pleural effusion وقُلنا إيش
+
+108
+00:06:38,370 --> 00:06:41,830
+معناها pleural effusion يعني في مُتَجَمّع في الـ pleural
+
+109
+00:06:41,830 --> 00:06:46,690
+إيش؟ fluid معناها تَجَمُّع سائل في منطقة الـ pleural
+
+110
+00:06:46,690 --> 00:06:50,370
+cavity فبقول إنها بتكون secondary ليش secondary؟
+
+111
+00:06:50,370 --> 00:06:55,210
+لما أقول كلمة secondary يعني في سبب خلىها تصير، لو
+
+112
+00:06:55,210 --> 00:06:59,330
+صارت الحالة بدون سبب بنسميها primary لكن لو صارت
+
+113
+00:06:59,330 --> 00:07:03,510
+ناتج عن سبب ثاني بنقول عنها secondary نحط مثال لكلمة
+
+114
+00:07:03,510 --> 00:07:06,650
+secondary هنا بيقول secondary to increased fluid
+
+115
+00:07:06,650 --> 00:07:12,050
+formation أنها بتصير مُسَاعِدة لتَجَمُّع سوائل هيجي زي كيف؟
+
+116
+00:07:12,050 --> 00:07:14,710
+زي واحد عنده congestive heart failure congestive
+
+117
+00:07:14,710 --> 00:07:17,370
+heart failure لما أقول كلمة congestive heart
+
+118
+00:07:17,370 --> 00:07:22,170
+failure معناها إيش؟ فشل في عضلة القلب مش قادر يضخّ
+
+119
+00:07:22,560 --> 00:07:26,420
+الدم كويس ومش قادر صار..صار الدم يرشّح منه السائل
+
+120
+00:07:26,420 --> 00:07:29,980
+الزيادة.. لما صار يرشّح كل ما يروح الدم على الرئتين
+
+121
+00:07:29,980 --> 00:07:34,060
+عشان يتنقّى صار إيش؟ يرشّح منه السائل..مش..
+
+122
+00:07:34,060 --> 00:07:36,800
+المشكلة مش من الرئة صارت..أجَتْنا المشكلة من
+
+123
+00:07:36,800 --> 00:07:39,840
+وراء من الـ heart..واحد step one مش من هنا..أجَتْنا
+
+124
+00:07:39,840 --> 00:07:43,720
+من برا..وهكذا..يعني في pleural effusion اتجمع
+
+125
+00:07:43,720 --> 00:07:47,540
+..increased.. إيش صار هنا؟ capillary permeability
+
+126
+00:07:47,540 --> 00:07:51,260
+بيصير اللي هو capillary كلكم عارفينها اللي هو اللي
+
+127
+00:07:51,260 --> 00:07:54,680
+هو الفتحات اللي موجودة في داخل اللي هو الشرايين
+
+128
+00:07:54,680 --> 00:07:58,640
+الدموية إيش صار فيها؟ زادت خاصة في الـ alveolar كذا
+
+129
+00:07:58,640 --> 00:08:02,460
+فبدأت تتسّرب صار يدخل فيها السائل أكثر increased
+
+130
+00:08:02,460 --> 00:08:06,800
+colloid osmotic pressure بيزيد الضغط الأسموزي كمان
+
+131
+00:08:06,800 --> 00:08:10,520
+في داخل إيش هنا؟ في داخل الـ blood ولما بيزيد ضغط
+
+132
+00:08:10,520 --> 00:08:15,350
+الأسموزي بيخلي إيش الـ إيش السائل يطلع منه أكثر زي
+
+133
+00:08:15,350 --> 00:08:17,490
+ليش؟ وأنتم عارفين هذه القصة أخذناها دائماً في
+
+134
+00:08:17,490 --> 00:08:20,390
+الكيمياء، أظن في الـ chemistry ممكن تكونوا أخذتوها، أنّه
+
+135
+00:08:20,390 --> 00:08:22,850
+بسبب ضغط الأسموزي عمالة بتصير عملية الرشح زي عملية
+
+136
+00:08:22,850 --> 00:08:25,790
+الحرق لما بيصير إنسان بنحرقه، فبتلاقي بيطلع منه
+
+137
+00:08:25,790 --> 00:08:29,550
+surface fluid وبتتجمع حوالي الـ skin. Increased
+
+138
+00:08:29,550 --> 00:08:33,130
+إيه هنا؟ Intra pleural negative pressure. Intra
+
+139
+00:08:33,130 --> 00:08:37,330
+pleural negative pressure اللي هو الضغط السلبي، بيزيد. لما
+
+140
+00:08:37,330 --> 00:08:40,710
+نزيد الضغط السلبي، بيسحب، ليش؟ يعني الضغط السلبي زي
+
+141
+00:08:40,710 --> 00:08:44,270
+الـ vacuum، زي اللي بشفط؟ ليش زمان كانوا يقولون أنّه
+
+142
+00:08:44,270 --> 00:08:49,590
+لما واحد بياخد سكينة أو بينضرب بشيء يعني مُؤذِي زي
+
+143
+00:08:49,590 --> 00:08:53,510
+stab wound أو سيخ أو كده، إيش بنقول لهم؟ خلي الإبرة
+
+144
+00:08:53,510 --> 00:08:57,590
+في مكانها، ليه؟ علشان أنا ما بدي إذا سحبنا الإبرة
+
+145
+00:08:57,590 --> 00:09:00,870
+من منطقة الصدر، هيدخل الهواء يعمل لنا حاجة اسمها
+
+146
+00:09:00,870 --> 00:09:04,420
+pneumothorax ليه؟ لأنه مليان negative pressure في
+
+147
+00:09:04,420 --> 00:09:08,160
+داخل الـ chest من جوا مغلق، عشانك إذا.. بكرة نروح
+
+148
+00:09:08,160 --> 00:09:13,020
+المستشفى إن شاء الله يعني ونتدرب هنلاقي في حاجة
+
+149
+00:09:13,020 --> 00:09:17,380
+بيسموها الـ chest tube إن هو بنحطها في صدر المريض و
+
+150
+00:09:17,380 --> 00:09:22,940
+بتروح تدخل على bottle زي وعاء زي..يعني خليني أقول
+
+151
+00:09:22,940 --> 00:09:28,260
+مرتبان زجاجي عشان تقدر تأخذ السوائل من جوا كشيء
+
+152
+00:09:28,260 --> 00:09:31,100
+مغلق ليش هذا الكلام؟ لأن الـ negative pressure
+
+153
+00:09:31,100 --> 00:09:34,780
+بيسحب أي شيء فلما بيزيد الـ negative pressure بيروح
+
+154
+00:09:34,780 --> 00:09:38,620
+بيسحب السوائل في داخل البلورة الكَفْتِي فبيصير بتتجمع
+
+155
+00:09:38,620 --> 00:09:43,540
+أكثر وبيصير عنده إشكالية أكبر صحية impaired
+
+156
+00:09:43,540 --> 00:09:46,720
+lymphatic drainage كمان الـ lymphatic drainage
+
+157
+00:09:46,720 --> 00:09:49,060
+وأنتوا عارفين الـ lymphatic system يعني نعتبره جهاز
+
+158
+00:09:49,060 --> 00:09:53,950
+مُنَاعِي وهي يعني بتعتبر التصريف العام للـ artery فبيصير
+
+159
+00:09:53,950 --> 00:09:57,590
+كمان إيش؟ الـ drainage بتاعها بيزيد ليش بيزيد كمان؟ ما
+
+160
+00:09:57,590 --> 00:10:00,950
+هو كله ماشي مع الـ inflammatory process أو حتى
+
+161
+00:10:00,950 --> 00:10:07,610
+dangerous process أو حتى يعني trauma أيًا كان فيه
+
+162
+00:10:07,610 --> 00:10:11,710
+مشكلة فبيصير إيش عامل؟ فبيصير يطلع أكثر كل ما طلع
+
+163
+00:10:11,710 --> 00:10:15,150
+الدم أكثر ما يرشّح منه أكثر إيش اللي هو السائل اللي
+
+164
+00:10:15,150 --> 00:10:19,710
+فيه جواه increased pressure in the capillaries بيزيد
+
+165
+00:10:19,710 --> 00:10:23,230
+الضغط وين؟ في الـ capillaries الشعيرات الدموية ولما
+
+166
+00:10:23,230 --> 00:10:25,390
+زاد في الشعيرات الدموية والـ lymphatics زي نفس
+
+167
+00:10:25,390 --> 00:10:29,050
+الكلام بيزيد إيش بيصير؟ فبيصير يتسرب منه السائل أكثر
+
+168
+00:10:29,050 --> 00:10:33,710
+طيب نيجي لمشكلة ثالثة ومشكلة خطيرة كثير وبرضه
+
+169
+00:10:33,710 --> 00:10:38,250
+بتعتبر حتى عندنا بيسموها من الـ medical emergency
+
+170
+00:10:38,250 --> 00:10:41,850
+بتعتبر حاجة اسمها medical emergency يعني يجب التدخل
+
+171
+00:10:41,850 --> 00:10:46,170
+فوراً حتى لو بندخله على جهاز تنفس صناعي طب ليه؟
+
+172
+00:10:46,170 --> 00:10:49,100
+هنيجي نقول لكم pneumothorax يعني بدل ما يتجمع
+
+173
+00:10:49,100 --> 00:10:52,940
+fluid اتجمع إيش؟ هواء جاي من الـ pneumo sudden onset
+
+174
+00:10:52,940 --> 00:10:57
+
+223
+00:14:04,030 --> 00:14:06,850
+ما يقولونه underwater seal تحت المرتبان هذا عشان
+
+224
+00:14:06,850 --> 00:14:10,210
+يصحى اللي هو الهواء الزائد عشان ما يضغطش على
+
+225
+00:14:10,210 --> 00:14:16,050
+الريقتين أكثر طيب اللي بعده اسمه pulmonary embolism
+
+226
+00:14:16,050 --> 00:14:19,550
+كلكم عارفين شو معنى embolism؟ هذكركم بس بكلمتين
+
+227
+00:14:19,550 --> 00:14:23,030
+أنه إيش الفرق بين .. إيش؟ بين ال thrombus و ال
+
+228
+00:14:23,030 --> 00:14:25,870
+embolus أكيد أنتم عارفينها، لكن من ببتد ..
+
+229
+00:14:25,870 --> 00:14:32,090
+thrombus هي نفس يعني لو بدنا نيجي بالوصف العام هي
+
+230
+00:14:32,090 --> 00:14:35,330
+نفس ال embolus لكن ال thrombus بتصير غالباً وين؟
+
+231
+00:14:35,330 --> 00:14:38,350
+غالباً بتصير في ال veins، في الأوردة، بالنسبة بقى
+
+232
+00:14:38,350 --> 00:14:41,890
+بنقول DVT، يعني ده إيش عن DVD؟ Deep Vein
+
+233
+00:14:41,890 --> 00:14:46,350
+Thrombosis طيب متى بتتحول ل embolism؟ بتتحول ل
+
+234
+00:14:46,350 --> 00:14:50,220
+embolism إذا اتحركت ومشت؟ ولما تخرج ما أحد يقول لي
+
+235
+00:14:50,220 --> 00:14:54,340
+طيب أن هو ال veins شغلات لحال و ال arteries لحال لأ
+
+236
+00:14:54,340 --> 00:14:59,320
+في الآخر هذا مش network كلها مع بعض، شبكة، بتنتهي ال
+
+237
+00:14:59,320 --> 00:15:01,920
+veins بتبدأ ال arteries بتنتهي ال arteries بتبدأ
+
+238
+00:15:01,920 --> 00:15:05,860
+ال veins وهكذا يعني نهايات الأطراف لل veins و ال
+
+239
+00:15:05,860 --> 00:15:09,860
+arteries بتكون اللي هو arterioles و venules بتشتغل
+
+240
+00:15:09,860 --> 00:15:13,220
+مع بعض واللي هكذا بتكون ما أحد يتخيل أنه كأنه
+
+241
+00:15:13,220 --> 00:15:17,600
+مواصير كل حاجة لحال لأ، فإيش بيصير هنا؟ Pulmonary
+
+242
+00:15:17,600 --> 00:15:21,220
+embolism طبعاً من القلب برضه تعتبر هذا top .. top
+
+243
+00:15:21,220 --> 00:15:25,380
+ها emergency وممكن نُتدخل فوراً وإذا
+
+244
+00:15:25,380 --> 00:15:28,160
+ما قدرناش نلحق المرض ممكن يموت، اللي عنده إيه؟
+
+245
+00:15:28,160 --> 00:15:30,880
+Pulmonary embolism خاصة في الـ pulmonary arteries
+
+246
+00:15:30,880 --> 00:15:34,760
+يعني وين؟ في الشريان اللي هو الرئة الأساسي صار فيه
+
+247
+00:15:34,760 --> 00:15:39,140
+عملية إيه؟ أنه راحت اللي هو ال deep vein هي ال DVT
+
+248
+00:15:39,140 --> 00:15:42,620
+ال deep vein thrombosis وزداله سرح ماشي في بعض الناس
+
+249
+00:15:42,620 --> 00:15:47,510
+بتروح على الشريان اللي عند المخ، ما نسميهوش DVD، بنسميه
+
+250
+00:15:47,510 --> 00:15:51,450
+CVA، بنقول عنده جلطة دماغية، في بعضها بتمشي بتمشي
+
+251
+00:15:51,450 --> 00:15:54,890
+بتقف عند شرايين القلب، اللي هي الشرايين التاجية،
+
+252
+00:15:54,890 --> 00:15:58,410
+بنقول عنده myocardial infarction، وينمشت ووقفت
+
+253
+00:15:58,410 --> 00:16:02,890
+يسمى التشخيص بناءً على وقوفه في هذا المكان، طيب،
+
+254
+00:16:02,890 --> 00:16:08,450
+بقول هنا traveled سافرت، lodged واستقرت في وين؟ في
+
+255
+00:16:08,450 --> 00:16:11,230
+الرئة، ال pulmonary artery، يبقى واقفة هنا عملت لي حاجة زي ما
+
+256
+00:16:11,230 --> 00:16:14,430
+ال pulmonary embolism، ما زالت واقفة في هذا المكان، يبقى
+
+257
+00:16:14,430 --> 00:16:17,790
+المنطق اللي بعدها هتموت، هيحصل فيها عملية cyanosis و
+
+258
+00:16:17,790 --> 00:16:20,810
+عملية يعني للأسف death of tissue لأنه بيبقى ما يوصلوش
+
+259
+00:16:20,810 --> 00:16:25,370
+الهواء الطبيعي وال oxygen، severity الحدة تبعها و
+
+260
+00:16:25,370 --> 00:16:29,230
+خطورتها depends on the extent، قد إيش درجة الإغلاق يعني
+
+261
+00:16:29,230 --> 00:16:32,910
+قد إيش أنا بحكم أنه خطير أو مش خطير، وين الشريان
+
+262
+00:16:32,910 --> 00:16:36,190
+بالضبط، في أوله وفي وسطه وفي آخره اللي صار فيه
+
+263
+00:16:36,190 --> 00:16:40,370
+إغلاق، mismatch of ventilation and perfusion بيصير
+
+264
+00:16:40,370 --> 00:16:44,830
+للأسف، ventilation بيصير mismatch، يعني بتتداخل الحالتين
+
+265
+00:16:44,830 --> 00:16:47,830
+مع بعض، اللي إحنا مش عارفين ال ventilation التهوية
+
+266
+00:16:47,830 --> 00:16:51,490
+مع ال perfusion، عملية كمان اللي هو إيش؟ اللي هو
+
+267
+00:16:51,490 --> 00:16:55,750
+التبادل بين الغازات، عملية اللي هو ال exchange
+
+268
+00:16:55,750 --> 00:16:58,930
+اللي بيصير من ناحية طبيعية، هنا إيش جالي؟ mismatch
+
+269
+00:16:58,930 --> 00:17:05,580
+يعني بيدخل في شرايين الرئة في إشكالية، مش قادر
+
+270
+00:17:05,580 --> 00:17:09,620
+يسيطر، لأنه صار فيه closure،  البدي يحاول يعمل الجسم حاجة
+
+271
+00:17:09,620 --> 00:17:12,800
+تسمى compensatory mechanism، وإذا لم يستطع طبعاً
+
+272
+00:17:12,800 --> 00:17:15,500
+إحنا بدنا نضطر ندخل لأنه مش سهل أنه يترك المرض
+
+273
+00:17:15,500 --> 00:17:20,100
+لوحده طبعاً، كيف بدنا نقدر نشخصه؟ مش سهل تشخيصه، ممكن
+
+274
+00:17:20,100 --> 00:17:24,100
+يكون الشريان اللي أغلق بسيط جداً جداً ومش قادر أطول
+
+275
+00:17:24,100 --> 00:17:27,680
+شو بعمله؟ بعمله حاجة تسمى pulmonary angiogram، لما
+
+276
+00:17:27,680 --> 00:17:32,620
+نقول كلمة angiogram يعني صورة ملونة، angiogram
+
+277
+00:17:32,620 --> 00:17:37,080
+أنجيوغرام، في صبغة، gram، الآن هالجهاز أنجيوغرام ال .. ال ..
+
+278
+00:17:37,080 --> 00:17:39,200
+ال .. ال .. vessels يعني ال blood vessels و gram
+
+279
+00:17:39,200 --> 00:17:42,980
+اللي هو المادة الملونة، فبصبغ في .. نسمع يقولوا
+
+280
+00:17:42,980 --> 00:17:48,040
+الله عملوا له صورة CT ملونة أو صورة رنين ملون، فبتظل
+
+281
+00:17:48,040 --> 00:17:51,820
+ماشية، بتنصبغ المكان المغلق وبيّن لي إيش المكان
+
+282
+00:17:51,820 --> 00:17:55,300
+اللي فيه، إيش المشكلة، تبقى عرفنا مين المشكلة هذه
+
+283
+00:17:55,300 --> 00:17:57,880
+سبحان الله، الصورة واضحة جداً وبطريقة يعني بتعرف
+
+284
+00:17:57,880 --> 00:18:01,940
+إيش مشكلتها، يعني مثلاً أنا لقيتها، لو تخيلنا هي
+
+285
+00:18:01,940 --> 00:18:06,000
+بيقول لي مثلاً multiple emboli in small branches، في
+
+286
+00:18:06,000 --> 00:18:10,140
+emboli صغيرة هنا وهنا وهنا موجودة، لاحظين أنه
+
+287
+00:18:10,140 --> 00:18:14,660
+اللون اللي هنا أشماله لون طبيعي، اللون كله مرتب
+
+288
+00:18:14,660 --> 00:18:18,550
+وحتى هنا النهايات كلها مرتبة، لكن لو لاحظنا هنا في
+
+289
+00:18:18,550 --> 00:18:21,910
+شوياتها، in polysmol، في ال branches of left
+
+290
+00:18:21,910 --> 00:18:25,950
+pulmonary artery، هنا في شوية مسكرة مع الصبغة بيرد
+
+291
+00:18:25,950 --> 00:18:29,270
+وهنا مع الصبغة بيرد، هنا أكثر من عدد خمسة لو
+
+292
+00:18:29,270 --> 00:18:32,090
+لاحظنا، طيب بداية الإنسداد اللي بعدها إيش صار فيها؟
+
+293
+00:18:32,090 --> 00:18:36,130
+بدأت تزرق، لاحظين كيف بدأت تزرق؟ لو تركناها شوية
+
+294
+00:18:36,130 --> 00:18:38,570
+ازرقاق، إيش بيصير فيها؟ gangrene، خلاص بتموت، إيش
+
+295
+00:18:38,570 --> 00:18:41,330
+بيعملوا؟ بيعملوا عملية بيقصوها هذا المكان، طبعاً مش
+
+296
+00:18:41,330 --> 00:18:45,200
+بس، هنا بتجيب الخطورة، ممكن يعلم، إذا تركنا واحد
+
+297
+00:18:45,200 --> 00:18:49,600
+يقول لي أنه هل بنتقل؟ آه، بنتقل، ممكن إيش؟ تبدأ هي ال
+
+298
+00:18:49,600 --> 00:18:53,060
+lung tissue بعدين تستقر، طيب لو اجت تسكير في مكان
+
+299
+00:18:53,060 --> 00:18:56,500
+أجواء زي إيه؟ هي كتبت لي هنا في ال right pulmonary
+
+300
+00:18:56,500 --> 00:18:59,380
+artery الأساسي، لو اجت في ال pulmonary artery
+
+301
+00:18:59,380 --> 00:19:03,700
+الأساسي، لاحظوا إيش صار؟ سكر هذا، كل الشجرة ماتت
+
+302
+00:19:03,700 --> 00:19:07,000
+اللي بعدها، إيش صار في ال lung tissue هنا؟ صار لونها
+
+303
+00:19:07,000 --> 00:19:10,800
+إيش؟ أزرق، ما هو أسود، حتى أسود ليه؟ لأنه خلاص
+
+304
+00:19:11,210 --> 00:19:14,530
+مزرق أسود، يبقى صار فيه gangrene هنا، و بده تدخل
+
+305
+00:19:14,530 --> 00:19:20,930
+عشانك مبينش إلا في التصوير الملون، طيب COPD قد إيش؟
+
+306
+00:19:20,930 --> 00:19:23,370
+كتير مدعوة كمان مرة اسمها chronic obstructive
+
+307
+00:19:23,370 --> 00:19:26,870
+pulmonary disease، إيش هذا؟ مرض مزمن، history of
+
+308
+00:19:26,870 --> 00:19:31,050
+exposure، إيه ال risk factors؟ إيش ال risk factors؟
+
+309
+00:19:31,050 --> 00:19:33,890
+في حاجة بيسموها الممرضات، comorbidities، كممرضات
+
+310
+00:19:33,890 --> 00:19:37,940
+يعني في شغلات ساعدته على الإصابة، في بعضهم عنده مثلاً
+
+311
+00:19:37,940 --> 00:19:41,880
+يعني فيه current مثلاً medical treatments، لاحظوا
+
+312
+00:19:41,880 --> 00:19:45,840
+أنه في بعض يعني في بعض العلاجات زي ال beta blockers
+
+313
+00:19:45,840 --> 00:19:48,360
+ومكرات بتاخدوها أكيد، يمكن اخذتوها في ال
+
+314
+00:19:48,360 --> 00:19:51,880
+pharmacology، اللي هو فيه أن ال beta blockers وفيه
+
+315
+00:19:51,880 --> 00:19:54,960
+alpha blockers وفيه ال beta طبعاً selective و non
+
+316
+00:19:54,960 --> 00:19:59,580
+selective، هتاخدوها مع الدكتور، الأدوية بتبين لنا إنه
+
+317
+00:19:59,580 --> 00:20:03,280
+إيه؟ يعني إيش؟ لأنه في بعض إحنا بناخد علاجات بتروح
+
+318
+00:20:03,280 --> 00:20:05,420
+ال beta cells اللي موجودة في ال heart، بتوقفها
+
+319
+00:20:05,420 --> 00:20:09,900
+لأن خاصة زي ال adrenaline مثلاً زي ال normetan، بكرة هتسمعوا
+
+320
+00:20:09,900 --> 00:20:13,460
+عنها، الدواءين لأنه أكتر دوايين مستخدمين as beta
+
+321
+00:20:13,460 --> 00:20:16,900
+blockers، لاحظوا أن دول الشغلات ممكن تتعمل برضه
+
+322
+00:20:16,900 --> 00:20:20,820
+COPD طبعاً، زي مين هم ال COPD؟ بيكون عندهم أزمة
+
+323
+00:20:20,820 --> 00:20:24,240
+chronic bronchitis، chronic bronchitis، كل على بعض
+
+324
+00:20:24,240 --> 00:20:27,880
+هذا متلازمة، فسموها chronic obstructive pulmonary
+
+325
+00:20:27,880 --> 00:20:32,400
+disease، ما نسميهوش مرض، دائماً لما يكون أكثر من مرض في
+
+326
+00:20:32,400 --> 00:20:35,920
+نفس الحالة بنسميها إيش؟ syndrome، أو بنسميها معضلة
+
+327
+00:20:35,920 --> 00:20:40,200
+طيب إيش بنعمل test له؟ هذاك عملنا له إيه؟ بيعملوا
+
+328
+00:20:40,200 --> 00:20:42,260
+serum لغوا؟ أنا لأ، أنا بعمل له حاجة اسمها
+
+329
+00:20:42,260 --> 00:20:47,200
+spirometry، spirometry، اسمه جهاز فحص إيش؟ اللي هو
+
+330
+00:20:47,200 --> 00:20:50,640
+قوة .. قوة النفس، موجود عند كل الأطباء الأخصائيين
+
+331
+00:20:51,060 --> 00:20:54,160
+بيجي بِخليه يتنفس في جهاز، الجهاز هذا إيه؟ اللي هو
+
+332
+00:20:54,160 --> 00:20:58,380
+زي بربيش بيمسكه في الفم وبيضغط فيه وبياخد نفس و
+
+333
+00:20:58,380 --> 00:21:02,180
+بيضغط، بياخد نفس وبيضغط عشان يقدر يعرف أنه هل في
+
+334
+00:21:02,180 --> 00:21:04,600
+مشكلة، ولا نفس اللي بيعبرش كويس ولا نفس اللي بيطلعش
+
+335
+00:21:04,600 --> 00:21:09,260
+طبعاً كمان مهم كتير أنه يعملوا ABGs، الاختصار
+
+336
+00:21:09,260 --> 00:21:13,300
+العالمي، arterial blood gases، يعني إيش؟ فحص اللي هو
+
+337
+00:21:13,300 --> 00:21:17,080
+إيش ال gases اللي موجودة في دم ال artery، زي ال
+
+338
+00:21:17,080 --> 00:21:22,420
+oxygen، وزي مثلاً انخفاض الكربون، وزي مثلاً ال
+
+339
+00:21:22,420 --> 00:21:26,660
+بيكربونات الصوديوم كمان، كل هذا عشان نعرف وين رايح
+
+340
+00:21:26,660 --> 00:21:30,620
+المريض بالضبط، إذا عالي ال CO2 مصيبة، إذا ناقص ال
+
+341
+00:21:30,620 --> 00:21:34,740
+oxygen مصيبة، إذا مثلاً ال CO3 مثلاً زادت كمان، ال
+
+342
+00:21:34,740 --> 00:21:37,860
+بيكربونات برضه مشكلة، كل حاجة لها حل بناءً على
+
+343
+00:21:37,860 --> 00:21:41,460
+التشخيص اللي بيطلع، طيب إيش بنعمل management؟
+
+344
+00:21:41,460 --> 00:21:45,100
+بنعطيه Oxygen، بدنا نعطيه Oxygen،  إن نعطيه  
+
+345
+00:21:45,100 --> 00:21:49,200
+تعليمات، أنه لازم يعرف أنه تحت الضغط ولما نحط
+
+346
+00:21:49,200 --> 00:21:51,540
+الـ oxygen، يظلوا ياخدوا
+
+347
+00:21:51,540 --> 00:21:54,120
+النفس، ما يظلوش يرفعوا زيّه، للأسف في بعض الناس
+
+348
+00:21:54,120 --> 00:21:56,780
+ما بياخدوش تعليمات كويسة في حياتهم، فبيزيد المرض
+
+349
+00:21:56,780 --> 00:22:00,400
+عندهم أكتر، وخطورة وبنعطيهم طبعاً علاجات أخرى حسب
+
+350
+00:22:00,400 --> 00:22:04,280
+الطبيب الأخصائي، ومن ناحية التغذية طبعاً بنزود كمية
+
+351
+00:22:04,280 --> 00:22:08,120
+البروتين عشان بدنا نعطيه مقاومة للجسم، بنخليه يعمل
+
+352
+00:22:08,120 --> 00:22:13,360
+شوية exercise وخاصة التمارين اللي علاقة بالتنفس، شهيق
+
+353
+00:22:13,360 --> 00:22:17,000
+زفير، تمارين صباحية، وفي الآخر إذا لا سمح الله قاسى،
+
+354
+00:22:17,000 --> 00:22:20,760
+بدنا ندخل جراحياً، لأنه ما نقدرش نخلي المريض زي ما هو،
+
+355
+00:22:20,760 --> 00:22:25,420
+لأ، هتموت الخلايا، طيب، من ال common
+
+356
+00:22:25,420 --> 00:22:29,180
+كمان، الرئيس ماردري، سبب للأزمة لحاله، كلكم عارفين
+
+357
+00:22:29,180 --> 00:22:32,380
+أزمة، أزمة يعني، أزمة من اسمها، طبعاً هي عبارة عن
+
+358
+00:22:32,380 --> 00:22:34,820
+chronic inflammatory disease اللي بيصير في ال
+
+359
+00:22:34,820 --> 00:22:38,760
+airway، هي عبارة عن يعني التهاب،  بخليني أقول مزمن
+
+360
+00:22:38,760 --> 00:22:42,940
+ومرض مزمن في مجاري الهواء اللي في الجهاز التنفسي
+
+361
+00:22:42,940 --> 00:22:46,480
+طبعاً إيش بيصير عندهم دول؟ ال hypersensitiveness؟ إيش
+
+362
+00:22:46,480 --> 00:22:48,780
+يعني ال hypersensitiveness؟ إنه بيصير عندهم
+
+363
+00:22:48,780 --> 00:22:53,800
+الاستجابة يعني فيه كثير منهم استجابتهم لأي شيء
+
+364
+00:22:53,800 --> 00:22:57,580
+بيعمل حساسية بيكون أكثر من الناس الطبيعيين، في ناس
+
+365
+00:22:57,580 --> 00:23:00,320
+بيقول لك جات معايا أزمة من العطر، صارت معايا أزمة
+
+366
+00:23:00,320 --> 00:23:06,260
+من ريحة الغاز، ريحة الطبيخ، ريحة المجلّات، من
+
+367
+00:23:06,260 --> 00:23:10,780
+الغبار، من الأشجار، من الحبوب اللقاح، أيّاً كان،
+
+368
+00:23:10,780 --> 00:23:14,940
+هذول عندهم استجابة حساسة، hyper responsiveness،
+
+369
+00:23:14,940 --> 00:23:18,420
+عندهم يعني حساسية أكثر للاستجابة من الناس الطبيعيين
+
+370
+00:23:19,020 --> 00:23:22,560
+طبعاً في بعضهم بيكون عندهم يعني airway obstruction
+
+371
+00:23:22,560 --> 00:23:25,740
+مش كلهم، هي عشان كده variable، يعني مختلفة، مش الكل
+
+372
+00:23:25,740 --> 00:23:30,620
+طبعاً بيقول لي ها أنا الأزمة وضيق النفس، بيقول لي
+
+373
+00:23:30,620 --> 00:23:34,960
+resolve spontaneously، يعني ممكن تلقائياً يخف مع
+
+374
+00:23:34,960 --> 00:23:37,900
+إيش؟ لما نعطيه حاجة اسمها bronchodilator، إيش
+
+375
+00:23:37,900 --> 00:23:42,580
+bronchodilator؟ لما نعطيه فاتح لمجاري التنفس، زي إيش
+
+376
+00:23:42,580 --> 00:23:46,190
+فاتح لقنوات التنفس؟ زي علاج مثلاً ال Ventolin، أكيد
+
+377
+00:23:46,190 --> 00:23:48,930
+سمعته عنه وهتسمعوه كتير، في Ventolin، في
+
+378
+00:23:48,930 --> 00:23:52,490
+Terbutaline، في Aerovent، أدوية بتستخدم ال
+
+379
+00:23:52,490 --> 00:23:55,350
+bronchodilator، وفي كمان بعضهم بيستخدم ال
+
+380
+00:23:55,350 --> 00:23:59,730
+adrenaline عشان يوسع قنوات النفس، طيب كيف بدي أنا
+
+381
+00:23:59,730 --> 00:24:02,490
+أقدر أعرف أن هذا أزمة وهذا مش أزمة؟ بعض الناس
+
+382
+00:24:02,490 --> 00:24:05,630
+بيقول لك طب أنا عندي ضيق نفس، هل أنا عندي أزمة؟ لأ،
+
+383
+00:24:05,630 --> 00:24:08,670
+بنعمل spirometry، بنجيزه على جهاز التنفس اللي موجود
+
+384
+00:24:08,670 --> 00:24:11,680
+عند الطبيب الأخصائي، اللي هو ال spirometry، و
+
+385
+00:24:11,680 --> 00:24:14,740
+بعدين بنعمل له pulmonary function testing، برضه فحص
+
+386
+00:24:14,740 --> 00:24:17,840
+لإيش؟ لكفاءة الرئتين، وهذا اللي بيعملوا الطبيب
+
+387
+00:24:17,840 --> 00:24:21,280
+الأخصائي، إحنا كويس إحنا للمعرفة، ما يجي واحد يقول طب
+
+388
+00:24:21,280 --> 00:24:24,820
+يا ده أستاذ ويا دكتور، هذه شغلات طبية، حتى لو كانت
+
+389
+00:24:24,820 --> 00:24:29,060
+طبية، يعني الحكمة ضالة المؤمن، أو كما قرر النبي صلى الله عليه وسلم،
+
+390
+00:24:29,060 --> 00:24:31,690
+إن ما وجدته هو
+
+391
+00:24
+
+445
+00:27:48,830 --> 00:27:51,650
+التانين بيعمل إيه؟ إيش خطورته؟ و وين بتصير؟
+
+446
+00:27:51,650 --> 00:27:53,590
+respiratory failure اللي هو عندك هذا بتودّي لشوية
+
+447
+00:27:53,590 --> 00:27:56,910
+معظم الناس اللي بيموتوا، عشان يكون عندكم علم، بيموتوا
+
+448
+00:27:56,910 --> 00:28:01,890
+من الـ .. الـ .. الكانون والفحم، أو يعني في حالات كتيرة
+
+449
+00:28:01,890 --> 00:28:06,910
+أخرى، يعني لو كان طبيب يعني أو هو يعني من خارج
+
+450
+00:28:06,910 --> 00:28:09,710
+الـ health professionals، يعني من المتخصصين الصحيين
+
+451
+00:28:09,710 --> 00:28:14,190
+كان فاتح الـ motor اللي تبع المولد الكهربائي، الـ motor
+
+452
+00:28:14,190 --> 00:28:17,900
+الصغير، حاطّه في داخل صيدلية، وعمّاله بيشتغل، الموتور
+
+453
+00:28:17,900 --> 00:28:20,160
+عمّاله بيطلع عنه دخان، بيطلع دخان وهو بيشتغل، ما فيش
+
+454
+00:28:20,160 --> 00:28:25,140
+شيء مكان يطلع منه برا، فكل المكان في الصيدلية انْتَلا أو
+
+455
+00:28:25,140 --> 00:28:29,040
+رَكْسِيل كربون، ما بيحسّش، ماحدش يقول لي إنه طب ما انتبهش
+
+456
+00:28:29,040 --> 00:28:31,760
+لحاله، لأ، ما انتبهش، silent killer، هذا يُعتبر من
+
+457
+00:28:31,760 --> 00:28:35,370
+القاتل الصامت، بتشبّع الـ oxygen .. ها بتشبّع الـ
+
+458
+00:28:35,370 --> 00:28:39,030
+oxygen  بيروح للأنسجة، وبتشبّع الدم .. الدم بتتشبّع بالـ
+
+459
+00:28:39,030 --> 00:28:42,430
+إيه؟ بثاني أكسيد الكربون، فبدل ما يُودّع خلايا الـ
+
+460
+00:28:42,430 --> 00:28:45,150
+oxygen، يُودّع ثاني أكسيد الكربون، فعمل respiratory
+
+461
+00:28:45,150 --> 00:28:48,830
+failure، بتؤدي للوفاة، هذا اسمه acute hypercapnic من
+
+462
+00:28:48,830 --> 00:28:53,890
+الكانون، من البنزين لما بنحرقه، جنبه من الحرائق بشكل
+
+463
+00:28:53,890 --> 00:28:56,870
+عام، لما بنخنقه، كتير من الناس بيقول لك ما ماتوش من
+
+464
+00:28:56,870 --> 00:28:59,310
+الحريق، ماتوا من الخنق من الحريق، وهذا اللي بيصير
+
+465
+00:28:59,310 --> 00:29:03,270
+type 3 combined، إيش يعني combined؟ بيكون مُشترك، بيكون
+
+466
+00:29:03,270 --> 00:29:06,890
+عنده hypoxemia وعنده hypercapnia، يعني عنده نقص
+
+467
+00:29:06,890 --> 00:29:10,930
+أكسجين، وزيادة فيه ثاني أكسيد الكربون، يبقى معناته إما
+
+468
+00:29:10,930 --> 00:29:14,730
+ما فيش أكسجين، وإما ثاني أكسيد الكربون زاد، وإما مُشترك
+
+469
+00:29:14,730 --> 00:29:18,450
+الاثنين مع بعض، طبعًا الثلاثة على بعض مصيبة، وبيعملوا
+
+470
+00:29:18,450 --> 00:29:21,030
+respiratory failure، وممكن تؤدي للوفاة إذا ما
+
+471
+00:29:21,030 --> 00:29:25,300
+تُلحقناهوش مباشرة، ودخوله للمستشفى، التست هنا بنعمله
+
+472
+00:29:25,300 --> 00:29:28,180
+arterial blood gases، فجأة بنتفاجأ بنلاقي الـ
+
+473
+00:29:28,180 --> 00:29:31,840
+carbon dioxide زايد جدًا جدًا، والـ oxygen قليل، و
+
+474
+00:29:31,840 --> 00:29:35,920
+هذا مصيبة، بنعمل chest x-ray، بيبين إيش إن العلامات
+
+475
+00:29:35,920 --> 00:29:40,220
+ممكن تكون ماتت بعض الخلايا في الـ lung، وبيبين إن
+
+476
+00:29:40,220 --> 00:29:44,240
+صار اللون ميل للون الأبيض، وده الأسود، بنعمل CT الـ
+
+477
+00:29:44,240 --> 00:29:46,900
+computerized tomography، اللي صورة .. الصورة اللي
+
+478
+00:29:46,900 --> 00:29:51,360
+هي المقطعية، اللي تحت الـ computer، كلكم عارفين هذا
+
+479
+00:29:51,360 --> 00:29:54,930
+المُصطلح، لأن كتير ناس عاديين بيعرفوه، بنعمل حاجة
+
+480
+00:29:54,930 --> 00:29:58,050
+تُسمّى thorough synthesis، thorough synthesis، يعني
+
+481
+00:29:58,050 --> 00:30:03,550
+بنحط له tube عشان نسحب منه إذا .. بنحط الـ tube في
+
+482
+00:30:03,550 --> 00:30:06,910
+منطقة الـ chest عشان نسحب إذا صار شيء، أو اللي
+
+483
+00:30:06,910 --> 00:30:10,730
+في الـ pleural، شيء مُعيّن، سواء كانت الـ fluid، سواء كانت
+
+484
+00:30:10,730 --> 00:30:15,030
+blood، سواء كانت أي شيء من الخارج، أو حتى لو كان فيه
+
+485
+00:30:15,030 --> 00:30:18,930
+هواء، أقدر أسحب، طب إيش بدي أعمله في هذه الحالة؟ أول
+
+486
+00:30:18,930 --> 00:30:22,330
+حاجة بدك تصلّح الـ gases اللي موجودة، الخربطة اللي صارت
+
+487
+00:30:22,330 --> 00:30:25,630
+كيف بتصلّحها؟ بدخله على أكسجين، ترابيز، مش أكسجين
+
+488
+00:30:25,630 --> 00:30:29,430
+عادي، لأ، endotracheal tube، بدخله على ventilation
+
+489
+00:30:29,430 --> 00:30:32,390
+اللي هو الـ ventilator، الـ machine، طبعًا الـ machine، و
+
+490
+00:30:32,390 --> 00:30:36,270
+بخليه يتنفس طبعًا عليه، عشان نقدر نحط الأكسجين
+
+491
+00:30:36,270 --> 00:30:38,450
+اللي بدنا إياه، والـ .. والنسب اللي بدنا إياها عشان
+
+492
+00:30:38,450 --> 00:30:40,550
+تتحسّن، اللي هو النسب اللي موجودة في الـ arterial
+
+493
+00:30:40,550 --> 00:30:44,810
+blood gases، بعدين بنشوف حاجة تُسمّى reversal of any
+
+494
+00:30:44,810 --> 00:30:49,760
+narcotics، طبعًا لما أقول كلمة reversal of any
+
+495
+00:30:49,760 --> 00:30:53,980
+narcotics، يعني بدنا نحاول قدر الإمكان، لأن هذا بيكون
+
+496
+00:30:53,980 --> 00:30:58,360
+عنده غيبوبة، فبدنا نحاول لما نعطيه narcotics يعني
+
+497
+00:30:58,360 --> 00:31:01,760
+العلاجات اللي علاقة بالإيش؟ زي ما أخذنا اللي علاقة
+
+498
+00:31:01,760 --> 00:31:07,140
+بالـ .. زي الـ narcotine، زي الـ opioid، يعني بشكل عام
+
+499
+00:31:07,140 --> 00:31:09,840
+إحنا بنقول عن المخدرات، مش هقول كلمة مخدرات عشان
+
+500
+00:31:09,840 --> 00:31:14,560
+أنا تردّدت أحكيها، يعني الـ opioid بشكل عام، مورفين
+
+501
+00:31:14,560 --> 00:31:19,080
+مثلاً، علاجات من هذا القبيل، بنشوف إيش بنعمل، بنعمل
+
+502
+00:31:19,080 --> 00:31:23,100
+إعادة رد فعل، يعني لو كانت زايدة عنده بدنا ننقصها،
+
+503
+00:31:23,100 --> 00:31:26,780
+لو لاقيناه عنده deep coma، بنخففها شوية، يعني لازم
+
+504
+00:31:26,780 --> 00:31:30,920
+نعطي حسب ما الطبيب بيتكلّم، possible، طبعًا mechanical
+
+505
+00:31:30,920 --> 00:31:34,180
+ventilation، أكيد أكيد أكيد، لازم نعمل mechanical
+
+506
+00:31:34,180 --> 00:31:37,140
+ventilation، لأن مش هنقدر نسيطر عليه، طبعًا إحنا
+
+507
+00:31:37,140 --> 00:31:41,050
+خلصنا الـ chapter، طبعًا الـ respiratory system
+
+508
+00:31:41,050 --> 00:31:44,990
+assessment، ونشوف إحنا يعني، إن شاء الله تكون
+
+509
+00:31:44,990 --> 00:31:48,590
+استفدتم، وإن شاء الله بننتقل للـ chapter القادم في
+
+510
+00:31:48,590 --> 00:31:52,310
+المحاضرة القادمة، والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c5dd3b2457a68de7475fd4dbbca4877804756733
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_postprocess.srt
@@ -0,0 +1,2040 @@
+1
+00:00:00,810 --> 00:00:04,290
+و بسم الله الرحمن الرحيم خلينا نكمل طبعا احنا
+
+2
+00:00:04,290 --> 00:00:08,770
+وصلنا لهذه الشريحة في المحاضرة السابقة و ان شاء
+
+3
+00:00:08,770 --> 00:00:13,450
+الله نكمل مع بعض في respiratory assessment طبعا ..
+
+4
+00:00:13,450 --> 00:00:15,210
+طبعا respiratory system يعني اللي هو الجهاز
+
+5
+00:00:15,210 --> 00:00:19,570
+التنفسي وصلنا لحاجة اسمها ال plural friction rub
+
+6
+00:00:19,570 --> 00:00:22,290
+طبعا خلصنا عندها ال stridor اللي لما حكينا عنها
+
+7
+00:00:22,290 --> 00:00:26,070
+خاصة في حالة ال inspiration و كيف تصير musical
+
+8
+00:00:26,070 --> 00:00:29,390
+ويزياني اللي هو الصوت الصفير أثناء النفس أو الشاي
+
+9
+00:00:30,320 --> 00:00:34,800
+طيب ايه plural friction rub من اسمها؟ plural ..
+
+10
+00:00:34,800 --> 00:00:37,580
+plural cavity طب friction زي احتكاك .. rub .. rub
+
+11
+00:00:37,580 --> 00:00:40,860
+يعني كأنه بيحك مع بعضه شو يعني دي؟ يعني صار من
+
+12
+00:00:40,860 --> 00:00:45,260
+منطقة ال plural صارت فيها جفاف وتحتك مع بعضها
+
+13
+00:00:45,260 --> 00:00:49,500
+ويلها صوت سماها loud dry cracking إش يعني كأنه هي
+
+14
+00:00:49,500 --> 00:00:53,260
+كإش بي .. بي .. بيعمل صوت وورقتين كانوا بيحكوا مع
+
+15
+00:00:53,260 --> 00:00:57,260
+بعض بيقولي grating sound indicating plural
+
+16
+00:00:57,260 --> 00:01:02,360
+friction أو plural irritationعبارة عن صوت كركة أو
+
+17
+00:01:02,360 --> 00:01:07,340
+خرخشة موجودة بتصير زي احتكاك اتنين مع بعض gratics
+
+18
+00:01:07,340 --> 00:01:12,160
+زي اشي .. زي اشي بيشحت .. اشي بيعمل صوت زي تشحت مع
+
+19
+00:01:12,160 --> 00:01:17,740
+بعض وين بيصير هذا؟ بيقوللي بكون على lateral and
+
+20
+00:01:17,740 --> 00:01:21,280
+anterior lung in sitting position مرات بيصير على
+
+21
+00:01:21,280 --> 00:01:24,460
+الجنب اللي هو خارجه .. اللي هو ال lung على الجنب
+
+22
+00:01:24,460 --> 00:01:27,660
+سواء كان right أو leftو بيصير وين كمان في ال
+
+23
+00:01:27,660 --> 00:01:30,100
+anterior و الأمام يعني بيصيرش في ال .. في ال
+
+24
+00:01:30,100 --> 00:01:33,260
+posterior اللي بيكون يعني مش .. مش من الظهري
+
+25
+00:01:33,260 --> 00:01:37,200
+بينسمع وانما .. طبعا بعض الناس بيقولك طيب إيش هذا
+
+26
+00:01:37,200 --> 00:01:40,840
+الصوت؟ ما هو يمكن هذا الصوت يكون في secretion أو
+
+27
+00:01:40,840 --> 00:01:44,930
+في شغلات موجودةفى الرقاتين وخلّيه يجوح شوية ممكن
+
+28
+00:01:44,930 --> 00:01:48,770
+تطلع عشان نقدر نفرج بين ال plural ال friction rub
+
+29
+00:01:48,770 --> 00:01:53,170
+و بين ال sputum with cuffing او مثلا .. خليني اقول
+
+30
+00:01:53,170 --> 00:01:57,170
+مثلا with sputum او with cuff او زى ما يقولوا يعني
+
+31
+00:01:57,170 --> 00:02:01,570
+اللى و الجحة اللى بتكون مختلطة بأى .. بأى
+
+32
+00:02:01,570 --> 00:02:06,370
+secretions هذهك لما يجوح الإنسان مجرد ما يطلع
+
+33
+00:02:06,370 --> 00:02:09,680
+secretions خلاص بروح الصوتلكن في ال plural ال
+
+34
+00:02:09,680 --> 00:02:12,900
+friction rub ايش كتبت هنا not clear with cuffing
+
+35
+00:02:12,900 --> 00:02:16,800
+يعني لو ضال يجوح منها لبكرة بيضل الصوت موجود ليه؟
+
+36
+00:02:16,800 --> 00:02:20,060
+على اعتبار ان الاشي مش موجود في داخل ال lung و
+
+37
+00:02:20,060 --> 00:02:24,240
+انما حوالين ال lung طب خلينا نشوف causes of
+
+38
+00:02:24,240 --> 00:02:27,260
+decreased or absent breath sounds متى الكتب بتكلم
+
+39
+00:02:27,260 --> 00:02:30,440
+بشكل عام؟ بتكلمش بشكل خاص بتكلم بشكل عام أصوات
+
+40
+00:02:30,440 --> 00:02:33,740
+النفس سواء كان في الmeno bronchus و ال bronchi و
+
+41
+00:02:33,740 --> 00:02:38,890
+ال bronchism بغض النظرمتى ممكن الأصوات تبع التنفس
+
+42
+00:02:38,890 --> 00:02:43,370
+بشكل عام ممكن اتجل يعني صوتها مايكونش عالي في حال
+
+43
+00:02:43,370 --> 00:02:46,150
+.. هتلاقي في كل اللي .. اللي .. اللي بدنا نذكره
+
+44
+00:02:46,150 --> 00:02:51,110
+شغلات فيها يعني .. يعني إما chronic problem أو إما
+
+45
+00:02:51,110 --> 00:02:54,610
+تكون يعني إيش .. يعني خلوني أقول danger problem من
+
+46
+00:02:54,610 --> 00:02:58,710
+إيش؟ زي الأزمة اللي بيكون عنده أزمة بشكل دائم و
+
+47
+00:02:58,710 --> 00:03:03,350
+طويلبكون نفسه أصلا يعني بكون ضيق شوية و مرات بكون
+
+48
+00:03:03,350 --> 00:03:05,950
+الصوت صفير و لما .. مابتكلمش على صوت الصفير هنا
+
+49
+00:03:05,950 --> 00:03:09,810
+بتروح تقوللي ما هو صوت .. يعتبر صوت نفس، لأ، هذا
+
+50
+00:03:09,810 --> 00:03:14,430
+بنسمع الصفير بدون سماعات، لكن أنا بتكلم على الصوت
+
+51
+00:03:14,430 --> 00:03:18,550
+اللي ممكن نسمعه ب stethoscope و نتأكد منه COPD
+
+52
+00:03:18,550 --> 00:03:22,510
+chronic obstructive pulmonary disease المرض اللي
+
+53
+00:03:22,510 --> 00:03:25,990
+خالص هو بيكون معاه bronchitis، مع أزمة، بعضهم جال
+
+54
+00:03:25,990 --> 00:03:30,020
+كمان اللي هو bronchectasis اللي الأخيرةكل هذا ايش
+
+55
+00:03:30,020 --> 00:03:33,240
+يعني بتعتبر من الأمراض اللي ايه اللي تلازم اللي هو
+
+56
+00:03:33,240 --> 00:03:36,960
+الجهاز تنفسه، plural effusion لما نقول كلمة plural
+
+57
+00:03:36,960 --> 00:03:39,740
+effusion معناه اللي plural cavity صارش في قلبه،
+
+58
+00:03:39,740 --> 00:03:42,900
+فيه سائل و السائل ايش ممكن يكون؟ ممكن يكون سرس
+
+59
+00:03:42,900 --> 00:03:46,480
+فلود، ممكن يكون فلود، بغض النظر المهم فيه fluid،
+
+60
+00:03:46,480 --> 00:03:50,590
+ال nemothorax هناطبعا بعضهم بيقولك في طبعا
+
+61
+00:03:50,590 --> 00:03:54,450
+hemothorax بيسموها و هنا إذا كانت blood بيسميها
+
+62
+00:03:54,450 --> 00:03:57,830
+hemothorax لكن nemothorax كلكم عارفين نمو جاي من
+
+63
+00:03:57,830 --> 00:04:01,930
+هواء معناته إيش دخول هواء في منطقة الblural cavity
+
+64
+00:04:01,930 --> 00:04:05,590
+و خاصة لما الواحد بيكون ماخد stab wound أو لقدر
+
+65
+00:04:05,590 --> 00:04:10,050
+لقطعنه من شيء أو أكل هواية أو صار عنده fracture في
+
+66
+00:04:10,050 --> 00:04:12,570
+ال ribs طبعا أو أوقات الاكتساز اللي ال
+
+67
+00:04:12,570 --> 00:04:14,490
+inflammatory process في ال lung tissue زي ما
+
+68
+00:04:14,490 --> 00:04:18,940
+شرحناها في المحاضرة السابقة طيبCommon respiratory
+
+69
+00:04:18,940 --> 00:04:22,340
+disorders، ايش اكتر؟ ماجيبتش كل ال respiratory
+
+70
+00:04:22,340 --> 00:04:26,560
+disorders، no، انا قولت common عشان ماحدش يقول انه
+
+71
+00:04:26,560 --> 00:04:30,680
+هاد اللي بتصيب فقط ال respiratory system، لأ،
+
+72
+00:04:30,680 --> 00:04:33,880
+اليوم احنا في كورونا، respiratory system problems،
+
+73
+00:04:33,880 --> 00:04:37,320
+ممكن يقول TB، respiratory problem، مش عارفين، حتى
+
+74
+00:04:37,320 --> 00:04:42,020
+بس أنا بتنجيب شكل عام ايش الشغلات اللي ممكن تؤثر و
+
+75
+00:04:42,020 --> 00:04:47,200
+تعمل عند المريض إشكالات في الجهاز التنفسيأول حاجة
+
+76
+00:04:47,200 --> 00:04:53,160
+النمونيا، شو النمونيا يعني؟ التهاب في أنسجات
+
+77
+00:04:53,160 --> 00:04:58,400
+وخلايا الرئتين طيب، النمونيا ده هل كل نمونيا زي
+
+78
+00:04:58,400 --> 00:05:02,080
+بعض؟ لأ، في نمونيا سموها community acquired
+
+79
+00:05:02,080 --> 00:05:05,120
+نمونيا، يعني جاي من إيش؟ جال community، من
+
+80
+00:05:05,120 --> 00:05:08,840
+المجتمع، من سكنه في مكان، جنبه في asbestos، جنبه
+
+81
+00:05:08,840 --> 00:05:11,660
+environmental مثلا إيه ال polytans أو شغلات زي
+
+82
+00:05:11,660 --> 00:05:15,320
+ذلك، عملة عنده نمونيافي ناس عندهم صارت للأسف cross
+
+83
+00:05:15,320 --> 00:05:18,300
+infection من وين اللي بيسموها من وين hospital
+
+84
+00:05:18,300 --> 00:05:21,200
+infection اللي ال hospital acquire pneumonia يعني
+
+85
+00:05:21,200 --> 00:05:23,420
+هو وكان كويس لكن اللي حواليه عندهم pneumonia عدو
+
+86
+00:05:23,420 --> 00:05:28,040
+ممكن إيه جاء من بكتيريا ممكن يكون السبب في viruses
+
+87
+00:05:28,040 --> 00:05:31,120
+زي ما الآن موجود في كورونا coronavirus ممكن
+
+88
+00:05:31,120 --> 00:05:34,880
+mycoplasma وانتوا درستوا واحدة في ايه كلكم درستوا
+
+89
+00:05:34,880 --> 00:05:37,540
+في الميكروبيولوجيا كل هذه الأنواع ممكن تكون فنجاى
+
+90
+00:05:37,540 --> 00:05:41,760
+فطري ممكن تكون chemical شغل كيماوية زي ايش كيميائي
+
+91
+00:05:41,760 --> 00:05:44,860
+زي بعض الناس اللي مشتغلوافي الأشياء اللي بتطلع عيش
+
+92
+00:05:44,860 --> 00:05:48,220
+روائح خاصة وفي مش بس كمان بتطلع روائح شديدة، حتى
+
+93
+00:05:48,220 --> 00:05:51,440
+مرات في خطأ، و كويس أن أنا أذكركم في هذا الحلقه،
+
+94
+00:05:51,440 --> 00:05:54,660
+في بعض الستات في البيوت بروحوا مشكلتهم مشكلة،
+
+95
+00:05:54,660 --> 00:05:57,300
+بتروح بتجيب بدأت نظف البيت أو الحمام، أكرمكم الله
+
+96
+00:05:57,300 --> 00:06:00,970
+زيادة عن اللزوم، بتروح بتحط ميه النارو بتحط معاك
+
+97
+00:06:00,970 --> 00:06:04,870
+لور، يصير التفاعل بتطلع طبعا offensive وضرائحة
+
+98
+00:06:04,870 --> 00:06:08,430
+شديدة جدا و من الحلات في كتير منهم أجوا صار عندهم
+
+99
+00:06:08,430 --> 00:06:12,450
+مش بسيمونيا صار عندهم يعني danger خليني أقول مثلا
+
+100
+00:06:12,450 --> 00:06:16,170
+shortness of breath صار عندهم سبب خطير و مش قادر
+
+101
+00:06:16,170 --> 00:06:18,830
+يتنفس ليش لإنه بقى صار بتصير عندهم إيش حاجة
+
+102
+00:06:18,830 --> 00:06:22,410
+بيسموها air collapse و هذا أمر مش سهل كله من إيش؟
+
+103
+00:06:22,410 --> 00:06:26,590
+من ال chemical، من التفاعلات اللي بتصيرفي حسمة
+
+104
+00:06:26,590 --> 00:06:28,850
+بدنا نلقي ندوق على ال plural effusion انا بتكلم عن
+
+105
+00:06:28,850 --> 00:06:31,770
+ايه ال common respiratory يعني اغلب الحالات اللي
+
+106
+00:06:31,770 --> 00:06:34,610
+بتيجي طبعا من الحالات التانية اللي هي ال
+
+107
+00:06:34,610 --> 00:06:38,370
+respiratory disorders plural effusion وقلنا ايش
+
+108
+00:06:38,370 --> 00:06:41,830
+معنات plural effusion يعني في متجمع في ال plural
+
+109
+00:06:41,830 --> 00:06:46,690
+ايش fluid معناته تجمع سائل في منطقة ال plural
+
+110
+00:06:46,690 --> 00:06:50,370
+cavity فبقوليها انا بتكون secondary ليش secondary
+
+111
+00:06:50,370 --> 00:06:55,210
+لما اقول كلمة secondary يعني في سبب خلاها تسيرلو
+
+112
+00:06:55,210 --> 00:06:59,330
+صارت لحالة بدون سبب بنسميها primary لكن لو صارت
+
+113
+00:06:59,330 --> 00:07:03,510
+ناتج عن سبب تاني بنقول عن secondary نحط مثال لكلمة
+
+114
+00:07:03,510 --> 00:07:06,650
+secondary هنا بيقول ال secondary to increase fluid
+
+115
+00:07:06,650 --> 00:07:12,050
+formation انه بتصير مضعفة لتجمع سوائل هيجي زي كيف؟
+
+116
+00:07:12,050 --> 00:07:14,710
+زي واحد عنده congestive heart failure congestive
+
+117
+00:07:14,710 --> 00:07:17,370
+heart failure لما اقول كلمة congestive heart
+
+118
+00:07:17,370 --> 00:07:22,170
+failure معناته ايش؟ فشل في عضلة القلب مش قادر التخ
+
+119
+00:07:22,560 --> 00:07:26,420
+الدم كويس ومش قادر صار .. صار الدم يرشح منه السائل
+
+120
+00:07:26,420 --> 00:07:29,980
+الزاد .. لما صار يرشح كل ما يروح الدم على الرياضين
+
+121
+00:07:29,980 --> 00:07:34,060
+عشان يتنقق صار إيش؟ يرشح منه السائل .. مش ..
+
+122
+00:07:34,060 --> 00:07:36,800
+المشكلة مش من الرياض صارت .. أجتنا المشكلة من
+
+123
+00:07:36,800 --> 00:07:39,840
+ورايا من الهارد .. واحد step one مش من هنا .. أجته
+
+124
+00:07:39,840 --> 00:07:43,720
+من برا .. و هكذا .. يعني في plural effuges اتجمع
+
+125
+00:07:43,720 --> 00:07:47,540
+.. increased .. إيش صار هنا؟capillary permeability
+
+126
+00:07:47,540 --> 00:07:51,260
+بيصير اللي هو capillary كلكم عارفينها اللي هو اللي
+
+127
+00:07:51,260 --> 00:07:54,680
+هو الفتحات اللي موجودة في داخل اللي هو الشراين
+
+128
+00:07:54,680 --> 00:07:58,640
+الدموية إيش صار فيها زادت خاصة في ال alveolar كذا
+
+129
+00:07:58,640 --> 00:08:02,460
+فبدت تتسح صار يدخل فيها السائل أكتر increased
+
+130
+00:08:02,460 --> 00:08:06,800
+colloid osmotic pressure بزيد الضغط الأسموزي كمان
+
+131
+00:08:06,800 --> 00:08:10,520
+في داخل إيش هنا؟ في داخل ال blood ولمّا بزيد ضغط
+
+132
+00:08:10,520 --> 00:08:15,350
+الأسموزي بيخلي إيش ال إيش السائل يطلع منه أكترزي
+
+133
+00:08:15,350 --> 00:08:17,490
+ليش؟ وانتوا عارفين هذه القصة خدناها دايما في
+
+134
+00:08:17,490 --> 00:08:20,390
+الكيميا، اظن في ال chemistry ممكن تكون اخدتها، انه
+
+135
+00:08:20,390 --> 00:08:22,850
+بعد ضغط الاسموزي عماله بيصير عملية الرشح زي عملية
+
+136
+00:08:22,850 --> 00:08:25,790
+الحرق لما بيصير انسان بنحرج، فبتلاقي بيطلع منه
+
+137
+00:08:25,790 --> 00:08:29,550
+surface fluid و بتجمع حوالين ال skin. Increased
+
+138
+00:08:29,550 --> 00:08:33,130
+ايه هنا؟ Intra plural negative pressure. Intra
+
+139
+00:08:33,130 --> 00:08:37,330
+negative pressure اللي هو الضغط السلبي، بزيد.لما
+
+140
+00:08:37,330 --> 00:08:40,710
+نزيد الضغط السلبي، بيسحب، ليش يعني الضغط السلبي زي
+
+141
+00:08:40,710 --> 00:08:44,270
+ال vacuum، زي اللي بشفط؟ ليش زمان كانوا يقولون أنه
+
+142
+00:08:44,270 --> 00:08:49,590
+لما واحد بياخد سكينة أو بينضرب بشيء يعني مؤدي زي
+
+143
+00:08:49,590 --> 00:08:53,510
+step wound أو سيخ أو كده، إيش بنقولهم؟ خلّي الأداء
+
+144
+00:08:53,510 --> 00:08:57,590
+في مكانها، ليه؟ علشان أنا مابدي إذا سحبنا الأداء
+
+145
+00:08:57,590 --> 00:09:00,870
+من منطقة الصدر، هيدخل الهواء يعملنا حاجة اسمها
+
+146
+00:09:00,870 --> 00:09:04,420
+nemothoraxليه؟ لأنه مليان negative pressure في
+
+147
+00:09:04,420 --> 00:09:08,160
+داخل ال chest من جوا مغلق، عشانك اذا .. بكرا نروح
+
+148
+00:09:08,160 --> 00:09:13,020
+المستشفى ان شاء الله يعني و نتدرب هنلاقي في حاجة
+
+149
+00:09:13,020 --> 00:09:17,380
+بيسموها ال chest tube ان هو بنحطها في صدر المريض و
+
+150
+00:09:17,380 --> 00:09:22,940
+بتروح تدخل على bottle زي وعاء زي ..يعني خلاني أقول
+
+151
+00:09:22,940 --> 00:09:28,260
+مرتبان زجاجي عشان تقدر تأخد السوائل من جوا كشيء
+
+152
+00:09:28,260 --> 00:09:31,100
+مغلق ليش هذا الكلام؟ لأن ال negative pressure
+
+153
+00:09:31,100 --> 00:09:34,780
+بيسحب أي شيء فلما بيزيد ال negative pressure بروح
+
+154
+00:09:34,780 --> 00:09:38,620
+بيسحب السوائل في داخل البلورة الكفتي فبيصير بتجمع
+
+155
+00:09:38,620 --> 00:09:43,540
+أكتر وبصير عنده إشكالية أكبر صحية impaired
+
+156
+00:09:43,540 --> 00:09:46,720
+lymphatic drainage كمان ال lymphatic drainage
+
+157
+00:09:46,720 --> 00:09:49,060
+وانتوا عارفين ال lymphatic system يعني تعتبره جسم
+
+158
+00:09:49,060 --> 00:09:53,950
+مناعيوهي يعني تعتبر التصريف العام للـ artery فبصير
+
+159
+00:09:53,950 --> 00:09:57,590
+كمان إيش ال drainage دماغها بزيد ليش بزيد كمان؟ ما
+
+160
+00:09:57,590 --> 00:10:00,950
+هو كله ماشي مع ال inflammatory process أو حتى
+
+161
+00:10:00,950 --> 00:10:07,610
+dangerous process أو حتى يعني trauma أيا كان فيه
+
+162
+00:10:07,610 --> 00:10:11,710
+مشكلة فبصير إيش عمله؟ فبصير يطلع أكتر كل ما طلع
+
+163
+00:10:11,710 --> 00:10:15,150
+الدم أكتر ماهيرشح منه أكتر أيش اللي هو السائل اللي
+
+164
+00:10:15,150 --> 00:10:19,710
+في جلبه increase pressure in the capillariesبزيد
+
+165
+00:10:19,710 --> 00:10:23,230
+الضغط وين في ال capillaries الشعيرات الدموية و لما
+
+166
+00:10:23,230 --> 00:10:25,390
+زاد في الشعيرات الدموية و ال emphatics زي نفس
+
+167
+00:10:25,390 --> 00:10:29,050
+الكلام بزيد ايش بيصير فبصير يتسرب منه السائل اكتر
+
+168
+00:10:29,050 --> 00:10:33,710
+طيب نجعلها مشكلة تالتة و مشكلة خطيرة كتير و برضه
+
+169
+00:10:33,710 --> 00:10:38,250
+تعتبر حتى عندنا بيسموها من ال medical emergency
+
+170
+00:10:38,250 --> 00:10:41,850
+تعتبر حاجة تسمى medical emergency يعني يجب التدخل
+
+171
+00:10:41,850 --> 00:10:46,170
+فورا حتى لو بندخله على جهاز تنفس الصناعي طب ليه؟
+
+172
+00:10:46,170 --> 00:10:49,100
+هالجيب يقولكواNemothorax يعني بدل ما يتجمع
+
+173
+00:10:49,100 --> 00:10:52,940
+solution اتجمع ايش هوى جاء من ال Nemo sudden onset
+
+174
+00:10:52,940 --> 00:10:57,240
+of pleuritic chest pain كيف بنعرف انه بيصير عنده
+
+175
+00:10:57,240 --> 00:11:03,920
+ألم شديد جدا في منطقة الصدر بس ايه يعني بيقوللي
+
+176
+00:11:03,920 --> 00:11:09,820
+sudden ليش sudden فجأة بيجي أكله وايه صار عنده اي
+
+177
+00:11:09,820 --> 00:11:13,860
+حاجة فجأة مش قادر ياخد نفسي بيقولك انا عندي chest
+
+178
+00:11:13,860 --> 00:11:18,400
+painماشي في منطقة بلوراتك يعني منطقة البلورة مش
+
+179
+00:11:18,400 --> 00:11:21,120
+قادر ياخد نفس مباشرة طبعا بعض الناس بيقولك طب ليش
+
+180
+00:11:21,120 --> 00:11:25,320
+لنتخل مباشرة؟ لأنه هذا نفس لو جاللي بطن بجوعني
+
+181
+00:11:25,320 --> 00:11:28,880
+ممكن أستنى شوية لو جاللي رجلي ماشي بس هذا نفس اذا
+
+182
+00:11:28,880 --> 00:11:33,060
+كان مات في المضطرين فورا شو صار عنده ديسنيا؟ اللي
+
+183
+00:11:33,060 --> 00:11:36,200
+هو صعوبة نفس shortness of breath قصر في النفس كمان
+
+184
+00:11:36,200 --> 00:11:38,580
+increased work of breathing ايش يعني work of
+
+185
+00:11:38,580 --> 00:11:41,540
+breathing؟ زاد الجهد تبع النفس اقعك و تفكر ان
+
+186
+00:11:41,540 --> 00:11:44,930
+الإنسانلو بستخدم الجهد دايما في حياته في النفس
+
+187
+00:11:44,930 --> 00:11:48,190
+ممكن عضلاته كله يصير في عندها حاجة بسمها paralysis
+
+188
+00:11:48,190 --> 00:11:51,990
+أو exhaustion فمجرد بنلاقي إنسان مش قادر .. احنا
+
+189
+00:11:51,990 --> 00:11:55,410
+ليش بنحط البني آدم على التنفس الصناعي؟ في معظم
+
+190
+00:11:55,410 --> 00:12:00,790
+الحالات أنه ممكن يتنفس بس مش قادر ياخد نفس عشان مش
+
+191
+00:12:00,790 --> 00:12:04,270
+قادر ياخد نفس أنا بحطله تنفس صناعي عشان أريح عضلات
+
+192
+00:12:04,270 --> 00:12:08,310
+النفس وعضلات الصدر لحين ما يستطيع ياخد لوحده خاصة
+
+193
+00:12:08,310 --> 00:12:12,600
+في حالات اللي بتكون high dangerطيب الان ايش بقولي
+
+194
+00:12:12,600 --> 00:12:15,880
+طب كيف بتشخص ال Nemo thorax بقولي بدك تعمله ايش
+
+195
+00:12:15,880 --> 00:12:20,220
+هنا CXR خليكوا ذاكرين اختصار عالمي عشان لما تشوفه
+
+196
+00:12:20,220 --> 00:12:25,020
+في المستشفيات اسمه chest x-ray صورة للصدر x-ray
+
+197
+00:12:25,020 --> 00:12:29,240
+صورة سينية للصدر هذا اللي بيشخص ان في نيمو ثوراكس
+
+198
+00:12:29,240 --> 00:12:33,260
+طبعا لو حد سألني طب ليش؟ الان عشان كوني عندكوا علم
+
+199
+00:12:33,260 --> 00:12:37,480
+اي شي فيه هوة على الصورة الصينية ال x-ray تطلع لنا
+
+200
+00:12:37,480 --> 00:12:41,930
+سودةو أي شي solid يعني حاجة جامدة بيطلع فيها بياض
+
+201
+00:12:41,930 --> 00:12:45,350
+يعني مثلا الرئاتين لما نيجي نصور المريض بنقوله خد
+
+202
+00:12:45,350 --> 00:12:48,870
+نفس باخد النفس و بنقوله اكتم النفس كتم النفس
+
+203
+00:12:48,870 --> 00:12:53,690
+صورناه و جرد ما احنا صورناه بنروح ايش نطلع في
+
+204
+00:12:53,690 --> 00:12:56,570
+الصورة بنلاقي الصورة كلها ايش زي منطقة سوداء ما
+
+205
+00:12:56,570 --> 00:13:00,570
+تخافوش اللون السواد معناته يعني ايش كويس الرئاتين
+
+206
+00:13:00,570 --> 00:13:05,470
+و اللي في جلمن يعني المبين واضح انه يعني داخل ال
+
+207
+00:13:05,470 --> 00:13:08,890
+oxygen و الهواء تماملكن اليوم زي الأيام الماضية
+
+208
+00:13:08,890 --> 00:13:11,590
+مثلا في كورونا ايش بيعملوا بيصوروا زي هيك بيلاقوا
+
+209
+00:13:11,590 --> 00:13:13,770
+ايش في حاجة اسمها white patches ايش يعني white
+
+210
+00:13:13,770 --> 00:13:17,510
+patches في مناطق بيضاء وين في منطقة بيضاء بنعرف ان
+
+211
+00:13:17,510 --> 00:13:21,070
+في المدربرس او في مشكلة هنا مش داخلة الهواء لإنه
+
+212
+00:13:21,070 --> 00:13:23,670
+نقول الحاجة الجامدة زي ال humor زي ال point زي هو
+
+213
+00:13:23,670 --> 00:13:26,590
+بتطلع ايش لونه أبيض هتتذكروا ده الكلام ان شاء الله
+
+214
+00:13:26,590 --> 00:13:30,210
+لما تروح تتدربوا شو بدي اعمل هنا بقول في ال
+
+215
+00:13:30,210 --> 00:13:32,790
+management ده بتاع اكسيجين حاطناه طناف الصناعة
+
+216
+00:13:32,790 --> 00:13:38,020
+وغيره لازم اعطيه اكسيجين عشان نعوضه بعدلازم نعطيش
+
+217
+00:13:38,020 --> 00:13:41,520
+chest tube ليه؟ لو حد سأل، ال chest tube ما أنتوا
+
+218
+00:13:41,520 --> 00:13:46,420
+عارفين البنورة ال cavity الآن مليان ومضغوط وفي جلب
+
+219
+00:13:46,420 --> 00:13:50,960
+هوا، بدي نفجر فأنا بدخل ال tube ما حد يفكر بدخل ال
+
+220
+00:13:50,960 --> 00:13:54,780
+tube يعني كأني بروح ب .. ب .. أخرق ال .. ال ..
+
+221
+00:13:54,780 --> 00:13:59,270
+الرئة، لأ لأ لأأنا بوصلش لطيوب للريقة، بوصلهاش لأ
+
+222
+00:13:59,270 --> 00:14:04,030
+بوصلها للblura ال cavity و بفتح من برا تحت اللي زي
+
+223
+00:14:04,030 --> 00:14:06,850
+ما يقولونه underwater seal تحت المرتبان هذا عشان
+
+224
+00:14:06,850 --> 00:14:10,210
+يصحى اللي هو الهواء الزائد عشان ما يضغطش على
+
+225
+00:14:10,210 --> 00:14:16,050
+الريقتين اكتر طيب اللي بعد اسمه pulmonary embolism
+
+226
+00:14:16,050 --> 00:14:19,550
+كلكم عارفين شو معنى embolism؟ هتذكركم بس كلمتين
+
+227
+00:14:19,550 --> 00:14:23,030
+انه ايش الفرق بين .. ايش؟ بين ال thrombus و ال
+
+228
+00:14:23,030 --> 00:14:25,870
+embolus أكيد انتوا عارفينها، لكن من ببتد ..
+
+229
+00:14:25,870 --> 00:14:32,090
+thrombusهي نفس يعني لو بدنا نيجي بالوصف العام هي
+
+230
+00:14:32,090 --> 00:14:35,330
+نفس ال embolus لكن ال thrombus بتصير غالبا وين؟
+
+231
+00:14:35,330 --> 00:14:38,350
+غالبا بتصير في ال veins، في الأوردة، بالنسبة بقى
+
+232
+00:14:38,350 --> 00:14:41,890
+بنقول DVT، يعني ده ايش عن DVD؟ Deep Vein
+
+233
+00:14:41,890 --> 00:14:46,350
+Thrombosis طيب متى بتتحول ل embolism؟ بتتحول ل
+
+234
+00:14:46,350 --> 00:14:50,220
+embolism إذا اتحركت ومشت؟ولما حارجة ما حد يقول لي
+
+235
+00:14:50,220 --> 00:14:54,340
+طب ان هو ال veins شغلات لحال و ال arteries لحال لأ
+
+236
+00:14:54,340 --> 00:14:59,320
+في الآخر هذا مش network كلها مع بعض شبكة بتنتهي ال
+
+237
+00:14:59,320 --> 00:15:01,920
+veins بتبدأ ال arteries بتنتهي ال arteries بتبدأ
+
+238
+00:15:01,920 --> 00:15:05,860
+ال veins و هكذا يعني نهايات الأطراف لل veins و ال
+
+239
+00:15:05,860 --> 00:15:09,860
+arteries بتكون اللي هو arterioles و venules بشتتجن
+
+240
+00:15:09,860 --> 00:15:13,220
+مع بعض و اللي هكذا بتكون ما حد يتخيل انه كأنه
+
+241
+00:15:13,220 --> 00:15:17,600
+مواصير كل حاجة لحال لأ فإيش بيصير هناBulmonary
+
+242
+00:15:17,600 --> 00:15:21,220
+embolism طبعا من القلب برضه تعتبر هذا top .. top
+
+243
+00:15:21,220 --> 00:15:25,380
+ها emergency و ممكن دلوقت نتدخل فورا و إذا
+
+244
+00:15:25,380 --> 00:15:28,160
+ماقدرناش نلحق المرض ممكن يموت، اللي عنده إيه؟
+
+245
+00:15:28,160 --> 00:15:30,880
+Bulmonary embolism خاصة في الـ Bulmonary arteries
+
+246
+00:15:30,880 --> 00:15:34,760
+يعني وين؟ في الشريان اللي هو الرؤه الأساسي صار فيه
+
+247
+00:15:34,760 --> 00:15:39,140
+عملية إيه؟ انه راحت اللي هو ال deep vein هي ال DVT
+
+248
+00:15:39,140 --> 00:15:42,620
+ال deep vein from وزداله سرح ماشي في بعض الناس
+
+249
+00:15:42,620 --> 00:15:47,510
+بروح على الشريان اللي عند المخبنسميهوش DVD، بنسميه
+
+250
+00:15:47,510 --> 00:15:51,450
+CVA، بنقول عنده جلطة دماغية، في بعضه بتمشي بتمشي
+
+251
+00:15:51,450 --> 00:15:54,890
+بتقف عند شراين القلب، اللي هي الشراين التاجية،
+
+252
+00:15:54,890 --> 00:15:58,410
+بنقول عنده my card of infarction، وينمشت ووقفت
+
+253
+00:15:58,410 --> 00:16:02,890
+يسمى التشخيص بناء على وقوفه في هذا المكان، طيب،
+
+254
+00:16:02,890 --> 00:16:08,450
+بقولني هناtraveled سافرت lodged و استقرت في وين في
+
+255
+00:16:08,450 --> 00:16:11,230
+البلمونة الارتز يبقى واقفة هنا عملتلي حاجة زي ما
+
+256
+00:16:11,230 --> 00:16:14,430
+البلمونة الامبوليزم مازال واقفة في هذا المكان يبقى
+
+257
+00:16:14,430 --> 00:16:17,790
+المنطق اللي بعدها هتموت حيزير فيه عملية cyanosis و
+
+258
+00:16:17,790 --> 00:16:20,810
+عملية يعني للأسف death of tissue لأنه بقى ليصلى
+
+259
+00:16:20,810 --> 00:16:25,370
+الهواء الطبيعي و ال oxygen severity الحدة تبعتها و
+
+260
+00:16:25,370 --> 00:16:29,230
+خطورتها depends on a extent جداش درجة الإغلاق يعني
+
+261
+00:16:29,230 --> 00:16:32,910
+جداش أنا بحكم إنه خطير أو مش خطيروين الشريان
+
+262
+00:16:32,910 --> 00:16:36,190
+بالظبط في أوله و في وسطه و في آخره اللي صار فيه
+
+263
+00:16:36,190 --> 00:16:40,370
+إغلاق mismatch of ventilation and perfusion بيصير
+
+264
+00:16:40,370 --> 00:16:44,830
+للأسف فالجيتا بيصير mismatch يعني بتدخل الحالتين
+
+265
+00:16:44,830 --> 00:16:47,830
+مع بعض اللي أحنا مش عارفين ال ventilation التهوية
+
+266
+00:16:47,830 --> 00:16:51,490
+مع ال perfusion عملية كمان اللي هو إيش اللي هو
+
+267
+00:16:51,490 --> 00:16:55,750
+التبادل بين الغازات و عملية اللي هو ال exchange
+
+268
+00:16:55,750 --> 00:16:58,930
+اللي بيصير من ناحية طبيعية هنا إيش جالي mismatch
+
+269
+00:16:58,930 --> 00:17:05,580
+يعني بيدخلالشرايين الرئوية في إشكالية مش قادر
+
+270
+00:17:05,580 --> 00:17:09,620
+يسيطر لأنه صار فيه closure بدي يحاول يعمل جسم حاجة
+
+271
+00:17:09,620 --> 00:17:12,800
+تسمى compensatory mechanism وإذا لم يستطع طبعا
+
+272
+00:17:12,800 --> 00:17:15,500
+احنا بدنا نضطر ندخل لأنه مش سهل أنه يترك المرض
+
+273
+00:17:15,500 --> 00:17:20,100
+لوحدي طبعا كيف بدنا نقدر نشخصه مش سهل تشخيصه ممكن
+
+274
+00:17:20,100 --> 00:17:24,100
+يكون الشريان اللي أغلب بسيط جدا جدا ومش قادر أطوله
+
+275
+00:17:24,100 --> 00:17:27,680
+شو بعمله بعمله حاجة تسمى pulmonary angiogram لما
+
+276
+00:17:27,680 --> 00:17:32,620
+نقول كلمة angiogram يعني صورة ملونة angiogram
+
+277
+00:17:32,620 --> 00:17:37,080
+أنجيوغ في صبغة gram الان هالجيت أنجيوغ ال .. ال ..
+
+278
+00:17:37,080 --> 00:17:39,200
+ال .. ال .. فيزلز يعني ال blood fizzles و gram
+
+279
+00:17:39,200 --> 00:17:42,980
+اللي هو المادة الملونة فبصبغ في .. نسمع يقولوا
+
+280
+00:17:42,980 --> 00:17:48,040
+الله عملوله صورة CT ملونة أو صورة رنين ملونة فبتظل
+
+281
+00:17:48,040 --> 00:17:51,820
+ماشية بتنصبغ المكان المغلق و ببينلي إيش المكان
+
+282
+00:17:51,820 --> 00:17:55,300
+اللي وراه إيش المشكلة تبني عرف مين المشكلة هذه
+
+283
+00:17:55,300 --> 00:17:57,880
+سبحان الله الصورة واضحة جدا و بطريقة يعني بتعرف
+
+284
+00:17:57,880 --> 00:18:01,940
+إيش مشكلتهايعني مثلا انا لقيتها لو تخيلنا هي
+
+285
+00:18:01,940 --> 00:18:06,000
+بيقولي مثلا multiple emboli in small branches فى
+
+286
+00:18:06,000 --> 00:18:10,140
+emboli صغيرة هنا و هنا و هنا موجودة، لاحظين أنه
+
+287
+00:18:10,140 --> 00:18:14,660
+اللون اللى هنا اشماله لون طبيعى، اللون كله مرتب
+
+288
+00:18:14,660 --> 00:18:18,550
+وحتى هنا النهايات كلها مرتبةلكن لو لاحظنا هنا في
+
+289
+00:18:18,550 --> 00:18:21,910
+شوياتها in polysmol في ال branches of left
+
+290
+00:18:21,910 --> 00:18:25,950
+pulmonary artery هنا في شوية مسكرة مع الصبغة بيرد
+
+291
+00:18:25,950 --> 00:18:29,270
+وهنا مع الصبغة بيرد هنا اكثر من عداد خمسة لو
+
+292
+00:18:29,270 --> 00:18:32,090
+لاحظنا طب بداية الانسجال اللي بعدها ايش صار فيها
+
+293
+00:18:32,090 --> 00:18:36,130
+بدت تزرجها لاحظين كيف بدت تزرج لو تركناها شوية
+
+294
+00:18:36,130 --> 00:18:38,570
+ازراج ايش بيصير فيها gangrene خلاص بتموت ايش
+
+295
+00:18:38,570 --> 00:18:41,330
+بيجيبوا بيعملوا عملية بيقصوها هذا المكان طبعا مش
+
+296
+00:18:41,330 --> 00:18:45,200
+بس هنا بتجيب الخطورة لاممكن يعلم اذا ترك واحد
+
+297
+00:18:45,200 --> 00:18:49,600
+يقوللي انه هل بنتقل؟ اه بنتقل ممكن ايش تبدأ هي ال
+
+298
+00:18:49,600 --> 00:18:53,060
+lung tissue بعدين تستقر طيب لو اجت تسكير في مكان
+
+299
+00:18:53,060 --> 00:18:56,500
+اجوى زي ايه؟ هي كتبلي هنا في ال right pulmonary
+
+300
+00:18:56,500 --> 00:18:59,380
+artery الأساسي لو اجت في ال pulmonary artery
+
+301
+00:18:59,380 --> 00:19:03,700
+الأساسي لاحظوا ايش صار؟ سكر هذا كل الشجرة ماتت
+
+302
+00:19:03,700 --> 00:19:07,000
+اللي بعدها ايش صار في ال lung tissue هنا؟ صارلون
+
+303
+00:19:07,000 --> 00:19:10,800
+ايش؟ أزرق ما الا السودة حتى أسود ليه؟ لأنه خلاص
+
+304
+00:19:11,210 --> 00:19:14,530
+مزارع أسود يبقى صار فيه gangrene هنا و بده تدخل
+
+305
+00:19:14,530 --> 00:19:20,930
+علشانك مبينهش إلا في التصوير الملور طيب COPD قدها
+
+306
+00:19:20,930 --> 00:19:23,370
+كتير مدعوة كمان مره اسمها chronic obstructive
+
+307
+00:19:23,370 --> 00:19:26,870
+pulmonary disease إيش هذا مرض مزمن history of
+
+308
+00:19:26,870 --> 00:19:31,050
+exposure إيه ال risk factors؟ إيش ال risk factors؟
+
+309
+00:19:31,050 --> 00:19:33,890
+في حاجة بيسموها الممرضات comorbidities كمربضات
+
+310
+00:19:33,890 --> 00:19:37,940
+يعني في شغلات ساعدته على الإمراضفي بعضهم عنده مثلا
+
+311
+00:19:37,940 --> 00:19:41,880
+يعني فيه ان current مثلا medical treatments لاحظوا
+
+312
+00:19:41,880 --> 00:19:45,840
+انه في بعض يعني في بعض العجزات زي ال beta blockers
+
+313
+00:19:45,840 --> 00:19:48,360
+ومكرا بتاخدوها اكيد يمكن اخدتوها في ال
+
+314
+00:19:48,360 --> 00:19:51,880
+pharmacology اللي هو فيه ان ال beta blockers وفيه
+
+315
+00:19:51,880 --> 00:19:54,960
+alpha blockers وفيه ال beta طبعا selective و non
+
+316
+00:19:54,960 --> 00:19:59,580
+selective هتاخدوها مع الدكتور الأدويةبتبينلنا إنه
+
+317
+00:19:59,580 --> 00:20:03,280
+إيه يعني إيش لإنه في بعض إحنا بناخد علاجات بتروح
+
+318
+00:20:03,280 --> 00:20:05,420
+ال beta cells اللي موجودة في ال heart بتوقفها
+
+319
+00:20:05,420 --> 00:20:09,900
+لأنخاصة زي الدرالين مثلا زي النورمتين بكرا هتسمعوا
+
+320
+00:20:09,900 --> 00:20:13,460
+عنها الدوين لإنه أكتر دوين مستخدمين as beta
+
+321
+00:20:13,460 --> 00:20:16,900
+blockers لاحظوا أن دول الشغلات ممكن تتعمل برضه
+
+322
+00:20:16,900 --> 00:20:20,820
+COPD طبعا زي مين هم ال COPD بكون عندهم أزمة
+
+323
+00:20:20,820 --> 00:20:24,240
+chronic bronchitis chronic bronchitis كل على بعض
+
+324
+00:20:24,240 --> 00:20:27,880
+هذا متلازمةفسموها chronic obstructive pulmonary
+
+325
+00:20:27,880 --> 00:20:32,400
+disease ماسموهاش مرض دايما لما يكون اكتر من مرض في
+
+326
+00:20:32,400 --> 00:20:35,920
+نفس الحالة بنسميها ايش؟ Syndrome او بنسميها معضلة
+
+327
+00:20:35,920 --> 00:20:40,200
+طب ايش بنعمل test له؟ هذاك عملنا له ايه؟ بيعملوا
+
+328
+00:20:40,200 --> 00:20:42,260
+serum لغوة؟ أنا لأ، انا بتعمله حاجة اسمها
+
+329
+00:20:42,260 --> 00:20:47,200
+spirometry spirometry اسمه جهاز فحص ايش؟ اللي هو
+
+330
+00:20:47,200 --> 00:20:50,640
+قوة .. قوة النفس موجود عند كل الأطباء الأخصائيين
+
+331
+00:20:51,060 --> 00:20:54,160
+بينجي بيخليه يتنفس في جهاز الجهاز هذا ايه اللي هو
+
+332
+00:20:54,160 --> 00:20:58,380
+زي بربيش بيمسكه في الفم و بيضغط فيه و بياخد نفس و
+
+333
+00:20:58,380 --> 00:21:02,180
+بيضغط بياخد نفس و بيضغط عشان يقدر يعرف انه هل في
+
+334
+00:21:02,180 --> 00:21:04,600
+مشكلة ولا نفس اللي بيعبرش كويس ولا نفس اللي بيطلعش
+
+335
+00:21:04,600 --> 00:21:09,260
+طبعا كمان مهم كتير انه يعملوا APGs الاختصار
+
+336
+00:21:09,260 --> 00:21:13,300
+العالمي arterial blood gases يعني ايش فحص اللي هو
+
+337
+00:21:13,300 --> 00:21:17,080
+ايش ال gases اللي موجودات في جلب الارتري زي ال
+
+338
+00:21:17,080 --> 00:21:22,420
+oxygenوزي مثلا فانكسجة الكربون وزي مثلا ال
+
+339
+00:21:22,420 --> 00:21:26,660
+بيكربونات الصوديوم كمان، كل هذا عشان نعرف وين رايح
+
+340
+00:21:26,660 --> 00:21:30,620
+المريض بالظبط، إذا عيل ال CO2 مصيبة، إذا نكس ال
+
+341
+00:21:30,620 --> 00:21:34,740
+oxygen مصيبة، إذا مثلا ال CO3 مثلا زادت كمان، ال
+
+342
+00:21:34,740 --> 00:21:37,860
+بيكربونات برضه مشكلة، كل حاجة إلى حل بناء على
+
+343
+00:21:37,860 --> 00:21:41,460
+التشخيص اللي بيطلع، طب إيش بتعمله management؟جالب
+
+344
+00:21:41,460 --> 00:21:45,100
+نعمله Oxygen، بدنا نعطيه Oxygen، ان نعطيه الهو
+
+345
+00:21:45,100 --> 00:21:49,200
+ديوكيشن، انه لازم يعرف ان هو تحت الضغط و لما نحط
+
+346
+00:21:49,200 --> 00:21:51,540
+اللي Vulcanic اللي تحت ال Oxygen، يظلوا ياخدوا
+
+347
+00:21:51,540 --> 00:21:54,120
+النفس، مايظلوش يرفعوا زيه، للأسف في بعض الناس
+
+348
+00:21:54,120 --> 00:21:56,780
+مااخدوش تعليمات كويسة في حياتهم، فبيزيد المرض
+
+349
+00:21:56,780 --> 00:22:00,400
+عندهم أكتر خطورةوبنعطيهم طبعا علاجات عققغير حسب
+
+350
+00:22:00,400 --> 00:22:04,280
+الطبيب الأخصائي ومن ناحية التخزين طبعا بنزود كمية
+
+351
+00:22:04,280 --> 00:22:08,120
+البروتين عشان بدنا نعطيه مقاومة للجسم، بنخليه يعمل
+
+352
+00:22:08,120 --> 00:22:13,360
+شوية exercise وخاصة التمارين للعلاقة بالتنفس، شهيق
+
+353
+00:22:13,360 --> 00:22:17,000
+زفير تمارين صباح، وفي الآخر إذا لا سمح الله يقسنا،
+
+354
+00:22:17,000 --> 00:22:20,760
+بدنا ندخل جراحيا، لأنه مقدرش نخلي المريض زي ما هو،
+
+355
+00:22:20,760 --> 00:22:25,420
+لأ هتموت الأمور، هتموت الخلاياطيب، من ال common
+
+356
+00:22:25,420 --> 00:22:29,180
+كمان، الرئيس ماردري سحب للأزمة لحاله، كلك عارفين
+
+357
+00:22:29,180 --> 00:22:32,380
+أزمة، أزمة يعني، أزمة من اسمها، طبعا هي عبارة عن
+
+358
+00:22:32,380 --> 00:22:34,820
+chronic inflammatory disease اللي بيصير في ال
+
+359
+00:22:34,820 --> 00:22:38,760
+airway، هي عبارة عن يعني إلتها بخليني أقول مزمن
+
+360
+00:22:38,760 --> 00:22:42,940
+ومرض مزمن في مجاري الهواء اللي في الجهاز التنفسي
+
+361
+00:22:42,940 --> 00:22:46,480
+طبعا إيش بيصير عندهم دول الhypersensitiveness؟ إيش
+
+362
+00:22:46,480 --> 00:22:48,780
+يعني الhypersensitiveness؟ إنه بيصير عندهم
+
+363
+00:22:48,780 --> 00:22:53,800
+الاستجابة يعني فيه كتير منهماستجابتهم لأي شيء
+
+364
+00:22:53,800 --> 00:22:57,580
+بيعمل حسية بكون أكتر من الناس الطبيعيين، في ناس
+
+365
+00:22:57,580 --> 00:23:00,320
+بيقولك كانت معايا أزمة من العطر، صارت معايا أزمة
+
+366
+00:23:00,320 --> 00:23:06,260
+من ريحة الغاز، ريحة الطبيخ، ريحة المجالي، من
+
+367
+00:23:06,260 --> 00:23:10,780
+الغبار، من الأشجار، من الحبوب اللقاح، أيا كان،
+
+368
+00:23:10,780 --> 00:23:14,940
+هذولش عندهم الاستجابة حسسين، hyper responsiveness،
+
+369
+00:23:14,940 --> 00:23:18,420
+عندهم يعني حسية أكتر للاستجابة من الناس الطبيعيين
+
+370
+00:23:19,020 --> 00:23:22,560
+طبعاً في بعضهم بيكون عندهم يعني airway obstruction
+
+371
+00:23:22,560 --> 00:23:25,740
+مش كلهم هي عشان تجلي variable يعني مختلفة مش الكل
+
+372
+00:23:25,740 --> 00:23:30,620
+طبعاً بيقوللي ها أنا الأزمة وضيق النفس بيقوللي
+
+373
+00:23:30,620 --> 00:23:34,960
+resolve spontaneously يعني ممكن تلقائياً يخف مع
+
+374
+00:23:34,960 --> 00:23:37,900
+إيش لما نعطيه حاجة اسمه bronchodilator إيش
+
+375
+00:23:37,900 --> 00:23:42,580
+برونكوديليتر لما نعطيه فاتح لمجاري التنفس زي إيش
+
+376
+00:23:42,580 --> 00:23:46,190
+فاتح لقنعة التنفس؟زي علاج مثلا ال Ventolin أكيد
+
+377
+00:23:46,190 --> 00:23:48,930
+سمعته عنه و هتسمعناه كتير في Ventolin في
+
+378
+00:23:48,930 --> 00:23:52,490
+Terbutolin في Aerovent أدوية تستخدم ال
+
+379
+00:23:52,490 --> 00:23:55,350
+Bronchodilator و في كمان بعضهم بيستخدم ال
+
+380
+00:23:55,350 --> 00:23:59,730
+adrenaline عشان يوسع قنوات النفس طب كيف بدي أنا
+
+381
+00:23:59,730 --> 00:24:02,490
+أقدر أعرف أن هذا أزمة و هذا مش أزمة؟ بعض الناس
+
+382
+00:24:02,490 --> 00:24:05,630
+بيقولك طب أنا عندي ديقة نفس، هل أنا عندي أزمة؟ لأ
+
+383
+00:24:05,630 --> 00:24:08,670
+بنعمل Spirometry بنجيزه على جهاز التنفس اللي موجود
+
+384
+00:24:08,670 --> 00:24:11,680
+عند الطبيب اللي أخصائي اللي هو ال Spirometryو
+
+385
+00:24:11,680 --> 00:24:14,740
+بعدين بنعمله Balmonary function testing برضه فحص
+
+386
+00:24:14,740 --> 00:24:17,840
+لإيش؟ لكفاءة الرئتين و هذا اللي بيعملوا الطبيب
+
+387
+00:24:17,840 --> 00:24:21,280
+الخصائمش احنا كويس احنا للمعرفة مايجي واحد يقول طب
+
+388
+00:24:21,280 --> 00:24:24,820
+يا ده أستاذ و يا دكتور هذه شغلات طبية حتى لو كانت
+
+389
+00:24:24,820 --> 00:24:29,060
+طبية يعني الحكمة ضالة المسلم أو ضالة المؤمنين أو
+
+390
+00:24:29,060 --> 00:24:31,690
+كما قرر النبي صلى الله عليه و سلماين ما وجدته هو
+
+391
+00:24:31,690 --> 00:24:34,430
+حق الناس بيهيجي، يعني الإنسان دائما يدور على العلم
+
+392
+00:24:34,430 --> 00:24:37,990
+ويدور على المعرفة، ماييجي بس يقول بس هي شغلي، لأ،
+
+393
+00:24:37,990 --> 00:24:40,790
+احنا بنعمل في طب أكتر ما بيعرف هذا الكلام، لكن
+
+394
+00:24:40,790 --> 00:24:44,830
+كويس احنا نكون معرفين طيب ال management إيش بنعمل؟
+
+395
+00:24:44,830 --> 00:24:47,610
+طبعا education to prevent exacerbation، لما يقول
+
+396
+00:24:47,610 --> 00:24:52,730
+كلمة exacerbation يعني امنع أي شي بهيجيهو بيهيج
+
+397
+00:24:52,730 --> 00:24:57,250
+الاستجابة الزائدة للحساسيات الموجودة يعني زي ايش؟
+
+398
+00:24:57,250 --> 00:24:59,870
+يعني تجعل ان عندي حساسية او صار معايا أزمة من
+
+399
+00:24:59,870 --> 00:25:03,130
+المجالب .. اقولهم لما يكونوا في البيت ما تجنوش هو
+
+400
+00:25:03,130 --> 00:25:06,290
+موجود خاصة زي جالي البندورة او جالي البتنجان بتعمل
+
+401
+00:25:06,290 --> 00:25:09,770
+رواح شديدة جدا في ناس ناضطيقها وفي ناس عندهم مشكلة
+
+402
+00:25:09,770 --> 00:25:13,790
+حساسية مطلقة من حساسية جالي السمك بس لكن دولة دالك
+
+403
+00:25:13,790 --> 00:25:18,070
+ممكن تكون على أهمر شوية الآن قولي optimize مثلا
+
+404
+00:25:18,070 --> 00:25:21,310
+هنا كمانpharmacotherapy يعني بدك تعطي يعني ال
+
+405
+00:25:21,310 --> 00:25:25,650
+optimum اللي هو العلاج المناسب له كعقق يرتبيه لأنه
+
+406
+00:25:25,650 --> 00:25:28,810
+مابينعطاش مش كله زي بعض في كتير علاجات للأزمة
+
+407
+00:25:28,810 --> 00:25:31,930
+أتروبين فنتولين ايرفان أي ان كان فبناء على
+
+408
+00:25:31,930 --> 00:25:35,210
+استجابته مش كل الناس زي موضوع السكة زي موضوع الضغط
+
+409
+00:25:35,210 --> 00:25:37,970
+مش كلهم باخدوا نفس العلاجات لازم تعطي علاجات
+
+410
+00:25:37,970 --> 00:25:44,170
+تتناسب مع وضع الصحة acute respiratory failure
+
+411
+00:25:44,170 --> 00:25:48,930
+acute respiratory failure ايش هو يعنيمن اسمها أول
+
+412
+00:25:48,930 --> 00:25:53,110
+حاجة فيها قصور أو فشل .. قصور أو فشل التنفس الحاد
+
+413
+00:25:53,110 --> 00:25:55,950
+.. فشل التنفس الحاد .. كيف بيصير هذا؟ ما زال قال
+
+414
+00:25:55,950 --> 00:25:59,290
+الحاد mechatronic معناته صدن .. يعني بيصير ايش؟
+
+415
+00:25:59,290 --> 00:26:02,550
+فجأة .. و هذا يعتبر ما زال فجأة life threatening
+
+416
+00:26:02,550 --> 00:26:06,030
+.. بدنا نحمله فورا و نضيع المستشفى .. فورا .. ليه؟
+
+417
+00:26:06,030 --> 00:26:10,430
+لأنه للأسف بطل عنده gas etc .. بعض الحالات نادرة
+
+418
+00:26:10,430 --> 00:26:13,910
+جدا .. نادرة .. لكن بتصير مرات .. ولكن هتقولكم متى
+
+419
+00:26:13,910 --> 00:26:18,170
+بتصير ..انه بيصير ان ال gas exchange .. بنضرب مرة
+
+420
+00:26:18,170 --> 00:26:21,690
+واحدة، ال gas exchange كويس للناس الطبيعيين،
+
+421
+00:26:21,690 --> 00:26:25,610
+بنتنفس، بتتبادل غازات في الalveoli، بيطلع تنكسط
+
+422
+00:26:25,610 --> 00:26:27,870
+الكربون و هكذا، و بيتوزع على الجسم الأكسجين و
+
+423
+00:26:27,870 --> 00:26:31,990
+هكذا، فيه من النوع اسمه ال type one acute اسمه إيش
+
+424
+00:26:31,990 --> 00:26:36,290
+hypoxemic، كلمة hypoxemic جاي من كلمة hypoxia، لما
+
+425
+00:26:36,290 --> 00:26:39,370
+أقول hypoxia يعني مافيش أكسجين واصل، لكن لما أقول
+
+426
+00:26:39,370 --> 00:26:44,470
+hypoxemic يعني جاي من إيميا، زي hypoxemiaلما أقول
+
+427
+00:26:44,470 --> 00:26:48,590
+كلمة إيميا يعني مافيش أكسيجين واصل للدم، لكن لو
+
+428
+00:26:48,590 --> 00:26:51,710
+قلت Hypoxia بشكل عام مافيش أكسيجين، لكن Hypoxemic
+
+429
+00:26:51,710 --> 00:26:55,230
+مافيش في الدم، طالما مافيش أكسيجين واصل للدم، يبقى
+
+430
+00:26:55,230 --> 00:26:57,930
+الدم اللي رايح على ال respiratory system، مش مافيش
+
+431
+00:26:57,930 --> 00:27:01,850
+فيه أكسيجين، يبقى صار فيه failure، يبلجأ الإنسان،
+
+432
+00:27:01,850 --> 00:27:05,570
+زي لما نلقى الدرلى بتنفس، فبدل ما ياخد أكسيجين،
+
+433
+00:27:05,570 --> 00:27:09,530
+لاجأ ثانوية أكسيط الكربونأو لجأة أواركس الكربون أو
+
+434
+00:27:09,530 --> 00:27:12,150
+لجأة لا سمح الله غزات سامة زي اللي بيصير عند بعض
+
+435
+00:27:12,150 --> 00:27:16,450
+كتير من الأسف اللي بيستخدموه زي الغزات السامة اللي
+
+436
+00:27:16,450 --> 00:27:18,690
+استخدمت في الحروب في أيام الحرب العراقية الإيرانية
+
+437
+00:27:18,690 --> 00:27:22,170
+وغيرهم كانوا بيستخدموا غزات وفي بعضهم للأسف يعني
+
+438
+00:27:22,170 --> 00:27:25,630
+حتى سمعت أنه كانوا في سوريا كمان استخدموا وكانوا
+
+439
+00:27:25,630 --> 00:27:29,030
+يموتوا ناس ماعرفوش ما بيصير زي جاز السرين وغيره في
+
+440
+00:27:29,030 --> 00:27:34,250
+غزات خطيرة جدا طيب ال type 2جال اكيوت ايش ها ..
+
+441
+00:27:34,250 --> 00:27:37,810
+hypercapnic لما نقول لي hypercapnic زيادة في ثانو
+
+442
+00:27:37,810 --> 00:27:41,710
+أكسيد الكربون هنا زيادة بإيش؟ نقص بالأكسيجين الحد
+
+443
+00:27:41,710 --> 00:27:45,310
+هنا زيادة في ثانو أكسيد الكربون بيسموه hypercapnia
+
+444
+00:27:45,310 --> 00:27:48,830
+زيادة في ثانو أكسيد الكربون أو أول أكسيد الكربون
+
+445
+00:27:48,830 --> 00:27:51,650
+التانين بيعمل إيه إيش خطورة زي وين بتصير ال
+
+446
+00:27:51,650 --> 00:27:53,590
+respiratory failure اللي هو عندك هذا بتدجف شوية
+
+447
+00:27:53,590 --> 00:27:56,910
+معظم الناس اللي بيموتوا عشان كون عندكم علم بيموتوا
+
+448
+00:27:56,910 --> 00:28:01,890
+من ال .. ال .. الكنون و الفحمأو يعني في حالات كتير
+
+449
+00:28:01,890 --> 00:28:06,910
+أجانع يعني لو كان طبيب يعني او هو يعني من خارجه من
+
+450
+00:28:06,910 --> 00:28:09,710
+ال health professionals يعني من المتخصين الصحيين
+
+451
+00:28:09,710 --> 00:28:14,190
+كان فاتح ال motor اللي تبع المولد الكهرة، ال motor
+
+452
+00:28:14,190 --> 00:28:17,900
+الصغير حاطه في داخل صيدلية وعمله بشتغلالموتور
+
+453
+00:28:17,900 --> 00:28:20,160
+عامله بيطلع العدم، بيطلع العدم و هو بيدروح، مافيش
+
+454
+00:28:20,160 --> 00:28:25,140
+شي مكان يطلع برا، فكل المكان في الصيدلية انتلا او
+
+455
+00:28:25,140 --> 00:28:29,040
+ركسيل كربون مابيشعرش، ماحدش يقوللي انه طب ماانتبهش
+
+456
+00:28:29,040 --> 00:28:31,760
+لحاله، لأ ماانتبهش، silent killer، هذا يعتبر من
+
+457
+00:28:31,760 --> 00:28:35,370
+القاتل الصامتفبتشبع ال oxygen .. ها بتشبع ال
+
+458
+00:28:35,370 --> 00:28:39,030
+oxygen بروح أشجة و بتشبع الدم .. الدم بتشبع بال
+
+459
+00:28:39,030 --> 00:28:42,430
+إيه؟ بثانوكسيد الكربون فبدل ما يودع خلايا ال
+
+460
+00:28:42,430 --> 00:28:45,150
+oxygen يودع ثانوكسيد الكربون فعملة respiratory
+
+461
+00:28:45,150 --> 00:28:48,830
+failure بتؤدي للوفاة هذا اسمه acute hypercapnic من
+
+462
+00:28:48,830 --> 00:28:53,890
+الكنون من البنزين لما بنحرقه جنبه من الحرائق بشكل
+
+463
+00:28:53,890 --> 00:28:56,870
+عام لما بنخنقه كتير من الناس بيقولك ما ماتوش من
+
+464
+00:28:56,870 --> 00:28:59,310
+الحريق ماتوا من الخنق من الحريق و هذا اللي بيصير
+
+465
+00:28:59,310 --> 00:29:03,270
+type 3 combined ايش يعني combined؟ بيكون مشتركبكون
+
+466
+00:29:03,270 --> 00:29:06,890
+عنده hypoxemia وعنده hypercapnia يعني عنده نقص
+
+467
+00:29:06,890 --> 00:29:10,930
+أكسيجين وزيادة فيه ثانكسيد الكربون يبقى معناته إما
+
+468
+00:29:10,930 --> 00:29:14,730
+مافيش أكسيجين وإما ثانكسيد الكربون زاد وإما مشترك
+
+469
+00:29:14,730 --> 00:29:18,450
+الأتنين مع بعض طبعا التلاتة على بعض مصيبة وبيعملوا
+
+470
+00:29:18,450 --> 00:29:21,030
+respiratory failure وممكن تؤدي للوفاق إذا ما
+
+471
+00:29:21,030 --> 00:29:25,300
+تلحقناهوش مباشرة ودلع المستشفىالتست هنا بنعمله
+
+472
+00:29:25,300 --> 00:29:28,180
+arterial blood gases فجأة بنتفاجأ بنلاقي ال
+
+473
+00:29:28,180 --> 00:29:31,840
+thermocyte carbon زايد جدا جدا و ال oxygen جليل و
+
+474
+00:29:31,840 --> 00:29:35,920
+هذا مصيبة بنعمله chest x-ray بيبين ايش ان العلمات
+
+475
+00:29:35,920 --> 00:29:40,220
+ممكن تكون ماتت بعض الخلايا في ال lung و بيانت ان
+
+476
+00:29:40,220 --> 00:29:44,240
+صار اللون ميل الأبيض و ده الأسود بنعمله CT ال
+
+477
+00:29:44,240 --> 00:29:46,900
+computerized tomography اللي صورة .. الصورة اللي
+
+478
+00:29:46,900 --> 00:29:51,360
+هو المقطعية اللي تحت ال computer كلكم عارفين هذا
+
+479
+00:29:51,360 --> 00:29:54,930
+المصطلح لأن كتير الناس العادين بيعرفوهو بنعمله حد
+
+480
+00:29:54,930 --> 00:29:58,050
+يسمى thorough synthesis thorough synthesis يعني
+
+481
+00:29:58,050 --> 00:30:03,550
+بنحطله tube عشان نسحب منه إذا .. نحطه ال tube في
+
+482
+00:30:03,550 --> 00:30:06,910
+منطقة ال chest عشان نسحب إذا صار إشي أو اللي
+
+483
+00:30:06,910 --> 00:30:10,730
+plural انتلت بشي معين سواء كانت ال fluid سواء كانت
+
+484
+00:30:10,730 --> 00:30:15,030
+blood سواء كانت أي شيء من الخارج أو حتى لو كان فيه
+
+485
+00:30:15,030 --> 00:30:18,930
+هوا أقدر أسحب طب إيش بده أعمله في هذه الحالة؟ أول
+
+486
+00:30:18,930 --> 00:30:22,330
+حاجة بدك تصلح الجازاللي موجودة الخربط اللي صارت
+
+487
+00:30:22,330 --> 00:30:25,630
+كيف بتصلحها؟ بدخله على اكسيجين ترابس مش اكسيجين
+
+488
+00:30:25,630 --> 00:30:29,430
+عادي لأ endotracheal tube بدخله على ventilation
+
+489
+00:30:29,430 --> 00:30:32,390
+اللي هو ال ventilator ال machine طبعا ال machine و
+
+490
+00:30:32,390 --> 00:30:36,270
+بخليه يتنفس طبعا عليها عشان نقدر نحط الاكسيجين
+
+491
+00:30:36,270 --> 00:30:38,450
+اللي بدناهيه و ال .. و النسب اللي بدناهيه عشان
+
+492
+00:30:38,450 --> 00:30:40,550
+تتحسن اللي هو النسب اللي موجودة في ال arterial
+
+493
+00:30:40,550 --> 00:30:44,810
+blood gases بعدين بنشوف حاجة تسمى reversal of any
+
+494
+00:30:44,810 --> 00:30:49,760
+narcoticsطبعاً لما أقول كلمة reversal of any
+
+495
+00:30:49,760 --> 00:30:53,980
+narcotics يعني بدك نحاول قدر الإمكان لأن هذا بيكون
+
+496
+00:30:53,980 --> 00:30:58,360
+عنده غيبوبة فبدنا نحاول لما نعطيه narcotics يعني
+
+497
+00:30:58,360 --> 00:31:01,760
+العلاجات اللي علاقة بالإيش زي ما ناخدنا اللي علاقة
+
+498
+00:31:01,760 --> 00:31:07,140
+بال .. زي ال narcotine زي ال opioid يعني بشكل عام
+
+499
+00:31:07,140 --> 00:31:09,840
+احنا بيقولون عن المخدرات مش هقول كلمة مخدرات عشان
+
+500
+00:31:09,840 --> 00:31:14,560
+انا ترددت أحكيهايعني ال opioid بشكل عام مورفين
+
+501
+00:31:14,560 --> 00:31:19,080
+مثدين علاجات من هذا القبيل بنشوف إيش نعمله بنعمله
+
+502
+00:31:19,080 --> 00:31:23,100
+إعادة رد فعلي يعني لو كانت زايدة عنده بدنا ننقصها
+
+503
+00:31:23,100 --> 00:31:26,780
+لو لاجناه عنده deep coma بنخففها شوية يعني لازم
+
+504
+00:31:26,780 --> 00:31:30,920
+نعطي حسب الطبيب ما بيتكلم possible طبعا mechanical
+
+505
+00:31:30,920 --> 00:31:34,180
+ventilation أكيد أكيد أكيد لازم نعمله mechanical
+
+506
+00:31:34,180 --> 00:31:37,140
+ventilation لأن مش هنقدر نسيطر عليه طبعا احنا
+
+507
+00:31:37,140 --> 00:31:41,050
+خلصنا ال chapterطبعا ال respiratory system
+
+508
+00:31:41,050 --> 00:31:44,990
+assessment ونشوف احنا يعني ان شاء الله تكون
+
+509
+00:31:44,990 --> 00:31:48,590
+استفدته وان شاء الله بننتقل لل chapter القادم في
+
+510
+00:31:48,590 --> 00:31:52,310
+المحاضرة القادمة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c5dd3b2457a68de7475fd4dbbca4877804756733
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/jBXPeLIh3RY_raw.srt
@@ -0,0 +1,2040 @@
+1
+00:00:00,810 --> 00:00:04,290
+و بسم الله الرحمن الرحيم خلينا نكمل طبعا احنا
+
+2
+00:00:04,290 --> 00:00:08,770
+وصلنا لهذه الشريحة في المحاضرة السابقة و ان شاء
+
+3
+00:00:08,770 --> 00:00:13,450
+الله نكمل مع بعض في respiratory assessment طبعا ..
+
+4
+00:00:13,450 --> 00:00:15,210
+طبعا respiratory system يعني اللي هو الجهاز
+
+5
+00:00:15,210 --> 00:00:19,570
+التنفسي وصلنا لحاجة اسمها ال plural friction rub
+
+6
+00:00:19,570 --> 00:00:22,290
+طبعا خلصنا عندها ال stridor اللي لما حكينا عنها
+
+7
+00:00:22,290 --> 00:00:26,070
+خاصة في حالة ال inspiration و كيف تصير musical
+
+8
+00:00:26,070 --> 00:00:29,390
+ويزياني اللي هو الصوت الصفير أثناء النفس أو الشاي
+
+9
+00:00:30,320 --> 00:00:34,800
+طيب ايه plural friction rub من اسمها؟ plural ..
+
+10
+00:00:34,800 --> 00:00:37,580
+plural cavity طب friction زي احتكاك .. rub .. rub
+
+11
+00:00:37,580 --> 00:00:40,860
+يعني كأنه بيحك مع بعضه شو يعني دي؟ يعني صار من
+
+12
+00:00:40,860 --> 00:00:45,260
+منطقة ال plural صارت فيها جفاف وتحتك مع بعضها
+
+13
+00:00:45,260 --> 00:00:49,500
+ويلها صوت سماها loud dry cracking إش يعني كأنه هي
+
+14
+00:00:49,500 --> 00:00:53,260
+كإش بي .. بي .. بيعمل صوت وورقتين كانوا بيحكوا مع
+
+15
+00:00:53,260 --> 00:00:57,260
+بعض بيقولي grating sound indicating plural
+
+16
+00:00:57,260 --> 00:01:02,360
+friction أو plural irritationعبارة عن صوت كركة أو
+
+17
+00:01:02,360 --> 00:01:07,340
+خرخشة موجودة بتصير زي احتكاك اتنين مع بعض gratics
+
+18
+00:01:07,340 --> 00:01:12,160
+زي اشي .. زي اشي بيشحت .. اشي بيعمل صوت زي تشحت مع
+
+19
+00:01:12,160 --> 00:01:17,740
+بعض وين بيصير هذا؟ بيقوللي بكون على lateral and
+
+20
+00:01:17,740 --> 00:01:21,280
+anterior lung in sitting position مرات بيصير على
+
+21
+00:01:21,280 --> 00:01:24,460
+الجنب اللي هو خارجه .. اللي هو ال lung على الجنب
+
+22
+00:01:24,460 --> 00:01:27,660
+سواء كان right أو leftو بيصير وين كمان في ال
+
+23
+00:01:27,660 --> 00:01:30,100
+anterior و الأمام يعني بيصيرش في ال .. في ال
+
+24
+00:01:30,100 --> 00:01:33,260
+posterior اللي بيكون يعني مش .. مش من الظهري
+
+25
+00:01:33,260 --> 00:01:37,200
+بينسمع وانما .. طبعا بعض الناس بيقولك طيب إيش هذا
+
+26
+00:01:37,200 --> 00:01:40,840
+الصوت؟ ما هو يمكن هذا الصوت يكون في secretion أو
+
+27
+00:01:40,840 --> 00:01:44,930
+في شغلات موجودةفى الرقاتين وخلّيه يجوح شوية ممكن
+
+28
+00:01:44,930 --> 00:01:48,770
+تطلع عشان نقدر نفرج بين ال plural ال friction rub
+
+29
+00:01:48,770 --> 00:01:53,170
+و بين ال sputum with cuffing او مثلا .. خليني اقول
+
+30
+00:01:53,170 --> 00:01:57,170
+مثلا with sputum او with cuff او زى ما يقولوا يعني
+
+31
+00:01:57,170 --> 00:02:01,570
+اللى و الجحة اللى بتكون مختلطة بأى .. بأى
+
+32
+00:02:01,570 --> 00:02:06,370
+secretions هذهك لما يجوح الإنسان مجرد ما يطلع
+
+33
+00:02:06,370 --> 00:02:09,680
+secretions خلاص بروح الصوتلكن في ال plural ال
+
+34
+00:02:09,680 --> 00:02:12,900
+friction rub ايش كتبت هنا not clear with cuffing
+
+35
+00:02:12,900 --> 00:02:16,800
+يعني لو ضال يجوح منها لبكرة بيضل الصوت موجود ليه؟
+
+36
+00:02:16,800 --> 00:02:20,060
+على اعتبار ان الاشي مش موجود في داخل ال lung و
+
+37
+00:02:20,060 --> 00:02:24,240
+انما حوالين ال lung طب خلينا نشوف causes of
+
+38
+00:02:24,240 --> 00:02:27,260
+decreased or absent breath sounds متى الكتب بتكلم
+
+39
+00:02:27,260 --> 00:02:30,440
+بشكل عام؟ بتكلمش بشكل خاص بتكلم بشكل عام أصوات
+
+40
+00:02:30,440 --> 00:02:33,740
+النفس سواء كان في الmeno bronchus و ال bronchi و
+
+41
+00:02:33,740 --> 00:02:38,890
+ال bronchism بغض النظرمتى ممكن الأصوات تبع التنفس
+
+42
+00:02:38,890 --> 00:02:43,370
+بشكل عام ممكن اتجل يعني صوتها مايكونش عالي في حال
+
+43
+00:02:43,370 --> 00:02:46,150
+.. هتلاقي في كل اللي .. اللي .. اللي بدنا نذكره
+
+44
+00:02:46,150 --> 00:02:51,110
+شغلات فيها يعني .. يعني إما chronic problem أو إما
+
+45
+00:02:51,110 --> 00:02:54,610
+تكون يعني إيش .. يعني خلوني أقول danger problem من
+
+46
+00:02:54,610 --> 00:02:58,710
+إيش؟ زي الأزمة اللي بيكون عنده أزمة بشكل دائم و
+
+47
+00:02:58,710 --> 00:03:03,350
+طويلبكون نفسه أصلا يعني بكون ضيق شوية و مرات بكون
+
+48
+00:03:03,350 --> 00:03:05,950
+الصوت صفير و لما .. مابتكلمش على صوت الصفير هنا
+
+49
+00:03:05,950 --> 00:03:09,810
+بتروح تقوللي ما هو صوت .. يعتبر صوت نفس، لأ، هذا
+
+50
+00:03:09,810 --> 00:03:14,430
+بنسمع الصفير بدون سماعات، لكن أنا بتكلم على الصوت
+
+51
+00:03:14,430 --> 00:03:18,550
+اللي ممكن نسمعه ب stethoscope و نتأكد منه COPD
+
+52
+00:03:18,550 --> 00:03:22,510
+chronic obstructive pulmonary disease المرض اللي
+
+53
+00:03:22,510 --> 00:03:25,990
+خالص هو بيكون معاه bronchitis، مع أزمة، بعضهم جال
+
+54
+00:03:25,990 --> 00:03:30,020
+كمان اللي هو bronchectasis اللي الأخيرةكل هذا ايش
+
+55
+00:03:30,020 --> 00:03:33,240
+يعني بتعتبر من الأمراض اللي ايه اللي تلازم اللي هو
+
+56
+00:03:33,240 --> 00:03:36,960
+الجهاز تنفسه، plural effusion لما نقول كلمة plural
+
+57
+00:03:36,960 --> 00:03:39,740
+effusion معناه اللي plural cavity صارش في قلبه،
+
+58
+00:03:39,740 --> 00:03:42,900
+فيه سائل و السائل ايش ممكن يكون؟ ممكن يكون سرس
+
+59
+00:03:42,900 --> 00:03:46,480
+فلود، ممكن يكون فلود، بغض النظر المهم فيه fluid،
+
+60
+00:03:46,480 --> 00:03:50,590
+ال nemothorax هناطبعا بعضهم بيقولك في طبعا
+
+61
+00:03:50,590 --> 00:03:54,450
+hemothorax بيسموها و هنا إذا كانت blood بيسميها
+
+62
+00:03:54,450 --> 00:03:57,830
+hemothorax لكن nemothorax كلكم عارفين نمو جاي من
+
+63
+00:03:57,830 --> 00:04:01,930
+هواء معناته إيش دخول هواء في منطقة الblural cavity
+
+64
+00:04:01,930 --> 00:04:05,590
+و خاصة لما الواحد بيكون ماخد stab wound أو لقدر
+
+65
+00:04:05,590 --> 00:04:10,050
+لقطعنه من شيء أو أكل هواية أو صار عنده fracture في
+
+66
+00:04:10,050 --> 00:04:12,570
+ال ribs طبعا أو أوقات الاكتساز اللي ال
+
+67
+00:04:12,570 --> 00:04:14,490
+inflammatory process في ال lung tissue زي ما
+
+68
+00:04:14,490 --> 00:04:18,940
+شرحناها في المحاضرة السابقة طيبCommon respiratory
+
+69
+00:04:18,940 --> 00:04:22,340
+disorders، ايش اكتر؟ ماجيبتش كل ال respiratory
+
+70
+00:04:22,340 --> 00:04:26,560
+disorders، no، انا قولت common عشان ماحدش يقول انه
+
+71
+00:04:26,560 --> 00:04:30,680
+هاد اللي بتصيب فقط ال respiratory system، لأ،
+
+72
+00:04:30,680 --> 00:04:33,880
+اليوم احنا في كورونا، respiratory system problems،
+
+73
+00:04:33,880 --> 00:04:37,320
+ممكن يقول TB، respiratory problem، مش عارفين، حتى
+
+74
+00:04:37,320 --> 00:04:42,020
+بس أنا بتنجيب شكل عام ايش الشغلات اللي ممكن تؤثر و
+
+75
+00:04:42,020 --> 00:04:47,200
+تعمل عند المريض إشكالات في الجهاز التنفسيأول حاجة
+
+76
+00:04:47,200 --> 00:04:53,160
+النمونيا، شو النمونيا يعني؟ التهاب في أنسجات
+
+77
+00:04:53,160 --> 00:04:58,400
+وخلايا الرئتين طيب، النمونيا ده هل كل نمونيا زي
+
+78
+00:04:58,400 --> 00:05:02,080
+بعض؟ لأ، في نمونيا سموها community acquired
+
+79
+00:05:02,080 --> 00:05:05,120
+نمونيا، يعني جاي من إيش؟ جال community، من
+
+80
+00:05:05,120 --> 00:05:08,840
+المجتمع، من سكنه في مكان، جنبه في asbestos، جنبه
+
+81
+00:05:08,840 --> 00:05:11,660
+environmental مثلا إيه ال polytans أو شغلات زي
+
+82
+00:05:11,660 --> 00:05:15,320
+ذلك، عملة عنده نمونيافي ناس عندهم صارت للأسف cross
+
+83
+00:05:15,320 --> 00:05:18,300
+infection من وين اللي بيسموها من وين hospital
+
+84
+00:05:18,300 --> 00:05:21,200
+infection اللي ال hospital acquire pneumonia يعني
+
+85
+00:05:21,200 --> 00:05:23,420
+هو وكان كويس لكن اللي حواليه عندهم pneumonia عدو
+
+86
+00:05:23,420 --> 00:05:28,040
+ممكن إيه جاء من بكتيريا ممكن يكون السبب في viruses
+
+87
+00:05:28,040 --> 00:05:31,120
+زي ما الآن موجود في كورونا coronavirus ممكن
+
+88
+00:05:31,120 --> 00:05:34,880
+mycoplasma وانتوا درستوا واحدة في ايه كلكم درستوا
+
+89
+00:05:34,880 --> 00:05:37,540
+في الميكروبيولوجيا كل هذه الأنواع ممكن تكون فنجاى
+
+90
+00:05:37,540 --> 00:05:41,760
+فطري ممكن تكون chemical شغل كيماوية زي ايش كيميائي
+
+91
+00:05:41,760 --> 00:05:44,860
+زي بعض الناس اللي مشتغلوافي الأشياء اللي بتطلع عيش
+
+92
+00:05:44,860 --> 00:05:48,220
+روائح خاصة وفي مش بس كمان بتطلع روائح شديدة، حتى
+
+93
+00:05:48,220 --> 00:05:51,440
+مرات في خطأ، و كويس أن أنا أذكركم في هذا الحلقه،
+
+94
+00:05:51,440 --> 00:05:54,660
+في بعض الستات في البيوت بروحوا مشكلتهم مشكلة،
+
+95
+00:05:54,660 --> 00:05:57,300
+بتروح بتجيب بدأت نظف البيت أو الحمام، أكرمكم الله
+
+96
+00:05:57,300 --> 00:06:00,970
+زيادة عن اللزوم، بتروح بتحط ميه النارو بتحط معاك
+
+97
+00:06:00,970 --> 00:06:04,870
+لور، يصير التفاعل بتطلع طبعا offensive وضرائحة
+
+98
+00:06:04,870 --> 00:06:08,430
+شديدة جدا و من الحلات في كتير منهم أجوا صار عندهم
+
+99
+00:06:08,430 --> 00:06:12,450
+مش بسيمونيا صار عندهم يعني danger خليني أقول مثلا
+
+100
+00:06:12,450 --> 00:06:16,170
+shortness of breath صار عندهم سبب خطير و مش قادر
+
+101
+00:06:16,170 --> 00:06:18,830
+يتنفس ليش لإنه بقى صار بتصير عندهم إيش حاجة
+
+102
+00:06:18,830 --> 00:06:22,410
+بيسموها air collapse و هذا أمر مش سهل كله من إيش؟
+
+103
+00:06:22,410 --> 00:06:26,590
+من ال chemical، من التفاعلات اللي بتصيرفي حسمة
+
+104
+00:06:26,590 --> 00:06:28,850
+بدنا نلقي ندوق على ال plural effusion انا بتكلم عن
+
+105
+00:06:28,850 --> 00:06:31,770
+ايه ال common respiratory يعني اغلب الحالات اللي
+
+106
+00:06:31,770 --> 00:06:34,610
+بتيجي طبعا من الحالات التانية اللي هي ال
+
+107
+00:06:34,610 --> 00:06:38,370
+respiratory disorders plural effusion وقلنا ايش
+
+108
+00:06:38,370 --> 00:06:41,830
+معنات plural effusion يعني في متجمع في ال plural
+
+109
+00:06:41,830 --> 00:06:46,690
+ايش fluid معناته تجمع سائل في منطقة ال plural
+
+110
+00:06:46,690 --> 00:06:50,370
+cavity فبقوليها انا بتكون secondary ليش secondary
+
+111
+00:06:50,370 --> 00:06:55,210
+لما اقول كلمة secondary يعني في سبب خلاها تسيرلو
+
+112
+00:06:55,210 --> 00:06:59,330
+صارت لحالة بدون سبب بنسميها primary لكن لو صارت
+
+113
+00:06:59,330 --> 00:07:03,510
+ناتج عن سبب تاني بنقول عن secondary نحط مثال لكلمة
+
+114
+00:07:03,510 --> 00:07:06,650
+secondary هنا بيقول ال secondary to increase fluid
+
+115
+00:07:06,650 --> 00:07:12,050
+formation انه بتصير مضعفة لتجمع سوائل هيجي زي كيف؟
+
+116
+00:07:12,050 --> 00:07:14,710
+زي واحد عنده congestive heart failure congestive
+
+117
+00:07:14,710 --> 00:07:17,370
+heart failure لما اقول كلمة congestive heart
+
+118
+00:07:17,370 --> 00:07:22,170
+failure معناته ايش؟ فشل في عضلة القلب مش قادر التخ
+
+119
+00:07:22,560 --> 00:07:26,420
+الدم كويس ومش قادر صار .. صار الدم يرشح منه السائل
+
+120
+00:07:26,420 --> 00:07:29,980
+الزاد .. لما صار يرشح كل ما يروح الدم على الرياضين
+
+121
+00:07:29,980 --> 00:07:34,060
+عشان يتنقق صار إيش؟ يرشح منه السائل .. مش ..
+
+122
+00:07:34,060 --> 00:07:36,800
+المشكلة مش من الرياض صارت .. أجتنا المشكلة من
+
+123
+00:07:36,800 --> 00:07:39,840
+ورايا من الهارد .. واحد step one مش من هنا .. أجته
+
+124
+00:07:39,840 --> 00:07:43,720
+من برا .. و هكذا .. يعني في plural effuges اتجمع
+
+125
+00:07:43,720 --> 00:07:47,540
+.. increased .. إيش صار هنا؟capillary permeability
+
+126
+00:07:47,540 --> 00:07:51,260
+بيصير اللي هو capillary كلكم عارفينها اللي هو اللي
+
+127
+00:07:51,260 --> 00:07:54,680
+هو الفتحات اللي موجودة في داخل اللي هو الشراين
+
+128
+00:07:54,680 --> 00:07:58,640
+الدموية إيش صار فيها زادت خاصة في ال alveolar كذا
+
+129
+00:07:58,640 --> 00:08:02,460
+فبدت تتسح صار يدخل فيها السائل أكتر increased
+
+130
+00:08:02,460 --> 00:08:06,800
+colloid osmotic pressure بزيد الضغط الأسموزي كمان
+
+131
+00:08:06,800 --> 00:08:10,520
+في داخل إيش هنا؟ في داخل ال blood ولمّا بزيد ضغط
+
+132
+00:08:10,520 --> 00:08:15,350
+الأسموزي بيخلي إيش ال إيش السائل يطلع منه أكترزي
+
+133
+00:08:15,350 --> 00:08:17,490
+ليش؟ وانتوا عارفين هذه القصة خدناها دايما في
+
+134
+00:08:17,490 --> 00:08:20,390
+الكيميا، اظن في ال chemistry ممكن تكون اخدتها، انه
+
+135
+00:08:20,390 --> 00:08:22,850
+بعد ضغط الاسموزي عماله بيصير عملية الرشح زي عملية
+
+136
+00:08:22,850 --> 00:08:25,790
+الحرق لما بيصير انسان بنحرج، فبتلاقي بيطلع منه
+
+137
+00:08:25,790 --> 00:08:29,550
+surface fluid و بتجمع حوالين ال skin. Increased
+
+138
+00:08:29,550 --> 00:08:33,130
+ايه هنا؟ Intra plural negative pressure. Intra
+
+139
+00:08:33,130 --> 00:08:37,330
+negative pressure اللي هو الضغط السلبي، بزيد.لما
+
+140
+00:08:37,330 --> 00:08:40,710
+نزيد الضغط السلبي، بيسحب، ليش يعني الضغط السلبي زي
+
+141
+00:08:40,710 --> 00:08:44,270
+ال vacuum، زي اللي بشفط؟ ليش زمان كانوا يقولون أنه
+
+142
+00:08:44,270 --> 00:08:49,590
+لما واحد بياخد سكينة أو بينضرب بشيء يعني مؤدي زي
+
+143
+00:08:49,590 --> 00:08:53,510
+step wound أو سيخ أو كده، إيش بنقولهم؟ خلّي الأداء
+
+144
+00:08:53,510 --> 00:08:57,590
+في مكانها، ليه؟ علشان أنا مابدي إذا سحبنا الأداء
+
+145
+00:08:57,590 --> 00:09:00,870
+من منطقة الصدر، هيدخل الهواء يعملنا حاجة اسمها
+
+146
+00:09:00,870 --> 00:09:04,420
+nemothoraxليه؟ لأنه مليان negative pressure في
+
+147
+00:09:04,420 --> 00:09:08,160
+داخل ال chest من جوا مغلق، عشانك اذا .. بكرا نروح
+
+148
+00:09:08,160 --> 00:09:13,020
+المستشفى ان شاء الله يعني و نتدرب هنلاقي في حاجة
+
+149
+00:09:13,020 --> 00:09:17,380
+بيسموها ال chest tube ان هو بنحطها في صدر المريض و
+
+150
+00:09:17,380 --> 00:09:22,940
+بتروح تدخل على bottle زي وعاء زي ..يعني خلاني أقول
+
+151
+00:09:22,940 --> 00:09:28,260
+مرتبان زجاجي عشان تقدر تأخد السوائل من جوا كشيء
+
+152
+00:09:28,260 --> 00:09:31,100
+مغلق ليش هذا الكلام؟ لأن ال negative pressure
+
+153
+00:09:31,100 --> 00:09:34,780
+بيسحب أي شيء فلما بيزيد ال negative pressure بروح
+
+154
+00:09:34,780 --> 00:09:38,620
+بيسحب السوائل في داخل البلورة الكفتي فبيصير بتجمع
+
+155
+00:09:38,620 --> 00:09:43,540
+أكتر وبصير عنده إشكالية أكبر صحية impaired
+
+156
+00:09:43,540 --> 00:09:46,720
+lymphatic drainage كمان ال lymphatic drainage
+
+157
+00:09:46,720 --> 00:09:49,060
+وانتوا عارفين ال lymphatic system يعني تعتبره جسم
+
+158
+00:09:49,060 --> 00:09:53,950
+مناعيوهي يعني تعتبر التصريف العام للـ artery فبصير
+
+159
+00:09:53,950 --> 00:09:57,590
+كمان إيش ال drainage دماغها بزيد ليش بزيد كمان؟ ما
+
+160
+00:09:57,590 --> 00:10:00,950
+هو كله ماشي مع ال inflammatory process أو حتى
+
+161
+00:10:00,950 --> 00:10:07,610
+dangerous process أو حتى يعني trauma أيا كان فيه
+
+162
+00:10:07,610 --> 00:10:11,710
+مشكلة فبصير إيش عمله؟ فبصير يطلع أكتر كل ما طلع
+
+163
+00:10:11,710 --> 00:10:15,150
+الدم أكتر ماهيرشح منه أكتر أيش اللي هو السائل اللي
+
+164
+00:10:15,150 --> 00:10:19,710
+في جلبه increase pressure in the capillariesبزيد
+
+165
+00:10:19,710 --> 00:10:23,230
+الضغط وين في ال capillaries الشعيرات الدموية و لما
+
+166
+00:10:23,230 --> 00:10:25,390
+زاد في الشعيرات الدموية و ال emphatics زي نفس
+
+167
+00:10:25,390 --> 00:10:29,050
+الكلام بزيد ايش بيصير فبصير يتسرب منه السائل اكتر
+
+168
+00:10:29,050 --> 00:10:33,710
+طيب نجعلها مشكلة تالتة و مشكلة خطيرة كتير و برضه
+
+169
+00:10:33,710 --> 00:10:38,250
+تعتبر حتى عندنا بيسموها من ال medical emergency
+
+170
+00:10:38,250 --> 00:10:41,850
+تعتبر حاجة تسمى medical emergency يعني يجب التدخل
+
+171
+00:10:41,850 --> 00:10:46,170
+فورا حتى لو بندخله على جهاز تنفس الصناعي طب ليه؟
+
+172
+00:10:46,170 --> 00:10:49,100
+هالجيب يقولكواNemothorax يعني بدل ما يتجمع
+
+173
+00:10:49,100 --> 00:10:52,940
+solution اتجمع ايش هوى جاء من ال Nemo sudden onset
+
+174
+00:10:52,940 --> 00:10:57,240
+of pleuritic chest pain كيف بنعرف انه بيصير عنده
+
+175
+00:10:57,240 --> 00:11:03,920
+ألم شديد جدا في منطقة الصدر بس ايه يعني بيقوللي
+
+176
+00:11:03,920 --> 00:11:09,820
+sudden ليش sudden فجأة بيجي أكله وايه صار عنده اي
+
+177
+00:11:09,820 --> 00:11:13,860
+حاجة فجأة مش قادر ياخد نفسي بيقولك انا عندي chest
+
+178
+00:11:13,860 --> 00:11:18,400
+painماشي في منطقة بلوراتك يعني منطقة البلورة مش
+
+179
+00:11:18,400 --> 00:11:21,120
+قادر ياخد نفس مباشرة طبعا بعض الناس بيقولك طب ليش
+
+180
+00:11:21,120 --> 00:11:25,320
+لنتخل مباشرة؟ لأنه هذا نفس لو جاللي بطن بجوعني
+
+181
+00:11:25,320 --> 00:11:28,880
+ممكن أستنى شوية لو جاللي رجلي ماشي بس هذا نفس اذا
+
+182
+00:11:28,880 --> 00:11:33,060
+كان مات في المضطرين فورا شو صار عنده ديسنيا؟ اللي
+
+183
+00:11:33,060 --> 00:11:36,200
+هو صعوبة نفس shortness of breath قصر في النفس كمان
+
+184
+00:11:36,200 --> 00:11:38,580
+increased work of breathing ايش يعني work of
+
+185
+00:11:38,580 --> 00:11:41,540
+breathing؟ زاد الجهد تبع النفس اقعك و تفكر ان
+
+186
+00:11:41,540 --> 00:11:44,930
+الإنسانلو بستخدم الجهد دايما في حياته في النفس
+
+187
+00:11:44,930 --> 00:11:48,190
+ممكن عضلاته كله يصير في عندها حاجة بسمها paralysis
+
+188
+00:11:48,190 --> 00:11:51,990
+أو exhaustion فمجرد بنلاقي إنسان مش قادر .. احنا
+
+189
+00:11:51,990 --> 00:11:55,410
+ليش بنحط البني آدم على التنفس الصناعي؟ في معظم
+
+190
+00:11:55,410 --> 00:12:00,790
+الحالات أنه ممكن يتنفس بس مش قادر ياخد نفس عشان مش
+
+191
+00:12:00,790 --> 00:12:04,270
+قادر ياخد نفس أنا بحطله تنفس صناعي عشان أريح عضلات
+
+192
+00:12:04,270 --> 00:12:08,310
+النفس وعضلات الصدر لحين ما يستطيع ياخد لوحده خاصة
+
+193
+00:12:08,310 --> 00:12:12,600
+في حالات اللي بتكون high dangerطيب الان ايش بقولي
+
+194
+00:12:12,600 --> 00:12:15,880
+طب كيف بتشخص ال Nemo thorax بقولي بدك تعمله ايش
+
+195
+00:12:15,880 --> 00:12:20,220
+هنا CXR خليكوا ذاكرين اختصار عالمي عشان لما تشوفه
+
+196
+00:12:20,220 --> 00:12:25,020
+في المستشفيات اسمه chest x-ray صورة للصدر x-ray
+
+197
+00:12:25,020 --> 00:12:29,240
+صورة سينية للصدر هذا اللي بيشخص ان في نيمو ثوراكس
+
+198
+00:12:29,240 --> 00:12:33,260
+طبعا لو حد سألني طب ليش؟ الان عشان كوني عندكوا علم
+
+199
+00:12:33,260 --> 00:12:37,480
+اي شي فيه هوة على الصورة الصينية ال x-ray تطلع لنا
+
+200
+00:12:37,480 --> 00:12:41,930
+سودةو أي شي solid يعني حاجة جامدة بيطلع فيها بياض
+
+201
+00:12:41,930 --> 00:12:45,350
+يعني مثلا الرئاتين لما نيجي نصور المريض بنقوله خد
+
+202
+00:12:45,350 --> 00:12:48,870
+نفس باخد النفس و بنقوله اكتم النفس كتم النفس
+
+203
+00:12:48,870 --> 00:12:53,690
+صورناه و جرد ما احنا صورناه بنروح ايش نطلع في
+
+204
+00:12:53,690 --> 00:12:56,570
+الصورة بنلاقي الصورة كلها ايش زي منطقة سوداء ما
+
+205
+00:12:56,570 --> 00:13:00,570
+تخافوش اللون السواد معناته يعني ايش كويس الرئاتين
+
+206
+00:13:00,570 --> 00:13:05,470
+و اللي في جلمن يعني المبين واضح انه يعني داخل ال
+
+207
+00:13:05,470 --> 00:13:08,890
+oxygen و الهواء تماملكن اليوم زي الأيام الماضية
+
+208
+00:13:08,890 --> 00:13:11,590
+مثلا في كورونا ايش بيعملوا بيصوروا زي هيك بيلاقوا
+
+209
+00:13:11,590 --> 00:13:13,770
+ايش في حاجة اسمها white patches ايش يعني white
+
+210
+00:13:13,770 --> 00:13:17,510
+patches في مناطق بيضاء وين في منطقة بيضاء بنعرف ان
+
+211
+00:13:17,510 --> 00:13:21,070
+في المدربرس او في مشكلة هنا مش داخلة الهواء لإنه
+
+212
+00:13:21,070 --> 00:13:23,670
+نقول الحاجة الجامدة زي ال humor زي ال point زي هو
+
+213
+00:13:23,670 --> 00:13:26,590
+بتطلع ايش لونه أبيض هتتذكروا ده الكلام ان شاء الله
+
+214
+00:13:26,590 --> 00:13:30,210
+لما تروح تتدربوا شو بدي اعمل هنا بقول في ال
+
+215
+00:13:30,210 --> 00:13:32,790
+management ده بتاع اكسيجين حاطناه طناف الصناعة
+
+216
+00:13:32,790 --> 00:13:38,020
+وغيره لازم اعطيه اكسيجين عشان نعوضه بعدلازم نعطيش
+
+217
+00:13:38,020 --> 00:13:41,520
+chest tube ليه؟ لو حد سأل، ال chest tube ما أنتوا
+
+218
+00:13:41,520 --> 00:13:46,420
+عارفين البنورة ال cavity الآن مليان ومضغوط وفي جلب
+
+219
+00:13:46,420 --> 00:13:50,960
+هوا، بدي نفجر فأنا بدخل ال tube ما حد يفكر بدخل ال
+
+220
+00:13:50,960 --> 00:13:54,780
+tube يعني كأني بروح ب .. ب .. أخرق ال .. ال ..
+
+221
+00:13:54,780 --> 00:13:59,270
+الرئة، لأ لأ لأأنا بوصلش لطيوب للريقة، بوصلهاش لأ
+
+222
+00:13:59,270 --> 00:14:04,030
+بوصلها للblura ال cavity و بفتح من برا تحت اللي زي
+
+223
+00:14:04,030 --> 00:14:06,850
+ما يقولونه underwater seal تحت المرتبان هذا عشان
+
+224
+00:14:06,850 --> 00:14:10,210
+يصحى اللي هو الهواء الزائد عشان ما يضغطش على
+
+225
+00:14:10,210 --> 00:14:16,050
+الريقتين اكتر طيب اللي بعد اسمه pulmonary embolism
+
+226
+00:14:16,050 --> 00:14:19,550
+كلكم عارفين شو معنى embolism؟ هتذكركم بس كلمتين
+
+227
+00:14:19,550 --> 00:14:23,030
+انه ايش الفرق بين .. ايش؟ بين ال thrombus و ال
+
+228
+00:14:23,030 --> 00:14:25,870
+embolus أكيد انتوا عارفينها، لكن من ببتد ..
+
+229
+00:14:25,870 --> 00:14:32,090
+thrombusهي نفس يعني لو بدنا نيجي بالوصف العام هي
+
+230
+00:14:32,090 --> 00:14:35,330
+نفس ال embolus لكن ال thrombus بتصير غالبا وين؟
+
+231
+00:14:35,330 --> 00:14:38,350
+غالبا بتصير في ال veins، في الأوردة، بالنسبة بقى
+
+232
+00:14:38,350 --> 00:14:41,890
+بنقول DVT، يعني ده ايش عن DVD؟ Deep Vein
+
+233
+00:14:41,890 --> 00:14:46,350
+Thrombosis طيب متى بتتحول ل embolism؟ بتتحول ل
+
+234
+00:14:46,350 --> 00:14:50,220
+embolism إذا اتحركت ومشت؟ولما حارجة ما حد يقول لي
+
+235
+00:14:50,220 --> 00:14:54,340
+طب ان هو ال veins شغلات لحال و ال arteries لحال لأ
+
+236
+00:14:54,340 --> 00:14:59,320
+في الآخر هذا مش network كلها مع بعض شبكة بتنتهي ال
+
+237
+00:14:59,320 --> 00:15:01,920
+veins بتبدأ ال arteries بتنتهي ال arteries بتبدأ
+
+238
+00:15:01,920 --> 00:15:05,860
+ال veins و هكذا يعني نهايات الأطراف لل veins و ال
+
+239
+00:15:05,860 --> 00:15:09,860
+arteries بتكون اللي هو arterioles و venules بشتتجن
+
+240
+00:15:09,860 --> 00:15:13,220
+مع بعض و اللي هكذا بتكون ما حد يتخيل انه كأنه
+
+241
+00:15:13,220 --> 00:15:17,600
+مواصير كل حاجة لحال لأ فإيش بيصير هناBulmonary
+
+242
+00:15:17,600 --> 00:15:21,220
+embolism طبعا من القلب برضه تعتبر هذا top .. top
+
+243
+00:15:21,220 --> 00:15:25,380
+ها emergency و ممكن دلوقت نتدخل فورا و إذا
+
+244
+00:15:25,380 --> 00:15:28,160
+ماقدرناش نلحق المرض ممكن يموت، اللي عنده إيه؟
+
+245
+00:15:28,160 --> 00:15:30,880
+Bulmonary embolism خاصة في الـ Bulmonary arteries
+
+246
+00:15:30,880 --> 00:15:34,760
+يعني وين؟ في الشريان اللي هو الرؤه الأساسي صار فيه
+
+247
+00:15:34,760 --> 00:15:39,140
+عملية إيه؟ انه راحت اللي هو ال deep vein هي ال DVT
+
+248
+00:15:39,140 --> 00:15:42,620
+ال deep vein from وزداله سرح ماشي في بعض الناس
+
+249
+00:15:42,620 --> 00:15:47,510
+بروح على الشريان اللي عند المخبنسميهوش DVD، بنسميه
+
+250
+00:15:47,510 --> 00:15:51,450
+CVA، بنقول عنده جلطة دماغية، في بعضه بتمشي بتمشي
+
+251
+00:15:51,450 --> 00:15:54,890
+بتقف عند شراين القلب، اللي هي الشراين التاجية،
+
+252
+00:15:54,890 --> 00:15:58,410
+بنقول عنده my card of infarction، وينمشت ووقفت
+
+253
+00:15:58,410 --> 00:16:02,890
+يسمى التشخيص بناء على وقوفه في هذا المكان، طيب،
+
+254
+00:16:02,890 --> 00:16:08,450
+بقولني هناtraveled سافرت lodged و استقرت في وين في
+
+255
+00:16:08,450 --> 00:16:11,230
+البلمونة الارتز يبقى واقفة هنا عملتلي حاجة زي ما
+
+256
+00:16:11,230 --> 00:16:14,430
+البلمونة الامبوليزم مازال واقفة في هذا المكان يبقى
+
+257
+00:16:14,430 --> 00:16:17,790
+المنطق اللي بعدها هتموت حيزير فيه عملية cyanosis و
+
+258
+00:16:17,790 --> 00:16:20,810
+عملية يعني للأسف death of tissue لأنه بقى ليصلى
+
+259
+00:16:20,810 --> 00:16:25,370
+الهواء الطبيعي و ال oxygen severity الحدة تبعتها و
+
+260
+00:16:25,370 --> 00:16:29,230
+خطورتها depends on a extent جداش درجة الإغلاق يعني
+
+261
+00:16:29,230 --> 00:16:32,910
+جداش أنا بحكم إنه خطير أو مش خطيروين الشريان
+
+262
+00:16:32,910 --> 00:16:36,190
+بالظبط في أوله و في وسطه و في آخره اللي صار فيه
+
+263
+00:16:36,190 --> 00:16:40,370
+إغلاق mismatch of ventilation and perfusion بيصير
+
+264
+00:16:40,370 --> 00:16:44,830
+للأسف فالجيتا بيصير mismatch يعني بتدخل الحالتين
+
+265
+00:16:44,830 --> 00:16:47,830
+مع بعض اللي أحنا مش عارفين ال ventilation التهوية
+
+266
+00:16:47,830 --> 00:16:51,490
+مع ال perfusion عملية كمان اللي هو إيش اللي هو
+
+267
+00:16:51,490 --> 00:16:55,750
+التبادل بين الغازات و عملية اللي هو ال exchange
+
+268
+00:16:55,750 --> 00:16:58,930
+اللي بيصير من ناحية طبيعية هنا إيش جالي mismatch
+
+269
+00:16:58,930 --> 00:17:05,580
+يعني بيدخلالشرايين الرئوية في إشكالية مش قادر
+
+270
+00:17:05,580 --> 00:17:09,620
+يسيطر لأنه صار فيه closure بدي يحاول يعمل جسم حاجة
+
+271
+00:17:09,620 --> 00:17:12,800
+تسمى compensatory mechanism وإذا لم يستطع طبعا
+
+272
+00:17:12,800 --> 00:17:15,500
+احنا بدنا نضطر ندخل لأنه مش سهل أنه يترك المرض
+
+273
+00:17:15,500 --> 00:17:20,100
+لوحدي طبعا كيف بدنا نقدر نشخصه مش سهل تشخيصه ممكن
+
+274
+00:17:20,100 --> 00:17:24,100
+يكون الشريان اللي أغلب بسيط جدا جدا ومش قادر أطوله
+
+275
+00:17:24,100 --> 00:17:27,680
+شو بعمله بعمله حاجة تسمى pulmonary angiogram لما
+
+276
+00:17:27,680 --> 00:17:32,620
+نقول كلمة angiogram يعني صورة ملونة angiogram
+
+277
+00:17:32,620 --> 00:17:37,080
+أنجيوغ في صبغة gram الان هالجيت أنجيوغ ال .. ال ..
+
+278
+00:17:37,080 --> 00:17:39,200
+ال .. ال .. فيزلز يعني ال blood fizzles و gram
+
+279
+00:17:39,200 --> 00:17:42,980
+اللي هو المادة الملونة فبصبغ في .. نسمع يقولوا
+
+280
+00:17:42,980 --> 00:17:48,040
+الله عملوله صورة CT ملونة أو صورة رنين ملونة فبتظل
+
+281
+00:17:48,040 --> 00:17:51,820
+ماشية بتنصبغ المكان المغلق و ببينلي إيش المكان
+
+282
+00:17:51,820 --> 00:17:55,300
+اللي وراه إيش المشكلة تبني عرف مين المشكلة هذه
+
+283
+00:17:55,300 --> 00:17:57,880
+سبحان الله الصورة واضحة جدا و بطريقة يعني بتعرف
+
+284
+00:17:57,880 --> 00:18:01,940
+إيش مشكلتهايعني مثلا انا لقيتها لو تخيلنا هي
+
+285
+00:18:01,940 --> 00:18:06,000
+بيقولي مثلا multiple emboli in small branches فى
+
+286
+00:18:06,000 --> 00:18:10,140
+emboli صغيرة هنا و هنا و هنا موجودة، لاحظين أنه
+
+287
+00:18:10,140 --> 00:18:14,660
+اللون اللى هنا اشماله لون طبيعى، اللون كله مرتب
+
+288
+00:18:14,660 --> 00:18:18,550
+وحتى هنا النهايات كلها مرتبةلكن لو لاحظنا هنا في
+
+289
+00:18:18,550 --> 00:18:21,910
+شوياتها in polysmol في ال branches of left
+
+290
+00:18:21,910 --> 00:18:25,950
+pulmonary artery هنا في شوية مسكرة مع الصبغة بيرد
+
+291
+00:18:25,950 --> 00:18:29,270
+وهنا مع الصبغة بيرد هنا اكثر من عداد خمسة لو
+
+292
+00:18:29,270 --> 00:18:32,090
+لاحظنا طب بداية الانسجال اللي بعدها ايش صار فيها
+
+293
+00:18:32,090 --> 00:18:36,130
+بدت تزرجها لاحظين كيف بدت تزرج لو تركناها شوية
+
+294
+00:18:36,130 --> 00:18:38,570
+ازراج ايش بيصير فيها gangrene خلاص بتموت ايش
+
+295
+00:18:38,570 --> 00:18:41,330
+بيجيبوا بيعملوا عملية بيقصوها هذا المكان طبعا مش
+
+296
+00:18:41,330 --> 00:18:45,200
+بس هنا بتجيب الخطورة لاممكن يعلم اذا ترك واحد
+
+297
+00:18:45,200 --> 00:18:49,600
+يقوللي انه هل بنتقل؟ اه بنتقل ممكن ايش تبدأ هي ال
+
+298
+00:18:49,600 --> 00:18:53,060
+lung tissue بعدين تستقر طيب لو اجت تسكير في مكان
+
+299
+00:18:53,060 --> 00:18:56,500
+اجوى زي ايه؟ هي كتبلي هنا في ال right pulmonary
+
+300
+00:18:56,500 --> 00:18:59,380
+artery الأساسي لو اجت في ال pulmonary artery
+
+301
+00:18:59,380 --> 00:19:03,700
+الأساسي لاحظوا ايش صار؟ سكر هذا كل الشجرة ماتت
+
+302
+00:19:03,700 --> 00:19:07,000
+اللي بعدها ايش صار في ال lung tissue هنا؟ صارلون
+
+303
+00:19:07,000 --> 00:19:10,800
+ايش؟ أزرق ما الا السودة حتى أسود ليه؟ لأنه خلاص
+
+304
+00:19:11,210 --> 00:19:14,530
+مزارع أسود يبقى صار فيه gangrene هنا و بده تدخل
+
+305
+00:19:14,530 --> 00:19:20,930
+علشانك مبينهش إلا في التصوير الملور طيب COPD قدها
+
+306
+00:19:20,930 --> 00:19:23,370
+كتير مدعوة كمان مره اسمها chronic obstructive
+
+307
+00:19:23,370 --> 00:19:26,870
+pulmonary disease إيش هذا مرض مزمن history of
+
+308
+00:19:26,870 --> 00:19:31,050
+exposure إيه ال risk factors؟ إيش ال risk factors؟
+
+309
+00:19:31,050 --> 00:19:33,890
+في حاجة بيسموها الممرضات comorbidities كمربضات
+
+310
+00:19:33,890 --> 00:19:37,940
+يعني في شغلات ساعدته على الإمراضفي بعضهم عنده مثلا
+
+311
+00:19:37,940 --> 00:19:41,880
+يعني فيه ان current مثلا medical treatments لاحظوا
+
+312
+00:19:41,880 --> 00:19:45,840
+انه في بعض يعني في بعض العجزات زي ال beta blockers
+
+313
+00:19:45,840 --> 00:19:48,360
+ومكرا بتاخدوها اكيد يمكن اخدتوها في ال
+
+314
+00:19:48,360 --> 00:19:51,880
+pharmacology اللي هو فيه ان ال beta blockers وفيه
+
+315
+00:19:51,880 --> 00:19:54,960
+alpha blockers وفيه ال beta طبعا selective و non
+
+316
+00:19:54,960 --> 00:19:59,580
+selective هتاخدوها مع الدكتور الأدويةبتبينلنا إنه
+
+317
+00:19:59,580 --> 00:20:03,280
+إيه يعني إيش لإنه في بعض إحنا بناخد علاجات بتروح
+
+318
+00:20:03,280 --> 00:20:05,420
+ال beta cells اللي موجودة في ال heart بتوقفها
+
+319
+00:20:05,420 --> 00:20:09,900
+لأنخاصة زي الدرالين مثلا زي النورمتين بكرا هتسمعوا
+
+320
+00:20:09,900 --> 00:20:13,460
+عنها الدوين لإنه أكتر دوين مستخدمين as beta
+
+321
+00:20:13,460 --> 00:20:16,900
+blockers لاحظوا أن دول الشغلات ممكن تتعمل برضه
+
+322
+00:20:16,900 --> 00:20:20,820
+COPD طبعا زي مين هم ال COPD بكون عندهم أزمة
+
+323
+00:20:20,820 --> 00:20:24,240
+chronic bronchitis chronic bronchitis كل على بعض
+
+324
+00:20:24,240 --> 00:20:27,880
+هذا متلازمةفسموها chronic obstructive pulmonary
+
+325
+00:20:27,880 --> 00:20:32,400
+disease ماسموهاش مرض دايما لما يكون اكتر من مرض في
+
+326
+00:20:32,400 --> 00:20:35,920
+نفس الحالة بنسميها ايش؟ Syndrome او بنسميها معضلة
+
+327
+00:20:35,920 --> 00:20:40,200
+طب ايش بنعمل test له؟ هذاك عملنا له ايه؟ بيعملوا
+
+328
+00:20:40,200 --> 00:20:42,260
+serum لغوة؟ أنا لأ، انا بتعمله حاجة اسمها
+
+329
+00:20:42,260 --> 00:20:47,200
+spirometry spirometry اسمه جهاز فحص ايش؟ اللي هو
+
+330
+00:20:47,200 --> 00:20:50,640
+قوة .. قوة النفس موجود عند كل الأطباء الأخصائيين
+
+331
+00:20:51,060 --> 00:20:54,160
+بينجي بيخليه يتنفس في جهاز الجهاز هذا ايه اللي هو
+
+332
+00:20:54,160 --> 00:20:58,380
+زي بربيش بيمسكه في الفم و بيضغط فيه و بياخد نفس و
+
+333
+00:20:58,380 --> 00:21:02,180
+بيضغط بياخد نفس و بيضغط عشان يقدر يعرف انه هل في
+
+334
+00:21:02,180 --> 00:21:04,600
+مشكلة ولا نفس اللي بيعبرش كويس ولا نفس اللي بيطلعش
+
+335
+00:21:04,600 --> 00:21:09,260
+طبعا كمان مهم كتير انه يعملوا APGs الاختصار
+
+336
+00:21:09,260 --> 00:21:13,300
+العالمي arterial blood gases يعني ايش فحص اللي هو
+
+337
+00:21:13,300 --> 00:21:17,080
+ايش ال gases اللي موجودات في جلب الارتري زي ال
+
+338
+00:21:17,080 --> 00:21:22,420
+oxygenوزي مثلا فانكسجة الكربون وزي مثلا ال
+
+339
+00:21:22,420 --> 00:21:26,660
+بيكربونات الصوديوم كمان، كل هذا عشان نعرف وين رايح
+
+340
+00:21:26,660 --> 00:21:30,620
+المريض بالظبط، إذا عيل ال CO2 مصيبة، إذا نكس ال
+
+341
+00:21:30,620 --> 00:21:34,740
+oxygen مصيبة، إذا مثلا ال CO3 مثلا زادت كمان، ال
+
+342
+00:21:34,740 --> 00:21:37,860
+بيكربونات برضه مشكلة، كل حاجة إلى حل بناء على
+
+343
+00:21:37,860 --> 00:21:41,460
+التشخيص اللي بيطلع، طب إيش بتعمله management؟جالب
+
+344
+00:21:41,460 --> 00:21:45,100
+نعمله Oxygen، بدنا نعطيه Oxygen، ان نعطيه الهو
+
+345
+00:21:45,100 --> 00:21:49,200
+ديوكيشن، انه لازم يعرف ان هو تحت الضغط و لما نحط
+
+346
+00:21:49,200 --> 00:21:51,540
+اللي Vulcanic اللي تحت ال Oxygen، يظلوا ياخدوا
+
+347
+00:21:51,540 --> 00:21:54,120
+النفس، مايظلوش يرفعوا زيه، للأسف في بعض الناس
+
+348
+00:21:54,120 --> 00:21:56,780
+مااخدوش تعليمات كويسة في حياتهم، فبيزيد المرض
+
+349
+00:21:56,780 --> 00:22:00,400
+عندهم أكتر خطورةوبنعطيهم طبعا علاجات عققغير حسب
+
+350
+00:22:00,400 --> 00:22:04,280
+الطبيب الأخصائي ومن ناحية التخزين طبعا بنزود كمية
+
+351
+00:22:04,280 --> 00:22:08,120
+البروتين عشان بدنا نعطيه مقاومة للجسم، بنخليه يعمل
+
+352
+00:22:08,120 --> 00:22:13,360
+شوية exercise وخاصة التمارين للعلاقة بالتنفس، شهيق
+
+353
+00:22:13,360 --> 00:22:17,000
+زفير تمارين صباح، وفي الآخر إذا لا سمح الله يقسنا،
+
+354
+00:22:17,000 --> 00:22:20,760
+بدنا ندخل جراحيا، لأنه مقدرش نخلي المريض زي ما هو،
+
+355
+00:22:20,760 --> 00:22:25,420
+لأ هتموت الأمور، هتموت الخلاياطيب، من ال common
+
+356
+00:22:25,420 --> 00:22:29,180
+كمان، الرئيس ماردري سحب للأزمة لحاله، كلك عارفين
+
+357
+00:22:29,180 --> 00:22:32,380
+أزمة، أزمة يعني، أزمة من اسمها، طبعا هي عبارة عن
+
+358
+00:22:32,380 --> 00:22:34,820
+chronic inflammatory disease اللي بيصير في ال
+
+359
+00:22:34,820 --> 00:22:38,760
+airway، هي عبارة عن يعني إلتها بخليني أقول مزمن
+
+360
+00:22:38,760 --> 00:22:42,940
+ومرض مزمن في مجاري الهواء اللي في الجهاز التنفسي
+
+361
+00:22:42,940 --> 00:22:46,480
+طبعا إيش بيصير عندهم دول الhypersensitiveness؟ إيش
+
+362
+00:22:46,480 --> 00:22:48,780
+يعني الhypersensitiveness؟ إنه بيصير عندهم
+
+363
+00:22:48,780 --> 00:22:53,800
+الاستجابة يعني فيه كتير منهماستجابتهم لأي شيء
+
+364
+00:22:53,800 --> 00:22:57,580
+بيعمل حسية بكون أكتر من الناس الطبيعيين، في ناس
+
+365
+00:22:57,580 --> 00:23:00,320
+بيقولك كانت معايا أزمة من العطر، صارت معايا أزمة
+
+366
+00:23:00,320 --> 00:23:06,260
+من ريحة الغاز، ريحة الطبيخ، ريحة المجالي، من
+
+367
+00:23:06,260 --> 00:23:10,780
+الغبار، من الأشجار، من الحبوب اللقاح، أيا كان،
+
+368
+00:23:10,780 --> 00:23:14,940
+هذولش عندهم الاستجابة حسسين، hyper responsiveness،
+
+369
+00:23:14,940 --> 00:23:18,420
+عندهم يعني حسية أكتر للاستجابة من الناس الطبيعيين
+
+370
+00:23:19,020 --> 00:23:22,560
+طبعاً في بعضهم بيكون عندهم يعني airway obstruction
+
+371
+00:23:22,560 --> 00:23:25,740
+مش كلهم هي عشان تجلي variable يعني مختلفة مش الكل
+
+372
+00:23:25,740 --> 00:23:30,620
+طبعاً بيقوللي ها أنا الأزمة وضيق النفس بيقوللي
+
+373
+00:23:30,620 --> 00:23:34,960
+resolve spontaneously يعني ممكن تلقائياً يخف مع
+
+374
+00:23:34,960 --> 00:23:37,900
+إيش لما نعطيه حاجة اسمه bronchodilator إيش
+
+375
+00:23:37,900 --> 00:23:42,580
+برونكوديليتر لما نعطيه فاتح لمجاري التنفس زي إيش
+
+376
+00:23:42,580 --> 00:23:46,190
+فاتح لقنعة التنفس؟زي علاج مثلا ال Ventolin أكيد
+
+377
+00:23:46,190 --> 00:23:48,930
+سمعته عنه و هتسمعناه كتير في Ventolin في
+
+378
+00:23:48,930 --> 00:23:52,490
+Terbutolin في Aerovent أدوية تستخدم ال
+
+379
+00:23:52,490 --> 00:23:55,350
+Bronchodilator و في كمان بعضهم بيستخدم ال
+
+380
+00:23:55,350 --> 00:23:59,730
+adrenaline عشان يوسع قنوات النفس طب كيف بدي أنا
+
+381
+00:23:59,730 --> 00:24:02,490
+أقدر أعرف أن هذا أزمة و هذا مش أزمة؟ بعض الناس
+
+382
+00:24:02,490 --> 00:24:05,630
+بيقولك طب أنا عندي ديقة نفس، هل أنا عندي أزمة؟ لأ
+
+383
+00:24:05,630 --> 00:24:08,670
+بنعمل Spirometry بنجيزه على جهاز التنفس اللي موجود
+
+384
+00:24:08,670 --> 00:24:11,680
+عند الطبيب اللي أخصائي اللي هو ال Spirometryو
+
+385
+00:24:11,680 --> 00:24:14,740
+بعدين بنعمله Balmonary function testing برضه فحص
+
+386
+00:24:14,740 --> 00:24:17,840
+لإيش؟ لكفاءة الرئتين و هذا اللي بيعملوا الطبيب
+
+387
+00:24:17,840 --> 00:24:21,280
+الخصائمش احنا كويس احنا للمعرفة مايجي واحد يقول طب
+
+388
+00:24:21,280 --> 00:24:24,820
+يا ده أستاذ و يا دكتور هذه شغلات طبية حتى لو كانت
+
+389
+00:24:24,820 --> 00:24:29,060
+طبية يعني الحكمة ضالة المسلم أو ضالة المؤمنين أو
+
+390
+00:24:29,060 --> 00:24:31,690
+كما قرر النبي صلى الله عليه و سلماين ما وجدته هو
+
+391
+00:24:31,690 --> 00:24:34,430
+حق الناس بيهيجي، يعني الإنسان دائما يدور على العلم
+
+392
+00:24:34,430 --> 00:24:37,990
+ويدور على المعرفة، ماييجي بس يقول بس هي شغلي، لأ،
+
+393
+00:24:37,990 --> 00:24:40,790
+احنا بنعمل في طب أكتر ما بيعرف هذا الكلام، لكن
+
+394
+00:24:40,790 --> 00:24:44,830
+كويس احنا نكون معرفين طيب ال management إيش بنعمل؟
+
+395
+00:24:44,830 --> 00:24:47,610
+طبعا education to prevent exacerbation، لما يقول
+
+396
+00:24:47,610 --> 00:24:52,730
+كلمة exacerbation يعني امنع أي شي بهيجيهو بيهيج
+
+397
+00:24:52,730 --> 00:24:57,250
+الاستجابة الزائدة للحساسيات الموجودة يعني زي ايش؟
+
+398
+00:24:57,250 --> 00:24:59,870
+يعني تجعل ان عندي حساسية او صار معايا أزمة من
+
+399
+00:24:59,870 --> 00:25:03,130
+المجالب .. اقولهم لما يكونوا في البيت ما تجنوش هو
+
+400
+00:25:03,130 --> 00:25:06,290
+موجود خاصة زي جالي البندورة او جالي البتنجان بتعمل
+
+401
+00:25:06,290 --> 00:25:09,770
+رواح شديدة جدا في ناس ناضطيقها وفي ناس عندهم مشكلة
+
+402
+00:25:09,770 --> 00:25:13,790
+حساسية مطلقة من حساسية جالي السمك بس لكن دولة دالك
+
+403
+00:25:13,790 --> 00:25:18,070
+ممكن تكون على أهمر شوية الآن قولي optimize مثلا
+
+404
+00:25:18,070 --> 00:25:21,310
+هنا كمانpharmacotherapy يعني بدك تعطي يعني ال
+
+405
+00:25:21,310 --> 00:25:25,650
+optimum اللي هو العلاج المناسب له كعقق يرتبيه لأنه
+
+406
+00:25:25,650 --> 00:25:28,810
+مابينعطاش مش كله زي بعض في كتير علاجات للأزمة
+
+407
+00:25:28,810 --> 00:25:31,930
+أتروبين فنتولين ايرفان أي ان كان فبناء على
+
+408
+00:25:31,930 --> 00:25:35,210
+استجابته مش كل الناس زي موضوع السكة زي موضوع الضغط
+
+409
+00:25:35,210 --> 00:25:37,970
+مش كلهم باخدوا نفس العلاجات لازم تعطي علاجات
+
+410
+00:25:37,970 --> 00:25:44,170
+تتناسب مع وضع الصحة acute respiratory failure
+
+411
+00:25:44,170 --> 00:25:48,930
+acute respiratory failure ايش هو يعنيمن اسمها أول
+
+412
+00:25:48,930 --> 00:25:53,110
+حاجة فيها قصور أو فشل .. قصور أو فشل التنفس الحاد
+
+413
+00:25:53,110 --> 00:25:55,950
+.. فشل التنفس الحاد .. كيف بيصير هذا؟ ما زال قال
+
+414
+00:25:55,950 --> 00:25:59,290
+الحاد mechatronic معناته صدن .. يعني بيصير ايش؟
+
+415
+00:25:59,290 --> 00:26:02,550
+فجأة .. و هذا يعتبر ما زال فجأة life threatening
+
+416
+00:26:02,550 --> 00:26:06,030
+.. بدنا نحمله فورا و نضيع المستشفى .. فورا .. ليه؟
+
+417
+00:26:06,030 --> 00:26:10,430
+لأنه للأسف بطل عنده gas etc .. بعض الحالات نادرة
+
+418
+00:26:10,430 --> 00:26:13,910
+جدا .. نادرة .. لكن بتصير مرات .. ولكن هتقولكم متى
+
+419
+00:26:13,910 --> 00:26:18,170
+بتصير ..انه بيصير ان ال gas exchange .. بنضرب مرة
+
+420
+00:26:18,170 --> 00:26:21,690
+واحدة، ال gas exchange كويس للناس الطبيعيين،
+
+421
+00:26:21,690 --> 00:26:25,610
+بنتنفس، بتتبادل غازات في الalveoli، بيطلع تنكسط
+
+422
+00:26:25,610 --> 00:26:27,870
+الكربون و هكذا، و بيتوزع على الجسم الأكسجين و
+
+423
+00:26:27,870 --> 00:26:31,990
+هكذا، فيه من النوع اسمه ال type one acute اسمه إيش
+
+424
+00:26:31,990 --> 00:26:36,290
+hypoxemic، كلمة hypoxemic جاي من كلمة hypoxia، لما
+
+425
+00:26:36,290 --> 00:26:39,370
+أقول hypoxia يعني مافيش أكسجين واصل، لكن لما أقول
+
+426
+00:26:39,370 --> 00:26:44,470
+hypoxemic يعني جاي من إيميا، زي hypoxemiaلما أقول
+
+427
+00:26:44,470 --> 00:26:48,590
+كلمة إيميا يعني مافيش أكسيجين واصل للدم، لكن لو
+
+428
+00:26:48,590 --> 00:26:51,710
+قلت Hypoxia بشكل عام مافيش أكسيجين، لكن Hypoxemic
+
+429
+00:26:51,710 --> 00:26:55,230
+مافيش في الدم، طالما مافيش أكسيجين واصل للدم، يبقى
+
+430
+00:26:55,230 --> 00:26:57,930
+الدم اللي رايح على ال respiratory system، مش مافيش
+
+431
+00:26:57,930 --> 00:27:01,850
+فيه أكسيجين، يبقى صار فيه failure، يبلجأ الإنسان،
+
+432
+00:27:01,850 --> 00:27:05,570
+زي لما نلقى الدرلى بتنفس، فبدل ما ياخد أكسيجين،
+
+433
+00:27:05,570 --> 00:27:09,530
+لاجأ ثانوية أكسيط الكربونأو لجأة أواركس الكربون أو
+
+434
+00:27:09,530 --> 00:27:12,150
+لجأة لا سمح الله غزات سامة زي اللي بيصير عند بعض
+
+435
+00:27:12,150 --> 00:27:16,450
+كتير من الأسف اللي بيستخدموه زي الغزات السامة اللي
+
+436
+00:27:16,450 --> 00:27:18,690
+استخدمت في الحروب في أيام الحرب العراقية الإيرانية
+
+437
+00:27:18,690 --> 00:27:22,170
+وغيرهم كانوا بيستخدموا غزات وفي بعضهم للأسف يعني
+
+438
+00:27:22,170 --> 00:27:25,630
+حتى سمعت أنه كانوا في سوريا كمان استخدموا وكانوا
+
+439
+00:27:25,630 --> 00:27:29,030
+يموتوا ناس ماعرفوش ما بيصير زي جاز السرين وغيره في
+
+440
+00:27:29,030 --> 00:27:34,250
+غزات خطيرة جدا طيب ال type 2جال اكيوت ايش ها ..
+
+441
+00:27:34,250 --> 00:27:37,810
+hypercapnic لما نقول لي hypercapnic زيادة في ثانو
+
+442
+00:27:37,810 --> 00:27:41,710
+أكسيد الكربون هنا زيادة بإيش؟ نقص بالأكسيجين الحد
+
+443
+00:27:41,710 --> 00:27:45,310
+هنا زيادة في ثانو أكسيد الكربون بيسموه hypercapnia
+
+444
+00:27:45,310 --> 00:27:48,830
+زيادة في ثانو أكسيد الكربون أو أول أكسيد الكربون
+
+445
+00:27:48,830 --> 00:27:51,650
+التانين بيعمل إيه إيش خطورة زي وين بتصير ال
+
+446
+00:27:51,650 --> 00:27:53,590
+respiratory failure اللي هو عندك هذا بتدجف شوية
+
+447
+00:27:53,590 --> 00:27:56,910
+معظم الناس اللي بيموتوا عشان كون عندكم علم بيموتوا
+
+448
+00:27:56,910 --> 00:28:01,890
+من ال .. ال .. الكنون و الفحمأو يعني في حالات كتير
+
+449
+00:28:01,890 --> 00:28:06,910
+أجانع يعني لو كان طبيب يعني او هو يعني من خارجه من
+
+450
+00:28:06,910 --> 00:28:09,710
+ال health professionals يعني من المتخصين الصحيين
+
+451
+00:28:09,710 --> 00:28:14,190
+كان فاتح ال motor اللي تبع المولد الكهرة، ال motor
+
+452
+00:28:14,190 --> 00:28:17,900
+الصغير حاطه في داخل صيدلية وعمله بشتغلالموتور
+
+453
+00:28:17,900 --> 00:28:20,160
+عامله بيطلع العدم، بيطلع العدم و هو بيدروح، مافيش
+
+454
+00:28:20,160 --> 00:28:25,140
+شي مكان يطلع برا، فكل المكان في الصيدلية انتلا او
+
+455
+00:28:25,140 --> 00:28:29,040
+ركسيل كربون مابيشعرش، ماحدش يقوللي انه طب ماانتبهش
+
+456
+00:28:29,040 --> 00:28:31,760
+لحاله، لأ ماانتبهش، silent killer، هذا يعتبر من
+
+457
+00:28:31,760 --> 00:28:35,370
+القاتل الصامتفبتشبع ال oxygen .. ها بتشبع ال
+
+458
+00:28:35,370 --> 00:28:39,030
+oxygen بروح أشجة و بتشبع الدم .. الدم بتشبع بال
+
+459
+00:28:39,030 --> 00:28:42,430
+إيه؟ بثانوكسيد الكربون فبدل ما يودع خلايا ال
+
+460
+00:28:42,430 --> 00:28:45,150
+oxygen يودع ثانوكسيد الكربون فعملة respiratory
+
+461
+00:28:45,150 --> 00:28:48,830
+failure بتؤدي للوفاة هذا اسمه acute hypercapnic من
+
+462
+00:28:48,830 --> 00:28:53,890
+الكنون من البنزين لما بنحرقه جنبه من الحرائق بشكل
+
+463
+00:28:53,890 --> 00:28:56,870
+عام لما بنخنقه كتير من الناس بيقولك ما ماتوش من
+
+464
+00:28:56,870 --> 00:28:59,310
+الحريق ماتوا من الخنق من الحريق و هذا اللي بيصير
+
+465
+00:28:59,310 --> 00:29:03,270
+type 3 combined ايش يعني combined؟ بيكون مشتركبكون
+
+466
+00:29:03,270 --> 00:29:06,890
+عنده hypoxemia وعنده hypercapnia يعني عنده نقص
+
+467
+00:29:06,890 --> 00:29:10,930
+أكسيجين وزيادة فيه ثانكسيد الكربون يبقى معناته إما
+
+468
+00:29:10,930 --> 00:29:14,730
+مافيش أكسيجين وإما ثانكسيد الكربون زاد وإما مشترك
+
+469
+00:29:14,730 --> 00:29:18,450
+الأتنين مع بعض طبعا التلاتة على بعض مصيبة وبيعملوا
+
+470
+00:29:18,450 --> 00:29:21,030
+respiratory failure وممكن تؤدي للوفاق إذا ما
+
+471
+00:29:21,030 --> 00:29:25,300
+تلحقناهوش مباشرة ودلع المستشفىالتست هنا بنعمله
+
+472
+00:29:25,300 --> 00:29:28,180
+arterial blood gases فجأة بنتفاجأ بنلاقي ال
+
+473
+00:29:28,180 --> 00:29:31,840
+thermocyte carbon زايد جدا جدا و ال oxygen جليل و
+
+474
+00:29:31,840 --> 00:29:35,920
+هذا مصيبة بنعمله chest x-ray بيبين ايش ان العلمات
+
+475
+00:29:35,920 --> 00:29:40,220
+ممكن تكون ماتت بعض الخلايا في ال lung و بيانت ان
+
+476
+00:29:40,220 --> 00:29:44,240
+صار اللون ميل الأبيض و ده الأسود بنعمله CT ال
+
+477
+00:29:44,240 --> 00:29:46,900
+computerized tomography اللي صورة .. الصورة اللي
+
+478
+00:29:46,900 --> 00:29:51,360
+هو المقطعية اللي تحت ال computer كلكم عارفين هذا
+
+479
+00:29:51,360 --> 00:29:54,930
+المصطلح لأن كتير الناس العادين بيعرفوهو بنعمله حد
+
+480
+00:29:54,930 --> 00:29:58,050
+يسمى thorough synthesis thorough synthesis يعني
+
+481
+00:29:58,050 --> 00:30:03,550
+بنحطله tube عشان نسحب منه إذا .. نحطه ال tube في
+
+482
+00:30:03,550 --> 00:30:06,910
+منطقة ال chest عشان نسحب إذا صار إشي أو اللي
+
+483
+00:30:06,910 --> 00:30:10,730
+plural انتلت بشي معين سواء كانت ال fluid سواء كانت
+
+484
+00:30:10,730 --> 00:30:15,030
+blood سواء كانت أي شيء من الخارج أو حتى لو كان فيه
+
+485
+00:30:15,030 --> 00:30:18,930
+هوا أقدر أسحب طب إيش بده أعمله في هذه الحالة؟ أول
+
+486
+00:30:18,930 --> 00:30:22,330
+حاجة بدك تصلح الجازاللي موجودة الخربط اللي صارت
+
+487
+00:30:22,330 --> 00:30:25,630
+كيف بتصلحها؟ بدخله على اكسيجين ترابس مش اكسيجين
+
+488
+00:30:25,630 --> 00:30:29,430
+عادي لأ endotracheal tube بدخله على ventilation
+
+489
+00:30:29,430 --> 00:30:32,390
+اللي هو ال ventilator ال machine طبعا ال machine و
+
+490
+00:30:32,390 --> 00:30:36,270
+بخليه يتنفس طبعا عليها عشان نقدر نحط الاكسيجين
+
+491
+00:30:36,270 --> 00:30:38,450
+اللي بدناهيه و ال .. و النسب اللي بدناهيه عشان
+
+492
+00:30:38,450 --> 00:30:40,550
+تتحسن اللي هو النسب اللي موجودة في ال arterial
+
+493
+00:30:40,550 --> 00:30:44,810
+blood gases بعدين بنشوف حاجة تسمى reversal of any
+
+494
+00:30:44,810 --> 00:30:49,760
+narcoticsطبعاً لما أقول كلمة reversal of any
+
+495
+00:30:49,760 --> 00:30:53,980
+narcotics يعني بدك نحاول قدر الإمكان لأن هذا بيكون
+
+496
+00:30:53,980 --> 00:30:58,360
+عنده غيبوبة فبدنا نحاول لما نعطيه narcotics يعني
+
+497
+00:30:58,360 --> 00:31:01,760
+العلاجات اللي علاقة بالإيش زي ما ناخدنا اللي علاقة
+
+498
+00:31:01,760 --> 00:31:07,140
+بال .. زي ال narcotine زي ال opioid يعني بشكل عام
+
+499
+00:31:07,140 --> 00:31:09,840
+احنا بيقولون عن المخدرات مش هقول كلمة مخدرات عشان
+
+500
+00:31:09,840 --> 00:31:14,560
+انا ترددت أحكيهايعني ال opioid بشكل عام مورفين
+
+501
+00:31:14,560 --> 00:31:19,080
+مثدين علاجات من هذا القبيل بنشوف إيش نعمله بنعمله
+
+502
+00:31:19,080 --> 00:31:23,100
+إعادة رد فعلي يعني لو كانت زايدة عنده بدنا ننقصها
+
+503
+00:31:23,100 --> 00:31:26,780
+لو لاجناه عنده deep coma بنخففها شوية يعني لازم
+
+504
+00:31:26,780 --> 00:31:30,920
+نعطي حسب الطبيب ما بيتكلم possible طبعا mechanical
+
+505
+00:31:30,920 --> 00:31:34,180
+ventilation أكيد أكيد أكيد لازم نعمله mechanical
+
+506
+00:31:34,180 --> 00:31:37,140
+ventilation لأن مش هنقدر نسيطر عليه طبعا احنا
+
+507
+00:31:37,140 --> 00:31:41,050
+خلصنا ال chapterطبعا ال respiratory system
+
+508
+00:31:41,050 --> 00:31:44,990
+assessment ونشوف احنا يعني ان شاء الله تكون
+
+509
+00:31:44,990 --> 00:31:48,590
+استفدته وان شاء الله بننتقل لل chapter القادم في
+
+510
+00:31:48,590 --> 00:31:52,310
+المحاضرة القادمة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo.srt
new file mode 100644
index 0000000000000000000000000000000000000000..69a0d2e2af07c60855ac0356bb5ecf428a66614b
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo.srt
@@ -0,0 +1,1565 @@
+1
+00:00:00,770 --> 00:00:05,090
+بسم الله الرحمن الرحيم خلينا نكمل الآن باقية ال
+
+2
+00:00:05,090 --> 00:00:11,010
+chapter وصلنا لعند ال muscle assessment طبعا أول
+
+3
+00:00:11,010 --> 00:00:16,170
+حاجة أساسية هنا muscle strength and tone يعني إيش
+
+4
+00:00:16,170 --> 00:00:20,790
+ال tone هنا إذا حكيت عن elasticity اللي هي مرونة
+
+5
+00:00:20,790 --> 00:00:25,770
+المفصل نفسه وقوة العضلة نفسها و ال range of
+
+6
+00:00:25,770 --> 00:00:29,700
+motion إيش range of motion اللي هو يعني قد إيش بقدر
+
+7
+00:00:29,700 --> 00:00:33,640
+أحرك اللي هو الإنسان عضلاته الطبيعية هذا اسمه range
+
+8
+00:00:33,640 --> 00:00:36,300
+of motion زي ما أنا أقدر أرفع إيدي على الآخر
+
+9
+00:00:36,300 --> 00:00:40,160
+abduction أو adduction أجربها هذا اسمه إيش full
+
+10
+00:00:40,160 --> 00:00:43,680
+range of motion عشان نشوف إذا في أي deformity إيش
+
+11
+00:00:43,680 --> 00:00:49,350
+نقدر نحكي عنها ونبلغها إن شاء الله الآن بقول لك إيش ال
+
+12
+00:00:49,350 --> 00:00:52,330
+tone اللي هو زي ما إحنا حكينا قد إيش ال muscular
+
+13
+00:00:52,330 --> 00:00:55,990
+resistance قد إيش مقاومة العضلات لما بيجي ال
+
+14
+00:00:55,990 --> 00:00:59,610
+examiner اللي هو الطبيب أو الفاحص وبيجي شوية
+
+15
+00:00:59,610 --> 00:01:03,970
+بيحاول يسترخي هو بيعمل relaxation للمريض وإحنا
+
+16
+00:01:03,970 --> 00:01:07,630
+بنعمل passively moved إيش passively moved in the
+
+17
+00:01:07,630 --> 00:01:11,770
+range of motion يعني مثلاً لو واحد فرد إيده بنقول له
+
+18
+00:01:11,770 --> 00:01:15,940
+اثنِ يدك هذا اسمه active لكن لو فرد إيده أنا أنا
+
+19
+00:01:15,940 --> 00:01:19,600
+نفسي اثنيت له إيده بس قلت له أنت خلي يدك مرخية شوية
+
+20
+00:01:19,600 --> 00:01:23,500
+معايا وأنا حاولت أثني إيده هذه بيسموها
+
+21
+00:01:23,500 --> 00:01:27,380
+passive passive movement ليه؟ لأنه مِنها passive
+
+22
+00:01:27,380 --> 00:01:31,660
+لأنه ما بي بذلش جهد المريض طبعاً ليش بعملها؟ عشان أشوف
+
+23
+00:01:31,660 --> 00:01:35,020
+لا قدر الله في muscular resistance or not يعني هل
+
+24
+00:01:35,020 --> 00:01:41,040
+في مقاومة العضلات ولا ما في بعدين ask a client to
+
+25
+00:01:41,040 --> 00:01:47,750
+relax شو يعني؟ خلي المريض يقعد ويكون مرتاح hang ..
+
+26
+00:01:47,750 --> 00:01:50,710
+لمب يعني على رجليه يعني زي اللي بيقعد على
+
+27
+00:01:50,710 --> 00:01:54,770
+طاولة عالية زي طاولة الفحص رجليه مش وصلت للأرض
+
+28
+00:01:54,770 --> 00:01:58,750
+علشان أقدر أفحص رجليه  أشوفهم بيتحركوا يعني مش
+
+29
+00:01:58,750 --> 00:02:01,810
+زي كرسي اللي رجلينا بتكون على الأرض لأ
+
+30
+00:02:01,810 --> 00:02:05,190
+بتكون الجلسة مرتفعة شوية زي في بعض المطاعم
+
+31
+00:02:05,190 --> 00:02:08,170
+بتلاقوا يعني عندهم مثلاً كرسي مقعد عالي أول ما
+
+32
+00:02:08,170 --> 00:02:12,650
+بيجلس إنسان بتلاقيه بيعمل .. بيرتفع أو بيعمل مثلاً
+
+33
+00:02:13,040 --> 00:02:16,140
+في نوع من الرافعة على زيت أو على غيره عشان إيه
+
+34
+00:02:16,140 --> 00:02:19,340
+يكون بعيد عن الأرض شوية لأنه ممكن تكون الطاولة
+
+35
+00:02:19,340 --> 00:02:23,500
+منخفضة ممكن تكون عالية طبعاً هنا بنعمل support يعني
+
+36
+00:02:23,500 --> 00:02:28,140
+بنحاول قدر الإمكان خشية ألا يوجع المريض يعني نعمله
+
+37
+00:02:28,140 --> 00:02:31,460
+زي تسنيدة أو دعم ونشوف إيش ال range of motion كيف
+
+38
+00:02:31,460 --> 00:02:36,660
+بيتحرك طيب في حالة hypertonicity وفي حالة
+
+39
+00:02:36,660 --> 00:02:39,960
+hypotonicity إحنا عرفنا إيش الـ muscle
+
+40
+00:02:39,960 --> 00:02:44,710
+resistance إذا ال muscle resistance يعني .. يعني شد
+
+41
+00:02:44,710 --> 00:02:50,190
+كثير hypertonicity إذا بنحس أنه بالمرة بنقول عنه
+
+42
+00:02:50,190 --> 00:02:53,550
+إيش hypotonicity طبعاً هي مش شغلنا هو شغل الطبيب
+
+43
+00:02:53,550 --> 00:02:57,530
+الأخصائي بس أنا قصدي من باب ذكر المصطلحات لا أكثر
+
+44
+00:02:57,530 --> 00:03:00,710
+إحنا بالنسبة لنا كلمة tone بنشوف ال muscle
+
+45
+00:03:00,710 --> 00:03:05,250
+resistance عاليه أو واضحة الآن ال strength of
+
+46
+00:03:05,250 --> 00:03:09,310
+dominant دائماً بدنا نحط في بالنا إن قوة العضلات في
+
+47
+00:03:09,310 --> 00:03:12,430
+الجهة اللي بنستخدمها دائماً يعني إذا أنت أيمن
+
+48
+00:03:12,430 --> 00:03:16,370
+معناته جهة اليمين عندك أقوى من اليسرى طب لو شفنا
+
+49
+00:03:16,370 --> 00:03:20,410
+إنسان ثاني يعني أيسر يعني بيستخدم يده الشمال يعني
+
+50
+00:03:20,410 --> 00:03:24,330
+عنده الجانب الشمال الأقوى بنلاقي دائماً إيش هنا؟ آه
+
+51
+00:03:24,330 --> 00:03:27,150
+بنلاقي more strength إيش يعني more strength from
+
+52
+00:03:27,150 --> 00:03:31,730
+بقول لك more strength than a than non dominant يعني
+
+53
+00:03:31,730 --> 00:03:36,220
+معناته الإنسان اللي هو الطبيعي لأنه normal person
+
+54
+00:03:36,220 --> 00:03:40,440
+اللي زيّنا لما تيجي لو أنت قلت له اثنِ يدك اليمين
+
+55
+00:03:40,440 --> 00:03:44,060
+اثنِها حاولنا نثنيها لقينا فيها قوة لما رحنا على شمال
+
+56
+00:03:44,060 --> 00:03:47,140
+لقينا فيها شوية ضعف مش معناته ذلك نقول فيه there's
+
+57
+00:03:47,140 --> 00:03:50,480
+abnormality لأ بس الموضوع له علاقة بالإيه؟ بال
+
+58
+00:03:50,480 --> 00:03:54,340
+dominant side و non dominant side طبعاً ال dominant
+
+59
+00:03:54,340 --> 00:03:58,240
+side اللي هو إيه؟ الشق الأيمن لكن في ناس عندهم الشق
+
+60
+00:03:58,240 --> 00:04:02,190
+الأيسر assessment of general appearance assessment
+
+61
+00:04:02,190 --> 00:04:06,390
+of general appearance أول حاجة نتطلع على body
+
+62
+00:04:06,390 --> 00:04:12,130
+build يعني شكل عام هيك يعني بنية الجسم ال gate
+
+63
+00:04:12,130 --> 00:04:16,570
+كيف بيمشي وضعيته طبعاً وإحنا قلنا body mass
+
+64
+00:04:16,570 --> 00:04:19,890
+index قلنا الصح يكون إيه؟ لو ما عنديش body mass
+
+65
+00:04:19,890 --> 00:04:23,270
+index وأنا بدي أفهم المريض اللي قدامي صح يعني كيف
+
+66
+00:04:23,270 --> 00:04:28,470
+صحته باختصار لو كان الطول كذا وكذا أقول مثلاً مئة و
+
+67
+00:04:28,470 --> 00:04:32,890
+ستين سم الوزن مثلاً سبعين كيلو إيش بقول هنا؟
+
+68
+00:04:32,890 --> 00:04:39,370
+خذ لي من المئة إيش يعني؟ زي ما المئة كافي إن
+
+69
+00:04:39,370 --> 00:04:43,650
+أنا آخذ من المئة يعني واحد مئة وستين جيب المئة واحد
+
+70
+00:04:43,650 --> 00:04:47,250
+مئة وستين سم عشان أعرف وزنه الطبيعي هذا بدون
+
+71
+00:04:47,250 --> 00:04:50,470
+إن أنا ما أروح على ال BMI index بيقول لك جيب من
+
+72
+00:04:50,470 --> 00:04:55,970
+المئة لو جيبنا المئة هكتب  height minus one
+
+73
+00:04:55,970 --> 00:05:01,990
+hundred لو نقصنا من ال height من الطول مئة بيصير
+
+74
+00:05:01,990 --> 00:05:06,390
+وزنه ستين طب ممكن يجي واحد بعض الناس يقول طب لو
+
+75
+00:05:06,390 --> 00:05:10,530
+كان وزنه سبعين فيه مشكلة ما هو كان إيه مريحنا جالنا
+
+76
+00:05:10,530 --> 00:05:14,750
+زائد أو ناقص عشرة كيلو أعطيكم مثال يعني مثلاً لو
+
+77
+00:05:14,750 --> 00:05:18,670
+واحد طوله مئة وسبعين سم لو واحد طوله مئة وسبعين
+
+78
+00:05:18,670 --> 00:05:23,990
+سم رفعنا المئة سم ضل قد إيش؟ ضل السبعين الآن
+
+79
+00:05:23,990 --> 00:05:28,270
+بنقول وزنه ال optimum يعني الوزن الدقيق 70 كيلو
+
+80
+00:05:28,270 --> 00:05:33,930
+لكن معاه من 60 ل 80 طبيعي خلاص نزلنا عشرة صار 60
+
+81
+00:05:33,930 --> 00:05:39,450
+رفعنا عشرة صار 80 يبقى بنقول لو رفعنا ال 100 سم
+
+82
+00:05:39,450 --> 00:05:43,490
+بكون الوزن يعني زاد أو نقص عشرة اللي بيضل من
+
+83
+00:05:43,490 --> 00:05:48,030
+الباقي اللي هو الطول طيب ال hygiene وال
+
+84
+00:05:48,030 --> 00:05:53,740
+grooming الهندام هنا كيف نظافته؟ كيف جسمه؟ هل هو
+
+85
+00:05:53,740 --> 00:05:57,020
+نظيف؟ هل فيه مشكلة عنده؟ فيه bad odor عنده؟ لا سمح
+
+86
+00:05:57,020 --> 00:05:59,800
+الله؟ appropriate ولا inappropriate؟ أنا
+
+87
+00:05:59,800 --> 00:06:03,880
+أذكركم المصطلح اللي هو ال bizarre ولا كويس وضعهم؟
+
+88
+00:06:03,880 --> 00:06:08,160
+بشكل عام هل هو متناسب مع اللي هو عمره؟ متناسب مع
+
+89
+00:06:08,160 --> 00:06:12,320
+البيئة؟ ولا دي نشوفه وهو عامل ولابس ملابس ثقيلة أو
+
+90
+00:06:12,320 --> 00:06:18,450
+كذا؟ signs of illness كيف يعني؟ أنا بتطلع الآن بطلع
+
+91
+00:06:18,450 --> 00:06:22,990
+.. بشوف وضعيته مش قادر يقعد .. لون جسمه مش طبيعي ال
+
+92
+00:06:22,990 --> 00:06:26,590
+respirations نفسه مش طبيعي non verbal هذه كلها non
+
+93
+00:06:26,590 --> 00:06:29,650
+verbal communication هي ال body language بينقلب هنا
+
+94
+00:06:29,650 --> 00:06:33,550
+بيسموها .. بنسميها إحنا pain language إيش يعني pain
+
+95
+00:06:33,550 --> 00:06:36,870
+language؟ يعني لغة الألم اللي بتدلل إنه فيه عيش
+
+96
+00:06:36,870 --> 00:06:41,110
+عنده وجع ومتقلم لما يقول إنه فيه وجع ومتقلم من غير
+
+97
+00:06:41,110 --> 00:06:46,670
+مسألة .. إنسان مش قادر يقعد أنا مش محتاج أقول له يعني
+
+98
+00:06:46,670 --> 00:06:50,690
+عنده distress اضطراب ما أبرجع أقول له أنت متألم من شيء
+
+99
+00:06:50,690 --> 00:06:54,210
+ما هو متألم مش قادر يقعد نشوف ال effect اللي هو
+
+100
+00:06:54,210 --> 00:06:57,330
+ال attitude وال mood والحمد لله عرفنا إنه ال
+
+101
+00:06:57,330 --> 00:07:00,250
+effect وإيش ال mood لو قلنا هذا خارجي وهذا داخلي وهذا
+
+102
+00:07:00,250 --> 00:07:03,550
+هذا زي السلوك بشكل عام ال attitude يعني يعني كيف
+
+103
+00:07:03,550 --> 00:07:08,470
+وجهته كيف طريقته كيف السلوك بشكل عام بنشوف ال
+
+104
+00:07:08,470 --> 00:07:11,550
+speech وال facial expression يعني تعبير الوجه
+
+105
+00:07:12,450 --> 00:07:16,310
+ability to relax بيقدر يرتاح ال eye contact بتطلع
+
+106
+00:07:16,310 --> 00:07:19,930
+فيه كويس ولا ما بتطلعش أشوف ال behavior سلوكه طبيعي
+
+107
+00:07:19,930 --> 00:07:23,430
+مش طبيعي كمان بعمل assessment لل cognitive process
+
+108
+00:07:23,430 --> 00:07:27,150
+اللي هي العملية المعرفية خاصة يعني مستجيب معايا
+
+109
+00:07:27,150 --> 00:07:32,570
+oriented or not بيحكي كلام مناسب ولا لأ طيب ال
+
+110
+00:07:32,570 --> 00:07:35,210
+height and weight وإحنا قلنا الحمد لله بحكي عنه
+
+111
+00:07:35,210 --> 00:07:39,230
+قد إيش لازم يكون طوله وقد إيش وزنه بس الصح لما نجيب
+
+112
+00:07:39,230 --> 00:07:42,530
+طوله ما يكونش بإيه؟ بال shoes يعني مش يكون زي بعض
+
+113
+00:07:42,530 --> 00:07:46,790
+الناس يعني بيكون لابس boot عالي شوية أو ستكون
+
+114
+00:07:46,790 --> 00:07:50,430
+لابسة يعني شيء عالي وأروح أنقص اللي هو أزود له
+
+115
+00:07:50,430 --> 00:07:54,370
+سبعة ثمانية تسعة سم هذا بنكون إيش يعني بنقول
+
+116
+00:07:54,370 --> 00:07:59,110
+إيش يعني default weighing يعني بصراحة بيكون وزن أو
+
+117
+00:07:59,110 --> 00:08:03,130
+طول مش طبيعي الصح إن without shoes without extra
+
+118
+00:08:03,130 --> 00:08:05,660
+clothing لما نقول extra clothing بدون يعني
+
+119
+00:08:05,660 --> 00:08:09,220
+السويتر والجاكيتات الخارجية لأن في بعض الحالات
+
+120
+00:08:09,220 --> 00:08:13,360
+مضطرين نعرف بالضبط خاصة زي حالات ال renal failure
+
+121
+00:08:13,360 --> 00:08:17,080
+مضطرين نعرف قد إيش زاد وقد إيش نقص عشان إحنا معنّين
+
+122
+00:08:17,080 --> 00:08:20,880
+نشوف سواء الجسم بنفس الهيئة ولا بنفس الشكل ولا
+
+123
+00:08:20,880 --> 00:08:25,360
+لأ طبعاً هذه الرسمة سهلة كتير هي بتتكلم عن range of
+
+124
+00:08:25,360 --> 00:08:29,220
+motion اللي إحنا عكسنا طبيعته اللي هو المفصل هنا ROM
+
+125
+00:08:29,220 --> 00:08:33,140
+range of motion باختصار عالمي طبعاً هي زي ما شايفين
+
+126
+00:08:33,140 --> 00:08:35,740
+reflection بدنا إياها كده أكيد أخذتوها كلها في ال
+
+127
+00:08:35,740 --> 00:08:38,560
+fundamental بس من باب التذكير بفرود إيده extension
+
+128
+00:08:38,560 --> 00:08:43,500
+وهنا abduction أبعد و abduction أجربها بعدين هنا
+
+129
+00:08:43,500 --> 00:08:47,280
+rotation دوران شمال ويمين إذا دارت برا اسمها
+
+130
+00:08:47,280 --> 00:08:50,720
+external rotation  دي الرجل وإذا رجعت رجله لجوا
+
+131
+00:08:50,720 --> 00:08:54,320
+اسمها internal rotation هذا بيسموه ال full range
+
+132
+00:08:54,320 --> 00:08:56,860
+of motion for the normal person
+
+133
+00:08:59,440 --> 00:09:08,320
+assessment of the skin, hair and nails لعزيزي
+
+134
+00:09:08,320 --> 00:09:11,180
+إحنا بدأنا من وين؟ بدأنا من أعلى شيء في جسم
+
+135
+00:09:11,180 --> 00:09:14,740
+الإنسان أنا بأتكلم physical كمان مرة skin infection
+
+136
+00:09:14,740 --> 00:09:17,320
+أول حاجة بتطلع skin infection هل فيه أي التهابات في
+
+137
+00:09:17,320 --> 00:09:21,800
+جلده؟ هل فيه عنده rashes, lesions, itching يعني فيه
+
+138
+00:09:21,800 --> 00:09:27,080
+حكة عندهم فيه شيء مبين إنه مثلاً مجروح شيء معين، هل
+
+139
+00:09:27,080 --> 00:09:31,140
+فيه أشياء طالعة على جسمه زي بثور معينة، كل هذا بدونه،
+
+140
+00:09:31,140 --> 00:09:33,000
+بعدين ال precipitating factors، إيش ال
+
+141
+00:09:33,000 --> 00:09:36,040
+precipitating factors، إيش العوامل المساعدة اللي
+
+142
+00:09:36,040 --> 00:09:39,860
+أثرت على ال skin infection، زي ال stress، زي ال
+
+143
+00:09:39,860 --> 00:09:42,220
+weather، واحدش يقول ليش دخل ال stress، أنا أبدأ
+
+144
+00:09:42,220 --> 00:09:45,880
+أقول لكم ال weather زي الجو يعني ال drugs exposure
+
+145
+00:09:45,880 --> 00:09:49,680
+to allergens زي إيش؟ طبعاً الجلد بتأثر نيجي من
+
+146
+00:09:49,680 --> 00:09:54,580
+الآخر واحدة بتأثر من إنه التعرض للحساسيات طبعاً يعني
+
+147
+00:09:54,580 --> 00:09:59,060
+في بعض الناس بقول لك أنا بمجرد ما أمسك مادة معينة
+
+148
+00:09:59,060 --> 00:10:01,520
+بيصير معايا حساسية هذا خلاص exposure to allergens
+
+149
+00:10:01,520 --> 00:10:06,080
+يعني حد ما يعني ما يحط يده على شيء محسس له بيعمل
+
+150
+00:10:06,080 --> 00:10:08,400
+حساسية ال drugs في بعض الناس بيقول لك زي شربت هذا
+
+151
+00:10:08,400 --> 00:10:11,560
+الدواء بيصير معايا حساسية بعضهم من الشمس بعضهم من
+
+152
+00:10:11,560 --> 00:10:16,140
+البرد بعضهم من ال stress أنا شخصياً كانت تصيبني حالة
+
+153
+00:10:16,140 --> 00:10:19,570
+مرة زمان بيصير عنده حاجة باسم Psychogenic Allergy
+
+154
+00:10:19,570 --> 00:10:22,970
+يعني حساسية نفسية مجرد ما يفكر في شيء معين بيصير حكة
+
+155
+00:10:22,970 --> 00:10:27,670
+هذا الشيء اللي وقع في باله وأشغله يبضحك ربما لكن
+
+156
+00:10:27,670 --> 00:10:30,650
+مرات عند بعض نفسياً أنا بكون عنده أحد من الأقارب كان
+
+157
+00:10:30,650 --> 00:10:34,110
+يشوفه زي لأ ما بيحملهش ولحد ما يتذكره يصير حكة طبعاً
+
+158
+00:10:34,110 --> 00:10:37,130
+ما ندخلش نمزّح وكأنه يكره حد ولحد ما يشوفه يصير
+
+159
+00:10:37,130 --> 00:10:40,990
+حساسية لأ مصيبة يبقى بيصير فممكن ال stress كمان يأثر
+
+160
+00:10:40,990 --> 00:10:45,710
+على ال allergy it changes in color of the skin لون
+
+161
+00:10:45,710 --> 00:10:50,550
+الجلد وطبيعته هل تغير ولا لأ؟ هل فيه lesions فيه
+
+162
+00:10:50,550 --> 00:10:54,290
+آثار فيه آلام في الجلد؟ أي ضرر بنسميه
+
+163
+00:10:54,290 --> 00:10:58,590
+lesions في الجلد؟ فيه bruising؟ ما بين إيش نتوئات
+
+164
+00:10:58,590 --> 00:11:01,690
+موجودة؟ فيه إيش زي الندبات الجلدية اللي بتكون
+
+165
+00:11:01,690 --> 00:11:06,310
+موجودة؟ ال amount of sun exposure؟ قد إيش اتعرض
+
+166
+00:11:06,310 --> 00:11:11,250
+للشمس؟ فيه اتعرض للشمس ولا لأ؟ هل بيستخدم lotion؟
+
+167
+00:11:11,250 --> 00:11:14,190
+زي بعض الناس اللي بيستخدموه واقي للشمس أنا كل وقت
+
+168
+00:11:14,190 --> 00:11:17,310
+أبقى أسأل عشان أكون مطمئن أعرف إن اللون طبيعي ولا
+
+169
+00:11:17,310 --> 00:11:20,970
+فيه مشكلة طبعاً بعدها بتشوف إيه هم بيسموه ال scalp
+
+170
+00:11:20,970 --> 00:11:25,070
+scalp lesions طبعاً ال scalp معناته فروة الرأس في
+
+171
+00:11:25,070 --> 00:11:27,650
+بكرا لما نروح إن شاء الله على التدريب ويمكن شفتوا
+
+172
+00:11:27,650 --> 00:11:30,930
+في المختبر ما بعرف لكن لما نروح على التدريب في
+
+173
+00:11:30,930 --> 00:11:34,630
+حسمة scalp فين؟ scalp فين؟ في كتير من الناس حتى
+
+174
+00:11:34,630 --> 00:11:38,270
+ما بيعرفوش يحددوها بيقولوا scalp فين؟ scalp لأ scalp
+
+175
+00:11:38,270 --> 00:11:41,490
+هي إيش تاني؟ أنا بأتكلم على scalp يعني فروة الرأس لكن
+
+176
+00:11:41,490 --> 00:11:45,570
+لما أقول scalp هتلاقوا عندكم حتلاقوا كم حرف؟ واحد
+
+177
+00:11:45
+
+223
+00:14:43,150 --> 00:14:49,000
+الحرارة بملامسة الجلد للهواء أما في بعض الحالات
+
+224
+00:14:49,000 --> 00:14:53,540
+القديمة لا بيصير لها القديمة لا تجمع سائل داخلي
+
+225
+00:14:53,540 --> 00:14:57,760
+داخل الجلد ويفصل ما بين الطبقة الملونة للجلد التي
+
+226
+00:14:57,760 --> 00:15:03,740
+هو الذي احنا بنقول يعني مرات بتعمل يعني لو بدها
+
+227
+00:15:03,740 --> 00:15:08,280
+تطلع في جسم إنسان ممكن يقول عنه طبيعي تمام؟ لكن
+
+228
+00:15:08,280 --> 00:15:13,220
+لكن أركز في بعض الناس لا خاصة الملينة نشوف يعني هل
+
+229
+00:15:13,220 --> 00:15:16,960
+اللون تعالي الجلد اختلف أم لا اختلاف لون الجلد
+
+230
+00:15:16,960 --> 00:15:20,580
+مرات تكون جاية من الأدمة التي احنا بنقول عنها
+
+231
+00:15:20,580 --> 00:15:27,880
+انتفاخ أو تجمع سائل في تحت الجلد مباشرة طيب أي
+
+232
+00:15:27,880 --> 00:15:31,440
+lesions موجود أُريدُ عمل notification يعني أُريدُ إخبار
+
+233
+00:15:31,440 --> 00:15:37,080
+عنه أي شغل أُريدُ أن أشوفه يعني خاصة في بعض الحالات يمكن
+
+234
+00:15:37,080 --> 00:15:40,630
+يكون عنده ندبات معينة في جسمه لازم أحكي وأحكي
+
+235
+00:15:40,630 --> 00:15:43,650
+للطبيب لستُ أجيء لأقول هذا طبيعي أو هذا حسنة أو هذا
+
+236
+00:15:43,650 --> 00:15:47,450
+شامة لا الذي موجود أنا أبدأ أذكره مباشرةً لِعَن
+
+237
+00:15:47,450 --> 00:15:52,650
+الطبيب يُحب دائماً أن يكون واضحاً خاصةً أن بعض الناس
+
+238
+00:15:52,650 --> 00:15:56,950
+يعني بيجيب يقول يعني مثلاً أن هذا اللون طبيعي لا
+
+239
+00:15:56,950 --> 00:15:59,770
+لا يقول واحد طبيعي والله هذا الندب طبيعي لا نشوف
+
+240
+00:15:59,770 --> 00:16:02,750
+الملانين يعني يمكن الملانين هذا زيادة طبيعية أو غير
+
+241
+00:16:02,750 --> 00:16:06,970
+طبيعية من خلِف من الطبيب هو الذي يحكم أكثر مني طبعاً و
+
+242
+00:16:06,970 --> 00:16:10,230
+يقول لي في الآخر شوف الـ skin و اكتب لي آخر شيء noted
+
+243
+00:16:10,230 --> 00:16:13,890
+for the skin faults خاصةً خاصةً في الـ skin faults
+
+244
+00:16:13,890 --> 00:16:17,990
+التي هي under أو beneath the breast و under axilla
+
+245
+00:16:17,990 --> 00:16:21,650
+كمان ممكن في بعض الحالات يكون في يعني more or
+
+246
+00:16:21,650 --> 00:16:24,650
+excess perspiration زيادة التعرّق التي هو
+
+247
+00:16:24,650 --> 00:16:28,330
+bromhidrosis إذا أحد يتذكر المصطلح color of the
+
+248
+00:16:28,330 --> 00:16:34,290
+skin لون الجلد هل كل جلدنا لونه نفس اللون؟ لا طبعاً هل
+
+249
+00:16:34,290 --> 00:16:37,490
+أحنا ممكن نتقارب ألواننا لبعض؟ أنا أُعطيكم مثل
+
+250
+00:16:37,490 --> 00:16:42,150
+صغير وخلاص ونكمله لا فيه واحد لونه زي الثاني ولا
+
+251
+00:16:42,150 --> 00:16:46,910
+فيه واحد لون جلده كله زي بعض خلصنا الآن، ماذا أقول؟
+
+252
+00:16:46,910 --> 00:16:50,630
+body part to body part change okay يختلف الـ normal
+
+253
+00:16:50,630 --> 00:16:53,990
+change بتكون وين؟ مع الـ aging كمان كل ما الواحد
+
+254
+00:16:53,990 --> 00:16:57,670
+بيكبر أكثر مرات بتلاقي وجهه أو يدَه بدأت التي يسمى
+
+255
+00:16:57,670 --> 00:17:02,490
+بده يجرمز أو بدأت يعني كرمشت شوية أو بده يعني شوية
+
+256
+00:17:02,490 --> 00:17:05,840
+atrophy مع الـ atrophy والملانين الموجود الذي هو
+
+257
+00:17:05,840 --> 00:17:09,500
+الصبغة الجلدية عمالة لون متغير لا أقدر أن أقول عنه
+
+258
+00:17:09,500 --> 00:17:13,980
+abnormal هذا أقول normal aging process طيب أنا لو
+
+259
+00:17:13,980 --> 00:17:17,500
+بدأت أقول أُعمل assessment أقول أول شيء أُعمل
+
+260
+00:17:17,500 --> 00:17:19,760
+assessment for the color of the skin روح على
+
+261
+00:17:19,760 --> 00:17:23,080
+المناطق التي not exposed to the sun ماذا يعني؟
+
+262
+00:17:23,080 --> 00:17:27,340
+ياريت تروح على المناطق التي لا تتعرض للشمس زي الـ
+
+263
+00:17:27,340 --> 00:17:31,920
+palms راحت اليد يعني ممكن أقول الـ abdomen ممكن
+
+264
+00:17:31,920 --> 00:17:35,040
+أقول مثلاً الـ above arm لِماذا؟ لأنه أيدينا التي
+
+265
+00:17:35,040 --> 00:17:39,100
+برهُ مُعرّضة، أنْ تطلع في يدك من الأمام وأنْ تطلع يدك
+
+266
+00:17:39,100 --> 00:17:42,600
+من الخلف ستجد اللون الذي من الأمام فيه لون يعني
+
+267
+00:17:42,600 --> 00:17:47,480
+... يعني لونه أصفى وأنقى أما اللون الذي في خلف
+
+268
+00:17:47,480 --> 00:17:51,880
+اليد لا بيكون شوية مائل أكثر ل... خليني أقول يعني
+
+269
+00:17:51,880 --> 00:17:56,200
+للـ darkness لماذا؟ لِعَن معاملات الـ sun waves التي هو
+
+270
+00:17:56,200 --> 00:17:59,940
+الموجات التي هو تبعات الشمس خاصةً الأشعة تحت الحمراء والأشعة
+
+271
+00:17:59,940 --> 00:18:03,360
+والأشعة فوق البنفسجية فيقدر يعمل لنا حماية هذه رحمة ربنا
+
+272
+00:18:03,360 --> 00:18:06,320
+سبحانه وتعالى الـ pallor الذي هو ماذا يعني؟ الشحوب
+
+273
+00:18:06,320 --> 00:18:09,180
+الشحوب وكيف أُريدُ أن أشوف فلان شحوب الذي أُريدُ أن أنظر في
+
+274
+00:18:09,180 --> 00:18:11,760
+الـ back of my mouth ماذا يعني back of my mouth الذي
+
+275
+00:18:11,760 --> 00:18:14,580
+هو ال... ال... ال... داخل الخدين يعني الخد من
+
+276
+00:18:14,580 --> 00:18:19,040
+داخل أُخليه يفتح فمه وأشوف هل فيه يعني pallor يعني
+
+277
+00:18:19,040 --> 00:18:22,960
+مبين شحوب أم فيه orange color مبين طبعاً يبين
+
+278
+00:18:22,960 --> 00:18:26,120
+مباشرةً إذا فيه عنده abnormalities أو لا أو not هو
+
+279
+00:18:26,120 --> 00:18:29,820
+أُريدُ أن أنظر أشوف دائماً خاصةً من يعني بعض الناس سيأتي
+
+280
+00:18:29,820 --> 00:18:32,380
+يقول لك طب والناس الذين عندهم dark skin يعني افرض يا
+
+281
+00:18:32,380 --> 00:18:36,300
+أستاذ الذي قدامي يعني أسود البشرة يعني هو أسمر
+
+282
+00:18:36,300 --> 00:18:41,040
+أسمر أو أبيض أو أي لون سبحان الله الـ  in the mouth the
+
+283
+00:18:41,040 --> 00:18:44,220
+same color لو فتح فمه من داخل نفس الألوان لِعَن
+
+284
+00:18:44,220 --> 00:18:47,500
+ربنا سبحانه وتعالى يسهل علينا نشوف يبقى color or
+
+285
+00:18:47,500 --> 00:18:51,040
+changes or not الـ cyanosis انظر على الـ cyanosis
+
+286
+00:18:51,040 --> 00:18:53,960
+الازرقاق أين يصير أكثر شيء؟ أكثر شيء يصير في الـ
+
+287
+00:18:53,960 --> 00:18:58,510
+lips نراه التي هي الشفتين أو في الـ nail beds أو
+
+288
+00:18:58,510 --> 00:19:01,890
+في الأظافر فوق الكتيبة في الأظافر نجدها طابعة
+
+289
+00:19:01,890 --> 00:19:05,810
+التي وراء شوية أعلى الأظفر نجد ماذا؟ نجد، لا سمح
+
+290
+00:19:05,810 --> 00:19:09,730
+الله إذا فيه أي ازرقاق الـ conjunctiva ملتحمة العين
+
+291
+00:19:09,730 --> 00:19:13,330
+التي هي المنطقة المغطية للطبقة البيضاء المنطقة التي
+
+292
+00:19:13,330 --> 00:19:16,070
+تغطي الطبقة البيضاء اسمها sclera التي فوق الـ sclera
+
+293
+00:19:16,070 --> 00:19:20,090
+تسمى conjunctiva التي هي اسم الملتحمة palms
+
+294
+00:19:20,090 --> 00:19:23,770
+خاصةً التي يصير عند بعض الناس في البرد بتلاقي ازرق
+
+295
+00:19:23,770 --> 00:19:28,290
+اق، هذا يسمى ماذا؟ cyanosis الـ jaundice
+
+296
+00:19:28,290 --> 00:19:32,290
+الـ jaundice وأين نجده؟ أكثر شيء الـ jaundice
+
+297
+00:19:32,290 --> 00:19:35,630
+يصير لونه زي الأصفر العينين أكثر شيء بيبقى يذكر
+
+298
+00:19:35,630 --> 00:19:40,770
+الذي هو clients sclera sclera ماذا هي الصلبة بتاعة
+
+299
+00:19:40,770 --> 00:19:43,610
+العين التي هو الجسم الأبيض الذي موجود  في
+
+300
+00:19:43,610 --> 00:19:47,610
+عينينا لو نظرنا على المنطقة البيضاء في العين
+
+301
+00:19:47,610 --> 00:19:50,890
+نجدها ماكنة شوية غير على المنطقة التي في الوسط
+
+302
+00:19:50,890 --> 00:19:55,370
+القرنية لأن القرنية تدخل فيها في جلدها يعني
+
+303
+00:19:55,370 --> 00:19:59,250
+سيكون الـ pupil وهكذا ووراها ستكون تركيبات فستكون
+
+304
+00:19:59,250 --> 00:20:03,610
+ماذا هي واضحة للأمام لِعَنْ يقدر الإنسان يشوف لكن لو
+
+305
+00:20:03,610 --> 00:20:06,910
+وضعنا أيدينا شوية على منطقة الـ sclera نجدها
+
+306
+00:20:06,910 --> 00:20:10,030
+أجمد شوية لو نرى الـ sclera نرى في هذا المكان
+
+307
+00:20:11,290 --> 00:20:14,590
+الاحمرار الحمرة ماذا؟  يدلُ على أنه فيه
+
+308
+00:20:14,590 --> 00:20:17,170
+circulatory changes أنا حكيت عنها أي احمرار في
+
+309
+00:20:17,170 --> 00:20:19,930
+الجلد معناه فيه تغير في الأوعية الدموية التي
+
+310
+00:20:19,930 --> 00:20:25,730
+أمامي moisture of the skin رطوبة الـ ماذا؟ الجلد هل
+
+311
+00:20:25,730 --> 00:20:29,050
+الجلد بطبيعته لو أحد سألنا هو بطبيعته لازم يكون
+
+312
+00:20:29,050 --> 00:20:34,050
+رطب؟ طيب لِأُجيبَ على هذا السؤال فيه حاجة كلمة
+
+313
+00:20:34,050 --> 00:20:37,690
+حلوة هنا ماذا مكتوب؟ أقول لك الـ skin عادةً
+
+314
+00:20:37,690 --> 00:20:42,380
+normally smooth and dry جلدنا الطبيعي يكون smooth
+
+315
+00:20:42,380 --> 00:20:47,400
+يعني ماذا؟ يكون فيه نعومة لكن ماذا؟ جاف لا يكون
+
+316
+00:20:47,400 --> 00:20:50,800
+رطب وإلا يصير excessive ماذا يعني؟ يزيد...يزيد
+
+317
+00:20:50,800 --> 00:20:54,040
+التعرق زيادة، طيب أقول للطبيب الـ moisture of the
+
+318
+00:20:54,040 --> 00:20:57,240
+skin ماذا تكون العلاقة؟ ما علاقة بالـ clients
+
+319
+00:20:57,240 --> 00:21:00,960
+hydration ماذا يعني hydration؟ كمية السوائل
+
+320
+00:21:00,960 --> 00:21:05,200
+التي شربها الإنسان يعني جلدك وأنت صائم غير عن جلدك
+
+321
+00:21:05,200 --> 00:21:08,840
+وأنت مفطر لو جلد أي إنسان صائم في آخر النهار
+
+322
+00:21:08,840 --> 00:21:13,560
+قبل المغرب تجد جلده جاف وليس فيه أي
+
+323
+00:21:13,560 --> 00:21:18,720
+يعني شبه نعومة لماذا؟ وكأنه بدأ يجف سبحان الله كل
+
+324
+00:21:18,720 --> 00:21:25,160
+أطراف الجلد الآن في بعض الحالات فأقول لك إذا ها فيه
+
+325
+00:21:25,160 --> 00:21:30,020
+زيادة يعني في زيادة في الشرب والماء وليس هكذا
+
+326
+00:21:30,020 --> 00:21:34,280
+فقط شوية عنده lipid layer طبقة دهنية زيادة ماذا
+
+327
+00:21:34,280 --> 00:21:36,920
+تفعل هذه؟ تفعل moisture in the skin
+
+328
+00:21:36,920 --> 00:21:42,380
+ستتركز، واحد ضعيف ليس لديه lipid layer وفي نفس
+
+329
+00:21:42,380 --> 00:21:45,580
+الوقت لا يشرب ماء كثير كيف يكون الـ skin أكيد
+
+330
+00:21:45,580 --> 00:21:50,200
+أنتم تعرفون كيف يكون؟ يكون يعني جاف وشوية ممكن
+
+331
+00:21:50,200 --> 00:21:54,300
+يكون shrink يعني متقلص شوية الـ skin folds أكيد
+
+332
+00:21:54,300 --> 00:21:57,580
+كلكم تعرفون وحكينا مئة مرة أنه يكون normally
+
+333
+00:21:57,580 --> 00:22:00,140
+ماذا يكون moist يعني تحت الإبط أو تحت الثدي أو
+
+334
+00:22:00,140 --> 00:22:05,460
+غيره assessment of the skin done by palpation طبعاً
+
+335
+00:22:05,460 --> 00:22:09,320
+أنا لستُ أستعجل كمان مرة، لكنني أسْرَعُ بالاشياء البسيطة
+
+336
+00:22:09,320 --> 00:22:12,800
+التي أنا شرحتها وتبقى تتكرر فلازم أكون شوية أمشي
+
+337
+00:22:12,800 --> 00:22:15,520
+فيها لِعَنْ لا نضيع وقت لأنه المنهج الذي أمامي لسه
+
+338
+00:22:15,520 --> 00:22:19,440
+طويل عليه كمية ليست بسيطة الآن أقول هنا
+
+339
+00:22:19,440 --> 00:22:23,060
+assessment of the skin done by ماذا palpation لازم
+
+340
+00:22:23,060 --> 00:22:25,800
+تعمل assessment of the skin بالـ palpation بأيديك
+
+341
+00:22:25,800 --> 00:22:29,160
+طيب لا تعمل percussion لو أحد سألني ماذا تفعل
+
+342
+00:22:29,160 --> 00:22:31,720
+percussion على الجلد لِتَفحصَ الجلد أو أحد يضع لي
+
+343
+00:22:31,720 --> 00:22:35,390
+السماعة يقول والله بدأت أنا أسمع الجلد لا ينفع يعني
+
+344
+00:22:35,390 --> 00:22:39,510
+هذه الأمور جداً يعني يجب أن نكون واضحين فيها أن
+
+345
+00:22:39,510 --> 00:22:42,610
+presence of skin lesions وجدنا أي ضرر أو أي ألم
+
+346
+00:22:42,610 --> 00:22:46,630
+موجود على الـ skin أقول ألبس ماذا gloves لو
+
+347
+00:22:46,630 --> 00:22:50,390
+أحنا نطلب وأحنا نعمل assessment وجدنا أن الـ
+
+348
+00:22:50,390 --> 00:22:53,710
+skin فيه some abnormalities oozing or not oozing
+
+349
+00:22:53,710 --> 00:22:58,870
+يعني يخرج يعني أي شيء مثلاً صديد أو يخرج أي
+
+350
+00:22:58,870 --> 00:23:02,370
+سائل فوراً أُريدُ أن ألبس ماذا gloves لِعَنْ to protect
+
+351
+00:23:02,370 --> 00:23:06,950
+myself ولأمنع ماذا انتشار الـ infection الـ
+
+352
+00:23:06,950 --> 00:23:10,390
+temperature نريدُ أن نشوف حرارة الجلد طب حرارة الجلد
+
+353
+00:23:10,390 --> 00:23:13,910
+أحنا عرفنا أن الماء تدل على ماذا؟ الذي هو الـ
+
+354
+00:23:13,910 --> 00:23:15,770
+moisture of the skin طب ماذا دخل الـ temperature
+
+355
+00:23:15,770 --> 00:23:19,870
+يقول لي يدل على الـ amount of blood circulation ماذا
+
+356
+00:23:19,870 --> 00:23:23,050
+يعني blood circulation الذي هو دوران الدم إذا
+
+357
+00:23:23,050 --> 00:23:26,910
+الجلد وجدناه حامي كثيراً نعرف أنه الذي هو الأوعية
+
+358
+00:23:26,910 --> 00:23:31,960
+الدموية تحت الجلد مباشرةً الأوعية الدموية التي تحت
+
+359
+00:23:31,960 --> 00:23:35,440
+الجلد مباشرةً معناه فيه انتشار في الدم بشكل كبير
+
+360
+00:23:35,440 --> 00:23:39,320
+يعني فيه تدفق في الدم للشرايين والأوردة التي تحت
+
+361
+00:23:39,320 --> 00:23:43,140
+الجلد يجعل الجلد يسخن هذا الذي يدلُ على ماذا؟ وهذا
+
+362
+00:23:43,140 --> 00:23:47,200
+رحمة ربنا لِعَنْ ماذا؟ عندما الإنسان يسخن يخرج الدم
+
+363
+00:23:47,200 --> 00:23:49,960
+إلى بره شوية لِعَنْ يحاول يفقد كمية الحرارة ولا
+
+364
+00:23:49,960 --> 00:23:53,600
+الإنسان يموت لو بقيت الحرارة ترتفع فوق إطلاقها
+
+365
+00:23:53,600 --> 00:23:56,860
+assessment of the skin is a critical point لِماذا يا
+
+366
+00:23:56,860 --> 00:24:00,370
+أستاذ؟ أقول لك يا أخي... يعني من الخطورة بمكان
+
+367
+00:24:00,370 --> 00:24:04,250
+أنك تعمل assessment للـ skin يعني أن تهمل الـ skin
+
+368
+00:24:04,250 --> 00:24:09,070
+أو أنك يعني لا تحط بالك لِماذا؟ أقول لك ممكن هذا في
+
+369
+00:24:09,070 --> 00:24:12,150
+بعض الحالات زي الـ cast application يعني فرضاً واحد
+
+370
+00:24:12,150 --> 00:24:15,670
+وضعنا له جبس جبيرة عندما يقول كلمة cast application
+
+371
+00:24:15,670 --> 00:24:20,310
+واحد كسر يده كسر عظمة الساعد أو الـ radius أو
+
+372
+00:24:20,310 --> 00:24:24,330
+الـ both bones وذهبنا للطبيب وضعنا الـ ماذا؟ وضعنا له
+
+373
+00:24:24,330 --> 00:24:27,430
+الجبس قلنا ذهبنا للبيت أنا دوري كممرض و كطبيب
+
+374
+00:24:27,430 --> 00:24:31,590
+فوراً أُريدُ أن أعمل assessment الذي هو خاصةً under... آه
+
+375
+00:24:31,590 --> 00:24:34,890
+... under the cast تحت الجبس والأصابع التي من الـ
+
+376
+00:24:34,890 --> 00:24:38,370
+cast تحت شوية كثيراً من الحالات ممكن أنظر في
+
+377
+00:24:38,370 --> 00:24:42,010
+الأصابع أجد اللون الأزرق أو صار ماذا؟ بارد
+
+378
+00:24:42,010 --> 00:24:46,310
+شوية فوراً أبلغ الطبيب لِعَنْ... يفك الـ
+
+379
+00:24:46,310 --> 00:24:50,340
+cast فوراً يأتي يمسكها ويكسرها لِماذا؟ لأنه صار الـ
+
+380
+00:24:50,340 --> 00:24:54,360
+blood supply بدأ ينعدم في بعض الحالات زي الـ bandage
+
+381
+00:24:54,360 --> 00:24:57,980
+ماذا الـ tight bandage الذي هو رباط الضغط أو رباط
+
+382
+00:24:57,980 --> 00:25:01,780
+الشاش عندما نحن مرات يأتي مرات بعض الناس يعمل
+
+383
+00:25:01,780 --> 00:25:05,160
+غيار الذي يجب أن يذهب يشد على اليد كأنه يشد على
+
+384
+00:25:05,160 --> 00:25:10,840
+مسامير أو كأنه يشد على قطعة خشب فمن شدة الشد السريع
+
+385
+00:25:10,840 --> 00:25:15,740
+عليها تجد صار معه أصابعه تبدأ تزرق في هذه
+
+386
+00:25:15,740 --> 00:25:20,680
+الحالة فوراً أعمل أنا نوع من تبليغ عن المريض و
+
+387
+00:25:20,680 --> 00:25:24,220
+إيقاف أو release تفكيك يعني لا ماذا لهذا الـ bandage
+
+388
+00:25:24,220 --> 00:25:27,680
+هذا يعني لِعَنْ أقول مهم كثيراً أن تعمل الـ skin في
+
+389
+00:25:27,680 --> 00:25:32,140
+هذه الحالة طيب texture حكينا عنها لكن نُعيد
+
+390
+00:25:32,140 --> 00:25:36,460
+كمان مرة هي عبارة عن ماذا الـ texture نتذكر عندما قلنا
+
+391
+00:25:36,460 --> 00:25:41,160
+نمسك الـ skin لِتَحُسَّ على الـ underlying tissue لِعَنْ
+
+392
+00:25:41,160 --> 00:25:43,840
+تستطيع أن ترى الـ tissue التي تحت أو تحس الـ tissue
+
+393
+00:25:43,840 --> 00:25:48,220
+التي تحت الـ skin طيب أقول هنا الـ texture of the
+
+394
+00:25:48,220 --> 00:25:52,840
+skin لازم يكون ماذا normally smooth, soft, flexible
+
+395
+00:25:52,840 --> 00
+
+445
+00:29:09,450 --> 00:29:13,130
+أحمر، وأشي أزرق، وأشي قاعد بتفشة بقول أنا ب check في
+
+446
+00:29:13,130 --> 00:29:16,340
+شغلات، مش أيش أقول له طبيعي، لأ بقول له أفحص، ممكن يكون
+
+447
+00:29:16,340 --> 00:29:20,560
+عنده أي اضطراب في الدم، أو في علاج اتفاعل مع بعض، أو
+
+448
+00:29:20,560 --> 00:29:27,000
+لا سمح الله اضطراب في وظائف الكبد. طيب، الإديمة
+
+449
+00:29:27,000 --> 00:29:32,080
+الإديمة عبارة عن تجمع لل solutions، أيش يعني؟ بعض
+
+450
+00:29:32,080 --> 00:29:35,340
+الناس معناها استسقاء، تجمع في السوائل تحت الجلد.
+
+451
+00:29:35,340 --> 00:29:39,060
+مباشرة، أوعى نيجي نطلع على لون الجلد في مكان
+
+452
+00:29:39,060 --> 00:29:42,460
+الإديمة، أنا قُلت لكم ليش قبل شوية؟ لأن الإديمة بتفصل
+
+453
+00:29:43,800 --> 00:29:46,640
+اللي هو الميلانين، ليه؟ لاحظين أنتم هنا، ما بقول
+
+454
+00:29:46,640 --> 00:29:49,560
+ليه؟ بقول ال edematous area، المنطقة اللي فيها
+
+455
+00:29:49,560 --> 00:29:53,100
+إديمة، يعني لو شوفنا إيد أو رجل أو منطقة البطن
+
+456
+00:29:53,100 --> 00:29:56,440
+فيها إديمة، ما بدناش نشوف لون الجلد فيها ونحكم عليه،
+
+457
+00:29:56,440 --> 00:30:00,720
+ليه؟ ما تشوفش ال location، بس ضروري تدوّن لنا أن أين
+
+458
+00:30:00,720 --> 00:30:03,080
+موجود، وكيف شكله، لكن مش هو اللي بدنا نحكم عليه،
+
+459
+00:30:03,080 --> 00:30:05,840
+ليه؟ لأن الإديمة مش بتعمل separate، أيش يعني
+
+460
+00:30:05,840 --> 00:30:10,920
+separate؟ بتفصل ال skin surface، طبقات الجلد عن ال
+
+461
+00:30:10,920 --> 00:30:16,100
+pigmented، عن المنطقة اللي فيها اللون بتاع الجلد
+
+462
+00:30:16,100 --> 00:30:20,460
+اللي هي سبقها الميلانين، علشان هي بتعمل masking of
+
+463
+00:30:20,460 --> 00:30:24,740
+skin color. إيش يعني mask؟ واحد يقول يعني كمامة، لأ
+
+464
+00:30:24,740 --> 00:30:28,460
+mask معناها إخفاء، أيش يعني؟ يعني بتعمل نوع من
+
+465
+00:30:28,460 --> 00:30:32,360
+الإخفاء، ليش جاروا كلمة masking؟ ال mask لو حطيناه
+
+466
+00:30:32,360 --> 00:30:37,400
+على وجهنا، بتخفي وجهنا وتعبير وجهنا، وكأنه بفعل الإديمة،
+
+467
+00:30:37,400 --> 00:30:42,260
+الإديمة بتخفي معالم الجلد في هذا المكان، علشانك ما
+
+468
+00:30:42,260 --> 00:30:47,420
+تحكم على لون الجلد في هذا المكان بالذات. Legions،
+
+469
+00:30:47,420 --> 00:30:52,510
+أي Legion، إيش يعني؟ إذا شفت ندبات، نتوءات، ضربات،
+
+470
+00:30:52,510 --> 00:30:56,590
+سحجات، كشطات، أي شيء في الجلد، بقول ياريت تنتبه له،
+
+471
+00:30:56,590 --> 00:31:00,090
+تشوف لي إيش اللون، وال size، وال
+
+472
+00:31:00,090 --> 00:31:06,090
+location، وال type، إيش نوعها، grouping، كتيرة،
+
+473
+00:31:06,090 --> 00:31:10,810
+جليلة، إذا لا سمح الله في بعض الحالات cancerous
+
+474
+00:31:10,810 --> 00:31:16,280
+regions، يعني هذول الناس بيكون عندهم، خاصة بشكل عام
+
+475
+00:31:16,280 --> 00:31:19,820
+بيكون عندهم لون الجلد مختلف كثير، يعني الندابات
+
+476
+00:31:19,820 --> 00:31:23,680
+الموجودة تختلف عن كل الـ ... الـ ... الـ ... الندابات كل
+
+477
+00:31:23,680 --> 00:31:27,060
+جلد الإنسان، يعني بتنطلع في الجلد بيلاقيه كله أسود
+
+478
+00:31:27,060 --> 00:31:31,700
+أسود، ندابات سوداء جداً ومنتشرة بشكل كبير جداً، هذول
+
+479
+00:31:31,700 --> 00:31:34,780
+الناس كويس نسألهم، يمكن يكون عنده cancer، واحنا مش
+
+480
+00:31:34,780 --> 00:31:38,180
+دارينه، وهو يكون عارف ويقول أنا لأ، أنا عندي كده و
+
+481
+00:31:38,180 --> 00:31:44,540
+كده، أنا شايف أنه ... أشوف إذا أنطول ولا لأ، لأ أنا
+
+482
+00:31:44,540 --> 00:31:52,740
+هنصل لأكثر من أربعين دقيقة، طيب طيب
+
+483
+00:31:52,740 --> 00:31:58,840
+خلينا معلش، عشان احنا نلتزم بـ ... ما بدناش نمد كتير
+
+484
+00:31:58,840 --> 00:32:02,280
+طيب، خلينا نوقف لهنا إن شاء الله، والمحاضرة القادمة
+
+485
+00:32:02,280 --> 00:32:04,700
+لو كانت قصيرة كثير إن شاء الله بأمد المحاضرة بعدها
+
+486
+00:32:04,700 --> 00:32:07,140
+السلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..2035e6f5ac1e9f8880e79a9b292ef05b4dcc8070
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_postprocess.srt
@@ -0,0 +1,1944 @@
+1
+00:00:00,770 --> 00:00:05,090
+بسم الله الرحمن الرحيم خلينا نكمل الآن باقية ال
+
+2
+00:00:05,090 --> 00:00:11,010
+chapter وصلنا لعند ال muscle assessment طبعا اول
+
+3
+00:00:11,010 --> 00:00:16,170
+حاجة اسس ايه هنا muscle strength and tone يعني ايش
+
+4
+00:00:16,170 --> 00:00:20,790
+ال tone هنا اذا حكيت ال elasticity اللي هي مرونة
+
+5
+00:00:20,790 --> 00:00:25,770
+ال joint نفسه وقوة العضلة نفسها و ال range of
+
+6
+00:00:25,770 --> 00:00:29,700
+motion ايش range of motion اللي هويعني كديش بقدر
+
+7
+00:00:29,700 --> 00:00:33,640
+يحرك اللي هو الإنسان عضلته الطبيعية هذا اسمه range
+
+8
+00:00:33,640 --> 00:00:36,300
+of motion زي ما انا اقدر ارفع ايدي على الآخر
+
+9
+00:00:36,300 --> 00:00:40,160
+abduction او adduction بجربها هذا اسمه ايش full
+
+10
+00:00:40,160 --> 00:00:43,680
+range of motion عشان نشوف اذا في اي deformity ايش
+
+11
+00:00:43,680 --> 00:00:49,350
+نقدر نحكي عنها ونبلغها ان شاء اللهالان بقوليش ال
+
+12
+00:00:49,350 --> 00:00:52,330
+tone اللي هو زي ما احنا حكينا جداش ال muscular
+
+13
+00:00:52,330 --> 00:00:55,990
+resistance جداش نقاومة العضلات لما بيجي ال
+
+14
+00:00:55,990 --> 00:00:59,610
+examiner اللي هو الطبيب او الحكيم و بيجي شوية
+
+15
+00:00:59,610 --> 00:01:03,970
+بيحاول يتنها هو بيعمل relaxation المريض و احنا
+
+16
+00:01:03,970 --> 00:01:07,630
+بنعمل passively moved ايش passively moved in the
+
+17
+00:01:07,630 --> 00:01:11,770
+range of motion يعني مثلا لو واحد فرض ايده بنقوله
+
+18
+00:01:11,770 --> 00:01:15,940
+اتني ايدك هذا اسمه activeلكن لو فرض ايده انا انا
+
+19
+00:01:15,940 --> 00:01:19,600
+نفسي تنيتله ايده بس قلتله انت خلي ايدك مرخية شوية
+
+20
+00:01:19,600 --> 00:01:23,500
+معايا و انا حاولت احمل ايده و اتنيها هذه بيسموها
+
+21
+00:01:23,500 --> 00:01:27,380
+passive passive movement ليه لأ لسه منها passive
+
+22
+00:01:27,380 --> 00:01:31,660
+لأنه مابيبذلش جهد المريض طبعا ليش بعملها عشان اشوف
+
+23
+00:01:31,660 --> 00:01:35,020
+لا قدر الله في muscular resistance or not يعني هل
+
+24
+00:01:35,020 --> 00:01:41,040
+في مقاومة العضلات ولا مافي بعدين ask a client to
+
+25
+00:01:41,040 --> 00:01:47,750
+relax شو يعنيخلّي المريض يقعد و يكون مرتاح hang ..
+
+26
+00:01:47,750 --> 00:01:50,710
+لمب يعني على اللي رجليه يعني زي اللي بقعد على
+
+27
+00:01:50,710 --> 00:01:54,770
+طاولة عالية زي طاولة الفحص رجليه مش وصلت للأرض
+
+28
+00:01:54,770 --> 00:01:58,750
+علشان بدي أقدر أفحص رجليهم عماهم بتحركوا يعني مش
+
+29
+00:01:58,750 --> 00:02:01,810
+زي جاعدة الكرسي اللي رجلينا بتكون على الأرض لأ
+
+30
+00:02:01,810 --> 00:02:05,190
+بتكون الجاعدة مرتفعة شوية زي في بعض المطاعم
+
+31
+00:02:05,190 --> 00:02:08,170
+بتلاقوا يعني عندهم مثلا جامع مقعد عالي أول ما
+
+32
+00:02:08,170 --> 00:02:12,650
+بيجلس إنسان بتلاقاش بيعمل .. بيرتفع أو بيعمل مثلا
+
+33
+00:02:13,040 --> 00:02:16,140
+في نوع من الرافعة على الزيت او على غيره عشان ايه
+
+34
+00:02:16,140 --> 00:02:19,340
+يكون بعيد على الأرض شوية لانه ممكن تكون الطاولة
+
+35
+00:02:19,340 --> 00:02:23,500
+تطعم ممكن تكون عالية طبعا هنا بنعمل support يعني
+
+36
+00:02:23,500 --> 00:02:28,140
+بنحاول قدر الإمكان خوف لا يوجع المريض يعني نعمله
+
+37
+00:02:28,140 --> 00:02:31,460
+زي تسنيدة او دعم و نشوف ايش ال range of motion كيف
+
+38
+00:02:31,460 --> 00:02:36,660
+بتحرك طيب في حزمة hypertonicity و في حزمة
+
+39
+00:02:36,660 --> 00:02:39,960
+hypotonicity احنا عرفنا ايش التون muscle
+
+40
+00:02:39,960 --> 00:02:44,710
+resistanceإذا ال muscle resistance يعني .. يعني شد
+
+41
+00:02:44,710 --> 00:02:50,190
+كتير hypertonicity إذا بنحس أنه بالمرة بنقول عنه
+
+42
+00:02:50,190 --> 00:02:53,550
+إيش hypotonicity طبعا هي مش شغلنا هو شغل الطبيب
+
+43
+00:02:53,550 --> 00:02:57,530
+الأخصائي بس أنا قصدي من باب ذكر المصطلحات لا أكتر
+
+44
+00:02:57,530 --> 00:03:00,710
+احنا بالنسبة لنا كلمة tone بنشوف ال muscle
+
+45
+00:03:00,710 --> 00:03:05,250
+resistance يا عالي يا واضح الأن ال strengthof
+
+46
+00:03:05,250 --> 00:03:09,310
+dominant دايما بدنا نحط فى بالنا ان قوة العضلات فى
+
+47
+00:03:09,310 --> 00:03:12,430
+الجهة اللى بنستخدمها دايما يعنى اذا انت أيمن
+
+48
+00:03:12,430 --> 00:03:16,370
+معناته جهة اليمنة عندك اقوى من اليسرى طب لو شفنا
+
+49
+00:03:16,370 --> 00:03:20,410
+انسان تانى يعني ايسر يعني بستخدم ايده الشمال يعني
+
+50
+00:03:20,410 --> 00:03:24,330
+عنده الجنب الشمال والاقوى بنلاقي دايما ايش هنا اه
+
+51
+00:03:24,330 --> 00:03:27,150
+بنلاقي more strength ايش يعني more strength from
+
+52
+00:03:27,150 --> 00:03:31,730
+بقولي more strength than a than non dominant يعني
+
+53
+00:03:31,730 --> 00:03:36,220
+معناتهالانسان اللى هو الطبيعى لانه normal person
+
+54
+00:03:36,220 --> 00:03:40,440
+اللى زى نمال تيجى لو انت قلتله اتنى ايدك اليمين
+
+55
+00:03:40,440 --> 00:03:44,060
+تنها حاولنا نتنى لجينا فيه قوة لما رحل ع شمال
+
+56
+00:03:44,060 --> 00:03:47,140
+لجينا فيه شوية ضعف مش معناه ذلك نقول فيه there's
+
+57
+00:03:47,140 --> 00:03:50,480
+abnormality لأ بس الموضوع له علاقة بالإيه بال
+
+58
+00:03:50,480 --> 00:03:54,340
+dominant side و non dominant side طبعا ال dominant
+
+59
+00:03:54,340 --> 00:03:58,240
+side اللى هو إيه الشق الأيمن لكن في ناس عندهم الشق
+
+60
+00:03:58,240 --> 00:04:02,190
+الأيسر assessment of general appearanceassessment
+
+61
+00:04:02,190 --> 00:04:06,390
+of a general appearance أول حاجة نتطلع علي body
+
+62
+00:04:06,390 --> 00:04:12,130
+build يعني شكل عام هيكا يعني بنية الجسم ال gate
+
+63
+00:04:12,130 --> 00:04:16,570
+كيف بيمشي بوصي و وضعيته طبعا و احنا قلنا body mass
+
+64
+00:04:16,570 --> 00:04:19,890
+index قلنا الصح يكون ايه لو ماعنديش body mass
+
+65
+00:04:19,890 --> 00:04:23,270
+index و انا بده افهم المريض اللي قدامي صح يعني كيف
+
+66
+00:04:23,270 --> 00:04:28,470
+صحته باختصار لو كان الطول كده و كده قول مثلا مية و
+
+67
+00:04:28,470 --> 00:04:32,890
+ستين صنطيو الوزن مثلا سبعين كيلو ايش بقولي هنا
+
+68
+00:04:32,890 --> 00:04:39,370
+خدلي نجس ايه نجس منه ايش يعني زي ما المية كافي ان
+
+69
+00:04:39,370 --> 00:04:43,650
+انا نجس المية يعني واحد مية ستين جيب المية واحد
+
+70
+00:04:43,650 --> 00:04:47,250
+مية ستين صنطين عشان انا اعرف وزنه الطبيعي هذا بدون
+
+71
+00:04:47,250 --> 00:04:50,470
+ان انا ماروح البطي مارس انديكس بيقولي جيب منه
+
+72
+00:04:50,470 --> 00:04:55,970
+المية لو جيبنا المية هكتب لل height minus one
+
+73
+00:04:55,970 --> 00:05:01,990
+hundred لو نجست من ال height من الطولمية بيصير
+
+74
+00:05:01,990 --> 00:05:06,390
+وزنه ستين طب ممكن يجيب واحد بعض الناس يقول طب لو
+
+75
+00:05:06,390 --> 00:05:10,530
+كان وزنه سبعين في مشكلة ما هو كان ايه مريحنا جالنا
+
+76
+00:05:10,530 --> 00:05:14,750
+زائد او ناقص عشرة كيلو اعطيكم مثال يعني مثلا لو
+
+77
+00:05:14,750 --> 00:05:18,670
+واحد طوله مية وسبعين سانتي لو واحد طوله مية وسبعين
+
+78
+00:05:18,670 --> 00:05:23,990
+سانتي رفعنا الميت سانتي ضال جديش ضال السبعينالان
+
+79
+00:05:23,990 --> 00:05:28,270
+بنقول وزنه ال optimum يعني الوزن الدقيق 70 كيلو
+
+80
+00:05:28,270 --> 00:05:33,930
+لكن معاه من 60 ل 80 طبيعي خلاص نزلنا عشرة صار 60
+
+81
+00:05:33,930 --> 00:05:39,450
+رفعنا عشرة صار 80 يبقى بنقول لو رفعنا ال 100 سانتي
+
+82
+00:05:39,450 --> 00:05:43,490
+بكون الوزن يعني زاد او نقص عشرة اللي بيظل من
+
+83
+00:05:43,490 --> 00:05:48,030
+الباقي اللي هو الطول طيب ال high ال hygiene و ال
+
+84
+00:05:48,030 --> 00:05:53,740
+groomingالهند ام هنا كيف نظافته؟ كيف جسمه؟ هل هو
+
+85
+00:05:53,740 --> 00:05:57,020
+نظافي؟ هل في مشكلة عنده؟ في bad odor عنده؟ لا سمح
+
+86
+00:05:57,020 --> 00:05:59,800
+الله؟ appropriate اللي ولا inappropriate؟ انا
+
+87
+00:05:59,800 --> 00:06:03,880
+اذكركم المصطلح اللي هو ال bizarre ولا كويس وضعهم؟
+
+88
+00:06:03,880 --> 00:06:08,160
+بشكل عام هل هو متناسب مع اللي هو عمره؟ متناسب مع
+
+89
+00:06:08,160 --> 00:06:12,320
+البيئة؟ ولا دي نشوب و هو عمال و لابس نفس ثقيل او ا
+
+90
+00:06:12,320 --> 00:06:18,450
+كده؟ signs of illness كيف يعني؟ انا بتطلع الآنبطلع
+
+91
+00:06:18,450 --> 00:06:22,990
+.. بشوف فضيته مش قادر يقعد .. لون جسمه مش طبيعي ال
+
+92
+00:06:22,990 --> 00:06:26,590
+respirations نفسه مش طبيعي non verbal هذه كلها non
+
+93
+00:06:26,590 --> 00:06:29,650
+verbal communication هي ال body language بينجوسين
+
+94
+00:06:29,650 --> 00:06:33,550
+بيسموها .. بنسمي احنا pain language ايش يعني pain
+
+95
+00:06:33,550 --> 00:06:36,870
+language؟ يعني لغة القلم اللي بتدلل انه في عيش
+
+96
+00:06:36,870 --> 00:06:41,110
+عنده وجع و متقلم لما قال انه في وجع و متقلم من غير
+
+97
+00:06:41,110 --> 00:06:46,670
+مسأله .. انسان مش قادر يقعدأنا مش محتاج أقوله يعني
+
+98
+00:06:46,670 --> 00:06:50,690
+عنده distress اضطراب مابرج أقوله أنت متألم من شيء
+
+99
+00:06:50,690 --> 00:06:54,210
+ما هو متألم مش قادر يقعد لنشوف ال effect اللي هو
+
+100
+00:06:54,210 --> 00:06:57,330
+ال attitude و ال mood و الحمد لله يعرفت انه ال
+
+101
+00:06:57,330 --> 00:07:00,250
+effect وش ال mood لو قلنا هذا خارجي و هذا داخلي و
+
+102
+00:07:00,250 --> 00:07:03,550
+هذا زي السلوك بشكل عام ال attitude يعني يعني كيف
+
+103
+00:07:03,550 --> 00:07:08,470
+وجهته كيف طريقته كيف السلوك بشكل عام بنشوف ال
+
+104
+00:07:08,470 --> 00:07:11,550
+speech و ال facial expression يعني تعبير الوجه
+
+105
+00:07:12,450 --> 00:07:16,310
+ability to relax بقدر يرتاح ال eye contact بتطلع
+
+106
+00:07:16,310 --> 00:07:19,930
+فيه كويس ولا مابتطلعش أشوف ال behavior سلوكه طبيعي
+
+107
+00:07:19,930 --> 00:07:23,430
+مش طبيعي كمان بعمل assessment لل cognitive process
+
+108
+00:07:23,430 --> 00:07:27,150
+اللي هي العملية المعرفية خاصة يعني مستجيب معايا
+
+109
+00:07:27,150 --> 00:07:32,570
+oriented or not بيحكي كلام مناسب ولا لأ طيب ال
+
+110
+00:07:32,570 --> 00:07:35,210
+height and weight واحنا جولنا الحمد لله بحكينا عنه
+
+111
+00:07:35,210 --> 00:07:39,230
+جداش لازم يكون طوله و جداش وزنه بس الصح لما انجيز
+
+112
+00:07:39,230 --> 00:07:42,530
+طوله مايكونش ب إيهبال shoes يعني مش كون زي بعض
+
+113
+00:07:42,530 --> 00:07:46,790
+الناس يعني بكون لابس boot عالي شوية أو ست تكون
+
+114
+00:07:46,790 --> 00:07:50,430
+لابسة يعني الشي عالي و اروح الجيس اللي هو زودلي
+
+115
+00:07:50,430 --> 00:07:54,370
+سبعة تمانية تسعة عصانطي هذا بنكون ايش يعني بنقول
+
+116
+00:07:54,370 --> 00:07:59,110
+ايش يعني default weighing يعني صراحة بكون وزن او
+
+117
+00:07:59,110 --> 00:08:03,130
+طول مش طبيعي الصح ان without shoes without extra
+
+118
+00:08:03,130 --> 00:08:05,660
+clothing لما نقول extra clothingبدون يعني
+
+119
+00:08:05,660 --> 00:08:09,220
+السويترات والجاكتات الخارجية لأن في بعض الحالات
+
+120
+00:08:09,220 --> 00:08:13,360
+مضطرين نجيص بالظبط خاصة زي حالات ال renal failure
+
+121
+00:08:13,360 --> 00:08:17,080
+مضطرين نعرف قداش زاد و قداش نجز عشان احنا معنيين
+
+122
+00:08:17,080 --> 00:08:20,880
+نشوف سواء الجسم بنفس الهيئة و لا بنفس الشكل و لا
+
+123
+00:08:20,880 --> 00:08:25,360
+لأ طبعا هذه الرسمه سهل كتير هي بتتكلم عن range of
+
+124
+00:08:25,360 --> 00:08:29,220
+motion اللي احنا عكسنا طبيعته اللي هو قبول هنا ROM
+
+125
+00:08:29,220 --> 00:08:33,140
+range of motion باختصار عالميطبعا هي زي ما تشايفين
+
+126
+00:08:33,140 --> 00:08:35,740
+reflection بدناها كده اكيد اخدته كله في ال
+
+127
+00:08:35,740 --> 00:08:38,560
+fundamental بس من باب التذكير بفرض ايده extension
+
+128
+00:08:38,560 --> 00:08:43,500
+و هنا abduction ابعد و abduction جربها بعدين هنا
+
+129
+00:08:43,500 --> 00:08:47,280
+rotation ديارة شمال ويمين اذا ديارة برا اسمها
+
+130
+00:08:47,280 --> 00:08:50,720
+external rotation دي الرجل و اذا رجع رجله لجوا
+
+131
+00:08:50,720 --> 00:08:54,320
+اسمها internal rotation هذا بيسموه ال full range
+
+132
+00:08:54,320 --> 00:08:56,860
+of motion for the normal person
+
+133
+00:08:59,440 --> 00:09:08,320
+assessment of the skin, hair and nails لعزيزي
+
+134
+00:09:08,320 --> 00:09:11,180
+احنا بدينا من وين؟ بدينا من اعلى شيء في جسم
+
+135
+00:09:11,180 --> 00:09:14,740
+الإنسان انا بتكلم physical كمان مرة skin infection
+
+136
+00:09:14,740 --> 00:09:17,320
+اول حاجة بتطلع skin infection هل في اي التهابات في
+
+137
+00:09:17,320 --> 00:09:21,800
+جلده؟ قال في عنده rashes, lesions, itching يعني في
+
+138
+00:09:21,800 --> 00:09:27,080
+حكة عندهمفي إشي مبين إنه مثلا مجروح شيء معين، هل
+
+139
+00:09:27,080 --> 00:09:31,140
+في أشياء طالع على جسمه زي حم معين، كل هذا بدونه،
+
+140
+00:09:31,140 --> 00:09:33,000
+بعدين ال precipitating factors، إيش ال
+
+141
+00:09:33,000 --> 00:09:36,040
+precipitating factors، إيش العوامل المساعدة اللي
+
+142
+00:09:36,040 --> 00:09:39,860
+أثرت على ال skin infection، زي ال stress، زي ال
+
+143
+00:09:39,860 --> 00:09:42,220
+weather، وحدش يقول ليش دخل ال stress، أنا أبدأ
+
+144
+00:09:42,220 --> 00:09:45,880
+أقولكوا ال weather زي الجو يعني ال drugs exposure
+
+145
+00:09:45,880 --> 00:09:49,680
+to allergens زي إيش؟ طبعا الجلد بتأثر نيجي من
+
+146
+00:09:49,680 --> 00:09:54,580
+الأخر واحدةبتأثر من انه التعرض للحساسيات طبعا يعني
+
+147
+00:09:54,580 --> 00:09:59,060
+في بعض الناس بقولك انا بس مجرد اذا مسكت مادة معينة
+
+148
+00:09:59,060 --> 00:10:01,520
+بيصير معايا حساسية هذا خلاص exposure to allergens
+
+149
+00:10:01,520 --> 00:10:06,080
+يعني حد ما يعني مايحط يده علي اشي محسس له بيعمل
+
+150
+00:10:06,080 --> 00:10:08,400
+حساسية ال drugs في بعض الناس بيقولك زي شربت هذا
+
+151
+00:10:08,400 --> 00:10:11,560
+الدواء بيصير معايا حساسية بعضهم من الشوق بعضهم من
+
+152
+00:10:11,560 --> 00:10:16,140
+البرد بعضهم من ال stress انا شخصيا كانت أجدني حالة
+
+153
+00:10:16,140 --> 00:10:19,570
+مرة زمانبيصير عنده حاجة باسم Psychogenic Allergy
+
+154
+00:10:19,570 --> 00:10:22,970
+يعني حسية نفسية مجرد ما يفكر في شيء معين بيصير حُك
+
+155
+00:10:22,970 --> 00:10:27,670
+هذا الحاجة اللي وقع في باله و أشغله يبضحك ربما لكن
+
+156
+00:10:27,670 --> 00:10:30,650
+مرات عند بعض نفسي أنا بكون عنده أحد من الأقارب كان
+
+157
+00:10:30,650 --> 00:10:34,110
+يشوفه زي لأ مابيتحملش و لحد ما يتذكر يصير حُك طبعا
+
+158
+00:10:34,110 --> 00:10:37,130
+ماندلاش نمزاك و كأنه نكره حد و لحد ما شوفه يصير
+
+159
+00:10:37,130 --> 00:10:40,990
+حسية لأ مصيبة يبقى بيصير فممكن ال stress كمان يأثر
+
+160
+00:10:40,990 --> 00:10:45,710
+على ال allergy it changes in color of the skinلون
+
+161
+00:10:45,710 --> 00:10:50,550
+الجلد و طبيعته هل تغير ولا لأ؟ هل فيه legions فيه
+
+162
+00:10:50,550 --> 00:10:54,290
+أدرار فيه آثام فيه ألام في الجلد؟ أي ضرر بنسميه
+
+163
+00:10:54,290 --> 00:10:58,590
+legions في الجلد؟ فيه bruising؟ مابين إيش نتوئات
+
+164
+00:10:58,590 --> 00:11:01,690
+موجودة؟ فيه إيش زي الندابات الجلدية اللي بتكون
+
+165
+00:11:01,690 --> 00:11:06,310
+موجودة؟ ال amount of sun exposure؟ قداش اتعرض
+
+166
+00:11:06,310 --> 00:11:11,250
+للشمس؟ فيه اتعرض للشمس ولا لأ؟ هل بيستخدم lotion؟
+
+167
+00:11:11,250 --> 00:11:14,190
+زي بعض الناس اللي بيستخدمه لواقي للشمسأنا كل وقت
+
+168
+00:11:14,190 --> 00:11:17,310
+أبقى أسئله عشان أكون مطمئن أعرف إن اللون طبيعي ولا
+
+169
+00:11:17,310 --> 00:11:20,970
+فيه مشكلة طبعا بعدها بتشوف إيه هم بيسموه ال scalp
+
+170
+00:11:20,970 --> 00:11:25,070
+scalp legions طبعا ال scalp معناته فرقة الرأس في
+
+171
+00:11:25,070 --> 00:11:27,650
+بكرة لما نروح ان شاء الله على التدريب و يمكن شفتوا
+
+172
+00:11:27,650 --> 00:11:30,930
+في المختبر ما بعرف لكن لما نروح على التدريب في
+
+173
+00:11:30,930 --> 00:11:34,630
+حسمة scalp فين؟ scalp فين؟ في كتير من الناس حتى
+
+174
+00:11:34,630 --> 00:11:38,270
+بيعرفوش يرفضوها بيقول scalp فين scalp لأ scalp
+
+175
+00:11:38,270 --> 00:11:41,490
+هتاشي تاني أنا بتكلم على scalp يعني عطبة الرأس لكن
+
+176
+00:11:41,490 --> 00:11:45,570
+لما أقول scalpطلع عندكوا حتلاجوا كام حرف؟ واحد
+
+177
+00:11:45,570 --> 00:11:49,470
+اتنين تلاتة اربعة خمسة و كلهم capital letter و على
+
+178
+00:11:49,470 --> 00:11:52,930
+فكرة لما ييجي كل كلمات capital letter معناته
+
+179
+00:11:52,930 --> 00:11:57,270
+اختصار كل حرف لكلمة و كتير في التوظيف بيسأله
+
+180
+00:11:57,270 --> 00:12:01,130
+بيقولك سمعت عن ال scalp فين؟ بتقوله اه ده اسمهإبرة
+
+181
+00:12:01,130 --> 00:12:04,750
+الفراشة هيك اسمها ليه؟ هي لونها زي صفرة أو مرات
+
+182
+00:12:04,750 --> 00:12:07,970
+كوني يعني بلافسجية هي زي الفراشة بالفعل نستخدمها
+
+183
+00:12:07,970 --> 00:12:11,630
+زي take away يعني needle زي لما بدى أستخدم دوة و
+
+184
+00:12:11,630 --> 00:12:14,670
+بدى أعطيه و أخلص منه واحد أجانب استعجب ياخد إبرة
+
+185
+00:12:14,670 --> 00:12:18,490
+IV مش قادر انا مديش أركب له canula فبدأ أضطر أعطيه
+
+186
+00:12:18,490 --> 00:12:22,390
+الإبرة و خلاص بكفي اللي لما أعطيه الإبرة و أكفي و
+
+187
+00:12:22,390 --> 00:12:25,590
+مديش أركب له canula بطل أعمل scalp fail لكن scalp
+
+188
+00:12:25,590 --> 00:12:30,700
+هي اختصار ياريد كلنا نحفظهالخمس كلمات ال S skin
+
+189
+00:12:30,700 --> 00:12:36,960
+connective tissue ال A aponeuretica loose
+
+190
+00:12:36,960 --> 00:12:41,180
+connective tissue بعدين ال P pericranium بكرا
+
+191
+00:12:41,180 --> 00:12:44,700
+بتاخدهم كلها في التشريح واحد لكن من باب التذكير
+
+192
+00:12:44,700 --> 00:12:47,660
+اسمها scalp skin connective tissue وaponeuretica
+
+193
+00:12:47,660 --> 00:12:50,660
+بعدين loose connective tissue و بعدين pericranium
+
+194
+00:12:50,660 --> 00:12:55,200
+هاد بيسموها ليش طب لو حد سأل طب ليش أستاذ ليش سموه
+
+195
+00:12:55,200 --> 00:13:00,570
+scalp فين؟لأنه يستخدم في أكثر الحالات في الرأس كيف
+
+196
+00:13:00,570 --> 00:13:04,890
+يعني عفوا بيجينا أطفال أعمارهم صغيرة و لما تدربوا
+
+197
+00:13:04,890 --> 00:13:07,350
+كرا في المستشفى للأطفال في سنة تالتة هتتسكروا
+
+198
+00:13:07,350 --> 00:13:11,650
+كلامي بيجي بيركب كاني و لا مش قادر يلاقي لا في
+
+199
+00:13:11,650 --> 00:13:15,890
+إيده فوق ولا تحت ولا في رجله فبيضطر يركبله في بعض
+
+200
+00:13:15,890 --> 00:13:19,270
+ال veins اللي مبينات في فروة الرأس خاصة فروة الرأس
+
+201
+00:13:19,270 --> 00:13:22,200
+اللي انتوا عارفين فيه تحت البون مباشرةففي veins
+
+202
+00:13:22,200 --> 00:13:25,160
+صغيرة بتكون مبينة فانا مضطر فبجيب ال scalp هنا و
+
+203
+00:13:25,160 --> 00:13:28,940
+بركب في هذا المكان عشان يسموها ال scalp يعني معظم
+
+204
+00:13:28,940 --> 00:13:31,940
+الناس هيك بيتكلموا ال changes in texture كلنا عارف
+
+205
+00:13:31,940 --> 00:13:35,520
+ماهي ال texture and amount of hair كده حجم الشعر
+
+206
+00:13:35,520 --> 00:13:40,660
+اللي موجود بعدين بنشوف ال nails الأظافر ال nail
+
+207
+00:13:40,660 --> 00:13:45,180
+breaking يعني هل فيه تكسر الأظافر ولا لأ عنده
+
+208
+00:13:45,180 --> 00:13:48,520
+inflammation or not بعدين بنشوف examination of the
+
+209
+00:13:48,520 --> 00:13:51,930
+skin includes ايهinclude ايش ان inspections of the
+
+210
+00:13:51,930 --> 00:13:57,430
+skin بتطلع في الجلد لون الجلد مش بس هيك moisture
+
+211
+00:13:57,430 --> 00:14:02,370
+ايش يعني رطوبة الجلد temperature حرارة الجلد
+
+212
+00:14:02,370 --> 00:14:06,390
+thickness كثافة الجلد terger يعني ال elasticity او
+
+213
+00:14:06,390 --> 00:14:10,570
+مرونة الجلد ال vascular changes كمان ايش يعني
+
+214
+00:14:10,570 --> 00:14:13,610
+vascular changes ايش دخله في ايه في ال skin لو
+
+215
+00:14:13,610 --> 00:14:18,470
+واحد عنده flushing احمرار بكون عنده ايش من وين جاي
+
+216
+00:14:18,470 --> 00:14:21,670
+من ال vascular changesفي حالات اسمها الـ Edema،
+
+217
+00:14:21,670 --> 00:14:25,150
+إيش يعني Vascular و إيش يعني Edema؟ الآن تخيلوا
+
+218
+00:14:25,150 --> 00:14:29,370
+معاه واحد سخن، الجلد بتطلع في وجهه، بلاقي وجهه
+
+219
+00:14:29,370 --> 00:14:32,190
+أحمر، الوجه الأحمر من هنا أجاب من الـ Vascular
+
+220
+00:14:32,190 --> 00:14:37,110
+Changes، بتروح الدم، بزيد كتير انتشاره في الـ Vein
+
+221
+00:14:37,110 --> 00:14:39,450
+و الـ Artery اللي موجودات في السكن، يعني خليني
+
+222
+00:14:39,450 --> 00:14:43,150
+أقول Under The Skin عشان يقدر يفقد أكتر كمية من
+
+223
+00:14:43,150 --> 00:14:49,000
+الحرارة بملامسة الجلد للهواءأما في بعض الحالات
+
+224
+00:14:49,000 --> 00:14:53,540
+القديمة لأ بيصير ليه القديمة لأ تجمع سائل داخلي
+
+225
+00:14:53,540 --> 00:14:57,760
+داخل الجلد وبيفصل ما بين الطبقة الملونة للجلد اللي
+
+226
+00:14:57,760 --> 00:15:03,740
+هو اللي احنا بنقول يعني مرات بتعمل يعني لو بدها
+
+227
+00:15:03,740 --> 00:15:08,280
+تطلع في جسم إنسان ممكن يقول عنه طبيعي تمام؟ لكن
+
+228
+00:15:08,280 --> 00:15:13,220
+لكن اركز في بعض الناس لأ خاصة الملينة نشوف يعني هل
+
+229
+00:15:13,220 --> 00:15:16,960
+اللون تعالي الجلد اختلف ولا لأاختلاف لون الجلد
+
+230
+00:15:16,960 --> 00:15:20,580
+مرات تكون جاية من الاديمة اللي احنا بنقول عنها
+
+231
+00:15:20,580 --> 00:15:27,880
+انتفاخ او تجمع سائل في تحت الجلد مباشرة طيب اي
+
+232
+00:15:27,880 --> 00:15:31,440
+legions موجود بدي اعمله notification يعني بدي اخبر
+
+233
+00:15:31,440 --> 00:15:37,080
+عنه اي شغل بدي اشوفه يعني خاصة في بعض الحلات يمكن
+
+234
+00:15:37,080 --> 00:15:40,630
+يكون عنده ندبات معينة في جسمهلازم احكي و احكي
+
+235
+00:15:40,630 --> 00:15:43,650
+للطبيب ماني اجي اقول هذا طبيبي او هذا حسنة او هذا
+
+236
+00:15:43,650 --> 00:15:47,450
+شامة لأ اللي موجود انا بدأ اذكره مباشرة عشان
+
+237
+00:15:47,450 --> 00:15:52,650
+الطبيب بيحب دايما يكون واضح خاصة انه بعض الناس
+
+238
+00:15:52,650 --> 00:15:56,950
+يعني بيجيبقول يعني مثلا ان هذا اللون طبيعي لأ
+
+239
+00:15:56,950 --> 00:15:59,770
+مايقول واحد طبيعي و الله هذا الندب طبيعي لأ نشوف
+
+240
+00:15:59,770 --> 00:16:02,750
+الملانين يعني يمكن الملانين هذا زيد لطبيعة و لغير
+
+241
+00:16:02,750 --> 00:16:06,970
+طبيعي من خل مين الطبيب هو اللي يحكم اكتر منىطبعا و
+
+242
+00:16:06,970 --> 00:16:10,230
+بيقوللي في الآخر شوف ال skin و ترزلي آخر شي noted
+
+243
+00:16:10,230 --> 00:16:13,890
+for the skin faults خاصة خاصة في ال skin faults
+
+244
+00:16:13,890 --> 00:16:17,990
+اللي هو under أو beneath the breast و under axilla
+
+245
+00:16:17,990 --> 00:16:21,650
+كمان ممكن في بعض الحلات يكون في يعني more or
+
+246
+00:16:21,650 --> 00:16:24,650
+excess perspiration زيادة التعرّف اللي هو
+
+247
+00:16:24,650 --> 00:16:28,330
+bromohydrosis إذا حد بتذكر المصطلح color of the
+
+248
+00:16:28,330 --> 00:16:34,290
+skin لون الجلد هل كل جلبنا لونه نفس اللون لأطب هل
+
+249
+00:16:34,290 --> 00:16:37,490
+احنا ممكن نتقارب ألواننا لبعض؟ انا بتعطيكوا مثل
+
+250
+00:16:37,490 --> 00:16:42,150
+صغير و خلاص و نكمله لا في واحد لونه زي التاني ولا
+
+251
+00:16:42,150 --> 00:16:46,910
+في واحد لون جلده كله زي بعض خلصنا الان اش بقولي
+
+252
+00:16:46,910 --> 00:16:50,630
+body part to body part change okay يختلف ال normal
+
+253
+00:16:50,630 --> 00:16:53,990
+change بتكون وين؟ مع ال aging كمان كل ما الواحد
+
+254
+00:16:53,990 --> 00:16:57,670
+بيكبر اكتر مرات بتلاقي وجهه او ادي بدت اللي بيسموه
+
+255
+00:16:57,670 --> 00:17:02,490
+بده يجرمز او بدت يعني كرمش شوية او بده يعني شوية
+
+256
+00:17:02,490 --> 00:17:05,840
+atrophyمع الأتروفي والميلانين الموجود اللي هو
+
+257
+00:17:05,840 --> 00:17:09,500
+الصبغة الجلدية عمالة لون متغير بقدرش أقول عنه
+
+258
+00:17:09,500 --> 00:17:13,980
+abnormal هذا بقول normal aging process طيب أنا لو
+
+259
+00:17:13,980 --> 00:17:17,500
+بدأ أقول بتعمل assessment بقولي أول شي بتعمل
+
+260
+00:17:17,500 --> 00:17:19,760
+assessment for the color of the skin روح على
+
+261
+00:17:19,760 --> 00:17:23,080
+المناطق اللي not exposed to the sun إيش يعني؟
+
+262
+00:17:23,080 --> 00:17:27,340
+ياريت تروح على المناطق اللي بتتعرضش للشمس زي ال
+
+263
+00:17:27,340 --> 00:17:31,920
+palms راحت اليدو يعني ممكن اقول ال abdomen ممكن
+
+264
+00:17:31,920 --> 00:17:35,040
+اقول مثلا ال above arm طب ليه؟ لأنه إيدينا اللي
+
+265
+00:17:35,040 --> 00:17:39,100
+برا معرضت انت تطلع في إيدك من الأمام و تطلع إيدك
+
+266
+00:17:39,100 --> 00:17:42,600
+من الجافة هتلاقي اللون اللي من الأمام فيه لون يعني
+
+267
+00:17:42,600 --> 00:17:47,480
+.. يعني اللونه أصفى و أنقى أما اللون اللي في جافة
+
+268
+00:17:47,480 --> 00:17:51,880
+الإيد لأ بيكون شوية مائل أكتر ل .. خليني أقول يعني
+
+269
+00:17:51,880 --> 00:17:56,200
+لل darkness ليه؟ عشان معاملات ال sun waves اللي هو
+
+270
+00:17:56,200 --> 00:17:59,940
+الموجات اللي هو تبعات الشمس خاصةالإنفرارد والإيش
+
+271
+00:17:59,940 --> 00:18:03,360
+والألترافيرد فيقدر يعملنا حماية هذا رحمة ربنا
+
+272
+00:18:03,360 --> 00:18:06,320
+سبحانه وتعالى ال palore اللي هو إيش يعني الشحوب
+
+273
+00:18:06,320 --> 00:18:09,180
+الشحوب وكيف بدي أشوف فلان شحوب اللي هو بدي أطلع في
+
+274
+00:18:09,180 --> 00:18:11,760
+ال back of my mouth إيش يعني back of my mouth اللي
+
+275
+00:18:11,760 --> 00:18:14,580
+هو ال .. ال .. ال .. داخل الوجنتين يعني الخد من
+
+276
+00:18:14,580 --> 00:18:19,040
+جوا بخليه فتحت تمه و بشوف هل في يعني palore يعني
+
+277
+00:18:19,040 --> 00:18:22,960
+مبين شحوب ولا في orange color مبين طبعا بيبين
+
+278
+00:18:22,960 --> 00:18:26,120
+مباشرة إذا في عنده abnormalities أو لا أو notهو
+
+279
+00:18:26,120 --> 00:18:29,820
+بده اطلع اشوف دايما خاصة مين يعني بعض الناس هيجي
+
+280
+00:18:29,820 --> 00:18:32,380
+يقولك طب و الناس اللي عندهم dark skin يعني افرض يا
+
+281
+00:18:32,380 --> 00:18:36,300
+أستاذ اللي قدامي يعني أسود البشرة يعني هو أسمر
+
+282
+00:18:36,300 --> 00:18:41,040
+أسمر أو أبيض أو أي لون سبحان الله ال بكل mouth the
+
+283
+00:18:41,040 --> 00:18:44,220
+same color لو فتحت تمه من جوا نفس الألوان عشان
+
+284
+00:18:44,220 --> 00:18:47,500
+ربنا سبحانه و تعالى يسهل علينا نشوف يبقى color or
+
+285
+00:18:47,500 --> 00:18:51,040
+changes or not ال cyanosis اطلع على ال cyanosis
+
+286
+00:18:51,040 --> 00:18:53,960
+الازرقاق وين بيصير أكتر شيء أكتر شيء بيصير في ال
+
+287
+00:18:53,960 --> 00:18:58,510
+lipsبنشوفه اللي هي الشفتين او في ال nail bits او
+
+288
+00:18:58,510 --> 00:19:01,890
+في الأضافر فوق الكبطلة في الأضافر بنلاقيها الطابعة
+
+289
+00:19:01,890 --> 00:19:05,810
+اللي ورا شوية اعلى الأضفر بنلاقي ايه؟ بنبين لا سمح
+
+290
+00:19:05,810 --> 00:19:09,730
+الله اذا في اي أزرقاء الكونجانك طايفة ملتحمة العين
+
+291
+00:19:09,730 --> 00:19:13,330
+اللي المنطقة المغطية للطبق البيضاء المنطقة اللي
+
+292
+00:19:13,330 --> 00:19:16,070
+عيشه الطبق البيضاء اسمها sclera اللي فوق ال sclera
+
+293
+00:19:16,070 --> 00:19:20,090
+عايش اسمها كونجانك طايفة اللي هي اسم الملتحمة palm
+
+294
+00:19:20,090 --> 00:19:23,770
+خاصة اللي بيصير عند بعض الناس في البرد بتلاقي ازرق
+
+295
+00:19:23,770 --> 00:19:28,290
+دي بازرقلهذا بيسموه ايش انا؟ Sinusis الـ jaundice
+
+296
+00:19:28,290 --> 00:19:32,290
+ال jaundice وان بيلاقيه انا اكتر شىء؟ ال jaundice
+
+297
+00:19:32,290 --> 00:19:35,630
+بيصير لو زي الصفر العينين اكتر شىء بيبقى بيذكر
+
+298
+00:19:35,630 --> 00:19:40,770
+اللي هو clients sclera sclera ايش هي الصلبة بتاعة
+
+299
+00:19:40,770 --> 00:19:43,610
+العين اللي هو الجسم الأبيضاللي موجود whale في
+
+300
+00:19:43,610 --> 00:19:47,610
+عينينا لو احنا عصينا على المنطقة البيضاء في العين
+
+301
+00:19:47,610 --> 00:19:50,890
+بنلاقيها ماكنة شوية غير على المنطقة اللي في الوسط
+
+302
+00:19:50,890 --> 00:19:55,370
+الكورنيا لإن القرانية بتدخل لنا فيه في جلبها يعني
+
+303
+00:19:55,370 --> 00:19:59,250
+هيكون ال pupil وكده و وراها هيكون تركيبات فهتكون
+
+304
+00:19:59,250 --> 00:20:03,610
+ايش هي واضحة للامام عشان يقدر الإنسان يشوف لكن لو
+
+305
+00:20:03,610 --> 00:20:06,910
+حطينا إيدينا شوية على منطقة ال sclera بنلاقيها
+
+306
+00:20:06,910 --> 00:20:10,030
+أجمد شوية لو بنشوف ال sclera بنشوف في هذا المكان
+
+307
+00:20:11,290 --> 00:20:14,590
+اريثيمة الحمرار الحمرار إيش؟ بالدل إنه فيه
+
+308
+00:20:14,590 --> 00:20:17,170
+circulatory changes أنا حكيت عنها أي حمرار في
+
+309
+00:20:17,170 --> 00:20:19,930
+الجلد معناته فيه تغير في الأوعية الدموية اللي
+
+310
+00:20:19,930 --> 00:20:25,730
+أمامي moisture of the skin رطوبة ال إيه؟ الجلد هل
+
+311
+00:20:25,730 --> 00:20:29,050
+الجلد بطبيعته لو حد سألنا هو بطبيعته لازم يكون
+
+312
+00:20:29,050 --> 00:20:34,050
+رطب؟ طيب عشان أجاب علي هذا السؤال في حاجة كلمة
+
+313
+00:20:34,050 --> 00:20:37,690
+حلوة هنا إيش مكتوب؟ بقول دلبلك ال skin شماله
+
+314
+00:20:37,690 --> 00:20:42,380
+normally smooth and dryجلبنا الطبيعي بيكون smooth
+
+315
+00:20:42,380 --> 00:20:47,400
+يعني إيش؟ بيكون فيه نعومة لكن إيش؟ جاف مابيكونش
+
+316
+00:20:47,400 --> 00:20:50,800
+رطب و إلا بيصير excessive إيش يعني؟ بيرش .. بيرش
+
+317
+00:20:50,800 --> 00:20:54,040
+التعرق زيادة طيب بقولي طبيبي ال monster of the
+
+318
+00:20:54,040 --> 00:20:57,240
+skin إيش بتكون العلاقة؟ إيه علاقة بال clients
+
+319
+00:20:57,240 --> 00:21:00,960
+hydration إيش يعني hydration؟ قداش كمية السوائل
+
+320
+00:21:00,960 --> 00:21:05,200
+اللي شرب الإنسان يعني جلدك و أنت صايم غير عن جلدك
+
+321
+00:21:05,200 --> 00:21:08,840
+و أنت مفطر لو جلد على أي إنسان صايم في آخر النهار
+
+322
+00:21:08,840 --> 00:21:13,560
+قبل المغربتلاقي جلده جامد وما يعني مافيش فيه أي
+
+323
+00:21:13,560 --> 00:21:18,720
+يعني شبه نعومة ليه؟ وكأنه بدأت جف سبحان الله كل
+
+324
+00:21:18,720 --> 00:21:25,160
+أطراف الجلد الآن في بعض الحالات فبقولك إذا ها في
+
+325
+00:21:25,160 --> 00:21:30,020
+زيادة يعني في زيادة في الشروب و الميه ومش بس هيك
+
+326
+00:21:30,020 --> 00:21:34,280
+ناصح شوية عنده lipid layer طبقة كمان دهن زيادة إيش
+
+327
+00:21:34,280 --> 00:21:36,920
+بتعمل ليها دي؟ بتعمل moisture in the skin
+
+328
+00:21:36,920 --> 00:21:42,380
+هتتراكزهاواحد ضيف ماعندهوش lipid layer وفي نفس
+
+329
+00:21:42,380 --> 00:21:45,580
+الوقت مابيشربش مياه كتير كيف بيكون ال skin اكيد
+
+330
+00:21:45,580 --> 00:21:50,200
+انتوا عارفين كيف بيكون بيكون يعني dry و شوية ممكن
+
+331
+00:21:50,200 --> 00:21:54,300
+يكون shrink يعني متقلص شوية ال skin falls اكيد
+
+332
+00:21:54,300 --> 00:21:57,580
+كلكوا عارفين وحكينا مائة مرة انه بيكون normally
+
+333
+00:21:57,580 --> 00:22:00,140
+ايش بيكون moist يعني تحت القبض او تحت الثدية او
+
+334
+00:22:00,140 --> 00:22:05,460
+غيره assessment of the skin done by palpation طبعا
+
+335
+00:22:05,460 --> 00:22:09,320
+انا مش بستعجل كمان مرةبس انا بسرق بالاشياء البسيطة
+
+336
+00:22:09,320 --> 00:22:12,800
+اللى انا شرحتها و بضلها تتكرر فلازم اكون شوية امشي
+
+337
+00:22:12,800 --> 00:22:15,520
+فيها عشان مانضيعوش وقت لأنه المنهج اللى قدامي لسه
+
+338
+00:22:15,520 --> 00:22:19,440
+ضاهل عليه كمية مش بسيطة الانش بقوللى هنا
+
+339
+00:22:19,440 --> 00:22:23,060
+assessment of the skin done by إيش palpation لازم
+
+340
+00:22:23,060 --> 00:22:25,800
+تعمل assessment of the skin بال palpation بإيديك
+
+341
+00:22:25,800 --> 00:22:29,160
+طيب ماتعملى percussion لو واحد سألني شو تعملى
+
+342
+00:22:29,160 --> 00:22:31,720
+percussion على الجلد عشان تفحص الجلد او واحد يحطلى
+
+343
+00:22:31,720 --> 00:22:35,390
+السماعة يقولى والله بدأ أنا أسمع الجلد مابنفعشيعني
+
+344
+00:22:35,390 --> 00:22:39,510
+هذه الأمور أوي يعني بدنا نكون واضحين فيها إن
+
+345
+00:22:39,510 --> 00:22:42,610
+presence of skin lesions لجينا أي ضرر أو أي ألم
+
+346
+00:22:42,610 --> 00:22:46,630
+موجود على ال skin بقول ألبسها أنا إيش gloves لو
+
+347
+00:22:46,630 --> 00:22:50,390
+إحنا بنطلب و إحنا بنعمل assessment وجدنا إن ال
+
+348
+00:22:50,390 --> 00:22:53,710
+skin في some abnormalities oozing or not oozing
+
+349
+00:22:53,710 --> 00:22:58,870
+يعني بيطلع يعني أي شيء مثلا سرسفلود أو بيطلع أي
+
+350
+00:22:58,870 --> 00:23:02,370
+سائل فورا بدي ألبس إيش gloves عشان إيش to protect
+
+351
+00:23:02,370 --> 00:23:06,950
+myselfوعشان أمنع إيش انتشار ال infection ال
+
+352
+00:23:06,950 --> 00:23:10,390
+temperature بدنا نشوف حرارة الجلد طب حرارة الجلد
+
+353
+00:23:10,390 --> 00:23:13,910
+احنا عرفنا أن الميه بتدل على إيش اللي هو ال
+
+354
+00:23:13,910 --> 00:23:15,770
+moisture of the skin طب إيش دخل ال temperature
+
+355
+00:23:15,770 --> 00:23:19,870
+بقوللي بدل على ال amount of blood circulation إيش
+
+356
+00:23:19,870 --> 00:23:23,050
+يعني blood circulation اللي هو دوران الدم إذا
+
+357
+00:23:23,050 --> 00:23:26,910
+الجلد لقناها حامي كتير بنعرف أنه اللي هو الأوعية
+
+358
+00:23:26,910 --> 00:23:31,960
+الدموية لتحت الجلد مباشرةالأوعية الدموية اللي تحت
+
+359
+00:23:31,960 --> 00:23:35,440
+الجلد مباشرة معناته فيه انتشار في الدم بشكل كبير
+
+360
+00:23:35,440 --> 00:23:39,320
+يعني فيه تدفق في الدم للشرين و الأورده اللي تحت
+
+361
+00:23:39,320 --> 00:23:43,140
+الجلد بيخل الجلد يسخن هذا اللي بدل انه ايش؟ و هذا
+
+362
+00:23:43,140 --> 00:23:47,200
+رحمة ربنا عشان ايه؟ لما الإنسان بيسخن بيطلع الدم
+
+363
+00:23:47,200 --> 00:23:49,960
+لبرا شوية عشان يحاول يفقد كمية الحرارة و لا
+
+364
+00:23:49,960 --> 00:23:53,600
+الإنسان بيموت لو بقى الحرارة ترتفع على إيش أطلاقها
+
+365
+00:23:53,600 --> 00:23:56,860
+assessment of the skin is a critical point ليش يا
+
+366
+00:23:56,860 --> 00:24:00,370
+أستاذ؟بقولي دل بالك اخ .. يعني من الخطورة بمكان
+
+367
+00:24:00,370 --> 00:24:04,250
+انك تعمل assessment لل skin يعني اقعد تهمل ال skin
+
+368
+00:24:04,250 --> 00:24:09,070
+ولا انك يعني ماتحطش بالك ليه؟ بقولي ممكن هذا في
+
+369
+00:24:09,070 --> 00:24:12,150
+بعض الحالات زي ال cast application يعني فرضا واحد
+
+370
+00:24:12,150 --> 00:24:15,670
+ركبناله gyps جابيرة لما يقول كلمة cast application
+
+371
+00:24:15,670 --> 00:24:20,310
+واحدين كسرت يده كسرت عظمة القلعة او ال radius او
+
+372
+00:24:20,310 --> 00:24:24,330
+ال both boneورحنا ع الصينة حطينا ال ايه؟ حطينا له
+
+373
+00:24:24,330 --> 00:24:27,430
+ال gypsy قلنا روحنا البيت انا دوري كتمريد و كحكيم
+
+374
+00:24:27,430 --> 00:24:31,590
+فورا بدي اعمل assessment اللي هو خاصة under .. اه
+
+375
+00:24:31,590 --> 00:24:34,890
+.. under the cast تحت الجن و الأصابع اللي من ال
+
+376
+00:24:34,890 --> 00:24:38,370
+cast لتحت شوية كتير من الحالات ممكن اطلع في
+
+377
+00:24:38,370 --> 00:24:42,010
+الأصابع اللي جدا صار اللون الأزرق او صار ايش بردل
+
+378
+00:24:42,010 --> 00:24:46,310
+شوية دول فورا بدي ابلغ الطبيب عشان يحك .. يفك ال
+
+379
+00:24:46,310 --> 00:24:50,340
+cast فورا بيجي يمسكها و بيكسرهاليه؟ لأنه صار ال
+
+380
+00:24:50,340 --> 00:24:54,360
+blood supply بدأ يندم في بعض الحالات زي ال bandage
+
+381
+00:24:54,360 --> 00:24:57,980
+ايش ال tight bandage اللي هو رباط الضغط او رباط
+
+382
+00:24:57,980 --> 00:25:01,780
+الشاشة لما احنا مرات بيجي مرات بعض الناس بيعمل
+
+383
+00:25:01,780 --> 00:25:05,160
+غيار اللي لازم يروح يروح يشد على اليد كأنه يشد على
+
+384
+00:25:05,160 --> 00:25:10,840
+مسورة او كأنه يشد على قطعة خشب فمن شدة الشد السريع
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+385
+00:25:10,840 --> 00:25:15,740
+عليها بتلاقي صار معاه أصابعهبدن يزرجن في هذه
+
+386
+00:25:15,740 --> 00:25:20,680
+الحالة فورا بعمل انا نوع من تبليغ عن المريض و
+
+387
+00:25:20,680 --> 00:25:24,220
+توقيف او release تفكيك يعني لا ايش لهذه ال bandage
+
+388
+00:25:24,220 --> 00:25:27,680
+هذا يعني عشان ايه بقول مهم كتير تعمل ال skin في
+
+389
+00:25:27,680 --> 00:25:32,140
+هذه الحالة طيب texture حكينا عنها بس يعني بنقيد
+
+390
+00:25:32,140 --> 00:25:36,460
+كمان مرةهى عبارة عن ايش ال texture نتذكر لما قلنا
+
+391
+00:25:36,460 --> 00:25:41,160
+بنمسك ال skin عشان تؤسس ال underlying tissue عشان
+
+392
+00:25:41,160 --> 00:25:43,840
+تقدر تشوف ال tissue اللى تحت اللى او تحس ال tissue
+
+393
+00:25:43,840 --> 00:25:48,220
+اللى تحت ال skin طيب بقولى هنا ال texture of the
+
+394
+00:25:48,220 --> 00:25:52,840
+skin لازم يكون ايش normally smooth, soft, flexible
+
+395
+00:25:52,840 --> 00:25:58,320
+يعني لازم يكون تحت ايدك الجلد لين و بتحرك بسهولة و
+
+396
+00:25:58,320 --> 00:26:01,550
+بمرونة و مافيش اي abnormalityلكن إيه ده فيه اللي
+
+397
+00:26:01,550 --> 00:26:05,650
+سبحان الله حسيت فيه شيء فيديو مر أي شيء لأ بعد هيك
+
+398
+00:26:05,650 --> 00:26:10,850
+مباشرة بدك تسأل مينها you must ask the client هل
+
+399
+00:26:10,850 --> 00:26:14,350
+انت اتعرض exposed to any recent injury؟ هل اتعرضت
+
+400
+00:26:14,350 --> 00:26:17,410
+لأي ضربة لجلدك ولا لأ؟ زي ايش ضربة لجلدك؟ زي
+
+401
+00:26:17,410 --> 00:26:21,530
+السحاجات و الكدمات شكوش أرجع عيده إيه باب سكر على
+
+402
+00:26:21,530 --> 00:26:28,050
+إيده و هكذا ال target هي بسمها ال elasticity درجة
+
+403
+00:26:28,050 --> 00:26:31,840
+المرونة للجلدهلجيت هقولكوا كيف بتكون انه انا بده
+
+404
+00:26:31,840 --> 00:26:34,920
+اشوف هل هي بتزيد او بتخلق او خليني اطلع هنا وبعدين
+
+405
+00:26:34,920 --> 00:26:38,440
+ارجع شايفين هذه الصورة طبعا هذه بتشوف ال
+
+406
+00:26:38,440 --> 00:26:41,240
+assessment of the age target of the skin انا مسكت
+
+407
+00:26:41,240 --> 00:26:43,600
+هذا ال examiner هذا ال examiner و هذا مين ال
+
+408
+00:26:43,600 --> 00:26:48,020
+patient لما نمسكه زي هيك اه نمسكه باسمه ال thumb و
+
+409
+00:26:48,020 --> 00:26:51,360
+ال index التاني من الاسم عيني شده لفوق اذا لخار
+
+410
+00:26:51,360 --> 00:26:55,180
+اذا ارتخ مباشرة انا مارتخش اذا ارتخ مباشرة بنقول
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+411
+00:26:55,180 --> 00:26:59,480
+عنه ايش elastic skin طب لو ضل واجب زي هيكبقول
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+412
+00:26:59,480 --> 00:27:02,420
+inelastic زي في حالات ال dehydration او في حالات
+
+413
+00:27:02,420 --> 00:27:05,520
+ال aging او في حالات ال abnormal disease of the
+
+414
+00:27:05,520 --> 00:27:08,620
+kidney يعني خاصة امراض الكلاب طب ايش بقولي هنا
+
+415
+00:27:08,620 --> 00:27:12,740
+بقولي انك عندما تشوف ال elasticity بدك تتأكد يمكن
+
+416
+00:27:12,740 --> 00:27:15,760
+في عندك dehydration وهي زي ما قاللي بنش بقى ايش
+
+417
+00:27:15,760 --> 00:27:19,300
+هنا thumb ها thumb and ايش هنا four finger وانا
+
+418
+00:27:19,300 --> 00:27:21,720
+خلصت مش صح تكون four finger ممكن تكون ال index
+
+419
+00:27:21,720 --> 00:27:25,180
+اللي بدك ايها normal ايش هنا بقولي ال skin ايه هنا
+
+420
+00:27:25,550 --> 00:27:30,710
+return immediately مجرد ما يفك إيده الصح يرجع
+
+421
+00:27:30,710 --> 00:27:34,630
+الجلد كما كان لو ما رجعش ايش بتقول عند المريض
+
+422
+00:27:34,630 --> 00:27:39,450
+dehydration هذا ايش اسمه target of the skin او
+
+423
+00:27:39,450 --> 00:27:44,090
+بيسموه elasticity degree درجة المرونة طيب ال
+
+424
+00:27:44,090 --> 00:27:48,870
+vascularity اللي هي بيسموه ايش دوران الدم ايه كيف
+
+425
+00:27:48,870 --> 00:27:52,730
+بدي اعمل دوران الدم تحت الجلد مباشرة بقولي انا في
+
+426
+00:27:52,730 --> 00:27:56,610
+بعض الحالات بتطلع على الجلدو انا بعمل inspection
+
+427
+00:27:56,610 --> 00:28:01,590
+في حالات اسمة بتيكيا شوفت كيف رفضت انا مش بتيشيا
+
+428
+00:28:01,590 --> 00:28:05,550
+بتيكيا اللي بسموه اشهرنا bleeding under the skin
+
+429
+00:28:05,550 --> 00:28:10,450
+اشهر نظيف تحت الجلد لما انا اشوف نظيف تحت الجلد مش
+
+430
+00:28:10,450 --> 00:28:14,530
+واحد يقول يا استاذ زي الشكوش اللي ضرب على الاصبع
+
+431
+00:28:14,530 --> 00:28:18,270
+لأ هذا شي تاني هذا ممكن اقول bleeding under the
+
+432
+00:28:18,270 --> 00:28:20,890
+finger و بعدين او under مثلا خلينا نقول ناله بروح
+
+433
+00:28:20,890 --> 00:28:24,490
+لما بكبر الاشاللي قد فر في بعض الحالات ممكن نعمله
+
+434
+00:28:24,490 --> 00:28:28,390
+إيش release عن طريق ال needle لكن هذا لأ عنده نزيف
+
+435
+00:28:28,390 --> 00:28:33,910
+تلقائي بتطلع في جسمه دايما مسبخ لونه أحمر و بيظل
+
+436
+00:28:33,910 --> 00:28:36,870
+يميل لأزرج أكتر من مرة بتطلع في جسمه خاصة في بعض
+
+437
+00:28:36,870 --> 00:28:39,850
+ال female و خاصة كثير من حالات الثلاثين موجود
+
+438
+00:28:39,850 --> 00:28:44,070
+عندهم قوة نيجي نغفل هذه الإشارة دقر بنتشك في إيش
+
+439
+00:28:44,070 --> 00:28:49,650
+blood clotting disorders بكون عنده اضطراب في إيشفي
+
+440
+00:28:49,650 --> 00:28:55,250
+تجلط الدم او لقدر الله عنده بيشرب دوة صار فيه
+
+441
+00:28:55,250 --> 00:28:59,230
+تفاعل بين الدوة drug reactions او liver disease
+
+442
+00:28:59,230 --> 00:29:02,210
+لاحظته؟ يبقى بقلته النظيف تحت الجلد اللي اسمه
+
+443
+00:29:02,210 --> 00:29:05,350
+بتيكيا وانا بتطلع مافيش عنده ضربات ولا حاجة لكن
+
+444
+00:29:05,350 --> 00:29:09,450
+بتطلع في بقع بقع زي البهاقة اللي موجودة عليه اشي
+
+445
+00:29:09,450 --> 00:29:13,130
+أحمر واشي أزرق واشي قاعد بتفشة بقول انا ب check في
+
+446
+00:29:13,130 --> 00:29:16,340
+شغلات مش ايش اقوله طبيعي لأ بقوله افحصممكن يكون
+
+447
+00:29:16,340 --> 00:29:20,560
+عنده اي اضطراب في الدم او في علاج اتفاعل مع بعض او
+
+448
+00:29:20,560 --> 00:29:27,000
+لا سمح الله اضطراب في وظائف الكبد طيب اديمة
+
+449
+00:29:27,000 --> 00:29:32,080
+الاديمة عبارة عن تجمع لل solutions ايش يعني بعض
+
+450
+00:29:32,080 --> 00:29:35,340
+الناس معناه استسقاق تجمع في السوائل تحت الجلد
+
+451
+00:29:35,340 --> 00:29:39,060
+مباشرة اوعى نيجي نطلع على لون الجلد في مكان
+
+452
+00:29:39,060 --> 00:29:42,460
+الاديمة انا قولتكوا ليش قبل شوية لأن الاديمة بتفصل
+
+453
+00:29:43,800 --> 00:29:46,640
+اللي هو ال melanin، ليه؟ لاحظين أنتوا هناش بقول
+
+454
+00:29:46,640 --> 00:29:49,560
+ليه؟ بقول ال edematous area، المنطقة اللي فيها
+
+455
+00:29:49,560 --> 00:29:53,100
+إديمة، يعني لو شوفنا إيد أو رجل أو منطقة البطن
+
+456
+00:29:53,100 --> 00:29:56,440
+فيها إديمة، بدناش نشوف لون الجلد فيها و نحكم عليه،
+
+457
+00:29:56,440 --> 00:30:00,720
+ليه؟ ماتشوفش ال location، بس ضروري تدوّنلنا أن أين
+
+458
+00:30:00,720 --> 00:30:03,080
+موجود و كيف شكله، لكن مش هو اللي بدنا نحكم عليه،
+
+459
+00:30:03,080 --> 00:30:05,840
+ليه؟ لأن الإديمة مش بتعمل separate، إيش يعني
+
+460
+00:30:05,840 --> 00:30:10,920
+separate؟بتفصل ل skin surface طبقات الجلد عن ال
+
+461
+00:30:10,920 --> 00:30:16,100
+pigmented عن المنطقة اللي فيها اللون بتاع الجلد
+
+462
+00:30:16,100 --> 00:30:20,460
+اللي هي سبقة الميليانين علشان هي بتعمل masking of
+
+463
+00:30:20,460 --> 00:30:24,740
+skin colorإيش يعني mask؟ واحد يقول يعني كمامة، لأ
+
+464
+00:30:24,740 --> 00:30:28,460
+mask معناته قناعة، إيش يعني يعني بتعملنا نوع من
+
+465
+00:30:28,460 --> 00:30:32,360
+الإخفاء، لش جاروا كلمة masking؟ ال mask لو حطيناه
+
+466
+00:30:32,360 --> 00:30:37,400
+وجهنا بتخفي وجهنا وتعبير وجهنا، وكأنه بجل الإديمة،
+
+467
+00:30:37,400 --> 00:30:42,260
+الإديمة بتخفي معالم الجلد في هذا المكان، علشانك ما
+
+468
+00:30:42,260 --> 00:30:47,420
+تحكم على لون الجلد في هذا المكان بالذات. Legions،
+
+469
+00:30:47,420 --> 00:30:52,510
+أي Legion إيش يعني؟إذا شوفت ندبات، نتوءات، ضربات،
+
+470
+00:30:52,510 --> 00:30:56,590
+سحجات، كشطات، أي إشي في الجلد بقول ياريت تنتبه له،
+
+471
+00:30:56,590 --> 00:31:00,090
+تشوف لي إيش ال color، اللونة و ال size و ال
+
+472
+00:31:00,090 --> 00:31:06,090
+location و ال type، إيش نوعها، grouping كتيرة،
+
+473
+00:31:06,090 --> 00:31:10,810
+جليلة، إذا لا سمح الله في بعض الحالات cancerous
+
+474
+00:31:10,810 --> 00:31:16,280
+regions يعني هذول الناس بيكون عندهم خاصةبشكل عام
+
+475
+00:31:16,280 --> 00:31:19,820
+بيكون عندهم لون الجلد مختلف كتير يعني الندابات
+
+476
+00:31:19,820 --> 00:31:23,680
+الموجودة تختلف عن كل ال .. ال .. ال .. الندابات كل
+
+477
+00:31:23,680 --> 00:31:27,060
+جلد الإنسان يعني بتنطلع في الجلد بيلاقي كله أسود
+
+478
+00:31:27,060 --> 00:31:31,700
+أسود ندابات سوداء جدا ومنتشرة بشكل كبير جدا هذول
+
+479
+00:31:31,700 --> 00:31:34,780
+الناس كويس نسألهم يمكن يكون عنده cancer و احنا مش
+
+480
+00:31:34,780 --> 00:31:38,180
+دارينه و هو يكون عارف و يقول انا لأ انا عندي كده و
+
+481
+00:31:38,180 --> 00:31:44,540
+كده انا شايف انه .. اشوف اذا انطول ولا لأ لأانا
+
+482
+00:31:44,540 --> 00:31:52,740
+هنصل لأكتر من اربعين دقيقة طيب طيب
+
+483
+00:31:52,740 --> 00:31:58,840
+خلينا ماعليش عشان احنا نلتزم ب .. بدناش نمد كتير
+
+484
+00:31:58,840 --> 00:32:02,280
+طيب خلينا نجف لهنا ان شاء الله و المحاضرة القادمة
+
+485
+00:32:02,280 --> 00:32:04,700
+لو كانت قصيرة كتير ان شاء الله بأمد المحاضرة بعدها
+
+486
+00:32:04,700 --> 00:32:07,140
+السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..15873b56c8545c349ecce851ed91c9c86eca55bd
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/k95X6My1pvo_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2767, "start": 0.77, "end": 27.67, "text": "بسم الله الرحمن الرحيم خلينا نكمل الآن باقية ال chapter وصلنا لعند ال muscle assessment طبعا اول حاجة اسس ايه هنا muscle strength and tone يعني ايش ال tone هنا اذا حكيت ال elasticity اللي هي مرونة ال joint نفسه وقوة العضلة نفسها و ال range of motion ايش range of motion اللي هو", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 16490, 20292, 8315, 8717, 24793, 1211, 6024, 48506, 4724, 995, 4587, 10632, 2423, 7187, 4032, 36520, 8315, 5296, 3615, 41260, 2423, 8679, 9687, 23032, 3555, 3615, 995, 1975, 12610, 11331, 26108, 3660, 24525, 3794, 1975, 1829, 3224, 34105, 8679, 3800, 293, 8027, 37495, 22653, 1975, 1829, 8592, 2423, 8027, 34105, 1975, 15730, 11331, 4117, 36081, 2423, 46260, 13672, 1829, 39896, 3714, 2288, 11536, 3660, 2423, 7225, 8717, 36178, 3224, 4032, 4587, 2407, 3660, 18863, 11242, 37977, 8717, 36178, 11296, 4032, 2423, 3613, 295, 5394, 1975, 1829, 8592, 3613, 295, 5394, 13672, 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legions فيه أدرار فيه آثام فيه ألام في الجلد؟ أي ضرر بنسميه legions في الجلد؟ فيه bruising؟ مابين إيش نتوئات موجودة؟ فيه إيش زي الندابات الجلدية اللي بتكون موجودة؟ ال amount of sun exposure؟ قداش اتعرض للشمس؟ فيه اتعرض للشمس ولا لأ؟ هل بيستخدم lotion؟ زي بعض الناس اللي بيستخدمه لواقي للشمس", "tokens": [1211, 11536, 25724, 1211, 3215, 4032, 23032, 21292, 34268, 3224, 8032, 1211, 6055, 17082, 13546, 49429, 5296, 10721, 22807, 8032, 1211, 8978, 3224, 1676, 626, 8978, 3224, 5551, 3215, 2288, 9640, 8978, 3224, 19753, 12984, 10943, 8978, 3224, 5551, 37440, 8978, 25724, 1211, 3215, 22807, 36632, 48812, 2288, 2288, 44945, 38251, 1829, 3224, 1676, 626, 8978, 25724, 1211, 3215, 22807, 8978, 3224, 25267, 3436, 22807, 3714, 16758, 9957, 11933, 1829, 8592, 8717, 2655, 2407, 19986, 9307, 3714, 29245, 23328, 3660, 22807, 8978, 3224, 11933, 1829, 8592, 30767, 1829, 28239, 3215, 16758, 9307, 25724, 1211, 3215, 10632, 13672, 1829, 39894, 30544, 3714, 29245, 23328, 3660, 22807, 2423, 2372, 295, 3295, 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موجودة؟", "probability": 0.97734375}, {"start": 659.79, "end": 660.03, "word": " فيه", "probability": 0.726318359375}, {"start": 660.03, "end": 660.17, "word": " إيش", "probability": 0.7876790364583334}, {"start": 660.17, "end": 660.39, "word": " زي", "probability": 0.966552734375}, {"start": 660.39, "end": 660.89, "word": " الندابات", "probability": 0.8619384765625}, {"start": 660.89, "end": 661.33, "word": " الجلدية", "probability": 0.9752197265625}, {"start": 661.33, "end": 661.45, "word": " اللي", "probability": 0.833251953125}, {"start": 661.45, "end": 661.69, "word": " بتكون", "probability": 0.935791015625}, {"start": 661.69, "end": 663.23, "word": " موجودة؟", "probability": 0.9638671875}, {"start": 663.23, "end": 663.37, "word": " ال", "probability": 0.86962890625}, {"start": 663.37, "end": 663.77, "word": " amount", "probability": 0.9560546875}, {"start": 663.77, "end": 663.99, "word": " of", "probability": 0.98095703125}, {"start": 663.99, "end": 664.23, "word": " sun", "probability": 0.91845703125}, {"start": 664.23, "end": 665.33, "word": " exposure؟", "probability": 0.7093505859375}, {"start": 665.33, "end": 665.83, "word": " قداش", "probability": 0.5149739583333334}, {"start": 665.83, "end": 666.31, "word": " اتعرض", "probability": 0.896484375}, {"start": 666.31, "end": 666.99, "word": " للشمس؟", "probability": 0.94091796875}, {"start": 666.99, "end": 667.15, "word": " فيه", "probability": 0.796142578125}, {"start": 667.15, "end": 667.33, "word": " اتعرض", "probability": 0.8990478515625}, {"start": 667.33, "end": 667.71, "word": " للشمس", "probability": 0.9832763671875}, {"start": 667.71, "end": 667.87, "word": " ولا", "probability": 0.923828125}, {"start": 667.87, "end": 669.49, "word": " لأ؟", "probability": 0.96875}, {"start": 669.49, "end": 669.97, "word": " هل", "probability": 0.971435546875}, {"start": 669.97, "end": 670.51, "word": " بيستخدم", "probability": 0.98671875}, {"start": 670.51, "end": 671.25, "word": " lotion؟", "probability": 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واحد", "probability": 0.9921875}, {"start": 1348.04, "end": 1348.42, "word": " سألني", "probability": 0.84326171875}, {"start": 1348.42, "end": 1348.9, "word": " شو", "probability": 0.968994140625}, {"start": 1348.9, "end": 1349.16, "word": " تعملى", "probability": 0.93115234375}, {"start": 1349.16, "end": 1349.5, "word": " percussion", "probability": 0.88623046875}, {"start": 1349.5, "end": 1349.64, "word": " على", "probability": 0.5087890625}, {"start": 1349.64, "end": 1349.86, "word": " الجلد", "probability": 0.9768880208333334}, {"start": 1349.86, "end": 1350.06, "word": " عشان", "probability": 0.9754231770833334}, {"start": 1350.06, "end": 1350.38, "word": " تفحص", "probability": 0.9840087890625}, {"start": 1350.38, "end": 1350.82, "word": " الجلد", "probability": 0.9820963541666666}, {"start": 1350.82, "end": 1351.24, "word": " او", "probability": 0.66552734375}, {"start": 1351.24, "end": 1351.42, "word": " واحد", "probability": 0.982666015625}, {"start": 1351.42, "end": 1351.72, 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assessment وجدنا إن ال skin في some abnormalities oozing or not oozing يعني بيطلع يعني أي شيء مثلا سرسفلود أو بيطلع أي سائل فورا بدي ألبس إيش gloves عشان إيش to protect myself", "tokens": [40228, 22653, 29538, 16247, 2304, 13063, 34051, 1829, 37495, 22653, 47525, 8315, 8717, 30544, 4032, 46958, 5016, 9957, 8978, 11296, 36145, 6814, 295, 3178, 1512, 626, 5296, 7435, 1829, 8315, 36632, 48812, 2288, 2288, 34051, 36632, 5551, 19528, 3714, 29245, 23328, 15844, 2423, 3178, 4724, 39648, 5551, 46152, 3794, 11296, 41850, 11933, 1829, 8592, 14976, 45164, 11933, 5016, 8315, 44945, 9566, 46152, 4032, 11933, 5016, 8315, 44945, 25957, 1211, 9687, 49610, 3215, 8315, 36145, 2423, 3178, 8978, 512, 47104, 16110, 32685, 8781, 420, 406, 32685, 8781, 37495, 22653, 4724, 1829, 9566, 1211, 3615, 37495, 22653, 36632, 44049, 38207, 50113, 15040, 8608, 2288, 3794, 5172, 1211, 23328, 34051, 4724, 1829, 9566, 1211, 3615, 36632, 8608, 16373, 1211, 6156, 13063, 995, 4724, 16254, 5551, 46152, 3794, 11933, 1829, 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"وعشان أمنع إيش انتشار ال infection ال temperature بدنا نشوف حرارة الجلد طب حرارة الجلد احنا عرفنا أن الميه بتدل على إيش اللي هو ال moisture of the skin طب إيش دخل ال temperature بقوللي بدل على ال amount of blood circulation إيش يعني blood circulation اللي هو دوران الدم إذا الجلد لقناها حامي كتير بنعرف أنه اللي هو الأوعية الدموية لتحت الجلد مباشرة", "tokens": [45367, 8592, 7649, 5551, 27842, 3615, 11933, 1829, 8592, 16472, 2655, 8592, 9640, 2423, 11764, 2423, 4292, 47525, 8315, 8717, 8592, 38688, 11331, 2288, 9640, 3660, 25724, 1211, 3215, 23032, 3555, 11331, 2288, 9640, 3660, 25724, 1211, 3215, 1975, 5016, 8315, 6225, 28480, 8315, 14739, 9673, 1829, 3224, 39894, 3215, 1211, 15844, 11933, 1829, 8592, 13672, 1829, 31439, 2423, 13814, 295, 264, 3178, 23032, 3555, 11933, 1829, 8592, 11778, 9778, 1211, 2423, 4292, 4724, 39648, 20292, 47525, 1211, 15844, 2423, 2372, 295, 3390, 23168, 11933, 1829, 8592, 37495, 22653, 3390, 23168, 13672, 1829, 31439, 11778, 13063, 7649, 32748, 2304, 11933, 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"word": " بقولي", "probability": 0.927734375}, {"start": 1644.38, "end": 1644.5, "word": " ال", "probability": 0.681640625}, {"start": 1644.5, "end": 1644.76, "word": " skin", "probability": 0.96142578125}, {"start": 1644.76, "end": 1644.94, "word": " ايه", "probability": 0.9650065104166666}, {"start": 1644.94, "end": 1645.18, "word": " هنا", "probability": 0.9736328125}], "temperature": 1.0}, {"id": 62, "seek": 167517, "start": 1645.55, "end": 1675.17, "text": "return immediately مجرد ما يفك إيده الصح يرجع الجلد كما كان لو ما رجعش ايش بتقول عند المريض dehydration هذا ايش اسمه target of the skin او بيسموه elasticity degree درجة المرونة طيب ال vascularity اللي هي بيسموه ايش دوران الدم ايه كيف بدي اعمل دوران الدم تحت الجلد مباشرة بقولي انا في بعض الحالات بتطلع على الجلد", "tokens": [1505, 925, 4258, 3714, 7435, 2288, 3215, 19446, 7251, 5172, 4117, 11933, 25708, 3224, 31767, 5016, 7251, 47341, 3615, 25724, 1211, 3215, 9122, 15042, 25961, 45164, 19446, 12602, 7435, 3615, 8592, 1975, 1829, 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{"start": 1901.96, "end": 1902.18, "word": " ولا", "probability": 0.87939453125}, {"start": 1902.18, "end": 1902.34, "word": " لأ", "probability": 0.708251953125}, {"start": 1902.34, "end": 1902.7, "word": " لأ", "probability": 0.7445068359375}], "temperature": 1.0}, {"id": 72, "seek": 192714, "start": 1904.22, "end": 1927.14, "text": "انا هنصل لأكتر من اربعين دقيقة طيب طيب خلينا ماعليش عشان احنا نلتزم ب .. بدناش نمد كتير طيب خلينا نجف لهنا ان شاء الله و المحاضرة القادمة لو كانت قصيرة كتير ان شاء الله بأمد المحاضرة بعدها السلام عليكم ورحمة الله وبركاته", "tokens": [7649, 995, 8032, 1863, 36520, 5296, 10721, 4117, 2655, 2288, 9154, 1975, 25513, 3615, 9957, 11778, 38436, 28671, 23032, 1829, 3555, 23032, 1829, 3555, 16490, 1211, 9957, 995, 19446, 3615, 20292, 8592, 6225, 8592, 7649, 1975, 5016, 8315, 8717, 1211, 2655, 11622, 2304, 4724, 4386, 47525, 8315, 8592, 8717, 2304, 3215, 9122, 2655, 13546, 23032, 1829, 3555, 16490, 1211, 9957, 995, 8717, 7435, 5172, 46740, 8315, 16472, 13412, 16606, 21984, 4032, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 45164, 25961, 2655, 12174, 9381, 48923, 9122, 2655, 13546, 16472, 13412, 16606, 21984, 4724, 10721, 2304, 3215, 9673, 5016, 46958, 25720, 39182, 11296, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.14089440284618016, "compression_ratio": 1.9701492537313432, "no_speech_prob": 2.980232238769531e-07, "words": [{"start": 1904.22, "end": 1904.54, "word": "انا", "probability": 0.494384765625}, {"start": 1904.54, "end": 1904.92, "word": " هنصل", "probability": 0.9142252604166666}, {"start": 1904.92, "end": 1905.32, "word": " لأكتر", "probability": 0.84482421875}, {"start": 1905.32, "end": 1905.44, "word": " من", "probability": 0.9970703125}, {"start": 1905.44, "end": 1905.76, "word": " اربعين", "probability": 0.84307861328125}, {"start": 1905.76, "end": 1906.28, "word": " دقيقة", "probability": 0.986328125}, {"start": 1906.28, "end": 1909.02, "word": " طيب", "probability": 0.9287109375}, {"start": 1909.02, "end": 1912.74, "word": " طيب", "probability": 0.85498046875}, {"start": 1912.74, "end": 1913.32, "word": " خلينا", "probability": 0.8140869140625}, {"start": 1913.32, "end": 1913.92, "word": " ماعليش", "probability": 0.77044677734375}, {"start": 1913.92, "end": 1914.18, "word": " عشان", "probability": 0.9542643229166666}, {"start": 1914.18, "end": 1914.42, "word": " احنا", "probability": 0.9230143229166666}, {"start": 1914.42, "end": 1915.34, "word": " نلتزم", "probability": 0.9880859375}, {"start": 1915.34, "end": 1915.54, "word": " ب", "probability": 0.69287109375}, {"start": 1915.54, "end": 1916.88, "word": " ..", "probability": 0.638671875}, {"start": 1916.88, "end": 1917.78, "word": " بدناش", "probability": 0.7127278645833334}, {"start": 1917.78, "end": 1918.48, "word": " نمد", "probability": 0.9580078125}, {"start": 1918.48, "end": 1918.84, "word": " كتير", "probability": 0.9886067708333334}, {"start": 1918.84, "end": 1919.86, "word": " طيب", "probability": 0.962890625}, {"start": 1919.86, "end": 1920.22, "word": " خلينا", "probability": 0.921142578125}, {"start": 1920.22, "end": 1920.44, "word": " نجف", "probability": 0.79931640625}, {"start": 1920.44, "end": 1920.72, "word": " لهنا", "probability": 0.61279296875}, {"start": 1920.72, "end": 1920.84, "word": " ان", "probability": 0.7216796875}, {"start": 1920.84, "end": 1920.98, "word": " شاء", "probability": 0.982421875}, {"start": 1920.98, "end": 1921.16, "word": " الله", "probability": 0.9677734375}, {"start": 1921.16, "end": 1921.64, "word": " و", "probability": 0.74365234375}, {"start": 1921.64, "end": 1922.0, "word": " المحاضرة", "probability": 0.963623046875}, {"start": 1922.0, "end": 1922.28, "word": " القادمة", "probability": 0.9388020833333334}, {"start": 1922.28, "end": 1922.44, "word": " لو", "probability": 0.82958984375}, {"start": 1922.44, "end": 1922.7, "word": " كانت", "probability": 0.990234375}, {"start": 1922.7, "end": 1923.04, "word": " قصيرة", "probability": 0.9933268229166666}, {"start": 1923.04, "end": 1923.26, "word": " كتير", "probability": 0.9791666666666666}, {"start": 1923.26, "end": 1923.4, "word": " ان", "probability": 0.8291015625}, {"start": 1923.4, "end": 1923.52, "word": " شاء", "probability": 0.993408203125}, {"start": 1923.52, "end": 1923.56, "word": " الله", "probability": 0.94580078125}, {"start": 1923.56, "end": 1923.98, "word": " بأمد", "probability": 0.80291748046875}, {"start": 1923.98, "end": 1924.4, "word": " المحاضرة", "probability": 0.9810791015625}, {"start": 1924.4, "end": 1924.7, "word": " بعدها", "probability": 0.9423828125}, {"start": 1924.7, "end": 1924.98, "word": " السلام", "probability": 0.90234375}, {"start": 1924.98, "end": 1925.34, "word": " عليكم", "probability": 0.9501953125}, {"start": 1925.34, "end": 1926.1, "word": " ورحمة", "probability": 0.870361328125}, {"start": 1926.1, "end": 1926.34, "word": " الله", "probability": 0.974609375}, {"start": 1926.34, "end": 1927.14, "word": " وبركاته", "probability": 0.89892578125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1929.0209375, "duration_after_vad": 1899.9618749999956}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE.srt
new file mode 100644
index 0000000000000000000000000000000000000000..105bcb00ca2801202479f8d0e400c3dc2ce7b9c8
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE.srt
@@ -0,0 +1,1333 @@
+1
+00:00:01,330 --> 00:00:05,510
+بسم الله الرحمن الرحيم طبعا احنا ..  مالنا اتوقفنا
+
+2
+00:00:05,510 --> 00:00:08,090
+عند المحاضرة السابقة اللي عند .. اللي هو آخر شيء
+
+3
+00:00:08,090 --> 00:00:11,030
+ما حكينا عن الـ agents اللي بتكون موجودة في الـ
+
+4
+00:00:11,030 --> 00:00:14,090
+cancerous clients أو يعني الندبات السرطانية اللي
+
+5
+00:00:14,090 --> 00:00:18,730
+بتكون موجودة في بعض أجسام الناس اللي عندهم مشكلة
+
+6
+00:00:18,730 --> 00:00:22,970
+يعني خليني أقول مثلا malignant something يعني
+
+7
+00:00:22,970 --> 00:00:26,550
+عندهم أي أورام أو أي يعني شغل .. شغلات علاقة
+
+8
+00:00:26,550 --> 00:00:30,850
+بالإيش .. بالأورام بشكل عام. الآن بدنا نكمل شوية الـ
+
+9
+00:00:30,850 --> 00:00:34,190
+hair and scalp واحنا قلنا اختصار الـ scalp و
+
+10
+00:00:34,190 --> 00:00:37,570
+ذكرنا دورها، اللي هو الخمس كلمات ممكن احنا نقول
+
+11
+00:00:37,570 --> 00:00:40,210
+skin مثلا، وبعدين connective tissue، وبعدين
+
+12
+00:00:40,210 --> 00:00:42,470
+aponeurotica، و طبقة connective tissue، وبعدين
+
+13
+00:00:42,470 --> 00:00:46,490
+pericrania. ما هي، بنذكركم هنا، بدنا نعمل أساس four
+
+14
+00:00:46,490 --> 00:00:50,350
+lesions. أول حاجة بتطلع في فروة الرأس، بشوف فيها الـ
+
+15
+00:00:50,350 --> 00:00:54,660
+lice. الحمد لله، يعني إيش؟ يبقى مش موجود بالمرة؟ طبعا
+
+16
+00:00:54,660 --> 00:00:57,040
+الله يسلم، يعني القمل، وإذا في صابة أو
+
+17
+00:00:57,040 --> 00:01:02,060
+حاجة زي هيك، الحمد لله مش موجودة، يعني انقرضت، إذا قدر الله موجودة، بندرس نلبس يعني هانحن gloves لأنه
+
+18
+00:01:02,060 --> 00:01:04,640
+مش .. مش .. مش .. ما بديش أنا أقعد نفسي. هذه كانت
+
+19
+00:01:04,640 --> 00:01:08,240
+زمان كانت موجودة لما بعض الناس يكونوا يعني صعب
+
+20
+00:01:08,240 --> 00:01:11,760
+عندهم في موضوع الاستحمام، وموضوع إيش؟ يعني النظافة
+
+21
+00:01:11,760 --> 00:01:14,600
+بشكل عام، مع جلة الماء، ويعني الناس، ويعني فقر
+
+22
+00:01:14,600 --> 00:01:18,760
+الحال. اليوم الحمد لله الأمور كويسة. types of hair
+
+23
+00:01:21,840 --> 00:01:25,640
+covering the body. أنواع الشعر اللي بيغطي الجسم. هل
+
+24
+00:01:25,640 --> 00:01:28,980
+كده أنا خلصت فروة الرأس. بتطلع، خلصت الجلد. أنا شوي
+
+25
+00:01:28,980 --> 00:01:33,060
+شوي بدي امسك الجلد، بتطلع في الشعر زي ما احنا قلنا
+
+26
+00:01:33,060 --> 00:01:37,440
+إذا بتذكروا، قلنا: هل في اتنين لونهم زي بعض؟ قلت له
+
+27
+00:01:37,440 --> 00:01:42,280
+لأ، اللون بيختلف من شخص لشخص. لون الجلد، ولون الجلد
+
+28
+00:01:42,280 --> 00:01:47,180
+بيختلف برضه كمان من منطقة لمنطقة. كذلك ايه برضه؟ عـ
+
+29
+00:01:47,180 --> 00:01:50,040
+الـ hair بالطبع، نفس الكلام. مافي واحد شعره متطابق
+
+30
+00:01:50,040 --> 00:01:53,680
+بالنسبة المائة مئة بالمائة مع الثاني، ولا هلاقي الشعر
+
+31
+00:01:53,680 --> 00:01:57,100
+متطابق في جميع أنحاء جسمك بنفس اللون والهيئة أو
+
+32
+00:01:57,100 --> 00:02:02,100
+الشكل، وإنما لأ، بيختلف من حين لآخر. الواحد يعني الآن
+
+33
+00:02:02,100 --> 00:02:06,600
+لما نشرح بعض التفاصيل، هيعرف إيش اللي بنقصده. شعرنا
+
+34
+00:02:06,600 --> 00:02:12,500
+في جسمنا نوعين. ماهي تتذكر إن حد يجي في بالك مثلا
+
+35
+00:02:12,500 --> 00:02:16,400
+الشعر، تتذكر منطقة مثلا الذقن، أو منطقة الرأس، أو
+
+36
+00:02:16,400 --> 00:02:20,170
+منطقة مثلا الـ genital area. لأ، دول بدنا نحكي كلمات
+
+37
+00:02:20,170 --> 00:02:23,090
+مهمة. في نوعين من الشعر، نوع اسمه terminal، ونوع
+
+38
+00:02:23,090 --> 00:02:27,730
+اسمه vellus. نوع اسمه terminal، ونوع إيش؟ vellus. لما
+
+39
+00:02:27,730 --> 00:02:29,850
+نقول كلمة terminal، ماحد يجي يقول terminal يعني
+
+40
+00:02:29,850 --> 00:02:33,930
+طرفي. لأ، terminal here يعني الشعر الدائم، هيك
+
+41
+00:02:33,930 --> 00:02:38,210
+فاهموها. الشعر الرسمي. vellus here بنسميه احنا
+
+42
+00:02:38,210 --> 00:02:43,030
+بسموها بالعامية بعض العائلات وبعض الناس بسموه ريش
+
+43
+00:02:43,030 --> 00:02:45,690
+الحمام. مش ريش الحمام، يعني هو أنه السفر قاضي بحرام.
+
+44
+00:02:45,690 --> 00:02:50,550
+لأ، يعني مش عارف إذا حد عمره ربى زغلول أو حمام
+
+45
+00:02:50,550 --> 00:02:54,890
+بتلاقيه أول ما .. أول ما يعني الزغلول أو العصفور
+
+46
+00:02:54,890 --> 00:02:58,610
+يبدأ ينبط عليه الشعر، هذا بيسموه إيش؟ هذا بيسموه
+
+47
+00:02:58,610 --> 00:03:05,310
+vellus hair. هو موجود في جسمنا، بس مش كل شعرنا،
+
+48
+00:03:05,310 --> 00:03:08,690
+يكون موجود في أماكن يدوب احنا شايفينه، ويمكن
+
+49
+00:03:08,690 --> 00:03:14,600
+ما نشوفوش كمان. على أيدينا من برة ومن جوة، يعني خاصة
+
+50
+00:03:14,600 --> 00:03:16,660
+بتتكلم عن الـ R، مش منطقة الـ palm. الـ palm ما يطلعش
+
+51
+00:03:16,660 --> 00:03:21,680
+عليها. خلف اليد، خلف الرجل، هذا كله. طب خليني أشوف الآن
+
+52
+00:03:21,680 --> 00:03:24,500
+الـ terminal بيقول اللي هو عبارة عن long، طويل،
+
+53
+00:03:24,500 --> 00:03:30,360
+coarse، كثيف، thick، يعني كتير وكثيف، وبنقدر نشوفه
+
+54
+00:03:30,360 --> 00:03:34,800
+بسهولة، easily visible. أين موجود هذا الشعر؟ في الـ
+
+55
+00:03:34,800 --> 00:03:37,380
+scalp، فوق في الفروة، أكشلة، والـ pubic area، أكيد.
+
+56
+00:03:37,380 --> 00:03:41,100
+هذا اللون ممكن يكون كله لون واحد. طب نيجي نشوف اللي
+
+57
+00:03:41,100 --> 00:03:44,920
+بعده. الـ vellus بيسموها peach fuzz، إيش يعني
+
+58
+00:03:44,920 --> 00:03:50,380
+peach fuzz؟ beach معناته الخوخ، تسمعوا الـ .. الـ ..
+
+59
+00:03:50,380 --> 00:03:55,020
+الـ .. في حاجة بيسموها .. بيسموها الخوخ أبو فروة،
+
+60
+00:03:55,020 --> 00:03:57,980
+كلكوا عارفينه، الخوخ أبو فروة اللي بيطلع عليه حاجة
+
+61
+00:03:57,980 --> 00:04:01,880
+بيسموها الـ fuzz، الفروة دي اللي طلع عـ طريق زي الـ
+
+62
+00:04:01,880 --> 00:04:06,040
+.. زي القطنيات الصغيرة جدا، أو الشعر، الشعر البسيط
+
+63
+00:04:06,040 --> 00:04:09,940
+كده. لما بنغسل، بتلاقي جراح، هذا يعني التشبيه عشان
+
+64
+00:04:09,940 --> 00:04:15,620
+يقول small, soft, tiny. صغير وناعم وتاني، يعني سهل
+
+65
+00:04:15,620 --> 00:04:19,220
+اللي يروح يمين وشمال، covering whole of the body،
+
+66
+00:04:19,220 --> 00:04:23,540
+يعني بيغطي كل جسم الإنسان، يا سبحان الله! يعني شوف
+
+67
+00:04:23,540 --> 00:04:28,360
+احنا، بيحكينا كل جسمنا يتغطى بالشعر، ما عدا مكانين:
+
+68
+00:04:28,360 --> 00:04:32,520
+كف الرجل وكف الإيد، palms and soles، palms and
+
+69
+00:04:32,520 --> 00:04:37,130
+soles. يبقى معناته الشعر بتاع الرأس، بتاع الـ axilla،
+
+70
+00:04:37,130 --> 00:04:40,730
+وبتاع الـ pubis، هذا اسمه terminal. ما دون ذلك اسمه
+
+71
+00:04:40,730 --> 00:04:43,830
+vellus. لو حاجة أجت طالعة زي عندنا مكبر، أو على
+
+72
+00:04:43,830 --> 00:04:47,350
+الجوال، زي ما راكبين عدسة مكبر بتاعة جوجل أو غيره،
+
+73
+00:04:47,350 --> 00:04:51,150
+تطلعنا على جسمنا في منطقة، احنا ممكن نقول طبعا، أنا
+
+74
+00:04:51,150 --> 00:04:54,610
+بتأكد، يمكن الأستاذ مش صح كلامه، نتأكد، في مكان أنا
+
+75
+00:04:54,610 --> 00:04:59,150
+لا أتوقع أنه يكون فيه شعر، وحاولنا نتأكد، هنعرف أنه
+
+76
+00:04:59,150 --> 00:05:04,240
+فيه موجود شعر. طبعا، يعني هو الإنسان ما بيطلعش أنه
+
+77
+00:05:04,240 --> 00:05:07,640
+يرفعه إلا لما يكون يعني مسبب له أي حرج. هو ممكن
+
+78
+00:05:07,640 --> 00:05:12,220
+يرفعه، خاصة النساء. الآن، إيش بقول؟ أنا بعد إيش بقول؟
+
+79
+00:05:12,220 --> 00:05:15,900
+assessment done by a distribution. بتطلع، وأنا بقعد
+
+80
+00:05:15,900 --> 00:05:19,700
+بقيم، بشوف distribution، توزيع الشعر، كتير ولا مش
+
+81
+00:05:19,700 --> 00:05:23,960
+كتير، الـ thickness، كثافته، الـ texture، وأنا بتطلع
+
+82
+00:05:23,960 --> 00:05:28,450
+فيه، بمسكه. طيب، الـ fabrication، مش بس هيك، كل هذا، هل
+
+83
+00:05:28,450 --> 00:05:32,330
+بيستخدم أي drugs or not؟ أنا جاي، بتطلع على الشعر،
+
+84
+00:05:32,330 --> 00:05:34,810
+بعمل أساس من دي، ممكن واحد، وأنا بتطلع في الشعر،
+
+85
+00:05:34,810 --> 00:05:38,870
+وماسكه، لاجيت فيه مشكلة، بقول له: ليه الشعر كذا؟ ولجيت
+
+86
+00:05:38,870 --> 00:05:41,910
+يقول لي: لأ، أنا حاطط عليه lubricant، أو حاطط
+
+87
+00:05:41,910 --> 00:05:45,270
+عليه شيء. يبقى أنا بسأل المريض عشان أعرف، وأتأكد إن
+
+88
+00:05:45,270 --> 00:05:48,430
+هذا normal or abnormal، صحيح. طيب، بقول، بقول له:
+
+89
+00:05:48,430 --> 00:05:53,150
+إنّشأنا some events، بعض الأشياء بتأثر على
+
+90
+00:05:53,150 --> 00:05:57,330
+distribution of hair. إيش يعني؟ بقول: بعض الأحداث
+
+91
+00:05:58,020 --> 00:06:02,700
+بتأثر كتير على توزيع الشعر في جسم الإنسان. زي إيش
+
+92
+00:06:02,700 --> 00:06:06,060
+يا أستاذ؟ بقول: زي الـ hormone disorders. إيش الـ
+
+93
+00:06:06,060 --> 00:06:10,980
+hormone disorders؟ يعني أقول، صحيح، إنه في شعر في
+
+94
+00:06:10,980 --> 00:06:14,940
+جسم الإنسان، لكن في بعض الناس ممكن أن آجي أطلع على
+
+95
+00:06:14,940 --> 00:06:22,500
+female، ست كبيرة، عندها مشكلة هرمونية، فوجها في شعر،
+
+96
+00:06:22,500 --> 00:06:26,020
+في شعر في الأماكن اللي أنا مش متوقع تكون عندها شعر.
+
+97
+00:06:26,420 --> 00:06:30,600
+هذا بيسموه hirsutism. المصطلح إيش اسمه؟ hirsutism.
+
+98
+00:06:30,600 --> 00:06:33,860
+يعني .. يعني بيسموه، يعني المرأة الشعورية، يعني زاد
+
+99
+00:06:33,860 --> 00:06:37,460
+عندها الشعر، بس ما .. هذا يعني ما بنقول، يعني لو واحد
+
+100
+00:06:37,460 --> 00:06:40,500
+دايما يصيح من الله، الحمد لله الذي عافانا مما ابتلى
+
+101
+00:06:40,500 --> 00:06:44,800
+بيغيرنا وفضلنا على كثير من خلقه تفضيله. أقصد هنا ما
+
+102
+00:06:44,800 --> 00:06:47,760
+نستغرب، يعني أنا قصدي اللي شافني هذا الأمر يبقى عرف
+
+103
+00:06:47,760 --> 00:06:54,650
+أنه هذا diseased، يعني قضية، يعني مرضية، لكن normal إن
+
+104
+00:06:54,650 --> 00:06:58,490
+يكون الشعر متناسب. لو شفنا بعض الـ changes، ممكن يكون
+
+105
+00:06:58,490 --> 00:07:02,650
+علاقة بالهرمون. مش بس هيك. فرضنا نعمل assessment،
+
+106
+00:07:02,650 --> 00:07:06,170
+لو واحد لقينا يعني عنده loss of hair، يعني مافيش
+
+107
+00:07:06,170 --> 00:07:11,270
+عنده شعر، يجينا سألنا، قال لك: لأ، أنا للأسف هذا يعني
+
+108
+00:07:11,270 --> 00:07:16,510
+طلع مريض، يعني عنده مثلا cancer، some lesions، وبياخد
+
+109
+00:07:16,510 --> 00:07:20,290
+كيموثيرابي. بياخد إيه؟ شعر. عشان الكيمو، طيب، ومن الـ
+
+110
+00:07:20,290 --> 00:07:24,790
+side effect الكيموثيرابي بشكل أساسي اللي هو إيه؟ الـ
+
+111
+00:07:24,790 --> 00:07:28,190
+loss of hair. فما أقدرش أقول هذا عنه abnormal، بقول
+
+112
+00:07:28,190 --> 00:07:32,390
+normal side effect for something. و بس يوقف إن شاء
+
+113
+00:07:32,390 --> 00:07:39,330
+الله بيرجع لطبيعته. فهكذا. طيب، الـ normal color، الـ
+
+114
+00:07:39,330 --> 00:07:42,510
+normal color للـ terminal hair، الشعر اللي إيه؟
+
+115
+00:07:42,510 --> 00:07:46,760
+الدائم. يا بيكون black، يا بيكون reddish. مش هنلاقيه في بعض
+
+116
+00:07:46,760 --> 00:07:49,240
+يبقى زي بعض، اللي هو نود، الحمرة وغيره، يا بيكون yellowish،
+
+117
+00:07:49,240 --> 00:07:51,880
+سبحان الله، زي ناس الألبين وغيره. في ناس بتيجي
+
+118
+00:07:51,880 --> 00:07:54,980
+شعرهم دائما أشقر. ما نقولش بعد حاطط عليه يعني
+
+119
+00:07:54,980 --> 00:07:59,100
+صبغة أو حنة. لأ، أنا بتكلم على الـ normal، إيش؟
+
+120
+00:07:59,100 --> 00:08:04,940
+normal color، يعني كل ألوان البشر: يا أسود، يا
+
+121
+00:08:04,940 --> 00:08:09,340
+أحمر، يا إما أشقر، يا إما مشتقات هذه الألوان، يعني
+
+122
+00:08:09,340 --> 00:08:14,440
+مش هنلاقي لون أخضر مثلا، مش هنلاقي لون بنفسجي، مش
+
+123
+00:08:14,440 --> 00:08:17,100
+هنلاقي .. إيش بقول؟ عن variations والاختلافات، إلا
+
+124
+00:08:17,100 --> 00:08:21,560
+إذا طبعا حاطط على شعره شيء ثاني. هذا من عنده. الـ older
+
+125
+00:08:21,560 --> 00:08:28,180
+men، رجال، لما بيكبروا في السن، بيوصلوا لستين وأكثر من
+
+126
+00:08:28,180 --> 00:08:32,860
+هيك، إيش بيصير عنده؟ الـ facial hair بيفقده، لكن الـ
+
+127
+00:08:32,860 --> 00:08:37,040
+older women، قلنا لكم الستات لما بيكبرن، سبحان الله،
+
+128
+00:08:37,040 --> 00:08:42,060
+بيبدأ يطلع عندهم شعر خاص في منطقة الـ chin، اللي هي الذقن،
+
+129
+00:08:42,060 --> 00:08:45,540
+يعني في الـ upper lip كمان، يعني خليني أقول زي في
+
+130
+00:08:45,540 --> 00:08:49,640
+منطقة الشنب. اللي بنسميه إيه؟ hirsutism. خلاص. سبحان
+
+131
+00:08:49,640 --> 00:08:52,720
+الله. ما حد يجي يضحك ويقول: لأ، هذا تغييرات في
+
+132
+00:08:52,720 --> 00:08:56,140
+السن، وتغييرات لا يعلم كنهها إلا الله سبحانه
+
+133
+00:08:56,140 --> 00:08:59,440
+وتعالى. الـ hirsutism، أنا بقول often caused by إيه؟
+
+134
+00:08:59,440 --> 00:09:03,080
+الـ genes، في بعض الناس، اللي علاقة بالجينات، بالوراثة،
+
+135
+00:09:03,080 --> 00:09:07,310
+والهرمونات، والـ medication، وبيحكي عن المصطلح نفسه، يعني
+
+136
+00:09:07,310 --> 00:09:10,930
+ممكن الإنسان يكون هذا مرتبط إما بالجينات، أو
+
+137
+00:09:10,930 --> 00:09:16,050
+بالهرمونات، أو باستخدام علاجات معينة. طيب، الـ amounts،
+
+138
+00:09:16,050 --> 00:09:20,370
+.. الـ amount of إيش؟ .. of hair covering
+
+139
+00:09:20,370 --> 00:09:23,610
+extremities. طيب، هل الـ amount .. هل حجم الشعر اللي
+
+140
+00:09:23,610 --> 00:09:27,390
+بيغطي الأطراف، خاصة الرجلين، بيضلوا طول العمر زي ما
+
+141
+00:09:27,390 --> 00:09:33,130
+هو؟ أبدا، لا. يمكن كيف يعني؟ يعني لو واحد عنده .. لو
+
+142
+00:09:33,130 --> 00:09:36,460
+واحد عنده مثلا في شعر في رجليه، وهذا طبيعي، أنا
+
+143
+00:09:36,460 --> 00:09:39,740
+بتكلم في رجليه، يعني في مناطق مثلا الـ thigh لتحت،
+
+144
+00:09:39,740 --> 00:09:43,620
+شوية below مثلا الركبة، وهكذا. الشعر هذا لما بيكبر
+
+145
+00:09:43,620 --> 00:09:47,740
+الإنسان، سبحان الله، كل ما بيكبر أكتر، بقل الدم اللي
+
+146
+00:09:47,740 --> 00:09:50,800
+واصل للرجلين تحت. فهيش بيقول لي: لحظوا، إيش بيقول لي؟
+
+147
+00:09:50,800 --> 00:09:55,800
+reduced as a result of aging. بقل الشعر اللي مغطي
+
+148
+00:09:55,800 --> 00:10:01,080
+اللي هو الأطراف اللي تحت، السفليين، السفليين. علشان
+
+149
+00:10:01,080 --> 00:10:06,160
+إيش؟ الأطراف السفليين. بيبدأ الدم الواصل لبصيلات
+
+150
+00:10:06,160 --> 00:10:10,460
+الشعر يقل. لما بيبدأ الدم الواصل لبصيلات الشعر يقل مع
+
+151
+00:10:10,460 --> 00:10:13,440
+الـ aging، إيش بيصير هنا، خاصة في الـ lower limbs؟
+
+152
+00:10:13,440 --> 00:10:17,590
+بتلاقي البني آدم بيصير إيش؟ بيقل، بتلاقي مباشرة
+
+153
+00:10:17,590 --> 00:10:21,650
+بتلاقي بطل الشعر يكون كثيف زي زمان، لأنه بيعتمد على تغذية
+
+154
+00:10:21,650 --> 00:10:25,170
+على الدم، والدم مع كبر السن بيقل. وفي بعض الناس دلوقت
+
+155
+00:10:25,170 --> 00:10:29,510
+مع الـ opposite كمان، مع النحافة الكثيرة برضه بتصير
+
+156
+00:10:29,510 --> 00:10:33,830
+عندهم loss of hair. طيب، الآن بقول لي هنا في حاجة
+
+157
+00:10:33,830 --> 00:10:36,810
+اسمها الـ scaliness or dryness، يعني القشور أو
+
+158
+00:10:36,810 --> 00:10:39,590
+الجفاف اللي بيصير في الـ scalp. في بعض الناس عندهم
+
+159
+00:10:39,590 --> 00:10:44,160
+يعني زي جشرة الرأس، جشرة الشعر، أو الجفاف الدائم اللي
+
+160
+00:10:44,160 --> 00:10:47,840
+موجود في الـ scalp. ليش بيصير؟ بقول هنا معظمها بيصير
+
+161
+00:10:47,840 --> 00:10:51,020
+مع الدندرف. الدندرف يعني المرض اللي هو القشرة ده،
+
+162
+00:10:51,020 --> 00:10:53,720
+اللي إيه؟ بيصير. وكده بيقول لك: والله عندي قشرة، قشرة في
+
+163
+00:10:53,720 --> 00:10:57,460
+شعري، فدائما بيصير عندي جفاف، وبروح بدور يعني حتى
+
+164
+00:10:57,460 --> 00:11:01,120
+الشنبو اللي بشتريه، بشتري حاجة بسموها، أنا بنصح أن
+
+165
+00:11:01,120 --> 00:11:03,340
+يكون مكتوب عليه مش protein، لأ، يكون مكتوب عليه
+
+166
+00:11:03,340 --> 00:11:08,760
+antidandruff. antidandruff، يعني ضد القشرة بالظبط.
+
+167
+00:11:08,760 --> 00:11:13,45
+
+223
+00:14:51,520 --> 00:14:54,860
+يعني محدّ يعني أُطلع في.. لحالك أُطلع في أضافيره
+
+224
+00:14:54,860 --> 00:14:58,380
+بيلاقي الطبيعي يكون إيش؟ يعني محدّب شوية مش مسطح
+
+225
+00:14:58,380 --> 00:15:01,760
+Surrounding cuticles اللي حوالينها،  cuticles اللي
+
+226
+00:15:01,760 --> 00:15:04,720
+حوالين الأظافر بتكون دايماً برضه smooth و intact دي
+
+227
+00:15:04,720 --> 00:15:08,340
+يعني مش لازم.. مش لازم تلاقي قشور حوالين الأظافر
+
+228
+00:15:08,340 --> 00:15:12,620
+ولا تشققات ولا inflammation أي التهابات الـ nail
+
+229
+00:15:12,620 --> 00:15:16,360
+bed لازم يكون إيش؟ firm on palpation يعني لو احنا
+
+230
+00:15:16,360 --> 00:15:19,420
+ضغطنا على الـ nail bed ما.. الصح أنه ما يتألمش
+
+231
+00:15:19,420 --> 00:15:23,990
+طبيعي ما فيه مشكلة. طيب هو كيف بينمو الأظافر؟ في بعض
+
+232
+00:15:23,990 --> 00:15:27,610
+الحالات زي واحد جرح أظفاره بالغلط، جرح شيء  لورّا شوية
+
+233
+00:15:27,610 --> 00:15:31,290
+أو لا سمح الله أكل هواية شوية، والضرر ده جاه
+
+234
+00:15:31,290 --> 00:15:34,510
+جرحه شوية من الأظافر بيكون زي أنا خايف إيش صار
+
+235
+00:15:34,510 --> 00:15:39,310
+معاه؟ احنا بنقول للجميع سبحان الله، بقول إنه دايماً
+
+236
+00:15:39,310 --> 00:15:42,750
+الـ nails يـ grow in constant rate إيش يعني constant
+
+237
+00:15:42,750 --> 00:15:49,190
+rate؟ يعني بينمو بمعدلات ثابتة، مزايا ربانية
+
+238
+00:15:49,710 --> 00:15:53,110
+في بعض الناس بقول لك أنا كل عشرين يوم بجرحه، وأسقط في
+
+239
+00:15:53,110 --> 00:15:56,210
+برجين على نفس الحجم، فبقول سبحان الله، واحنا بنقوله
+
+240
+00:15:56,210 --> 00:15:59,530
+سبحان الله، الأظافر تكبر بنفس الحجم، بنفس الشيء، لو
+
+241
+00:15:59,530 --> 00:16:03,470
+صار في قص أو كده، ما يخافش الإنسان، يكبر يكبر يكبر
+
+242
+00:16:03,470 --> 00:16:08,210
+يكبر لما يصل يعاود لطبيعته، ويكتمل نمو الأظافر في
+
+243
+00:16:08,210 --> 00:16:11,210
+بعض الحالات عندهم يصير عندهم هم باريش، خاصة وين أكل
+
+244
+00:16:11,210 --> 00:16:15,270
+هواية شوية على أظفاره، في بعض الحالات يصير عندهم
+
+245
+00:16:15,270 --> 00:16:18,860
+transverse bands، إيش transverse band اللي بيسموه
+
+246
+00:16:18,860 --> 00:16:22,860
+الخطوط العرضية اللي موجودة في الأظافر؟ لإنه أُطلع
+
+247
+00:16:22,860 --> 00:16:26,420
+في الأظافر بتصير بالنلاج عليه زي خطوط بيضاء زي
+
+248
+00:16:26,420 --> 00:16:29,660
+خطوط زي الحليب، أو زي مثلاً بعض الناس بتقول لك هذا من
+
+249
+00:16:29,660 --> 00:16:32,780
+الـ calcium، والـ calcium طبعاً هو بعض الناس جانوا
+
+250
+00:16:32,780 --> 00:16:35,470
+بعض الأطباء جانوا إيه؟ علاقة بالـ calcium؟ عموماً احنا
+
+251
+00:16:35,470 --> 00:16:39,850
+لو وجدناها مش غلط نعمل فحوصات علشان نتأكد، وخاصة لو
+
+252
+00:16:39,850 --> 00:16:42,630
+بتكون زيادة كتير، لكن إذا لاقينا واحدة أو اتنتين مش
+
+253
+00:16:42,630 --> 00:16:45,990
+كتير، نقاط بيضاء، لكن إذا كانت خطوط كتير، كل أظافر
+
+254
+00:16:45,990 --> 00:16:49,810
+البني آدم يعني فيه مشكلة، وفيه abnormal يعني
+
+255
+00:16:49,810 --> 00:16:53,490
+things، وبندرسها، كيف الـ thickness يعني كيف سماكة
+
+256
+00:16:53,490 --> 00:16:56,890
+الأظافر، كثيف، مش كثيف، يبقى عنده سماكة فيه ولا لأ؟
+
+257
+00:16:56,890 --> 00:17:04,000
+طيب، بقول لك أنا notable الـ vitamins زي الـ vitamins والـ
+
+258
+00:17:04,000 --> 00:17:06,100
+الـ protein والـ electrolyte يعني الشغلات المغذية
+
+259
+00:17:06,100 --> 00:17:09,060
+زي الفيتامينات والـ.. وخليني أقول والـ proteins
+
+260
+00:17:09,060 --> 00:17:13,480
+بشكل عام، والـ electrolytes الأملاح اللي مذابة، خاصة
+
+261
+00:17:13,480 --> 00:17:19,140
+الشغلات المغذية ممكن تأثر على إيش؟ على الـ lines والـ
+
+262
+00:17:19,140 --> 00:17:22,780
+إيه؟ والـ band، إيش يعني الـ band؟ forming of the
+
+263
+00:17:22,780 --> 00:17:25,860
+nail pits، يعني في بعض الناس واحنا بنعمل
+
+264
+00:17:25,860 --> 00:17:28,820
+assessment لمنطقة الـ nail pit، ولاقينا عنده
+
+265
+00:17:28,820 --> 00:17:33,280
+الألوان هذه موجودة، جينا جبنا دي على مستشفى، خاصة
+
+266
+00:17:33,280 --> 00:17:37,280
+أنه لاقينا اللي هو المسطح تبع الأظافر، هذا المسطح
+
+267
+00:17:37,280 --> 00:17:41,280
+صار في عنده ألوان غريبة في أظفاره، مش غلط نسأل
+
+268
+00:17:41,280 --> 00:17:43,940
+السؤال أنت بتأخذ فيتامينات؟ بقول لك آه والله أنا بأخذ
+
+269
+00:17:43,940 --> 00:17:48,300
+مكملات من نوع كذا، أنا بأخذ protein مكمل غذائي اسمه
+
+270
+00:17:48,300 --> 00:17:51,280
+كذا، أو أنا فيها مثلاً electrolyte، واحدة من التلاتة
+
+271
+00:17:51,280 --> 00:17:56,560
+هذا بنوجهه للطبيب المتخصص في هذا المجال، ما نقدرش
+
+272
+00:17:56,560 --> 00:17:59,580
+نقول هذا normal change، بنقول هذا side effect for
+
+273
+00:17:59,580 --> 00:18:03,390
+something، يعني صارت عنده الأشياء هذه استجابة لإيش؟
+
+274
+00:18:03,390 --> 00:18:06,650
+..استجابة.. آه side effect لفيتامينات معينة و
+
+275
+00:18:06,650 --> 00:18:09,910
+بياخذها دي بس، يعني ملاحظة لبعض الحالات النادرة
+
+276
+00:18:09,910 --> 00:18:12,410
+اللي ممكن تشوفها، ممكن ما تشوفهاش في حياتك العملية
+
+277
+00:18:12,410 --> 00:18:18,530
+أبداً، color of nails لون الأظافر يدل على درجة إيه؟
+
+278
+00:18:18,530 --> 00:18:21,330
+على درجة الـ oxygenation، يعني إيش درجة الـ
+
+279
+00:18:21,330 --> 00:18:25,190
+oxygenation؟ لو طلعنا اللي هو عملية قد إيش اللي هو
+
+280
+00:18:25,190 --> 00:18:29,710
+عملية الأكسدة، أو قد إيش فيه أكسجين واصل لأطراف
+
+281
+00:18:29,710 --> 00:18:34,990
+الإنسان تحت الجلد مباشرة، فهو إيش؟ بقول لي أنا بقول لي
+
+282
+00:18:34,990 --> 00:18:39,370
+سبحان الله، الـ blush color، إيش يعني اللون اللي ميل
+
+283
+00:18:39,370 --> 00:18:43,790
+للأزرق شوية، الظفر اللي لونه ميل للأزرق، إيش بنسميه؟
+
+284
+00:18:43,790 --> 00:18:49,430
+cyanosis، طب اللي لونه ميل للأبيض، إيش بنسميه؟ هه هم
+
+285
+00:18:49,430 --> 00:18:52,370
+بسموه شاحب، بنسميه إيش؟ يعني إيه؟ فيه عنده
+
+286
+00:18:52,370 --> 00:18:58,390
+أنيميا، طيب palpation of the nail حس الأظافر عشان
+
+287
+00:18:58,390 --> 00:19:02,830
+تشوف الـ adequacy of إيش؟ circulation، أو بيسموها إيش؟
+
+288
+00:19:02,830 --> 00:19:06,290
+هنا capillary refill، أعتقد أخذتوها في الـ
+
+289
+00:19:06,290 --> 00:19:09,910
+fundamental، اسمها capillary refill examination
+
+290
+00:19:09,910 --> 00:19:12,430
+يعني اللي قبلكم أنا سألتهم، قالوا اللي أخذناها في
+
+291
+00:19:12,430 --> 00:19:15,370
+الـ fundamental، عموماً لو حد سأل نفسه إيش يعني
+
+292
+00:19:15,370 --> 00:19:19,950
+capillary refill، أعطيكم مثال، احنا هي الأظافر عند
+
+293
+00:19:19,950 --> 00:19:21,950
+الإبهام، وهي الأظافر عند الإبهام
+
+294
+00:19:24,840 --> 00:19:30,820
+أضغط على أعلى الأظافر الأيمن
+
+295
+00:19:30,820 --> 00:19:35,440
+..أضغط على أعلى الأظافر الأيمن.. أضغط على أعلى
+
+296
+00:19:35,440 --> 00:19:39,900
+الأظافر الأيمن.. أضغط على أعلى الأظافر الأيمن..
+
+297
+00:19:39,900 --> 00:19:43,690
+أضغط على أعلى الأظافر الأيمن.. المفروض يرجع، إذا
+
+298
+00:19:43,690 --> 00:19:48,650
+رجع اللون كويس، برجع أقول إيش؟ يعني بقول good
+
+299
+00:19:48,650 --> 00:19:51,770
+capillary refill، إيش يعني capillary؟ ما أنتم
+
+300
+00:19:51,770 --> 00:19:55,890
+عارفين نهايات الـ vein ونهايات الـ artery اسمها
+
+301
+00:19:55,890 --> 00:19:59,210
+capillaries، اللي هي الشعيرات الدموية، يبقى لو
+
+302
+00:19:59,210 --> 00:20:03,090
+ضغطت على الأظافر، رفعت إيدي ورجع الدم مباشرة، بقول
+
+303
+00:20:03,090 --> 00:20:07,210
+good capillary refill، طب لو أنا ضغطت ورفعت و
+
+304
+00:20:07,210 --> 00:20:12,010
+ما رجعش الدم مباشرة، بقول إيش؟ abnormal refill، أو مثلاً
+
+305
+00:20:12,010 --> 00:20:15,330
+difficult refill، أو بيقولوا slow refill، يعني أي
+
+306
+00:20:15,330 --> 00:20:19,490
+مصطلح بيجي في بالنا بنحكيه عشان نعرف يمكن العلاقة
+
+307
+00:20:19,490 --> 00:20:23,150
+..العلاقة يا بالدم قلّت زي الأنيميا، يا بالأكسجين
+
+308
+00:20:23,150 --> 00:20:26,770
+قلّت، loss of oxygenation، في حاجة بنسموها الـ
+
+309
+00:20:26,770 --> 00:20:30,270
+calluses، إيش الـ calluses؟ بنسمع بعض الناس اللي كان
+
+310
+00:20:30,270 --> 00:20:33,950
+بيقول لك هذا صار عنده إيش؟ من كثر الـ calcium
+
+311
+00:20:33,950 --> 00:20:37,800
+deposition، يعني الترسبات الكالسيوم عملت حاجة
+
+312
+00:20:37,800 --> 00:20:41,960
+بنسموها callus، بنسموها.. يعني أنا المصطلح مرات مش كل
+
+313
+00:20:41,960 --> 00:20:46,600
+الناس متفقين عليه، زي الشيء الأبيض اللي بيكون على
+
+314
+00:20:46,600 --> 00:20:49,700
+الأظافر، أو مرات زيادة.. يعني احنا بنقول عنه تكلس
+
+315
+00:20:49,700 --> 00:20:53,460
+بمعنى عشان نسميها callus زي التكلس تاع الأظافر
+
+316
+00:20:53,460 --> 00:20:58,380
+من شدة التجمع، يعني زي الكالسيوم الأبيض عليه، هذا
+
+317
+00:20:58,380 --> 00:21:01,650
+بيكون موجود وين؟ ممكن يكون موجود ده common الموجود
+
+318
+00:21:01,650 --> 00:21:05,130
+هنا في الـ toes، يعني في أصابع الأقدام، والأظافر، ومرات
+
+319
+00:21:05,130 --> 00:21:08,190
+بيكون في أصابع إيش؟ الإيد، بس ما أحدش يقول يا أستاذ
+
+320
+00:21:08,190 --> 00:21:13,290
+أنه هذا normal finding، no، إذا كان موجود وبكثرة
+
+321
+00:21:13,290 --> 00:21:16,810
+الصح يعمل الإنسان في حسابه، خاصة مش غلط يشوف الـ
+
+322
+00:21:16,810 --> 00:21:20,510
+vitamin D، ويشوف الـ calcium level علشان نعرف إنه
+
+323
+00:21:20,510 --> 00:21:26,150
+هل فيه hypokalemia or not، some abnormalities of the
+
+324
+00:21:26,150 --> 00:21:30,160
+A of the nails، الآن إيش الـ abnormalities of the
+
+325
+00:21:30,160 --> 00:21:36,040
+nail؟ الآن بعض الحالات بطلع، نحكي المصطلحات، هم
+
+326
+00:21:36,040 --> 00:21:39,280
+يكملوا المصطلح، وللأسف كتير من.. أو الله يمكن
+
+327
+00:21:39,280 --> 00:21:41,700
+الطب، وحتى كتير منهم ما بيعرفوا هذه المصطلحات، و
+
+328
+00:21:41,700 --> 00:21:44,300
+ما بيقدروا يفرّقوا بينهم، إيه؟ كويس احنا نكون عارفينهم
+
+329
+00:21:44,300 --> 00:21:46,760
+وفاهمينهم، ما أحد يجي يقول لي يا أستاذ والله صعب هذا
+
+330
+00:21:46,760 --> 00:21:49,840
+أنا مش موضوع صعب، هذا ممكن احنا نوليه شغلات بسيطة
+
+331
+00:21:49,840 --> 00:21:53,380
+بنجيبها في أسئلة موضوعية، مش حاجة أقول لك أذكرهم و
+
+332
+00:21:53,380 --> 00:21:56,060
+أعددهم وأحفظهم كلهم، لأ، بس في الأسئلة الموضوعية
+
+333
+00:21:56,060 --> 00:21:59,300
+match، مثلاً true or false، حاجة، أكملوا، عضة إيه؟ تلاتة
+
+334
+00:21:59,300 --> 00:22:04,220
+أربعة، خمسة، ستة، سبعة، ثمانية، إيش يعني؟ أول واحد اسمه
+
+335
+00:22:04,220 --> 00:22:06,520
+Paronychia، أو بارونيشيا، في بعض الناس بالفضول
+
+336
+00:22:06,520 --> 00:22:10,260
+بارونيشيا، شو الـ Paronychia؟ يعني inflammation
+
+337
+00:22:10,260 --> 00:22:13,280
+surrounding of the nail، لو طلعنا في الأظافر و
+
+338
+00:22:13,280 --> 00:22:15,900
+لاقيناه حوالين الأظافر، حوالين الأظافر surrounding
+
+339
+00:22:15,900 --> 00:22:19,860
+أي infection حوالين الأظافر، أو أي inflammation، إيش
+
+340
+00:22:19,860 --> 00:22:24,820
+بنسميها؟ Paronychia، طيب في بعض الناس نادرين لكن
+
+341
+00:22:24,820 --> 00:22:29,460
+موجودين، كل مستوى بيجي.. يمكن من زمان وأنا بشرح في
+
+342
+00:22:29,460 --> 00:22:32,840
+هذا المساق، بلاقي في كل مستوى يا بيطلع واحد أو اثنين
+
+343
+00:22:32,840 --> 00:22:35,740
+ومرة تلاتة، بيكون عندهم complete absence يعني
+
+344
+00:22:35,740 --> 00:22:39,640
+مولود ما عنده أظافر، complete absence of nail، ما أحد
+
+345
+00:22:39,640 --> 00:22:43,230
+يسألني، الله سبحانه وتعالى هذا خلقي، لأ، هو بتلاقي
+
+346
+00:22:43,230 --> 00:22:47,530
+منطقة الأظافر صار إيش؟ صار الجلد شوية جامد، وصار
+
+347
+00:22:47,530 --> 00:22:51,350
+يعني زي نوع من التكلس صار فيه، عشان يقدر الإنسان
+
+348
+00:22:51,350 --> 00:22:56,730
+إيش؟ يعني صار يعني اتكلس شوية، عشان يقدر يتأقلم
+
+349
+00:22:56,730 --> 00:23:01,490
+بعوامل التغيير فيه، والتعامل مع الـ weather يعني
+
+350
+00:23:01,490 --> 00:23:04,750
+البيئة بشكل عام، ليش؟ لأن ما فيش
+
+351
+00:23:04,750 --> 00:23:07,650
+أظافر تحمي، فالله سبحانه وتعالى بيخلي الجلد هنا
+
+352
+00:23:07,650 --> 00:23:13,360
+يكون مكان في هذا المكان شوية، طيب في حاجة اسمها هنا
+
+353
+00:23:13,360 --> 00:23:18,320
+Platonychia.. Platonychia، وقلنا لكم في بعض الناس
+
+354
+00:23:18,320 --> 00:23:22,500
+يعني، برافوها،  كي Platonychia مهم، يعني Platonychia
+
+355
+00:23:22,500 --> 00:23:26,400
+flattening of the nail اسمه الظفر المسطح، لو
+
+356
+00:23:26,400 --> 00:23:29,980
+اطلعنا في الظفر كله هيك مسطح، وقَدَّامنا يعني كام؟
+
+357
+00:23:29,980 --> 00:23:33,780
+مسطح، مش معمول convex زي ما احنا قلنا، لأ، ولا قلنا
+
+358
+00:23:33,780 --> 00:23:37,200
+مقعر، يعني اللي هو محدّب، ولا مقعر وأنا ماشي زي إيش؟
+
+359
+00:23:37,200 --> 00:23:40,600
+زي كأنه.. زي اللوح، الأظافر زي كده مباشرة، هذا اسمه
+
+360
+00:23:40,600 --> 00:23:45,920
+Platonychia، طيب الآن.. الآن في حاجة اسمها اللي
+
+361
+00:23:45,920 --> 00:23:49,620
+بعدها، كليلونيشيا، إيش أنا كليلونيشيا؟ اللي هو
+
+362
+00:23:49,620 --> 00:23:53,580
+كليلونيشيا.. كليلونيشيا، بيكون الـ nails زي الـ spoon
+
+363
+00:23:53,580 --> 00:23:57,100
+-like، إيش يعني زي الـ spoon-like؟ spoon-like يعني
+
+364
+00:23:57,100 --> 00:24:00,340
+بشبه.. بشبه الملعقة، زي الملعقة، الشاشة الصغيرة
+
+365
+00:24:00,340 --> 00:24:05,740
+بتلاقي زي عامل زي مقعر هيك، وخاصة في بعض الحالات
+
+366
+00:24:05,740 --> 00:24:10,580
+النادرة، اللي علاقة بصراحة بأمراض القلب، بأمراض
+
+367
+00:24:10,580 --> 00:24:14,240
+القلب، أو بأمراض الرئتين، بأمراض القلب، أو بأمراض
+
+368
+00:24:14,240 --> 00:24:18,760
+الرئتين، هذا اللي أنا بقوله عنه الكليلونيشيا، هذا
+
+369
+00:24:18,760 --> 00:24:21,840
+بيصير إيش؟ بتطلع في أظفاره، بنلاقي الظفر..
+
+370
+00:24:21,840 --> 00:24:25,460
+الظفر عامل زي الإيش؟ زي الملعقة الصغيرة تبعت إيش؟
+
+371
+00:24:25,460 --> 00:24:29,640
+المطبخ اللي قدامنا، طيب في اسمه كليلونيشيا
+
+372
+00:24:29,640 --> 00:24:33,580
+الكليلونيشيا قلناها، sorry، في اسمه racket nail
+
+373
+00:24:33,580 --> 00:24:38,460
+racket nail، racket، racket، أكيد كلكم عارفينه، لما
+
+374
+00:24:38,460 --> 00:24:40,940
+أقول racket، الـ racket، الـ racket اللي بنستخدمه..
+
+375
+00:24:40,940 --> 00:24:44,040
+اللي بنلعب فيه، بنلعب فيه الـ tennis، بنلعب فيه مثلاً
+
+376
+00:24:44,040 --> 00:24:48,340
+الـ table tennis، أنتم متخيلين كيف الـ racket معايا؟ إله إيد
+
+377
+00:24:48,340 --> 00:24:52,860
+مصبوبة، مقبض، ومن قدام كيف شكله؟ آه، إله من ورا مقبض
+
+378
+00:24:52,860 --> 00:24:57,660
+ومن قدام زي مدور هيك، يعني إيه؟ وعليه ممكن يكون
+
+379
+00:24:57,660 --> 00:25:00,640
+جلدة أو لا، المهم يكون من ورا.. من ورا إيه؟ زي
+
+380
+00:25:00,640 --> 00:25:04,900
+العصاية، ومن قدام إيه؟ دائرة، إذا شفنا الأظافر بهذا
+
+381
+00:25:04,900 --> 00:25:09,760
+الشكل، اسمه racket nail، والأظافر يشبه الـ racket
+
+382
+00:25:09,760 --> 00:25:14,430
+اللي هو flat، مسطح، وexpand، ممتد، إذا لا قدر الله
+
+383
+00:25:14,430 --> 00:25:18,510
+لكنها خاصة عند الـ male، بيكون عندهم إيش هنا؟
+
+384
+00:25:18,510 --> 00:25:23,430
+secondary syphilis، مرض اسمه إيش هنا؟ اللي هو سموه
+
+385
+00:25:23,430 --> 00:25:30,490
+الزهري، يعني مرض من الأمراض الجنسية، يعني حتى بيسموه
+
+386
+00:25:30,490 --> 00:25:33,950
+بالعربي مرض الـ syphilis، يعني بغض النظر احنا بس لا
+
+387
+00:25:33,950 --> 00:25:37,210
+قدر الله وشَفناه، مش شرط نحكم ونقول إنه عنده كذا، بس
+
+388
+00:25:37,210 --> 00:25:41,520
+على الأقل نبلغ، نقول إنه هذا ليش؟ أدفعوا زي هيك، طيب في
+
+389
+00:25:41,520 -->
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..affdaf28b3dbe7141534bb99aa65b2606f0d0ae2
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.json
@@ -0,0 +1 @@
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"probability": 0.94677734375}, {"start": 1657.45, "end": 1657.67, "word": " ايش", "probability": 0.8585611979166666}, {"start": 1657.67, "end": 1657.87, "word": " بقول", "probability": 0.880615234375}, {"start": 1657.87, "end": 1658.17, "word": " عنه", "probability": 0.985107421875}, {"start": 1658.17, "end": 1659.21, "word": " melanomacia", "probability": 0.2274169921875}, {"start": 1659.21, "end": 1659.53, "word": " ايش", "probability": 0.8997395833333334}, {"start": 1659.53, "end": 1659.61, "word": " يعني", "probability": 0.79052734375}, {"start": 1659.61, "end": 1660.11, "word": " melanomacia", "probability": 0.8518880208333334}, {"start": 1660.11, "end": 1660.67, "word": " يعني", "probability": 0.718994140625}, {"start": 1660.67, "end": 1661.23, "word": " زيادة", "probability": 0.9891357421875}, {"start": 1661.23, "end": 1661.83, "word": " صبغة", "probability": 0.8641357421875}, {"start": 1661.83, "end": 1663.03, "word": " التلون", "probability": 0.9072265625}, {"start": 1663.03, "end": 1663.27, "word": " في", "probability": 0.96826171875}, {"start": 1663.27, "end": 1663.77, "word": " الأطفال", "probability": 0.8299560546875}, {"start": 1663.77, "end": 1664.51, "word": " طبعا", "probability": 0.9727783203125}, {"start": 1664.51, "end": 1665.71, "word": " قدش", "probability": 0.6793619791666666}, {"start": 1665.71, "end": 1666.33, "word": " الوقت", "probability": 0.96826171875}, {"start": 1666.33, "end": 1666.69, "word": " الان", "probability": 0.614013671875}, {"start": 1666.69, "end": 1667.63, "word": " مش", "probability": 0.74462890625}, {"start": 1667.63, "end": 1667.99, "word": " خلاني", "probability": 0.6859130859375}, {"start": 1667.99, "end": 1668.33, "word": " اكتف", "probability": 0.89111328125}, {"start": 1668.33, "end": 1668.63, "word": " الان", "probability": 0.634033203125}, {"start": 1668.63, "end": 1669.07, "word": " لعند", "probability": 0.73046875}, {"start": 1669.07, "end": 1669.41, "word": " هذه", "probability": 0.8603515625}, {"start": 1669.41, "end": 1670.47, "word": " الشريحة", "probability": 0.946044921875}, {"start": 1670.47, "end": 1670.67, "word": " عشان", "probability": 0.9755859375}, {"start": 1670.67, "end": 1670.77, "word": " ان", "probability": 0.8525390625}, {"start": 1670.77, "end": 1670.91, "word": " شاء", "probability": 0.889404296875}, {"start": 1670.91, "end": 1670.99, "word": " الله", "probability": 0.95556640625}, {"start": 1670.99, "end": 1671.77, "word": " نبدأ", "probability": 0.9671223958333334}, {"start": 1671.77, "end": 1672.01, "word": " شرف", "probability": 0.43743896484375}, {"start": 1672.01, "end": 1672.33, "word": " المحاضرة", "probability": 0.9803466796875}, {"start": 1672.33, "end": 1672.83, "word": " القادمة", "probability": 0.99072265625}, {"start": 1672.83, "end": 1673.27, "word": " في", "probability": 0.92919921875}, {"start": 1673.27, "end": 1673.35, "word": " ال", "probability": 0.5810546875}, {"start": 1673.35, "end": 1673.63, "word": " chapter", "probability": 0.95849609375}, {"start": 1673.63, "end": 1674.27, "word": " الجديد", "probability": 0.91259765625}, {"start": 1674.27, "end": 1674.69, "word": " واتمنى", "probability": 0.7999267578125}, {"start": 1674.69, "end": 1674.77, "word": " من", "probability": 0.96337890625}, {"start": 1674.77, "end": 1674.91, "word": " الله", "probability": 0.94921875}, {"start": 1674.91, "end": 1675.17, "word": " سبحانه", "probability": 0.9681396484375}, {"start": 1675.17, "end": 1675.49, "word": " وتعالى", "probability": 0.84710693359375}], "temperature": 1.0}, {"id": 64, "seek": 168557, "start": 1675.97, "end": 1685.57, "text": "إنه تكون يعني استفدت و استوعبت و اللي مابستوعبش يحاول يعيد المحاضرة أكتر من مرة عشان يعني يلسق الأمر في ذهنه ان شاء الله والسلام عليكم ورحمة الله وبركاته", "tokens": [28814, 1863, 3224, 6055, 30544, 37495, 22653, 44713, 5172, 3215, 2655, 4032, 44713, 45367, 3555, 2655, 4032, 13672, 1829, 3714, 16758, 14851, 45367, 3555, 8592, 7251, 5016, 995, 12610, 37495, 25708, 9673, 5016, 46958, 25720, 5551, 4117, 2655, 2288, 9154, 3714, 25720, 6225, 8592, 7649, 37495, 22653, 7251, 1211, 3794, 4587, 16247, 29973, 8978, 29910, 3224, 1863, 3224, 16472, 13412, 16606, 21984, 16070, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.13231169547025973, "compression_ratio": 1.7707006369426752, "no_speech_prob": 1.4066696166992188e-05, "words": [{"start": 1675.97, "end": 1676.33, "word": "إنه", "probability": 0.6033528645833334}, {"start": 1676.33, "end": 1676.53, "word": " تكون", "probability": 0.9345703125}, {"start": 1676.53, "end": 1676.69, "word": " يعني", "probability": 0.903564453125}, {"start": 1676.69, "end": 1677.71, "word": " استفدت", "probability": 0.914306640625}, {"start": 1677.71, "end": 1677.79, "word": " و", "probability": 0.5791015625}, {"start": 1677.79, "end": 1678.17, "word": " استوعبت", "probability": 0.857177734375}, {"start": 1678.17, "end": 1678.21, "word": " و", "probability": 0.442626953125}, {"start": 1678.21, "end": 1678.31, "word": " اللي", "probability": 0.90283203125}, {"start": 1678.31, "end": 1678.93, "word": " مابستوعبش", "probability": 0.879638671875}, {"start": 1678.93, "end": 1679.51, "word": " يحاول", "probability": 0.9842529296875}, {"start": 1679.51, "end": 1679.75, "word": " يعيد", "probability": 0.863525390625}, {"start": 1679.75, "end": 1680.17, "word": " المحاضرة", "probability": 0.9876708984375}, {"start": 1680.17, "end": 1680.49, "word": " أكتر", "probability": 0.91259765625}, {"start": 1680.49, "end": 1680.61, "word": " من", "probability": 0.982421875}, {"start": 1680.61, "end": 1680.83, "word": " مرة", "probability": 0.994140625}, {"start": 1680.83, "end": 1681.61, "word": " عشان", "probability": 0.9580078125}, {"start": 1681.61, "end": 1682.03, "word": " يعني", "probability": 0.960693359375}, {"start": 1682.03, "end": 1682.39, "word": " يلسق", "probability": 0.89599609375}, {"start": 1682.39, "end": 1682.65, "word": " الأمر", "probability": 0.977294921875}, {"start": 1682.65, "end": 1682.81, "word": " في", "probability": 0.978515625}, {"start": 1682.81, "end": 1683.11, "word": " ذهنه", "probability": 0.8416748046875}, {"start": 1683.11, "end": 1683.17, "word": " ان", "probability": 0.5751953125}, {"start": 1683.17, "end": 1683.31, "word": " شاء", "probability": 0.98828125}, {"start": 1683.31, "end": 1683.37, "word": " الله", "probability": 0.9609375}, {"start": 1683.37, "end": 1683.69, "word": " والسلام", "probability": 0.771240234375}, {"start": 1683.69, "end": 1684.15, "word": " عليكم", "probability": 0.954345703125}, {"start": 1684.15, "end": 1684.89, "word": " ورحمة", "probability": 0.95458984375}, {"start": 1684.89, "end": 1685.03, "word": " الله", "probability": 0.97265625}, {"start": 1685.03, "end": 1685.57, "word": " وبركاته", "probability": 0.984375}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1685.7919375, "duration_after_vad": 1663.1606249999957}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e59ef0bc240f240a541390da03f389ac580b1f5f
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nZZF8Z21rdE_raw.srt
@@ -0,0 +1,1700 @@
+1
+00:00:01,330 --> 00:00:05,510
+بسم الله الرحمن الرحيم طبعا احنا .. مالش اتوقفنا
+
+2
+00:00:05,510 --> 00:00:08,090
+عند المحاضرة السابقة اللي عند .. اللي هو اخر شيء
+
+3
+00:00:08,090 --> 00:00:11,030
+ما حكينا عن ال agents اللي بتكون موجودة في ال
+
+4
+00:00:11,030 --> 00:00:14,090
+cancerous clients او يعني الندابات السرطانية اللي
+
+5
+00:00:14,090 --> 00:00:18,730
+بتكون موجودة في بعض أجسام الناس اللي عندهم مشكلة
+
+6
+00:00:18,730 --> 00:00:22,970
+يعني خليني أقول مثلا malignant something يعني
+
+7
+00:00:22,970 --> 00:00:26,550
+عندهم أي أورام أو أي يعني شغل .. شغلات علاقة
+
+8
+00:00:26,550 --> 00:00:30,850
+بالإيش .. بالأورام بشكل عامالان بدنا نكمل شوية ال
+
+9
+00:00:30,850 --> 00:00:34,190
+hair and scalp و احنا قولنا اختصار ال scalp و
+
+10
+00:00:34,190 --> 00:00:37,570
+ذكرنا دورفات اللي هو الخمس كلمات ممكن احنا نقول
+
+11
+00:00:37,570 --> 00:00:40,210
+skin مثلا و بعدين connective tissue و بعدين
+
+12
+00:00:40,210 --> 00:00:42,470
+aponeuritica و لوزقة connective tissue و بعدين
+
+13
+00:00:42,470 --> 00:00:46,490
+pericrania ما هي بنذكركوا هنا بدنا نعمل أساس four
+
+14
+00:00:46,490 --> 00:00:50,350
+lesions أول حاجة بتطلع في فروة الرأس بشوف فيها ال
+
+15
+00:00:50,350 --> 00:00:54,660
+lice الحمد للهيعني إيش يبقى مش موجود بالمرة؟ طبعا
+
+16
+00:00:54,660 --> 00:00:57,040
+الله يسوي الجبل يعني القمليات و إذا في سبانة أو
+
+17
+00:00:57,040 --> 00:01:02,060
+حاجة زي هيك الحمد لله مش موجودة يعني انقرضت إذا لأ
+
+18
+00:01:02,060 --> 00:01:04,640
+قدر الله موجودة بندنسي نلبس يعني هانا gloves لأنه
+
+19
+00:01:04,640 --> 00:01:08,240
+مش .. مش .. مش .. مابديش أنا أقعد نفسي هذه كانت
+
+20
+00:01:08,240 --> 00:01:11,760
+زمان كانت موجودة لما بعض الناس يكونوا يعني صعب
+
+21
+00:01:11,760 --> 00:01:14,600
+عندهم في موضوع الاستحمام و موضوع إيش يعني النظافة
+
+22
+00:01:14,600 --> 00:01:18,760
+بشكل عام مع جلة الماء و يعني الناس و يعني فقر
+
+23
+00:01:18,760 --> 00:01:21,840
+الحال اليوم الحمد لله الأمور كويسةtypes of hair
+
+24
+00:01:21,840 --> 00:01:25,640
+covering the body أنواع الشعر اللي بيغطي الجسم هل
+
+25
+00:01:25,640 --> 00:01:28,980
+كده أنا خلصت فروة الرأس بتطلع خلصت الجلد انا شوي
+
+26
+00:01:28,980 --> 00:01:33,060
+شوي بدي امسك الجد بتطلع في الشعر زي ما احنا قلنا
+
+27
+00:01:33,060 --> 00:01:37,440
+اذا بتذكروا قلنا هل في اتنين لونهم زي بعضكم قلتله
+
+28
+00:01:37,440 --> 00:01:42,280
+لأ اللون بيختلف من شخص لشخص لون الجلد ولون الجلد
+
+29
+00:01:42,280 --> 00:01:47,180
+بيختلف برضه كمان من منطقة لمنطقة كذلك ايه برضه ع
+
+30
+00:01:47,180 --> 00:01:50,040
+ال hair بالطبع نفس الكلاممافي واحد شعره متطابق
+
+31
+00:01:50,040 --> 00:01:53,680
+بالنمية مائة بالمائة مع التاني ولا هلاقي الشعر
+
+32
+00:01:53,680 --> 00:01:57,100
+متطابق في جميع أنحاء جسمك بنفس اللون والهي أو
+
+33
+00:01:57,100 --> 00:02:02,100
+الشكل وإنما لأ بختلف من حين لآخر الواحد يعني الان
+
+34
+00:02:02,100 --> 00:02:06,600
+لما نشرح بعض التفاصيل هيعرف إيش اللي بنقصده شعرنا
+
+35
+00:02:06,600 --> 00:02:12,500
+في جسمنا نوعين ماهي تتذكر إن حد ميجي في بالك مثلا
+
+36
+00:02:12,500 --> 00:02:16,400
+الشعر تتذكر منطقة مثلا الذقن أو منطقة الرأس أو
+
+37
+00:02:16,400 --> 00:02:20,170
+منطقة مثلا ال genital areaلأ دول بدنا نحكي كلمات
+
+38
+00:02:20,170 --> 00:02:23,090
+مهمة، في نوعين من الشعر، نوع اسمه terminal و نوع
+
+39
+00:02:23,090 --> 00:02:27,730
+اسمه villas نوع اسمه terminal و نوع ايش villas لما
+
+40
+00:02:27,730 --> 00:02:29,850
+نقول كلمة terminal ماحد يجي يقول terminal يعني
+
+41
+00:02:29,850 --> 00:02:33,930
+طرفي لأ terminal here يعني الشعر الدائم هيك
+
+42
+00:02:33,930 --> 00:02:38,210
+فاهموها الشعر الرسمي villas here بنسميه احنا
+
+43
+00:02:38,210 --> 00:02:43,030
+بسموها بالعامية بعض العائلات و بعض الناس بسموه ريش
+
+44
+00:02:43,030 --> 00:02:45,690
+الحرام مش ريش الحرام يعني هو أنه السفر قاضي بحرام
+
+45
+00:02:45,690 --> 00:02:50,550
+لأيعني مش عارف اذا حد عمره رب زغليل او حمام
+
+46
+00:02:50,550 --> 00:02:54,890
+بتلاقيه اول ما .. اول ما يعني الزغلول او العصفور
+
+47
+00:02:54,890 --> 00:02:58,610
+يبدأ ينبط عليه الشعر هذا بيسموه ايش؟ هذا بيسموه
+
+48
+00:02:58,610 --> 00:03:05,310
+villa seire هو موجود في جسمنا بس مش كلها شعرنا،
+
+49
+00:03:05,310 --> 00:03:08,690
+يكون موجود في اماكن يدوب احنا شايفينا ويمكن
+
+50
+00:03:08,690 --> 00:03:14,600
+مانشوفاش كمان على ادينا من برة و من جوايعني خاصة
+
+51
+00:03:14,600 --> 00:03:16,660
+بتتكلم عن ال R مش منطقة ال palm ال palm ماطلعش
+
+52
+00:03:16,660 --> 00:03:21,680
+عليها خلف اليد خلف الرجلها كذا طب خليني أشوف الآن
+
+53
+00:03:21,680 --> 00:03:24,500
+ال terminal بيقول اللي هو عبارة عن long طويل
+
+54
+00:03:24,500 --> 00:03:30,360
+course كثيف thick يعني كتير و كثيف و بنقدر نشوفه
+
+55
+00:03:30,360 --> 00:03:34,800
+بسهولة easily visible اين موجود هذا الشعر؟ في ال
+
+56
+00:03:34,800 --> 00:03:37,380
+scalp فوق في الفروع أكزلها و ال pubic area أكيد
+
+57
+00:03:37,380 --> 00:03:41,100
+هذا اللون ممكن يكون كله لون واحد طب نيجي نشوف اللي
+
+58
+00:03:41,100 --> 00:03:44,920
+بعده الفلسال villas بيسموها beach fuzz، إيش يعني
+
+59
+00:03:44,920 --> 00:03:50,380
+beach fuzz؟ beach معناته الخوخ، تسمعوا ال .. ال ..
+
+60
+00:03:50,380 --> 00:03:55,020
+ال .. في حاجة بيسموها .. بيسموها الخوخ أبو فروة،
+
+61
+00:03:55,020 --> 00:03:57,980
+كلكوا عارفينه، الخوخ أبو فروة اللي بيطلع عليه حاجة
+
+62
+00:03:57,980 --> 00:04:01,880
+بيسموها ال fuzz، الفروة دي اللي طلع ع طريق زي ال
+
+63
+00:04:01,880 --> 00:04:06,040
+.. زي القطنيات الصغيرة جدا أو الشعر، الشعر البسيط
+
+64
+00:04:06,040 --> 00:04:09,940
+كده، لما بنغسل بتلاقي جراح، هذا يعني التشبيه عشان
+
+65
+00:04:09,940 --> 00:04:15,620
+يقول small, soft, tinyصغير و سهل و تاني يعني سهل
+
+66
+00:04:15,620 --> 00:04:19,220
+اللي يروح يشمال ويمين covering whole of the body
+
+67
+00:04:19,220 --> 00:04:23,540
+يعني بيغطي كل جسم الإنسان يا سبحان الله يعني شوف
+
+68
+00:04:23,540 --> 00:04:28,360
+احنا بيحكينا كل جسمنا يتغطى بالشعر ما عدا مكانين
+
+69
+00:04:28,360 --> 00:04:32,520
+كف الرجل و كف الإيد palms and soles palms and
+
+70
+00:04:32,520 --> 00:04:37,130
+soles يبقى معناته الشعر بتاع الرأسبتاع ال axilla
+
+71
+00:04:37,130 --> 00:04:40,730
+وبتاع ال pubis هذا اسمه terminal ما دون ذلك اسمه
+
+72
+00:04:40,730 --> 00:04:43,830
+villas لو حاجة أجت طالع زي عندنا مكبر أو على
+
+73
+00:04:43,830 --> 00:04:47,350
+الجوال زي ما راكبين عدسة مكبر تاعة جوجل أو غيره
+
+74
+00:04:47,350 --> 00:04:51,150
+تطلعنا على جسمنا في منطقة احنا ممكن نقول طبعا أنا
+
+75
+00:04:51,150 --> 00:04:54,610
+بتتأكد يمكن الأستاذ مش صح كلامه نتأكد في مكان أنا
+
+76
+00:04:54,610 --> 00:04:59,150
+لا أتوقع أنه يكون فيه شعر وحاولنا نتقيق هنعرف أنه
+
+77
+00:04:59,150 --> 00:05:04,240
+فيه موجود شعرطبعا يعني هو الانسان مابتطلعش انه
+
+78
+00:05:04,240 --> 00:05:07,640
+يرفعه الا لما يكون يعني مسبب له اي حرج هو ممكن
+
+79
+00:05:07,640 --> 00:05:12,220
+يرفعه خاصة الفيمين الان اش بقولي انا بعدي اش بقولي
+
+80
+00:05:12,220 --> 00:05:15,900
+assessment done by a distribution بتطلع و انا بقعد
+
+81
+00:05:15,900 --> 00:05:19,700
+بقيم بشوف distribution توزيع الشعر كتير ولا مش
+
+82
+00:05:19,700 --> 00:05:23,960
+كتير ال thickness كثافته ال texture و انا بتطلع
+
+83
+00:05:23,960 --> 00:05:28,450
+فيه بمسكه طيب ال fabrication مش بس هيككل هذا هل
+
+84
+00:05:28,450 --> 00:05:32,330
+بيستخدم اي drugs or not انا جاي بتطلع على الشعر
+
+85
+00:05:32,330 --> 00:05:34,810
+بعمل اساس من دي ممكن واحد و انا بتطلع في الشعر
+
+86
+00:05:34,810 --> 00:05:38,870
+وماسكته لجيت فيه مشكلة بقوله ليه الشعر كذا و لجيته
+
+87
+00:05:38,870 --> 00:05:41,910
+موسيقى يقول لأ انا حاطط عليه lubricant او حاطط
+
+88
+00:05:41,910 --> 00:05:45,270
+عليه شيء يبقى انا بسأل المريض عشان اعرف واتاكد ان
+
+89
+00:05:45,270 --> 00:05:48,430
+هذا normal or abnormal صحيح طيب بقولش بقولليه
+
+90
+00:05:48,430 --> 00:05:53,150
+انشأنا some events بعض الأشياء بتأثر على
+
+91
+00:05:53,150 --> 00:05:57,330
+distribution of hair ايش يعني بقوللي بعض الأحداث
+
+92
+00:05:58,020 --> 00:06:02,700
+بتأثر كتير على توزيع الشعر في جسم الإنسان زي إيش
+
+93
+00:06:02,700 --> 00:06:06,060
+يا أستاذ؟ بقول زي ال hormone disorders إيش ال
+
+94
+00:06:06,060 --> 00:06:10,980
+hormone disorders؟ يعني أجدت صحيح إنه في شعر في
+
+95
+00:06:10,980 --> 00:06:14,940
+جسم الإنسان لكن في بعض الناس ممكن أن آجي أطلع على
+
+96
+00:06:14,940 --> 00:06:22,500
+female ست كبيرة عندها مشكلة هرمونية فوجها في شعر
+
+97
+00:06:22,500 --> 00:06:26,020
+في شعر في الأماكن اللي أنا مش متوقع تكون عندها شعر
+
+98
+00:06:26,420 --> 00:06:30,600
+هذا بيسموه hersetism المصطلع إيش اسمه؟ hersetism
+
+99
+00:06:30,600 --> 00:06:33,860
+يعني .. يعني بيسموه يعني المرأة الشعورية يعني زاد
+
+100
+00:06:33,860 --> 00:06:37,460
+أنت الشعر بس ما .. هذا يعني ما بنقول يعني لو واحد
+
+101
+00:06:37,460 --> 00:06:40,500
+دايما يصيح من الله الحمد لله اللذي عفانا من مبتلى
+
+102
+00:06:40,500 --> 00:06:44,800
+بيغيرنا وفضلنا على كتير من خلقه تفضيله أقصد هنا ما
+
+103
+00:06:44,800 --> 00:06:47,760
+نستغرب يعني أنا قصدي اللي شوفني هذا الأمر يبني عرف
+
+104
+00:06:47,760 --> 00:06:54,650
+أنه هذا diseased يعنيقضية يعني مرضية لكن normal ان
+
+105
+00:06:54,650 --> 00:06:58,490
+يكون الشعر متناسب لو شفنا بعض ال changes ممكن يكون
+
+106
+00:06:58,490 --> 00:07:02,650
+علاقة بالهيرومون مش بس هيك فرضنا نعمل assessment
+
+107
+00:07:02,650 --> 00:07:06,170
+لو واحد لقنا يعني عنده loss of hair يعني مافيش
+
+108
+00:07:06,170 --> 00:07:11,270
+عنده شعر يجينا سألنا قالك لأ انا للأسف هذا يعني
+
+109
+00:07:11,270 --> 00:07:16,510
+طلع مريض يعني عنده مثلا cancer some lesions وباخد
+
+110
+00:07:16,510 --> 00:07:20,290
+كيمو ثرابي باخد إيه أشعر؟ عشان كيموطيب و من ال
+
+111
+00:07:20,290 --> 00:07:24,790
+side effect الكيمو ثرابي بشكل أساسي اللي هو إيه ال
+
+112
+00:07:24,790 --> 00:07:28,190
+loss of hair فماقدرش أقول هذا عنه abnormal بقول
+
+113
+00:07:28,190 --> 00:07:32,390
+normal side effect for something و بس يوقف ان شاء
+
+114
+00:07:32,390 --> 00:07:39,330
+الله بيرجع لطبيعته فهكذا طيب ال normal color ال
+
+115
+00:07:39,330 --> 00:07:42,510
+normal color لل terminal hair الشعر اللي إيه
+
+116
+00:07:42,510 --> 00:07:46,760
+الدائم يا بيكون blackيا بكون رده مش هالناه في بعض
+
+117
+00:07:46,760 --> 00:07:49,240
+يبقى زي بعض اللي هو نود الحمره وغيره، يا بكون ياله
+
+118
+00:07:49,240 --> 00:07:51,880
+سبحان الله زي ناس الألبين وغيره، في ناس بتاجي
+
+119
+00:07:51,880 --> 00:07:54,980
+شعرهم دايما أسفر، ما يقولوا بعد حاطط عليه يعني
+
+120
+00:07:54,980 --> 00:07:59,100
+صبغه أو حنيه، لأ أنا بتكلم على ال normal .. إيش؟
+
+121
+00:07:59,100 --> 00:08:04,940
+normal color، يعني كل ألوان البشر، يا أسود، يا
+
+122
+00:08:04,940 --> 00:08:09,340
+أحمر، يا إما أسفر، يا إما مشتقات هذه الألوان، يعني
+
+123
+00:08:09,340 --> 00:08:14,440
+مش هنلاقي لون أخضر مثلامش هنلاقي لون بنفسي مش
+
+124
+00:08:14,440 --> 00:08:17,100
+هنلاقي .. إيش بقول عن variations والاختلافات إلا
+
+125
+00:08:17,100 --> 00:08:21,560
+إذا طبعا حط على شعره شي تاني هذا من عنده ال older
+
+126
+00:08:21,560 --> 00:08:28,180
+men رجال لما بيكبروا في السن بيصل لستين و أكتر من
+
+127
+00:08:28,180 --> 00:08:32,860
+هيك إيش بيصير عنده ال facial hair بيفقده لكن ال
+
+128
+00:08:32,860 --> 00:08:37,040
+older women قلنالكوا الستات لما بيكبرن سبحان الله
+
+129
+00:08:37,040 --> 00:08:42,060
+بيبدأ يطلع عندهم شعر خاص في منطقة ال chinاللي دقن
+
+130
+00:08:42,060 --> 00:08:45,540
+يعني في ال upper lip كمان، يعني خليني أقول زي في
+
+131
+00:08:45,540 --> 00:08:49,640
+منطقة الشنب اللي يسمينا إيه hirsutism خلاص سبحان
+
+132
+00:08:49,640 --> 00:08:52,720
+الله ماحد ييجي يضحك ويقول لأ هذا تغييرات في
+
+133
+00:08:52,720 --> 00:08:56,140
+السيراجية و تغييرات لا يعلم كنهاها إلا الله سبحانه
+
+134
+00:08:56,140 --> 00:08:59,440
+وتعالى ال hersutism أنا بقول often caused by ايه
+
+135
+00:08:59,440 --> 00:09:03,080
+ال genes في بعض الناس اللي علاقة بالجينات بالوراثة
+
+136
+00:09:03,080 --> 00:09:07,310
+والهرمونات وال medication وبيحكي عن مصطلح نفسهيعني
+
+137
+00:09:07,310 --> 00:09:10,930
+ممكن الإنسان يكون هذا مرتبط إما بالجينات أو
+
+138
+00:09:10,930 --> 00:09:16,050
+بالهرمونات أو باستخدام علاجات معينة طيب ال amounts
+
+139
+00:09:16,050 --> 00:09:20,370
+.. ال amount of ايش .. of hair covering
+
+140
+00:09:20,370 --> 00:09:23,610
+extremities طيب هل ال amount .. هل حجم الشعر اللي
+
+141
+00:09:23,610 --> 00:09:27,390
+بيغطي الأطراف خاصة الرجلين بيضلوا طول العمر زي ما
+
+142
+00:09:27,390 --> 00:09:33,130
+هو؟ أبدا لا يمكن كيف يعني؟ يعني لو واحد عنده .. لو
+
+143
+00:09:33,130 --> 00:09:36,460
+واحد عنده مثلا في شعر في رجليهو هذا طبيعي انا
+
+144
+00:09:36,460 --> 00:09:39,740
+بتتكلم في رجليي يعني في منطقات مثلا ال thigh لتحت
+
+145
+00:09:39,740 --> 00:09:43,620
+شوية below مثلا نيه و هكذا الشعر هذا لما بيكبر
+
+146
+00:09:43,620 --> 00:09:47,740
+الإنسان سبحان الله كل ما بيكبر أكتر بجل الدم اللي
+
+147
+00:09:47,740 --> 00:09:50,800
+واصل للرجليين تحت فهيش بيقوللي لحظوا هش بيقوللي
+
+148
+00:09:50,800 --> 00:09:55,800
+reduced as a result of aging بجل الشعر اللي مغطي
+
+149
+00:09:55,800 --> 00:10:01,080
+اللي هو الطرفين اللي تحت السفليينالسفلين علشان
+
+150
+00:10:01,080 --> 00:10:06,160
+إيش؟ الطرفين السفلين بيبدأ الدم الواصل لبصيلات
+
+151
+00:10:06,160 --> 00:10:10,460
+الشعرقل لما بيبدأ الدم الواصل لبصيلات الشعرقل مع
+
+152
+00:10:10,460 --> 00:10:13,440
+ال aging، إيش بيصير هنا خاصة في ال lower limbs؟
+
+153
+00:10:13,440 --> 00:10:17,590
+بتلاقي البني آدم بيصير إيش؟بنزل بتلاقي مباشرة
+
+154
+00:10:17,590 --> 00:10:21,650
+بتلاقي بطل الشعر يكون كثيف زي زمان لإنه بدي تغذى
+
+155
+00:10:21,650 --> 00:10:25,170
+على الدم والدم مع كبر السن بطل وفي بعض الناس دلوقت
+
+156
+00:10:25,170 --> 00:10:29,510
+مع ال opposite كمان مع النصاحة الكثيرة برضه بتصير
+
+157
+00:10:29,510 --> 00:10:33,830
+عندهم loss of hair طيب الآن بقولي هنا في حاجة
+
+158
+00:10:33,830 --> 00:10:36,810
+اسمها ال skilliness or dryness يعني القشور أو
+
+159
+00:10:36,810 --> 00:10:39,590
+الجفاف اللي بيصير في ال scalp في بعض الناس عندهم
+
+160
+00:10:39,590 --> 00:10:44,160
+يعني زي جشرة الراس جشرة الشعرأو الجفاف الدائم اللى
+
+161
+00:10:44,160 --> 00:10:47,840
+موجود فى الـ scalp ليش بيصير؟ بقول هنا معظمه بيصير
+
+162
+00:10:47,840 --> 00:10:51,020
+مع الدندرف الدندرف يعني المرض اللى هو القشرة ده
+
+163
+00:10:51,020 --> 00:10:53,720
+اللى إيه بيصير وكده بيقولك والله عندي قشرة قشرة فى
+
+164
+00:10:53,720 --> 00:10:57,460
+شعري فدائما بيصير عندي جفاف و بروح بدور يعني حتى
+
+165
+00:10:57,460 --> 00:11:01,120
+الشنب اللى بشتريه بشتري حاجة بسموها أنا بنصح أن
+
+166
+00:11:01,120 --> 00:11:03,340
+يكون مكتوب عليه مش protein لأ يكون مكتوب عليه
+
+167
+00:11:03,340 --> 00:11:08,760
+antidandruff antidandruff يعني ضد القشرة بالظبط
+
+168
+00:11:08,760 --> 00:11:13,450
+الآن فى بعض الحالات عندهم بيكون سيروياسسمش بـ be
+
+169
+00:11:13,450 --> 00:11:17,670
+silent هنا الـ psoriasis اللي الصدفية مرض الصدفية
+
+170
+00:11:17,670 --> 00:11:21,650
+هو autoimmune disease يعني مرض ما .. ما .. ما ..
+
+171
+00:11:21,650 --> 00:11:24,730
+مالوش علاقة بال .. بال .. بالاتهابات اللي علاقة
+
+172
+00:11:24,730 --> 00:11:28,130
+بالمناعة و بيجي عند الناس ب .. بصيبهم في أماكن
+
+173
+00:11:28,130 --> 00:11:32,450
+معينة في .. في جسمهم و سبحان الله يعني بيجيوا بروع
+
+174
+00:11:32,450 --> 00:11:36,370
+زي ال waves يعني زي الموجات و مالو يعني علاج يعني
+
+175
+00:11:36,370 --> 00:11:39,490
+حقيقي و واضحبنعطيه لما بتزيد الحالة
+
+176
+00:11:39,490 --> 00:11:42,930
+immunosuppressive يعني مضادات او يعني مثبتات
+
+177
+00:11:42,930 --> 00:11:50,970
+للمناعة و مرات يعني لما بيكون مافيشش عنده يعني هذا
+
+178
+00:11:50,970 --> 00:11:55,130
+التقشر في الجلد مرات ايش مابنعطيه علاج علشان ايش
+
+179
+00:11:55,130 --> 00:11:59,110
+يعني مش لازم يتعرض الإنسان طول الوقت طول عمره
+
+180
+00:11:59,110 --> 00:12:02,290
+أدوية لأنه أنا قلتلكوا له علاقة بالمناعة مالوش
+
+181
+00:12:02,290 --> 00:12:07,440
+علاقة بال infection طيب ال nails assessmentتقييم
+
+182
+00:12:07,440 --> 00:12:11,740
+الأضافر قبل ما ندخل و نحكي في كتير بعض الناس بيقول
+
+183
+00:12:11,740 --> 00:12:16,320
+لي هو الأضافر يا أستاذ مهمة، الآن هتكتشفوا أنه
+
+184
+00:12:16,320 --> 00:12:19,540
+الإضافر مرات بدللنا على أمراض خطيرة في جسم الإنسان
+
+185
+00:12:19,540 --> 00:12:24,040
+و أن الإضافر مرات بدللنا على أشياء إما normal أو
+
+186
+00:12:24,040 --> 00:12:27,900
+abnormal، أقولكوا في بعض الحالات ممكن تبعين ال
+
+187
+00:12:27,900 --> 00:12:32,740
+forensic medicineالطب الشرعي بيستدلوا على أشياء
+
+188
+00:12:32,740 --> 00:12:36,500
+criminal يعني إجرامية من الأضافر يعني زي لما واحد
+
+189
+00:12:36,500 --> 00:12:41,860
+بيكون مثلا مات مقتول أو كذا فمن كتر حالات كتير
+
+190
+00:12:41,860 --> 00:12:45,820
+انوجدت سواء بعينها أو برا فكان مش قادر .. كان
+
+191
+00:12:45,820 --> 00:12:49,840
+يدافع نفسه قبل ما يموت فأخد تحت الأضافر يعني بعض
+
+192
+00:12:49,840 --> 00:12:53,180
+ال antigen بسيطة جدا و تم فحص ال DNA و التعرف على
+
+193
+00:12:53,180 --> 00:12:56,540
+هوية القاتل هذه يعني أنا لمحة بسيطة عشان أقولكوا
+
+194
+00:12:56,540 --> 00:13:01,000
+إيش أهمية أن ال assessmentال nails بيقول بتعكس
+
+195
+00:13:01,000 --> 00:13:04,720
+reflect individuals إيش بتعكس ال general state of
+
+196
+00:13:04,720 --> 00:13:07,740
+health يعني اللي .. اللي .. المستوى الصحي طبيعي
+
+197
+00:13:07,740 --> 00:13:11,560
+مية في المية أطافيره كويسات مافيش فيها جفاف مافيش
+
+198
+00:13:11,560 --> 00:13:15,140
+فيها تقصف مافيش فيها بياض مافيش فيها خطوط مافيش
+
+199
+00:13:15,140 --> 00:13:18,960
+فيها أي انحناء بيبقى مافيش فيها تستيغي يعني كله
+
+200
+00:13:18,960 --> 00:13:23,260
+أقصد إن الأطفال بيكون طبيعي بتدليل على ال state of
+
+201
+00:13:23,260 --> 00:13:25,940
+nutrition متقد كويس و بتدل على ال occupation اللي
+
+202
+00:13:25,940 --> 00:13:29,490
+بيشتغل طبعا في البناء و الطبار و الشغلات فيهايعني
+
+203
+00:13:29,490 --> 00:13:34,490
+شغلات ربما بتأثر على يعني تركيبات الأطفال أو اللي
+
+204
+00:13:34,490 --> 00:13:36,750
+بيشتغلوا في زي مهن كله يشتغلوا في تحميط الصور
+
+205
+00:13:36,750 --> 00:13:40,910
+الموضوع الكيموية غير على اللي بيشتغل مثلا في أشياء
+
+206
+00:13:40,910 --> 00:13:44,710
+مابتأثش على ضعفر زي التدريس أو زي مثلا التمريد
+
+207
+00:13:44,710 --> 00:13:49,510
+أوها كذا ال vascularity of the nail نسبة انتشار
+
+208
+00:13:49,510 --> 00:13:53,830
+الدم في تحت الأطفال اللي هو nail bits بيسموها لو
+
+209
+00:13:53,830 --> 00:13:56,160
+تحت الأطفال يعني ال nail bits اللي هوبتما انتوا
+
+210
+00:13:56,160 --> 00:13:59,160
+عارفين معنات سرير ليش سموه يعني سرير الإطفار يعني
+
+211
+00:13:59,160 --> 00:14:02,740
+الإطفار هذا كله اللي مبين قدامنا بنسميه نيربد
+
+212
+00:14:02,740 --> 00:14:06,420
+بقوللي اتطلع عليه عشان ال underlying كده بدك تشوف
+
+213
+00:14:06,420 --> 00:14:09,700
+ايه بدك تشوف اللون اللي تعدي يعني إذا بدنا نشوف
+
+214
+00:14:09,700 --> 00:14:14,620
+اللون اللون الجلد بسمع علينا اللي أنا هتطلع في ال
+
+215
+00:14:14,620 --> 00:14:17,920
+نيربد ببين اللون يعني لو اتطلعنا في اللون الجلد
+
+216
+00:14:17,920 --> 00:14:22,120
+تحت الإطفار الطبيب يكون ما إلا الحمرة ما إلا إيه
+
+217
+00:14:22,120 --> 00:14:26,600
+للحمرةمش معناته اه ما الا الحمراء مش معناته لازم
+
+218
+00:14:26,600 --> 00:14:29,900
+يكون أحمر زيادة عن نزوم لأ و ذكرا أبيض برضه لأ
+
+219
+00:14:29,900 --> 00:14:35,620
+لازم يكون ما الا الحمراء لأ أكتر ولا أقل طيب ال
+
+220
+00:14:35,620 --> 00:14:39,500
+nails are normally transparent ايش يعني بقولي
+
+221
+00:14:39,500 --> 00:14:44,880
+الطبيعي الطبيعي يكون ايش هنا transparent شفاف
+
+222
+00:14:44,880 --> 00:14:51,520
+smooth ايش يعني smooth في نقومة convex محدد ايش
+
+223
+00:14:51,520 --> 00:14:54,860
+يعني محدديعني اتطلع في .. لحالك اتطلع في أضافيره
+
+224
+00:14:54,860 --> 00:14:58,380
+بيلاقي الطبيعي يكون إيش يعني محدّم شوية مش مسطح
+
+225
+00:14:58,380 --> 00:15:01,760
+Surrounding cuticles اللي حوالينها cuticles اللي
+
+226
+00:15:01,760 --> 00:15:04,720
+حوالين الإطفار بتكون دايما برضه smooth و intact دي
+
+227
+00:15:04,720 --> 00:15:08,340
+يعني مش لازم .. مش لازم تلاقي قشور حوالين الإطفار
+
+228
+00:15:08,340 --> 00:15:12,620
+ولا تشققات ولا inflammation أي التهابات ال nail
+
+229
+00:15:12,620 --> 00:15:16,360
+bed لازم يكون إيش firm on palpation يعني لو احنا
+
+230
+00:15:16,360 --> 00:15:19,420
+ضغطنا على ال nail bed ما .. الصح أنه مايتألمش
+
+231
+00:15:19,420 --> 00:15:23,990
+طبيعي مافيه مشكلةطب هو كيف بينمو الإدفار؟ في بعض
+
+232
+00:15:23,990 --> 00:15:27,610
+الحالات زي واحد جس إدفاره بالغلط جس شيء لورة شوية
+
+233
+00:15:27,610 --> 00:15:31,290
+أو لا سمح الله أكل هواية شوية و الدربة دي جاته
+
+234
+00:15:31,290 --> 00:15:34,510
+جسّته شوية من الإدفار بيكون زي أنا خايف إيش صار
+
+235
+00:15:34,510 --> 00:15:39,310
+معاه؟ إحنا بنتقول للجميع سبحان الله بقول إنه دايما
+
+236
+00:15:39,310 --> 00:15:42,750
+ال nails ي grow in constant rate إيش يعني constant
+
+237
+00:15:42,750 --> 00:15:49,190
+rate؟ يعني بينمو بمعدلات ثابتة ربانية مزايا ربانية
+
+238
+00:15:49,710 --> 00:15:53,110
+في بعض الناس بقولك انا كل عشرين يوم بجبج و أسقط في
+
+239
+00:15:53,110 --> 00:15:56,210
+برجين على نفس الحجم فبقول سبحان الله و احنا بنقوله
+
+240
+00:15:56,210 --> 00:15:59,530
+سبحان الله الأضافير تكبر بنفس الحجم بنفس الشيء لو
+
+241
+00:15:59,530 --> 00:16:03,470
+صار في قص أو كده مايخافش الانسان يكبر يكبر يكبر
+
+242
+00:16:03,470 --> 00:16:08,210
+يكبر لما يصل يعاود لطبيعته و يكتمل نمو الأدفار في
+
+243
+00:16:08,210 --> 00:16:11,210
+بعض الحالات عندهم يصير عندهم هم باريش خاصة وين أكل
+
+244
+00:16:11,210 --> 00:16:15,270
+هواية شوية على أدفره في بعض الحالات يصير عندهم
+
+245
+00:16:15,270 --> 00:16:18,860
+transverse bandsايش transverse band اللي بيسموه
+
+246
+00:16:18,860 --> 00:16:22,860
+الخطوط العرضية اللي موجودة في الإدفار؟ لإنه اتطلع
+
+247
+00:16:22,860 --> 00:16:26,420
+في الإدفار بتسيير بالنلاج عليه زي خطوط بيضة زي
+
+248
+00:16:26,420 --> 00:16:29,660
+خطوط زي الحليب أو زي مثلا بعض الناس بتقولك هذا من
+
+249
+00:16:29,660 --> 00:16:32,780
+ال calcium و ال calcium طبعا هو بعض الناس جانوا
+
+250
+00:16:32,780 --> 00:16:35,470
+بعض الطباء جانوا إيه علاقة بال calcium؟عموما احنا
+
+251
+00:16:35,470 --> 00:16:39,850
+لو وجدناها مش غلط نعمل فحصات علشان نتأكد و خاصة لو
+
+252
+00:16:39,850 --> 00:16:42,630
+بتكون زيادة كتير لكن اذا لجينا واحدة او اتنتين مش
+
+253
+00:16:42,630 --> 00:16:45,990
+كتير نقاط بيضاع لكن اذا كانت خطوط كتير كل اضافير
+
+254
+00:16:45,990 --> 00:16:49,810
+البني ادم يعني فيه مشكلة و فيه abnormal يعني
+
+255
+00:16:49,810 --> 00:16:53,490
+things و بندرشوك كيف ال thickness يعني كيف خمالة
+
+256
+00:16:53,490 --> 00:16:56,890
+الأطفال كثيف مش كثيف يبقى عنده خمالة فيه ولا لأ
+
+257
+00:16:56,890 --> 00:17:04,000
+طيب بقولي انا notable ال vitaminsزي ال vitamins و
+
+258
+00:17:04,000 --> 00:17:06,100
+ال protein و ال electrolyte يعني الشغلات المغضية
+
+259
+00:17:06,100 --> 00:17:09,060
+زي الفيتامينات و ال .. و خليني أقول و ال proteins
+
+260
+00:17:09,060 --> 00:17:13,480
+بشكل عام و ال electrolytes الأملح اللي مجلوقة خاصة
+
+261
+00:17:13,480 --> 00:17:19,140
+الشغلات المغضية ممكن تأثر على إيش؟ على ال lines و
+
+262
+00:17:19,140 --> 00:17:22,780
+ال إيه؟ و ال band إيش يعني ال band؟ forming of the
+
+263
+00:17:22,780 --> 00:17:25,860
+nail pits يعني في بعض الناس و احنا بنعمل
+
+264
+00:17:25,860 --> 00:17:28,820
+assessment لمنطقة ال nail pit و لاجينا عنده
+
+265
+00:17:28,820 --> 00:17:33,280
+الألوان هذه موجودة جينا جابنا دي على مستشفىخاصة
+
+266
+00:17:33,280 --> 00:17:37,280
+انه لاجينا اللي هو المسطح تبع الإطفار هذا المسطح
+
+267
+00:17:37,280 --> 00:17:41,280
+صار في عنده ألوان غريبة في إطفاره مش غلط نسأل
+
+268
+00:17:41,280 --> 00:17:43,940
+السؤال انت بتاخد فيتميلات بقولك اه والله انا باخد
+
+269
+00:17:43,940 --> 00:17:48,300
+مكملات من نوع كذا انا باخد protein مكمل غذائي اسمه
+
+270
+00:17:48,300 --> 00:17:51,280
+كذا او انا فيها مثلا electrolyte واحدة من التلاتة
+
+271
+00:17:51,280 --> 00:17:56,560
+هذا بنوجهه للطبيب المتخصص في هذا المجال مانقدرش
+
+272
+00:17:56,560 --> 00:17:59,580
+نقول هذا normal change بنقول هذا side effect for
+
+273
+00:17:59,580 --> 00:18:03,390
+something يعني صارت عنده الأشياء هذهاستجابة لإيش
+
+274
+00:18:03,390 --> 00:18:06,650
+.. استجابة .. اه side effect لفيتامينات معينة و
+
+275
+00:18:06,650 --> 00:18:09,910
+بياخدها دي بس يعني ملاحظة لبعض الحالات النادرة
+
+276
+00:18:09,910 --> 00:18:12,410
+اللي ممكن تشوفها ممكن ماتشوفهاش في حياتك العملية
+
+277
+00:18:12,410 --> 00:18:18,530
+أبدا color of nails لون الأضافر بدل على درجة ايه
+
+278
+00:18:18,530 --> 00:18:21,330
+على درجة ال oxygenation يعني ايش درجة ال
+
+279
+00:18:21,330 --> 00:18:25,190
+oxygenation لو طلعنا اللي هو عمليةقداش اللي هو
+
+280
+00:18:25,190 --> 00:18:29,710
+عملية الأكسدا أو قداش فيه أكسجين واصل لأطراف
+
+281
+00:18:29,710 --> 00:18:34,990
+الإنسان تحت الجلد مباشرة فهو إيش بقوللي أنا بقوللي
+
+282
+00:18:34,990 --> 00:18:39,370
+سبحان الله ال blush color إيش يعني اللون اللي ميل
+
+283
+00:18:39,370 --> 00:18:43,790
+الأزرق شوية الإضفر اللي لونه ميل الأزرق إيش بنسميه
+
+284
+00:18:43,790 --> 00:18:49,430
+cyanosis طب اللي لون ميل الأبيض إيش بنسميه هه هم
+
+285
+00:18:49,430 --> 00:18:52,370
+بسموه شاحب بالر بنسميه إيش يعني إيه فيه عنده
+
+286
+00:18:52,370 --> 00:18:58,390
+أنيمياطيب palpation of the nail حس الإطفار عشان
+
+287
+00:18:58,390 --> 00:19:02,830
+تشوف ال adequacy of ايش circulation او بيسموها ايش
+
+288
+00:19:02,830 --> 00:19:06,290
+هنا capillary refill اعتقد اخدتوها في ال
+
+289
+00:19:06,290 --> 00:19:09,910
+fundamental اسمها capillary refill examination
+
+290
+00:19:09,910 --> 00:19:12,430
+يعني اللي قبلكوا انا سألتهم قالوا اللي اخدناها في
+
+291
+00:19:12,430 --> 00:19:15,370
+ال fundamental عموما لو حد سأل نفسه ايش يعني
+
+292
+00:19:15,370 --> 00:19:19,950
+capillary refill اعطيكم مثال احنا هي الإطفار عند
+
+293
+00:19:19,950 --> 00:19:21,950
+الإبهام وهي الإطفار عند الإبهام
+
+294
+00:19:24,840 --> 00:19:30,820
+أضغط على أعلى الأدفار الأيسر
+
+295
+00:19:30,820 --> 00:19:35,440
+.. اضغط على أعلى الأدفار الأيسر .. اضغط على أعلى
+
+296
+00:19:35,440 --> 00:19:39,900
+الأدفار الأيسر .. اضغط على أعلى الأدفار الأيسر ..
+
+297
+00:19:39,900 --> 00:19:43,690
+اضغط على أعلى الأدفار الأيسر ..المفروض يرجع اذا
+
+298
+00:19:43,690 --> 00:19:48,650
+رجع اللون كويس برجع اقول ايش يعني بقول good
+
+299
+00:19:48,650 --> 00:19:51,770
+capillary refill ايش يعني capillary ما انتوا
+
+300
+00:19:51,770 --> 00:19:55,890
+عارفين نهايات الفين و نهايات الارتري اسمها
+
+301
+00:19:55,890 --> 00:19:59,210
+capillaries اللي هي بسبب الشعيرات الدموية يبقى لو
+
+302
+00:19:59,210 --> 00:20:03,090
+ضغطت على الإطفال رفعت ايدي و رجعت دم مباشرة بقول
+
+303
+00:20:03,090 --> 00:20:07,210
+good capillary refill طب لو انا ضغطت و رفعت و
+
+304
+00:20:07,210 --> 00:20:12,010
+مارجعش الدم مباشرةبقول ايش abnormal refill او مثلا
+
+305
+00:20:12,010 --> 00:20:15,330
+difficult refill او بيقول small refill يعني اي
+
+306
+00:20:15,330 --> 00:20:19,490
+مصطلح بيجي في بالنا بنحكيه عشان نعرف يمكن العلاقة
+
+307
+00:20:19,490 --> 00:20:23,150
+.. العلاقة يا بالدم اقلته زي الانيميا يا بالاكسجين
+
+308
+00:20:23,150 --> 00:20:26,770
+اقلته loss of oxygenation في حاجة بسموها ال
+
+309
+00:20:26,770 --> 00:20:30,270
+calluses ايش ال calluses بنسمع بعض الناس اللي كان
+
+310
+00:20:30,270 --> 00:20:33,950
+بيقولك هذا صار عنده ايش من كتر ال calcium
+
+311
+00:20:33,950 --> 00:20:37,800
+deposition يعني الترثبات الكالسيومعملت حاجة
+
+312
+00:20:37,800 --> 00:20:41,960
+بيسموها كلص بيسموها .. يعني انا المصطلح مرات مش كل
+
+313
+00:20:41,960 --> 00:20:46,600
+الناس متفقين عليه زي الاشي الأبيض اللي بيكون على
+
+314
+00:20:46,600 --> 00:20:49,700
+الإطفار أو مرات زيادة .. يعني احنا بنقول عنه تكلس
+
+315
+00:20:49,700 --> 00:20:53,460
+بما معناه عشان اتسميها كلص زي التكلث تاع الإطفار
+
+316
+00:20:53,460 --> 00:20:58,380
+من شدة تجمع يعني زي الكالسيوم الأبيض عليه هذا
+
+317
+00:20:58,380 --> 00:21:01,650
+بيكون موجود وين؟ممكن يكون موجود ده common الموجود
+
+318
+00:21:01,650 --> 00:21:05,130
+هنا في ال toes يعني في الأصابع الأدافر و مرات
+
+319
+00:21:05,130 --> 00:21:08,190
+بيكون في أصابع إيش الإيدة بس ماحدش يقول يا أستاذ
+
+320
+00:21:08,190 --> 00:21:13,290
+أنه هذا normal finding no إذا كان موجود و بكثرة
+
+321
+00:21:13,290 --> 00:21:16,810
+الصح يعمل الإنسان في حسابه خاصة مش غلط يشوف ال
+
+322
+00:21:16,810 --> 00:21:20,510
+vitamin D و يشوف ال calcium level علشان نعرف إنه
+
+323
+00:21:20,510 --> 00:21:26,150
+هل في hypokalemia or not some abnormalities of the
+
+324
+00:21:26,150 --> 00:21:30,160
+A of the nails الآنإيش ال abnormalities of the
+
+325
+00:21:30,160 --> 00:21:36,040
+nail؟ الآن بعض الحالات بطلع نحكي المصطلحات هم
+
+326
+00:21:36,040 --> 00:21:39,280
+أكملوا المصطلح و للأسف كتير من .. او الله يمكن
+
+327
+00:21:39,280 --> 00:21:41,700
+الطب و حتى كتير منهم مابيعرفوا هذه المصطلحات و
+
+328
+00:21:41,700 --> 00:21:44,300
+مابيقدروا يفرقوا بينهم ايه كويس احنا نكون عارفينهم
+
+329
+00:21:44,300 --> 00:21:46,760
+و فاهمينهم ماحد يجي يقولي يا أستاذ والله صعب هذا
+
+330
+00:21:46,760 --> 00:21:49,840
+أنا مش موضوع صعب هذا ممكن احنا يوليه شغلات بسيطة
+
+331
+00:21:49,840 --> 00:21:53,380
+بنجيبها في أسئلة موضوعية مش حاجة أقولك أذكرهم و
+
+332
+00:21:53,380 --> 00:21:56,060
+أعددهم و أحفظهم كلهم لأ بس في الأسئلة الموضوعية
+
+333
+00:21:56,060 --> 00:21:59,300
+match مثلا true or false حاجةأكملوا عضة ايه؟ تلاتة
+
+334
+00:21:59,300 --> 00:22:04,220
+اربع خمسة ستة سبعة تمانية ايش يعني؟ اول واحد اسمه
+
+335
+00:22:04,220 --> 00:22:06,520
+Paronychia او بارونيشيا في بعض الناس بالفضول
+
+336
+00:22:06,520 --> 00:22:10,260
+بارونيشيا شو ال Paronychia؟ يعني inflammation
+
+337
+00:22:10,260 --> 00:22:13,280
+surrounding of the nail لو طلعنا في الإدفار و
+
+338
+00:22:13,280 --> 00:22:15,900
+لجيناه حوالين الإدفار حوالين الإدفار surrounding
+
+339
+00:22:15,900 --> 00:22:19,860
+أي infection حوالين الإدفار او اي inflammation ايش
+
+340
+00:22:19,860 --> 00:22:24,820
+بنسميها؟ Paronychia طيب في بعض الناس نادرين لكن
+
+341
+00:22:24,820 --> 00:22:29,460
+موجودينكل مستوى بيجي .. يمكن من زمان و أنا بشرح في
+
+342
+00:22:29,460 --> 00:22:32,840
+هذا مساق، بلاقي في كل مستوى يا بطلع واحد او اتنين
+
+343
+00:22:32,840 --> 00:22:35,740
+و مرة اتلاتة، بكون عندهم complete absence يعني
+
+344
+00:22:35,740 --> 00:22:39,640
+مولود ماعنده أضافر، complete absence of nail، ماحد
+
+345
+00:22:39,640 --> 00:22:43,230
+يسألني الله سبحانه وتعالىهذا خلقي لأ، هو بتلاقي
+
+346
+00:22:43,230 --> 00:22:47,530
+منطقة الأضافر صار إيش؟ صار الجلد شوية جمد وصار
+
+347
+00:22:47,530 --> 00:22:51,350
+يعني زي نوع من التكلس صار فيه عشان يقدر الإنسان
+
+348
+00:22:51,350 --> 00:22:56,730
+إيش؟ يعني صار يعني اتكلس شوية عشان يقدر يتأقلم
+
+349
+00:22:56,730 --> 00:23:01,490
+بعوامل التغيير فيه و التعامل مع ال weather يعني
+
+350
+00:23:01,490 --> 00:23:04,750
+المجتمع بشكل .. البيئة بشكل عام، عليش؟ لإن مافيش
+
+351
+00:23:04,750 --> 00:23:07,650
+أدفر يحمي، فالله سبحانه وتعالى بيخلي الجلد هنا
+
+352
+00:23:07,650 --> 00:23:13,360
+يكون ماكن في هذا المكان شويةطيب فى حاجة اسمها هنا
+
+353
+00:23:13,360 --> 00:23:18,320
+Platonicia .. Platonicia وقولنا لكوا فى بعض الناس
+
+354
+00:23:18,320 --> 00:23:22,500
+يعني برفضها كي Platonicia مهم يعنىPlatonicia
+
+355
+00:23:22,500 --> 00:23:26,400
+flattening of the nail اسمه الإطفار المسطح لو
+
+356
+00:23:26,400 --> 00:23:29,980
+اطلعنا في الإطفار كله هيك مسطح و قدامنا يعني كام
+
+357
+00:23:29,980 --> 00:23:33,780
+مسطح مش معمول convex زي ما احنا قلنا لأ ولا قلنا
+
+358
+00:23:33,780 --> 00:23:37,200
+مقعر يعني اللي هو محطب ولا مقعر وانا مماشي زي ايش
+
+359
+00:23:37,200 --> 00:23:40,600
+زي كأنه .. زي اللوح الاجزال زيك مباشرة هذا اسمه
+
+360
+00:23:40,600 --> 00:23:45,920
+Platonicia طيب الآن .. الآن في حاجة اسمها اللي
+
+361
+00:23:45,920 --> 00:23:49,620
+بعدها كليلونيشيا إيش أنا كليلونيشيا؟اللي هو
+
+362
+00:23:49,620 --> 00:23:53,580
+كليلونيشيا .. كليلونيشيا بكون ال nails زي ال spoon
+
+363
+00:23:53,580 --> 00:23:57,100
+-like ايش يعني زي ال spoon-like؟ spoon-like يعني
+
+364
+00:23:57,100 --> 00:24:00,340
+بشبه .. بشبه الملعقة زي الملعقة الشاشة الصغيرة
+
+365
+00:24:00,340 --> 00:24:05,740
+بتلاقي زي عامل زي مقعر هيك و خاصة في بعض الحالات
+
+366
+00:24:05,740 --> 00:24:10,580
+النادرة اللي علاقة بصراحة بأمراض القلب بأمراض
+
+367
+00:24:10,580 --> 00:24:14,240
+القلب أو بأمراض الرئتين بأمراض القلب أو بأمراض
+
+368
+00:24:14,240 --> 00:24:18,760
+الرئتينهذا اللي انا بتقوله عنه الكليلونيشيا هذا
+
+369
+00:24:18,760 --> 00:24:21,840
+بيصير إيش؟ بتطلع في إطفاره بنلاقي الإطفار ..
+
+370
+00:24:21,840 --> 00:24:25,460
+الإطفار عامل زي الإيش؟ زي الملعقة الصغيرة تبعت إيش
+
+371
+00:24:25,460 --> 00:24:29,640
+المطبخ اللي قدامنا طيب في عسمة كليلونيشيا
+
+372
+00:24:29,640 --> 00:24:33,580
+الكليلونيشيا قلناها sorry في عسمة racket nail
+
+373
+00:24:33,580 --> 00:24:38,460
+racket nail racket racket أكيد كلكوا عارفينه لما
+
+374
+00:24:38,460 --> 00:24:40,940
+أقول racket ال racket ال racket اللي بنستخدمه ..
+
+375
+00:24:40,940 --> 00:24:44,040
+اللي بنلعب فيه بنلعب فيه ال tennis بنلعب فيه مثلا
+
+376
+00:24:44,040 --> 00:24:48,340
+الطب هذيانتوا متخيلين كيف ال racket معايا؟ إله إيد
+
+377
+00:24:48,340 --> 00:24:52,860
+مصبوط مقبض و من قدام كيف شكله؟ أه إله من ورا مقبض
+
+378
+00:24:52,860 --> 00:24:57,660
+و من قدام زي مدور هيك يعني إيه و عليها ممكن يكون
+
+379
+00:24:57,660 --> 00:25:00,640
+جلدة أو لا المهم يكون من ورا .. من ورا إيه زي
+
+380
+00:25:00,640 --> 00:25:04,900
+العصاير و من قدام إيه دائرة إذا شوفنا الإدفار بهذا
+
+381
+00:25:04,900 --> 00:25:09,760
+الشكل اسمه racket nail و الإدفار يشبه ال racket
+
+382
+00:25:09,760 --> 00:25:14,430
+اللي هو flatمتسطح و expand ممتد اذا لا قدر الله
+
+383
+00:25:14,430 --> 00:25:18,510
+لكنها خاصة عند ال male بكون عندهم ايش هنا
+
+384
+00:25:18,510 --> 00:25:23,430
+secondary syphilis مرض اسمه ايش هنا اللي هو سموه
+
+385
+00:25:23,430 --> 00:25:30,490
+الزهري يعني مرض من الأمراض الجنسية يعني حتى بيسموه
+
+386
+00:25:30,490 --> 00:25:33,950
+بالعرب مرض ال syphilis يعني بغض النظر احنا بس لا
+
+387
+00:25:33,950 --> 00:25:37,210
+قدر الله وشفناه مش شرط نحكم و نقول انه عنده كذا بس
+
+388
+00:25:37,210 --> 00:25:41,520
+على القل نبلغ نقول انه هذا ليش ادفعوا زي هيك طيبفي
+
+389
+00:25:41,520 --> 00:25:45,280
+حياتي اسمها Onycholysis، إيش اسمها؟ Onycholysis،
+
+390
+00:25:45,280 --> 00:25:49,160
+من اسمها Lycis، Lycis يعني الحلال، إيش صار في
+
+391
+00:25:49,160 --> 00:25:53,100
+النيل بدل ما يكون ملزق في الجلد ارتفع عن وين؟ عن
+
+392
+00:25:53,100 --> 00:25:56,340
+الجلد، راح عن ال nail pit، يعني في بعض الحالات
+
+393
+00:25:56,340 --> 00:25:59,940
+النادرة جدا، بتلاقي الإطفار بدل ما يظل ماشي فوق
+
+394
+00:25:59,940 --> 00:26:03,800
+الجلد وبيطلع، مجرد ما يبدأ ينمو، بتلاقي يطلع لفوق
+
+395
+00:26:04,230 --> 00:26:07,710
+بتلاقي الإطفر تبعه دايما يعني بيصعد إلى الأعلى و
+
+396
+00:26:07,710 --> 00:26:13,090
+بيصير تحته .. بيصير تحته لأكتر من يعني .. يعني
+
+397
+00:26:13,090 --> 00:26:17,130
+وجود .. يعني مش بس وجود اللحم أو وجود .. لأ بيصير
+
+398
+00:26:17,130 --> 00:26:19,710
+الإطفر كأنه .. يعني بالظبط بالظبط زي .. كأنه إشي
+
+399
+00:26:19,710 --> 00:26:24,630
+بنزلع أو بنفصل عن المكان الطبيعي تبعه، إذا فصل
+
+400
+00:26:24,630 --> 00:26:27,790
+الإطفر عن المكان الطبيعي تبعه و طلع لفوق، هذا إشي
+
+401
+00:26:27,790 --> 00:26:34,580
+بنسميه كمان مرة اسمه .. اسمه Lycis و Nicolysisليكو
+
+402
+00:26:34,580 --> 00:26:37,640
+ذكروا كلمة ليكوسايد اللي هو زي الأبيض ليكو معناته
+
+403
+00:26:37,640 --> 00:26:42,140
+أبيض ليكنيشيا أو ليكنيكيا إيش يعني ليكنيشيا white
+
+404
+00:26:42,140 --> 00:26:45,040
+nail إيش يعني white nail بيسموا الإذفر الأبيض
+
+405
+00:26:45,040 --> 00:26:48,320
+بتلاقي تطلع entire plate إيش entire plate يعني كل
+
+406
+00:26:48,320 --> 00:26:53,060
+الإذفر لونه أبيض أبيض بنطلع اتحول لون الإذفر للون
+
+407
+00:26:53,060 --> 00:26:56,300
+أبيض كامل هو كأنه زي ال sheet أو كأنه زي اللون
+
+408
+00:26:56,300 --> 00:27:01,140
+الأبيض المدهون هذا اسمه ليكنيشيا فهذا برضه علامة
+
+409
+00:27:01,140 --> 00:27:04,800
+لازم نبلغ فيها الطبيب لو كانت موجودةفي حاجة اسمها
+
+410
+00:27:04,800 --> 00:27:08,560
+ال milanonesia milano جاب كلمة milanine معناته
+
+411
+00:27:08,560 --> 00:27:12,540
+فيها صبغة هذا فيها لون أبيض هذا milanine فيه لون
+
+412
+00:27:12,540 --> 00:27:16,940
+أسود يعني أو مقل أسود لون ال brown البني إذا لجينا
+
+413
+00:27:16,940 --> 00:27:20,080
+لون الإطفار لون بني مايجي واحد يقول لي لأنه ماكل
+
+414
+00:27:20,080 --> 00:27:23,980
+هواي لأ أنا بتكلم على النقل اللي هو plate كل
+
+415
+00:27:23,980 --> 00:27:27,780
+الإطفار و البني آدم هذا مش ماكل هواية بتطلع في
+
+416
+00:27:27,780 --> 00:27:33,230
+الإطفار لجيته لون الإطفارلونه بني كتير قاتم هذا
+
+417
+00:27:33,230 --> 00:27:37,150
+اللون البني بدون ما يكون عنده اي trauma او اي
+
+418
+00:27:37,150 --> 00:27:39,610
+injury ايش بقول عنه melanomacia ايش يعني
+
+419
+00:27:39,610 --> 00:27:44,510
+melanomacia يعني زيادة صبغة التلون في الأطفال طبعا
+
+420
+00:27:44,510 --> 00:27:50,470
+قدش الوقت الان مش خلاني اكتف الان لعند هذه الشريحة
+
+421
+00:27:50,470 --> 00:27:53,350
+عشان ان شاء الله نبدأ شرف المحاضرة القادمة في ال
+
+422
+00:27:53,350 --> 00:27:56,330
+chapter الجديد واتمنى من الله سبحانه وتعالىإنه
+
+423
+00:27:56,330 --> 00:27:59,510
+تكون يعني استفدت و استوعبت و اللي مابستوعبش يحاول
+
+424
+00:27:59,510 --> 00:28:02,810
+يعيد المحاضرة أكتر من مرة عشان يعني يلسق الأمر في
+
+425
+00:28:02,810 --> 00:28:05,570
+ذهنه ان شاء الله والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko.srt
new file mode 100644
index 0000000000000000000000000000000000000000..68d014bcec8cc88c9b86123612dac41fa38f625a
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko.srt
@@ -0,0 +1,1482 @@
+1
+00:00:00,540 --> 00:00:03,240
+أعوذ بالله، بسم الله الرحمن الرحيم، الصلاة والسلام
+
+2
+00:00:03,240 --> 00:00:06,440
+على أشرف المرسلين سيدنا محمد وعلى آله وصحبه
+
+3
+00:00:06,440 --> 00:00:11,900
+السلام عليكم، خلينا نكمل اليوم في المحاضرة، الشق الثاني في
+
+4
+00:00:11,900 --> 00:00:14,860
+الـ nutritional assessment اللي احنا اتوقفنا طبعًا
+
+5
+00:00:14,860 --> 00:00:20,940
+في المحاضرة السابقة عند تقريبًا، قبل هذه الشريحة
+
+6
+00:00:20,940 --> 00:00:25,440
+تقريبًا بالظبط، اليوم بدنا نكمل طبعًا signs and
+
+7
+00:00:25,440 --> 00:00:29,760
+symptoms of malnutrition، شو الأعراض؟ يعني خلينا
+
+8
+00:00:29,760 --> 00:00:33,040
+نقول الأعراض اللي هي ناتجة عن سوء التغذية
+
+9
+00:00:33,040 --> 00:00:37,320
+dry and thin hair، أكيد طبعًا يعني اللي هو جفاف
+
+10
+00:00:37,320 --> 00:00:40,580
+وتقصّف في الشعر، بيصير كثير، yellowish lump around
+
+11
+00:00:40,580 --> 00:00:44,460
+the eye، بنلاقي بعض الناس اللي عندهم malnutrition عندهم
+
+12
+00:00:44,460 --> 00:00:49,880
+زي lump بسيطة، زي تكتلات صفراء موجودة حوالي العين
+
+13
+00:00:49,880 --> 00:00:54,160
+وخاصة تحت العين، white ring around both
+
+14
+00:00:54,160 --> 00:00:58,550
+eyes، بتلاقي زي حوالي العين، زي هالة، زي هالبيضاء
+
+15
+00:00:58,550 --> 00:01:02,870
+زي دائرة بيضاء، طبعًا هنا بيكون في معها
+
+16
+00:01:02,870 --> 00:01:06,250
+الـ conjunctiva اللي هي الـ conjunctiva  الشاحبة
+
+17
+00:01:06,250 --> 00:01:09,570
+هذا يدل على أن الـ hemoglobin أقل من الطبيعي
+
+18
+00:01:09,570 --> 00:01:13,630
+وهذا رايح على أنيميا، لأنه
+
+19
+00:01:13,630 --> 00:01:17,570
+أكيد مع سوء التغذية بتصير أنيميا، طيب الآن
+
+20
+00:01:17,570 --> 00:01:21,010
+بقول نقطة ثانية، aridness and swelling of the lips
+
+21
+00:01:21,010 --> 00:01:25,250
+especially corners of the mouth، بنلاقي مرات بيصير
+
+22
+00:01:25,250 --> 00:01:29,530
+فيه انتفاخ في شفاه الإنسان، عنده سوء تغذية
+
+23
+00:01:29,530 --> 00:01:33,130
+ومش بس هيك، خاصة في الـ corners، يعني اللي
+
+24
+00:01:33,130 --> 00:01:37,750
+هو في الجانبين تبع الـ mouth، وعلى فكرة لما يصير
+
+25
+00:01:37,750 --> 00:01:41,150
+تشققات في جانب الـ mouth هنا وجانب الـ mouth هنا
+
+26
+00:01:41,150 --> 00:01:44,950
+اسمه، بيسموه cheilosis، يعني لو حد سمع هذا المصطلح
+
+27
+00:01:44,950 --> 00:01:49,210
+اسمه cheilosis، اللي هو abnormal corners of the
+
+28
+00:01:49,210 --> 00:01:53,300
+mouth and erosions، يعني عامل زي التشققات، طيب
+
+29
+00:01:53,300 --> 00:01:56,940
+teeth caries، بيصير طبعًا أكيد، يعني تسوّس أسنان
+
+30
+00:01:56,940 --> 00:02:01,460
+abnormal missing of teeth، مرات بيفقد الإنسان أسنانه
+
+31
+00:02:01,460 --> 00:02:04,900
+بيقول: ماعندي مشكلة، مش عارف من إيش صار عندي فقد
+
+32
+00:02:04,900 --> 00:02:08,220
+أسنان، بيكون الأساس والمرجع هو سوء التغذية
+
+33
+00:02:08,220 --> 00:02:13,780
+طيب، a dryness of the skin، جفاف الجلد، وهذا بنسميه
+
+34
+00:02:13,780 --> 00:02:18,180
+xerosis، إيش بنسميه؟ xerosis، بيسموه sandpaper fields
+
+35
+00:02:18,180 --> 00:02:22,320
+يعني إيش sandpaper؟ زي ورقة الصنفرة، sandpaper زي
+
+36
+00:02:22,320 --> 00:02:25,560
+ورقة البرد، زي بتعرفوها اللي بنعمل فيها مرات
+
+37
+00:02:25,560 --> 00:02:29,720
+الحديد أو الخشب، يعني يصبح الجلد من شدة خشونة
+
+38
+00:02:29,720 --> 00:02:35,420
+كأن ورقة برد، spoon shaped nails، بيسموها هنا يعني
+
+39
+00:02:35,420 --> 00:02:39,900
+زي ما بتشوفوا، koilonychia، إيش koilonychia؟ بقول هنا
+
+40
+00:02:39,900 --> 00:02:44,620
+بيصير spoon shaped nails، يعني الظفر بيصبح زي
+
+41
+00:02:44,620 --> 00:02:49,400
+الملعقة، زي الملعقة الصغيرة، هيك مدوّر ومقعّر شوية
+
+42
+00:02:51,140 --> 00:02:54,380
+Tachycardia، أكيد عارفين إيش معناه، elevated blood
+
+43
+00:02:54,380 --> 00:02:58,060
+pressure due to excessive sodium intake، هذا
+
+44
+00:02:58,060 --> 00:03:01,260
+بتدللنا أنه مش دائمًا سوء التغذية معناه نقص
+
+45
+00:03:01,260 --> 00:03:03,800
+هيقولوا لأ، من سوء التغذية اللي بيأكل
+
+46
+00:03:03,800 --> 00:03:08,560
+أملاح كثيرة، بيصير عنده elevated blood pressure، صحيح
+
+47
+00:03:08,560 --> 00:03:11,860
+وبيزيد عنده excessive cholesterol، صحيح، إذا كان في
+
+48
+00:03:11,860 --> 00:03:16,320
+عنده bad nutrient style، خليني أقول يعني، أو
+
+49
+00:03:16,320 --> 00:03:19,380
+nourishment style، يعني بتلاقي بتغذّي بشغلات فيها دسم
+
+50
+00:03:19,380 --> 00:03:23,180
+كثيرة، أو فيها high calorie diet
+
+51
+00:03:23,180 --> 00:03:26,560
+muscle weakness and growth retardation، طبعًا
+
+52
+00:03:26,560 --> 00:03:29,680
+أكيد ضعف عضلات، وأكيد في نفس الوقت إيش بيصير؟
+
+53
+00:03:29,680 --> 00:03:34,900
+كمان بيصير فيه ضعف في معدل النمو عند الإنسان
+
+54
+00:03:34,900 --> 00:03:39,140
+اللي عنده سوء التغذية، طيب dietary analysis،
+
+55
+00:03:39,140 --> 00:03:44,140
+بقول ودائمًا تذكر وأنت بتحلل الأكل والطعام
+
+56
+00:03:44,140 --> 00:03:47,840
+للمريض، بدك تفهم أن الـ food represent cultural and
+
+57
+00:03:47,840 --> 00:03:55,360
+ethnic background، يعني دائمًا الطعام بيمثل شيء ثقافي، إثني، يعني
+
+58
+00:03:55,360 --> 00:03:59,840
+خلفية عرقية، and socio economic
+
+59
+00:03:59,840 --> 00:04:03,700
+status and have many emotional and psychological
+
+60
+00:04:03,700 --> 00:04:07,260
+meaning، يعني كأنه بقول لي: تذكر، خليك ذاكر، أن الطعام
+
+61
+00:04:07,260 --> 00:04:13,300
+له طقوس خاصة، وله مردود ثقافي، وله خلفية عرقية
+
+62
+00:04:13,300 --> 00:04:17,050
+ربما، زي ما احنا حكينا، في بعض العائلات بترفض أشياء
+
+63
+00:04:17,050 --> 00:04:20,830
+عن أشياء، أو بعض الأقوام ما بتأكلش أشياء، على حسب
+
+64
+00:04:20,830 --> 00:04:24,830
+أشياء أخرى، يعني هو من باب أنه بيتذكر، assessment
+
+65
+00:04:24,830 --> 00:04:27,650
+includes usual foods، واحنا بنسأل المريض، ماننساش
+
+66
+00:04:27,650 --> 00:04:30,670
+بنسأله: إيش الـ usual foods عندك؟ الـ consumed، اللي
+
+67
+00:04:30,670 --> 00:04:34,270
+بتستهلكه، الـ habits of food، كيف عادتك في الأكل؟ كأنه
+
+68
+00:04:34,270 --> 00:04:36,710
+الإشي بيعيد نفسه، نفس اللي حكيناه في المحاضرة
+
+69
+00:04:36,710 --> 00:04:39,750
+السابقة، بعدين بيقول: ask the client to recall
+
+70
+00:04:39,750 --> 00:04:44,190
+everything consumed within each
+
+71
+00:04:44,190 --> 00:04:48,840
+within the past 24 hours، يعني لما نسأل المريض إيش
+
+72
+00:04:48,840 --> 00:04:52,220
+أكلت؟ وإحنا بنعمل dietary analysis لازم نسأل كل
+
+73
+00:04:52,220 --> 00:04:56,800
+شيء، إنت إيش أكلت؟ أي شيء، لدرجة أنه بيقول: مش بس all
+
+74
+00:04:56,800 --> 00:04:59,900
+foods، حتى الـ fluids، هذا شيء، بيسأل حتى الـ vitamins
+
+75
+00:04:59,900 --> 00:05:03,500
+حتى الـ minerals or other supplements، لو قاعد واحد
+
+76
+00:05:03,500 --> 00:05:07,280
+سألني: طب ليش يا أستاذ الـ vitamins؟ هي إيش بتعمل؟ لأ،
+
+77
+00:05:07,280 --> 00:05:11,100
+في بعض الـ vitamins مكملات يعني، بتعملنا شغلات ممكن
+
+78
+00:05:11,100 --> 00:05:13,900
+تزيد في بعض الـ minerals، بعض الـ supplements يعني
+
+79
+00:05:13,900 --> 00:05:16,760
+يكون بياخذ omega أو بياخذ شغلات زي هيك، هذه ممكن
+
+80
+00:05:16,760 --> 00:05:20,580
+تأثر على عملية الـ metabolism في داخل جسم الإنسان
+
+81
+00:05:20,580 --> 00:05:24,280
+يعني ممكن تقلل من الـ product، فبالتالي لازم نسأل
+
+82
+00:05:24,280 --> 00:05:27,380
+عن كل شيء، إيه علاقته بـ، إيه علاقته بالتغذية
+
+83
+00:05:27,380 --> 00:05:32,300
+don't bias، خلينا نذاكر هذا الكلام، don't bias the
+
+84
+00:05:32,300 --> 00:05:37,100
+client response، دائمًا ما توجّه استجابة المريض، يعني
+
+85
+00:05:37,100 --> 00:05:39,360
+السؤال ما يكونش عندك leading question
+
+86
+00:05:39,360 --> 00:05:43,050
+السؤال يكون leading question
+
+87
+00:05:43,050 --> 00:05:47,790
+خاصة من وجهة نظر الـ interviewer، مرات إنت بيكون
+
+88
+00:05:47,790 --> 00:05:50,890
+عندك personal habits أو knowledge، يعني ممكن
+
+89
+00:05:50,890 --> 00:05:54,210
+إنت مثلًا بدك تسأل عن اللحمة، أو بدك تسأل عن أكل
+
+90
+00:05:54,210 --> 00:05:57,850
+معيّن، إنت بتحب اللحمة، ما تقوله: أكيد إنت بتحب اللحمة
+
+91
+00:05:57,850 --> 00:06:02,590
+لأ، أنا biased، لأن إنت كأنك بتخليه يجاوب زي إجابتك
+
+92
+00:06:02,590 --> 00:06:06,870
+لأ، إحنا بنسأله بتجرد وبعيدًا عن رأينا الشخصي
+
+93
+00:06:06,870 --> 00:06:12,160
+بالمطلق، طيب diseases affected by nutritional
+
+94
+00:06:12,160 --> 00:06:18,380
+problems، ما هي الأمراض اللي ممكن تتأثر أو تزيد من
+
+95
+00:06:18,380 --> 00:06:22,680
+المشاكل اللي ناتجة عن سوء التغذية، أنا ما بقولش أن هو
+
+96
+00:06:22,680 --> 00:06:27,820
+يعني سوء التغذية اللي عمل هيك، لكن بيلعب دورًا رئيسيًا في
+
+97
+00:06:27,820 --> 00:06:32,160
+حدوث هذه، طبعًا أنا ذكرت سبعة لكن هو كثير أكثر من
+
+98
+00:06:32,160 --> 00:06:35,960
+ذلك، وأنا كاتب القائمة، تريدوا تتطلعوا في الكتاب في
+
+99
+00:06:35,960 --> 00:06:39,270
+page 15، أو حسب الكتاب اللي موجود معكم، أو حتى ممكن
+
+100
+00:06:39,270 --> 00:06:42,170
+إنت تشوف على الإنترنت كثير من الأمراض، أول مرض
+
+101
+00:06:42,170 --> 00:06:45,550
+الـ obesity، طبعًا بيعتبروه disease، لأنه الكثير من
+
+102
+00:06:45,550 --> 00:06:48,510
+الناس ما بيقدروا ينزلوا عن الوزن اللي هو بيقصر عنهم
+
+103
+00:06:48,510 --> 00:06:52,010
+زيادة excessive of body fat، طبعًا أكيد الـ diabetes
+
+104
+00:06:52,010 --> 00:06:54,690
+من الـ leading، ما بقولش أنه سبب، لكن من الـ predisposing factors
+
+105
+00:06:54,690 --> 00:06:56,970
+ومن الـ high predisposing factors
+
+106
+00:06:56,970 --> 00:07:01,050
+هو للأسف الـ high calorie، الـ high sugar diet وهكذا
+
+107
+00:07:01,050 --> 00:07:05,410
+hypertension، أكيد الضغط بيرتفع مع الأملاح
+
+108
+00:07:05,410 --> 00:07:09,540
+coronary heart disease، أكيد مع الدهون، وخاصة يعني
+
+109
+00:07:09,540 --> 00:07:12,820
+الدهون اللي هي السيئة واللي ممكن تعمل كثير جلطات
+
+110
+00:07:12,820 --> 00:07:17,640
+several cancers، اللي هو السرطان، على اعتبار أن بعض
+
+111
+00:07:17,640 --> 00:07:22,640
+العلماء أظهروا أن الـ cancer cells يعني بتتغذّى على
+
+112
+00:07:22,640 --> 00:07:27,840
+السكر بشكل كبير، endocrine diseases، أمراض بتصيب غدد
+
+113
+00:07:27,840 --> 00:07:30,740
+الصم، على فكرة من ضمنها diabetes، ومن ضمن أمراض ثانية
+
+114
+00:07:30,740 --> 00:07:33,500
+زي الـ hyperthyroidism أو الـ hypothyroidism، وهو
+
+115
+00:07:33,500 --> 00:07:37,900
+كذا، وكثير، others، يعني في أمراض كثيرة بتتأثر من
+
+116
+00:07:37,900 --> 00:07:43,200
+سوء التغذية والـ problems اللي ممكن المريض يعاني
+
+117
+00:07:43,200 --> 00:07:47,180
+منها بشكل عام، assessment of sleep and wakefulness
+
+118
+00:07:47,180 --> 00:07:52,520
+patterns، تقييم النوم واليقظة عند المريض، طبعًا في
+
+119
+00:07:52,520 --> 00:07:56,700
+البداية بدنا نفهم أن الـ normal human إيش يعني
+
+120
+00:07:56,700 --> 00:07:59,980
+الشخص الطبيعي، الإنسان الطبيعي، عنده حالة اسمها
+
+121
+00:07:59,980 --> 00:08:03,310
+homeostasis، لما أقول كلمة homeostasis بسمّيها
+
+122
+00:08:03,310 --> 00:08:06,450
+homeostatic، homeostasis يعني التوازن، إيش
+
+123
+00:08:06,450 --> 00:08:10,310
+التوازن؟ الإنسان الطبيعي عنده توازن بين اليقظة وبين
+
+124
+00:08:10,310 --> 00:08:13,110
+النوم، يعني ability to maintain
+
+125
+00:08:13,110 --> 00:08:17,950
+relative internal consistency
+
+126
+00:08:17,950 --> 00:08:21,570
+أو consistency، إيش أنا consistency؟ الثبات، سبحان
+
+127
+00:08:21,570 --> 00:08:24,970
+الله، الله سبحانه وتعالى حط في كل جسم إنسان حالة
+
+128
+00:08:24,970 --> 00:08:28,570
+من التوازن، يستطيع الإنسان يحافظ عليها ما بين النوم
+
+129
+00:08:28,570 --> 00:08:32,140
+واليقظة والراحة والعمل، Any person
+
+130
+00:08:32,140 --> 00:08:35,380
+complaining of sleep patterns، أي إنسان، بعالم، أي
+
+131
+00:08:35,380 --> 00:08:40,320
+إنسان بعاني من مشاكل في النوم، يعني أي اضطراب يعتبر
+
+132
+00:08:40,320 --> 00:08:43,500
+primary problem أو secondary problem due to، إيش
+
+133
+00:08:43,500 --> 00:08:47,480
+هنا؟ لما أقول primary، primary problem، إيش يعني؟
+
+134
+00:08:47,480 --> 00:08:50,980
+يعني مشكلة النوم هي أصلاً من النوم، لما أقول
+
+135
+00:08:50,980 --> 00:08:55,340
+secondary problem، يعني ناتجة لسبب آخر، أعطيكم مثال
+
+136
+00:08:55,340 --> 00:08:59,040
+صغير جدًا، زي إيش؟ بيجي واحد بيقول: أنا عندي أرق في
+
+137
+00:08:59,040 --> 00:09:01,960
+النوم، بيقول: طب ليش؟ بيقول: والله ما بعرف، أنا هيك جيت
+
+138
+00:09:01,960 --> 00:09:05,260
+أنام، ما عرفتش أنام، دائمًا بتصير معي؟ لأ، مرات بسيطة
+
+139
+00:09:05,260 --> 00:09:08,540
+هذا بيقول primary problem، يعني المشكلة اللي عندك
+
+140
+00:09:08,540 --> 00:09:11,740
+مشكلة بس في النوم، بيجي واحد ثاني بيقول: أنا مش
+
+141
+00:09:11,740 --> 00:09:15,340
+عارف أنام، بيقول: ليش؟ بيقول: عندي وجع شديد جدًا في
+
+142
+00:09:15,340 --> 00:09:19,140
+رجلي، مش مخليني أعرف أنام، أو الثاني بيقول: عندي
+
+143
+00:09:19,140 --> 00:09:22,340
+صداع، أو الثالث بيقول: عندي anxiety، هذا بنسميه
+
+144
+00:09:22,340 --> 00:09:25,260
+secondary، يعني السبب له سبب ثاني، زي موضوع
+
+145
+00:09:25,730 --> 00:09:28,470
+الـ Primary Hypertension والـ Secondary Hypertension
+
+146
+00:09:28,470 --> 00:09:32,230
+الـ Primary الضغط، مش معروف إيش سببه، والـ Secondary
+
+147
+00:09:32,230 --> 00:09:35,770
+بكون الضغط له سبب آخر في جسم الإنسان، لحظة اللي
+
+148
+00:09:35,770 --> 00:09:39,570
+محطوط بالخط الأحمر ده شيء مهم وخطير، أنه يقول ربع
+
+149
+00:09:39,570 --> 00:09:42,430
+ربع المرضى، ربع المرضى، one fourth of the
+
+150
+00:09:42,430 --> 00:09:45,650
+clients اللي هم اللي بيروحوا على المستشفيات، who seek
+
+151
+00:09:45,650 --> 00:09:48,470
+healthcare، complaining of difficulty related to
+
+152
+00:09:48,470 --> 00:09:51,950
+sleep، ربع المرضى اللي بيتجهوا للمستشفيات في العالم
+
+153
+00:09:51,950 --> 00:09:56,300
+يعني بتتكلم على 25% من المرضى في العالم، عدد مش قليل
+
+154
+00:09:56,300 --> 00:10:00,180
+بيعاني من اضطرابات في النوم، وعلى فكرة حتى الناس
+
+155
+00:10:00,180 --> 00:10:04,740
+الطبيعيين اليوم صارت نسبة كبيرة منهم بتعاني من اضطرابات
+
+156
+00:10:04,740 --> 00:10:08,540
+النوم، حسب الوضع اللي احنا بنعاني منه، وحسب الأوضاع
+
+157
+00:10:08,540 --> 00:10:12,080
+سواء اقتصادية أو اجتماعية أو نفسية أو حتى روحية
+
+158
+00:10:12,080 --> 00:10:16,520
+طيب factors affecting length and quality of sleep
+
+159
+00:10:16,520 --> 00:10:22,000
+ما هي العوامل اللي بتأثر على جودة النوم وطول النوم؟
+
+160
+00:10:22,000 --> 00:10:26,010
+طبعًا طول النوم مش دائمًا مرتبط بالجودة، ليش رابطهم مع
+
+161
+00:10:26,010 --> 00:10:29,910
+بعض؟ مش كل نوم طويل معناه فيه جودة، مرات
+
+162
+00:10:29,910 --> 00:10:35,330
+بيكون النوم في الحدود الطبيعية، بنقول
+
+163
+00:10:35,330 --> 00:10:39,110
+عنه quality، وسليم، ومرات بتكون أكثر وما بتكونش فيها
+
+164
+00:10:39,110 --> 00:10:44,370
+quality، خلينا نشوف، أول حاجة anxiety، القلق، طبعًا
+
+165
+00:10:44,370 --> 00:10:48,010
+القلق دغري، إيش مرتبط هنا؟ مرتبط كثير بقلة النوم وبـ
+
+166
+00:10:48,010 --> 00:10:50,850
+اضطراب النوم، بيقول related to the need to meet
+
+167
+00:10:50,850 --> 00:10:56,040
+مثلًا a task such as waking at an early hour for
+
+168
+00:10:56,040 --> 00:11:00,540
+work، إحنا أكثر ناس بكرة رح نروح لما نتدرب، رح نصل
+
+169
+00:11:00,540 --> 00:11:04,400
+لمرحلة شوية anxiety، بتأثر عليهم ليه؟ لأنه مرتبط
+
+170
+00:11:04,400 --> 00:11:08,660
+حياتنا بالعمل، فهو بيقول دائمًا أهل التمريض وأهل
+
+171
+00:11:08,660 --> 00:11:13,080
+الطب، وحتى اللي بيشتغلوا في الشرطة أو في الأعمال
+
+172
+00:11:13,080 --> 00:11:16,400
+الأمنية أو الدفاع المدني، في منهم anxiety
+
+173
+00:11:16,400 --> 00:11:19,670
+الـ anxiety بتخلي عندهم loss of quality of sleep
+
+174
+00:11:19,670 --> 00:11:23,370
+عندهم نوم متقطع، لأنه دائمًا مرتبط أنه بيصحى بدري
+
+175
+00:11:23,370 --> 00:11:26,170
+عشان يروح وين؟ على العمل، عشان هيك بنلاقي حالنا في
+
+176
+00:11:26,170 --> 00:11:31,190
+أيام الإجازات
+
+223
+00:14:02,560 --> 00:14:07,200
+بيقول لي الأمراض الفيزيولوجية والفيزياء التي تكون
+
+224
+00:14:07,200 --> 00:14:10,020
+في جسم الإنسان تؤثر على النوم وأنا قاعد بقول إن
+
+225
+00:14:10,020 --> 00:14:14,680
+أي تغيير في جسمنا.. دعوني أذكر حديث النبي صلى
+
+226
+00:14:14,680 --> 00:14:17,480
+الله عليه وسلم.. إذا اشتاق من عضو.. طبعاً أعجبنا
+
+227
+00:14:17,480 --> 00:14:20,500
+أن.. سبحان الله الجسد الواحد.. إذا اشتاق من عضو
+
+228
+00:14:20,500 --> 00:14:23,960
+.. تداعله سائر الأعضاء.. السهر والحمى أو كما قال
+
+229
+00:14:23,960 --> 00:14:26,360
+النبي صلى الله عليه وسلم فبالتالي يصير استجابة
+
+230
+00:14:26,360 --> 00:14:30,840
+من كل جسم الإنسان طيب.. good sleep.. النوم الجيد
+
+231
+00:14:30,840 --> 00:14:33,840
+..النوم الطيب.. النوم المحترم.. depends on
+
+232
+00:14:33,840 --> 00:14:37,540
+the number of awakenings and the total number of
+
+233
+00:14:37,540 --> 00:14:41,520
+sleeping hours. إذا أردنا معرفة النوم الطبيعي نريد
+
+234
+00:14:41,520 --> 00:14:47,480
+نسأله كم بتصحى في الليل وكم بتنام ساعات النوم
+
+235
+00:14:47,480 --> 00:14:51,160
+في بعض الناس بيقول لي بقوم في الليل مرتين أو ثلاثاً
+
+236
+00:14:51,160 --> 00:14:54,520
+يعني ممكن يكون عنده diabetes. ليس كثيراً ما يخوّفني لكن في
+
+237
+00:14:54,520 --> 00:14:58,420
+الآخر أنا أريد أن أسأله كم عدد ساعات نومك إذا
+
+238
+00:14:58,420 --> 00:15:01,180
+ساعات النوم الموجودة عنده within normal.  طبعاً لو
+
+239
+00:15:01,180 --> 00:15:04,520
+حد سألني كم ساعات النوم الطبيعية، نحن زمان حكينا
+
+240
+00:15:04,520 --> 00:15:08,790
+فيها، هم العلماء اختلفوا، اعتبروا من 6 إلى 8 لكن
+
+241
+00:15:08,790 --> 00:15:11,870
+الطبيعي دعوني أقول سبعة، يعني ممكن يكون سبعة في
+
+242
+00:15:11,870 --> 00:15:14,390
+الصيف، ثمانية في الشتاء على اعتبار أن طول الليل
+
+243
+00:15:14,390 --> 00:15:19,010
+طيب، the nurse assesses sleep patterns by doing an interview.  أنا ما عندي أي
+
+244
+00:15:19,010 --> 00:15:21,730
+شيء يعني أكثر من هيك تمريض
+
+245
+00:15:21,730 --> 00:15:26,190
+أنا فقط أستطيع أن أسأل عن طريق الـ interview  لكن لو
+
+246
+00:15:26,190 --> 00:15:31,330
+حد بيسألنا طيب كيف نقدر نقيم إنهم للأخصائيين في
+
+247
+00:15:31,330 --> 00:15:34,480
+عندهم حاجة special chart عندهم عن طريق الـ EEG
+
+248
+00:15:34,480 --> 00:15:39,060
+Electroencephalogram  بيعملوا تخطيط للدماغ عشان
+
+249
+00:15:39,060 --> 00:15:43,040
+يشوفوا ذبذبات المخ، كده كان هذا طبيعي عنده النوم ولا
+
+250
+00:15:43,040 --> 00:15:48,500
+لا مش طبيعي، طبعاً هذا ليس شغلنا، شغل أخصائي disorders
+
+251
+00:15:48,500 --> 00:15:54,500
+related to sleep.  الاضطرابات التي يمكن أن تحدث مرتبطة
+
+252
+00:15:54,500 --> 00:15:59,540
+مباشرة بالنوم. أول حاجة بقول أنا sleep
+
+253
+00:15:59,540 --> 00:16:03,430
+disturbances affect family life.  أكيد الـ الـ
+
+254
+00:16:03,430 --> 00:16:06,330
+الذي عنده مشاكل في النوم تؤثر كل شيء.. كل عائلة
+
+255
+00:16:06,330 --> 00:16:10,250
+تتأثر كيف يعني؟ لو قلنا رب البيت أو المسؤول
+
+256
+00:16:10,250 --> 00:16:13,150
+عن البيت لا يعرف أن ينام، وصار عنده مشكلة أو
+
+257
+00:16:13,150 --> 00:16:16,250
+يعني لِجوا الأولاد الصغار، عم يسببوا له إزعاج، ولا
+
+258
+00:16:16,250 --> 00:16:20,430
+يعرف أن ينام، أكيد ستتأثر هنا وظيفته، ليس فقط هذا
+
+259
+00:16:20,430 --> 00:16:23,670
+social adjustment. التوافق الاجتماعي يعني بين قوسين
+
+260
+00:16:23,670 --> 00:16:26,790
+اضطراب النوم يعمل اضطراب في البيت، اضطراب في
+
+261
+00:16:26,790 --> 00:16:30,690
+العائلة، اضطراب في العمل. بعدها feelings of
+
+262
+00:16:30,690 --> 00:16:35,710
+fatigue.  أكيد بالشعور بالإرهاق، بالتعب، بالارهاق. الـ
+
+263
+00:16:35,710 --> 00:16:38,790
+irritability، التوتر، difficulty in concentrating
+
+264
+00:16:38,790 --> 00:16:43,250
+لا أستطيع التركيز.  الذي لا ينام كثيراً، اسمعوني جيداً، الذي
+
+265
+00:16:43,250 --> 00:16:45,190
+لا ينام كثيراً، وأنا هذا كلام دائماً أقوله لطلابي و
+
+266
+00:16:45,190 --> 00:16:50,090
+لطالباتي، قلة النوم مرتبطة بقلة التركيز، لأنها
+
+267
+00:16:50,090 --> 00:16:53,790
+الذي يكون نائماً جيداً يكون عنده open mind، يعني
+
+268
+00:16:53,790 --> 00:16:58,650
+يجد عقله متفتحاً وقادراً على الاستيعاب طبعاً
+
+269
+00:16:58,650 --> 00:17:01,440
+ليس واحد يقول لي طيب يا أستاذ أنا أنام كثيراً، لا، النوم
+
+270
+00:17:01,440 --> 00:17:03,600
+الكثير أيضاً يصير loss of concentration
+
+271
+00:17:03,600 --> 00:17:07,100
+أنا عندما أقول ثمانية، أقبل تسع ساعات لكن لا أقبل عشر
+
+272
+00:17:07,100 --> 00:17:10,620
+أو فوق، وعندما أقول ستة لا أقبل خمسة أو أقل، يعني من
+
+273
+00:17:10,620 --> 00:17:12,980
+الساعات. في بعض الناس يقول لك أنا أنام أربع ساعات
+
+274
+00:17:12,980 --> 00:17:16,180
+فقط طوال اليوم، difficulty in maintaining
+
+275
+00:17:16,180 --> 00:17:19,660
+orientation. لا يستطيع الواحد أن يركز طوال النهار، يظل عنده
+
+276
+00:17:19,660 --> 00:17:22,600
+يعني نقول عنه full oriented الذي هو اخذ.. غداً
+
+277
+00:17:22,600 --> 00:17:24,860
+أخذناها في fundamentals وغداً سنأخذها على
+
+278
+00:17:24,860 --> 00:17:27,940
+المستشفى، الـ orientation  يعني هل هو يَقظ، وصاحي، مدرك،
+
+279
+00:17:27,940 --> 00:17:32,610
+مُدرك بنُسأله عن ثلاث أشياء، الـ time والـ
+
+280
+00:17:32,610 --> 00:17:36,170
+name والـ place. إذا يعرف الإنسان وقته ويعرف
+
+281
+00:17:36,170 --> 00:17:38,450
+اسمه وأين هو موجود، معناته هو full
+
+282
+00:17:38,450 --> 00:17:41,850
+oriented.  عندما يكون لدى الواحد مشاكل في النوم
+
+283
+00:17:41,850 --> 00:17:44,490
+يصير عنده disturbance في الـ في الـ orientation
+
+284
+00:17:44,490 --> 00:17:47,610
+illusions
+
+285
+00:17:47,610 --> 00:17:50,770
+تخيلات، يصير عنده، إن كنتم في قلة النوم تصير
+
+286
+00:17:50,770 --> 00:17:54,390
+تخيلات، يتخيل أنه كأنه شيء على الحائط، كأنه شيء يمشي
+
+287
+00:17:54,390 --> 00:17:57,270
+كأنه شيء يتحرك، يصير عنده hallucination
+
+288
+00:17:57,270 --> 00:17:59,800
+hallucinations الهلوسة التي أخذناها في السنة الأولى
+
+289
+00:17:59,800 --> 00:18:03,380
+visual or tactile hallucinations، سواء كانت بصرية
+
+290
+00:18:03,380 --> 00:18:07,720
+أو لمسية، من كثرة ما هو، من كثرة ما هو عنده
+
+291
+00:18:07,720 --> 00:18:11,120
+أرق شديد، صار عنده يهلوس شوية، وهذا يدل على أنه
+
+292
+00:18:11,120 --> 00:18:14,660
+سبحان الله يعني الإنسان يجب أن يأخذ قدر من الراحة
+
+293
+00:18:14,660 --> 00:18:19,740
+لكي يظل الجسم ماشياً بِـ biology وساعته الـ
+
+294
+00:18:19,740 --> 00:18:25,840
+biology الطبيعية. decreased incentive to
+
+295
+00:18:25,840 --> 00:18:29,790
+work. incentive يعني أنه يبتل عنده رغبة ودافع
+
+296
+00:18:29,790 --> 00:18:33,330
+للعمل. الذي يكون عنده نقص كبير في النوم
+
+297
+00:18:33,330 --> 00:18:37,810
+يقل عنده الرغبة الحركية للعمل، Psychomotor
+
+298
+00:18:37,810 --> 00:18:40,670
+يعني يسمى نفسي حركي. باختصار، الذي لا ينام كثيراً
+
+299
+00:18:40,670 --> 00:18:44,070
+تجديه دائماً خاملاً، دائماً لا يستطيع أن يتحرك، دائماً تجديه
+
+300
+00:18:44,070 --> 00:18:47,810
+عمال شوية شوية، يريد أن يجمع بأداء الوظائف التي
+
+301
+00:18:47,810 --> 00:18:51,140
+موجودة عنده، عشان هذه كانت مشكلة كبيرة لما.. بعد
+
+302
+00:18:51,140 --> 00:18:54,700
+الفترة التي فاتت، بعد انتهاء فترة كورونا، رجعوا
+
+303
+00:18:54,700 --> 00:18:57,840
+الطلاب للمدارس، كانت بمشكلة، لا يستطيعون التأقلم، ولا
+
+304
+00:18:57,840 --> 00:19:00,980
+يمكن هذا ما جعلهم يأخذوا شوية شهر استدراكي، ولا
+
+305
+00:19:00,980 --> 00:19:04,360
+لم يكن له فائدة كبيرة للأسف، حتى حسب الخبراء
+
+306
+00:19:04,360 --> 00:19:09,460
+mild nystagmus.  زغللة في العينين من قلة النوم، تجد
+
+307
+00:19:09,460 --> 00:19:12,080
+عينيك تزغلل يمين ويسار أو فوق وتحت، يعني لا
+
+308
+00:19:12,080 --> 00:19:15,770
+يستطيع التركيز. Tremor of hands. طبعاً الـ tremor
+
+309
+00:19:15,770 --> 00:19:18,390
+يعني أن يصير لديك رجفة في اليدين من كثرة ما هو
+
+310
+00:19:18,390 --> 00:19:21,130
+الأرق الموجود عنده والتوتر وقلة النوم
+
+311
+00:19:21,130 --> 00:19:24,830
+تجد يديه ورجليه عصبيين. Increased
+
+312
+00:19:24,830 --> 00:19:28,190
+glucocorticoid and adrenergic hormone secretion
+
+313
+00:19:28,190 --> 00:19:33,170
+يعني كما بيقول أيضاً يزيد عنده glucose و
+
+314
+00:19:33,170 --> 00:19:35,890
+يزيد عنده adrenaline. طبعاً الـ adrenaline من أين
+
+315
+00:19:35,890 --> 00:19:38,410
+جاء؟ من الـ adrenal gland، كما أنتم تعرفون، و
+
+316
+00:19:38,410 --> 00:19:40,510
+glucocorticoid أيضاً من الـ adrenaline، لكن
+
+317
+00:19:41,160 --> 00:19:43,280
+أذكركم بـ anatomy، الـ adrenaline جاءت من الـ
+
+318
+00:19:43,280 --> 00:19:47,120
+adrenal medulla والـ glucocorticoid جاءت من الـ
+
+319
+00:19:47,120 --> 00:19:50,180
+adrenal cortex، الذي هو القشرة الكظرية، والقشرة
+
+320
+00:19:50,180 --> 00:19:53,560
+طبعاً لماذا؟ هذا كله استجابة لقلة النوم، لأن
+
+321
+00:19:53,560 --> 00:19:56,340
+الإنسان لم يكن صاحياً ولا يعرف أن ينام يظل الـ
+
+322
+00:19:56,340 --> 00:20:01,880
+adrenaline عنده عالياً شوية، increased
+
+323
+00:20:01,880 --> 00:20:06,460
+anxiety with a sense of tiredness. تزيد القلق كثيراً
+
+324
+00:20:06,460 --> 00:20:09,540
+عند الإنسان، ومن شدة القلق الذي صار عنده، صار عنده
+
+325
+00:20:09,540 --> 00:20:13,300
+ماذا أنا؟ إحساس بماذا؟ التعب، sense of tiredness
+
+326
+00:20:13,300 --> 00:20:18,560
+إحساس بالإرهاق، إرهاق القوة، لا يستطيع التركيز. Insomnia
+
+327
+00:20:18,560 --> 00:20:22,600
+Insomnia، يعني يصير عنده أرق، وكلّكم تعرفون الأرق
+
+328
+00:20:22,600 --> 00:20:25,920
+الأرق أخذناه زمان. short and sleeping pills.  يعني
+
+329
+00:20:25,920 --> 00:20:30,140
+إما difficulty to start sleep أو difficulty to
+
+330
+00:20:30,140 --> 00:20:34,100
+stay asleep.  يعني إما لا يستطيع أن يدخل في النوم أو لا
+
+331
+00:20:34,100 --> 00:20:39,370
+يستطيع أن يبقى نائماً. هذا نسميه insomnia. لاحظتم كثر
+
+332
+00:20:39,370 --> 00:20:42,310
+disorders كثيرة مرتبطة بالنوم، شفنا نحن
+
+333
+00:20:42,310 --> 00:20:46,530
+قاعدين، لازلنا لم نقل 11 و12.  كثيرة sleep apnea، الـ
+
+334
+00:20:46,530 --> 00:20:49,510
+sleep apnea، الذي يصير عنده هنا cessation of
+
+335
+00:20:49,510 --> 00:20:53,290
+breathing.  تجد توقف النفس أثناء النوم، لما
+
+336
+00:20:53,290 --> 00:20:55,690
+قلنا في بعض الحالات، مثل الناس الذين عندهم
+
+337
+00:20:55,690 --> 00:20:59,390
+bronchial asthma أو COPD، تجد مجرد ما هو
+
+338
+00:20:59,390 --> 00:21:02,820
+نائماً فجأة يصير عنده gasping for air، يعني تجد
+
+339
+00:21:02,820 --> 00:21:05,700
+كأنه.. يعني يصير عنده حالات الروح كأنه يريد أن يأخذ
+
+340
+00:21:05,700 --> 00:21:09,480
+شوية نفس، يصحو من النوم لكي يأخذ شوية نفس،
+
+341
+00:21:09,480 --> 00:21:12,860
+هذا نسميه sleep apnea، توقف النفس أثناء النوم
+
+342
+00:21:12,860 --> 00:21:17,000
+hypersomnia، ليس insomnia، hyper، مزاج الذي
+
+343
+00:21:17,000 --> 00:21:21,300
+hypersomnia يعني excessive sleeping، ينام طويلاً،
+
+344
+00:21:21,300 --> 00:21:25,280
+كم ينام؟ في بعض الحالات extended to 16 to 18
+
+345
+00:21:25,280 --> 00:21:30,180
+hours، حالات نادرة، 16 ساعة في اليوم، طبعاً ليس
+
+346
+00:21:30,180 --> 00:21:34,180
+واحد يأتي ويقول يا أستاذ أنا أخذت إبرة أو أخذت
+
+347
+00:21:34,180 --> 00:21:37,840
+حبة دواء معينة، مثل دواء اسمه Phenergan Pro
+
+348
+00:21:37,840 --> 00:21:41,540
+methazine.  الـ Phenergan هذا يُعتبر من الـ potent
+
+349
+00:21:41,540 --> 00:21:45,940
+antihistamine، يعني من المضادات للهستامين قوية جداً
+
+350
+00:21:45,940 --> 00:21:49,000
+لأ، إذا أخذها الإنسان، ممكن ينام 16 ساعة، لا أستطيع أن أقول هذا
+
+351
+00:21:49,000 --> 00:21:52,920
+يعني diseased  لا، أو أقول disturbances  لا، هذا
+
+352
+00:21:52,920 --> 00:21:56,080
+أعتبره normal situation لأنه استجابة للعلاج لكن لو
+
+353
+00:21:56,080 --> 00:21:58,460
+واحد بطبيعته ينام 16 ساعة، لا، أقول إنه عنده
+
+354
+00:21:58,460 --> 00:22:03,330
+مشكلة. hypersomnia.  perihypersomnia.  عندما نقول كلمة
+
+355
+00:22:03,330 --> 00:22:06,450
+perihypersomnia هو ينام كثيراً كما قلنا 16
+
+356
+00:22:06,450 --> 00:22:12,110
+أو 18 ساعة لكن ليس كثيراً، ليس طوال الوقت، أقول هنا
+
+357
+00:22:12,110 --> 00:22:17,550
+لاحظتم few days، ماذا هنا؟ few days، هنا ينام 16
+
+358
+00:22:17,550 --> 00:22:22,650
+14، 18 ساعة، لكن ينام بشكل دوري دائم، هكذا
+
+359
+00:22:22,650 --> 00:22:25,430
+هنا نسميها hypersomnia لاعتبارها مرض، disorder
+
+360
+00:22:25,430 --> 00:22:29,490
+without trouble. هنا perihypersomnia لا، ينام نوم
+
+361
+00:22:29,490 --> 00:22:32,650
+كثير لكن في أيام متقطعة، سأعطيكم مثالاً
+
+362
+00:22:32,650 --> 00:22:35,470
+مثل ما يأتي الطالب يسألني، يقول لي طيب أنا يوم الخميس
+
+363
+00:22:35,470 --> 00:22:38,110
+والله يا أستاذ مرات أنام 14 ساعة، أو مرات يوم
+
+364
+00:22:38,110 --> 00:22:41,730
+الجمعة، أقول لهم ليس مشكلة، لماذا؟ لأنه أعتبره pre-
+
+365
+00:22:41,730 --> 00:22:45,030
+hypersomnia، يعني في هذا الوقت لا أستطيع أن أقول عنه
+
+366
+00:22:45,030 --> 00:22:48,890
+disorder لأنه ليس مستمراً ودائماً، لذلك ليس
+
+367
+00:22:48,890 --> 00:22:53,510
+كل شيء نقول عنه مرض إلا إذا استمر. طيب
+
+368
+00:22:53,510 --> 00:22:57,270
+ناركليبسيا أخذناها زمان في الـ psychology، ونَزِيجي
+
+369
+00:22:57,270 --> 00:23:00,030
+أنا أُعِيدُها لكم عدة مرات. Excessive daytime
+
+370
+00:23:00,030 --> 00:23:04,310
+drowsiness or uncontrolled onset of sleep. عدم
+
+371
+00:23:04,310 --> 00:23:08,350
+القدرة على التحكم في النوم أثناء أثناء
+
+372
+00:23:08,350 --> 00:23:11,970
+النهار. Narcolepsy. كيف يعني؟ مثل بعض الناس الذين
+
+373
+00:23:11,970 --> 00:23:15,650
+يكون راكباً في الـ bus ولسة لم ينم جيداً وصار عنده
+
+374
+00:23:15,650 --> 00:23:18,830
+drowsiness ولا يستطيع أن يتحكم في نفسه أو يجد
+
+375
+00:23:18,830 --> 00:23:21,530
+يصير رأسه يذهب يمين أو يسار أو يكون على مقعد
+
+376
+00:23:21,530 --> 00:23:24,250
+الدراسة والأستاذ عمّ يَشرح، يصير عند الأطفال
+
+377
+00:23:24,250 --> 00:23:28,860
+مرات، تجد لا يستطيع، يضع رأسه على المنضدة وينام،
+
+378
+00:23:28,860 --> 00:23:33,900
+لا يستطيع أن يتحمل. هذا اسمه Narcolepsy.  خمسة عشر
+
+379
+00:23:33,900 --> 00:23:37,060
+Cataplexy. عندما نقول Cataplexy، هنا نقاش يصير
+
+380
+00:23:37,060 --> 00:23:40,200
+appropriate weakness or paralysis of voluntary
+
+381
+00:23:40,200 --> 00:23:45,700
+muscles. فجأة نجد ماذا؟ ضعف أو شلل في العضلات
+
+382
+00:23:45,700 --> 00:23:49,120
+في العضلات التي نتحكم فيها، التي
+
+383
+00:23:49,120 --> 00:23:53,760
+نستطيع أن نتحكم فيها بشكل إرادي، يعني voluntary، يعني
+
+384
+00:23:53,760 --> 00:23:59,050
+إرادياً، في الـ arms، الـ legs، الـ face. طيب، last
+
+385
+00:23:59,050 --> 00:24:02,490
+condition from half seconds to ten minutes. هذا
+
+386
+00:24:02,490 --> 00:24:06,670
+طبعاً نادر أن يحصل، نادر أن يحصل، كيف يحصل؟ أقول الذي يحصل
+
+387
+00:24:06,670 --> 00:24:10,970
+مرة أو مرتين في العام كله. كيف تصير؟ من
+
+388
+00:24:10,970 --> 00:24:14,090
+الاضطراب الموجود عنده في النوم، يحكون أنه يصير
+
+389
+00:24:14,090 --> 00:24:19,350
+عنده فقدان لحركة اليدين فجأة أو مثل شلل، إما ضعف
+
+390
+00:24:19,350 --> 00:24:23,490
+أو شلل، أقول لا يستطيع أن يحرك يده، مرات تستمر يعني
+
+391
+00:24:23,490 --> 00:24:26,930
+ثانية، ومرات تقعد دقيقة، دقيقتين، ثلاث، ممكن
+
+392
+00:24:26,930 --> 00:24:29,470
+أكثر، تحدث مرة أو مرتين في العام، بعدها الإنسان
+
+393
+00:24:29,470 --> 00:24:33,670
+يرجع لطبيعته، هذه لا نخاف منها ولا
+
+394
+00:24:33,670 --> 00:24:36,190
+نقول إنها تحتاج علاج، هذه سبحان الله مرتبطة
+
+395
+00:24:
+
+445
+00:27:48,440 --> 00:27:51,900
+leading ال question اللي بعدها إيش بيسموها ال
+
+446
+00:27:51,900 --> 00:27:54,920
+history هنا enclosed general sleep لازم تتذكر
+
+447
+00:27:54,920 --> 00:27:58,680
+بتسأل دائما على ال general sleep يعني أنهم بشكل
+
+448
+00:27:58,680 --> 00:28:03,540
+عام ال history psychological history لو حد سألني
+
+449
+00:28:03,540 --> 00:28:06,060
+أو حد سألني يقول لي إيش داخل ال psychological
+
+450
+00:28:06,060 --> 00:28:12,430
+history من أخطر اضطرابات النوم المنشأ النفسي، من أخطر
+
+451
+00:28:12,430 --> 00:28:16,490
+اضطرابات النوم المنشأ النفسي ما عمرك شفت واحد لا
+
+452
+00:28:16,490 --> 00:28:20,610
+خائف ولا عنده anxiety ولا عنده لا سمح الله أي
+
+453
+00:28:20,610 --> 00:28:23,970
+tremors ولا عنده خلينا نقول بعض يعني personal
+
+454
+00:28:23,970 --> 00:28:27,390
+disorders اللي طلعت شخصية وجادر بنامي كويس اللي
+
+455
+00:28:27,390 --> 00:28:31,990
+يكون اللي عنده psychological problems عنده sleep
+
+456
+00:28:31,990 --> 00:28:35,510
+problems على فكرة والعكس صحيح واللي عنده sleep
+
+457
+00:28:35,510 --> 00:28:39,430
+problems برضه عنده psychological problems. بعض الناس
+
+458
+00:28:39,430 --> 00:28:43,510
+نسأل عن drug history ممكن يقول لك أنا بأخذ دواء كده
+
+459
+00:28:43,510 --> 00:28:46,570
+بيخلّيني صاحي ممكن فلان يقول لك أنا بأخذ دواء كده
+
+460
+00:28:46,570 --> 00:28:50,070
+بيخلّيني نايم وبعضهم يقول لك أنا بأخذ دواء بيخلّيني
+
+461
+00:28:50,070 --> 00:28:54,350
+أشعر بدقات القلب سريعاً طبعاً بنسأل إيش الـ drug
+
+462
+00:28:54,350 --> 00:28:57,190
+history وإيش اللي عامله عنده أي اضطرابات في
+
+463
+00:28:57,190 --> 00:29:02,090
+النوم. إحنا هنخلّي نخلص اللي عندنا عشان نبدأ إن شاء
+
+464
+00:29:02,090 --> 00:29:05,930
+الله في الشابتر القادم عشان دائماً نلتزم بالوقت
+
+465
+00:29:05,930 --> 00:29:10,460
+المناسب اللي هو حدود الـ 30 دقيقة والسلام عليكم
+
+466
+00:29:10,460 --> 00:29:11,960
+ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..9a0d3098ececca563d0983f3d567df48745c371a
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_postprocess.srt
@@ -0,0 +1,1864 @@
+1
+00:00:00,540 --> 00:00:03,240
+أعوذ بالنفسي بسم الله الرحمن الرحيم الصلاة والسلام
+
+2
+00:00:03,240 --> 00:00:06,440
+على أشرف المرسلين سيدنا محمد وعلى أليه وصحابيه
+
+3
+00:00:06,440 --> 00:00:11,900
+السلم خلينا نكمل اليوم في المحاضرة الشق التاني في
+
+4
+00:00:11,900 --> 00:00:14,860
+ال nutritional assessment اللي احنا اتوقفنا طبعا
+
+5
+00:00:14,860 --> 00:00:20,940
+في المحاضرة السابقة عند تقريبا لأ قبل هذه الشريحة
+
+6
+00:00:20,940 --> 00:00:25,440
+تقريبا بالظبط اليوم بدنا نكمل طبعا signs and
+
+7
+00:00:25,440 --> 00:00:29,760
+symptoms of malnutrition شو العلماتيعني خلينا
+
+8
+00:00:29,760 --> 00:00:33,040
+نقولوا الأعراض اللي هي ناتجة عن إيه سوء التخدية
+
+9
+00:00:33,040 --> 00:00:37,320
+dry and thin hair أكيد طبعا يعني اللي هو جفاف
+
+10
+00:00:37,320 --> 00:00:40,580
+واتقصه في الشعر بيصير كتير yellowish lump around
+
+11
+00:00:40,580 --> 00:00:44,460
+eye بنلاقي بعض الناس اللي عندهم malnutrition عندهم
+
+12
+00:00:44,460 --> 00:00:49,880
+زي lump بسيطة زي تكتلات صفراء موجودة حوالين اللي
+
+13
+00:00:49,880 --> 00:00:54,160
+هو العين وخاصة تحت العين white ring around both
+
+14
+00:00:54,160 --> 00:00:58,550
+eyes بتلاقي زي حوالين العين زي هالةزي هالعيش زي
+
+15
+00:00:58,550 --> 00:01:02,870
+هالبيضاء زي دائرة بيضاء طبعا هنا بيكون في معاه ال
+
+16
+00:01:02,870 --> 00:01:06,250
+conjunctiva اللي هم التحمط اللي هي بتكون شاحبة كل
+
+17
+00:01:06,250 --> 00:01:09,570
+هذا يدل على انه ايه عمال ال hemoglobin باكد ليه
+
+18
+00:01:09,570 --> 00:01:13,630
+انه اقل من الطبيعي ويعني هذا رايح على أنيميا لأنه
+
+19
+00:01:13,630 --> 00:01:17,570
+اكيد مع المال ال nutrition بتصير أنيميا طيب الآن
+
+20
+00:01:17,570 --> 00:01:21,010
+بقول نقطة تانية aridness and swelling of the lips
+
+21
+00:01:21,010 --> 00:01:25,250
+especially corners of the mouth بنلاقيمرات بيصير
+
+22
+00:01:25,250 --> 00:01:29,530
+إيش انتفاخ في شفاف ال .. ال .. الإنسان عنده مالي
+
+23
+00:01:29,530 --> 00:01:33,130
+nutrition ومش بس هيك خاصة في ال corners يعني اللي
+
+24
+00:01:33,130 --> 00:01:37,750
+هو في الجنبين تبع ال mouth وعلى فكرة لما يصير
+
+25
+00:01:37,750 --> 00:01:41,150
+تشققات في الجنب ال mouth هنا وجنب ال mouth هنا
+
+26
+00:01:41,150 --> 00:01:44,950
+اسمه بيسموه chialosis يعني لو حد اسمع هذا المصطلح
+
+27
+00:01:44,950 --> 00:01:49,210
+اسمه chialosis اللي هو abnormal corners of the
+
+28
+00:01:49,210 --> 00:01:53,300
+mouth and إيش erosions يعني عامل زي التشققاتطيب
+
+29
+00:01:53,300 --> 00:01:56,940
+teeth cares بيصير طبعا أكيد يعني تسوص أسنان
+
+30
+00:01:56,940 --> 00:02:01,460
+abnormal missing of it مرات بيفقد الإنسان أسنان هو
+
+31
+00:02:01,460 --> 00:02:04,900
+بيقول ماعندي مشكلة مش عارف من إيش صار عندي فقد
+
+32
+00:02:04,900 --> 00:02:08,220
+أسنان بيكون الأساس و المرجع هو ال marine nutrition
+
+33
+00:02:08,220 --> 00:02:13,780
+طيب a dryness of the skin جفاف الجلد و هذا بنسميه
+
+34
+00:02:13,780 --> 00:02:18,180
+xerosis إيش بنسميه xerosis بيسموه sandpaper fields
+
+35
+00:02:18,180 --> 00:02:22,320
+يعني إيش sandpaper زي ورقة الصنفرةsandpaper زي
+
+36
+00:02:22,320 --> 00:02:25,560
+ورقة البرداخ زي بتعرفوها اللي بنعمل فيها مرات
+
+37
+00:02:25,560 --> 00:02:29,720
+الحديد أو الخشب يعني يصبح الجلد من شدة الخشونته
+
+38
+00:02:29,720 --> 00:02:35,420
+كأن ورقة برداخ spoon shaped nails بيسموها هنا يعني
+
+39
+00:02:35,420 --> 00:02:39,900
+زي ما تشوفينا collionial ايش collionial بقول هنا
+
+40
+00:02:39,900 --> 00:02:44,620
+بيصير spoon shaped nail يعني الإضفر بيصبح زي
+
+41
+00:02:44,620 --> 00:02:49,400
+الملعق زي الملعق الصغيرة هيك مدور ومقعر شوية
+
+42
+00:02:51,140 --> 00:02:54,380
+Tachycardia أكيد عارفين إيش معناته elevated blood
+
+43
+00:02:54,380 --> 00:02:58,060
+pressure due to excessive sodium intake هذا
+
+44
+00:02:58,060 --> 00:03:01,260
+بتدللنا أنه مش دايما ال malnutrition معناته نقص
+
+45
+00:03:01,260 --> 00:03:03,800
+هيبقوا يقولوا لأ من ال malnutrition اللي بيأكل
+
+46
+00:03:03,800 --> 00:03:08,560
+أملاح كتير بيصير عنده elevated blood pressure صحيح
+
+47
+00:03:08,560 --> 00:03:11,860
+و بزيد عنده excessive cholesterol صحيح إذا كان في
+
+48
+00:03:11,860 --> 00:03:16,320
+عنده bad nutrient style خليني أقول يعني أو
+
+49
+00:03:16,320 --> 00:03:19,380
+nourishment style يعني بتلاقي بتغذى شغلاتفيها فات
+
+50
+00:03:19,380 --> 00:03:23,180
+كتير او فيها ايش او فيها high calorie diet ال
+
+51
+00:03:23,180 --> 00:03:26,560
+muscle weakness and the growth retardation طبعا
+
+52
+00:03:26,560 --> 00:03:29,680
+اكيد بتضاعف العضلات و اكيد في نفس الوقت اش بيصير
+
+53
+00:03:29,680 --> 00:03:34,900
+كمان كمان بيصير فيه ضعف في معدل النمو عند الإنسان
+
+54
+00:03:34,900 --> 00:03:39,140
+اللي عنده مال ال nutrition طيب، dietary analysis
+
+55
+00:03:39,140 --> 00:03:44,140
+بقول و دايما اتذكر و انت بتحلل الأكل و الطعام
+
+56
+00:03:44,140 --> 00:03:47,840
+للمريض بدك تفهم ان ال food represent cultural and
+
+57
+00:03:47,840 --> 00:03:55,360
+ethnicيعني دائما الطعام بيمثل شيء ثقافي إثنك يعني
+
+58
+00:03:55,360 --> 00:03:59,840
+background يعني شيء خلفية عرقية and socio economic
+
+59
+00:03:59,840 --> 00:04:03,700
+status and have many emotional and psychological
+
+60
+00:04:03,700 --> 00:04:07,260
+meaning يعني كأنه بقولي دربا، خلّيك ذاكر أن الطعام
+
+61
+00:04:07,260 --> 00:04:13,300
+له طقوس خاصة ويله مردود ثقافي ويله خلفية عرقية
+
+62
+00:04:13,300 --> 00:04:17,050
+ربما في زي ما احنا حكينا في بعض العائلاتتفضل أشياء
+
+63
+00:04:17,050 --> 00:04:20,830
+عن أشياء أو بعض الأقوام ما بتاكلش أشياء على حسب
+
+64
+00:04:20,830 --> 00:04:24,830
+أشياء أخرى يعني هو من باب أنه بيتذكر assessment
+
+65
+00:04:24,830 --> 00:04:27,650
+includes usual foods و احنا بنسأل المريض ده مانعش
+
+66
+00:04:27,650 --> 00:04:30,670
+بنسأله إيش ال usual foods عندك؟ ال consumed اللي
+
+67
+00:04:30,670 --> 00:04:34,270
+بتستهلكه ال habits of food كيف عادتك في الأكل كأنه
+
+68
+00:04:34,270 --> 00:04:36,710
+الإشي بيعيد نفسه نفس اللي حكيناه في المحاضرة
+
+69
+00:04:36,710 --> 00:04:39,750
+السابقة بعدين بيقول ask the client to recall
+
+70
+00:04:39,750 --> 00:04:44,190
+everything خليه يذكر كل شيء consumed with each
+
+71
+00:04:44,190 --> 00:04:48,840
+withinthe past 24 hours يعني لما نسأل المريض ايش
+
+72
+00:04:48,840 --> 00:04:52,220
+اكلت و احنا بنعمله dietary analysis لازم نسأل كل
+
+73
+00:04:52,220 --> 00:04:56,800
+شي انت ايش اكلته اي شي لدرجة انه بيقول مش بس all
+
+74
+00:04:56,800 --> 00:04:59,900
+foods حتى ال fluid دي مش شئ بيسأل حتى ال vitamins
+
+75
+00:04:59,900 --> 00:05:03,500
+حتى ال minerals or other supplements لو قاعد واحد
+
+76
+00:05:03,500 --> 00:05:07,280
+سألني طب ليش يا أستاذ ال vitamins هي ايش بتعمل؟ لأ
+
+77
+00:05:07,280 --> 00:05:11,100
+في بعض ال vitamins مكملات يعني بتعملنا شغلات ممكن
+
+78
+00:05:11,100 --> 00:05:13,900
+تزيد في بعض ال mineralsبعض ال supplements يعني
+
+79
+00:05:13,900 --> 00:05:16,760
+يكون باخدلي omega أو باخد شغلات زي هيك هذه ممكن
+
+80
+00:05:16,760 --> 00:05:20,580
+تأثر على عملية ال metabolism في داخل جسم الإنسان
+
+81
+00:05:20,580 --> 00:05:24,280
+يعني ممكن نتقلل وسط ال product فبالتالي لازم نسأل
+
+82
+00:05:24,280 --> 00:05:27,380
+عن كل شيء إيه علاقة بال إيه علاقة بال nutrition
+
+83
+00:05:27,380 --> 00:05:32,300
+don't bias خلينا نذاكر هذا الكلام don't bias the
+
+84
+00:05:32,300 --> 00:05:37,100
+client response دايما ما يتقود استجابة المريض يعني
+
+85
+00:05:37,100 --> 00:05:39,360
+ال question مايكونش عندك ال question biased
+
+86
+00:05:39,360 --> 00:05:43,050
+questionولي يكون عندك اللي هو leading question
+
+87
+00:05:43,050 --> 00:05:47,790
+خاصة من وجهة نظر ال interviewer مرات انت بيكون
+
+88
+00:05:47,790 --> 00:05:50,890
+عندك ايش personal habits او knowledge يعني ممكن
+
+89
+00:05:50,890 --> 00:05:54,210
+انت مثلا بدك تسأل عن اللحمة او بدك تسأل عن اكل
+
+90
+00:05:54,210 --> 00:05:57,850
+معين انت بتحب اللحمة ماتقوله اكيد انت بتحب اللحمة
+
+91
+00:05:57,850 --> 00:06:02,590
+لأ انا bias لأن انت وكأنك بتخليه اجاوب زي اجابتك
+
+92
+00:06:02,590 --> 00:06:06,870
+لأ احنا بنسأله بتجرد و بعيدا عن رأينا الشخصي
+
+93
+00:06:06,870 --> 00:06:12,160
+بالمطلق طيبdiseases affected by nutritional
+
+94
+00:06:12,160 --> 00:06:18,380
+problems ما هي الأمراض اللي ممكن تتأثر أو تزيد من
+
+95
+00:06:18,380 --> 00:06:22,680
+المشاكل اللي ناتجة عن التخضيه أنا مابقولش أن هو ..
+
+96
+00:06:22,680 --> 00:06:27,820
+يعني التخضيه اللي عملت هيك لكن بتلعب سبب رئيسي في
+
+97
+00:06:27,820 --> 00:06:32,160
+حدوث هذه طبعا أنا ذكرت من سبعة لكن هو كتير أكتر من
+
+98
+00:06:32,160 --> 00:06:35,960
+ذلك و أنا كاتب القهانة يريد تتطلعوا في الكتاب في
+
+99
+00:06:35,960 --> 00:06:39,270
+page 15 أو حسب الكتاب اللي موجود معاكمأو حتى ممكن
+
+100
+00:06:39,270 --> 00:06:42,170
+انت تشوف على الانترنت كتير من الأمراض أول مرض
+
+101
+00:06:42,170 --> 00:06:45,550
+obesity طبعا ليهم بعتبروه disease لأنه الكتير من
+
+102
+00:06:45,550 --> 00:06:48,510
+الناس مابيقدروا ينزلوا عن الوزن اللي هو بيقصر عنهم
+
+103
+00:06:48,510 --> 00:06:52,010
+زيادة excessive of body fat طبعا أكيد ال diabetes
+
+104
+00:06:52,010 --> 00:06:54,690
+من ال latest مابقولش أنه سبب لكن من ال breeds
+
+105
+00:06:54,690 --> 00:06:56,970
+posing factors ومن ال high breeds posing factors
+
+106
+00:06:56,970 --> 00:07:01,050
+هو للأسف ال high calorie ال high sugar diet و هكذا
+
+107
+00:07:01,050 --> 00:07:05,410
+hypertension أكيد الدغط برتفع مع الأملح معدوه
+
+108
+00:07:05,410 --> 00:07:09,540
+الكوروناريheart disease أكيد مع الدهون وخاصة يعني
+
+109
+00:07:09,540 --> 00:07:12,820
+الدهون اللي هي السيئة و اللي ممكن تعمل كتير جلطات
+
+110
+00:07:12,820 --> 00:07:17,640
+five cancer اللي هو السرطان على اعتبار ان بعض
+
+111
+00:07:17,640 --> 00:07:22,640
+العلماء أشهروا ان ال cancer cells يعني بتتغدى على
+
+112
+00:07:22,640 --> 00:07:27,840
+السكر بشكل كبير endocrine disease أمراض بتصيب غضب
+
+113
+00:07:27,840 --> 00:07:30,740
+الصمم على فكرة من ضمن الدهبيتس ومن ضمن أمراض تانية
+
+114
+00:07:30,740 --> 00:07:33,500
+زي ال hyperthyroidism أو ال hypothyroidism و هو
+
+115
+00:07:33,500 --> 00:07:37,900
+كدهو كتبركو others يعني في أمراض كتير تتأثر من ال
+
+116
+00:07:37,900 --> 00:07:43,200
+malnutrition و ال problems اللي ممكن المريض يعاني
+
+117
+00:07:43,200 --> 00:07:47,180
+منها بشكل عام assessment of sleep and wakefulness
+
+118
+00:07:47,180 --> 00:07:52,520
+patterns تقييم النوم و اليقظة عند المريض طبعا في
+
+119
+00:07:52,520 --> 00:07:56,700
+البداية بدنا نفهم ان ال normal human ايش يعني
+
+120
+00:07:56,700 --> 00:07:59,980
+الشخص الطبيعي الإنسان الطبيعي عنده حالة اسمها
+
+121
+00:07:59,980 --> 00:08:03,310
+homeostasisلما أقول كلمة homeostasis بسمها
+
+122
+00:08:03,310 --> 00:08:06,450
+homeostatic، homeostasis يعني التوازن، إيش
+
+123
+00:08:06,450 --> 00:08:10,310
+التوازن؟ البني آدم الطبيعي عنده توازن بين اليقظة و
+
+124
+00:08:10,310 --> 00:08:13,110
+بين النوم، يعني كتب لي ability to maintain
+
+125
+00:08:13,110 --> 00:08:17,950
+relative internal .. relative internal consistency
+
+126
+00:08:17,950 --> 00:08:21,570
+أو consistency، إيش أنا consistency؟ الثبات، سبحان
+
+127
+00:08:21,570 --> 00:08:24,970
+الله، الله سبحانه وتعالى حط في كل جسم إنسان حالة
+
+128
+00:08:24,970 --> 00:08:28,570
+من التوازن يستطيع الإنسان يحافظ عليها ما بين النوم
+
+129
+00:08:28,570 --> 00:08:32,140
+و اليقظة و الراحة و العملAny person .. أي شخص ..
+
+130
+00:08:32,140 --> 00:08:35,380
+complaint of sleep pattern .. أي إنسان بعالم .. أي
+
+131
+00:08:35,380 --> 00:08:40,320
+إنسان بعالم المشاكل في النوم يعني أي اضطراب تعتبر
+
+132
+00:08:40,320 --> 00:08:43,500
+primary problem أو secondary problem due to إيش
+
+133
+00:08:43,500 --> 00:08:47,480
+هنا؟ لما أقول primary .. primary problem إيش يعني؟
+
+134
+00:08:47,480 --> 00:08:50,980
+يعني مشكلة النوم هي أصلا من النوم لما أقول
+
+135
+00:08:50,980 --> 00:08:55,340
+secondary problem يعني ناتجة لسبب أخر، أعطيكم مثال
+
+136
+00:08:55,340 --> 00:08:59,040
+صغير جدا، زي إيش؟هل جيت واحد بيقول انا عندي أرق في
+
+137
+00:08:59,040 --> 00:09:01,960
+النوم بيقول طب ليش؟ بيقول والله مانعرف انا هيك جيت
+
+138
+00:09:01,960 --> 00:09:05,260
+انام ماعرفتش انام دايما بتصير معجلة؟ لأ مرات بسيطة
+
+139
+00:09:05,260 --> 00:09:08,540
+هذا بيقول primary problem يعني المشكلة اللي عندك
+
+140
+00:09:08,540 --> 00:09:11,740
+مشكلة بس في النوم بيجين واحد تاني بيقول انا مش
+
+141
+00:09:11,740 --> 00:09:15,340
+عارف انام بيقول ليش؟ بيقول ان عندي وجع شديد جدا في
+
+142
+00:09:15,340 --> 00:09:19,140
+رجلي مش هم يخليني اعرف انام او التاني بيقول عندي
+
+143
+00:09:19,140 --> 00:09:22,340
+صداع او التالت بيقول عندي anxiety هذا بنسميه
+
+144
+00:09:22,340 --> 00:09:25,260
+secondary يعني السبب له سبب تاني زي الموضوع
+
+145
+00:09:25,730 --> 00:09:28,470
+الـPrimary Hypertension والـSecondary Hypertension
+
+146
+00:09:28,470 --> 00:09:32,230
+الـPrimary الضغط مش معروف إيش سبب والـSecondary
+
+147
+00:09:32,230 --> 00:09:35,770
+بكون الضغط إيه سبب أخر في جسم الإنسان لحظة اللي
+
+148
+00:09:35,770 --> 00:09:39,570
+محطوط بالخط الأحمر ده شيء مهم وخطير أنه يقول ربع
+
+149
+00:09:39,570 --> 00:09:42,430
+.. ربع المرضى .. ربع المرضى one fourth of the
+
+150
+00:09:42,430 --> 00:09:45,650
+client اللي هم اللي بروح على المستشفيات who seek
+
+151
+00:09:45,650 --> 00:09:48,470
+healthcare complaint of difficulty related to
+
+152
+00:09:48,470 --> 00:09:51,950
+sleep ربع المرضى اللي بيتجهل المستشفيات في العالم
+
+153
+00:09:51,950 --> 00:09:56,300
+يعني بتتكلم على 25% من المرضى في العالمعدد مشتهل
+
+154
+00:09:56,300 --> 00:10:00,180
+بيعاني من الطرابات في النوم وعلى فكرة حتى الناس
+
+155
+00:10:00,180 --> 00:10:04,740
+الطبيعيين اليوم صار نسبة كبيرة منهم يعاني من طرابة
+
+156
+00:10:04,740 --> 00:10:08,540
+النوم حسب الوضع اللي احنا بنعاني منه وحسب الأوضاع
+
+157
+00:10:08,540 --> 00:10:12,080
+سواء اقتصادية او اجتماعية او نفسية او حتى روحانية
+
+158
+00:10:12,080 --> 00:10:16,520
+طيب factors affecting length and equality of sleep
+
+159
+00:10:16,520 --> 00:10:22,000
+ما هي العوامل اللي بتأثر على جودة النوم وطول النوم
+
+160
+00:10:22,000 --> 00:10:26,010
+طبعا طول النوم مش دايما مرتبط بالجودةليش رابطهم مع
+
+161
+00:10:26,010 --> 00:10:29,910
+بعض؟ مش كل شي نوم طويل، معناه تفيه جودة، مرات
+
+162
+00:10:29,910 --> 00:10:35,330
+بيكون النوم في الحدود المتزامنة أو الطبيعية، بنقول
+
+163
+00:10:35,330 --> 00:10:39,110
+عنه equality اسليم و مرات تكون أكثر و بتكونش فيها
+
+164
+00:10:39,110 --> 00:10:44,370
+equality، خلنا نشوف، أول حاجة anxiety القلق، طبعا
+
+165
+00:10:44,370 --> 00:10:48,010
+القلق دغري، إيش مرتبط هنا؟ مرتبط كتير بقلة النوم و
+
+166
+00:10:48,010 --> 00:10:50,850
+بالترابط النوم، بيقول related to the need to meet
+
+167
+00:10:50,850 --> 00:10:56,040
+مثلا a tasksuch as waking at an early hour for
+
+168
+00:10:56,040 --> 00:11:00,540
+work احنا أكتر ناس بكرا هنروح لما نتدرب هنصل
+
+169
+00:11:00,540 --> 00:11:04,400
+لمرحلة شويه anxiety بتأثر عنهم ليه؟ لأنه مرتبط
+
+170
+00:11:04,400 --> 00:11:08,660
+حياتنا بالعمل فهو بيقول دائما أهل التمريد و أهل
+
+171
+00:11:08,660 --> 00:11:13,080
+الطب و حتى اللي بيشتغلوا في الشرطة أو في الأعمال
+
+172
+00:11:13,080 --> 00:11:16,400
+الأمنية أو الدفاع المدني في منهم anxiety ال
+
+173
+00:11:16,400 --> 00:11:19,670
+anxiety بتخلي عندهمloss of equality of the sleep
+
+174
+00:11:19,670 --> 00:11:23,370
+عندهم نوم ممتقطع لأنه دايما مرتبط انه بتيصحى بدري
+
+175
+00:11:23,370 --> 00:11:26,170
+عشان بتروح وين على العامل عشانك بنلاقي حالنا في
+
+176
+00:11:26,170 --> 00:11:31,190
+أيام الإجازات بناخد أكتر قصة من الراحة ال promise
+
+177
+00:11:31,190 --> 00:11:34,870
+ايش دخل ال promise هنا الوعد لما الإنسان بيوعد حدا
+
+178
+00:11:34,870 --> 00:11:39,070
+for pleasurable activity زي starting vacation في
+
+179
+00:11:39,070 --> 00:11:41,550
+بعض الحلقات أخدنا زمان اذا بتذكروا انه بتأثر النوم
+
+180
+00:11:41,550 --> 00:11:46,320
+تبعنا لما يكون في إنسان بتيوعد بشغل معينيعني مثلا
+
+181
+00:11:46,320 --> 00:11:48,900
+زي واحد بيقول للتاني أو بتكون مثلا مشتركين في رحلة
+
+182
+00:11:48,900 --> 00:11:51,960
+و بنتظر ده الرحلة من زمان لل vacation و بكرا في
+
+183
+00:11:51,960 --> 00:11:54,660
+عندنا إجازة فجاهديني بيقول بكرا ان شاء الله بدنا
+
+184
+00:11:54,660 --> 00:11:56,520
+نصعي الساعة السابعة الصبح عشان بكرا نكون كلنا
+
+185
+00:11:56,520 --> 00:11:59,980
+موجودين لإن ال bus بدهي يحضر الساعة كده بتلاقينا
+
+186
+00:11:59,980 --> 00:12:03,940
+لا .. لا إراديا رغم إنه إشي مفرح و إشي مبسط لكن
+
+187
+00:12:03,940 --> 00:12:06,460
+صار في عندنا إيه؟ صار في عندنا disturbance of
+
+188
+00:12:06,460 --> 00:12:09,960
+sleep وضلينا صاحين عشان إيش نكون ياقظين زي موضوع
+
+189
+00:12:09,960 --> 00:12:12,520
+الامتحانات وموضوع الاكوزات وموضوع ال interview
+
+190
+00:12:12,520 --> 00:12:18,570
+بيخلينا دايبيأثر ليش على quality of sleep؟ في حاجة
+
+191
+00:12:18,570 --> 00:12:20,790
+اسمها conditioned patterns of sleeping ايش ال
+
+192
+00:12:20,790 --> 00:12:23,450
+conditioned؟ زمان ذكرناها في ال psychology و
+
+193
+00:12:23,450 --> 00:12:27,930
+العيدة كمان برا اللي بيسموها النوم المشروط ايش
+
+194
+00:12:27,930 --> 00:12:30,510
+النوم المشروط؟ في بعض الناس عندهم طقوس في النوم
+
+195
+00:12:30,510 --> 00:12:33,890
+إذا ما صارش هذا الطقوس بيصير عندهم مشكلة يعني لازم
+
+196
+00:12:33,890 --> 00:12:38,570
+ينام ع فرش معينة ع مخدة معينة يكون جنبه مثلا ميه
+
+197
+00:12:38,570 --> 00:12:42,330
+يحط سماعات في دنيه يفتح مثلا شي معين هذا اسمها
+
+198
+00:12:42,330 --> 00:12:45,090
+conditioned sleep لو انفقدت شيء من هدول بيعرفش
+
+199
+00:12:45,090 --> 00:12:47,440
+ينامعلشان هيك كتير من المرضى لما بيجيوا علنا في
+
+200
+00:12:47,440 --> 00:12:50,800
+المستشفيات بنقوله نام لو سمحت، بقولي أنا مش عارف
+
+201
+00:12:50,800 --> 00:12:53,860
+أنام، ليه؟ بقولك أنا نومي، لازم أكون على الفرشة
+
+202
+00:12:53,860 --> 00:12:58,260
+الفلانية أو أنا أستخدم شغلة علانية، فهذا اللي
+
+203
+00:12:58,260 --> 00:13:01,780
+بيخلق .. بيسموه إيش هنا conditioned patterns وفي
+
+204
+00:13:01,780 --> 00:13:03,900
+ناس ماعندهم مش conditioned يعني لو كواين مانام،
+
+205
+00:13:03,900 --> 00:13:06,660
+بنام، حاطناع فرشة، بتون فرشة، مخدة، بتون مخدة،
+
+206
+00:13:06,660 --> 00:13:10,580
+بنام في حاجة اسمها physiological wake up، في ناس
+
+207
+00:13:10,580 --> 00:13:13,180
+عندهم ياقظة في السيورجية، يمكن احنا مش موجود في
+
+208
+00:13:13,180 --> 00:13:16,530
+أعماركملكن في الكبار السن إذا عندك جدك جد تلك
+
+209
+00:13:16,530 --> 00:13:19,110
+بتلاقي يا سبحان الله عندهم يقضة فيسيولوجية، لا
+
+210
+00:13:19,110 --> 00:13:22,390
+إرادة، بتلاقي جام قبل أدان الفجر وصحي وقاعد يعني
+
+211
+00:13:22,390 --> 00:13:25,130
+في البيت ويعمل حركة، هذه بسمها physiological wake
+
+212
+00:13:25,130 --> 00:13:28,150
+up، سبحان الله الساعة البيولوجية الفيسيولوجية عنده
+
+213
+00:13:28,150 --> 00:13:32,450
+يعني قوية جدا لدرجة أنها مرتبط ارتباط وثيق بساعة
+
+214
+00:13:32,450 --> 00:13:35,290
+محددة في الليل بيقوم فيها، بينام في وقت محدد
+
+215
+00:13:35,290 --> 00:13:38,150
+وبيقوم في وقت محدد، ان شاء الله يكون عند حد منكم
+
+216
+00:13:38,150 --> 00:13:41,300
+موجودة، هذه كويسة مش عادلة يعنيage differences
+
+217
+00:13:41,300 --> 00:13:45,660
+أكيد اختلافات الأعمار الولد صغير بنام كتير الإنسان
+
+218
+00:13:45,660 --> 00:13:48,220
+لما بيكبر بيبدأ إيش نوم يصير متوسط أو طبيعي و
+
+219
+00:13:48,220 --> 00:13:52,060
+بعدين لما بيكبر يخاتر برجع لأصل و بيبتسر ينام قليل
+
+220
+00:13:52,060 --> 00:13:56,480
+و النوم القليل في الكبار يعني دائما هذا سائد اللي
+
+221
+00:13:56,480 --> 00:13:58,820
+بعد في physiological alterations التغييرات
+
+222
+00:13:58,820 --> 00:14:02,560
+الفيزيولوجية such as disease يعني باختصار كأنه
+
+223
+00:14:02,560 --> 00:14:07,200
+بيقولي الأمراض الفيزيولوجية و الفيزياء اللي بتكون
+
+224
+00:14:07,200 --> 00:14:10,020
+في جسم الإنسان بتأثر على النوم و أنا قاعد بقولإن
+
+225
+00:14:10,020 --> 00:14:14,680
+أي تغيير في جسمنا .. دعوني أذكر حديث النبي صلى
+
+226
+00:14:14,680 --> 00:14:17,480
+الله عليه و سلم .. إذا أشتاق من عضو .. طبعا أعجبنا
+
+227
+00:14:17,480 --> 00:14:20,500
+أن .. سبحان الله الجسد الواحد .. إذا أشتاق من عضو
+
+228
+00:14:20,500 --> 00:14:23,960
+.. تداعله سائر الأعضاء .. السهر والحمة أو كما قال
+
+229
+00:14:23,960 --> 00:14:26,360
+النبي صلى الله عليه و سلم فبالتالي بيصير استجابة
+
+230
+00:14:26,360 --> 00:14:30,840
+من كل جسم الإنسان طيب .. good sleep .. النوم الجيد
+
+231
+00:14:30,840 --> 00:14:33,840
+.. النوم الطيب .. النوم المحترم .. depends on
+
+232
+00:14:33,840 --> 00:14:37,540
+number of awakenings and the total number of
+
+233
+00:14:37,540 --> 00:14:41,520
+sleeping hoursإذا بدنا نعرف النوم الطبيعي بدنا
+
+234
+00:14:41,520 --> 00:14:47,480
+نسأله قداش بتصحى في الليل و قداش بتنام ساعتك النوم
+
+235
+00:14:47,480 --> 00:14:51,160
+في بعض الناس بيقوللي بقوم في الليل مرتين أو تلاتة
+
+236
+00:14:51,160 --> 00:14:54,520
+يعني ممكن يكون عنده diabetes مش كتير بخوفني لكن في
+
+237
+00:14:54,520 --> 00:14:58,420
+الآخر أنا بده أسأله قداش في عندك ساعات نوم إذا
+
+238
+00:14:58,420 --> 00:15:01,180
+ساعات النوم اللي موجودة عنده within normal طبعا لو
+
+239
+00:15:01,180 --> 00:15:04,520
+حد سألني قداش ساعات النوم الطبيعية احنا زمان حكينا
+
+240
+00:15:04,520 --> 00:15:08,790
+فيها هم العلماء اختلفوا، اعتبروا من 6 إلى 8لكن
+
+241
+00:15:08,790 --> 00:15:11,870
+الطبيعي خليني اقول سبعة يعني ممكن يكون سبعة في
+
+242
+00:15:11,870 --> 00:15:14,390
+الصيف تمانية في الشتاء على اعتبار انه طول الليل
+
+243
+00:15:14,390 --> 00:15:19,010
+طيب the nurse assists sleep pattern by doing each
+
+244
+00:15:19,010 --> 00:15:21,730
+interview انا ماعنديش ايه يعني اكتر من هيك تمريض
+
+245
+00:15:21,730 --> 00:15:26,190
+انا بس بقدر اسأله عن طريق ال ايه المقابلة لكن لو
+
+246
+00:15:26,190 --> 00:15:31,330
+حد بيسألنا طب كيف نقدر نقيم انهم لأ الخصائيين في
+
+247
+00:15:31,330 --> 00:15:34,480
+عندهم حاجة special chart عندهمعن طريق ال EEG
+
+248
+00:15:34,480 --> 00:15:39,060
+Electroencephalogram بيعملوا تخطيط في الدماغ عشان
+
+249
+00:15:39,060 --> 00:15:43,040
+يشوف ذبذبات المخ كده كان هذا الطبيعي عنده النوم و
+
+250
+00:15:43,040 --> 00:15:48,500
+لا مش طبيعي طبعا هذا مش شغلنا شغل أخصائي disorders
+
+251
+00:15:48,500 --> 00:15:54,500
+related to sleep الإضطرابات اللي ممكن تحدث مرتبطة
+
+252
+00:15:54,500 --> 00:15:59,540
+مباشرة بالنوم أول حاجة بقولي أنا sleep
+
+253
+00:15:59,540 --> 00:16:03,430
+disturbances affects family life أكيدال .. ال ..
+
+254
+00:16:03,430 --> 00:16:06,330
+اللي عنده مشاكل في النوم بتأثر كل حاجة .. كل عائلة
+
+255
+00:16:06,330 --> 00:16:10,250
+بتأثر كيف يعني؟ لو قلنا رب البيت أو يعني المسئول
+
+256
+00:16:10,250 --> 00:16:13,150
+عن البيت مابيعرفش ينام و صارت فيه عنده مشكلة أو
+
+257
+00:16:13,150 --> 00:16:16,250
+يعني لاجوا الأولاد الصغار عمله بيسببوله الزعاج و
+
+258
+00:16:16,250 --> 00:16:20,430
+مش عارف ينام أكيد هتتأثرش هنا وظيفته مش بس هيك
+
+259
+00:16:20,430 --> 00:16:23,670
+social adjustment توافق الإجتماعي يعني بين قصين
+
+260
+00:16:23,670 --> 00:16:26,790
+اضطراب النوم بيعمل اضطراب في البيت اضطراب في
+
+261
+00:16:26,790 --> 00:16:30,690
+العائلة اضطراب في العمل اللي بعد feelings of
+
+262
+00:16:30,690 --> 00:16:35,710
+fatigue أكيدبالشعور بالإشهنة، بالتعب، بالارهاق ال
+
+263
+00:16:35,710 --> 00:16:38,790
+retability، التوتر difficulty in a concentrating
+
+264
+00:16:38,790 --> 00:16:43,250
+ما بقدرش أركز اللي بينامش كتير أسمعوني كويس اللي
+
+265
+00:16:43,250 --> 00:16:45,190
+بينامش كتير و أنا هذا كلام دايما بقوله لطلابي و
+
+266
+00:16:45,190 --> 00:16:50,090
+طالباتي قلة النوم مرتبطة بقلة التركيز علشان هي
+
+267
+00:16:50,090 --> 00:16:53,790
+اللي بيكون نايم كويس بيكون عنده open mind يعني
+
+268
+00:16:53,790 --> 00:16:58,650
+بيلاقي مخه متفتح و عقله متفتح و قادر يستوعب طبعا
+
+269
+00:16:58,650 --> 00:17:01,440
+مش واحد يقولي طب يا أستاذ أنا بنام كتير، لأالنوم
+
+270
+00:17:01,440 --> 00:17:03,600
+الكتير لأ برضه بيصير فينا loss of concentration
+
+271
+00:17:03,600 --> 00:17:07,100
+أنا لما أقول تمانية بقبل تسعة ساعات بس مابقبلش عشر
+
+272
+00:17:07,100 --> 00:17:10,620
+أو فوق و لما أقول ستة مابقبلش خمسة أو تحت يعني من
+
+273
+00:17:10,620 --> 00:17:12,980
+الساعات في بعض الناس بيقولك أنا بنامش أربع ساعات
+
+274
+00:17:12,980 --> 00:17:16,180
+على بعض طول اليوم difficulty in maintaining
+
+275
+00:17:16,180 --> 00:17:19,660
+orientation بيقدرش الواحد يركز طول النهار يظل عنده
+
+276
+00:17:19,660 --> 00:17:22,600
+يعني بنقول عنه full oriented اللي هو أخد .. بكرا
+
+277
+00:17:22,600 --> 00:17:24,860
+أخدناها في ال fundamental و بكرا هناخدناها على
+
+278
+00:17:24,860 --> 00:17:27,940
+المستشفى ال orientation يعني ان هو هل هو ياقظ و
+
+279
+00:17:27,940 --> 00:17:32,610
+صاحيو مدرك ابن جنسقله على تلت أشياء ال time و
+
+280
+00:17:32,610 --> 00:17:36,170
+النيم و ال place إذا بيعرف الإنسان وقته و بيعرف
+
+281
+00:17:36,170 --> 00:17:38,450
+اللي هو إيش اسمه و وين هو موجود معناته هو full
+
+282
+00:17:38,450 --> 00:17:41,850
+oriented لما واحد كتير في عنده مشاكل في النوم
+
+283
+00:17:41,850 --> 00:17:44,490
+بيصير عنده disturbance في ال إيش في ال orientation
+
+284
+00:17:44,490 --> 00:17:47,610
+illusions
+
+285
+00:17:47,610 --> 00:17:50,770
+تخيلات بيصير عنده إن كنتوا في قلة النوم بيصيروا
+
+286
+00:17:50,770 --> 00:17:54,390
+تخيلات بتخيل أنه كأنه شيء ع الحد كأنه شيء بيمشي
+
+287
+00:17:54,390 --> 00:17:57,270
+كأنه شيء بتحرك بيصير عنده hallucination
+
+288
+00:17:57,270 --> 00:17:59,800
+hallucination الهلاوساللي أخدناه في السنة الأولى
+
+289
+00:17:59,800 --> 00:18:03,380
+halos visual or tactile هجرة halos سواء كانت بصرية
+
+290
+00:18:03,380 --> 00:18:07,720
+أو halos لمسية من كتر ما هو إيش من كتر ما هو عنده
+
+291
+00:18:07,720 --> 00:18:11,120
+أرق شديد صار عنده يهلوس شوية وهذا بدل على أنه
+
+292
+00:18:11,120 --> 00:18:14,660
+سبحان الله يعني الإنسان يجب أن يأخذ قصد من الراحة
+
+293
+00:18:14,660 --> 00:18:19,740
+علشان الجسم يظل ماشي بأمره ال biology وساعته ال
+
+294
+00:18:19,740 --> 00:18:25,840
+biology الطبيعية decreased incentive to
+
+295
+00:18:25,840 --> 00:18:29,790
+work incentive يعنيإنه بتبطل في عنده رغبة ودافع
+
+296
+00:18:29,790 --> 00:18:33,330
+للعمل اللي بيكون عنده سبحان الله نقص كتير في النوم
+
+297
+00:18:33,330 --> 00:18:37,810
+بيجلي عنده الرغبة الحركية لإيش للعمل Psychomotor
+
+298
+00:18:37,810 --> 00:18:40,670
+يعني بيسموه نفسي حركي يعني باختصار اللي بنامش كتير
+
+299
+00:18:40,670 --> 00:18:44,070
+بتلاقي دايما خامل دايما مش قادر يتحرك دايما بتلاقي
+
+300
+00:18:44,070 --> 00:18:47,810
+عمال شوية شوية بده يقدر يجمع بأداء الوظائف اللي
+
+301
+00:18:47,810 --> 00:18:51,140
+موجودة عنده عشان ايه كانت مشكلة كبيرة لما ..بعد
+
+302
+00:18:51,140 --> 00:18:54,700
+الفترة اللي فاتت بعد انقضاء في فترة كورونا رجعوا
+
+303
+00:18:54,700 --> 00:18:57,840
+الطلاب المدارس كانت بمشكلة مش قادرين يتأقلموا و
+
+304
+00:18:57,840 --> 00:19:00,980
+يمكن هذا اللي خلاهم ياخدوا شوية شهر استدراكي و
+
+305
+00:19:00,980 --> 00:19:04,360
+ماكانش له فائدة كبيرة للأسف حتى حسب يعني الخبراء
+
+306
+00:19:04,360 --> 00:19:09,460
+ستة mild nystagmas زغلى لفلعين من جلة النوم بتلاقي
+
+307
+00:19:09,460 --> 00:19:12,080
+عينيك بتزغلى مبروح شمال ويمين أو فوق وتحت يعني مش
+
+308
+00:19:12,080 --> 00:19:15,770
+قادر أيش يركز شويةTremor of hands طبعا ال tremor
+
+309
+00:19:15,770 --> 00:19:18,390
+يعني أنك بتصير عندك راجفة في الأيدين من كتر اللي
+
+310
+00:19:18,390 --> 00:19:21,130
+هو الأرق اللي موجود عنده و التوتر و قلة النوم
+
+311
+00:19:21,130 --> 00:19:24,830
+بتلاقي أديه عمال و برجل عصبيهم Increased
+
+312
+00:19:24,830 --> 00:19:28,190
+glucocorticoid and adrenergic hormone secretion
+
+313
+00:19:28,190 --> 00:19:33,170
+يعني كأما ما بيقولي كمان بزيد عنه إيش ال glucose و
+
+314
+00:19:33,170 --> 00:19:35,890
+بزيد عنه ال adrenaline طبعا ال adrenaline من وين
+
+315
+00:19:35,890 --> 00:19:38,410
+جاي؟ من ال adrenal gland من ما أنتوا عارفين و
+
+316
+00:19:38,410 --> 00:19:40,510
+glucocorticoid برضه من ال adrenaline بس اللهم
+
+317
+00:19:41,160 --> 00:19:43,280
+بنذكركم ال Anatomy ال adrenaline جاية من ال
+
+318
+00:19:43,280 --> 00:19:47,120
+adrenaline مضلة و ال glucocorticoid جاية من ال
+
+319
+00:19:47,120 --> 00:19:50,180
+adrenaline cortex اللي هو القشرة اللحاق و القشرة
+
+320
+00:19:50,180 --> 00:19:53,560
+طبعا ليش؟ برضه هذا كله استجابة لقلة النوم أكيد لإن
+
+321
+00:19:53,560 --> 00:19:56,340
+الإنسان لم يكن صاحي و مش عارف ينام بيضال ال
+
+322
+00:19:56,340 --> 00:20:01,880
+adrenaline عنده عالي شوية اتنين او تسعة increased
+
+323
+00:20:01,880 --> 00:20:06,460
+anxiety with a sense of tiredness بتزيد القلق كتير
+
+324
+00:20:06,460 --> 00:20:09,540
+عند الإنسانو من شدة القلق اللي صار عنده صار عنده
+
+325
+00:20:09,540 --> 00:20:13,300
+إيش أنا؟ إحساس بالإيش؟ التعب sense of tiredness
+
+326
+00:20:13,300 --> 00:20:18,560
+إحساس بالانهاج، انهاج القوة، مش قادر، ركز Insomnia
+
+327
+00:20:18,560 --> 00:20:22,600
+Insomnia يعني انا بيصير عنده قرق و كلكوا عارفين شو
+
+328
+00:20:22,600 --> 00:20:25,920
+القرق خدناها زمان short and sleeping pills يعني
+
+329
+00:20:25,920 --> 00:20:30,140
+إما difficulty to start sleep or difficulty to
+
+330
+00:20:30,140 --> 00:20:34,100
+stay sleep يعني إما مش قادر يخش في النوم أو مش
+
+331
+00:20:34,100 --> 00:20:39,370
+قادر يبقى نائما، هذا بيسميه insomnia11 لاحظين كدهش
+
+332
+00:20:39,370 --> 00:20:42,310
+disorders كتيرة اللي مرتبطة بالنوم شوفوا احنا
+
+333
+00:20:42,310 --> 00:20:46,530
+قاعدين لسه ما أقول 11 و 12 كتير sleep apnea ال
+
+334
+00:20:46,530 --> 00:20:49,510
+sleep apnea اللي هو بيصير عناش هنا cessation of
+
+335
+00:20:49,510 --> 00:20:53,290
+breathing بتلاقي بتوقف النفس أثناء النوم اللي لما
+
+336
+00:20:53,290 --> 00:20:55,690
+احنا جولنا في بعض الحالات زي الناس اللي عندهم
+
+337
+00:20:55,690 --> 00:20:59,390
+bronchial أزمة بتلاقي أو ب COPD بتلاقي مجرد ما هو
+
+338
+00:20:59,390 --> 00:21:02,820
+نائم فجأةبصير عنده gasping for air يعني بتلاقي
+
+339
+00:21:02,820 --> 00:21:05,700
+كأنه .. يعني بصير عنده حالات الروح كأنه بده ياخد
+
+340
+00:21:05,700 --> 00:21:09,480
+شوية نفس، بيجوم من النوم علشان يقدر ياخد شوية نفس،
+
+341
+00:21:09,480 --> 00:21:12,860
+هذا بسمى sleep apnea، توقف النفس أثناء النوم
+
+342
+00:21:12,860 --> 00:21:17,000
+hypersomnia مش insomnia، hyper، مزاج اللي
+
+343
+00:21:17,000 --> 00:21:21,300
+hypersomnia يعني excessive sleeping، بنام طويل،
+
+344
+00:21:21,300 --> 00:21:25,280
+قدش بنام؟ في بعض الحالات extended to 16 to 18
+
+345
+00:21:25,280 --> 00:21:30,180
+hours، حالات نادرة، بصلى 16 ساعة في اليومطبعا مش
+
+346
+00:21:30,180 --> 00:21:34,180
+واحد ييجي يقول يا استاذ أنا أخدت إبرة كده أو أخدت
+
+347
+00:21:34,180 --> 00:21:37,840
+حبة دوة معينة زي مثلا دوة اسمه Phenergan Pro
+
+348
+00:21:37,840 --> 00:21:41,540
+Methazine ال Phenergan هذا يعتبر من ال potent
+
+349
+00:21:41,540 --> 00:21:45,940
+antihistamine يعني من المضادات للهستامين قوية جدا
+
+350
+00:21:45,940 --> 00:21:49,000
+لأ اخدها الإنسان ممكن ينام 16 ساعة بقدرش أقول هذا
+
+351
+00:21:49,000 --> 00:21:52,920
+يعني diseased لأ أو بقول disturbances لأ هذا
+
+352
+00:21:52,920 --> 00:21:56,080
+بعتبره normal situation لأنه استجابة للعلاج لكن لو
+
+353
+00:21:56,080 --> 00:21:58,460
+واحد في طبيعته ينام 16 ساعة لأ بقول إنه فيه عنده
+
+354
+00:21:58,460 --> 00:22:03,330
+مشكلةhypersomnia perihypersomnia لما نقول كلمة
+
+355
+00:22:03,330 --> 00:22:06,450
+perihypersomnia هو بنام كتير زي ما احنا قولنا 16
+
+356
+00:22:06,450 --> 00:22:12,110
+أو 18 ساعة لكن مش لكتير مش طول الوقت بقوللي هنا
+
+357
+00:22:12,110 --> 00:22:17,550
+لاحظين few days ايش هنا few days هنا بنام صحيح 16
+
+358
+00:22:17,550 --> 00:22:22,650
+.. 14 .. 18 ساعة لكن بنام بشكل دوري دائم زي هيك
+
+359
+00:22:22,650 --> 00:22:25,430
+هنا بنسميها hypersomnia لإعتبارها سرط سرط disorder
+
+360
+00:22:25,430 --> 00:22:29,490
+without trouble هنا perhypersomnia لأبنام صحيح نوم
+
+361
+00:22:29,490 --> 00:22:32,650
+كتير لكن كدهش في أيام متقطعة، يا انا اعطيكم مثال
+
+362
+00:22:32,650 --> 00:22:35,470
+زي ما ييجي الطالب يسألني، يقولني طب أنا يوم الخميس
+
+363
+00:22:35,470 --> 00:22:38,110
+و الله يا استاذ مرات بنام 14 ساعة أو مرات يوم
+
+364
+00:22:38,110 --> 00:22:41,730
+الجمعة، بقولهم مش مشكلة، ليه؟ لأنه اعتبرتها pre
+
+365
+00:22:41,730 --> 00:22:45,030
+-hypersomnia، يعني في هذه الوقت ماقدرش اقول عنه ال
+
+366
+00:22:45,030 --> 00:22:48,890
+disorder لأنه مش مستمر معاك و دائم، فعلشان هيك مش
+
+367
+00:22:48,890 --> 00:22:53,510
+كل شيء بدنا نقدر نقول عنه مرض إلا إذا استمر، طيب
+
+368
+00:22:53,510 --> 00:22:57,270
+ناركوليبسي أخدناها زمان في ال psychology، و نزيجي
+
+369
+00:22:57,270 --> 00:23:00,030
+أنا أيديه كم مرةExcessive بسموها daytime
+
+370
+00:23:00,030 --> 00:23:04,310
+drowsiness or uncontrolled onset of sleep عدم
+
+371
+00:23:04,310 --> 00:23:08,350
+الاستطاع على ايه التحكم في النوم أثناء ال .. أثناء
+
+372
+00:23:08,350 --> 00:23:11,970
+النهار Narcolepsy كيف يعني؟ زي بعض الإنسان اللي
+
+373
+00:23:11,970 --> 00:23:15,650
+بيكون راكب في ال bus و لسه مش نايم كويس و عمار صار
+
+374
+00:23:15,650 --> 00:23:18,830
+عنده drowsiness و مش قادر يتحكم في نفسه أو بيلاقي
+
+375
+00:23:18,830 --> 00:23:21,530
+بيصير الرأس و يروح شمال أو يمين أو بيكون على مقعد
+
+376
+00:23:21,530 --> 00:23:24,250
+الدراسة و الأستاذ عمار بيشرح بيصير عند الأطفال
+
+377
+00:23:24,250 --> 00:23:28,860
+مراتو بتلاقي مش قادر فحط رأسه على ال بانكيكا ونام،
+
+378
+00:23:28,860 --> 00:23:33,900
+ماقدرش يتحمل، هذا اسمه Narcolepsy خمستاشر
+
+379
+00:23:33,900 --> 00:23:37,060
+Cataplexy لما نقول Cataplexy هناقش بيصير
+
+380
+00:23:37,060 --> 00:23:40,200
+Appropriate weakness or paralysis of a voluntary
+
+381
+00:23:40,200 --> 00:23:45,700
+muscles فجأة بنلاقي إيش؟ ضعف أو مرتشة للبسيط في
+
+382
+00:23:45,700 --> 00:23:49,120
+إيش؟ في العضلات اللي هي بنقدر نتحكم فيها اللي هي
+
+383
+00:23:49,120 --> 00:23:53,760
+نستطيع نتحكم فيها بشكل تلقائي يعني voluntary يعني
+
+384
+00:23:53,760 --> 00:23:59,050
+إيراديازي ال arms ال legs ال face طيب last
+
+385
+00:23:59,050 --> 00:24:02,490
+condition from half seconds to ten minutes هذا
+
+386
+00:24:02,490 --> 00:24:06,670
+طبعا نادر تحصل نادر تحصل كيف تحصل بقول اللي بتحصل
+
+387
+00:24:06,670 --> 00:24:10,970
+يا مرة يا إما مرتين في العام كله كيف بتصير من
+
+388
+00:24:10,970 --> 00:24:14,090
+الإضطراب اللي موجود عنده في النوم بيحكوا أنه بيصير
+
+389
+00:24:14,090 --> 00:24:19,350
+عنده فقد فجأة لحركة الإيدين أو مرات زي شلل إما ضعف
+
+390
+00:24:19,350 --> 00:24:23,490
+أو شلل بقولك مش قادر حق أحرك إيدي مرات تستمر يعني
+
+391
+00:24:23,490 --> 00:24:26,930
+ثانيةو مرات بتقعد دقيقة، دقيقتين، تلاتة، ممكن
+
+392
+00:24:26,930 --> 00:24:29,470
+ازيد، بتحدث مرة او مرتين في العالم، بعدين الإنسان
+
+393
+00:24:29,470 --> 00:24:33,670
+برجع لطبيعته، هذه ما بندرش .. ما بنخوفش منها و ما
+
+394
+00:24:33,670 --> 00:24:36,190
+بنقولش بيدا علاج، هذه سبحان الله برضه مرتبطة
+
+395
+00:24:36,190 --> 00:24:38,990
+بالإيه؟ بال sleep disturbances اللي بتصير عند بعض
+
+396
+00:24:38,990 --> 00:24:43,350
+الحالات في مصطلع جديد اسمه hypnagogic أو
+
+397
+00:24:43,350 --> 00:24:46,130
+hypnagogic hallucinations إيش ال hypnagogic
+
+398
+00:24:46,130 --> 00:24:49,570
+hallucinations؟ هذه عبارة عن الطراب في إيش؟ في
+
+399
+00:24:49,570 --> 00:24:53,210
+النوم، بس للأسف لما بيصير مع الأحلام، الأحلام
+
+400
+00:24:53,210 --> 00:24:56,220
+المزعجةليه frightening dreams .. frightening
+
+401
+00:24:56,220 --> 00:24:59,080
+dreams اللي زي ال nightmares يعني بيصير عنده أحلام
+
+402
+00:24:59,080 --> 00:25:04,040
+صعبة جدا بتخلي الواحد دايما إيش عنده كأنه مش قادر
+
+403
+00:25:04,040 --> 00:25:07,940
+يدخل في النوم يعني بتلاقي مشكلة عنده متى بيجي
+
+404
+00:25:07,940 --> 00:25:10,460
+بيقوللي مجرد ما أجي أنام يا أستاذ أو يا دكتور
+
+405
+00:25:10,460 --> 00:25:15,600
+بيصير عنده إيش بخاف كأني أنا إيش كأنه شيء بيخنقني
+
+406
+00:25:15,600 --> 00:25:19,020
+يعني بتدوجع كأن كده مع بداية النوم هذا بيسموه
+
+407
+00:25:19,020 --> 00:25:20,160
+hallucination
+
+408
+00:25:22,090 --> 00:25:25,470
+برضه يعني إذا ضلت استمرت بعض الأطباء بيوصفوا
+
+409
+00:25:25,470 --> 00:25:29,210
+العلاج بسيط أنا مش في طور أن أكتب أو أحكي عن أي
+
+410
+00:25:29,210 --> 00:25:33,050
+علاج حتى الإنسان مايروح يشتري أي علاج وأنما يعني
+
+411
+00:25:33,050 --> 00:25:36,270
+ممكن تكون حالة ان شاء الله عابرة أو تنتهي لحظين
+
+412
+00:25:36,270 --> 00:25:41,130
+أكم يعني أكم من ال disorder بتكلم 14 واحد فليس
+
+413
+00:25:41,130 --> 00:25:46,290
+سهلا اضطرابة النوم للإنسان لازم يكون يعني مركز أنه
+
+414
+00:25:46,290 --> 00:25:48,850
+مش سهل أن الإنسان يكون عنده اضطراب في النوم
+
+415
+00:25:48,850 --> 00:25:54,380
+assessment of sleephabits طيب كيف بدأ أعمل تقييم
+
+416
+00:25:54,380 --> 00:25:57,380
+للنوم؟ أول حاجة بنجي بنسأل و بنقول للمريض record
+
+417
+00:25:57,380 --> 00:26:00,940
+the times ياريخ يسجللنا أوقات النوم و ال awakening
+
+418
+00:26:00,940 --> 00:26:05,080
+و اليقظة و including naps إيش نابس يا ماناتا؟
+
+419
+00:26:05,080 --> 00:26:08,640
+الغفوة بيسموها الغفوات بنسمع اللي احنا مرات ..
+
+420
+00:26:08,640 --> 00:26:12,460
+احنا بنقول عنها في الدين الإسلامي القيلولة لازم
+
+421
+00:26:12,460 --> 00:26:17,100
+نسأل المريض لو سمحت أنت كده بتنام في 24 ساعة؟ كده
+
+422
+00:26:17,100 --> 00:26:20,460
+في الليل؟ كده في النهار؟ كده تصحى؟و لو بتغف .. حتى
+
+423
+00:26:20,460 --> 00:26:23,880
+لو بتغفى، هيك نقوله أو بتسهي في بعض الناس، أقول
+
+424
+00:26:23,880 --> 00:26:28,540
+عنها، كده بتغفى و بتسهي عشان أنا أحسبها، كله لازم
+
+425
+00:26:28,540 --> 00:26:31,700
+ينحسب في الآخر، بنجمع مع بعض، كده نام و كده صحي
+
+426
+00:26:31,700 --> 00:26:35,260
+Allow the client to describe their sleep habits in
+
+427
+00:26:35,260 --> 00:26:38,800
+their own words وكأنه بيقوللي أقعد تتدخل في إيش في
+
+428
+00:26:38,800 --> 00:26:43,840
+كلامك، ماتخلوش يتأثر، خل المريض يوصف حالته النومية
+
+429
+00:26:43,840 --> 00:26:50,030
+و المناميةوعادته باسلوبه الخاص يعني بطريقته بكلامه
+
+430
+00:26:50,030 --> 00:26:54,310
+مابدناش نتدخل بأي كلمة احنا من عنا ممكن تخربته you
+
+431
+00:26:54,310 --> 00:26:58,270
+can ask the following questions يمكن للممرض او
+
+432
+00:26:58,270 --> 00:27:02,530
+للحكيم انه يسأل هذه الأسئلة ايش الأسئلة بتقول how
+
+433
+00:27:02,530 --> 00:27:06,930
+have you been sleeping؟ كيف انت بتنام؟ لو سمعت كيف
+
+434
+00:27:06,930 --> 00:27:13,080
+نومك؟ كيف انت و النوم؟ يعني سؤال open حلوالسؤال
+
+435
+00:27:13,080 --> 00:27:16,820
+التاني can you tell me your sleeping habits؟ ممكن
+
+436
+00:27:16,820 --> 00:27:20,220
+تحكيلي عن عاداتك في النوم؟ كيف عادات النوم
+
+437
+00:27:20,220 --> 00:27:23,440
+بالنسبالك؟ ممكن تتكلمني إيش اللي أنت الطقوس اللي
+
+438
+00:27:23,440 --> 00:27:26,820
+موجودة عندك أو أكتر شي في حياتك يعني عادات
+
+439
+00:27:26,820 --> 00:27:30,280
+بتتاخدها لموضوع النوم؟ اللي بعده are you getting
+
+440
+00:27:30,280 --> 00:27:34,020
+enough rest؟ هل بتاخد راحتك وكفيتك في النوم و في
+
+441
+00:27:34,020 --> 00:27:37,860
+حياتك يعني الاسترخائية و بتشعر أنك أنت مرتاح ولا
+
+442
+00:27:37,860 --> 00:27:41,660
+لأ؟tell me about your sleeping problems احكيلي عن
+
+443
+00:27:41,660 --> 00:27:45,500
+اي مشكلات في انهم موجودة عندك لاحظين انه مافيش
+
+444
+00:27:45,500 --> 00:27:48,440
+فيها bias مافيش فيها ايش يعني انت عايز مافيش فيها
+
+445
+00:27:48,440 --> 00:27:51,900
+leading ال question اللي بعد ايش بيسموها ال
+
+446
+00:27:51,900 --> 00:27:54,920
+history هنا enclosed general sleep لازم تتذكر
+
+447
+00:27:54,920 --> 00:27:58,680
+بتسأل دايما على ال general sleep يعني انهم بشكل
+
+448
+00:27:58,680 --> 00:28:03,540
+عام ال history psychological history لو حد سألني
+
+449
+00:28:03,540 --> 00:28:06,060
+او حد سألني يقولي ايش داخل ال psychological
+
+450
+00:28:06,060 --> 00:28:12,430
+history من اخطرالترابات النوم المنشأ نفسي، من أخطر
+
+451
+00:28:12,430 --> 00:28:16,490
+الترابات النوم المنشأ نفسي ما عمرك شفت واحد لا
+
+452
+00:28:16,490 --> 00:28:20,610
+خايف ولا عنده anxiety ولا عنده لا سمح الله اي
+
+453
+00:28:20,610 --> 00:28:23,970
+tremors ولا عنده خليني نقول بعض يعني personal
+
+454
+00:28:23,970 --> 00:28:27,390
+disorders اللي طلعت شخصية و جادر بنامي كويس اللي
+
+455
+00:28:27,390 --> 00:28:31,990
+يكون اللي عنده psychological problems عنده sleep
+
+456
+00:28:31,990 --> 00:28:35,510
+problems على فكرة و العكس صحيح و اللي عنده sleep
+
+457
+00:28:35,510 --> 00:28:39,430
+problems برضه عنده psychological problemsبعض الناس
+
+458
+00:28:39,430 --> 00:28:43,510
+نسأل عن drug history ممكن يقولك انا باخد دوة كده
+
+459
+00:28:43,510 --> 00:28:46,570
+بيخليني صاحي ممكن فلان يقولك انا باخد دوة كده
+
+460
+00:28:46,570 --> 00:28:50,070
+بيخليني نايم و بعضهم يقولك انا باخد دوة بيخليني
+
+461
+00:28:50,070 --> 00:28:54,350
+عندي أشعر بدجات الجلب سريعا طبعا بنسأل ايش ل drug
+
+462
+00:28:54,350 --> 00:28:57,190
+history و ايش اللي عامله عامله عنده اي اضطرابات في
+
+463
+00:28:57,190 --> 00:29:02,090
+النوم احنا هنخلنا نخلص اللي عندنا عشان نبدأ ان شاء
+
+464
+00:29:02,090 --> 00:29:05,930
+الله في الشبتر القادم عشان دائما نلتزم بالوقت
+
+465
+00:29:05,930 --> 00:29:10,460
+المناسب اللي هو حدودالـ 30 دقيقة والسلام عليكم
+
+466
+00:29:10,460 --> 00:29:11,960
+ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..2e9087983905c465a27be0a21722531619a39985
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.json
@@ -0,0 +1 @@
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endocrine disease أمراض بتصيب غضب الصمم على فكرة من ضمن الدهبيتس ومن ضمن أمراض تانية زي ال hyperthyroidism أو ال hypothyroidism و هو كده", "tokens": [12864, 4752, 5551, 4117, 25708, 20449, 32748, 3224, 11536, 4032, 9778, 33546, 3660, 37495, 22653, 32748, 3224, 11536, 13672, 1829, 39896, 21136, 1829, 19986, 3660, 4032, 13672, 1829, 3714, 43020, 6055, 25957, 1211, 9122, 2655, 13546, 10874, 1211, 9566, 9307, 1732, 5592, 13672, 1829, 31439, 21136, 2288, 9566, 7649, 15844, 1975, 34268, 3555, 9640, 16472, 45030, 11242, 18863, 19528, 16606, 5551, 8592, 3224, 2288, 14407, 16472, 2423, 5592, 5438, 37495, 22653, 39894, 2655, 17082, 3215, 7578, 15844, 21136, 37983, 4724, 8592, 28820, 9122, 3555, 13546, 917, 3617, 533, 4752, 5551, 29973, 46958, 39894, 9381, 1829, 3555, 32771, 11242, 3555, 31767, 2304, 2304, 15844, 6156, 4117, 25720, 9154, 48812, 27842, 32748, 3224, 21292, 2655, 3794, 4032, 27842, 48812, 27842, 5551, 29973, 46958, 6055, 7649, 10632, 30767, 1829, 2423, 9848, 28433, 6490, 1434, 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"probability": 0.88623046875}, {"start": 1575.52, "end": 1575.72, "word": " 24", "probability": 0.2183837890625}, {"start": 1575.72, "end": 1576.82, "word": " ساعة؟", "probability": 0.79754638671875}, {"start": 1576.82, "end": 1577.1, "word": " كده", "probability": 0.9742838541666666}, {"start": 1577.1, "end": 1577.22, "word": " في", "probability": 0.88232421875}, {"start": 1577.22, "end": 1577.52, "word": " الليل؟", "probability": 0.9261067708333334}, {"start": 1577.52, "end": 1577.72, "word": " كده", "probability": 0.9913736979166666}, {"start": 1577.72, "end": 1577.82, "word": " في", "probability": 0.99267578125}, {"start": 1577.82, "end": 1578.12, "word": " النهار؟", "probability": 0.9539794921875}, {"start": 1578.12, "end": 1578.36, "word": " كده", "probability": 0.9851888020833334}, {"start": 1578.36, "end": 1578.92, "word": " تصحى؟", "probability": 0.88701171875}], "temperature": 1.0}, {"id": 57, "seek": 160522, "start": 1579.38, "end": 1605.22, "text": "و لو بتغف .. حتى لو بتغفى، هيك نقوله أو بتسهي في بعض الناس، أقول عنها، كده بتغفى و بتسهي عشان أنا أحسبها، كله لازم ينحسب في الآخر، بنجمع مع بعض، كده نام و كده صحي Allow the client to describe their sleep habits in their own words وكأنه بيقوللي أقعد تتدخل في إيش في كلامك، ماتخلوش يتأثر، خل المريض يوصف حالته النومية و المنامية", "tokens": [2407, 45164, 39894, 17082, 5172, 4386, 11331, 49975, 45164, 39894, 17082, 5172, 7578, 12399, 39896, 4117, 8717, 39648, 3224, 34051, 39894, 3794, 3224, 1829, 8978, 45030, 11242, 2423, 8315, 3794, 12399, 5551, 39648, 18871, 11296, 12399, 9122, 3215, 3224, 39894, 17082, 5172, 7578, 4032, 39894, 3794, 3224, 1829, 6225, 8592, 7649, 41850, 5551, 5016, 35457, 11296, 12399, 28242, 3224, 5296, 31377, 2304, 7251, 1863, 5016, 35457, 8978, 6024, 95, 34740, 12399, 44945, 7435, 2304, 3615, 20449, 45030, 11242, 12399, 9122, 3215, 3224, 8717, 10943, 4032, 9122, 3215, 3224, 20328, 5016, 1829, 1057, 305, 264, 6423, 281, 6786, 641, 2817, 14100, 294, 641, 1065, 2283, 4032, 4117, 33456, 3224, 4724, 1829, 39648, 20292, 5551, 4587, 22488, 6055, 2655, 3215, 9778, 1211, 8978, 11933, 1829, 8592, 8978, 28242, 10943, 4117, 12399, 3714, 9307, 9778, 1211, 2407, 8592, 7251, 2655, 10721, 49115, 12399, 16490, 1211, 9673, 16572, 11242, 7251, 2407, 9381, 5172, 11331, 6027, 47395, 28239, 20498, 10632, 4032, 9673, 8315, 2304, 10632], "avg_logprob": -0.2146739100817568, "compression_ratio": 1.724025974025974, "no_speech_prob": 0.0, "words": [{"start": 1579.38, "end": 1579.56, "word": "و", "probability": 0.59423828125}, {"start": 1579.56, "end": 1579.7, "word": " لو", "probability": 0.7392578125}, {"start": 1579.7, "end": 1580.08, "word": " بتغف", "probability": 0.6505533854166666}, {"start": 1580.08, "end": 1580.08, "word": " ..", "probability": 0.494140625}, {"start": 1580.08, "end": 1580.46, "word": " حتى", "probability": 0.884521484375}, {"start": 1580.46, "end": 1580.6, "word": " لو", "probability": 0.9951171875}, {"start": 1580.6, "end": 1581.3, "word": " بتغفى،", "probability": 0.709423828125}, {"start": 1581.3, "end": 1581.54, "word": " هيك", "probability": 0.890380859375}, {"start": 1581.54, "end": 1581.9, "word": " نقوله", "probability": 0.5804036458333334}, {"start": 1581.9, "end": 1582.52, "word": " أو", "probability": 0.425048828125}, {"start": 1582.52, "end": 1583.14, "word": " بتسهي", "probability": 0.8720703125}, {"start": 1583.14, "end": 1583.3, "word": " في", "probability": 0.755859375}, {"start": 1583.3, "end": 1583.54, "word": " بعض", "probability": 0.9912109375}, {"start": 1583.54, "end": 1583.78, "word": " الناس،", "probability": 0.8690185546875}, {"start": 1583.78, "end": 1583.88, "word": " أقول", "probability": 0.678466796875}, {"start": 1583.88, "end": 1584.68, "word": " عنها،", "probability": 0.82861328125}, {"start": 1584.68, "end": 1584.96, "word": " كده", "probability": 0.66748046875}, {"start": 1584.96, "end": 1585.72, "word": " بتغفى", "probability": 0.8533935546875}, {"start": 1585.72, "end": 1585.78, "word": " و", "probability": 0.65673828125}, {"start": 1585.78, "end": 1586.04, "word": " بتسهي", "probability": 0.9427490234375}, {"start": 1586.04, "end": 1586.3, "word": " عشان", "probability": 0.9571940104166666}, {"start": 1586.3, "end": 1586.52, "word": " أنا", "probability": 0.658203125}, {"start": 1586.52, "end": 1587.86, "word": " أحسبها،", "probability": 0.820849609375}, {"start": 1587.86, "end": 1588.3, "word": " كله", "probability": 0.6317138671875}, {"start": 1588.3, "end": 1588.54, "word": " لازم", "probability": 0.9913736979166666}, {"start": 1588.54, "end": 1588.88, "word": " ينحسب", "probability": 0.9034423828125}, {"start": 1588.88, "end": 1589.0, "word": " في", "probability": 0.95654296875}, {"start": 1589.0, "end": 1589.34, "word": " الآخر،", "probability": 0.88037109375}, {"start": 1589.34, "end": 1589.72, "word": " بنجمع", "probability": 0.965576171875}, {"start": 1589.72, "end": 1589.84, "word": " مع", "probability": 0.82373046875}, {"start": 1589.84, "end": 1590.46, "word": " بعض،", "probability": 0.8203938802083334}, {"start": 1590.46, "end": 1590.74, "word": " كده", "probability": 0.9471028645833334}, {"start": 1590.74, "end": 1591.04, "word": " نام", "probability": 0.6104736328125}, {"start": 1591.04, "end": 1591.12, "word": " و", "probability": 0.8994140625}, {"start": 1591.12, "end": 1591.34, "word": " كده", "probability": 0.98095703125}, {"start": 1591.34, "end": 1591.7, "word": " صحي", "probability": 0.8284505208333334}, {"start": 1591.7, "end": 1592.8, "word": " Allow", "probability": 0.448394775390625}, {"start": 1592.8, "end": 1592.96, "word": " the", "probability": 0.92626953125}, {"start": 1592.96, "end": 1593.32, "word": " client", "probability": 0.8984375}, {"start": 1593.32, "end": 1593.54, "word": " to", "probability": 0.9794921875}, {"start": 1593.54, "end": 1594.02, "word": " describe", "probability": 0.8837890625}, {"start": 1594.02, "end": 1594.26, "word": " their", "probability": 0.95751953125}, {"start": 1594.26, "end": 1594.62, "word": " sleep", "probability": 0.93994140625}, {"start": 1594.62, "end": 1595.0, "word": " habits", "probability": 0.92041015625}, {"start": 1595.0, "end": 1595.26, "word": " in", "probability": 0.96337890625}, {"start": 1595.26, "end": 1595.52, "word": " their", "probability": 0.96630859375}, {"start": 1595.52, "end": 1595.78, "word": " own", "probability": 0.93115234375}, {"start": 1595.78, "end": 1596.08, "word": " words", "probability": 0.91552734375}, {"start": 1596.08, "end": 1596.96, "word": " وكأنه", "probability": 0.74493408203125}, {"start": 1596.96, "end": 1597.22, "word": " بيقوللي", "probability": 0.75286865234375}, {"start": 1597.22, "end": 1597.56, "word": " أقعد", "probability": 0.6996256510416666}, {"start": 1597.56, "end": 1598.26, "word": " تتدخل", "probability": 0.90078125}, {"start": 1598.26, "end": 1598.44, "word": " في", "probability": 0.9677734375}, {"start": 1598.44, "end": 1598.68, "word": " إيش", "probability": 0.8981119791666666}, {"start": 1598.68, "end": 1598.8, "word": " في", "probability": 0.5625}, {"start": 1598.8, "end": 1599.84, "word": " كلامك،", "probability": 0.9022216796875}, {"start": 1599.84, "end": 1600.24, "word": " ماتخلوش", "probability": 0.868896484375}, {"start": 1600.24, "end": 1601.04, "word": " يتأثر،", "probability": 0.905078125}, {"start": 1601.04, "end": 1601.34, "word": " خل", "probability": 0.9013671875}, {"start": 1601.34, "end": 1601.7, "word": " المريض", "probability": 0.7921549479166666}, {"start": 1601.7, "end": 1602.3, "word": " يوصف", "probability": 0.989501953125}, {"start": 1602.3, "end": 1602.94, "word": " حالته", "probability": 0.9915364583333334}, {"start": 1602.94, "end": 1603.84, "word": " النومية", "probability": 0.8743489583333334}, {"start": 1603.84, "end": 1604.52, "word": " و", "probability": 0.70556640625}, {"start": 1604.52, "end": 1605.22, "word": " المنامية", "probability": 0.97900390625}], "temperature": 1.0}, {"id": 58, "seek": 163207, "start": 1605.71, "end": 1632.07, "text": "وعادته باسلوبه الخاص يعني بطريقته بكلامه مابدناش نتدخل بأي كلمة احنا من عنا ممكن تخربته you can ask the following questions يمكن للممرض او للحكيم انه يسأل هذه الأسئلة ايش الأسئلة بتقول how have you been sleeping؟ كيف انت بتنام؟ لو سمعت كيف نومك؟ كيف انت و النوم؟ يعني سؤال open حلو", "tokens": [45367, 18513, 47395, 4724, 32277, 1211, 37746, 3224, 33962, 33546, 37495, 22653, 4724, 9566, 16572, 38149, 3224, 4724, 28820, 10943, 3224, 19446, 44510, 1863, 33599, 8717, 2655, 3215, 9778, 1211, 4724, 10721, 1829, 9122, 19528, 3660, 1975, 5016, 8315, 9154, 6225, 8315, 3714, 43020, 6055, 9778, 25513, 47395, 291, 393, 1029, 264, 3480, 1651, 7251, 43020, 5296, 19528, 29973, 11242, 1975, 2407, 5296, 1211, 5016, 4117, 32640, 16472, 3224, 7251, 3794, 10721, 1211, 29538, 16247, 3794, 19986, 37977, 1975, 1829, 8592, 16247, 3794, 19986, 37977, 39894, 39648, 577, 362, 291, 668, 8296, 22807, 9122, 33911, 16472, 2655, 39894, 8315, 2304, 22807, 45164, 8608, 2304, 34268, 9122, 33911, 8717, 20498, 4117, 22807, 9122, 33911, 16472, 2655, 4032, 28239, 20498, 22807, 37495, 22653, 8608, 33604, 6027, 1269, 11331, 1211, 2407], "avg_logprob": -0.1583091085271318, "compression_ratio": 1.6977611940298507, "no_speech_prob": 0.0, "words": [{"start": 1605.71, "end": 1606.65, "word": "وعادته", "probability": 0.69384765625}, {"start": 1606.65, "end": 1607.77, "word": " باسلوبه", "probability": 0.8775390625}, {"start": 1607.77, "end": 1608.11, "word": " الخاص", "probability": 0.989501953125}, {"start": 1608.11, "end": 1608.77, "word": " يعني", "probability": 0.721435546875}, {"start": 1608.77, "end": 1609.37, "word": " بطريقته", "probability": 0.98251953125}, {"start": 1609.37, "end": 1610.03, "word": " بكلامه", "probability": 0.8624267578125}, {"start": 1610.03, "end": 1610.53, "word": " مابدناش", "probability": 0.7879638671875}, {"start": 1610.53, "end": 1611.01, "word": " نتدخل", "probability": 0.916796875}, {"start": 1611.01, "end": 1611.31, "word": " بأي", "probability": 0.87548828125}, {"start": 1611.31, "end": 1611.67, "word": " كلمة", "probability": 0.9425455729166666}, {"start": 1611.67, "end": 1611.91, "word": " احنا", "probability": 0.8623046875}, {"start": 1611.91, "end": 1612.05, "word": " من", "probability": 0.984375}, {"start": 1612.05, "end": 1612.29, "word": " عنا", "probability": 0.779052734375}, {"start": 1612.29, "end": 1612.91, "word": " ممكن", "probability": 0.972412109375}, {"start": 1612.91, "end": 1613.49, "word": " تخربته", "probability": 0.8441162109375}, {"start": 1613.49, "end": 1614.31, "word": " you", "probability": 0.6982421875}, {"start": 1614.31, "end": 1614.63, "word": " can", "probability": 0.96240234375}, {"start": 1614.63, "end": 1615.09, "word": " ask", "probability": 0.92919921875}, {"start": 1615.09, "end": 1615.35, "word": " the", "probability": 0.91015625}, {"start": 1615.35, "end": 1615.61, "word": " following", "probability": 0.86865234375}, {"start": 1615.61, "end": 1616.27, "word": " questions", "probability": 0.912109375}, {"start": 1616.27, "end": 1617.27, "word": " يمكن", "probability": 0.9560546875}, {"start": 1617.27, "end": 1618.11, "word": " للممرض", "probability": 0.97216796875}, {"start": 1618.11, "end": 1618.27, "word": " او", "probability": 0.78125}, {"start": 1618.27, "end": 1618.87, "word": " للحكيم", "probability": 0.808056640625}, {"start": 1618.87, "end": 1619.27, "word": " انه", "probability": 0.857177734375}, {"start": 1619.27, "end": 1619.65, "word": " يسأل", "probability": 0.9818115234375}, {"start": 1619.65, "end": 1619.87, "word": " هذه", "probability": 0.91943359375}, {"start": 1619.87, "end": 1620.39, "word": " الأسئلة", "probability": 0.93896484375}, {"start": 1620.39, "end": 1621.59, "word": " ايش", "probability": 0.8566080729166666}, {"start": 1621.59, "end": 1621.83, "word": " الأسئلة", "probability": 0.976318359375}, {"start": 1621.83, "end": 1622.13, "word": " بتقول", "probability": 0.940185546875}, {"start": 1622.13, "end": 1622.53, "word": " how", "probability": 0.765625}, {"start": 1622.53, "end": 1622.95, "word": " have", "probability": 0.9033203125}, {"start": 1622.95, "end": 1623.81, "word": " you", "probability": 0.91650390625}, {"start": 1623.81, "end": 1624.11, "word": " been", "probability": 0.8876953125}, {"start": 1624.11, "end": 1624.65, "word": " sleeping؟", "probability": 0.6585693359375}, {"start": 1624.65, "end": 1624.87, "word": " كيف", "probability": 0.958984375}, {"start": 1624.87, "end": 1625.09, "word": " انت", "probability": 0.7484130859375}, {"start": 1625.09, "end": 1626.21, "word": " بتنام؟", "probability": 0.94287109375}, {"start": 1626.21, "end": 1626.35, "word": " لو", "probability": 0.28369140625}, {"start": 1626.35, "end": 1626.67, "word": " سمعت", "probability": 0.91015625}, {"start": 1626.67, "end": 1626.93, "word": " كيف", "probability": 0.942626953125}, {"start": 1626.93, "end": 1627.79, "word": " نومك؟", "probability": 0.9676513671875}, {"start": 1627.79, "end": 1628.85, "word": " كيف", "probability": 0.541259765625}, {"start": 1628.85, "end": 1629.03, "word": " انت", "probability": 0.87255859375}, {"start": 1629.03, "end": 1629.15, "word": " و", "probability": 0.83984375}, {"start": 1629.15, "end": 1630.25, "word": " النوم؟", "probability": 0.7314453125}, {"start": 1630.25, "end": 1630.75, "word": " يعني", "probability": 0.9560546875}, {"start": 1630.75, "end": 1631.21, "word": " سؤال", "probability": 0.8857421875}, {"start": 1631.21, "end": 1631.67, "word": " open", "probability": 0.96435546875}, {"start": 1631.67, "end": 1632.07, "word": " حلو", "probability": 0.93212890625}], "temperature": 1.0}, {"id": 59, "seek": 165822, "start": 1632.74, "end": 1658.22, "text": "السؤال التاني can you tell me your sleeping habits؟ ممكن تحكيلي عن عاداتك في النوم؟ كيف عادات النوم بالنسبالك؟ ممكن تتكلمني إيش اللي أنت الطقوس اللي موجودة عندك أو أكتر شي في حياتك يعني عادات بتتاخدها لموضوع النوم؟ اللي بعده are you getting enough rest؟ هل بتاخد راحتك وكفيتك في النوم و في حياتك يعني الاسترخائية و بتشعر أنك أنت مرتاح ولا لأ؟", "tokens": [6027, 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1708.63, "word": " عنده", "probability": 0.976318359375}, {"start": 1708.63, "end": 1709.05, "word": " psychological", "probability": 0.9775390625}, {"start": 1709.05, "end": 1709.85, "word": " problems", "probability": 0.92724609375}, {"start": 1709.85, "end": 1710.97, "word": " عنده", "probability": 0.96826171875}, {"start": 1710.97, "end": 1711.99, "word": " sleep", "probability": 0.97119140625}, {"start": 1711.99, "end": 1712.65, "word": " problems", "probability": 0.8818359375}, {"start": 1712.65, "end": 1712.95, "word": " على", "probability": 0.814453125}, {"start": 1712.95, "end": 1713.29, "word": " فكرة", "probability": 0.9899088541666666}, {"start": 1713.29, "end": 1713.57, "word": " و", "probability": 0.54541015625}, {"start": 1713.57, "end": 1713.85, "word": " العكس", "probability": 0.9462890625}, {"start": 1713.85, "end": 1714.67, "word": " صحيح", "probability": 0.99267578125}, {"start": 1714.67, "end": 1714.85, "word": " و", "probability": 0.564453125}, {"start": 1714.85, 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في النوم احنا هنخلنا نخلص اللي عندنا عشان نبدأ ان شاء الله في الشبتر القادم عشان دائما نلتزم بالوقت المناسب اللي هو حدود", "tokens": [3555, 3615, 11242, 2423, 8315, 3794, 8717, 3794, 10721, 1211, 18871, 4110, 2503, 3714, 43020, 7251, 39648, 4117, 1975, 8315, 4724, 47283, 3215, 11778, 2407, 3660, 9122, 3215, 3224, 4724, 1829, 9778, 1211, 9957, 1829, 20328, 39319, 1829, 3714, 43020, 6156, 1211, 7649, 7251, 39648, 4117, 1975, 8315, 4724, 47283, 3215, 11778, 2407, 3660, 9122, 3215, 3224, 4724, 1829, 9778, 1211, 9957, 1829, 8717, 995, 32640, 4032, 45030, 11242, 16095, 7251, 39648, 4117, 1975, 8315, 4724, 47283, 3215, 11778, 2407, 3660, 4724, 1829, 9778, 1211, 9957, 1829, 18871, 16254, 5551, 8592, 3615, 2288, 47525, 7435, 9307, 25724, 46152, 8608, 16572, 3615, 995, 23032, 3555, 3615, 995, 44945, 3794, 10721, 1211, 1975, 1829, 8592, 5296, 4110, 2503, 4032, 1975, 1829, 8592, 13672, 1829, 6225, 10943, 43761, 6225, 10943, 43761, 43242, 3224, 1975, 1829, 1975, 11242, 9566, 2288, 16758, 9307, 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{"start": 1720.65, "end": 1721.25, "word": " ممكن", "probability": 0.81201171875}, {"start": 1721.25, "end": 1721.69, "word": " يقولك", "probability": 0.958984375}, {"start": 1721.69, "end": 1721.99, "word": " انا", "probability": 0.7037353515625}, {"start": 1721.99, "end": 1722.89, "word": " باخد", "probability": 0.97509765625}, {"start": 1722.89, "end": 1723.15, "word": " دوة", "probability": 0.7958984375}, {"start": 1723.15, "end": 1723.51, "word": " كده", "probability": 0.9697265625}, {"start": 1723.51, "end": 1723.99, "word": " بيخليني", "probability": 0.8697102864583334}, {"start": 1723.99, "end": 1724.45, "word": " صاحي", "probability": 0.95947265625}, {"start": 1724.45, "end": 1725.21, "word": " ممكن", "probability": 0.861328125}, {"start": 1725.21, "end": 1725.45, "word": " فلان", "probability": 0.6971028645833334}, {"start": 1725.45, "end": 1725.71, "word": " يقولك", "probability": 0.9635416666666666}, {"start": 1725.71, "end": 1725.85, "word": " انا", "probability": 0.817626953125}, {"start": 1725.85, "end": 1726.17, "word": " باخد", "probability": 0.966796875}, {"start": 1726.17, "end": 1726.37, "word": " دوة", "probability": 0.9729817708333334}, {"start": 1726.37, "end": 1726.57, "word": " كده", "probability": 0.9951171875}, {"start": 1726.57, "end": 1726.97, "word": " بيخليني", "probability": 0.9852701822916666}, {"start": 1726.97, "end": 1727.37, "word": " نايم", "probability": 0.88916015625}, {"start": 1727.37, "end": 1728.29, "word": " و", "probability": 0.364013671875}, {"start": 1728.29, "end": 1728.59, "word": " بعضهم", "probability": 0.8287760416666666}, {"start": 1728.59, "end": 1728.85, "word": " يقولك", "probability": 0.9378255208333334}, {"start": 1728.85, "end": 1728.97, "word": " انا", "probability": 0.85693359375}, {"start": 1728.97, "end": 1729.29, "word": " باخد", "probability": 0.97021484375}, {"start": 1729.29, "end": 1729.49, "word": " دوة", "probability": 0.9767252604166666}, {"start": 1729.49, "end": 1730.07, "word": " بيخليني", "probability": 0.9867350260416666}, {"start": 1730.07, "end": 1730.37, "word": " عندي", "probability": 0.71337890625}, {"start": 1730.37, "end": 1730.67, "word": " أشعر", "probability": 0.73455810546875}, {"start": 1730.67, "end": 1731.17, "word": " بدجات", "probability": 0.6273600260416666}, {"start": 1731.17, "end": 1731.39, "word": " الجلب", "probability": 0.906005859375}, {"start": 1731.39, "end": 1732.05, "word": " سريعا", "probability": 0.77423095703125}, {"start": 1732.05, "end": 1732.69, "word": " طبعا", "probability": 0.947998046875}, {"start": 1732.69, "end": 1733.47, "word": " بنسأل", "probability": 0.845703125}, {"start": 1733.47, "end": 1734.03, "word": " ايش", "probability": 0.7577311197916666}, {"start": 1734.03, "end": 1734.15, "word": " ل", "probability": 0.87548828125}, {"start": 1734.15, "end": 1734.35, "word": " drug", "probability": 0.9150390625}, {"start": 1734.35, "end": 1734.79, "word": " history", "probability": 0.88330078125}, {"start": 1734.79, "end": 1735.41, "word": " و", "probability": 0.89453125}, {"start": 1735.41, "end": 1735.53, "word": " ايش", "probability": 0.807861328125}, {"start": 1735.53, "end": 1735.69, "word": " اللي", "probability": 0.934326171875}, {"start": 1735.69, "end": 1735.97, "word": " عامله", "probability": 0.8572591145833334}, {"start": 1735.97, "end": 1736.23, "word": " عامله", "probability": 0.7810872395833334}, {"start": 1736.23, "end": 1736.47, "word": " عنده", "probability": 0.98681640625}, {"start": 1736.47, "end": 1736.65, "word": " اي", "probability": 0.89501953125}, {"start": 1736.65, "end": 1737.11, "word": " اضطرابات", "probability": 0.88671875}, {"start": 1737.11, "end": 1737.19, "word": " في", "probability": 0.93212890625}, {"start": 1737.19, "end": 1737.79, "word": " النوم", "probability": 0.98583984375}, {"start": 1737.79, "end": 1738.87, "word": " احنا", "probability": 0.9267578125}, {"start": 1738.87, "end": 1739.35, "word": " هنخلنا", "probability": 0.808349609375}, {"start": 1739.35, "end": 1739.83, "word": " نخلص", "probability": 0.98388671875}, {"start": 1739.83, "end": 1740.93, "word": " اللي", "probability": 0.76611328125}, {"start": 1740.93, "end": 1741.23, "word": " عندنا", "probability": 0.95068359375}, {"start": 1741.23, "end": 1741.49, "word": " عشان", "probability": 0.9812825520833334}, {"start": 1741.49, "end": 1741.79, "word": " نبدأ", "probability": 0.9801432291666666}, {"start": 1741.79, "end": 1741.89, "word": " ان", "probability": 0.8857421875}, {"start": 1741.89, "end": 1742.09, "word": " شاء", "probability": 0.951171875}, {"start": 1742.09, "end": 1742.27, "word": " الله", "probability": 0.962890625}, {"start": 1742.27, "end": 1742.89, "word": " في", "probability": 0.7197265625}, {"start": 1742.89, "end": 1743.27, "word": " الشبتر", "probability": 0.7508544921875}, {"start": 1743.27, "end": 1743.61, "word": " القادم", "probability": 0.9921875}, {"start": 1743.61, "end": 1743.91, "word": " عشان", "probability": 0.9944661458333334}, {"start": 1743.91, "end": 1744.17, "word": " دائما", "probability": 0.73486328125}, {"start": 1744.17, "end": 1744.77, "word": " نلتزم", "probability": 0.99287109375}, {"start": 1744.77, "end": 1745.93, "word": " بالوقت", "probability": 0.9270833333333334}, {"start": 1745.93, "end": 1746.37, "word": " المناسب", "probability": 0.9943033854166666}, {"start": 1746.37, "end": 1746.51, "word": " اللي", "probability": 0.6475830078125}, {"start": 1746.51, "end": 1747.07, "word": " هو", "probability": 0.93310546875}, {"start": 1747.07, "end": 1748.13, "word": " حدود", "probability": 0.9488932291666666}], "temperature": 1.0}, {"id": 63, "seek": 175196, "start": 1748.48, "end": 1751.96, "text": "الـ 30 دقيقة والسلام عليكم ورحمة الله وبركاته", "tokens": [6027, 39184, 2217, 11778, 38436, 28671, 16070, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.15207741070877423, "compression_ratio": 1.08, "no_speech_prob": 0.0, "words": [{"start": 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..9a0d3098ececca563d0983f3d567df48745c371a
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/nvcGVWVNlko_raw.srt
@@ -0,0 +1,1864 @@
+1
+00:00:00,540 --> 00:00:03,240
+أعوذ بالنفسي بسم الله الرحمن الرحيم الصلاة والسلام
+
+2
+00:00:03,240 --> 00:00:06,440
+على أشرف المرسلين سيدنا محمد وعلى أليه وصحابيه
+
+3
+00:00:06,440 --> 00:00:11,900
+السلم خلينا نكمل اليوم في المحاضرة الشق التاني في
+
+4
+00:00:11,900 --> 00:00:14,860
+ال nutritional assessment اللي احنا اتوقفنا طبعا
+
+5
+00:00:14,860 --> 00:00:20,940
+في المحاضرة السابقة عند تقريبا لأ قبل هذه الشريحة
+
+6
+00:00:20,940 --> 00:00:25,440
+تقريبا بالظبط اليوم بدنا نكمل طبعا signs and
+
+7
+00:00:25,440 --> 00:00:29,760
+symptoms of malnutrition شو العلماتيعني خلينا
+
+8
+00:00:29,760 --> 00:00:33,040
+نقولوا الأعراض اللي هي ناتجة عن إيه سوء التخدية
+
+9
+00:00:33,040 --> 00:00:37,320
+dry and thin hair أكيد طبعا يعني اللي هو جفاف
+
+10
+00:00:37,320 --> 00:00:40,580
+واتقصه في الشعر بيصير كتير yellowish lump around
+
+11
+00:00:40,580 --> 00:00:44,460
+eye بنلاقي بعض الناس اللي عندهم malnutrition عندهم
+
+12
+00:00:44,460 --> 00:00:49,880
+زي lump بسيطة زي تكتلات صفراء موجودة حوالين اللي
+
+13
+00:00:49,880 --> 00:00:54,160
+هو العين وخاصة تحت العين white ring around both
+
+14
+00:00:54,160 --> 00:00:58,550
+eyes بتلاقي زي حوالين العين زي هالةزي هالعيش زي
+
+15
+00:00:58,550 --> 00:01:02,870
+هالبيضاء زي دائرة بيضاء طبعا هنا بيكون في معاه ال
+
+16
+00:01:02,870 --> 00:01:06,250
+conjunctiva اللي هم التحمط اللي هي بتكون شاحبة كل
+
+17
+00:01:06,250 --> 00:01:09,570
+هذا يدل على انه ايه عمال ال hemoglobin باكد ليه
+
+18
+00:01:09,570 --> 00:01:13,630
+انه اقل من الطبيعي ويعني هذا رايح على أنيميا لأنه
+
+19
+00:01:13,630 --> 00:01:17,570
+اكيد مع المال ال nutrition بتصير أنيميا طيب الآن
+
+20
+00:01:17,570 --> 00:01:21,010
+بقول نقطة تانية aridness and swelling of the lips
+
+21
+00:01:21,010 --> 00:01:25,250
+especially corners of the mouth بنلاقيمرات بيصير
+
+22
+00:01:25,250 --> 00:01:29,530
+إيش انتفاخ في شفاف ال .. ال .. الإنسان عنده مالي
+
+23
+00:01:29,530 --> 00:01:33,130
+nutrition ومش بس هيك خاصة في ال corners يعني اللي
+
+24
+00:01:33,130 --> 00:01:37,750
+هو في الجنبين تبع ال mouth وعلى فكرة لما يصير
+
+25
+00:01:37,750 --> 00:01:41,150
+تشققات في الجنب ال mouth هنا وجنب ال mouth هنا
+
+26
+00:01:41,150 --> 00:01:44,950
+اسمه بيسموه chialosis يعني لو حد اسمع هذا المصطلح
+
+27
+00:01:44,950 --> 00:01:49,210
+اسمه chialosis اللي هو abnormal corners of the
+
+28
+00:01:49,210 --> 00:01:53,300
+mouth and إيش erosions يعني عامل زي التشققاتطيب
+
+29
+00:01:53,300 --> 00:01:56,940
+teeth cares بيصير طبعا أكيد يعني تسوص أسنان
+
+30
+00:01:56,940 --> 00:02:01,460
+abnormal missing of it مرات بيفقد الإنسان أسنان هو
+
+31
+00:02:01,460 --> 00:02:04,900
+بيقول ماعندي مشكلة مش عارف من إيش صار عندي فقد
+
+32
+00:02:04,900 --> 00:02:08,220
+أسنان بيكون الأساس و المرجع هو ال marine nutrition
+
+33
+00:02:08,220 --> 00:02:13,780
+طيب a dryness of the skin جفاف الجلد و هذا بنسميه
+
+34
+00:02:13,780 --> 00:02:18,180
+xerosis إيش بنسميه xerosis بيسموه sandpaper fields
+
+35
+00:02:18,180 --> 00:02:22,320
+يعني إيش sandpaper زي ورقة الصنفرةsandpaper زي
+
+36
+00:02:22,320 --> 00:02:25,560
+ورقة البرداخ زي بتعرفوها اللي بنعمل فيها مرات
+
+37
+00:02:25,560 --> 00:02:29,720
+الحديد أو الخشب يعني يصبح الجلد من شدة الخشونته
+
+38
+00:02:29,720 --> 00:02:35,420
+كأن ورقة برداخ spoon shaped nails بيسموها هنا يعني
+
+39
+00:02:35,420 --> 00:02:39,900
+زي ما تشوفينا collionial ايش collionial بقول هنا
+
+40
+00:02:39,900 --> 00:02:44,620
+بيصير spoon shaped nail يعني الإضفر بيصبح زي
+
+41
+00:02:44,620 --> 00:02:49,400
+الملعق زي الملعق الصغيرة هيك مدور ومقعر شوية
+
+42
+00:02:51,140 --> 00:02:54,380
+Tachycardia أكيد عارفين إيش معناته elevated blood
+
+43
+00:02:54,380 --> 00:02:58,060
+pressure due to excessive sodium intake هذا
+
+44
+00:02:58,060 --> 00:03:01,260
+بتدللنا أنه مش دايما ال malnutrition معناته نقص
+
+45
+00:03:01,260 --> 00:03:03,800
+هيبقوا يقولوا لأ من ال malnutrition اللي بيأكل
+
+46
+00:03:03,800 --> 00:03:08,560
+أملاح كتير بيصير عنده elevated blood pressure صحيح
+
+47
+00:03:08,560 --> 00:03:11,860
+و بزيد عنده excessive cholesterol صحيح إذا كان في
+
+48
+00:03:11,860 --> 00:03:16,320
+عنده bad nutrient style خليني أقول يعني أو
+
+49
+00:03:16,320 --> 00:03:19,380
+nourishment style يعني بتلاقي بتغذى شغلاتفيها فات
+
+50
+00:03:19,380 --> 00:03:23,180
+كتير او فيها ايش او فيها high calorie diet ال
+
+51
+00:03:23,180 --> 00:03:26,560
+muscle weakness and the growth retardation طبعا
+
+52
+00:03:26,560 --> 00:03:29,680
+اكيد بتضاعف العضلات و اكيد في نفس الوقت اش بيصير
+
+53
+00:03:29,680 --> 00:03:34,900
+كمان كمان بيصير فيه ضعف في معدل النمو عند الإنسان
+
+54
+00:03:34,900 --> 00:03:39,140
+اللي عنده مال ال nutrition طيب، dietary analysis
+
+55
+00:03:39,140 --> 00:03:44,140
+بقول و دايما اتذكر و انت بتحلل الأكل و الطعام
+
+56
+00:03:44,140 --> 00:03:47,840
+للمريض بدك تفهم ان ال food represent cultural and
+
+57
+00:03:47,840 --> 00:03:55,360
+ethnicيعني دائما الطعام بيمثل شيء ثقافي إثنك يعني
+
+58
+00:03:55,360 --> 00:03:59,840
+background يعني شيء خلفية عرقية and socio economic
+
+59
+00:03:59,840 --> 00:04:03,700
+status and have many emotional and psychological
+
+60
+00:04:03,700 --> 00:04:07,260
+meaning يعني كأنه بقولي دربا، خلّيك ذاكر أن الطعام
+
+61
+00:04:07,260 --> 00:04:13,300
+له طقوس خاصة ويله مردود ثقافي ويله خلفية عرقية
+
+62
+00:04:13,300 --> 00:04:17,050
+ربما في زي ما احنا حكينا في بعض العائلاتتفضل أشياء
+
+63
+00:04:17,050 --> 00:04:20,830
+عن أشياء أو بعض الأقوام ما بتاكلش أشياء على حسب
+
+64
+00:04:20,830 --> 00:04:24,830
+أشياء أخرى يعني هو من باب أنه بيتذكر assessment
+
+65
+00:04:24,830 --> 00:04:27,650
+includes usual foods و احنا بنسأل المريض ده مانعش
+
+66
+00:04:27,650 --> 00:04:30,670
+بنسأله إيش ال usual foods عندك؟ ال consumed اللي
+
+67
+00:04:30,670 --> 00:04:34,270
+بتستهلكه ال habits of food كيف عادتك في الأكل كأنه
+
+68
+00:04:34,270 --> 00:04:36,710
+الإشي بيعيد نفسه نفس اللي حكيناه في المحاضرة
+
+69
+00:04:36,710 --> 00:04:39,750
+السابقة بعدين بيقول ask the client to recall
+
+70
+00:04:39,750 --> 00:04:44,190
+everything خليه يذكر كل شيء consumed with each
+
+71
+00:04:44,190 --> 00:04:48,840
+withinthe past 24 hours يعني لما نسأل المريض ايش
+
+72
+00:04:48,840 --> 00:04:52,220
+اكلت و احنا بنعمله dietary analysis لازم نسأل كل
+
+73
+00:04:52,220 --> 00:04:56,800
+شي انت ايش اكلته اي شي لدرجة انه بيقول مش بس all
+
+74
+00:04:56,800 --> 00:04:59,900
+foods حتى ال fluid دي مش شئ بيسأل حتى ال vitamins
+
+75
+00:04:59,900 --> 00:05:03,500
+حتى ال minerals or other supplements لو قاعد واحد
+
+76
+00:05:03,500 --> 00:05:07,280
+سألني طب ليش يا أستاذ ال vitamins هي ايش بتعمل؟ لأ
+
+77
+00:05:07,280 --> 00:05:11,100
+في بعض ال vitamins مكملات يعني بتعملنا شغلات ممكن
+
+78
+00:05:11,100 --> 00:05:13,900
+تزيد في بعض ال mineralsبعض ال supplements يعني
+
+79
+00:05:13,900 --> 00:05:16,760
+يكون باخدلي omega أو باخد شغلات زي هيك هذه ممكن
+
+80
+00:05:16,760 --> 00:05:20,580
+تأثر على عملية ال metabolism في داخل جسم الإنسان
+
+81
+00:05:20,580 --> 00:05:24,280
+يعني ممكن نتقلل وسط ال product فبالتالي لازم نسأل
+
+82
+00:05:24,280 --> 00:05:27,380
+عن كل شيء إيه علاقة بال إيه علاقة بال nutrition
+
+83
+00:05:27,380 --> 00:05:32,300
+don't bias خلينا نذاكر هذا الكلام don't bias the
+
+84
+00:05:32,300 --> 00:05:37,100
+client response دايما ما يتقود استجابة المريض يعني
+
+85
+00:05:37,100 --> 00:05:39,360
+ال question مايكونش عندك ال question biased
+
+86
+00:05:39,360 --> 00:05:43,050
+questionولي يكون عندك اللي هو leading question
+
+87
+00:05:43,050 --> 00:05:47,790
+خاصة من وجهة نظر ال interviewer مرات انت بيكون
+
+88
+00:05:47,790 --> 00:05:50,890
+عندك ايش personal habits او knowledge يعني ممكن
+
+89
+00:05:50,890 --> 00:05:54,210
+انت مثلا بدك تسأل عن اللحمة او بدك تسأل عن اكل
+
+90
+00:05:54,210 --> 00:05:57,850
+معين انت بتحب اللحمة ماتقوله اكيد انت بتحب اللحمة
+
+91
+00:05:57,850 --> 00:06:02,590
+لأ انا bias لأن انت وكأنك بتخليه اجاوب زي اجابتك
+
+92
+00:06:02,590 --> 00:06:06,870
+لأ احنا بنسأله بتجرد و بعيدا عن رأينا الشخصي
+
+93
+00:06:06,870 --> 00:06:12,160
+بالمطلق طيبdiseases affected by nutritional
+
+94
+00:06:12,160 --> 00:06:18,380
+problems ما هي الأمراض اللي ممكن تتأثر أو تزيد من
+
+95
+00:06:18,380 --> 00:06:22,680
+المشاكل اللي ناتجة عن التخضيه أنا مابقولش أن هو ..
+
+96
+00:06:22,680 --> 00:06:27,820
+يعني التخضيه اللي عملت هيك لكن بتلعب سبب رئيسي في
+
+97
+00:06:27,820 --> 00:06:32,160
+حدوث هذه طبعا أنا ذكرت من سبعة لكن هو كتير أكتر من
+
+98
+00:06:32,160 --> 00:06:35,960
+ذلك و أنا كاتب القهانة يريد تتطلعوا في الكتاب في
+
+99
+00:06:35,960 --> 00:06:39,270
+page 15 أو حسب الكتاب اللي موجود معاكمأو حتى ممكن
+
+100
+00:06:39,270 --> 00:06:42,170
+انت تشوف على الانترنت كتير من الأمراض أول مرض
+
+101
+00:06:42,170 --> 00:06:45,550
+obesity طبعا ليهم بعتبروه disease لأنه الكتير من
+
+102
+00:06:45,550 --> 00:06:48,510
+الناس مابيقدروا ينزلوا عن الوزن اللي هو بيقصر عنهم
+
+103
+00:06:48,510 --> 00:06:52,010
+زيادة excessive of body fat طبعا أكيد ال diabetes
+
+104
+00:06:52,010 --> 00:06:54,690
+من ال latest مابقولش أنه سبب لكن من ال breeds
+
+105
+00:06:54,690 --> 00:06:56,970
+posing factors ومن ال high breeds posing factors
+
+106
+00:06:56,970 --> 00:07:01,050
+هو للأسف ال high calorie ال high sugar diet و هكذا
+
+107
+00:07:01,050 --> 00:07:05,410
+hypertension أكيد الدغط برتفع مع الأملح معدوه
+
+108
+00:07:05,410 --> 00:07:09,540
+الكوروناريheart disease أكيد مع الدهون وخاصة يعني
+
+109
+00:07:09,540 --> 00:07:12,820
+الدهون اللي هي السيئة و اللي ممكن تعمل كتير جلطات
+
+110
+00:07:12,820 --> 00:07:17,640
+five cancer اللي هو السرطان على اعتبار ان بعض
+
+111
+00:07:17,640 --> 00:07:22,640
+العلماء أشهروا ان ال cancer cells يعني بتتغدى على
+
+112
+00:07:22,640 --> 00:07:27,840
+السكر بشكل كبير endocrine disease أمراض بتصيب غضب
+
+113
+00:07:27,840 --> 00:07:30,740
+الصمم على فكرة من ضمن الدهبيتس ومن ضمن أمراض تانية
+
+114
+00:07:30,740 --> 00:07:33,500
+زي ال hyperthyroidism أو ال hypothyroidism و هو
+
+115
+00:07:33,500 --> 00:07:37,900
+كدهو كتبركو others يعني في أمراض كتير تتأثر من ال
+
+116
+00:07:37,900 --> 00:07:43,200
+malnutrition و ال problems اللي ممكن المريض يعاني
+
+117
+00:07:43,200 --> 00:07:47,180
+منها بشكل عام assessment of sleep and wakefulness
+
+118
+00:07:47,180 --> 00:07:52,520
+patterns تقييم النوم و اليقظة عند المريض طبعا في
+
+119
+00:07:52,520 --> 00:07:56,700
+البداية بدنا نفهم ان ال normal human ايش يعني
+
+120
+00:07:56,700 --> 00:07:59,980
+الشخص الطبيعي الإنسان الطبيعي عنده حالة اسمها
+
+121
+00:07:59,980 --> 00:08:03,310
+homeostasisلما أقول كلمة homeostasis بسمها
+
+122
+00:08:03,310 --> 00:08:06,450
+homeostatic، homeostasis يعني التوازن، إيش
+
+123
+00:08:06,450 --> 00:08:10,310
+التوازن؟ البني آدم الطبيعي عنده توازن بين اليقظة و
+
+124
+00:08:10,310 --> 00:08:13,110
+بين النوم، يعني كتب لي ability to maintain
+
+125
+00:08:13,110 --> 00:08:17,950
+relative internal .. relative internal consistency
+
+126
+00:08:17,950 --> 00:08:21,570
+أو consistency، إيش أنا consistency؟ الثبات، سبحان
+
+127
+00:08:21,570 --> 00:08:24,970
+الله، الله سبحانه وتعالى حط في كل جسم إنسان حالة
+
+128
+00:08:24,970 --> 00:08:28,570
+من التوازن يستطيع الإنسان يحافظ عليها ما بين النوم
+
+129
+00:08:28,570 --> 00:08:32,140
+و اليقظة و الراحة و العملAny person .. أي شخص ..
+
+130
+00:08:32,140 --> 00:08:35,380
+complaint of sleep pattern .. أي إنسان بعالم .. أي
+
+131
+00:08:35,380 --> 00:08:40,320
+إنسان بعالم المشاكل في النوم يعني أي اضطراب تعتبر
+
+132
+00:08:40,320 --> 00:08:43,500
+primary problem أو secondary problem due to إيش
+
+133
+00:08:43,500 --> 00:08:47,480
+هنا؟ لما أقول primary .. primary problem إيش يعني؟
+
+134
+00:08:47,480 --> 00:08:50,980
+يعني مشكلة النوم هي أصلا من النوم لما أقول
+
+135
+00:08:50,980 --> 00:08:55,340
+secondary problem يعني ناتجة لسبب أخر، أعطيكم مثال
+
+136
+00:08:55,340 --> 00:08:59,040
+صغير جدا، زي إيش؟هل جيت واحد بيقول انا عندي أرق في
+
+137
+00:08:59,040 --> 00:09:01,960
+النوم بيقول طب ليش؟ بيقول والله مانعرف انا هيك جيت
+
+138
+00:09:01,960 --> 00:09:05,260
+انام ماعرفتش انام دايما بتصير معجلة؟ لأ مرات بسيطة
+
+139
+00:09:05,260 --> 00:09:08,540
+هذا بيقول primary problem يعني المشكلة اللي عندك
+
+140
+00:09:08,540 --> 00:09:11,740
+مشكلة بس في النوم بيجين واحد تاني بيقول انا مش
+
+141
+00:09:11,740 --> 00:09:15,340
+عارف انام بيقول ليش؟ بيقول ان عندي وجع شديد جدا في
+
+142
+00:09:15,340 --> 00:09:19,140
+رجلي مش هم يخليني اعرف انام او التاني بيقول عندي
+
+143
+00:09:19,140 --> 00:09:22,340
+صداع او التالت بيقول عندي anxiety هذا بنسميه
+
+144
+00:09:22,340 --> 00:09:25,260
+secondary يعني السبب له سبب تاني زي الموضوع
+
+145
+00:09:25,730 --> 00:09:28,470
+الـPrimary Hypertension والـSecondary Hypertension
+
+146
+00:09:28,470 --> 00:09:32,230
+الـPrimary الضغط مش معروف إيش سبب والـSecondary
+
+147
+00:09:32,230 --> 00:09:35,770
+بكون الضغط إيه سبب أخر في جسم الإنسان لحظة اللي
+
+148
+00:09:35,770 --> 00:09:39,570
+محطوط بالخط الأحمر ده شيء مهم وخطير أنه يقول ربع
+
+149
+00:09:39,570 --> 00:09:42,430
+.. ربع المرضى .. ربع المرضى one fourth of the
+
+150
+00:09:42,430 --> 00:09:45,650
+client اللي هم اللي بروح على المستشفيات who seek
+
+151
+00:09:45,650 --> 00:09:48,470
+healthcare complaint of difficulty related to
+
+152
+00:09:48,470 --> 00:09:51,950
+sleep ربع المرضى اللي بيتجهل المستشفيات في العالم
+
+153
+00:09:51,950 --> 00:09:56,300
+يعني بتتكلم على 25% من المرضى في العالمعدد مشتهل
+
+154
+00:09:56,300 --> 00:10:00,180
+بيعاني من الطرابات في النوم وعلى فكرة حتى الناس
+
+155
+00:10:00,180 --> 00:10:04,740
+الطبيعيين اليوم صار نسبة كبيرة منهم يعاني من طرابة
+
+156
+00:10:04,740 --> 00:10:08,540
+النوم حسب الوضع اللي احنا بنعاني منه وحسب الأوضاع
+
+157
+00:10:08,540 --> 00:10:12,080
+سواء اقتصادية او اجتماعية او نفسية او حتى روحانية
+
+158
+00:10:12,080 --> 00:10:16,520
+طيب factors affecting length and equality of sleep
+
+159
+00:10:16,520 --> 00:10:22,000
+ما هي العوامل اللي بتأثر على جودة النوم وطول النوم
+
+160
+00:10:22,000 --> 00:10:26,010
+طبعا طول النوم مش دايما مرتبط بالجودةليش رابطهم مع
+
+161
+00:10:26,010 --> 00:10:29,910
+بعض؟ مش كل شي نوم طويل، معناه تفيه جودة، مرات
+
+162
+00:10:29,910 --> 00:10:35,330
+بيكون النوم في الحدود المتزامنة أو الطبيعية، بنقول
+
+163
+00:10:35,330 --> 00:10:39,110
+عنه equality اسليم و مرات تكون أكثر و بتكونش فيها
+
+164
+00:10:39,110 --> 00:10:44,370
+equality، خلنا نشوف، أول حاجة anxiety القلق، طبعا
+
+165
+00:10:44,370 --> 00:10:48,010
+القلق دغري، إيش مرتبط هنا؟ مرتبط كتير بقلة النوم و
+
+166
+00:10:48,010 --> 00:10:50,850
+بالترابط النوم، بيقول related to the need to meet
+
+167
+00:10:50,850 --> 00:10:56,040
+مثلا a tasksuch as waking at an early hour for
+
+168
+00:10:56,040 --> 00:11:00,540
+work احنا أكتر ناس بكرا هنروح لما نتدرب هنصل
+
+169
+00:11:00,540 --> 00:11:04,400
+لمرحلة شويه anxiety بتأثر عنهم ليه؟ لأنه مرتبط
+
+170
+00:11:04,400 --> 00:11:08,660
+حياتنا بالعمل فهو بيقول دائما أهل التمريد و أهل
+
+171
+00:11:08,660 --> 00:11:13,080
+الطب و حتى اللي بيشتغلوا في الشرطة أو في الأعمال
+
+172
+00:11:13,080 --> 00:11:16,400
+الأمنية أو الدفاع المدني في منهم anxiety ال
+
+173
+00:11:16,400 --> 00:11:19,670
+anxiety بتخلي عندهمloss of equality of the sleep
+
+174
+00:11:19,670 --> 00:11:23,370
+عندهم نوم ممتقطع لأنه دايما مرتبط انه بتيصحى بدري
+
+175
+00:11:23,370 --> 00:11:26,170
+عشان بتروح وين على العامل عشانك بنلاقي حالنا في
+
+176
+00:11:26,170 --> 00:11:31,190
+أيام الإجازات بناخد أكتر قصة من الراحة ال promise
+
+177
+00:11:31,190 --> 00:11:34,870
+ايش دخل ال promise هنا الوعد لما الإنسان بيوعد حدا
+
+178
+00:11:34,870 --> 00:11:39,070
+for pleasurable activity زي starting vacation في
+
+179
+00:11:39,070 --> 00:11:41,550
+بعض الحلقات أخدنا زمان اذا بتذكروا انه بتأثر النوم
+
+180
+00:11:41,550 --> 00:11:46,320
+تبعنا لما يكون في إنسان بتيوعد بشغل معينيعني مثلا
+
+181
+00:11:46,320 --> 00:11:48,900
+زي واحد بيقول للتاني أو بتكون مثلا مشتركين في رحلة
+
+182
+00:11:48,900 --> 00:11:51,960
+و بنتظر ده الرحلة من زمان لل vacation و بكرا في
+
+183
+00:11:51,960 --> 00:11:54,660
+عندنا إجازة فجاهديني بيقول بكرا ان شاء الله بدنا
+
+184
+00:11:54,660 --> 00:11:56,520
+نصعي الساعة السابعة الصبح عشان بكرا نكون كلنا
+
+185
+00:11:56,520 --> 00:11:59,980
+موجودين لإن ال bus بدهي يحضر الساعة كده بتلاقينا
+
+186
+00:11:59,980 --> 00:12:03,940
+لا .. لا إراديا رغم إنه إشي مفرح و إشي مبسط لكن
+
+187
+00:12:03,940 --> 00:12:06,460
+صار في عندنا إيه؟ صار في عندنا disturbance of
+
+188
+00:12:06,460 --> 00:12:09,960
+sleep وضلينا صاحين عشان إيش نكون ياقظين زي موضوع
+
+189
+00:12:09,960 --> 00:12:12,520
+الامتحانات وموضوع الاكوزات وموضوع ال interview
+
+190
+00:12:12,520 --> 00:12:18,570
+بيخلينا دايبيأثر ليش على quality of sleep؟ في حاجة
+
+191
+00:12:18,570 --> 00:12:20,790
+اسمها conditioned patterns of sleeping ايش ال
+
+192
+00:12:20,790 --> 00:12:23,450
+conditioned؟ زمان ذكرناها في ال psychology و
+
+193
+00:12:23,450 --> 00:12:27,930
+العيدة كمان برا اللي بيسموها النوم المشروط ايش
+
+194
+00:12:27,930 --> 00:12:30,510
+النوم المشروط؟ في بعض الناس عندهم طقوس في النوم
+
+195
+00:12:30,510 --> 00:12:33,890
+إذا ما صارش هذا الطقوس بيصير عندهم مشكلة يعني لازم
+
+196
+00:12:33,890 --> 00:12:38,570
+ينام ع فرش معينة ع مخدة معينة يكون جنبه مثلا ميه
+
+197
+00:12:38,570 --> 00:12:42,330
+يحط سماعات في دنيه يفتح مثلا شي معين هذا اسمها
+
+198
+00:12:42,330 --> 00:12:45,090
+conditioned sleep لو انفقدت شيء من هدول بيعرفش
+
+199
+00:12:45,090 --> 00:12:47,440
+ينامعلشان هيك كتير من المرضى لما بيجيوا علنا في
+
+200
+00:12:47,440 --> 00:12:50,800
+المستشفيات بنقوله نام لو سمحت، بقولي أنا مش عارف
+
+201
+00:12:50,800 --> 00:12:53,860
+أنام، ليه؟ بقولك أنا نومي، لازم أكون على الفرشة
+
+202
+00:12:53,860 --> 00:12:58,260
+الفلانية أو أنا أستخدم شغلة علانية، فهذا اللي
+
+203
+00:12:58,260 --> 00:13:01,780
+بيخلق .. بيسموه إيش هنا conditioned patterns وفي
+
+204
+00:13:01,780 --> 00:13:03,900
+ناس ماعندهم مش conditioned يعني لو كواين مانام،
+
+205
+00:13:03,900 --> 00:13:06,660
+بنام، حاطناع فرشة، بتون فرشة، مخدة، بتون مخدة،
+
+206
+00:13:06,660 --> 00:13:10,580
+بنام في حاجة اسمها physiological wake up، في ناس
+
+207
+00:13:10,580 --> 00:13:13,180
+عندهم ياقظة في السيورجية، يمكن احنا مش موجود في
+
+208
+00:13:13,180 --> 00:13:16,530
+أعماركملكن في الكبار السن إذا عندك جدك جد تلك
+
+209
+00:13:16,530 --> 00:13:19,110
+بتلاقي يا سبحان الله عندهم يقضة فيسيولوجية، لا
+
+210
+00:13:19,110 --> 00:13:22,390
+إرادة، بتلاقي جام قبل أدان الفجر وصحي وقاعد يعني
+
+211
+00:13:22,390 --> 00:13:25,130
+في البيت ويعمل حركة، هذه بسمها physiological wake
+
+212
+00:13:25,130 --> 00:13:28,150
+up، سبحان الله الساعة البيولوجية الفيسيولوجية عنده
+
+213
+00:13:28,150 --> 00:13:32,450
+يعني قوية جدا لدرجة أنها مرتبط ارتباط وثيق بساعة
+
+214
+00:13:32,450 --> 00:13:35,290
+محددة في الليل بيقوم فيها، بينام في وقت محدد
+
+215
+00:13:35,290 --> 00:13:38,150
+وبيقوم في وقت محدد، ان شاء الله يكون عند حد منكم
+
+216
+00:13:38,150 --> 00:13:41,300
+موجودة، هذه كويسة مش عادلة يعنيage differences
+
+217
+00:13:41,300 --> 00:13:45,660
+أكيد اختلافات الأعمار الولد صغير بنام كتير الإنسان
+
+218
+00:13:45,660 --> 00:13:48,220
+لما بيكبر بيبدأ إيش نوم يصير متوسط أو طبيعي و
+
+219
+00:13:48,220 --> 00:13:52,060
+بعدين لما بيكبر يخاتر برجع لأصل و بيبتسر ينام قليل
+
+220
+00:13:52,060 --> 00:13:56,480
+و النوم القليل في الكبار يعني دائما هذا سائد اللي
+
+221
+00:13:56,480 --> 00:13:58,820
+بعد في physiological alterations التغييرات
+
+222
+00:13:58,820 --> 00:14:02,560
+الفيزيولوجية such as disease يعني باختصار كأنه
+
+223
+00:14:02,560 --> 00:14:07,200
+بيقولي الأمراض الفيزيولوجية و الفيزياء اللي بتكون
+
+224
+00:14:07,200 --> 00:14:10,020
+في جسم الإنسان بتأثر على النوم و أنا قاعد بقولإن
+
+225
+00:14:10,020 --> 00:14:14,680
+أي تغيير في جسمنا .. دعوني أذكر حديث النبي صلى
+
+226
+00:14:14,680 --> 00:14:17,480
+الله عليه و سلم .. إذا أشتاق من عضو .. طبعا أعجبنا
+
+227
+00:14:17,480 --> 00:14:20,500
+أن .. سبحان الله الجسد الواحد .. إذا أشتاق من عضو
+
+228
+00:14:20,500 --> 00:14:23,960
+.. تداعله سائر الأعضاء .. السهر والحمة أو كما قال
+
+229
+00:14:23,960 --> 00:14:26,360
+النبي صلى الله عليه و سلم فبالتالي بيصير استجابة
+
+230
+00:14:26,360 --> 00:14:30,840
+من كل جسم الإنسان طيب .. good sleep .. النوم الجيد
+
+231
+00:14:30,840 --> 00:14:33,840
+.. النوم الطيب .. النوم المحترم .. depends on
+
+232
+00:14:33,840 --> 00:14:37,540
+number of awakenings and the total number of
+
+233
+00:14:37,540 --> 00:14:41,520
+sleeping hoursإذا بدنا نعرف النوم الطبيعي بدنا
+
+234
+00:14:41,520 --> 00:14:47,480
+نسأله قداش بتصحى في الليل و قداش بتنام ساعتك النوم
+
+235
+00:14:47,480 --> 00:14:51,160
+في بعض الناس بيقوللي بقوم في الليل مرتين أو تلاتة
+
+236
+00:14:51,160 --> 00:14:54,520
+يعني ممكن يكون عنده diabetes مش كتير بخوفني لكن في
+
+237
+00:14:54,520 --> 00:14:58,420
+الآخر أنا بده أسأله قداش في عندك ساعات نوم إذا
+
+238
+00:14:58,420 --> 00:15:01,180
+ساعات النوم اللي موجودة عنده within normal طبعا لو
+
+239
+00:15:01,180 --> 00:15:04,520
+حد سألني قداش ساعات النوم الطبيعية احنا زمان حكينا
+
+240
+00:15:04,520 --> 00:15:08,790
+فيها هم العلماء اختلفوا، اعتبروا من 6 إلى 8لكن
+
+241
+00:15:08,790 --> 00:15:11,870
+الطبيعي خليني اقول سبعة يعني ممكن يكون سبعة في
+
+242
+00:15:11,870 --> 00:15:14,390
+الصيف تمانية في الشتاء على اعتبار انه طول الليل
+
+243
+00:15:14,390 --> 00:15:19,010
+طيب the nurse assists sleep pattern by doing each
+
+244
+00:15:19,010 --> 00:15:21,730
+interview انا ماعنديش ايه يعني اكتر من هيك تمريض
+
+245
+00:15:21,730 --> 00:15:26,190
+انا بس بقدر اسأله عن طريق ال ايه المقابلة لكن لو
+
+246
+00:15:26,190 --> 00:15:31,330
+حد بيسألنا طب كيف نقدر نقيم انهم لأ الخصائيين في
+
+247
+00:15:31,330 --> 00:15:34,480
+عندهم حاجة special chart عندهمعن طريق ال EEG
+
+248
+00:15:34,480 --> 00:15:39,060
+Electroencephalogram بيعملوا تخطيط في الدماغ عشان
+
+249
+00:15:39,060 --> 00:15:43,040
+يشوف ذبذبات المخ كده كان هذا الطبيعي عنده النوم و
+
+250
+00:15:43,040 --> 00:15:48,500
+لا مش طبيعي طبعا هذا مش شغلنا شغل أخصائي disorders
+
+251
+00:15:48,500 --> 00:15:54,500
+related to sleep الإضطرابات اللي ممكن تحدث مرتبطة
+
+252
+00:15:54,500 --> 00:15:59,540
+مباشرة بالنوم أول حاجة بقولي أنا sleep
+
+253
+00:15:59,540 --> 00:16:03,430
+disturbances affects family life أكيدال .. ال ..
+
+254
+00:16:03,430 --> 00:16:06,330
+اللي عنده مشاكل في النوم بتأثر كل حاجة .. كل عائلة
+
+255
+00:16:06,330 --> 00:16:10,250
+بتأثر كيف يعني؟ لو قلنا رب البيت أو يعني المسئول
+
+256
+00:16:10,250 --> 00:16:13,150
+عن البيت مابيعرفش ينام و صارت فيه عنده مشكلة أو
+
+257
+00:16:13,150 --> 00:16:16,250
+يعني لاجوا الأولاد الصغار عمله بيسببوله الزعاج و
+
+258
+00:16:16,250 --> 00:16:20,430
+مش عارف ينام أكيد هتتأثرش هنا وظيفته مش بس هيك
+
+259
+00:16:20,430 --> 00:16:23,670
+social adjustment توافق الإجتماعي يعني بين قصين
+
+260
+00:16:23,670 --> 00:16:26,790
+اضطراب النوم بيعمل اضطراب في البيت اضطراب في
+
+261
+00:16:26,790 --> 00:16:30,690
+العائلة اضطراب في العمل اللي بعد feelings of
+
+262
+00:16:30,690 --> 00:16:35,710
+fatigue أكيدبالشعور بالإشهنة، بالتعب، بالارهاق ال
+
+263
+00:16:35,710 --> 00:16:38,790
+retability، التوتر difficulty in a concentrating
+
+264
+00:16:38,790 --> 00:16:43,250
+ما بقدرش أركز اللي بينامش كتير أسمعوني كويس اللي
+
+265
+00:16:43,250 --> 00:16:45,190
+بينامش كتير و أنا هذا كلام دايما بقوله لطلابي و
+
+266
+00:16:45,190 --> 00:16:50,090
+طالباتي قلة النوم مرتبطة بقلة التركيز علشان هي
+
+267
+00:16:50,090 --> 00:16:53,790
+اللي بيكون نايم كويس بيكون عنده open mind يعني
+
+268
+00:16:53,790 --> 00:16:58,650
+بيلاقي مخه متفتح و عقله متفتح و قادر يستوعب طبعا
+
+269
+00:16:58,650 --> 00:17:01,440
+مش واحد يقولي طب يا أستاذ أنا بنام كتير، لأالنوم
+
+270
+00:17:01,440 --> 00:17:03,600
+الكتير لأ برضه بيصير فينا loss of concentration
+
+271
+00:17:03,600 --> 00:17:07,100
+أنا لما أقول تمانية بقبل تسعة ساعات بس مابقبلش عشر
+
+272
+00:17:07,100 --> 00:17:10,620
+أو فوق و لما أقول ستة مابقبلش خمسة أو تحت يعني من
+
+273
+00:17:10,620 --> 00:17:12,980
+الساعات في بعض الناس بيقولك أنا بنامش أربع ساعات
+
+274
+00:17:12,980 --> 00:17:16,180
+على بعض طول اليوم difficulty in maintaining
+
+275
+00:17:16,180 --> 00:17:19,660
+orientation بيقدرش الواحد يركز طول النهار يظل عنده
+
+276
+00:17:19,660 --> 00:17:22,600
+يعني بنقول عنه full oriented اللي هو أخد .. بكرا
+
+277
+00:17:22,600 --> 00:17:24,860
+أخدناها في ال fundamental و بكرا هناخدناها على
+
+278
+00:17:24,860 --> 00:17:27,940
+المستشفى ال orientation يعني ان هو هل هو ياقظ و
+
+279
+00:17:27,940 --> 00:17:32,610
+صاحيو مدرك ابن جنسقله على تلت أشياء ال time و
+
+280
+00:17:32,610 --> 00:17:36,170
+النيم و ال place إذا بيعرف الإنسان وقته و بيعرف
+
+281
+00:17:36,170 --> 00:17:38,450
+اللي هو إيش اسمه و وين هو موجود معناته هو full
+
+282
+00:17:38,450 --> 00:17:41,850
+oriented لما واحد كتير في عنده مشاكل في النوم
+
+283
+00:17:41,850 --> 00:17:44,490
+بيصير عنده disturbance في ال إيش في ال orientation
+
+284
+00:17:44,490 --> 00:17:47,610
+illusions
+
+285
+00:17:47,610 --> 00:17:50,770
+تخيلات بيصير عنده إن كنتوا في قلة النوم بيصيروا
+
+286
+00:17:50,770 --> 00:17:54,390
+تخيلات بتخيل أنه كأنه شيء ع الحد كأنه شيء بيمشي
+
+287
+00:17:54,390 --> 00:17:57,270
+كأنه شيء بتحرك بيصير عنده hallucination
+
+288
+00:17:57,270 --> 00:17:59,800
+hallucination الهلاوساللي أخدناه في السنة الأولى
+
+289
+00:17:59,800 --> 00:18:03,380
+halos visual or tactile هجرة halos سواء كانت بصرية
+
+290
+00:18:03,380 --> 00:18:07,720
+أو halos لمسية من كتر ما هو إيش من كتر ما هو عنده
+
+291
+00:18:07,720 --> 00:18:11,120
+أرق شديد صار عنده يهلوس شوية وهذا بدل على أنه
+
+292
+00:18:11,120 --> 00:18:14,660
+سبحان الله يعني الإنسان يجب أن يأخذ قصد من الراحة
+
+293
+00:18:14,660 --> 00:18:19,740
+علشان الجسم يظل ماشي بأمره ال biology وساعته ال
+
+294
+00:18:19,740 --> 00:18:25,840
+biology الطبيعية decreased incentive to
+
+295
+00:18:25,840 --> 00:18:29,790
+work incentive يعنيإنه بتبطل في عنده رغبة ودافع
+
+296
+00:18:29,790 --> 00:18:33,330
+للعمل اللي بيكون عنده سبحان الله نقص كتير في النوم
+
+297
+00:18:33,330 --> 00:18:37,810
+بيجلي عنده الرغبة الحركية لإيش للعمل Psychomotor
+
+298
+00:18:37,810 --> 00:18:40,670
+يعني بيسموه نفسي حركي يعني باختصار اللي بنامش كتير
+
+299
+00:18:40,670 --> 00:18:44,070
+بتلاقي دايما خامل دايما مش قادر يتحرك دايما بتلاقي
+
+300
+00:18:44,070 --> 00:18:47,810
+عمال شوية شوية بده يقدر يجمع بأداء الوظائف اللي
+
+301
+00:18:47,810 --> 00:18:51,140
+موجودة عنده عشان ايه كانت مشكلة كبيرة لما ..بعد
+
+302
+00:18:51,140 --> 00:18:54,700
+الفترة اللي فاتت بعد انقضاء في فترة كورونا رجعوا
+
+303
+00:18:54,700 --> 00:18:57,840
+الطلاب المدارس كانت بمشكلة مش قادرين يتأقلموا و
+
+304
+00:18:57,840 --> 00:19:00,980
+يمكن هذا اللي خلاهم ياخدوا شوية شهر استدراكي و
+
+305
+00:19:00,980 --> 00:19:04,360
+ماكانش له فائدة كبيرة للأسف حتى حسب يعني الخبراء
+
+306
+00:19:04,360 --> 00:19:09,460
+ستة mild nystagmas زغلى لفلعين من جلة النوم بتلاقي
+
+307
+00:19:09,460 --> 00:19:12,080
+عينيك بتزغلى مبروح شمال ويمين أو فوق وتحت يعني مش
+
+308
+00:19:12,080 --> 00:19:15,770
+قادر أيش يركز شويةTremor of hands طبعا ال tremor
+
+309
+00:19:15,770 --> 00:19:18,390
+يعني أنك بتصير عندك راجفة في الأيدين من كتر اللي
+
+310
+00:19:18,390 --> 00:19:21,130
+هو الأرق اللي موجود عنده و التوتر و قلة النوم
+
+311
+00:19:21,130 --> 00:19:24,830
+بتلاقي أديه عمال و برجل عصبيهم Increased
+
+312
+00:19:24,830 --> 00:19:28,190
+glucocorticoid and adrenergic hormone secretion
+
+313
+00:19:28,190 --> 00:19:33,170
+يعني كأما ما بيقولي كمان بزيد عنه إيش ال glucose و
+
+314
+00:19:33,170 --> 00:19:35,890
+بزيد عنه ال adrenaline طبعا ال adrenaline من وين
+
+315
+00:19:35,890 --> 00:19:38,410
+جاي؟ من ال adrenal gland من ما أنتوا عارفين و
+
+316
+00:19:38,410 --> 00:19:40,510
+glucocorticoid برضه من ال adrenaline بس اللهم
+
+317
+00:19:41,160 --> 00:19:43,280
+بنذكركم ال Anatomy ال adrenaline جاية من ال
+
+318
+00:19:43,280 --> 00:19:47,120
+adrenaline مضلة و ال glucocorticoid جاية من ال
+
+319
+00:19:47,120 --> 00:19:50,180
+adrenaline cortex اللي هو القشرة اللحاق و القشرة
+
+320
+00:19:50,180 --> 00:19:53,560
+طبعا ليش؟ برضه هذا كله استجابة لقلة النوم أكيد لإن
+
+321
+00:19:53,560 --> 00:19:56,340
+الإنسان لم يكن صاحي و مش عارف ينام بيضال ال
+
+322
+00:19:56,340 --> 00:20:01,880
+adrenaline عنده عالي شوية اتنين او تسعة increased
+
+323
+00:20:01,880 --> 00:20:06,460
+anxiety with a sense of tiredness بتزيد القلق كتير
+
+324
+00:20:06,460 --> 00:20:09,540
+عند الإنسانو من شدة القلق اللي صار عنده صار عنده
+
+325
+00:20:09,540 --> 00:20:13,300
+إيش أنا؟ إحساس بالإيش؟ التعب sense of tiredness
+
+326
+00:20:13,300 --> 00:20:18,560
+إحساس بالانهاج، انهاج القوة، مش قادر، ركز Insomnia
+
+327
+00:20:18,560 --> 00:20:22,600
+Insomnia يعني انا بيصير عنده قرق و كلكوا عارفين شو
+
+328
+00:20:22,600 --> 00:20:25,920
+القرق خدناها زمان short and sleeping pills يعني
+
+329
+00:20:25,920 --> 00:20:30,140
+إما difficulty to start sleep or difficulty to
+
+330
+00:20:30,140 --> 00:20:34,100
+stay sleep يعني إما مش قادر يخش في النوم أو مش
+
+331
+00:20:34,100 --> 00:20:39,370
+قادر يبقى نائما، هذا بيسميه insomnia11 لاحظين كدهش
+
+332
+00:20:39,370 --> 00:20:42,310
+disorders كتيرة اللي مرتبطة بالنوم شوفوا احنا
+
+333
+00:20:42,310 --> 00:20:46,530
+قاعدين لسه ما أقول 11 و 12 كتير sleep apnea ال
+
+334
+00:20:46,530 --> 00:20:49,510
+sleep apnea اللي هو بيصير عناش هنا cessation of
+
+335
+00:20:49,510 --> 00:20:53,290
+breathing بتلاقي بتوقف النفس أثناء النوم اللي لما
+
+336
+00:20:53,290 --> 00:20:55,690
+احنا جولنا في بعض الحالات زي الناس اللي عندهم
+
+337
+00:20:55,690 --> 00:20:59,390
+bronchial أزمة بتلاقي أو ب COPD بتلاقي مجرد ما هو
+
+338
+00:20:59,390 --> 00:21:02,820
+نائم فجأةبصير عنده gasping for air يعني بتلاقي
+
+339
+00:21:02,820 --> 00:21:05,700
+كأنه .. يعني بصير عنده حالات الروح كأنه بده ياخد
+
+340
+00:21:05,700 --> 00:21:09,480
+شوية نفس، بيجوم من النوم علشان يقدر ياخد شوية نفس،
+
+341
+00:21:09,480 --> 00:21:12,860
+هذا بسمى sleep apnea، توقف النفس أثناء النوم
+
+342
+00:21:12,860 --> 00:21:17,000
+hypersomnia مش insomnia، hyper، مزاج اللي
+
+343
+00:21:17,000 --> 00:21:21,300
+hypersomnia يعني excessive sleeping، بنام طويل،
+
+344
+00:21:21,300 --> 00:21:25,280
+قدش بنام؟ في بعض الحالات extended to 16 to 18
+
+345
+00:21:25,280 --> 00:21:30,180
+hours، حالات نادرة، بصلى 16 ساعة في اليومطبعا مش
+
+346
+00:21:30,180 --> 00:21:34,180
+واحد ييجي يقول يا استاذ أنا أخدت إبرة كده أو أخدت
+
+347
+00:21:34,180 --> 00:21:37,840
+حبة دوة معينة زي مثلا دوة اسمه Phenergan Pro
+
+348
+00:21:37,840 --> 00:21:41,540
+Methazine ال Phenergan هذا يعتبر من ال potent
+
+349
+00:21:41,540 --> 00:21:45,940
+antihistamine يعني من المضادات للهستامين قوية جدا
+
+350
+00:21:45,940 --> 00:21:49,000
+لأ اخدها الإنسان ممكن ينام 16 ساعة بقدرش أقول هذا
+
+351
+00:21:49,000 --> 00:21:52,920
+يعني diseased لأ أو بقول disturbances لأ هذا
+
+352
+00:21:52,920 --> 00:21:56,080
+بعتبره normal situation لأنه استجابة للعلاج لكن لو
+
+353
+00:21:56,080 --> 00:21:58,460
+واحد في طبيعته ينام 16 ساعة لأ بقول إنه فيه عنده
+
+354
+00:21:58,460 --> 00:22:03,330
+مشكلةhypersomnia perihypersomnia لما نقول كلمة
+
+355
+00:22:03,330 --> 00:22:06,450
+perihypersomnia هو بنام كتير زي ما احنا قولنا 16
+
+356
+00:22:06,450 --> 00:22:12,110
+أو 18 ساعة لكن مش لكتير مش طول الوقت بقوللي هنا
+
+357
+00:22:12,110 --> 00:22:17,550
+لاحظين few days ايش هنا few days هنا بنام صحيح 16
+
+358
+00:22:17,550 --> 00:22:22,650
+.. 14 .. 18 ساعة لكن بنام بشكل دوري دائم زي هيك
+
+359
+00:22:22,650 --> 00:22:25,430
+هنا بنسميها hypersomnia لإعتبارها سرط سرط disorder
+
+360
+00:22:25,430 --> 00:22:29,490
+without trouble هنا perhypersomnia لأبنام صحيح نوم
+
+361
+00:22:29,490 --> 00:22:32,650
+كتير لكن كدهش في أيام متقطعة، يا انا اعطيكم مثال
+
+362
+00:22:32,650 --> 00:22:35,470
+زي ما ييجي الطالب يسألني، يقولني طب أنا يوم الخميس
+
+363
+00:22:35,470 --> 00:22:38,110
+و الله يا استاذ مرات بنام 14 ساعة أو مرات يوم
+
+364
+00:22:38,110 --> 00:22:41,730
+الجمعة، بقولهم مش مشكلة، ليه؟ لأنه اعتبرتها pre
+
+365
+00:22:41,730 --> 00:22:45,030
+-hypersomnia، يعني في هذه الوقت ماقدرش اقول عنه ال
+
+366
+00:22:45,030 --> 00:22:48,890
+disorder لأنه مش مستمر معاك و دائم، فعلشان هيك مش
+
+367
+00:22:48,890 --> 00:22:53,510
+كل شيء بدنا نقدر نقول عنه مرض إلا إذا استمر، طيب
+
+368
+00:22:53,510 --> 00:22:57,270
+ناركوليبسي أخدناها زمان في ال psychology، و نزيجي
+
+369
+00:22:57,270 --> 00:23:00,030
+أنا أيديه كم مرةExcessive بسموها daytime
+
+370
+00:23:00,030 --> 00:23:04,310
+drowsiness or uncontrolled onset of sleep عدم
+
+371
+00:23:04,310 --> 00:23:08,350
+الاستطاع على ايه التحكم في النوم أثناء ال .. أثناء
+
+372
+00:23:08,350 --> 00:23:11,970
+النهار Narcolepsy كيف يعني؟ زي بعض الإنسان اللي
+
+373
+00:23:11,970 --> 00:23:15,650
+بيكون راكب في ال bus و لسه مش نايم كويس و عمار صار
+
+374
+00:23:15,650 --> 00:23:18,830
+عنده drowsiness و مش قادر يتحكم في نفسه أو بيلاقي
+
+375
+00:23:18,830 --> 00:23:21,530
+بيصير الرأس و يروح شمال أو يمين أو بيكون على مقعد
+
+376
+00:23:21,530 --> 00:23:24,250
+الدراسة و الأستاذ عمار بيشرح بيصير عند الأطفال
+
+377
+00:23:24,250 --> 00:23:28,860
+مراتو بتلاقي مش قادر فحط رأسه على ال بانكيكا ونام،
+
+378
+00:23:28,860 --> 00:23:33,900
+ماقدرش يتحمل، هذا اسمه Narcolepsy خمستاشر
+
+379
+00:23:33,900 --> 00:23:37,060
+Cataplexy لما نقول Cataplexy هناقش بيصير
+
+380
+00:23:37,060 --> 00:23:40,200
+Appropriate weakness or paralysis of a voluntary
+
+381
+00:23:40,200 --> 00:23:45,700
+muscles فجأة بنلاقي إيش؟ ضعف أو مرتشة للبسيط في
+
+382
+00:23:45,700 --> 00:23:49,120
+إيش؟ في العضلات اللي هي بنقدر نتحكم فيها اللي هي
+
+383
+00:23:49,120 --> 00:23:53,760
+نستطيع نتحكم فيها بشكل تلقائي يعني voluntary يعني
+
+384
+00:23:53,760 --> 00:23:59,050
+إيراديازي ال arms ال legs ال face طيب last
+
+385
+00:23:59,050 --> 00:24:02,490
+condition from half seconds to ten minutes هذا
+
+386
+00:24:02,490 --> 00:24:06,670
+طبعا نادر تحصل نادر تحصل كيف تحصل بقول اللي بتحصل
+
+387
+00:24:06,670 --> 00:24:10,970
+يا مرة يا إما مرتين في العام كله كيف بتصير من
+
+388
+00:24:10,970 --> 00:24:14,090
+الإضطراب اللي موجود عنده في النوم بيحكوا أنه بيصير
+
+389
+00:24:14,090 --> 00:24:19,350
+عنده فقد فجأة لحركة الإيدين أو مرات زي شلل إما ضعف
+
+390
+00:24:19,350 --> 00:24:23,490
+أو شلل بقولك مش قادر حق أحرك إيدي مرات تستمر يعني
+
+391
+00:24:23,490 --> 00:24:26,930
+ثانيةو مرات بتقعد دقيقة، دقيقتين، تلاتة، ممكن
+
+392
+00:24:26,930 --> 00:24:29,470
+ازيد، بتحدث مرة او مرتين في العالم، بعدين الإنسان
+
+393
+00:24:29,470 --> 00:24:33,670
+برجع لطبيعته، هذه ما بندرش .. ما بنخوفش منها و ما
+
+394
+00:24:33,670 --> 00:24:36,190
+بنقولش بيدا علاج، هذه سبحان الله برضه مرتبطة
+
+395
+00:24:36,190 --> 00:24:38,990
+بالإيه؟ بال sleep disturbances اللي بتصير عند بعض
+
+396
+00:24:38,990 --> 00:24:43,350
+الحالات في مصطلع جديد اسمه hypnagogic أو
+
+397
+00:24:43,350 --> 00:24:46,130
+hypnagogic hallucinations إيش ال hypnagogic
+
+398
+00:24:46,130 --> 00:24:49,570
+hallucinations؟ هذه عبارة عن الطراب في إيش؟ في
+
+399
+00:24:49,570 --> 00:24:53,210
+النوم، بس للأسف لما بيصير مع الأحلام، الأحلام
+
+400
+00:24:53,210 --> 00:24:56,220
+المزعجةليه frightening dreams .. frightening
+
+401
+00:24:56,220 --> 00:24:59,080
+dreams اللي زي ال nightmares يعني بيصير عنده أحلام
+
+402
+00:24:59,080 --> 00:25:04,040
+صعبة جدا بتخلي الواحد دايما إيش عنده كأنه مش قادر
+
+403
+00:25:04,040 --> 00:25:07,940
+يدخل في النوم يعني بتلاقي مشكلة عنده متى بيجي
+
+404
+00:25:07,940 --> 00:25:10,460
+بيقوللي مجرد ما أجي أنام يا أستاذ أو يا دكتور
+
+405
+00:25:10,460 --> 00:25:15,600
+بيصير عنده إيش بخاف كأني أنا إيش كأنه شيء بيخنقني
+
+406
+00:25:15,600 --> 00:25:19,020
+يعني بتدوجع كأن كده مع بداية النوم هذا بيسموه
+
+407
+00:25:19,020 --> 00:25:20,160
+hallucination
+
+408
+00:25:22,090 --> 00:25:25,470
+برضه يعني إذا ضلت استمرت بعض الأطباء بيوصفوا
+
+409
+00:25:25,470 --> 00:25:29,210
+العلاج بسيط أنا مش في طور أن أكتب أو أحكي عن أي
+
+410
+00:25:29,210 --> 00:25:33,050
+علاج حتى الإنسان مايروح يشتري أي علاج وأنما يعني
+
+411
+00:25:33,050 --> 00:25:36,270
+ممكن تكون حالة ان شاء الله عابرة أو تنتهي لحظين
+
+412
+00:25:36,270 --> 00:25:41,130
+أكم يعني أكم من ال disorder بتكلم 14 واحد فليس
+
+413
+00:25:41,130 --> 00:25:46,290
+سهلا اضطرابة النوم للإنسان لازم يكون يعني مركز أنه
+
+414
+00:25:46,290 --> 00:25:48,850
+مش سهل أن الإنسان يكون عنده اضطراب في النوم
+
+415
+00:25:48,850 --> 00:25:54,380
+assessment of sleephabits طيب كيف بدأ أعمل تقييم
+
+416
+00:25:54,380 --> 00:25:57,380
+للنوم؟ أول حاجة بنجي بنسأل و بنقول للمريض record
+
+417
+00:25:57,380 --> 00:26:00,940
+the times ياريخ يسجللنا أوقات النوم و ال awakening
+
+418
+00:26:00,940 --> 00:26:05,080
+و اليقظة و including naps إيش نابس يا ماناتا؟
+
+419
+00:26:05,080 --> 00:26:08,640
+الغفوة بيسموها الغفوات بنسمع اللي احنا مرات ..
+
+420
+00:26:08,640 --> 00:26:12,460
+احنا بنقول عنها في الدين الإسلامي القيلولة لازم
+
+421
+00:26:12,460 --> 00:26:17,100
+نسأل المريض لو سمحت أنت كده بتنام في 24 ساعة؟ كده
+
+422
+00:26:17,100 --> 00:26:20,460
+في الليل؟ كده في النهار؟ كده تصحى؟و لو بتغف .. حتى
+
+423
+00:26:20,460 --> 00:26:23,880
+لو بتغفى، هيك نقوله أو بتسهي في بعض الناس، أقول
+
+424
+00:26:23,880 --> 00:26:28,540
+عنها، كده بتغفى و بتسهي عشان أنا أحسبها، كله لازم
+
+425
+00:26:28,540 --> 00:26:31,700
+ينحسب في الآخر، بنجمع مع بعض، كده نام و كده صحي
+
+426
+00:26:31,700 --> 00:26:35,260
+Allow the client to describe their sleep habits in
+
+427
+00:26:35,260 --> 00:26:38,800
+their own words وكأنه بيقوللي أقعد تتدخل في إيش في
+
+428
+00:26:38,800 --> 00:26:43,840
+كلامك، ماتخلوش يتأثر، خل المريض يوصف حالته النومية
+
+429
+00:26:43,840 --> 00:26:50,030
+و المناميةوعادته باسلوبه الخاص يعني بطريقته بكلامه
+
+430
+00:26:50,030 --> 00:26:54,310
+مابدناش نتدخل بأي كلمة احنا من عنا ممكن تخربته you
+
+431
+00:26:54,310 --> 00:26:58,270
+can ask the following questions يمكن للممرض او
+
+432
+00:26:58,270 --> 00:27:02,530
+للحكيم انه يسأل هذه الأسئلة ايش الأسئلة بتقول how
+
+433
+00:27:02,530 --> 00:27:06,930
+have you been sleeping؟ كيف انت بتنام؟ لو سمعت كيف
+
+434
+00:27:06,930 --> 00:27:13,080
+نومك؟ كيف انت و النوم؟ يعني سؤال open حلوالسؤال
+
+435
+00:27:13,080 --> 00:27:16,820
+التاني can you tell me your sleeping habits؟ ممكن
+
+436
+00:27:16,820 --> 00:27:20,220
+تحكيلي عن عاداتك في النوم؟ كيف عادات النوم
+
+437
+00:27:20,220 --> 00:27:23,440
+بالنسبالك؟ ممكن تتكلمني إيش اللي أنت الطقوس اللي
+
+438
+00:27:23,440 --> 00:27:26,820
+موجودة عندك أو أكتر شي في حياتك يعني عادات
+
+439
+00:27:26,820 --> 00:27:30,280
+بتتاخدها لموضوع النوم؟ اللي بعده are you getting
+
+440
+00:27:30,280 --> 00:27:34,020
+enough rest؟ هل بتاخد راحتك وكفيتك في النوم و في
+
+441
+00:27:34,020 --> 00:27:37,860
+حياتك يعني الاسترخائية و بتشعر أنك أنت مرتاح ولا
+
+442
+00:27:37,860 --> 00:27:41,660
+لأ؟tell me about your sleeping problems احكيلي عن
+
+443
+00:27:41,660 --> 00:27:45,500
+اي مشكلات في انهم موجودة عندك لاحظين انه مافيش
+
+444
+00:27:45,500 --> 00:27:48,440
+فيها bias مافيش فيها ايش يعني انت عايز مافيش فيها
+
+445
+00:27:48,440 --> 00:27:51,900
+leading ال question اللي بعد ايش بيسموها ال
+
+446
+00:27:51,900 --> 00:27:54,920
+history هنا enclosed general sleep لازم تتذكر
+
+447
+00:27:54,920 --> 00:27:58,680
+بتسأل دايما على ال general sleep يعني انهم بشكل
+
+448
+00:27:58,680 --> 00:28:03,540
+عام ال history psychological history لو حد سألني
+
+449
+00:28:03,540 --> 00:28:06,060
+او حد سألني يقولي ايش داخل ال psychological
+
+450
+00:28:06,060 --> 00:28:12,430
+history من اخطرالترابات النوم المنشأ نفسي، من أخطر
+
+451
+00:28:12,430 --> 00:28:16,490
+الترابات النوم المنشأ نفسي ما عمرك شفت واحد لا
+
+452
+00:28:16,490 --> 00:28:20,610
+خايف ولا عنده anxiety ولا عنده لا سمح الله اي
+
+453
+00:28:20,610 --> 00:28:23,970
+tremors ولا عنده خليني نقول بعض يعني personal
+
+454
+00:28:23,970 --> 00:28:27,390
+disorders اللي طلعت شخصية و جادر بنامي كويس اللي
+
+455
+00:28:27,390 --> 00:28:31,990
+يكون اللي عنده psychological problems عنده sleep
+
+456
+00:28:31,990 --> 00:28:35,510
+problems على فكرة و العكس صحيح و اللي عنده sleep
+
+457
+00:28:35,510 --> 00:28:39,430
+problems برضه عنده psychological problemsبعض الناس
+
+458
+00:28:39,430 --> 00:28:43,510
+نسأل عن drug history ممكن يقولك انا باخد دوة كده
+
+459
+00:28:43,510 --> 00:28:46,570
+بيخليني صاحي ممكن فلان يقولك انا باخد دوة كده
+
+460
+00:28:46,570 --> 00:28:50,070
+بيخليني نايم و بعضهم يقولك انا باخد دوة بيخليني
+
+461
+00:28:50,070 --> 00:28:54,350
+عندي أشعر بدجات الجلب سريعا طبعا بنسأل ايش ل drug
+
+462
+00:28:54,350 --> 00:28:57,190
+history و ايش اللي عامله عامله عنده اي اضطرابات في
+
+463
+00:28:57,190 --> 00:29:02,090
+النوم احنا هنخلنا نخلص اللي عندنا عشان نبدأ ان شاء
+
+464
+00:29:02,090 --> 00:29:05,930
+الله في الشبتر القادم عشان دائما نلتزم بالوقت
+
+465
+00:29:05,930 --> 00:29:10,460
+المناسب اللي هو حدودالـ 30 دقيقة والسلام عليكم
+
+466
+00:29:10,460 --> 00:29:11,960
+ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs.srt
new file mode 100644
index 0000000000000000000000000000000000000000..05cba932436040c780e9e68ba55e2733696379f8
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs.srt
@@ -0,0 +1,1381 @@
+1
+00:00:01,480 --> 00:00:04,420
+بسم الله الرحمن الرحيم خلينا نكمل طبعاً احنا
+
+2
+00:00:04,420 --> 00:00:08,460
+توقفنا في المحاضرة السابقة عند how to detect
+
+3
+00:00:08,460 --> 00:00:11,100
+liver size by percussion و how to detect stomach
+
+4
+00:00:11,100 --> 00:00:14,900
+position و كيف نقدر نمر على اليمين و نمر على
+
+5
+00:00:14,900 --> 00:00:19,500
+اليسار حسب الـ organ. نكمل الآن. طيب، الآن kidney
+
+6
+00:00:19,500 --> 00:00:24,020
+tenderness. كيف بعض الناس بيكون عندهم ألم في منطقة
+
+7
+00:00:24,020 --> 00:00:27,420
+الكلاوي، و احنا ما ننسى الكلام اللي حكيته في
+
+8
+00:00:27,420 --> 00:00:30,440
+المحاضرة السابقة أن الله سبحانه وتعالى وضع الـ
+
+9
+00:00:30,440 --> 00:00:35,160
+organs للعلاقة بالجهاز البولي والجهاز التناسلي خارج
+
+10
+00:00:35,160 --> 00:00:38,380
+اللي هو البريتون، و هذا رحمة من ربنا، عشان لما يصير
+
+11
+00:00:38,380 --> 00:00:41,920
+حمل عند الست، يكون الحمل و الـ uterus و هذا كله برا
+
+12
+00:00:41,920 --> 00:00:46,620
+عشان لو استعجلنا و بدنا نعمل عملية قيصرية (CS)، نقدر
+
+13
+00:00:46,620 --> 00:00:50,450
+ندخل بدون أي مشكلة. تخيلوا لو كان سبحان الله الحمل
+
+14
+00:00:50,450 --> 00:00:54,750
+في داخل البطن، جوا، هيكون، وصار لا قدر الله أي نزيف
+
+15
+00:00:54,750 --> 00:00:59,550
+أو أي رب شر،  ما حنقدر نعمل أمر مش سهل. طيب، الآن كيف
+
+16
+00:00:59,550 --> 00:01:02,910
+الـ kidney tenderness؟ الألم اللي بيصير زي واحد بقول لك
+
+17
+00:01:02,910 --> 00:01:07,010
+عنده renal colic، مغص كلوي. أول حاجة بنحط المريض
+
+18
+00:01:07,010 --> 00:01:10,070
+sitting position أو erect position، عشان erect
+
+19
+00:01:10,070 --> 00:01:13,270
+position؟ هو ممكن يكون قاعد أو ممكن يكون واقف. يعني
+
+20
+00:01:13,270 --> 00:01:15,090
+عشان ايه؟ بعض الناس بيقول لك، هو بنقدر نعمل
+
+21
+00:01:15,090 --> 00:01:17,870
+assessment لإنسان و هو واقف؟ طبعاً هي في الـ kidney
+
+22
+00:01:17,870 --> 00:01:21,350
+assessment بنقدر نعمل assessment و هو واقف. كيف
+
+23
+00:01:21,350 --> 00:01:25,090
+بنعمله؟ بيقول: استخدم direct or indirect percussion.
+
+24
+00:01:25,090 --> 00:01:29,230
+يعني اضغط بإصبعك وإيديك direct لحالهم أو بالـ
+
+25
+00:01:29,230 --> 00:01:31,990
+percussion زي ما قلنا، استخدم اللي هو إصبع إيدك
+
+26
+00:01:31,990 --> 00:01:35,610
+الشمال، و حطه على جسم الإنسان، و بعدين استخدم إصبع
+
+27
+00:01:35,610 --> 00:01:38,490
+إيدك اليمين اللي هو برضه اليمين، عشان تعمل ايش
+
+28
+00:01:38,490 --> 00:01:42,190
+percussion. هذا إذا بدنا نكون يعني نقدر نعمل
+
+29
+00:01:42,190 --> 00:01:47,370
+assessment و المريض متعاون معنا، لكن أفضل شيء أنه
+
+30
+00:01:47,370 --> 00:01:51,870
+نعمل حاجة بيسموها ايه؟ أنه نستخدم يد واحدة، و هي
+
+31
+00:01:51,870 --> 00:01:54,270
+اليد اللي هي الـ dominant hand، يعني إيدنا اللي
+
+32
+00:01:54,270 --> 00:01:58,070
+بنستخدمها دائماً، يعني إذا احنا right handed نستخدم
+
+33
+00:01:58,070 --> 00:02:01,230
+ايه؟ إيدنا اليمين. إذا left handed، مثل الناس
+
+34
+00:02:01,230 --> 00:02:05,290
+اليسرى، ايه؟ بنستخدم إيدنا اليسرى. ايش بيقول لي هنا؟
+
+35
+00:02:05,290 --> 00:02:08,110
+بيقول لي استخدم الـ ulnar surface، عارفين ايش الـ
+
+36
+00:02:08,110 --> 00:02:11,110
+ulnar surface؟ اللي مش فيه، قلنا فيه radius موجودة
+
+37
+00:02:11,110 --> 00:02:13,950
+العظم الثاني موجودة في إيدنا، و الـ ulnar دائماً لجوه
+
+38
+00:02:13,950 --> 00:02:17,390
+انتوا عارفين، و الـ radius لبرا. كأنه بيقول استخدم
+
+39
+00:02:17,390 --> 00:02:21,970
+ايش؟ المنطقة في إيدك اللي جوه. يعني كيف اللي جوه؟ اتخيل
+
+40
+00:02:21,970 --> 00:02:25,630
+معايا، اعمل إيدك زي الـ box، اعمل إيدك زي الـ box، بس
+
+41
+00:02:25,630 --> 00:02:30,550
+ما يكونش انت ضاغط على الآخر، يعني سكر إيدك، إغلاق شبه
+
+42
+00:02:30,550 --> 00:02:33,750
+يعني خليني أقول semi closed. ايش يعني؟ يعني كأنه شبه
+
+43
+00:02:33,750 --> 00:02:38,690
+مغلقة. ولو انت ضغطت إيدك هيك، ضغطة بسيطة بدون ما تغلق
+
+44
+00:02:38,690 --> 00:02:42,970
+إيدك على الآخر. روح على الجهة اللي عند إصبعك الصغير،
+
+45
+00:02:42,970 --> 00:02:47,170
+الجهة الجلد اللي عند إصبعك الصغير. اضغط على الـ skin.
+
+46
+00:02:47,170 --> 00:02:50,710
+اللي انت ضغطت على الجلد، انت ضغطت بيدك اليمين، روح
+
+47
+00:02:50,710 --> 00:02:55,610
+بإصبعك الشمال، حط شوية، هتلاقي soft tissue، هتلاقي الـ
+
+48
+00:02:55,610 --> 00:03:00,690
+skin يعني لين. و احنا عاملين بنعمل زي الـ box بسيط في
+
+49
+00:03:00,690 --> 00:03:04,850
+إيدنا اليمين، و روحنا على منطقة الـ ulnar surface تبع
+
+50
+00:03:04,850 --> 00:03:08,650
+نفس إيدنا اليمين، و ضغطنا عليها ضغطة بسيطة كتير بإصبع
+
+51
+00:03:08,650 --> 00:03:13,010
+إيدنا الشمال. بيحس إن هذه المنطقة ايش؟ يعني لينة طبعاً
+
+52
+00:03:13,010 --> 00:03:16,850
+عشان تتخيلوا معايا، ما بدي أعمل box، كأني بعمل بإيدي
+
+53
+00:03:16,850 --> 00:03:21,510
+... بإيدي للأمام. No، أنا بقول بإيدي للجنب. يعني فليه
+
+54
+00:03:21,510 --> 00:03:25,070
+يتخيل الواحد فينا؟ و لا تشبيه زي لما واحد بيجي
+
+55
+00:03:25,070 --> 00:03:28,910
+بيقول مثلاً زي المتهم لما بيجي يقوله: مد إيدك عشان
+
+56
+00:03:28,910 --> 00:03:33,470
+نعمل لك كلب شات. فبيمد إيده باتجاه، انه كيف؟ كأنه
+
+57
+00:03:33,470 --> 00:03:37,750
+يعني حط إيده و رفعها لفوق، و خل اتجاه الإصبع الصغير
+
+58
+00:03:37,750 --> 00:03:42,480
+لقدام. يعني بالضبط، حط اتجاه إصبعك الصغير لقدام
+
+59
+00:03:42,480 --> 00:03:45,840
+المريض، و بتروح بتعمل ... و بتعمل percussion، يعني
+
+60
+00:03:45,840 --> 00:03:50,160
+بتصير تدق على وين؟ على ظهر المريض، في منطقة ايش؟ في
+
+61
+00:03:50,160 --> 00:03:54,400
+منطقة الـ kidney، في منطقة الـ ايه؟ اللي هو لتحت شوية
+
+62
+00:03:54,400 --> 00:03:58,900
+من الـ scapular line. شوفتوا العضمة اللي ورا في
+
+63
+00:03:58,900 --> 00:04:03,560
+عضمتين؟ عضمة في الظهر على اليمين اللي اللوحة، و
+
+64
+00:04:03,560 --> 00:04:06,810
+عضمة، انتم اخذتوها في الـ Anatomy، و عضمة ... في اليسار.
+
+65
+00:04:06,810 --> 00:04:11,230
+انزل لتحت العضمتين، لتحت شوية، بتلاقي الكلية هنا
+
+66
+00:04:11,230 --> 00:04:14,090
+على اليمين، و الكلية هنا على اليسار. في عندنا two
+
+67
+00:04:14,090 --> 00:04:19,030
+kidneys، و بنعمل شوية percussion، ضغط بسيط. إذا تألم
+
+68
+00:04:19,030 --> 00:04:23,130
+المريض، بنعرف فوراً أنه عنده ايش؟ inflammatory process
+
+69
+00:04:23,130 --> 00:04:26,250
+أو عنده some problems، أو يمكن عنده stone، أو هذا أو
+
+70
+00:04:26,250 --> 00:04:30,630
+شيء من هذا القبيل. طيب، إذا المريض عنده tenderness،
+
+71
+00:04:30,630 --> 00:04:34,580
+طب في الـ palpation، بقول لي الآن بدنا نستخدم الـ
+
+72
+00:04:34,580 --> 00:04:37,280
+palpation. خلصنا الآن الـ percussion. الـ palpation
+
+73
+00:04:37,280 --> 00:04:43,340
+هنا إذا كان في abdominal tenderness، بدنا فوراً نعرف
+
+74
+00:04:43,340 --> 00:04:46,540
+ليش صار tenderness. احنا كشفنا أنه في tenderness في
+
+75
+00:04:46,540 --> 00:04:49,500
+الـ percussion، لكن ابعدنا عنها شوية و خليناها للـ
+
+76
+00:04:49,500 --> 00:04:56,260
+palpation. هنا بدنا نشوف كيف الـ quality، كيف الـ
+
+77
+00:04:56,260 --> 00:05:01,920
+distinction. هل هي ممتدة، أكثر، لا قدر الله، يعني
+
+78
+00:05:01,920 --> 00:05:06,080
+المكان المؤلم كبير، صغير؟ هل في، لا سمح الله، تحت
+
+79
+00:05:06,080 --> 00:05:10,680
+إيدينا masses، يعني في بعض الحالات، ندغط عليه بتلاقي
+
+80
+00:05:10,680 --> 00:05:14,900
+تحت إيد الـ examiner mass، مش شرط يكون وراه، لا من
+
+81
+00:05:14,900 --> 00:05:18,600
+ضمن الحالات، مرة الـ examiner حط إيده فإجأة طلع
+
+82
+00:05:18,600 --> 00:05:23,340
+abscess، دمل كبير، و هو المريض مش عارف أن هذا دمل
+
+83
+00:05:23,340 --> 00:05:27,700
+لكن إحساسه من برا عامل كأنه وراه. فعشان هيك بنكون
+
+84
+00:05:27,700 --> 00:05:31,930
+احنا صاحيين لهذه النقطة. الست، ايش كمان؟ muscular
+
+85
+00:05:31,930 --> 00:05:36,250
+resistance. بتشوف كده عضلات البطن ومقاومتها، عشان
+
+86
+00:05:36,250 --> 00:05:40,290
+هيك، كتير من الحالات بيكون في عندهم مشكلة في عضلات
+
+87
+00:05:40,290 --> 00:05:45,670
+البطن، و خاصة يعني ... يعني خليني أقول لما في ... يعني
+
+88
+00:05:45,670 --> 00:05:50,250
+للأسف عضلات البطن ضعيفة، و الـ organs عاملة بتكبر، و
+
+89
+00:05:50,250 --> 00:05:53,430
+الـ masses بتكبر، بتضغط على الجلد من برا. طبعاً، كيف
+
+90
+00:05:53,430 --> 00:05:57,270
+جيزة عضلات البطن ضعيفة؟ يعني زي ست يعني ... يعني
+
+91
+00:05:57,270 --> 00:06:02,240
+عندها حمل متكرر. و هو مش متباعد، المسافة كلها قريبة على
+
+92
+00:06:02,240 --> 00:06:07,500
+بعض. زي واحد highly obese كمان، زي ست عملية
+
+93
+00:06:07,500 --> 00:06:11,120
+قيصرية أكثر، يعني من ثلاث أربع مرات. فبيصير الـ
+
+94
+00:06:11,120 --> 00:06:14,080
+abdomen اللي ما صار فيه flaccid، يعني خلاص زي ارتخاء
+
+95
+00:06:14,080 --> 00:06:17,620
+شوية. فبيصير الـ organ، أي شيء فيه في داخل الـ abdomen،
+
+96
+00:06:17,620 --> 00:06:25,240
+ممكن ايش؟ ينحس برا الجلد، أو برا الجسم. طيب، assess
+
+97
+00:06:25,240 --> 00:06:29,120
+for bladder distention. و احنا بنعمل assessment، هل
+
+98
+00:06:29,120 --> 00:06:32,840
+جينا الآن بالـ palpation؟ بدنا نشوف أنه مع أنه
+
+99
+00:06:32,840 --> 00:06:36,020
+المريض ممكن يكون رايح، عامل urination، لكن ممكن في
+
+100
+00:06:36,020 --> 00:06:39,880
+بعض الحالات نكتشف أنه لا، عنده bladder distention،
+
+101
+00:06:39,880 --> 00:06:44,080
+أو بنسميه urine retention، عنده احتقان في البول. اه،
+
+102
+00:06:44,080 --> 00:06:47,480
+لو حدث هذا، طب ليش؟ ممكن يكون عنده، إذا كان male،
+
+103
+00:06:47,480 --> 00:06:51,780
+prostatitis. وإذا كان لا سمح الله في female، ممكن severe
+
+104
+00:06:51,780 --> 00:06:53,860
+urinary tract infection، أو حتى عند female ممكن
+
+105
+00:06:53,860 --> 00:06:57,420
+severe urinary tract infection، اللي هو UTI. فمش شرط
+
+106
+00:06:57,420 --> 00:07:00,240
+يكون راح على الحمام، يعني أنه خلاص، هنلاقي الـ
+
+107
+00:07:00,240 --> 00:07:03,860
+bladder empty. No، ممكن أنه في عنده مشكلة، فهو بيجي
+
+108
+00:07:03,860 --> 00:07:07,700
+بيقول لي أنا يعني inability، أنا I complain، أنا بأعاني
+
+109
+00:07:07,700 --> 00:07:10,360
+from inability to urinate، أنا مش قادر أروح
+
+110
+00:07:10,360 --> 00:07:14,540
+الحمام، يعني، و أتبوّل. فهذه مشكلة بنقدر نعرف أنه صار
+
+111
+00:07:14,540 --> 00:07:19,300
+ايش؟ a bladder distention. طيب، الـ bladder وين موجودة
+
+112
+00:07:19,300 --> 00:07:21,640
+يا ناس، عشان أنا أقدر أعرف أنه وين الـ bladder، عشان
+
+113
+00:07:21,640 --> 00:07:25,920
+ما اخربطش. الـ bladder طبيعياً موجودة تحت الـ umbilicus،
+
+114
+00:07:25,920 --> 00:07:29,620
+تحت الـ umbilicus، و فوق ايش؟ الـ symphysis pubis. شوفنا
+
+115
+00:07:29,620 --> 00:07:33,460
+وين عظمتين الـ symphysis pubis، أخريتها من فوق، و
+
+116
+00:07:33,460 --> 00:07:35,800
+الـ umbilicus أخريتها من ... خلينا نقول من تحت.
+
+117
+00:07:35,800 --> 00:07:41,230
+المسافة اللي بينهم هي الـ bladder. ممكن أنا عشان أقدر
+
+118
+00:07:41,230 --> 00:07:44,830
+أعرف وين فيه، أو ما فيش، حاسس أنه فيه مشكلة، بس
+
+119
+00:07:44,830 --> 00:07:48,490
+بده اضغط أكثر من مرة، بستخدم superficial، أو مثلاً
+
+120
+00:07:48,490 --> 00:07:51,930
+light palpation، و مرات بستخدم deep palpation. الـ
+
+121
+00:07:51,930 --> 00:07:54,130
+light palpation كلنا عارفينه، ممكن نضغط سنتيمتر بسيط،
+
+122
+00:07:54,130 --> 00:07:57,390
+لكن الـ deep palpation كده، ممكن نضغط إيدينا لجوه،
+
+123
+00:07:57,390 --> 00:08:01,810
+بتوصل لكم من ٢.٥ لـ ٧.٥ سم، يعني كأني
+
+124
+00:08:01,810 --> 00:08:05,970
+بقول، على اعتبار أن كل إنش ٢.٥ سم،
+
+125
+00:08:05,970 --> 00:08:11,160
+فاهمين مقولين؟ ممكن تضغط على الـ abdomen بالذات في الـ
+
+126
+00:08:11,160 --> 00:08:13,840
+abdomen، الـ organ. لو واحد ساكر، طب يا أستاذ مش كثير؟
+
+127
+00:08:13,840 --> 00:08:17,820
+لا مش كثير. افرض واحد عنده appendicitis، التهاب
+
+128
+00:08:17,820 --> 00:08:21,200
+الزائدة الدودية، و أنا جيت على منطقة اليمين، و بدي
+
+129
+00:08:21,200 --> 00:08:23,560
+أعمل له pressure في الـ point  اللي  أهمّ، اللي احنا
+
+130
+00:08:23,560 --> 00:08:27,660
+حكينا عنه، و ضغطت ضغط بسيط، ما بيبينش أنه في
+
+131
+00:08:27,660 --> 00:08:33,040
+مشكلة كتيرة، لا. لكن الضغط الكثير، لما أضغط لجوه،
+
+132
+00:08:33,040 --> 00:08:37,000
+بيبين أنه في problem. بقول له: لا، استنى، في معناته
+
+133
+00:08:37,990 --> 00:08:42,310
+positive sign، على ما واضح أن في عندك مشكلة. يعني
+
+134
+00:08:42,310 --> 00:08:46,330
+معناته مش في كل الـ organs، لو حد سألنا، نستخدم الـ
+
+135
+00:08:46,330 --> 00:08:49,970
+deep palpation. يعني لو أجينا للسؤال: هل بقدر استخدم
+
+136
+00:08:49,970 --> 00:08:54,330
+الـ deep palpation في الـ painful areas؟ أبداً. طب هل
+
+137
+00:08:54,330 --> 00:08:58,390
+بقدر استخدم الـ deep palpation في الـ surgical areas؟
+
+138
+00:08:58,390 --> 00:09:00,970
+برضه أبداً. يعني أنا بقدر استخدمها في الأماكن اللي
+
+139
+00:09:00,970 --> 00:09:05,190
+انعمل فيها جراحة. يعني ما يجي واحد يقول: هيّا أعمل
+
+140
+00:09:05,190 --> 00:09:08,710
+عملية في بطنه، خلينا نعمل deep palpation. أبداً، ممنوع.
+
+141
+00:09:08,710 --> 00:09:12,210
+لا يمكن أنه نسمح، لأنه ممكن، لا سمح الله، أن تعمل تمزق،
+
+142
+00:09:12,210 --> 00:09:17,290
+أو حتى العملية نفسها يصير فيها مشكلة. عشان هيك،
+
+143
+00:09:17,290 --> 00:09:21,750
+بقول لي هي بالأحمر: never used في surgical incision.
+
+144
+00:09:21,750 --> 00:09:27,110
+ممنوع يستخدم، خاصة في tender organs، يعني في الأعضاء
+
+145
+00:09:27,110 --> 00:09:30,250
+اللي عاملة ألم، أو لا قدر الله فيه masses.
+
+146
+00:09:30,250 --> 00:09:37,370
+طيب، if tenderness ... إذا والله الـ tenderness موجود،
+
+147
+00:09:37,370 --> 00:09:40,690
+إذا فيه tenderness، ايش بيقول لي؟ خاصة في منطقة
+
+148
+00:09:40,690 --> 00:09:42,550
+اليمين زي ما احنا قلنا ... احنا قلنا ده ايش
+
+149
+00:09:42,550 --> 00:09:45,590
+بيسموه؟ rebound tenderness. كلمة rebound، إنه لما
+
+150
+00:09:45,590 --> 00:09:48,230
+بضغط عليه ... لما بضغط على المنطقة اليمين، خاصة الـ
+
+151
+00:09:48,230 --> 00:09:52,750
+appendicitis، و بكون ما فيش ألم، برفع إيده مباشرة
+
+152
+00:09:52,750 --> 00:09:56,190
+الطبيب، المعالج، الأخصائي، بتلاقي يصير عنده ألم. لو
+
+153
+00:09:56,190 --> 00:09:58,890
+حد سألنا: طب ليش بيصير عنده ألم؟ هذا من الـ
+
+154
+00:09:58,890 --> 00:10:01,230
+peritoneal irritation، من الـ peritoneal
+
+155
+00:10:01,230 --> 00:10:03,730
+irritation، لأنه احنا قلنا الـ peritoneal مغطي
+
+156
+00:10:03,730 --> 00:10:07,270
+الأعضاء جوا، فلو ضغطنا عليه، بيرتاح المريض، زي السن
+
+157
+00:10:07,270 --> 00:10:11,990
+لما بكون بوجعك، أو بيرتاح. بتروح تضغط عليه شوية هيك،
+
+158
+00:10:11,990 --> 00:10:16,370
+بترفع إيدك بتلاقي حالك يعني، مع الضغط شوية، خف الألم،
+
+159
+00:10:16,370 --> 00:10:20,090
+لكن لما بنرجع بنرفع إيدنا، رجع الألم. هذا دليل
+
+160
+00:10:20,090 --> 00:10:23,410
+طبعاً أنه في مشكلة، عصبي، لكن بالنسبة للأبدومين
+
+161
+00:10:23,410 --> 00:10:31,130
+معناته في التهاب في الزائدة الدودية. طبعاً حكينا كيف
+
+162
+00:10:31,130 --> 00:10:35,930
+يعني نجس مثلاً حدود الـ liver، كيف نجس حدود الـ
+
+163
+00:10:35,930 --> 00:10:41,080
+stomach بشكل عام. الآن بيقول لي هنا الـ liver نفسه، لما
+
+164
+00:10:41,080 --> 00:10:43,980
+أنا بدي أعمل assessment و بدي أعرف كيف العضو نفسه،
+
+165
+00:10:43,980 --> 00:10:48,660
+يعني مرات هو مش كبير في الطول من فوق أو لتحت، يعني،
+
+166
+00:10:48,660 --> 00:10:52,940
+لكن نفس الـ organ فيه مشكلة. طب كيف أنا بدي أتأكد
+
+167
+00:10:52,940 --> 00:10:57,500
+أنه فيه مشكلة؟ هذا طبعاً شغل متخصص. ايش بيجي؟ بيجي،
+
+168
+00:10:57,500 --> 00:11:00,740
+بيحط له أنه الـ normal ما بينحس الـ liver بشكل سهل،
+
+169
+00:1
+
+223
+00:14:26,070 --> 00:14:29,990
+الصراحة يعني المنطقة تحت يعني كتير بتسبب حرج لل
+
+224
+00:14:29,990 --> 00:14:35,070
+male وال female بشكل عام لكن مرات مضطر أعملها
+
+225
+00:14:35,070 --> 00:14:38,050
+examination في حالات ال severe abdominal pain ومش
+
+226
+00:14:38,050 --> 00:14:42,120
+عارف شو السبب، في حالات التغير في ال bowel habits
+
+227
+00:14:42,120 --> 00:14:45,200
+،functional alteration يعني أفرض أجر المريض قال أنه
+
+228
+00:14:45,200 --> 00:14:48,360
+معاه إمساك، بعدين بيصير معاه إيش؟ إسهال، إمساك،
+
+229
+00:14:48,360 --> 00:14:52,000
+إسهال، لأ مرات بتغلى، مرات بقعد يومين، مرات في يوم
+
+230
+00:14:52,000 --> 00:14:55,580
+بروح مرتين، لما يصير هذا إيش اسمه؟ ال alteration،
+
+231
+00:14:55,580 --> 00:14:59,240
+يعني تغير في منظومة اللي هو خليني أقول يعني مثلا
+
+232
+00:14:59,240 --> 00:15:03,730
+ال defecation بشكل عام. لو واحد عنده anal pain،
+
+233
+00:15:03,730 --> 00:15:07,010
+anal pain يعني ألم شديد جدا مثلا في منطقة الشرج،
+
+234
+00:15:07,010 --> 00:15:10,270
+مش عارف إيش شو هو، ما أقدرش أجي أقول بدون صورة .. مش
+
+235
+00:15:10,270 --> 00:15:14,610
+كل حاجة الصورة بتجيبها، anal spasm، تقلص شديد في
+
+236
+00:15:14,610 --> 00:15:17,970
+منطقة الشرج، يعني خاصة في ال anal sphincter، بدنا
+
+237
+00:15:17,970 --> 00:15:21,470
+نعرف إيش السبب، واحد عنده anal itching بحكة كتير في
+
+238
+00:15:21,470 --> 00:15:25,090
+هذا أو بره أو مثلا burning أو عنده حرج، زي بعض
+
+239
+00:15:25,090 --> 00:15:28,490
+الناس اللي عندهم يعني اللي يسموها ال pin worm اللي
+
+240
+00:15:28,490 --> 00:15:32,190
+هو زي الدودة الدبوسية، فبيقول لك أنا مش عارف عندي منطقة
+
+241
+00:15:32,190 --> 00:15:36,050
+اهتكاك شديد جدا ومش قادر، أنا حرجانه ده بيحصل كتير
+
+242
+00:15:36,050 --> 00:15:40,090
+ونقول له بنعمل أكثر examination، واحد عنده black
+
+243
+00:15:40,090 --> 00:15:42,830
+tarry stool، إيش يعني black tarry stool؟ ثاني معناه
+
+244
+00:15:42,830 --> 00:15:47,230
+الدم المتجبّن، يعني عنده براز مدمم، خاصة الناس اللي عندهم
+
+245
+00:15:47,230 --> 00:15:51,310
+يعني فيه abdominal خليني أقوله أو intestinal
+
+246
+00:15:51,310 --> 00:15:55,380
+bleeding، فيه نزيف في الداخل، مع الهضم ومع كذا نزل
+
+247
+00:15:55,380 --> 00:15:59,480
+إيش؟ الدم صار لونه أسود مع الستول ومع عمليات اللي
+
+248
+00:15:59,480 --> 00:16:03,900
+هو ال catabolism، واحد عنده rectal bleeding يعني
+
+249
+00:16:03,900 --> 00:16:07,560
+فيه نزيف من تحت، مش عارفين شو السبب، ما بنقدر الشخص
+
+250
+00:16:07,560 --> 00:16:10,900
+اللي إحنا بنعمله، نعمله rectal examination، طيب إيش ال
+
+251
+00:16:10,900 --> 00:16:13,680
+positions اللي ممكن أعمل فيهم rectal examination
+
+252
+00:16:13,680 --> 00:16:17,180
+لدي clients، يعني كيف لازم يكون ال client طبعا
+
+253
+00:16:17,180 --> 00:16:20,960
+الوضع اللي إحنا بنستخدمه في معظم المستشفيات اللي
+
+254
+00:16:20,960 --> 00:16:24,410
+عندنا في غزة هو ال Sims position اللي هو left
+
+255
+00:16:24,410 --> 00:16:27,870
+lateral، على اعتبار أنه أقل إحراجا للمريض، لكن مرات
+
+256
+00:16:27,870 --> 00:16:32,250
+بنضطر نستخدم موضوع ثاني إذا الطبيب يعني ما قدرش أو
+
+257
+00:16:32,250 --> 00:16:35,870
+كان خليني أقول مثلا obese على الآخر أو كان
+
+258
+00:16:35,870 --> 00:16:39,810
+embarrassing ومش قادر يعني المريض يعمل relax عشان
+
+259
+00:16:39,810 --> 00:16:43,250
+يقدر الطبيب يعمله assessment أكثر، فممكن نستخدم ال
+
+260
+00:16:43,250 --> 00:16:45,930
+knee chest position، وإنتوا عارفينه كيف، أو ممكن
+
+261
+00:16:45,930 --> 00:16:49,020
+نستخدم ال standing position، ال standing position
+
+262
+00:16:49,020 --> 00:16:52,940
+هذا للميل بالذات عشان نشوف ال prostate لأنه هو
+
+263
+00:16:52,940 --> 00:16:56,760
+واقف، بنقدر عن طريق ال rectal examination نعرف أنه
+
+264
+00:16:56,760 --> 00:16:59,780
+لغدة ال prostate إيش أخبارها؟ هل هي في enlargement
+
+265
+00:16:59,780 --> 00:17:02,300
+في inflammatory process أو في لقدر الله some
+
+266
+00:17:02,300 --> 00:17:05,580
+abnormalities، ممكن نستخدم ال lithotomy position
+
+267
+00:17:05,580 --> 00:17:07,880
+ووضع الولادة طبعا مش شرط يكون وضع الولادة يعني في
+
+268
+00:17:07,880 --> 00:17:11,980
+ميل، لأ ممكن نستخدم يعني للميل خاصة في حالات ال إيه
+
+269
+00:17:11,980 --> 00:17:15,040
+في حالات ال piles اللي عنده بواسير عشان نقدر نتأكد
+
+270
+00:17:15,040 --> 00:17:18,540
+منها برضه بنحطه في ال lithotomy position، في وضع
+
+271
+00:17:18,540 --> 00:17:21,700
+اسمه squatting position، squatting position اللي
+
+272
+00:17:21,700 --> 00:17:25,200
+باسمه وضع القرفصاء، القرفصاء يعني مجنبز شوية يعني
+
+273
+00:17:25,200 --> 00:17:28,680
+كجالس على .. يعني أكرمكم الله زي اللي جالس على ..
+
+274
+00:17:28,680 --> 00:17:33,020
+زي الحمامات القديمة، الحمام العربي، خاصة علشان يشوف
+
+275
+00:17:33,020 --> 00:17:36,420
+لما عامل هذا الطريقة وكأنه جالس في .. بده يصير
+
+276
+00:17:36,420 --> 00:17:39,380
+defecation عشان يقدر يشوف العضلات اللي موجودة
+
+277
+00:17:39,380 --> 00:17:43,450
+تحت كيف وضعها، طبعا بقول لك in all positions، في جميع
+
+278
+00:17:43,450 --> 00:17:48,010
+الأوضاع لازم إيه؟ أنت كمعالج أو كإنسان بتعمل
+
+279
+00:17:48,010 --> 00:17:52,250
+assessment، لازم تلبس two gloves، يعني ليش two
+
+280
+00:17:52,250 --> 00:17:57,310
+gloves؟ عشان لقدر الله لو في أي مشكلة خاصة في هذه
+
+281
+00:17:57,310 --> 00:18:00,350
+المنطقة يعني ال dirty area، لازم الإنسان يحمي نفسه
+
+282
+00:18:00,350 --> 00:18:04,870
+فلازم يلبس إيه؟ يعني قفازين مع بعض على الإيد
+
+283
+00:18:04,870 --> 00:18:09,870
+الواحدة، طيب ال assessment هنا نكمل هنا of the anus
+
+284
+00:18:09,870 --> 00:18:11,890
+وال rectum، دي ييجي على ال inspection
+
+285
+00:18:11,890 --> 00:18:15,330
+بيقول لك في ال inspection، تتطلع و بتلاحظ المنطقة
+
+286
+00:18:15,330 --> 00:18:18,790
+تطلع فيها بس بدك تعمل إيش هنا؟ بيقول لك spread  perianal
+
+287
+00:18:18,790 --> 00:18:21,470
+طبعا إنتوا عارفين من ناحية الشرحية ال perianal، مرات
+
+288
+00:18:21,470 --> 00:18:25,090
+تكون يعني مغطية على المكان هذا، نعمل spreading شوية
+
+289
+00:18:25,090 --> 00:18:28,490
+عشان نعمل ونشوف ال skin حوالين ال anus هل فيها
+
+290
+00:18:28,490 --> 00:18:32,110
+مشكلة كيف؟ ال pigmentation يعني كيف تلونها؟ في moist
+
+291
+00:18:32,820 --> 00:18:36,360
+فيه رطوبة، هذه المنطقة هي بتكون hairless طبعا أكيد
+
+292
+00:18:36,360 --> 00:18:39,860
+سبحان الله رحمة ربنا ما فيش فيها يعني شعر، طبعا هي
+
+293
+00:18:39,860 --> 00:18:43,600
+بتكون moist لكن إذا كانت moist زيادة معناته فيه
+
+294
+00:18:43,600 --> 00:18:47,220
+discharge، معناته فيه problem، فبدنا نحددها، بدنا
+
+295
+00:18:47,220 --> 00:18:50,460
+نشوف إذا فيه lesions، النقطة الثانية أي lesion
+
+296
+00:18:50,460 --> 00:18:55,100
+موجود في هذا المكان، نشوف ال scars ندبات معينة
+
+297
+00:18:55,100 --> 00:19:00,180
+موجودة، نشوف ال inflammation إذا في أي التهاب موجود
+
+298
+00:19:00,180 --> 00:19:05,180
+تحت، في ال perirectal abscess إذا فيه لا سمح الله،
+
+299
+00:19:05,180 --> 00:19:09,180
+بيسموه دمل حوالين ال rectum، بعض الناس بيسموه
+
+300
+00:19:09,180 --> 00:19:12,880
+أسماء غريبة، بيقول لك دمل صيني، دمل في المنطقة، يعني
+
+301
+00:19:12,880 --> 00:19:16,650
+على الاعتبار عشان هالمنطقة محرجة، فبيجي بيقول
+
+302
+00:19:16,650 --> 00:19:21,070
+perirectal أو بيقول مثلا يعني أو nearly in this
+
+303
+00:19:21,070 --> 00:19:23,970
+site، يعني في هذا المكان، ممكن يكون بعض الناس عندهم
+
+304
+00:19:23,970 --> 00:19:27,090
+fissures، الشرخ بنسمع بنقول عن حاجة اسمها الشرخ
+
+305
+00:19:27,090 --> 00:19:31,990
+الشرجي، بتبين واحد عنده بيكون piles أو ممكن تجينا
+
+306
+00:19:31,990 --> 00:19:36,290
+مصطلح ثاني اسمه hemorrhoids، الاثنين نفس المعنى برضه
+
+307
+00:19:36,290 --> 00:19:40,600
+بنقدر نعمل assessment لها، في ناس عندهم fistula، هيش
+
+308
+00:19:40,600 --> 00:19:45,440
+fistula يعني شيء مفتوح من جوه، يعني مغلق من جوه
+
+309
+00:19:45,440 --> 00:19:49,060
+لكن عامل فتحة للخارج، زي مين؟ زي الناس اللي عندهم
+
+310
+00:19:49,060 --> 00:19:55,200
+حاجة بيسموها الناسور، مش البواسير، الناسور
+
+311
+00:19:55,200 --> 00:19:58,480
+هو عبارة عن الفستيولا بيسمونه biological sinuses
+
+312
+00:19:58,480 --> 00:20:02,100
+أنه نفس المكان، في هذا المكان، نهاية عند ال rectum
+
+313
+00:20:02,100 --> 00:20:05,920
+عما لو في فتحة طالعة برة بتعمل discharge وهذه من
+
+314
+00:20:05,920 --> 00:20:09,560
+الأمراض اللي chronic شوية و بتغلب شوية في العلاج
+
+315
+00:20:09,560 --> 00:20:13,740
+عشان هذه المنطقة عليها pressure و high risk area، بنشوف
+
+316
+00:20:13,740 --> 00:20:19,920
+كمان بعد شوية منطقة العصعص كمان، منطقة اللي هو إذا في
+
+317
+00:20:19,920 --> 00:20:23,570
+لا قدر الله، إذا في لا قدر الله كمان، مش بس هي، إذا في
+
+318
+00:20:23,570 --> 00:20:25,850
+لسه، محرقة ال erectile prolapse أو ال tunica يعني
+
+319
+00:20:25,850 --> 00:20:28,570
+خاصة بعض الناس بيكون في هذا المكان ممكن يكون في
+
+320
+00:20:28,570 --> 00:20:31,350
+عندهم أي ورم في هذا المكان، برضه بنحاول نعمله
+
+321
+00:20:31,350 --> 00:20:34,130
+assessment، يعني اللي قدر الله ممكن بعض الناس
+
+322
+00:20:34,130 --> 00:20:37,530
+بيكون يعني في هذا المكان فيه ورم أو مبين أو عامل
+
+323
+00:20:37,530 --> 00:20:41,970
+bulging، فبرضه بنقدر نعمله assessment، طيب وإحنا
+
+324
+00:20:41,970 --> 00:20:46,750
+بنعمل assessment في هذا المكان بالذات لازم نخلي
+
+325
+00:20:46,750 --> 00:20:49,370
+المريض في هذه الحالة يعمل زي إيه؟ نوع من حاجة
+
+326
+00:20:49,370 --> 00:20:54,320
+بيسموها، طبعا ليش بنعمل .. بنقول المريض يعمل عملية
+
+327
+00:20:54,320 --> 00:20:59,140
+الضغط يعني زي .. يعني أكرمكم الله كأنه الإنسان في
+
+328
+00:20:59,140 --> 00:21:02,540
+جلسة الخلاء أو بده يحاول يضغط على نفسه عشان إذا في
+
+329
+00:21:02,540 --> 00:21:06,700
+أي bulging، اتبين واضحة جدا أمام اللي هو ال exam ده
+
+330
+00:21:06,700 --> 00:21:10,380
+طبعا بقول لك تتطلع كمان على حاجات ما اللي أنا قلتها
+
+331
+00:21:10,380 --> 00:21:13,340
+الآن قبل شوية، اللي هي ال pilonidal sinuses اللي
+
+332
+00:21:13,340 --> 00:21:17,290
+بيسموه الناسور العصعصي، خاصة في منطقة العصعص أو
+
+333
+00:21:17,290 --> 00:21:20,310
+بيسموها ال cyst، يعني في زي غدة بتكون موجودة وين؟ في
+
+334
+00:21:20,310 --> 00:21:23,410
+منطقة اللي هو ال sacrococcygeal area، في نهاية
+
+335
+00:21:23,410 --> 00:21:27,880
+العصعص، نهاية العمود الفقري من تحت، بتكون لأنها جاية
+
+336
+00:21:27,880 --> 00:21:30,980
+مع نهاية اللي هو ال rectum، فبتكون في هذا المكان
+
+337
+00:21:30,980 --> 00:21:35,020
+فيه fistula عاملة بتطلع discharge برة، خاصة عن بعض
+
+338
+00:21:35,020 --> 00:21:39,200
+الناس اللي هم في حياتهم بيقعدوا كتير و بيقعدوا على
+
+339
+00:21:39,200 --> 00:21:43,620
+الكراسي بجلد اللي بتعمل ربما سخونة في هذا المكان
+
+340
+00:21:43,620 --> 00:21:47,900
+فلازم نعرف أن الجلد في هذا المكان أصلا soft skin
+
+341
+00:21:47,900 --> 00:21:51,800
+ومتحملش ال pressure كله تبع جسم الإنسان، فممكن يصير
+
+342
+00:21:51,800 --> 00:21:56,440
+عنده نوع من إيش؟ إحنا فيستولة من ال pressure اللي صار
+
+343
+00:21:56,440 --> 00:21:59,440
+و من ال hair follicles اللي هو الشعر اللي بينمو
+
+344
+00:21:59,440 --> 00:22:03,220
+صار فيه إشكالية و بينمو بالطريقة العكسية و هذا
+
+345
+00:22:03,220 --> 00:22:06,900
+بينعكس سلبا على إيش؟ بينعكس سلبا على ال discharge
+
+346
+00:22:06,900 --> 00:22:10,900
+ال discharge اللي بيصير عند المريض، تمام؟ طيب،
+
+347
+00:22:10,900 --> 00:22:17,240
+الآن بدنا نشوف، بدنا نعمل اللي هو بنسمع في فحص يمكن
+
+348
+00:22:17,240 --> 00:22:20,580
+تشوف اسمه، سمعته في السنة الأولى اللي هو اسمه PR
+
+349
+00:22:20,580 --> 00:22:25,000
+examination اللي هو per rectal examination، طبعا
+
+350
+00:22:25,000 --> 00:22:30,980
+هذا يعتبر doctor procedure، متى إحنا بنعمل ال PR
+
+351
+00:22:30,980 --> 00:22:37,440
+examination؟ طبعا أول حاجة، هنحكي لقدام شوية في ال
+
+352
+00:22:37,440 --> 00:22:41,150
+slide اللي بعدها، متى إحنا بنحتاجه وإيش ال events
+
+353
+00:22:41,150 --> 00:22:45,810
+اللي ممكن .. يعني نقدر نكتشفها وإحنا بنعمل per
+
+354
+00:22:45,810 --> 00:22:49,290
+rectal examination، عن طريق طبعا اللي هو الطبيب، لأن
+
+355
+00:22:49,290 --> 00:22:51,870
+هذا يعتبر ال doctor procedure زي ما أنا قلت، لكن
+
+356
+00:22:51,870 --> 00:22:54,430
+كيف بنعمله؟ زي ما إحنا قلنا، ولا حاجة، الأمر بده
+
+357
+00:22:54,430 --> 00:22:57,930
+يكون ال perianal spread pathogen، يعني بده المنطقة
+
+358
+00:22:57,930 --> 00:23:01,110
+يعمل exposure، وبعدين يلبس gloves زي ما إحنا حكينا
+
+359
+00:23:01,110 --> 00:23:06,010
+ويفضل يكون two gloves، بعدين ييجي بال index طبعا
+
+360
+00:23:06,010 --> 00:23:10,530
+بإصبعه اللي هو ال index الأول عشان يحاول يعني يدخل
+
+361
+00:23:10,530 --> 00:23:14,410
+إصبعه ويحاول يعمل إيش؟ assessment بشكل واضح عشان
+
+362
+00:23:14,410 --> 00:23:18,670
+يشوف إذا في أي مشكلة، طبعا بيكون اللي اتجاهها اتجاه
+
+363
+00:23:18,670 --> 00:23:21,930
+الشرج، مش شرط إحنا جد ما بدنا نحاول نشرح في
+
+364
+00:23:21,930 --> 00:23:26,540
+هذا المقام، مش هيبين إيه لما الطبيب أمامكم يعمل ل
+
+365
+00:23:26,540 --> 00:23:29,380
+client معين، وكتير كل يوم كل يوم كل يوم، نعمل كتير
+
+366
+00:23:29,380 --> 00:23:32,840
+لمرضى، أي مريض عنده abdominal pain، أي مريض عنده
+
+367
+00:23:32,840 --> 00:23:36,300
+bleeding، أي مريض عنده itching، أي حاجة بيحتاج أو
+
+368
+00:23:36,300 --> 00:23:39,940
+distinction، بيحتاج يعمل طبعا بعد ما بيحط بيحاول
+
+369
+00:23:39,940 --> 00:23:43,220
+يحط ال finger، بروح إيش بقول لها ال client؟ ياريت تعملي
+
+370
+00:23:43,220 --> 00:23:47,000
+tighten، tighten يعني اضغط شوية على الإصبع عشان يشوف
+
+371
+00:23:47,000 --> 00:23:51,420
+ال sphincter إيش control أو sphincter يعني power
+
+372
+00:23:51,420 --> 00:23:54,000
+كذا جوه، ال dysfunction، لما تضغط على إصبع ال
+
+373
+00:23:54,000 --> 00:23:57,580
+examiner عشان يعرف اللي اللي سمح الله يمكن عند
+
+374
+00:23:57,580 --> 00:24:00,240
+المريض incontinence، لما شاف في bleeding أو شاف في
+
+375
+00:24:00,240 --> 00:24:03,920
+discharge أو شيء من هذا القبيل، طبعا بدنا نشوف هل في
+
+376
+00:24:03,920 --> 00:24:08,040
+يعني أي problems طالعة ولا لأ، في نفس الوقت بدي
+
+377
+00:24:08,040 --> 00:24:10,800
+أعمل إحساس لمنطقة ال mucosa اللي تحت اللي في ال
+
+378
+00:24:10,800 --> 00:24:15,520
+anal area، لقدر الله هل في tumor؟ هل في nodules يعني
+
+379
+00:24:15,520 --> 00:24:20,020
+نتوءات لحمية أو شغلة، أو حتى ممكن يكشف إذا في ال
+
+380
+00:24:20,020 --> 00:24:23,300
+internal piles اللي هي البواسير الداخلية، مش كل
+
+381
+00:24:23,300 --> 00:24:27,540
+بواسير يعني لازم نعتقد أنه بواسير خارجية، لأ فيه
+
+382
+00:24:27,540 --> 00:24:31,840
+بواسير داخلية ممكن تكون يعني ما بتبينش إلا عن طريق
+
+383
+00:24:31,840 --> 00:24:35,600
+ال examiner finger، بعدين بقول لك أنا كمان أسس إيش؟
+
+384
+00:24:35,600 --> 00:24:39,760
+أنا normal cervix، ال normal cervix يعني لل female
+
+385
+00:24:39,760 --> 00:24:44,300
+لو حد سأل، طب يعني كيف نقدر نعمل assessment؟ طبعا
+
+386
+00:24:44,300 --> 00:24:48,110
+إنتوا عارفين يعني شو ال cervix يعني؟ عنق الرحم، لما
+
+387
+00:24:48,110 --> 00:24:52,550
+بيجي يقدر يعمله assessment، بيعمله assessment إلا
+
+388
+00:24:52,550 --> 00:24:56,470
+عن طريق ال rectal examination، بيبين كأنه ring، إيش
+
+389
+00:24:56,470 --> 00:24:59,810
+يعني ring؟ يعني زي ال mass، يعني كأنها كتلة يعني
+
+390
+00:24:59,810 --> 00:25:03,550
+دائرية، بيقدر يحسها اللي هو الطبيب المعالج، هو بيعمل
+
+391
+00:25:03,550 --> 00:25:07,250
+PR examination، طيب ال variations هذا اللي أنا قلت
+
+392
+00:25:07,250 --> 00:25:10,430
+عنه، الشريحة الثانية اللي بتحكي فيها إيش؟ الشغلات
+
+393
+00:25:10,430 --> 00:25:13,430
+اللي ممكن إحنا نقدر نكتشفها وإحنا بنعمل rectal
+
+394
+00:25:13,430 --> 00:25:18,370
+examination، أو نقدر نشخصها، ممكن نلاقي حاجة اسمها
+
+395
+00:25:18,370 --> 00:25:22,59
+
+445
+00:28:36,450 --> 00:28:41,010
+impaction من أي شيء أو من جسم الإنسان، هذه كلها اسمها
+
+446
+00:28:41,010 --> 00:28:44,010
+variations بتكون، أيش ممكن نعملها detection واحنا
+
+447
+00:28:44,010 --> 00:28:48,810
+بنعمل rectal examination، طيب أنا خليني أقف عند هذه
+
+448
+00:28:48,810 --> 00:28:49,350
+الشريحة
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..b40ff02f2397a0765769501b04ead1cb51dc49c0
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.json
@@ -0,0 +1 @@
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"probability": 0.83203125}, {"start": 363.68, "end": 364.04, "word": " واحد", "probability": 0.989013671875}, {"start": 364.04, "end": 364.76, "word": " highly", "probability": 0.75146484375}, {"start": 364.76, "end": 365.24, "word": " obese", "probability": 0.91796875}, {"start": 365.24, "end": 365.68, "word": " كمان", "probability": 0.9640299479166666}, {"start": 365.68, "end": 366.68, "word": " زي", "probability": 0.921875}, {"start": 366.68, "end": 367.06, "word": " ست", "probability": 0.941650390625}, {"start": 367.06, "end": 367.5, "word": " عملية", "probability": 0.6670735677083334}, {"start": 367.5, "end": 368.02, "word": " السيزيريا", "probability": 0.68203125}, {"start": 368.02, "end": 368.44, "word": " اكتر", "probability": 0.8697509765625}, {"start": 368.44, "end": 368.92, "word": " يعني", "probability": 0.841796875}, {"start": 368.92, "end": 369.18, "word": " من", "probability": 0.98486328125}, {"start": 369.18, "end": 369.52, "word": " تلت", "probability": 0.89306640625}, {"start": 369.52, "end": 369.78, "word": " اربع", "probability": 0.9404296875}, {"start": 369.78, "end": 370.24, "word": " مرات", "probability": 0.9591471354166666}, {"start": 370.24, "end": 371.06, "word": " فبصير", "probability": 0.8553466796875}, {"start": 371.06, "end": 371.12, "word": " ال", "probability": 0.7001953125}, {"start": 371.12, "end": 371.38, "word": " abdomen", "probability": 0.5625}, {"start": 371.38, "end": 371.52, "word": " اللي", "probability": 0.5955810546875}, {"start": 371.52, "end": 371.62, "word": " ما", "probability": 0.268310546875}, {"start": 371.62, "end": 372.4, "word": " صار", "probability": 0.7705078125}, {"start": 372.4, "end": 372.56, "word": " فيه", "probability": 0.90234375}, {"start": 372.56, "end": 373.06, "word": " flaccid", "probability": 0.81787109375}, {"start": 373.06, "end": 373.26, "word": " يعني", "probability": 0.94189453125}, {"start": 373.26, "end": 373.5, "word": " خلاص", "probability": 0.9873046875}, {"start": 373.5, "end": 373.66, "word": " زي", "probability": 0.942626953125}, {"start": 373.66, "end": 374.08, "word": " ارتخط", "probability": 0.8154296875}, {"start": 374.08, "end": 374.46, "word": " شوية", "probability": 0.9124348958333334}, {"start": 374.46, "end": 375.54, "word": " فبصير", "probability": 0.96142578125}, {"start": 375.54, "end": 375.66, "word": " ال", "probability": 0.9775390625}, {"start": 375.66, "end": 376.02, "word": " organ", "probability": 0.87060546875}, {"start": 376.02, "end": 376.4, "word": " اي", "probability": 0.75244140625}, {"start": 376.4, "end": 376.6, "word": " شي", "probability": 0.88330078125}, {"start": 376.6, "end": 376.9, "word": " فيه", "probability": 0.6337890625}, {"start": 376.9, "end": 376.92, "word": " في", "probability": 0.6904296875}, {"start": 376.92, "end": 377.22, "word": " داخل", "probability": 0.94580078125}, {"start": 377.22, "end": 377.34, "word": " ال", "probability": 0.9404296875}, {"start": 377.34, "end": 377.62, "word": " abdomen", "probability": 0.9892578125}, {"start": 377.62, "end": 378.02, "word": " ممكن", "probability": 0.9833984375}, {"start": 378.02, "end": 378.3, "word": " ايش", "probability": 0.7928059895833334}, {"start": 378.3, "end": 379.26, "word": " ينحس", "probability": 0.9515380859375}, {"start": 379.26, "end": 379.96, "word": " برا", "probability": 0.92822265625}, {"start": 379.96, "end": 380.54, "word": " الجلد", "probability": 0.9842122395833334}, {"start": 380.54, "end": 380.96, "word": " او", "probability": 0.85107421875}, {"start": 380.96, "end": 381.28, "word": " برا", "probability": 0.989990234375}, {"start": 381.28, "end": 381.76, "word": " الجسم", "probability": 0.984619140625}, {"start": 381.76, "end": 384.12, "word": " طيب", "probability": 0.9254557291666666}, {"start": 384.12, "end": 385.24, "word": " assess", "probability": 0.23974609375}, {"start": 385.24, "end": 386.3, "word": " for", "probability": 0.95849609375}, {"start": 386.3, "end": 386.64, "word": " bladder", "probability": 0.818359375}, 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"probability": 0.97900390625}, {"start": 406.3, "end": 406.54, "word": " يكون", "probability": 0.9873046875}, {"start": 406.54, "end": 406.86, "word": " عنده", "probability": 0.993896484375}, {"start": 406.86, "end": 407.06, "word": " اذا", "probability": 0.84033203125}, {"start": 407.06, "end": 407.26, "word": " كان", "probability": 0.99658203125}, {"start": 407.26, "end": 407.48, "word": " male", "probability": 0.76025390625}, {"start": 407.48, "end": 408.3, "word": " prostatitis", "probability": 0.8557942708333334}], "temperature": 1.0}, {"id": 17, "seek": 43712, "start": 409.64, "end": 437.12, "text": "واذا كان لأ سمح الله في ميل ممكن severe urinary tract infection او حتى عند الميل ممكن severe urinary tract infection اللي هو UTI فمش شرط يكون راح على الحمام يعني انه خلاص هنلاقي ال bladder empty no ممكن انه في عنده مشكلة فهو بيجي بقوللي انا يعني inability انا I complain انا بعاني from inability to hate to avoid انا مش قادر اروح الحمام يعني و اتبول فهذه مشكلة بنقدر نعرف انه صار ايش a bladder extinction طيب", "tokens": [2407, 45636, 995, 25961, 5296, 10721, 8608, 2304, 5016, 21984, 8978, 3714, 26895, 3714, 43020, 8922, 4038, 4066, 24207, 11764, 1975, 2407, 11331, 49975, 43242, 9673, 26895, 3714, 43020, 8922, 4038, 4066, 24207, 11764, 13672, 1829, 31439, 624, 5422, 6156, 2304, 8592, 13412, 2288, 9566, 7251, 30544, 12602, 39319, 15844, 21542, 2304, 10943, 37495, 22653, 16472, 3224, 16490, 1211, 33546, 8032, 1863, 15040, 38436, 2423, 37032, 6707, 572, 3714, 43020, 16472, 3224, 8978, 43242, 3224, 37893, 28820, 3660, 6156, 3224, 2407, 4724, 1829, 7435, 1829, 4724, 39648, 20292, 1975, 8315, 37495, 22653, 33162, 1975, 8315, 286, 11024, 1975, 8315, 45030, 7649, 1829, 490, 33162, 281, 4700, 281, 5042, 1975, 8315, 37893, 12174, 18513, 2288, 1975, 32887, 5016, 21542, 2304, 10943, 37495, 22653, 4032, 1975, 2655, 3555, 12610, 6156, 3224, 24192, 37893, 28820, 3660, 44945, 28543, 2288, 8717, 3615, 28480, 16472, 3224, 20328, 9640, 1975, 1829, 8592, 257, 37032, 33163, 23032, 1829, 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بيسموه rebound tenderness كلمة rebound إنه لما بضغط عليه .. لما بضغط على المنطقة اليمين خاصة ال appendicitis", "tokens": [41185, 16247, 3615, 11242, 16606, 13672, 1829, 6225, 10943, 37977, 5551, 19528, 34051, 20193, 12174, 3215, 2288, 21984, 8978, 3224, 23935, 23032, 1829, 3555, 498, 15036, 1287, 4386, 11933, 15730, 16070, 43761, 2423, 15036, 1287, 3714, 29245, 23328, 11933, 15730, 8978, 3224, 15036, 1287, 11933, 1829, 8592, 4724, 1829, 39648, 20292, 16490, 33546, 3660, 8978, 9154, 9566, 28671, 2423, 32640, 9957, 30767, 1829, 19446, 1975, 5016, 8315, 12174, 12610, 8315, 4386, 1975, 5016, 8315, 12174, 12610, 8315, 11778, 3224, 11933, 1829, 8592, 4724, 1829, 38251, 2407, 3224, 31850, 3928, 19416, 9122, 19528, 3660, 31850, 36145, 3224, 5296, 15042, 4724, 11242, 17082, 9566, 47356, 4386, 5296, 15042, 4724, 11242, 17082, 9566, 15844, 9673, 1863, 9566, 28671, 2423, 32640, 9957, 16490, 33546, 3660, 2423, 34116, 8876, 271], "avg_logprob": -0.1953125059131592, "compression_ratio": 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"probability": 0.91650390625}, {"start": 1717.91, "end": 1718.11, "word": " او", "probability": 0.79541015625}, {"start": 1718.11, "end": 1718.27, "word": " من", "probability": 0.86181640625}, {"start": 1718.27, "end": 1718.43, "word": " جسم", "probability": 0.990966796875}, {"start": 1718.43, "end": 1718.87, "word": " الإنسان", "probability": 0.90966796875}, {"start": 1718.87, "end": 1719.85, "word": " هذه", "probability": 0.85498046875}, {"start": 1719.85, "end": 1720.51, "word": " كلها", "probability": 0.975341796875}, {"start": 1720.51, "end": 1721.01, "word": " اسمة", "probability": 0.586669921875}, {"start": 1721.01, "end": 1721.55, "word": " variations", "probability": 0.7529296875}, {"start": 1721.55, "end": 1721.97, "word": " بتكون", "probability": 0.97216796875}, {"start": 1721.97, "end": 1722.25, "word": " ايش", "probability": 0.7605794270833334}, {"start": 1722.25, "end": 1722.83, "word": " ممكن", "probability": 0.982666015625}, {"start": 1722.83, "end": 1723.17, "word": " نعملها", "probability": 0.9073486328125}, {"start": 1723.17, "end": 1723.57, "word": " detection", "probability": 0.8955078125}, {"start": 1723.57, "end": 1723.85, "word": " و", "probability": 0.5771484375}, {"start": 1723.85, "end": 1724.01, "word": " احنا", "probability": 0.7644856770833334}, {"start": 1724.01, "end": 1724.39, "word": " بنعمل", "probability": 0.9798177083333334}, {"start": 1724.39, "end": 1724.81, "word": " rectal", "probability": 0.89208984375}, {"start": 1724.81, "end": 1725.45, "word": " examination", "probability": 0.9501953125}, {"start": 1725.45, "end": 1726.47, "word": " طيب", "probability": 0.9490559895833334}, {"start": 1726.47, "end": 1727.07, "word": " انا", "probability": 0.866943359375}, {"start": 1727.07, "end": 1727.67, "word": " خليني", "probability": 0.916748046875}, {"start": 1727.67, "end": 1728.05, "word": " اقف", "probability": 0.7353515625}, {"start": 1728.05, "end": 1728.53, "word": " عند", "probability": 0.94384765625}, {"start": 1728.53, "end": 1728.81, "word": " هذه", "probability": 0.818359375}, {"start": 1728.81, "end": 1729.35, "word": " الشريحة", "probability": 0.9931640625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1729.42225, "duration_after_vad": 1701.0024999999957}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ffcb02064d4f96b483668add49b1dbd7f1e8f683
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/wirLye295Gs_raw.srt
@@ -0,0 +1,1792 @@
+1
+00:00:01,480 --> 00:00:04,420
+بسم الله الرحمن الرحيم خلينا نكمل طبعا احنا
+
+2
+00:00:04,420 --> 00:00:08,460
+اتوقفنا في المحاضرة السابقة لعند how to detect
+
+3
+00:00:08,460 --> 00:00:11,100
+liver size by percussion و how to detect stomach
+
+4
+00:00:11,100 --> 00:00:14,900
+position و كيف بنقدر نمر على اليمين و نمر على
+
+5
+00:00:14,900 --> 00:00:19,500
+اليسار حسب ال organ نكمل الآن طيب الان kidney
+
+6
+00:00:19,500 --> 00:00:24,020
+tenderness كيف بعض الناس بيكون عندهم ألمفي مطقة
+
+7
+00:00:24,020 --> 00:00:27,420
+الكلاوي و احنا مانساش الكلام اللي حكيته في
+
+8
+00:00:27,420 --> 00:00:30,440
+المحاضرة السابقة ان الله سبحانه وتعالى وضع ال
+
+9
+00:00:30,440 --> 00:00:35,160
+organs للعلاقة بالجهاز البول والجهاز التناسلي خارج
+
+10
+00:00:35,160 --> 00:00:38,380
+اللي هو البريتون و هذا رحمه من ربنا عشان لما يصير
+
+11
+00:00:38,380 --> 00:00:41,920
+حمل عند الست يكون الحمل و ال uterus و هذا كله برا
+
+12
+00:00:41,920 --> 00:00:46,620
+عشان لو استعجلنا و بدنا نعمل عملية قيصرية CS نقدر
+
+13
+00:00:46,620 --> 00:00:50,450
+ندخل بدون اي مشكلةتخيلوا لو كان سبحان الله الحمل
+
+14
+00:00:50,450 --> 00:00:54,750
+في داخل البطن جوا، هيكون وصار لأ قدر الله أي نزيف
+
+15
+00:00:54,750 --> 00:00:59,550
+أو أي رب شرشو حنقدر نعمل أمر مش سهل طيب، الآن كيف
+
+16
+00:00:59,550 --> 00:01:02,910
+ال kidney تندرنس؟ الألم اللي بيصير زي واحد، بقولك
+
+17
+00:01:02,910 --> 00:01:07,010
+عنده renal colic، مغس كلوي أول حاجة بنحط المريض
+
+18
+00:01:07,010 --> 00:01:10,070
+setting position أو erect position، عشان erect
+
+19
+00:01:10,070 --> 00:01:13,270
+position؟ هو ممكن يكون قاعد أو ممكن يكون واقفيعني
+
+20
+00:01:13,270 --> 00:01:15,090
+عشان أيه؟ بعض الناس بيقولك هو بنقدر نعمل
+
+21
+00:01:15,090 --> 00:01:17,870
+assessment لإنسان و هو واقف؟ طبعا هي في ال kidney
+
+22
+00:01:17,870 --> 00:01:21,350
+assessment بنقدر نعمل assessment و هو واقف كيف
+
+23
+00:01:21,350 --> 00:01:25,090
+بنعمله؟ بيقول استخدم direct or indirect percussion
+
+24
+00:01:25,090 --> 00:01:29,230
+يعني اضغط بعصابي و إيديك direct لحالهم أو بال
+
+25
+00:01:29,230 --> 00:01:31,990
+percussion زي ما قلنا استخدم اللي هو أصبع إيدك
+
+26
+00:01:31,990 --> 00:01:35,610
+الشمال و حطه على جسم الإنسان و بعدين استخدم أصبع
+
+27
+00:01:35,610 --> 00:01:38,490
+إيدك الوسط اللي هو برضه اليمين عشان تعمل إيش
+
+28
+00:01:38,490 --> 00:01:42,190
+percussionهذا إذا بدنا نكون يعني نقدر نعمل
+
+29
+00:01:42,190 --> 00:01:47,370
+assessment و المريض متسهل معناه، لكن أفضل شيء أنه
+
+30
+00:01:47,370 --> 00:01:51,870
+نعمل حاجة بيسموها إيه؟ أنه نستخدم يد واحدة، و هي
+
+31
+00:01:51,870 --> 00:01:54,270
+اليد اللي هي ال dominant hand، يعني إيدنا اللي
+
+32
+00:01:54,270 --> 00:01:58,070
+بنستخدمها دايما، يعني إذا إحنا right handed نستخدم
+
+33
+00:01:58,070 --> 00:02:01,230
+إيه؟ إيدنا اليمين، إذا left handed، مثل الناس
+
+34
+00:02:01,230 --> 00:02:05,290
+الأيسر، إيه بنستخدم إيدنا اليسرى؟ إيش بيقوللي هنا؟
+
+35
+00:02:05,290 --> 00:02:08,110
+بيقوللي استخدم ال ulnar surface، عارفين إيش ال
+
+36
+00:02:08,110 --> 00:02:11,110
+ulnar surface؟اللي مش فيه قلنا وفيه radius موجودة
+
+37
+00:02:11,110 --> 00:02:13,950
+العظم التاني موجودة في إيدنا و القلنا دايما لجوة
+
+38
+00:02:13,950 --> 00:02:17,390
+انتوا عارفين و ال radius لبرا كأنه بيقول استخدم
+
+39
+00:02:17,390 --> 00:02:21,970
+إيش المنطقة إيدك اللي جوا يعني كيف اللي جوا اتخيل
+
+40
+00:02:21,970 --> 00:02:25,630
+معايا اعمل إيدك زي ال box اعمل إيدك زي ال box بس
+
+41
+00:02:25,630 --> 00:02:30,550
+مايكونش انت ضاغط على الآخر يعني سكر إيدك إغلاق شبه
+
+42
+00:02:30,550 --> 00:02:33,750
+يعني خليني أقول semi closed إيش يعني يعني كإنا شبه
+
+43
+00:02:33,750 --> 00:02:38,690
+مغلقةو لو انت ضغط ايدك هيك ضغطة بسيطة بدون ما تغلق
+
+44
+00:02:38,690 --> 00:02:42,970
+ايدك على الآخر روح على الجهة اللي عند أصبعك الصغير
+
+45
+00:02:42,970 --> 00:02:47,170
+الجهة الجلد اللي عند أصبعك الصغير اضغط على ال skin
+
+46
+00:02:47,170 --> 00:02:50,710
+اللي انت ضغطت على الجلد انت ضغط بيدك اليمين روح
+
+47
+00:02:50,710 --> 00:02:55,610
+بصبعك الشمال حط شويه هتلاقي soft tissue هتلاقي ال
+
+48
+00:02:55,610 --> 00:03:00,690
+skin يعني لين و احنا عاملا بنعمل زي ال box بسيط في
+
+49
+00:03:00,690 --> 00:03:04,850
+ايدنا اليمينو روحنا على منطقة ال النار surface تبع
+
+50
+00:03:04,850 --> 00:03:08,650
+نفسي إيدي اليمين وضغط عليها ضغطة بسيطة كتير بإصبع
+
+51
+00:03:08,650 --> 00:03:13,010
+إيدي الشمال بيحس إن هذا المنطقة إيشيعني لينة طبعا
+
+52
+00:03:13,010 --> 00:03:16,850
+عشان تتخيلوا معايا ما بدي أعمل box كإني بعمل بإيدي
+
+53
+00:03:16,850 --> 00:03:21,510
+.. بإيدي للأمام No أنا بقول بإيدي الجنب يعني فليه
+
+54
+00:03:21,510 --> 00:03:25,070
+يتخيل الواحد فينا و لا تشبيه زي لما واحد بيجي
+
+55
+00:03:25,070 --> 00:03:28,910
+بيقول مثلا زي المتهم لما بيجي يقوله مد إيدك عشان
+
+56
+00:03:28,910 --> 00:03:33,470
+نعمل لك كلب شات فبيمد إيده باتجاه انه كيف كأنه
+
+57
+00:03:33,470 --> 00:03:37,750
+يعني حط إيديه و رفعه لفوق و خل اتجاه الإصبع الصغير
+
+58
+00:03:37,750 --> 00:03:42,480
+لجدامكيعني بالظبط حط اتجاه الإصبعك الصغير لقدام
+
+59
+00:03:42,480 --> 00:03:45,840
+المريض و بتروحش بتعمل .. و بتعمل percussion يعني
+
+60
+00:03:45,840 --> 00:03:50,160
+بتصير تدج على وين؟ على دهر المريض في منطقة إيش؟ في
+
+61
+00:03:50,160 --> 00:03:54,400
+منطقة ال kidney في منطقة ال إيه؟ اللي هو لتحت شوية
+
+62
+00:03:54,400 --> 00:03:58,900
+من ال scapular line شوفتوا العضمة اللي ورا في
+
+63
+00:03:58,900 --> 00:04:03,560
+عضمتين؟ عضمة في الدهر على اليمين اللي اللوحة و
+
+64
+00:04:03,560 --> 00:04:06,810
+عضمة انت خدتوها في ال Anatomy و عضمة ..في اليسار
+
+65
+00:04:06,810 --> 00:04:11,230
+انزل لتحت العضمتين لتحت شوية بتلاقي الكيليا هنا
+
+66
+00:04:11,230 --> 00:04:14,090
+على اليمين و الكيليا هنا على اليسار في عندنا two
+
+67
+00:04:14,090 --> 00:04:19,030
+kidneys و بنعمل شوية percussion ضغط بسيط إذا تألم
+
+68
+00:04:19,030 --> 00:04:23,130
+المريض بعرف فورا أنه عنده إيش inflammatory process
+
+69
+00:04:23,130 --> 00:04:26,250
+أو عنده some problems أو يمكن عنده stone أو هذا أو
+
+70
+00:04:26,250 --> 00:04:30,630
+شيء من هذا القبيل طيب إذا كاب نصار عنده tenderness
+
+71
+00:04:30,630 --> 00:04:34,580
+طب في ال palpationبقولي الآن بدنا نستخدم ال
+
+72
+00:04:34,580 --> 00:04:37,280
+palpation خلصنا الآن ال percussion ال palpation
+
+73
+00:04:37,280 --> 00:04:43,340
+هنا إذا كان في abdominal tenderness بدنا فورا نعرف
+
+74
+00:04:43,340 --> 00:04:46,540
+ليش صار tenderness احنا كشفنا إنه في tenderness في
+
+75
+00:04:46,540 --> 00:04:49,500
+ال percussion لكن ابعدنا عنها شوية و خلينها لل
+
+76
+00:04:49,500 --> 00:04:56,260
+palpation هنا بدنا نشوف كيف ال quality كيف ال
+
+77
+00:04:56,260 --> 00:05:01,920
+distinction هل هي ممتدة أكترلا قدر الله يعني
+
+78
+00:05:01,920 --> 00:05:06,080
+المكان المؤلم كبير صغير هل في لا سمح الله تحت
+
+79
+00:05:06,080 --> 00:05:10,680
+إيدينا masses يعني في بعض الحلات ندغط عليه بتلاقي
+
+80
+00:05:10,680 --> 00:05:14,900
+تحت إيد ال examiner mass مش شرط يكون وراه لأ من
+
+81
+00:05:14,900 --> 00:05:18,600
+ضمن الحلات مرة ال examiner حط إيده فإشلجة طلع
+
+82
+00:05:18,600 --> 00:05:23,340
+abscess دمل كبير و هو المريض مش عارف أن هذا دمل
+
+83
+00:05:23,340 --> 00:05:27,700
+لكن إحساسه من برا عامل كأنه وراه فعلشانك بنكون
+
+84
+00:05:27,700 --> 00:05:31,930
+احنا صحين لهذا النقطةالست أيش كمان؟ muscular
+
+85
+00:05:31,930 --> 00:05:36,250
+resistance بتشوف كدهش عضلات البطل ومقاومتها عشان
+
+86
+00:05:36,250 --> 00:05:40,290
+هيك كتير من الحالات بيكون في عندهم مشكلة في عضلات
+
+87
+00:05:40,290 --> 00:05:45,670
+البطن وخاصة يعني .. يعني خليني أقول لما في .. يعني
+
+88
+00:05:45,670 --> 00:05:50,250
+للأسف عضلات البطن ضعيفة و ال organs عاملة بتكبر و
+
+89
+00:05:50,250 --> 00:05:53,430
+ال masses بتكبر بتضغط على الجلد من برا طبعا كيف
+
+90
+00:05:53,430 --> 00:05:57,270
+جزة عضلات البطن ضعيفة؟ يعني زي ست يعني .. يعني
+
+91
+00:05:57,270 --> 00:06:02,240
+عندها الحمل متكرروهو مش متبعد المسافة كله جريب على
+
+92
+00:06:02,240 --> 00:06:07,500
+بعض زي واحد highly obese كمان زي ست عملية
+
+93
+00:06:07,500 --> 00:06:11,120
+السيزيريا اكتر يعني من تلت اربع مرات فبصير ال
+
+94
+00:06:11,120 --> 00:06:14,080
+abdomen اللي ما صار فيه flaccid يعني خلاص زي ارتخط
+
+95
+00:06:14,080 --> 00:06:17,620
+شوية فبصير ال organ اي شي فيه في داخل ال abdomen
+
+96
+00:06:17,620 --> 00:06:25,240
+ممكن ايش ينحس برا الجلد او برا الجسم طيب assess
+
+97
+00:06:25,240 --> 00:06:29,120
+for bladder distinctionو احنا بنعمل assessment هل
+
+98
+00:06:29,120 --> 00:06:32,840
+جيت الآن بال palpation؟ بدنا نشوف انه مع انه
+
+99
+00:06:32,840 --> 00:06:36,020
+المريض ممكن يكون رايح عام urination لكن ممكن في
+
+100
+00:06:36,020 --> 00:06:39,880
+بعض الحالات نكتشف انه لأ عنده bladder distention
+
+101
+00:06:39,880 --> 00:06:44,080
+او بسماه urine retention عنده احتقان في البول اه
+
+102
+00:06:44,080 --> 00:06:47,480
+لو حدث هذا طب ليش؟ ممكن يكون عنده اذا كان male
+
+103
+00:06:47,480 --> 00:06:51,780
+prostatitisواذا كان لأ سمح الله في ميل ممكن severe
+
+104
+00:06:51,780 --> 00:06:53,860
+urinary tract infection او حتى عند الميل ممكن
+
+105
+00:06:53,860 --> 00:06:57,420
+severe urinary tract infection اللي هو UTI فمش شرط
+
+106
+00:06:57,420 --> 00:07:00,240
+يكون راح على الحمام يعني انه خلاص هنلاقي ال
+
+107
+00:07:00,240 --> 00:07:03,860
+bladder empty no ممكن انه في عنده مشكلة فهو بيجي
+
+108
+00:07:03,860 --> 00:07:07,700
+بقوللي انا يعني inability انا I complain انا بعاني
+
+109
+00:07:07,700 --> 00:07:10,360
+from inability to hate to avoid انا مش قادر اروح
+
+110
+00:07:10,360 --> 00:07:14,540
+الحمام يعني و اتبول فهذه مشكلة بنقدر نعرف انه صار
+
+111
+00:07:14,540 --> 00:07:19,300
+ايش a bladder extinction طيبال blooder وين موجودة
+
+112
+00:07:19,300 --> 00:07:21,640
+يا ناس عشان انا اقدر اعرف انه وين ال blooder عشان
+
+113
+00:07:21,640 --> 00:07:25,920
+ما اخربطش ال blooder طبيعيا موجودة تحت الambulicus
+
+114
+00:07:25,920 --> 00:07:29,620
+تحت الambulicus و فوق ايه ال synthesis pubis شوفنا
+
+115
+00:07:29,620 --> 00:07:33,460
+وين عطمة ال synthesis pubis أخريتها من فوق و
+
+116
+00:07:33,460 --> 00:07:35,800
+الambulicus أخريتها من .. خلينا نقول من تحت
+
+117
+00:07:35,800 --> 00:07:41,230
+المسافة اللي بينهم هي ال blooderممكن انا عشان اقدر
+
+118
+00:07:41,230 --> 00:07:44,830
+اعرف وين فيه قلم او مافيش حاسيت انه فيه مشكلة بس
+
+119
+00:07:44,830 --> 00:07:48,490
+بده اضغط اكتر من مرات بستخدم superficial او مثلا
+
+120
+00:07:48,490 --> 00:07:51,930
+light palpation و مرات بستخدم deep palpation ال
+
+121
+00:07:51,930 --> 00:07:54,130
+light palpation كلنا عارفينه ممكن نضغط سانت بسيط
+
+122
+00:07:54,130 --> 00:07:57,390
+لكن ال deep palpation كدهش ممكن نضغط ايدينا لجوا
+
+123
+00:07:57,390 --> 00:08:01,810
+بتوصل لكم من اتنين و نص لسبعة و نص سانت يعني كأني
+
+124
+00:08:01,810 --> 00:08:05,970
+بقول على اعتبار ان كل واحد انش اتنين سانت و نص
+
+125
+00:08:05,970 --> 00:08:11,160
+فاهمش مقولين؟ممكن تضغط على ال abdomen بالذات في ال
+
+126
+00:08:11,160 --> 00:08:13,840
+abdomen ال organ لو واحد ساكر طب يا أستاذ مش كتير؟
+
+127
+00:08:13,840 --> 00:08:17,820
+لأ مش كتير افرض واحد عنده appendicitis التهاب
+
+128
+00:08:17,820 --> 00:08:21,200
+الزائدة الدودية و أنا جيت على منطقة اليمين و بدي
+
+129
+00:08:21,200 --> 00:08:23,560
+اعمله pressure في ال point ال ماكبيرني اللي احنا
+
+130
+00:08:23,560 --> 00:08:27,660
+حاكينا عنه و ضغطت الدغط البسيط مابيبينش انه في
+
+131
+00:08:27,660 --> 00:08:33,040
+مشكلة كتيرة لأ لكن الدغط الكتير لما أضغط لجوا
+
+132
+00:08:33,040 --> 00:08:37,000
+بيبين انه في problem بقوله لأ استنى في معناته
+
+133
+00:08:37,990 --> 00:08:42,310
+positive sign على ما واضح ان في عندك مشكلة يعني
+
+134
+00:08:42,310 --> 00:08:46,330
+معناته مش في كل ال organ لو حد سألنا نستخدم ال
+
+135
+00:08:46,330 --> 00:08:49,970
+deep palpation يعني لو أجينا السؤال هل بقدر استخدم
+
+136
+00:08:49,970 --> 00:08:54,330
+ال deep palpation في ال painful areas أبدا طب هل
+
+137
+00:08:54,330 --> 00:08:58,390
+بقدر استخدم ال deep palpationفي ال surgical areas
+
+138
+00:08:58,390 --> 00:09:00,970
+برضه أبدا يعني انا بقدر استخدامها في الأماكن اللي
+
+139
+00:09:00,970 --> 00:09:05,190
+انعمل فيها جراحة يعني مايجي واحد يقول هيا أعمل
+
+140
+00:09:05,190 --> 00:09:08,710
+عملية في بطنه خلينا نعمل deep palpation أبدا ممنوع
+
+141
+00:09:08,710 --> 00:09:12,210
+لا يمكن أنه نسمح لأنه ممكن أسمح الله أن تعمل ربشار
+
+142
+00:09:12,210 --> 00:09:17,290
+أو حتى العملية نفسها يصير فيها مشكلة عشان هيكش
+
+143
+00:09:17,290 --> 00:09:21,750
+بقولي هي بالأحمر never used في surgical incision
+
+144
+00:09:21,750 --> 00:09:27,110
+ممنوع يستخدم خاصة في tender organs يعني في الاشفي
+
+145
+00:09:27,110 --> 00:09:30,250
+الأعضاء اللي عاملة ألم أو لا قدر الله فيه masses
+
+146
+00:09:30,250 --> 00:09:37,370
+طيب if tenderness .. إذا والله ال tenderness موجود
+
+147
+00:09:37,370 --> 00:09:40,690
+إذا فيه tenderness إيش بيقوللي خاصة في منطقة
+
+148
+00:09:40,690 --> 00:09:42,550
+اليمين زي ما احنا قولنا .. احنا قولنا ده إيش
+
+149
+00:09:42,550 --> 00:09:45,590
+بيسموه rebound tenderness كلمة rebound إنه لما
+
+150
+00:09:45,590 --> 00:09:48,230
+بضغط عليه .. لما بضغط على المنطقة اليمين خاصة ال
+
+151
+00:09:48,230 --> 00:09:52,750
+appendicitisو بكون مافيش ألم، برفع إيده مباشرة
+
+152
+00:09:52,750 --> 00:09:56,190
+الطبيب، المعالج الأخصائي بتلاقي يصير عنده ألم، لو
+
+153
+00:09:56,190 --> 00:09:58,890
+حد سألنا طب ليش بيصير عنده ألم؟ هذا من ال
+
+154
+00:09:58,890 --> 00:10:01,230
+peritoneal irritation، من ال peritoneal
+
+155
+00:10:01,230 --> 00:10:03,730
+irritation، لأنه احنا قلنا ال peritoneal مغطي
+
+156
+00:10:03,730 --> 00:10:07,270
+الأعضاء جوا، فلو ضفطنا عليه بيرتاح المريض، زي السن
+
+157
+00:10:07,270 --> 00:10:11,990
+لما بكون بوجعكأو يرتاحونا بتروح تضغط عليه شوية هيك
+
+158
+00:10:11,990 --> 00:10:16,370
+بترفع إيدك بتلاقي حالك يعني مع الضغط شوية خف القلم
+
+159
+00:10:16,370 --> 00:10:20,090
+لكن لما نقعد نرفع إيدنا عودي القلم رجال هذا بدل
+
+160
+00:10:20,090 --> 00:10:23,410
+طبعا أنه في مشكلة عصبي لكن بالنسبة للأبدومين
+
+161
+00:10:23,410 --> 00:10:31,130
+معناته في التهاب في الزائدة الدودية طبعا حكينا كيف
+
+162
+00:10:31,130 --> 00:10:35,930
+يعني نجيس مثلا حدود ال liver كيف نجيس حدود ال
+
+163
+00:10:35,930 --> 00:10:41,080
+stomach بشكل عامالان بيقوللي هنا ال liver نفسه لما
+
+164
+00:10:41,080 --> 00:10:43,980
+انا بدي اعمل assessment و بدي اعرف كيف العضو نفسه
+
+165
+00:10:43,980 --> 00:10:48,660
+يعني مرات هو مش كبير في الطول من فوق او لتحت يعني
+
+166
+00:10:48,660 --> 00:10:52,940
+لكن نفس ال organ فيه مشكلة طب كيف انا بدي اتأكد
+
+167
+00:10:52,940 --> 00:10:57,500
+انه فيه مشكلة؟ هذا طبعا شغل متخصص ايش بيجي؟ بيجي
+
+168
+00:10:57,500 --> 00:11:00,740
+بيحطله انه ال normal ما بينحس ال liver بشكل سهل
+
+169
+00:11:00,740 --> 00:11:04,480
+لكن احنا قلنا اذا كان فيه اي hepatomegaly يعني
+
+170
+00:11:04,480 --> 00:11:09,730
+تضخم في الكابيت ممكن يحسهفهو ايش بيقول هنا؟ بدنا
+
+171
+00:11:09,730 --> 00:11:14,670
+نحط يعني بيجي اللي هو .. اللي هو المعالج أو الطبيب
+
+172
+00:11:14,670 --> 00:11:18,450
+أو الأخصائي أو الحكيم بيحط ال left hand يعني إيده
+
+173
+00:11:18,450 --> 00:11:22,010
+الشمال .. إيده الشمال تحت ال posterior thorax ..
+
+174
+00:11:22,010 --> 00:11:24,650
+إيش عن ال posterior thorax؟ يعني من خلف الصدر ..
+
+175
+00:11:24,650 --> 00:11:27,930
+خلف الصدر على تقريبا ما يوازي اللي هو ال
+
+176
+00:11:27,930 --> 00:11:31,550
+intercostal اللي هو space من ال 11 أو ال 12 يعني
+
+177
+00:11:31,550 --> 00:11:33,630
+عند ال ribs تقريبا الأخير .. عند ال ribs الأخير
+
+178
+00:11:34,070 --> 00:11:37,650
+ليش؟ لأنه بيكون ده free movable بيضغط عليه إيده من
+
+179
+00:11:37,650 --> 00:11:41,170
+ورا و الإيد الأمامية .. طبعا الإيد اليسار بتنحط
+
+180
+00:11:41,170 --> 00:11:45,210
+على خلف القفص الصدري من تحت و الإيد اليمين مين
+
+181
+00:11:45,210 --> 00:11:50,030
+بتنحط من قدام شوية و ال .. إيش بيصير؟و بيقوللي هنا
+
+182
+00:11:50,030 --> 00:11:53,330
+.. بيقول اضغط in and up .. ايش in and up؟ يعني
+
+183
+00:11:53,330 --> 00:11:56,530
+بإيدك اليمين .. يعني اضغط بإيدك اليمين .. إيدك
+
+184
+00:11:56,530 --> 00:11:59,330
+اليمين .. لا جوا ولا فوق .. ليش لا جوا ولا فوق؟
+
+185
+00:11:59,330 --> 00:12:03,990
+عشان يحاول الأخصائي يقدر يمسك ال organ نفسه .. مش
+
+186
+00:12:03,990 --> 00:12:07,370
+موضوع كتير مهم إلينا .. يعني إحنا نطبقه .. لأ بس
+
+187
+00:12:07,370 --> 00:12:10,390
+يعني من باب المعرفة و ممكن هذا كون مش شغلنا هو شغل
+
+188
+00:12:10,390 --> 00:12:14,110
+الأخصائي أكتر .. طيبال goalie bladder لو حد سألنا
+
+189
+00:12:14,110 --> 00:12:18,190
+goalie bladder هل .. هل الحواصل المرارية normal
+
+190
+00:12:18,190 --> 00:12:23,050
+تكون يعني نقدر نلاحظها؟ يعني نقدر نعملها إحساس؟
+
+191
+00:12:23,050 --> 00:12:27,730
+أبدا .. أبدا لإنها جوا جوا و تحت يعني ال liver و
+
+192
+00:12:27,730 --> 00:12:31,560
+مش سهللكن في حالات لما تكون على الآخر كبرت كتير و
+
+193
+00:12:31,560 --> 00:12:34,820
+صار distention، هذا ممكن، فهو يعني سير إلى إحساس و
+
+194
+00:12:34,820 --> 00:12:37,580
+مش احنا الطبيب اللي أخصاهي، عشان هيك يقولي النات
+
+195
+00:12:37,580 --> 00:12:41,160
+طفلتي على اللي يمكن استشعارها أو إحساسها، لكن لو
+
+196
+00:12:41,160 --> 00:12:46,640
+صار distended يعني كتير كبرت و ال liver مش قادر
+
+197
+00:12:46,640 --> 00:12:50,030
+يسيطر و يعملها cover يغطيها،وفي حالات اللي هي
+
+198
+00:12:50,030 --> 00:12:53,270
+cursivitis التهاب الحواريسي المرني ممكن تكبر لدرجة
+
+199
+00:12:53,270 --> 00:12:57,910
+أنه يشعر الطبيب الخصائي أنه يعني يقدر يعمله إحساس
+
+200
+00:12:57,910 --> 00:13:01,170
+عن طريق ال pulpation اللي هو ال deep pulpation طيب
+
+201
+00:13:01,170 --> 00:13:05,690
+ال spleen برضه نفس القضية بشكل عام لا يمكن يعني
+
+202
+00:13:05,690 --> 00:13:09,270
+نقدر عن طريق اللي هو ال pulpation نقدر نحسه أبدا
+
+203
+00:13:10,710 --> 00:13:13,110
+لأن في ال normal adult person و ال normal healthy
+
+204
+00:13:13,110 --> 00:13:17,030
+person صعب نقدر نحس ال spleen لانه لجوه داخل صح في
+
+205
+00:13:17,030 --> 00:13:20,010
+ال left side لكن لدو جوه شوية حسب ما تدرسوا في ال
+
+206
+00:13:20,010 --> 00:13:23,410
+anatomy ف .. لكن لا قدر الله لو صار enlargement
+
+207
+00:13:23,410 --> 00:13:27,970
+كتير ممكن في منطقة ايش تحت ال coastal margin يعني
+
+208
+00:13:27,970 --> 00:13:31,990
+اخر قفص شوية لتحت شوية في منطقة الشمال ممكن يصير
+
+209
+00:13:31,990 --> 00:13:36,670
+احساس لل spleen اذا كان كبر زيادة عن الميزون طيب
+
+210
+00:13:36,670 --> 00:13:43,900
+أسس دقينات عشان نكمل اللي هوال gastrointestinal
+
+211
+00:13:43,900 --> 00:13:48,000
+tract طيب تقولي أول حاجة بتعمل اسمات كمان لمنطقة
+
+212
+00:13:48,000 --> 00:13:50,100
+الانس و ال rectosagmoid يعني اللي خلينا نقول
+
+213
+00:13:50,100 --> 00:13:54,080
+المنطقة يعني من تحت خاصة نهاية اللي هو القناة
+
+214
+00:13:54,080 --> 00:13:57,400
+الهضمية اللي بتنتهي في منطقة اللي هو ال rectum
+
+215
+00:13:58,380 --> 00:14:00,860
+فبقول كمان ال rectal lesion بدك تعمل ايش
+
+216
+00:14:00,860 --> 00:14:04,380
+assessment ليش؟ لأن مرات بتكون هذه مهمة كتير، ليش
+
+217
+00:14:04,380 --> 00:14:07,340
+مهمة؟ بقول important لأنه ممكن تدلنا على أمراض
+
+218
+00:14:07,340 --> 00:14:10,880
+وممكن تكون هي كمان تعرفنا أن في إشكالية و بدنا
+
+219
+00:14:10,880 --> 00:14:15,720
+نحاول نحلها طيب متى ممكن أنا ألجأ لازم أعمل rectal
+
+220
+00:14:15,720 --> 00:14:18,970
+examination؟طبعا rectal examination يعني ليش بدي
+
+221
+00:14:18,970 --> 00:14:22,030
+أروح لهذه المنطقة معينة embarrassing area يعني
+
+222
+00:14:22,030 --> 00:14:26,070
+منطقة محرجة أي نعم و المريض بيحبهاش خاصة يعني
+
+223
+00:14:26,070 --> 00:14:29,990
+الصراحة يعني المنطقة تحت يعني كتير بتسبب حرج لل
+
+224
+00:14:29,990 --> 00:14:35,070
+male و ال female بشكل عام لكن مرات مضطر أعملها
+
+225
+00:14:35,070 --> 00:14:38,050
+examination في حالات ال severe abdominal pain و مش
+
+226
+00:14:38,050 --> 00:14:42,120
+عارف شو السببفي حالات الالتراشن في ال bowel habits
+
+227
+00:14:42,120 --> 00:14:45,200
+,ational alteration يعني افرض أجر المريض قال انه
+
+228
+00:14:45,200 --> 00:14:48,360
+معاه مساك، بعدين بيصير معاه إيش إسهال، إمساك،
+
+229
+00:14:48,360 --> 00:14:52,000
+إسهال، لأ مرات بتغلى، مرات بقعد يومين، مرات في يوم
+
+230
+00:14:52,000 --> 00:14:55,580
+بروح مرتين، لما يصير هذا إيش اسمه ال alteration،
+
+231
+00:14:55,580 --> 00:14:59,240
+يعني تغير في منظومة اللي هو خليني أقول يعني مثلا
+
+232
+00:14:59,240 --> 00:15:03,730
+ال defecation بشكل عام.لو واحد عنده anal pain،
+
+233
+00:15:03,730 --> 00:15:07,010
+anal pain يعني ألم شديد جدا مثلا في منطقة الانص،
+
+234
+00:15:07,010 --> 00:15:10,270
+مش عارف ايش شو هو، ماقدرش أجي أقول بدا صورة .. مش
+
+235
+00:15:10,270 --> 00:15:14,610
+كل حاجة الصورة بتجيبها، anal spasm، تقلص شديد في
+
+236
+00:15:14,610 --> 00:15:17,970
+منطقة الانص، يعني خاصة في ال anal sphincter، بدنا
+
+237
+00:15:17,970 --> 00:15:21,470
+نعرف إيش السبب، واحد عنده anal itching بحق كتير في
+
+238
+00:15:21,470 --> 00:15:25,090
+هذا أو بره أو مثلا burning أو عنده حرجان زي بعض
+
+239
+00:15:25,090 --> 00:15:28,490
+الناس اللي عندهم يعني اللي يسموها ال pen worm اللي
+
+240
+00:15:28,490 --> 00:15:32,190
+هو زي الدودة الدبوسيةفبقولك انا مش عارف عندي منطقة
+
+241
+00:15:32,190 --> 00:15:36,050
+اهتكاك شديد جدا ومش قادر انا حرجان ده بيحني كتير
+
+242
+00:15:36,050 --> 00:15:40,090
+ونقوله بنعمل اكتر اكتر examination واحد عنده black
+
+243
+00:15:40,090 --> 00:15:42,830
+terry stool ايش يعني black terry stool؟ تاني معناه
+
+244
+00:15:42,830 --> 00:15:47,230
+الذفته يعني عنده براز مدمم خاصة الناس اللي عندهم
+
+245
+00:15:47,230 --> 00:15:51,310
+يعني فيه abdominal خليني أقوله أو intestinal
+
+246
+00:15:51,310 --> 00:15:55,380
+bleeding فيه نزيف في الداخلومع الهضم ومع الكذا نزل
+
+247
+00:15:55,380 --> 00:15:59,480
+إيش الدم صار لونه أسود مع الستولة ومع عمليات اللي
+
+248
+00:15:59,480 --> 00:16:03,900
+هو ال catabolism واحد عنده rectal bleeding يعني
+
+249
+00:16:03,900 --> 00:16:07,560
+فيه نزيف من تحت مش عارفين شو السبب مابنقدر الشخص
+
+250
+00:16:07,560 --> 00:16:10,900
+اللي انا بناه نعمله rectal examination طيب إيش ال
+
+251
+00:16:10,900 --> 00:16:13,680
+positions اللي ممكن أعمل فيهم rectal examination
+
+252
+00:16:13,680 --> 00:16:17,180
+لدى clients يعني كيف لازم يكون ال client طبعا
+
+253
+00:16:17,180 --> 00:16:20,960
+الوضع اللي احنا نستخدمه في معظم المستشفيات اللي
+
+254
+00:16:20,960 --> 00:16:24,410
+عندنا في غزةهو ال sims position اللي هو left
+
+255
+00:16:24,410 --> 00:16:27,870
+lateral على اعتبار أنه أقل إحراجا للمريض، لكن مرات
+
+256
+00:16:27,870 --> 00:16:32,250
+بنضطر نستخدم موضوع تاني إذا الطبيب يعني ماقدرش أو
+
+257
+00:16:32,250 --> 00:16:35,870
+كان خليني أقول مثلا obese على الآخر أو كان
+
+258
+00:16:35,870 --> 00:16:39,810
+embarrassing ومش قادر يعني المريض يعمل relax عشان
+
+259
+00:16:39,810 --> 00:16:43,250
+يقدر الطبيب يعمله assessment أكتر، فممكن نستخدم ال
+
+260
+00:16:43,250 --> 00:16:45,930
+knee chest position وانتوا عارفينه كيف أو ممكن
+
+261
+00:16:45,930 --> 00:16:49,020
+نستخدم ال standing positionالـ standing position
+
+262
+00:16:49,020 --> 00:16:52,940
+هذا للميل بالذات عشان نشوف ال prostate لأنه هو
+
+263
+00:16:52,940 --> 00:16:56,760
+واقف بنقدر عن طريق ال rectal examination نعرف إنه
+
+264
+00:16:56,760 --> 00:16:59,780
+لغد ال prostate إيش أخبارها هل هي في enlargement
+
+265
+00:16:59,780 --> 00:17:02,300
+في inflammatory process أو في لقدر الله some
+
+266
+00:17:02,300 --> 00:17:05,580
+abnormalities ممكن نستخدم ال light atomy position
+
+267
+00:17:05,580 --> 00:17:07,880
+ووضع الولادة طبعا مش شرط يكون وضع الولادة يعني في
+
+268
+00:17:07,880 --> 00:17:11,980
+ميل لأ ممكن نستخدم يعني للميل خاصة في حالات ال إيه
+
+269
+00:17:11,980 --> 00:17:15,040
+في حالات ال piles اللي عنده بوسير عشان نقدر نتأكد
+
+270
+00:17:15,040 --> 00:17:18,540
+منها برضه بنحطه في ال light atomy positionفي وضع
+
+271
+00:17:18,540 --> 00:17:21,700
+اسمه squatting position، squatting position اللي
+
+272
+00:17:21,700 --> 00:17:25,200
+باسمه وضع القرفصاء، القرفصاء يعني مجنبز شوية يعني
+
+273
+00:17:25,200 --> 00:17:28,680
+كجاعد على .. يعني اكرمكم الله زي اللي جاعد على ..
+
+274
+00:17:28,680 --> 00:17:33,020
+زي الحمامات القديمة، الحمام العربي، خاص علشان يشوف
+
+275
+00:17:33,020 --> 00:17:36,420
+لما عامل هذا الطريقة وكأنه جاعد في .. بده يسير
+
+276
+00:17:36,420 --> 00:17:39,380
+feedification عشان يقدر يشوف العضلات اللي موجودة
+
+277
+00:17:39,380 --> 00:17:43,450
+تحت كيف وضعهاطبعا بقولي in all positions في جميع
+
+278
+00:17:43,450 --> 00:17:48,010
+الأوضاع لازم إيه أنت كمعالج أو كإنسان بتعمل
+
+279
+00:17:48,010 --> 00:17:52,250
+assessment لازم تلبس two gloves يعني ليش two
+
+280
+00:17:52,250 --> 00:17:57,310
+gloves عشان لقدر الله لو في أي مشكلة خاصة في هذه
+
+281
+00:17:57,310 --> 00:18:00,350
+المنطقة يعني ال dirty area لازم الإنسان يحمي نفسه
+
+282
+00:18:00,350 --> 00:18:04,870
+فلازم يلبس إيه يعني جوانتين مع بعض على الإيد
+
+283
+00:18:04,870 --> 00:18:09,870
+الواحدةطيب ال assessment هنا نكمل هنا of the anus
+
+284
+00:18:09,870 --> 00:18:11,890
+و ال rectosarcoma دي ييجي على ال inspection
+
+285
+00:18:11,890 --> 00:18:15,330
+بيقوللي في ال inspection تتطلع و بتلاحظ المنطقة
+
+286
+00:18:15,330 --> 00:18:18,790
+تطلع فيها بس بدك تعمل ايش هنا بيقوللي spread patex
+
+287
+00:18:18,790 --> 00:18:21,470
+طبعا انتوا عارفين من ناحية الشرحية ال patex مرات
+
+288
+00:18:21,470 --> 00:18:25,090
+تكون يعني مغطية على المكان هذا نعمل spreading شوية
+
+289
+00:18:25,090 --> 00:18:28,490
+عشان نعمل و نشوف ال skin حوالين ال anus هل فيها
+
+290
+00:18:28,490 --> 00:18:32,110
+مشكلة كيف ال pigmentation يعني كيف تلونا في moist
+
+291
+00:18:32,820 --> 00:18:36,360
+فيه رطوبة هذه المنطقة هي بتكون hairless طبعا أكيد
+
+292
+00:18:36,360 --> 00:18:39,860
+سبحان الله رحمة ربنا مافيش فيها يعني شعر طبعا هي
+
+293
+00:18:39,860 --> 00:18:43,600
+بتكون moist لكن إذا كانت moist زيادة معناته فيه
+
+294
+00:18:43,600 --> 00:18:47,220
+discharge معناته فيه problem فبدنا نحددها بدنا
+
+295
+00:18:47,220 --> 00:18:50,460
+نشوف إذا فيه legions النقطة التانية أي legion
+
+296
+00:18:50,460 --> 00:18:55,100
+موجود في هذا المكان نشوف ال scars ندبات معينة
+
+297
+00:18:55,100 --> 00:19:00,180
+موجودةنشوف ال inflammation إذا في أي التهاب موجود
+
+298
+00:19:00,180 --> 00:19:05,180
+تحت، في ال perirectal abscess إذا فيه لا سمح الله،
+
+299
+00:19:05,180 --> 00:19:09,180
+بيسموه دمل حوالين ال rectum، بعض الناس بيسموه
+
+300
+00:19:09,180 --> 00:19:12,880
+أسماء غريبة، بيقولك دمل صيني، دمل في المنطقة، يعني
+
+301
+00:19:12,880 --> 00:19:16,650
+على الأعتبار عشان هالمنطقة محرجةفبيجي بيقول
+
+302
+00:19:16,650 --> 00:19:21,070
+perirectal أو بيقول مثلا يعني أو nearly in this
+
+303
+00:19:21,070 --> 00:19:23,970
+site يعني في هذا المكان ممكن يكون بعض الناس عندهم
+
+304
+00:19:23,970 --> 00:19:27,090
+fishers الشريخ بنسمع بنقول عن حاجة اسمها الشريخ
+
+305
+00:19:27,090 --> 00:19:31,990
+الشرجي بتبين واحد عنده بيكون piles أو ممكن تجينا
+
+306
+00:19:31,990 --> 00:19:36,290
+مصطلح تاني اسمه hemorrhoids التنين نفس المعنى برضه
+
+307
+00:19:36,290 --> 00:19:40,600
+بنقدر نعمل assessment لها في ناس عندهم fistulaهيش
+
+308
+00:19:40,600 --> 00:19:45,440
+فستيولاق يعني اشي مفتوح من جوا يعني مغلق من جوا
+
+309
+00:19:45,440 --> 00:19:49,060
+لكن عامل فتحة للخارج زي مين؟ زي الناس اللي عندهم
+
+310
+00:19:49,060 --> 00:19:55,200
+حاجة بيسموها الناسور مش البا البا البواسيرالناسور
+
+311
+00:19:55,200 --> 00:19:58,480
+هو عبارة عن الفستيولا بيسمونه biological sinuses
+
+312
+00:19:58,480 --> 00:20:02,100
+انه نفس المكان في هذا المكان نهاية عند ال rectum
+
+313
+00:20:02,100 --> 00:20:05,920
+عما لو في فتحة طالعة برا بتعمل discharge وهذه من
+
+314
+00:20:05,920 --> 00:20:09,560
+الأمراض اللي chronic شوية و بتغلب شوية في العلاج
+
+315
+00:20:09,560 --> 00:20:13,740
+عشان هذه المنطقة عليها pressure وDRT area بنشوف
+
+316
+00:20:13,740 --> 00:20:19,920
+كمان بعد شوية منطقة الاش كمان منطقة اللي هو إذا في
+
+317
+00:20:19,920 --> 00:20:23,570
+لا قدر الله إذا في لا قدر الله كمان مش بس هيإذا في
+
+318
+00:20:23,570 --> 00:20:25,850
+لسة محرقة الـ erectile prolapse أو الـ tunar يعني
+
+319
+00:20:25,850 --> 00:20:28,570
+خاصة بعض الناس بيكون في هذا المكان ممكن يكون في
+
+320
+00:20:28,570 --> 00:20:31,350
+عندهم أي ورم في هذا المكان برضه بنحاول نعمله
+
+321
+00:20:31,350 --> 00:20:34,130
+assessment يعني اللي أقدر الله ممكن بعض الناس
+
+322
+00:20:34,130 --> 00:20:37,530
+بيكون يعني في هذا المكان فيه ورم أو مبين أو عامل
+
+323
+00:20:37,530 --> 00:20:41,970
+bulging فبرضه بنقدر نعمله assessment طيب وإحنا
+
+324
+00:20:41,970 --> 00:20:46,750
+بنعمل assessment في هذا المكان بالذات لازم نخلي
+
+325
+00:20:46,750 --> 00:20:49,370
+المريض في هذا الحالة يعمل زي إيه نوع من حاجة
+
+326
+00:20:49,370 --> 00:20:54,320
+بيسموهاطبعا ليش بنعمل .. بنقول المريض يعمل عملية
+
+327
+00:20:54,320 --> 00:20:59,140
+الضغط يعني زي .. يعني أكرمكم الله كأنه الإنسان في
+
+328
+00:20:59,140 --> 00:21:02,540
+جلسة الخلاء أو بده يحاول يضغط على نفسه عشان إذا في
+
+329
+00:21:02,540 --> 00:21:06,700
+أي bulging اتبين واضحة جدا أمام اللي هو ال exam ده
+
+330
+00:21:06,700 --> 00:21:10,380
+طبعا بقول اتطلع كمان على حاجز ما اللي أنا قلتها
+
+331
+00:21:10,380 --> 00:21:13,340
+الآن قبل شوية اللي هي الpyeloneidarsinases اللي
+
+332
+00:21:13,340 --> 00:21:17,290
+بيسموه الناسور العصعوسينخاصة في منطقة الاش او
+
+333
+00:21:17,290 --> 00:21:20,310
+بيسموها ال cyst يعني في زي غدا بتكون موجودة وين في
+
+334
+00:21:20,310 --> 00:21:23,410
+منطقة اللي هو ال sacro coccygeal area في نهاية
+
+335
+00:21:23,410 --> 00:21:27,880
+العصعس، نهاية العمود الفقري من تحتبتكون لأنها جاية
+
+336
+00:21:27,880 --> 00:21:30,980
+مع نهاية اللي هو ال rectum فبتكون في هذا المكان
+
+337
+00:21:30,980 --> 00:21:35,020
+فيه fistula عاملة بتطلع discharge برا خاصة عن بعض
+
+338
+00:21:35,020 --> 00:21:39,200
+الناس اللي هم في حياتهم بيقعدوا كتير و بيقعدوا على
+
+339
+00:21:39,200 --> 00:21:43,620
+الكراسي بجلد اللي بتعمل ربما سخونة في هذا المكان
+
+340
+00:21:43,620 --> 00:21:47,900
+فلازم نعرف أن الجلد في هذا المكان أصلا soft skin
+
+341
+00:21:47,900 --> 00:21:51,800
+ومتحملش ال pressure كله تبع جسم الإنسان فممكن يصير
+
+342
+00:21:51,800 --> 00:21:56,440
+عنده نوع من إيشانه فيستولة من ال pressure اللي صار
+
+343
+00:21:56,440 --> 00:21:59,440
+و من ال hair follicles اللي هو الشعر اللي بينمو
+
+344
+00:21:59,440 --> 00:22:03,220
+صار فيه إشكالية و ينمو بالطريقة العكسية و هذا
+
+345
+00:22:03,220 --> 00:22:06,900
+بينعكس سلبا على ايش؟ بينعكس سلبا على ال discharge
+
+346
+00:22:06,900 --> 00:22:10,900
+.. ال discharge اللي بيصير عند المريض، تمام؟ طيب،
+
+347
+00:22:10,900 --> 00:22:17,240
+الآن بدنا نشوفبدنا نعمل اللي هو بنسمع في فحص يمكن
+
+348
+00:22:17,240 --> 00:22:20,580
+تشوف اسمه سمعته في السنة الأولى اللي هو اسمه PR
+
+349
+00:22:20,580 --> 00:22:25,000
+examination اللي هو per rectal examination طبعا
+
+350
+00:22:25,000 --> 00:22:30,980
+هذا يعتبر doctor procedure متى احنا بنعمل ال PR
+
+351
+00:22:30,980 --> 00:22:37,440
+examination طبعا أول حاجة هنحكي لقدام شوية في ال
+
+352
+00:22:37,440 --> 00:22:41,150
+slide اللي بعدهامات احنا بنحتاجه و إيش ال events
+
+353
+00:22:41,150 --> 00:22:45,810
+اللي ممكن .. يعني نقدر نكتشفها و احنا بنعمل pair
+
+354
+00:22:45,810 --> 00:22:49,290
+rectal examination عن طريق طبعا اللي هو الطبيب لإن
+
+355
+00:22:49,290 --> 00:22:51,870
+هذا يعتبر ال doctor procedure زي ما أنا قلت لكن
+
+356
+00:22:51,870 --> 00:22:54,430
+كيف بنعمله؟ زي ما احنا قلناه ولا حاجة الأمر بده
+
+357
+00:22:54,430 --> 00:22:57,930
+يكون الشيشانة spread pathogen يعني بده المنطقة
+
+358
+00:22:57,930 --> 00:23:01,110
+يعمل exposure و بعدين يلبس gloves زي ما احنا حكينا
+
+359
+00:23:01,110 --> 00:23:06,010
+و يفضل يكون two glovesبعدين ييجي بال index طبعا
+
+360
+00:23:06,010 --> 00:23:10,530
+بإصبعه اللي هو ال index الأول عشان يحاول يعني يدخل
+
+361
+00:23:10,530 --> 00:23:14,410
+إصبعه و يحاول يعمل إيش assessment بشكل واضح عشان
+
+362
+00:23:14,410 --> 00:23:18,670
+يشوف إذا في أي مشكلة طبعا بكون اللي اتجاهها اتجاه
+
+363
+00:23:18,670 --> 00:23:21,930
+الambiguous مش شرط احنا جد ما بدنا نحاول نشرح في
+
+364
+00:23:21,930 --> 00:23:26,540
+هذا المقاممش هيبين ايه لما الطبيب امامكم يعمل ل
+
+365
+00:23:26,540 --> 00:23:29,380
+client معين وكتير كل يوم كل يوم كل يوم نعمل كتير
+
+366
+00:23:29,380 --> 00:23:32,840
+لمرضى اي مريض عنده abdomen pain اي مريض عنده
+
+367
+00:23:32,840 --> 00:23:36,300
+bleeding اي مريض عنده itching اي حاجة بيحتاج او
+
+368
+00:23:36,300 --> 00:23:39,940
+distinction بيحتاج يعمل طبعا بعد ما بيحط بيحاول
+
+369
+00:23:39,940 --> 00:23:43,220
+يحط ال finger بروح ايش بقولها ال client ياريت تعمل
+
+370
+00:23:43,220 --> 00:23:47,000
+tighten Titan يعني اضغط شويه على الإصبع عشان يشوف
+
+371
+00:23:47,000 --> 00:23:51,420
+ال sphincter ايش control او sphincterيعني power
+
+372
+00:23:51,420 --> 00:23:54,000
+كده جوه ال dysfunction لما تضغط على أصبع ال
+
+373
+00:23:54,000 --> 00:23:57,580
+examiner عشان يعرف اللي اللي سمح الله يمكن عند
+
+374
+00:23:57,580 --> 00:24:00,240
+المرض incontinence لما شاف في bleeding او شاف في
+
+375
+00:24:00,240 --> 00:24:03,920
+discharge او شي من هذا القبيل طبعا بدنا نشوف هل في
+
+376
+00:24:03,920 --> 00:24:08,040
+يعني اي problems طالعة و لا لأ في نفس الوقت بدي
+
+377
+00:24:08,040 --> 00:24:10,800
+أعمل إحساس لمنطقة ال mycosis اللي تحت اللي في ال
+
+378
+00:24:10,800 --> 00:24:15,520
+anal area لقدر الله هل في tumor هل في bullets يعني
+
+379
+00:24:15,520 --> 00:24:20,020
+نطقات لحميات او شغلة او حتى ممكن يكشف إذا فيال
+
+380
+00:24:20,020 --> 00:24:23,300
+internal piles اللي هي البواصير الداخلية مش كل
+
+381
+00:24:23,300 --> 00:24:27,540
+بواصير يعني لازم نعتقد انه بواصير خارجي لأ فيه
+
+382
+00:24:27,540 --> 00:24:31,840
+بواصير داخلية ممكن تكون يعني مابتبينش الا عن طريق
+
+383
+00:24:31,840 --> 00:24:35,600
+ال examiner finger بعدين بقولي انا كمان اسس ايش
+
+384
+00:24:35,600 --> 00:24:39,760
+انا normal cervix ال normal cervix يعني لل female
+
+385
+00:24:39,760 --> 00:24:44,300
+لو حد سأل طب يعني كيف نقدر نعمل assessment طبعا
+
+386
+00:24:44,300 --> 00:24:48,110
+انتوا عارفون يعني شو ال cervix يعنيعنق الرحم لما
+
+387
+00:24:48,110 --> 00:24:52,550
+بيجي يقدر يعمله assessment بيعملهش assessment إلا
+
+388
+00:24:52,550 --> 00:24:56,470
+عن طريق ال rectal examination بيبين كأنه ring ايش
+
+389
+00:24:56,470 --> 00:24:59,810
+يعني ring يعني زي ال mass يعني كأنها كتلة يعني
+
+390
+00:24:59,810 --> 00:25:03,550
+دائرية بيقدر يحسها اللي هو الطبيب المعالج هو بيعمل
+
+391
+00:25:03,550 --> 00:25:07,250
+PR examination طيب ال variations هذا اللي أنا قلت
+
+392
+00:25:07,250 --> 00:25:10,430
+عنه الشريحة التانية اللي بتحكي فيها ايش الشغلات
+
+393
+00:25:10,430 --> 00:25:13,430
+اللي ممكن احنا نقدر نكتشفها و احنا بنعمل rectal
+
+394
+00:25:13,430 --> 00:25:18,370
+examinationأو نقدر نشخصها ممكن نلاقي حاجة اسمها
+
+395
+00:25:18,370 --> 00:25:22,590
+Pyeloneid Sinus او Crest او Cyst sorry Cyst اللي
+
+396
+00:25:22,590 --> 00:25:26,030
+هي اللي بيسموها النصور العصعوسي ممكن نلاقي المريض
+
+397
+00:25:26,030 --> 00:25:30,170
+عنده Pruritus Anus يعني عنده احتكاك شديد في منطقة
+
+398
+00:25:30,170 --> 00:25:34,950
+الانص يعني منطقة ال rectum ممكن يكون عنده rectal
+
+399
+00:25:34,950 --> 00:25:37,710
+tennis muscle tennis muscle معناته التعناية ايش
+
+400
+00:25:37,710 --> 00:25:40,950
+التعناية انه بيكون المريض بيحكي لنا بيقول ان انا
+
+401
+00:25:40,950 --> 00:25:45,480
+بروح الحمام بنزل زي mucous membraneيعني زي إيش
+
+402
+00:25:45,480 --> 00:25:48,760
+برازي فيه مخات و بيكونش كبير يعني فيه small
+
+403
+00:25:48,760 --> 00:25:52,720
+amounts of air و فيه ديفكاشن يعني volume بشكل عام
+
+404
+00:25:52,720 --> 00:25:57,900
+فهذه بيسموها tennis mass اللي هي مغس و لما بروح
+
+405
+00:25:57,900 --> 00:26:04,280
+على الحمام بنزل شوية مخات مع الستول ممكن نكتشف فيك
+
+406
+00:26:04,280 --> 00:26:08,100
+ال impaction انسداد من تحت خاصة يعني انسداد في آخر
+
+407
+00:26:08,100 --> 00:26:13,340
+مجرةالكلوان لتحت، خاصة في الناس اللي بيكونوا ماكل
+
+408
+00:26:13,340 --> 00:26:17,900
+يعني أكلة زي بذر، ماكل كتير، ماكل شغلات يعني
+
+409
+00:26:17,900 --> 00:26:21,440
+عملتله انسداد زي بعض الناس أجتنا حالها، كان ماكل
+
+410
+00:26:21,440 --> 00:26:25,140
+صبر كتير كتير بشكل كبير يعني وفي واحد حالة أنا
+
+411
+00:26:25,140 --> 00:26:28,300
+شوفتها برضه كان ماكل استقبلناها في استقبال كان
+
+412
+00:26:28,300 --> 00:26:33,460
+ماكل بذر بطيخ نيء مش مش مستوينيعني هو كان عنده
+
+413
+00:26:33,460 --> 00:26:37,460
+حقله و كان يقطع البطيخ و بعدين يطلع منه بذر و
+
+414
+00:26:37,460 --> 00:26:41,940
+يأكله هو نهي طبعا كان يصعب على الهضم على المعدة و
+
+415
+00:26:41,940 --> 00:26:45,420
+الكمية الكبيرة عملتله فيه كلمباكشن طبعا ممكن نكتشف
+
+416
+00:26:45,420 --> 00:26:49,560
+إيه الفشر، الإيه الفشر يعني الشرخ الشرجييعني يعتبر
+
+417
+00:26:49,560 --> 00:26:53,840
+من .. من أنواع البواسير الداخلية ممكن نكتشف إذا
+
+418
+00:26:53,840 --> 00:26:57,540
+فيه fistula in the anus يعني أي .. أي fistula يعني
+
+419
+00:26:57,540 --> 00:27:01,140
+موجودة ال fistula يعني فاتحة بين تجوفين ممكن في
+
+420
+00:27:01,140 --> 00:27:05,710
+داخل جسم الإنسان أيا كانت إشنوحةممكن نكتشف إذا فيه
+
+421
+00:27:05,710 --> 00:27:08,090
+hemorrhoids و ال hemorrhoids احنا قلنا في منها
+
+422
+00:27:08,090 --> 00:27:11,030
+داخلية و خارجية لو حد سألنا ال external
+
+423
+00:27:11,030 --> 00:27:14,730
+hemorrhoids يعني البواصير الخارجية بالمناسبة هي
+
+424
+00:27:14,730 --> 00:27:17,830
+مؤلمة لأنها بتكون عاملة bulging و طالة على برا
+
+425
+00:27:17,830 --> 00:27:21,770
+مؤلمة جدا ال internal piles اللي هو البواصير
+
+426
+00:27:21,770 --> 00:27:25,410
+الداخلية مش مؤلمة لكن إذا صار فيها complication
+
+427
+00:27:25,410 --> 00:27:30,370
+إيش يعني؟ يعني إذا صار فيها يعنيخلّيني نقول إن
+
+428
+00:27:30,370 --> 00:27:34,890
+مضاعفات وزادت عن حدها بتكون مؤلمة جدا يبقى
+
+429
+00:27:34,890 --> 00:27:38,870
+بالمناسبة ما ننساش دايما البواصيل الخارجية مافي
+
+430
+00:27:38,870 --> 00:27:44,110
+ألم البواصيل الداخلية مابيكون في ألم لكن تتألم
+
+431
+00:27:44,110 --> 00:27:48,430
+عندما يكون هناك أيش مضاعفات بنشوف أن في ركتل بولبس
+
+432
+00:27:48,430 --> 00:27:52,450
+نطقات لحمية خارج من هذا المكان ركتل prolapse
+
+433
+00:27:52,450 --> 00:27:57,740
+prolapse يعني نفس ال rectum كأنه طالع لبراخاصة بعض
+
+434
+00:27:57,740 --> 00:28:00,740
+الحلات مع كتر ال strain اللي تحت مع كتر الضغط
+
+435
+00:28:00,740 --> 00:28:03,720
+زيادة عن نزوم من حيث ال rectum صار فيه زي إيش ..
+
+436
+00:28:03,720 --> 00:28:07,240
+زي نوع من ال إيش ال .. ال hyper relaxation زيادة
+
+437
+00:28:07,240 --> 00:28:10,640
+في الارتخاء فطلّي على برا هذا كله يعني خاصة في
+
+438
+00:28:10,640 --> 00:28:13,660
+حالة ال internal hemorrhoids نشوف لقدر الله إذا في
+
+439
+00:28:13,660 --> 00:28:17,340
+anal incontinence إيه ده فيه لا سمح الله يعني مش
+
+440
+00:28:17,340 --> 00:28:21,180
+قادر يتحكم في نفسه إذا في abscess أو في masses أو
+
+441
+00:28:21,180 --> 00:28:26,410
+يعني في منطقة الSQ يعني SQM ركتال يعني ركتال ابسس
+
+442
+00:28:26,410 --> 00:28:30,370
+في هذه المنطقة او per rectal obstruction او انسداد
+
+443
+00:28:30,370 --> 00:28:33,550
+في هذا المكان اي ان كان هو انسداد من form body او
+
+444
+00:28:33,550 --> 00:28:36,450
+من ال humor او لا سمح الله اشي داخل من جسم او
+
+445
+00:28:36,450 --> 00:28:41,010
+impaction من اي شي او من جسم الإنسان هذه كلها اسمة
+
+446
+00:28:41,010 --> 00:28:44,010
+variations بتكون ايش ممكن نعملها detection و احنا
+
+447
+00:28:44,010 --> 00:28:48,810
+بنعمل rectal examination طيب انا خليني اقف عند هذه
+
+448
+00:28:48,810 --> 00:28:49,350
+الشريحة
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU.srt
new file mode 100644
index 0000000000000000000000000000000000000000..af8cf6b205d10ac3014ae175120b1528fd108233
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU.srt
@@ -0,0 +1,1541 @@
+1
+00:00:01,180 --> 00:00:07,020
+بسم الله الرحمن الرحيم أبنائي وبنات الطلبة، خلينا
+
+2
+00:00:07,020 --> 00:00:12,420
+الآن نكمل مع محاضرات التقييم الصحي التمريضي، فاليوم
+
+3
+00:00:12,420 --> 00:00:16,780
+إن شاء الله، الـ chapter السابع، هنتكلم على موضوع الـ
+
+4
+00:00:16,780 --> 00:00:22,160
+assessment of the respiratory system. طبعا احنا في
+
+5
+00:00:22,160 --> 00:00:27,580
+الأول كانت كلها مقدّمات، ثم اتجهنا لـ
+
+6
+00:00:27,580 --> 00:00:30,040
+system by system. احنا حكينا، قولنا بدنا نبدأ من
+
+7
+00:00:30,040 --> 00:00:33,920
+head to toe، وبدينا شوية من الـ hair assessment، و
+
+8
+00:00:33,920 --> 00:00:37,020
+الـ skin assessment، وشوية اتكلمنا عن الـ vital
+
+9
+00:00:37,020 --> 00:00:39,320
+signs، وشوية اتكلمنا عن الـ positions، واتكلمنا
+
+10
+00:00:39,320 --> 00:00:42,360
+عن الـ influence. خلينا نتكلم الآن على موضوع الـ
+
+11
+00:00:42,360 --> 00:00:46,620
+respiratory system بشكل عام. هذه بتذكرنا، يعني، و
+
+12
+00:00:46,620 --> 00:00:51,380
+أخذنا كلنا في الـ anatomy. هذه بس التشريح لأي جهاز
+
+13
+00:00:51,380 --> 00:00:56,930
+التنفسي بشكل عام. بداية طبعا هو مش محطوط هنا، الـ nose
+
+14
+00:00:56,930 --> 00:00:59,850
+على اعتبار أنه بداية، سواء كان الـ nose أو الـ mouth، على
+
+15
+00:00:59,850 --> 00:01:03,470
+اعتبار أنه air entrance، يعني دخول لمجرى الهواء، لكن
+
+16
+00:01:03,470 --> 00:01:06,870
+هي قدامنا في الـ larynx، وفي الـ main bronchus، و
+
+17
+00:01:06,870 --> 00:01:11,590
+بعدين الـ trachea، وننزل شوية بتلاقي كمان هنا إيش هنا؟
+
+18
+00:01:11,590 --> 00:01:15,530
+طبعا هنا اللي هو الـ tertiary والـ secondary
+
+19
+00:01:15,530 --> 00:01:18,890
+bronchi. بعدين هنا الـ bronchioles. لما تنتهي في
+
+20
+00:01:18,890 --> 00:01:22,290
+الحويصلات الهوائية الأخيرة. لما بيصير بعض الناس في عندهم
+
+21
+00:01:22,290 --> 00:01:26,270
+inflammation فيها، بنسميها برونكايوليتس، أو بنطلع فوق،
+
+22
+00:01:26,270 --> 00:01:30,950
+بنقول برونكايتس، أو أكثر، Tracheitis، وهكذا. خلينا
+
+23
+00:01:30,950 --> 00:01:33,150
+الآن، احنا مش موضوع التشريح، لأن الحمد لله أنتم
+
+24
+00:01:33,150 --> 00:01:37,550
+كلكم أخذتو في التشريح مع الدكتورة. التشريح بإذن
+
+25
+00:01:37,550 --> 00:01:40,910
+الله، تكونوا أنتم يعني ذاكرين. الآن، الـ subjective
+
+26
+00:01:40,910 --> 00:01:44,110
+data you must ask. إيه؟ احنا بنسأل عن إيه؟ عن الـ
+
+27
+00:01:44,110 --> 00:01:47,470
+coughing. أول حاجة قبل ما نبدأ نعمل assessment، بنسأل
+
+28
+00:01:47,470 --> 00:01:52,790
+على الـ coughing. هل في عندك أنت سعلة؟ جحة؟ هل هي
+
+29
+00:01:52,790 --> 00:01:54,770
+productive or not productive؟ طبعا لما نقول
+
+30
+00:01:54,770 --> 00:01:57,650
+productive، يعني الجحة، كلكم عارفين، يعني في بلغم
+
+31
+00:01:57,650 --> 00:02:00,890
+بيطلع معاك، في secretion، ولا بتطلع جحة ناشفة؟ طبعا
+
+32
+00:02:00,890 --> 00:02:04,790
+إلى اعتبار لما نجي نعمل أساسية لقدام شوية، الـ
+
+33
+00:02:04,790 --> 00:02:08,450
+sputum. طبعا نسأل، إذا قال لي: اه والله في sputum بتطلع،
+
+34
+00:02:08,450 --> 00:02:11,770
+يعني طب إيش لونه؟ إيش نوعه؟ إيش شكله؟ طبعا
+
+35
+00:02:11,770 --> 00:02:16,240
+الدكاترة المتخصصين في الأمر هذا بيجيبوا يقولوا لك يعني كان
+
+36
+00:02:16,240 --> 00:02:18,380
+إذا كان green، معناته في infection، إذا كان yellow
+
+37
+00:02:18,380 --> 00:02:21,300
+والله كان شوية nearly infection، والله إذا كان
+
+38
+00:02:21,300 --> 00:02:24,800
+clear، معناته فيه، لأ، ممكن يكون عنده rhinitis أو
+
+39
+00:02:24,800 --> 00:02:29,000
+يعني عنده بشكل عام يعني allergic condition. كل
+
+40
+00:02:29,000 --> 00:02:32,520
+حاجة إلها معنى. ممكن يقول لك sputum with blood،
+
+41
+00:02:32,520 --> 00:02:36,140
+وهاكذا. طيب، الـ allergies، ده نسأله عن إيش؟ عن
+
+42
+00:02:36,140 --> 00:02:40,120
+الحساسية. هل عندك حساسية معينة؟ زي حساسية الربو اللي
+
+43
+00:02:40,120 --> 00:02:44,120
+بتصير عند بعض الناس، ضيق في التنفس. في عندك dyspnea؟
+
+44
+00:02:44,580 --> 00:02:47,340
+في عندك shortness of breath، هذا اختصار عالمي. يا
+
+45
+00:02:47,340 --> 00:02:50,600
+أخي، إذا كان S.O.B، shortness of breath، هل عندك
+
+46
+00:02:50,600 --> 00:02:54,280
+يعني دائما ضيق في النفس؟ ولا بيصير معايا إذا جالك؟
+
+47
+00:02:54,280 --> 00:02:57,800
+اه، بصير معايا. نروح نسأله: طيب وأنت مرتاح؟ ولا لما
+
+48
+00:02:57,800 --> 00:03:01,940
+أنت تكون تعبان؟ on rest أو on exertion؟ طبعا اللي هو
+
+49
+00:03:01,940 --> 00:03:06,140
+معنى الإنسان هو مرتاح وعنده ضيق نفس، أخطر بكثير من
+
+50
+00:03:06,140 --> 00:03:09,340
+اللي تعبان وعنده ضيق نفس. معناته أن الإنسان هو
+
+51
+00:03:09,340 --> 00:03:13,380
+مرتاحة، وعضلات جسمه مرتاحة وعنده ضيق نفس، معناته
+
+52
+00:03:13,380 --> 00:03:18,340
+الأمر مش سهل. الأمر الثاني، بنسأل: ليش الـ chest pain؟
+
+53
+00:03:18,340 --> 00:03:22,800
+طبعا الـ chest pain بهمني في إيه؟ عشان أنا أعرف هل في
+
+54
+00:03:22,800 --> 00:03:27,200
+عنده history of، يعني مثلا أزمة، أو لا قدر الله أي
+
+55
+00:03:27,200 --> 00:03:30,700
+حتى مش بس أزمة. يعني الـ pain ما بتيجي بس من الأزمة.
+
+56
+00:03:30,700 --> 00:03:33,780
+نقول: لأ، ممكن يكون عنده trauma، ممكن لا قدر الله
+
+57
+00:03:33,780 --> 00:03:37,820
+tumor، ممكن لا قدر الله، يعني عنده sharp pain، يعني
+
+58
+00:03:37,820 --> 00:03:41,080
+عنده شيء يعني originated from أي blood، يعني جاي من
+
+59
+00:03:41,080 --> 00:03:46,700
+وين؟ من الـ from the heart. أقصد هنا يعني كيف كيف، يعني
+
+60
+00:03:46,700 --> 00:03:49,500
+from heart؟ يعني بيكون الـ origin تبع الـ pain اللي
+
+61
+00:03:49,500 --> 00:03:51,880
+هو الـ chest، جاي من أين؟ من القلب. فاحنا ما بننسى
+
+62
+00:03:51,880 --> 00:03:54,620
+نستعجب. يمكن جاي من الـ muscle. احنا بنسأل بس الآن
+
+63
+00:03:54,620 --> 00:03:58,460
+أسئلة عامة. في ألم؟ اه، في ألم. وين مكان الألم؟ وبعدين
+
+64
+00:03:58,460 --> 00:04:01,560
+بنكمل. وبعدين بنسأل على الـ history، إيه؟ على الأزمة
+
+65
+00:04:01,560 --> 00:04:05,120
+أو الـ bronchitis، أو الالتهاب في الشعب الهوائية. هل
+
+66
+00:04:05,120 --> 00:04:07,360
+عنده emphysema؟ هو اللي كنا بنقوله، وقعدنا نقول
+
+67
+00:04:07,360 --> 00:04:10,560
+emphysema، أو tuberculosis. الـ tuberculosis، يعني الـ
+
+68
+00:04:10,560 --> 00:04:14,320
+TB، اللي بيسموه السل الرئوي. طبعا هو مرض قديم، نادر
+
+69
+00:04:14,320 --> 00:04:16,760
+وإن كان في بعض الدول اللي لا يزال موجود، زي جنوب
+
+70
+00:04:16,760 --> 00:04:20,420
+أفريقيا، أو الدول الفقيرة نوعا ما، لا يزال موجود.
+
+71
+00:04:20,420 --> 00:04:25,040
+وعمراض خطيرة ومعضلة. كمان، الـ emphysema هي عبارة عن
+
+72
+00:04:25,040 --> 00:04:27,640
+rupture في الـ alveoli، و rupture في الـ alveoli، في
+
+73
+00:04:27,640 --> 00:04:31,620
+الحويصلات الهوائية. في بعض الحالات من كتر ما بيصير
+
+74
+00:04:31,620 --> 00:04:35,440
+يعني دخول الـ oxygen مثلا للحويصلات، وعدم الاستطاعة
+
+75
+00:04:35,440 --> 00:04:41,630
+على عملية اللي هو الـ oxygen exchange، فبيصير احتباس
+
+76
+00:04:41,630 --> 00:04:45,010
+في داخل الحويصلات للأكسجين أو الهواء بشكل عام، وبقدرش
+
+77
+00:04:45,010 --> 00:04:49,290
+الإنسان يطلعه لظروف معينة. في foreign body، في أزمة،
+
+78
+00:04:49,290 --> 00:04:51,950
+في أي شيء. فممكن يصير إيش؟ rupture، والـ rupture
+
+79
+00:04:51,950 --> 00:04:56,210
+بيطلع الهواء. طبعا ممكن تحت الـ skin، ممكن يعمل زي
+
+80
+00:04:56,210 --> 00:04:59,970
+نوع من إيش؟ أنه تنفخ في الرقبة، أو في منطقة الـ chest،
+
+81
+00:04:59,970 --> 00:05:02,710
+أو حتى في منطقة كل الـ ... الـ ... الـ ... الـ ...
+
+82
+00:05:02,710 --> 00:05:02,810
+الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ
+
+83
+00:05:02,810 --> 00:05:02,870
+... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ...
+
+84
+00:05:02,870 --> 00:05:03,690
+الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ
+
+85
+00:05:03,690 --> 00:05:05,170
+... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ... الـ ...
+
+86
+00:05:05,170 --> 00:05:11,880
+الـ ... الـ ... الـ ... الـ ... الـ ...  المنطقة الزرقاء بالورق.
+
+87
+00:05:11,880 --> 00:05:14,800
+نسأله: إذا في عندك شحوب معين؟ طبعا الشحوب هنا مش
+
+88
+00:05:14,800 --> 00:05:18,200
+معناته اللي علاقة بالبرد. لأ، أنا بتكلم على اللي
+
+89
+00:05:18,200 --> 00:05:20,800
+اللي اسمه، ولا الـ sinusitis. أنا كل اللي بتكلم عليه أنه
+
+90
+00:05:20,800 --> 00:05:23,800
+له علاقة بالـ respiratory system problems.
+
+91
+00:05:23,800 --> 00:05:27,520
+اللي قدامك. وهنفهم إيش اللي بنقصده. exposure to
+
+92
+00:05:27,520 --> 00:05:32,980
+environmental inhalants. هل اتعرض لأي أشياء من
+
+93
+00:05:32,980 --> 00:05:36,920
+البيئة، بس ممكن تكون أثرت عليه؟ inhalants، يعني
+
+94
+00:05:36,920 --> 00:05:41,170
+استنشق أشياء ضارة زي الـ chemicals، كيمويات، زي الـ
+
+95
+00:05:41,170 --> 00:05:45,350
+fumes، أي ... مش أي عطور معينة. لأ، ممكن يكون في
+
+96
+00:05:45,350 --> 00:05:50,250
+بعض أشياء volatile، يعني متطايرة، لكن مؤذية، زي الـ
+
+97
+00:05:50,250 --> 00:05:54,090
+turpentine، يعني اللي اسمها التربنتينة هذه، أو زي مثلا
+
+98
+00:05:54,090 --> 00:05:58,810
+مرات رائحة الكحول اللي هو المركز جدا، ممكن يصل لـ 90
+
+99
+00:05:58,810 --> 00:06:03,210
+%، لو استنشق ريحة شديدة منه، أو بنزين، أو سولر، أو كذا،
+
+100
+00:06:03,210 --> 00:06:06,710
+هذا ممكن يتعيش وهو كان عنده استعداد أنه ممكن يصير
+
+101
+00:06:06,710 --> 00:06:12,470
+عنده أي مشكلة. فممكن دغري تصير عنده هذه المشكلة. طيب،
+
+102
+00:06:12,470 --> 00:06:16,150
+history of smoking. نسأله: بتدخن؟ اه، قد إيش بتدخن؟ زي ما
+
+103
+00:06:16,150 --> 00:06:18,770
+احنا اتعلمنا في السنة الأولى، لما شفنا في الـ
+
+104
+00:06:18,770 --> 00:06:22,630
+nursing care plan، كنا دائما يُعلمونا نسأل المريض
+
+105
+00:06:22,630 --> 00:06:27,990
+إذا بيدخن، قد إيش بيدخن، وهل في عنده يعني، اليوم، زمان، مش
+
+106
+00:06:27,990 --> 00:06:31,410
+بس قد إيش بيدخن في اليوم؟ لأ، هل هو يعني addict؟ هل هو
+
+107
+00:06:31,410 --> 00:06:35,770
+chronic؟ هل هو acute case؟ يعني له يومين؟ له شهرين؟
+
+108
+00:06:35,770 --> 00:06:39,660
+ثلاثة؟ مش زي اللي هو سنوات طويلة. طبعا من ناحية الـ
+
+109
+00:06:39,660 --> 00:06:42,420
+anatomy، احنا بس تذكير، لأ أكثر ولا أقل، لأن أنتم
+
+110
+00:06:42,420 --> 00:06:46,180
+إن شاء الله كلكم أخذتو اللي هو التشريح، ويعني اللي
+
+111
+00:06:46,180 --> 00:06:49,320
+أنا نريد أن احنا ... يعني، وكأنه بدنا نعيد العلم
+
+112
+00:06:49,320 --> 00:06:52,820
+من أول وجديد. لكن بندكر أن الـ respiratory tract
+
+113
+00:06:52,820 --> 00:06:56,080
+هي extends، بتمتد من وين؟ من الـ mouth أو الـ nose، اثنين
+
+114
+00:06:56,080 --> 00:07:00,020
+على اعتبارهم مدخل الهواء. nose و mouth. لما نصل في
+
+115
+00:07:00,020 --> 00:07:03,860
+الأخر لـ alveoli. كما حكينا على الرسمة. احنا الآن
+
+116
+00:07:03,860 --> 00:07:07,440
+بهمنا أن في حاجة اسمها upper airway و lower airway.
+
+117
+00:07:07,440 --> 00:07:10,940
+في upper airway وفي lower airway. طبعا سامحونا
+
+118
+00:07:10,940 --> 00:07:14,880
+عشان الصوت شوية، لإنه محشرج شوية، الواحد يمكن مع الشتاء
+
+119
+00:07:14,880 --> 00:07:19,860
+بس شوية. الآن، upper airway. الـ upper airway، ليش هذا
+
+120
+00:07:19,860 --> 00:07:22,880
+موجود؟ سبحان الله! بقول لك: filters air، pore. يعني هو
+
+121
+00:07:22,880 --> 00:07:26,080
+بيعمل filters للي إيه؟ للـ particles. يعني كل الهواء
+
+122
+00:07:26,080 --> 00:07:30,410
+اللي بيدخل علينا، إذا في أي حاجة محمولة معاه
+
+123
+00:07:30,410 --> 00:07:35,790
+الهواء، أي molecules، أي غبار، أي أشياء ممكن
+
+124
+00:07:35,790 --> 00:07:39,130
+تضرنا، بيروح إيش؟ عاملها عملية تنقية. ومش بس هيك،
+
+125
+00:07:39,130 --> 00:07:42,390
+humidifies، humidifies يعني إيه؟ بيعمل ترطيب،
+
+126
+00:07:42,390 --> 00:07:47,050
+warm، برضه إيش؟ تدفئة. لإيه؟ للـ gases. ليه؟ لأنه
+
+127
+00:07:47,050 --> 00:07:50,290
+على افتراض احنا ... احنا قاعدين بنتنفس، أخذنا oxygen
+
+128
+00:07:50,290 --> 00:07:53,970
+مثلا، أخذنا hydrogen، hydrogen، أيًا كان، واحنا
+
+129
+00:07:53,970 --> 00:07:58,410
+قاعدين بناخده، ممكن يكون الهواء الخارجي بارد أو سخن،
+
+130
+00:07:58,410 --> 00:08:02,830
+بيقدرش يكون اللي سبحان الله يدخل على ما هو، لجسم
+
+131
+00:08:02,830 --> 00:08:05,350
+الإنسان، وإيه اللي هيضره؟ فسبحان الله، للإنسان إيش
+
+132
+00:08:05,350 --> 00:08:09,390
+بيصير هنا؟ أنه هذا بيعمل عملية تلطيف وترتيب
+
+133
+00:08:09,390 --> 00:08:12,810
+وإزالة من الشوائب. طب الـ lower airway لإيه؟ دغري
+
+134
+00:08:12,810 --> 00:08:16,150
+نحط في بالنا الـ lower لإيه؟ للـ gas exchange. لإيه؟
+
+135
+00:08:16,150 --> 00:08:19,070
+مجرد ما ننزل تحت للـ bronchioles أو alveoli، روحنا
+
+136
+00:08:19,070 --> 00:08:22,670
+واشتغلنا فيه أننا ... إيش هنا؟ إيه علاقة بالـ gas
+
+137
+00:08:22,670 --> 00:08:28,350
+exchange؟ طيب، technique for respiratory exam. كيف
+
+138
+00:08:28,350 --> 00:08:31,450
+بنعمل احنا respiratory exam؟ لو أمامنا المريض، و
+
+139
+00:08:31,450 --> 00:08:34,550
+بدنا نحاول نعمله assessment. أول حاجة قبل ما نبدأ
+
+140
+00:08:34,550 --> 00:08:37,330
+إذا كان بالإمكان، بقول: if possible، يعني إذا مش
+
+141
+00:08:37,330 --> 00:08:41,650
+بالإمكان، خلاص. بس إذا قدرت تعمل مكون كويس، أول حاجة
+
+142
+00:08:41,650 --> 00:08:47,090
+quiet environment، لازم تكون البيئة هادئة، ما تأثرش
+
+143
+00:08:47,090 --> 00:08:51,330
+على المريض، ما تخليش نفسه يزيد أو ينقص، أو تجد قلبه
+
+144
+00:08:51,330 --> 00:08:54,780
+يزيد. proper position. إيه؟ لما أقول كلمة proper
+
+145
+00:08:54,780 --> 00:08:58,800
+position، يعني الوضع المناسب. المريض نفسه، هو الصح
+
+146
+00:08:58,800 --> 00:09:02,200
+يكون إيه؟ sitting، هو الصح يكون إيه؟ sitting. لكن
+
+147
+00:09:02,200 --> 00:09:05,680
+إذا ما قدرش يكون sitting، مش مشكلة، نخليه supine. بس
+
+148
+00:09:05,680 --> 00:09:09,100
+احنا بنقول أحسن حاجة. بيقول إيه؟ ألجيتة، إذا بدك
+
+149
+00:09:09,100 --> 00:09:12,440
+تعمل الـ posterior thorax، بيقول إيه؟ ممكن أنت كمان
+
+150
+00:09:12,440 --> 00:09:15,120
+مش بس posterior، حتى الـ anterior thorax ممكن تعمل. و
+
+151
+00:09:15,120 --> 00:09:18,660
+أنت قاعد، والمريض قاعد. طب، إذا ما قدرش أشوفه وهو قاعد،
+
+152
+00:09:18,660 --> 00:09:23,540
+ونخليه supine. فعشان كده، أعطاني وضعين. جالي ده مش قادر
+
+153
+00:09:23,540 --> 00:09:26,560
+أنت ممكن تجعده شوية، بتشوف صدره من ورا. عشانك بتشوف
+
+154
+00:09:26,560 --> 00:09:30,260
+الطبيب مرات بيجعد المريض، بيفحص صدره من ورا، وبعدين
+
+155
+00:09:30,260 --> 00:09:34,000
+بنيّمه على ضهره عشان يفحصه من الأمام. لكن إذا دلق
+
+156
+00:09:34,000 --> 00:09:36,300
+مستطيع وقادر يتحمل، مافي مشكلة. يعني ممكن واحد
+
+157
+00:09:36,300 --> 00:09:40,800
+يفحصه بإثنين وهو جالس. expose skin. بدنا نكشف
+
+158
+00:09:40,800 --> 00:09:45,100
+إيش؟ الجلد. ليه؟ عشان auscultation. بس خلينا هنا في
+
+159
+00:09:45,100 --> 00:09:48,300
+هذا المكان بالذات، بدي أحكي كلمة، أنه إذا كان اللي
+
+160
+00:09:48,300 --> 00:09:51,320
+قدامنا طفل، ما نكشفوش كله على الآخر، أو يعني كبير في
+
+161
+00:09:51,320 --> 00:09:54,440
+السن، Geriatric clients، بقى بالفعل أنه هيكون
+
+162
+00:09:54,440 --> 00:09:57,040
+بالنسبة له يعني، ممكن يكون exaggerated، لأنه هيعمل له
+
+163
+00:09:57,040 --> 00:10:02,900
+مشكلة، لأن حساسية البرد، أو حساسية السماعة نفسها اللي
+
+164
+00:10:02,900 --> 00:10:07,460
+بتستخدمها الطبيب. علشان هيك، بيفضل دائما الطبيب أنه
+
+165
+00:10:07,460 --> 00:10:14,020
+هنا على مهله، ولو استخدم مع الطفل، مش غلط، إما بيدفع
+
+166
+00:10:14,020 --> 00:10:18,240
+زي ما اتعلمنا زمان، اللي هو الـ bell تبعت اللي هو، أو
+
+167
+00:10:18,240 --> 00:10:21,820
+الـ diaphragm تبعت السماعة نفسها، أو بيخلي الفانيلا
+
+168
+00:10:21,820 --> 00:10:2
+
+223
+00:13:48,880 --> 00:13:51,860
+خلصنا من النفس، نروح على إيش؟ لون الجلد.. وين
+
+224
+00:13:51,860 --> 00:13:55,300
+لون الجلد؟ مش في جسمه كله.. لأ، أفضل شيء نشوف
+
+225
+00:13:55,300 --> 00:13:58,700
+لون الجلد في منطقة الـ respiratory system، يعني
+
+226
+00:13:58,700 --> 00:14:02,840
+بنطلع في منطقة الـ nose، منطقة الـ mouth، ومنطقة
+
+227
+00:14:02,840 --> 00:14:06,320
+الرقبة، هل في sinuses؟ هل ما فيش منطقة الـ mouth
+
+228
+00:14:06,320 --> 00:14:09,700
+نفسه حتى من جوا، ولا ما في، كيف وضعه بشكل عام؟
+
+229
+00:14:09,700 --> 00:14:12,900
+اللي بعدها؟ الآن بدنا نشوف معدل التنفس كلكم،
+
+230
+00:14:12,900 --> 00:14:16,500
+أنتم عارفين، بس نذكركم، المعدل مش كل اللي هو
+
+231
+00:14:16,500 --> 00:14:20,660
+معدلات النفس تعتبر نفس المعدل، أكيد طبعاً الإنسان
+
+232
+00:14:20,660 --> 00:14:24,060
+سبحان الله، هو صغير نفسه بيكون سريع جداً، وهذا لا
+
+233
+00:14:24,060 --> 00:14:28,120
+يعتبر شيء مرضي، وإنما يعتبر شيء طبيعي لأنه سبحان
+
+234
+00:14:28,120 --> 00:14:32,000
+الله، على اعتبار أن قلب الطفل لسه قلب صغير، والـ
+
+235
+00:14:32,000 --> 00:14:35,940
+body surface area كبيرة شوية، فبيكون سريع جداً عشان
+
+236
+00:14:35,940 --> 00:14:39,460
+يقدر يعوض و يعمل gas exchange، ويعمل ضخ
+
+237
+00:14:39,460 --> 00:14:43,580
+الدم لكل أنحاء الجسم. طيب، الـ infant بيقول لي إيش هنا؟
+
+238
+00:14:44,230 --> 00:14:47,270
+اللي هو من عند الولادة لحد سنتين، ثلاثين لستين
+
+239
+00:14:47,270 --> 00:14:50,830
+طبعاً، بتكلم على beat per minute، كلكم أذكروا beat
+
+240
+00:14:50,830 --> 00:14:55,070
+per minute، يعني اللي بيسموها بي بي إم، يعني لما
+
+241
+00:14:55,070 --> 00:14:58,130
+نقول بي، الأول بي (beat)، اللي هو beat، يعني أما
+
+242
+00:14:58,130 --> 00:15:02,110
+التانية اللي هو per، اللي هو بالـ P، اللي هو beat per
+
+243
+00:15:02,110 --> 00:15:05,910
+minute. الآن قد إيش؟ بقول ثلاثين لستين، اللي هو نفس في
+
+244
+00:15:05,910 --> 00:15:09,570
+الدقيقة. في منطقة الـ toddler، لما نقول الـ toddler هنا، اللي
+
+245
+00:15:09,570 --> 00:15:12,710
+هي المرحلة أو المنطقة اللي واقع ما بين سنتين لثلاث
+
+246
+00:15:12,710 --> 00:15:18,110
+سنوات، اللي هي إيش بنسميها هنا؟ اسمها مرحلة الدرج، ليش
+
+247
+00:15:18,110 --> 00:15:21,570
+سموها الدرج؟ على اعتبار أن الطفل بيسير درج في هذه
+
+248
+00:15:21,570 --> 00:15:26,650
+الفترة، وعمالة يعني بيزيد بده يسير درج، ويسير
+
+249
+00:15:26,650 --> 00:15:30,390
+يمشي، وفي منهم بيكونوا يعني ماشيين وخلص، وبيكون
+
+250
+00:15:30,390 --> 00:15:34,990
+مشي على سنة، حتى ممكن يكون مشي. طيب، أربعة وعشرين
+
+251
+00:15:34,990 --> 00:15:39,570
+لأربعين. طيب، pre school قبل المدرسة، ثلاث لأربع سنوات،
+
+252
+00:15:39,940 --> 00:15:45,120
+من ٢٢ لـ ٣٤، اللي هو نفس في الدقيقة. لو لاحظنا.. لو
+
+253
+00:15:45,120 --> 00:15:51,020
+لاحظنا المعدل، الأمر اختلف، عمالة بيقل شوية هنا، نفس
+
+254
+00:15:51,020 --> 00:15:55,780
+..هنا نفس بيزيد، لأ بيقل، وهنا عمالة بيقل، يعني معناته
+
+255
+00:15:55,780 --> 00:15:59,600
+كل ما بيكبر شوية الطفل، كل ما عمالة إيش؟ كل ما
+
+256
+00:15:59,600 --> 00:16:05,180
+عمالة اللي هو نفسه بيخف في الدقيقة. طيب، الـ school age
+
+257
+00:16:05,180 --> 00:16:08,540
+بيقول لي إيه؟ هذه معلش، الـ school age اللي هو من صف أول
+
+258
+00:16:08,540 --> 00:16:14,230
+لصف سادس، بيصير من ١٨ لـ ٣٠ breathing per minute، يعني
+
+259
+00:16:14,230 --> 00:16:16,930
+اللي هو breathing per minute، اللي هو يعني التنفس
+
+260
+00:16:16,930 --> 00:16:21,570
+في الدقيقة. طيب، adolescent، أنتَ في مرحلة إيش؟ المراهقة، من ١٣
+
+261
+00:16:21,570 --> 00:16:24,690
+لـ ١٩، اللي هي على اعتبار اسمها الـ teen age، الـ teen
+
+262
+00:16:24,690 --> 00:16:29,410
+age، اللي هو بيصير ١٢ لـ ١٦، عشان يصل لمرحلة البلوغ، و
+
+263
+00:16:29,410 --> 00:16:33,870
+المرحلة الطبيعية اللي هو من ٢٠ لـ ٤٠، طبعاً plus or
+
+264
+00:16:33,870 --> 00:16:38,260
+minus، بيصير من ١٦ لـ ٢٠ breathing per minute، اللي
+
+265
+00:16:38,260 --> 00:16:42,060
+بتقوله أنا إني احنا بشكل عام.. احنا هنتعامل معظم
+
+266
+00:16:42,060 --> 00:16:45,340
+تعاملنا هيكون في هذه.. في هذه، خليني أقول اللي هو
+
+267
+00:16:45,340 --> 00:16:50,620
+الـ area. ممكن لما يصير سنة ثالثة هنتعامل مع الـ
+
+268
+00:16:50,620 --> 00:16:54,860
+infant وشوية ربما مع الـ toddler. مدونة لو حد قال طب
+
+269
+00:16:54,860 --> 00:16:58,320
+ليش ما نتعاملش مع الـ toddler؟ لأ، خليني أقول منطقة محايدة
+
+270
+00:16:58,320 --> 00:17:03,460
+على اعتبار أن معظم الأطفال بتصير دائماً عندهم
+
+271
+00:17:03,460 --> 00:17:06,760
+الأمراض دائماً في بداية أعمارهم. كل ما بيكبر الطفل
+
+272
+00:17:06,760 --> 00:17:10,920
+حتى سبحان الله، وكأنه مناعته بيزيد، فبيصير حتى مرضه
+
+273
+00:17:10,920 --> 00:17:14,820
+يعني بيخف كتير، يعني بيلقى الأمراض في هذه الأعمار
+
+274
+00:17:14,820 --> 00:17:18,200
+يعني سبحان الله، يسهل أنه التعامل والتغلب على أي
+
+275
+00:17:18,200 --> 00:17:21,920
+شيء بيجي للطفل. فمش هيجيك على المستشفى لكن بعد هيك
+
+276
+00:17:21,920 --> 00:17:24,520
+لما يصيروا adults، لأ، بيصيروا احنا بدنا نصير
+
+277
+00:17:24,520 --> 00:17:27,620
+دائماً نراقبهم، نشوف كده شعار نفسهم، طبعاً زاد أو نقص
+
+278
+00:17:27,620 --> 00:17:31,520
+كله إله إيش؟ تشخيص. خليني نمشي شوية، inspection أول
+
+279
+00:17:31,520 --> 00:17:34,380
+حاجة، إيش؟ نشوف الـ measurement and assessment of a
+
+280
+00:17:34,380 --> 00:17:38,920
+respiration patterns. بتأكي نشوف قد إيش حجم وقد إيش
+
+281
+00:17:38,920 --> 00:17:43,220
+وقد إيش اللي هو كمية وأسلوب النفس اللي بيصير عند إيش؟
+
+282
+00:17:43,220 --> 00:17:47,400
+حجم اللي هو النفس، وكمية النفس اللي بتدخل المريض، مش
+
+283
+00:17:47,400 --> 00:17:50,740
+بس هيك، بقول لي بتأكي تشوف الـ skin على المنطقة كلها
+
+284
+00:17:50,740 --> 00:17:53,740
+اللي إحنا حاكيين عنها، لأن في كل منطقة الـ thorax
+
+285
+00:17:53,740 --> 00:17:58,230
+اللي هو منطقة الصدر. طيب، وبعدين، أسس إيش هنا؟ الـ thorax
+
+286
+00:17:58,230 --> 00:18:00,990
+configuration. إيش يعني الـ configuration؟
+
+287
+00:18:00,990 --> 00:18:03,510
+الـ configuration معناته التضاريس. إيش يعني التضاريس؟
+
+288
+00:18:03,510 --> 00:18:07,210
+أو بيسموه يعني زي ما نشوف، زي هضبات أو نزلات أو
+
+289
+00:18:07,210 --> 00:18:10,950
+شغلات يعني.. يعني خلينا نقول out of normal أو
+
+290
+00:18:10,950 --> 00:18:15,750
+abnormal. بنطلع على منطقة الصدر، هل في أي شيء مبين
+
+291
+00:18:15,750 --> 00:18:19,370
+على منطقة الصدر عنده أشياء مش طبيعية؟ طبعاً إذا
+
+292
+00:18:19,370 --> 00:18:22,590
+واحد قال لي إيه؟ إيش قصدك فيها؟ لقدام هقول لكم أن
+
+293
+00:18:22,590 --> 00:18:25,150
+في بعض الناس بيقول لك صدره عامل زي الحمامة، اسمه
+
+294
+00:18:25,150 --> 00:18:27,930
+pigeon chest. في ناس بيقول لك والله صدره حاسس زي
+
+295
+00:18:27,930 --> 00:18:31,930
+المفلطح، اسمه barrel chest. كل حاجة إلها مسمى على
+
+296
+00:18:31,930 --> 00:18:35,770
+حسب الـ..الـ..خليني أقول الـ..يعني المشكلة
+
+297
+00:18:35,770 --> 00:18:38,810
+الصحية اللي موجودة عندهم. The client must be
+
+298
+00:18:38,810 --> 00:18:41,210
+uncovered. حاضراً، يعني أنا بقول يا ريت أنت لما تعمل
+
+299
+00:18:41,210 --> 00:18:44,610
+assessment كامل لمنطقة الصدر، بدك تكشفه من إيش
+
+300
+00:18:44,610 --> 00:18:47,550
+هنا؟ من الـ waist. إيش يعني الـ waist؟ you get
+
+301
+00:18:47,550 --> 00:18:50,410
+uncovered to the waist، يعني لعند الخصر، من الصدر
+
+302
+00:18:50,410 --> 00:18:53,490
+لعند الخصر. لو حد جاي يقول لي طيب ليش يا أستاذ أنتَ
+
+303
+00:18:53,490 --> 00:18:57,030
+كشفته شوية لتحت، لعند البطن كله؟ لأن في بعض الناس
+
+304
+00:18:57,030 --> 00:18:59,470
+عندهم حاجة بسمها abdominal breathing، يعني بتحسّه
+
+305
+00:18:59,470 --> 00:19:03,310
+لما بِتنفس باستخدام الـ accessory muscles، فبيروح الـ
+
+306
+00:19:03,310 --> 00:19:05,290
+diaphragm، اللي هو الحجاب الحاجز، بتغطي على عضلات
+
+307
+00:19:05,290 --> 00:19:09,410
+البطن، فأنا بدي أشوف هل البطن بيتحرك بيستجيب ولا
+
+308
+00:19:09,410 --> 00:19:12,570
+فيه مشكلة معينة عند المريض. لازم يكون المريض بقولنا
+
+309
+00:19:12,570 --> 00:19:16,750
+sitting position without support، بدون ما إحنا
+
+310
+00:19:16,750 --> 00:19:20,210
+ندعمه. كيف يعني؟ يعني نحاول نجلس المريض ونقوله
+
+311
+00:19:20,210 --> 00:19:25,290
+لو سمحت اجلس لوحدك، ما بدي أحط إيدي يعني أدعمك أو
+
+312
+00:19:25,290 --> 00:19:29,410
+أركزك أو تركز على كرسي، عشان تشوف المريض كيف قدرته
+
+313
+00:19:29,410 --> 00:19:33,330
+على إنه جالس، يقدر ياخد النفس، وكيف النفس بيعمل في
+
+314
+00:19:33,330 --> 00:19:39,350
+جسمه، في كل تقسيم جسمه بشكل عام. طيب، observation of
+
+315
+00:19:39,350 --> 00:19:42,770
+skin، ليش بدعمله؟ لأنه بيقول لي ممكن يعطيني
+
+316
+00:19:42,770 --> 00:19:46,810
+knowledge، معرفة قد إيش كمية الـ nutrition الموجودة
+
+317
+00:19:46,810 --> 00:19:52,350
+عند الـ client. كتير من الناس بيبين نقص وزنه مش
+
+318
+00:19:52,350 --> 00:19:55,980
+في الأطراف ولا في الـ abdomen، في منطقة الصدر، بيجي
+
+319
+00:19:55,980 --> 00:19:59,540
+نطلع حتى بسمع واحد بقوله فلان، الصدر بتبين، وبحس
+
+320
+00:19:59,540 --> 00:20:01,880
+عظامه. وهو بيقول عظامه، يعني إحنا عارفين اللي هي الـ
+
+321
+00:20:01,880 --> 00:20:05,880
+cartilage. بيقول لك أنا حاسس عظامه مبينة، يعني طلعات
+
+322
+00:20:05,880 --> 00:20:10,160
+كأنّ طلعات بدنها تطلع من الجلد، هذا بدل أنه لأ، very
+
+323
+00:20:10,160 --> 00:20:12,860
+thin person، يعني القصة مش في العبرة في العضلات
+
+324
+00:20:12,860 --> 00:20:15,940
+الخارجية اللي مبينة والواضحة. كتير من الناس خاصة
+
+325
+00:20:15,940 --> 00:20:17,820
+الـ heavy smokers كمان موجودين عندهم هذا الكلام، و
+
+326
+00:20:17,820 --> 00:20:21,180
+في العكس، في عندهم skin deposition، يعني الـ skin
+
+327
+00:20:21,180 --> 00:20:26,030
+ممكن يكون كمان فيه ترسبات دهنية موجودة في
+
+328
+00:20:26,030 --> 00:20:30,530
+هذه المنطقة بشكل عام. طيب، بدنا نشوف الـ anterior
+
+329
+00:20:30,530 --> 00:20:33,130
+posterior diameter. إيش يعني anterior posterior
+
+330
+00:20:33,130 --> 00:20:37,830
+diameter؟ الآن الصورة اللي هي جاية بعد شوية هتبين
+
+331
+00:20:37,830 --> 00:20:42,450
+إيش بنقصد فيها anterior posterior diameter. بقول
+
+332
+00:20:42,450 --> 00:20:49,770
+هنا خلينا نركز مع بعض. الآن الصدر في diameter لما
+
+333
+00:20:49,770 --> 00:20:53,230
+يكون الإنسان واقف بالـ أمام، اتخيله كأنه انسان أمامك
+
+334
+00:20:53,230 --> 00:20:57,420
+واقف، اللي واقف أمامك فيه إله يمين وفيه إله يسار
+
+335
+00:20:57,420 --> 00:21:02,960
+وفيه إله يمين ويسار، وفيه إله اللي هو الأمام، وفيه
+
+336
+00:21:02,960 --> 00:21:06,740
+إله خلف. هنجيب المسافة ما بين اللي هو الأمام اللي هو
+
+337
+00:21:06,740 --> 00:21:10,140
+قدامنا، الصدر من الأمام ومن الخلف، منطقة الظهر اللي
+
+338
+00:21:10,140 --> 00:21:13,950
+على الجبال الصدر. هذا إيش اسمها؟ اسمها anterior
+
+339
+00:21:13,950 --> 00:21:17,170
+posterior diameter. تمام. هذا اسمها anterior
+
+340
+00:21:17,170 --> 00:21:20,810
+posterior diameter. طيب، بين اليمين وبين الشمال، بين
+
+341
+00:21:20,810 --> 00:21:23,770
+اليمين وبين الشمال، يعني هاي الصدر أمامي، وبتطلع
+
+342
+00:21:23,770 --> 00:21:27,690
+لإنسان قدامي، بين اليمين وبين الشمال، من تحت طبعاً
+
+343
+00:21:27,690 --> 00:21:32,310
+اللي هو الـ..خلينا نقول مثلاً under axilla، تحت
+
+344
+00:21:32,310 --> 00:21:34,750
+الإبط من اليمين، وتحت الإبط من الشمال على الجهتين.
+
+345
+00:21:34,750 --> 00:21:37,950
+إيش اسم المقياس؟ transverse diameter، اللي بيسموه
+
+346
+00:21:37,950 --> 00:21:41,310
+المقياس المستعرض. عشان تفهموا الصح، تتخيلوا اللي
+
+347
+00:21:41,310 --> 00:21:45,190
+أنا بقوله. شفتوا كيف خياطين كيف بيستخدم لما
+
+348
+00:21:45,190 --> 00:21:50,090
+بيجي بده يفصل لبعض الناس بدلة، أو بده يفصل لـ جيمس، أو
+
+349
+00:21:50,090 --> 00:21:54,590
+بده يفصل لبنت معينة مثلاً فستان أو شيء. بتاخد الخياطة
+
+350
+00:21:54,590 --> 00:21:59,010
+مقاييس معينة. الآن المقياس الأمامي من اليمين لليسار
+
+351
+00:21:59,010 --> 00:22:03,690
+اسمه transverse. والمقياس من الأمام للخلف، ها الأمام
+
+352
+00:22:03,690 --> 00:22:07,630
+للخلف اسمه إيه؟ اسمه posterior diameter. طيب، السؤال
+
+353
+00:22:07,630 --> 00:22:12,940
+لو حد سألنا هل الاثنين زي بعض؟ لأ، بقول له من واحد
+
+354
+00:22:12,940 --> 00:22:16,280
+لاثنين. إيش يعني من واحد لاثنين الطبيعي؟ يعني لو
+
+355
+00:22:16,280 --> 00:22:21,520
+جسّينا الآن أمام انسان وجسّينا من يمينه ليساره،
+
+356
+00:22:21,520 --> 00:22:24,700
+بالضبط حطينا مسطرة على اليمين ومسطرة على اليسار
+
+357
+00:22:24,700 --> 00:22:28,340
+على الجنبين، على الجنبين، حطينا طبقنا المسطرتين هيك
+
+358
+00:22:28,340 --> 00:22:32,500
+على الجنبين، وجسّينا المسافة بينهم، هنجيب إيش؟ هنجيب
+
+359
+00:22:32,500 --> 00:22:36,600
+مثلاً، نعتبر أربعين سنتي، مثلاً، فليكن أربعين
+
+360
+00:22:36,600 --> 00:22:42,300
+سنتي، ولو جسّينا الآن ما بينه الأمام والخلف، الجسد لو
+
+361
+00:22:42,300 --> 00:22:45,900
+حطينا برضه مسطرتين، واحدة على الأمام، صدر من الأمام
+
+362
+00:22:45,900 --> 00:22:49,060
+وواحدة على منطقة الظهر من الخلف، اللي هو مقابلة
+
+363
+00:22:49,060 --> 00:22:52,980
+لنفس المسطرة، وجسّينا المسافة بينهم، حتجيب عشرين
+
+364
+00:22:52,980 --> 00:22:57,820
+عشرين سنتي. إيش يعني معناته؟ اللي قدام ضعف إيش؟ اللي
+
+365
+00:22:57,820 --> 00:23:01,140
+قدام المقياس ضعف اللي هو الخلف، اللي هو من الأمام
+
+366
+00:23:01,140 --> 00:23:04,580
+إلى الخلف. هذا بيسموها posterior diameter للـ
+
+367
+00:23:04,580 --> 00:23:08,240
+transverse diameter. واحد لاثنين. طبعاً لو كان أكثر
+
+368
+00:23:08,240 --> 00:23:12,410
+من هيك معناته فيه مشكلة. زي إيش؟ أعطيك مثال: في
+
+369
+00:23:12,410 --> 00:23:15,950
+مرات abnormality، زي مين؟ زي حاجة بيسموها pigeon chest، بيجون
+
+370
+00:23:15,950 --> 00:23:18,930
+chest. يعني بعض الناس بيقول لك هذا الصدر زي الحمامة.
+
+371
+00:23:18,930 --> 00:23:22,850
+طيب، ليش زي الحمامة؟ اللي ربي حمام بيعرف، واللي ما
+
+372
+00:23:22,850 --> 00:23:25,510
+ربيهاش، أنا بدي أقول لكم الحمامة، سبحان الله، بطبيعتها
+
+373
+00:23:25,510 --> 00:23:29,950
+دائماً..دائماً لما بيجوا يشتريوا الزغاليل، بيحسوا لحمتها
+
+374
+00:23:29,950 --> 00:23:33,960
+من ظهرها ولا من بطنها، لأ، بيحسّوها من صدرها، على اعتبار
+
+375
+00:23:33,960 --> 00:23:37,360
+أنه هل فيها مثلاً لحم، لأن اللحمة بتكون قليلة جداً
+
+376
+00:23:37,360 --> 00:23:41,080
+فيها، فايدتها عالية لكن قليلة شوية اللحمة، فبيحسها من
+
+377
+00:23:41,080 --> 00:23:44,580
+الصدر، فدائماً الحمامة صدرها بيكون مرتفع، يعني زي
+
+378
+00:23:44,580 --> 00:23:48,900
+اللي شاهقة لفوق شوية. هذه الـ issue أو الارتفاع
+
+379
+00:23:48,900 --> 00:23:52,000
+بيخلق، بعض الناس من كثر ما بيدخل أو عنده COPD،
+
+380
+00:23:52,000 --> 00:23:55,980
+chronic obstructive pulmonary disease، أو عنده أزمة
+
+381
+00:23:55,980 --> 00:24:00,100
+مع ضيقة نفس دائمة، واستخدام العضلات التنفسية لمساعدة
+
+382
+00:24:00,480 --> 00:24:04,220
+بيصير صدره من قدام عامل زي صدر الحمامة، طالع لفوق،
+
+383
+00:24:04,220 --> 00:24:08,100
+ليه؟ لأنه استخدم عضلات كتير زيادة على اللزوم أثناء
+
+384
+00:24:08,100 --> 00:24:12,120
+تنفسه. بعض الناس عندهم barrel chest، زي البرميل،
+
+385
+00:24:12,120 --> 00:24:15,260
+صدره بيكون فيه بعد..بعد المرة، بيكونوا spinal
+
+386
+00:24:15,260 --> 00:24:19,040
+deformity. إيش؟ الـ spinal نفس بيكون إيش؟ يعني بيصير
+
+387
+00:24:19,040 --> 00:24:23,900
+بعض التشّوهات اللي موجودة في العمود الفقري، سموها
+
+388
+00:24:23,900 --> 00:24:28
+
+445
+00:27:52,680 --> 00:27:56,130
+cartilage يعني اللي هو الغضاريف، يعني بتحس الأم
+
+446
+00:27:56,130 --> 00:28:00,470
+سبحان الله والمرأة بشكل عام والبنت تنافسها في منطقة
+
+447
+00:28:00,470 --> 00:28:04,190
+الصدر، هذا رحمة ربنا، يعني من الإعجاز العلمي في
+
+448
+00:28:04,190 --> 00:28:09,790
+هذه النقطة سبحان الله، أن المرأة مرشحة للحمل، ويصير
+
+449
+00:28:09,790 --> 00:28:13,670
+عندها بكرا زواج وحمل وولادة، تخيلوا أن الجنين لم يصل
+
+450
+00:28:13,670 --> 00:28:19,170
+إلى 36، 37، 40 أسبوع، ضغط على النفس ربما
+
+451
+00:28:19,170 --> 00:28:23,230
+أكثر من ذلك فمش قادرة تتخذ نفسها لو تخيلنا أن النفس
+
+452
+00:28:23,230 --> 00:28:26,550
+بتظل ضيقة pragmatic زي الرجال بيصير كل ما تتنفس
+
+453
+00:28:26,550 --> 00:28:29,210
+تضغط على الجنين، تضغط على الجنين وممكن الجنين يموت
+
+454
+00:28:29,210 --> 00:28:33,350
+لكن رحمة ربنا أعطاها هذه الخاصية أنها تتنفس
+
+455
+00:28:33,350 --> 00:28:37,250
+بالتساع الصدر أو بتساع القفص الصدري أكثر من قضية
+
+456
+00:28:37,250 --> 00:28:42,010
+اللي هو الانزول للأسفل استجابة زي إيه للحجاب الحاجز
+
+457
+00:28:42,010 --> 00:28:47,250
+زي الرجال، هذه من الإعجاز العلمي. طيب، إذا عماله زاد
+
+458
+00:28:47,250 --> 00:28:50,690
+النفس كثيرا، إيش اسمه؟ تاكيبنيا طبعا تاكيبنيا وقت
+
+459
+00:28:50,690 --> 00:28:55,090
+إيش بنقولها؟ إذا كان النفس أكثر من عشرين، عشرين نفسا
+
+460
+00:28:55,090 --> 00:29:00,130
+في الدقيقة برديبنيا إذا كان أقل من إيش؟ عشر يعني
+
+461
+00:29:00,130 --> 00:29:03,690
+كأنه بيقول لي أنا بقدر أصبر لعند عشرة، أحد عشر،
+
+462
+00:29:03,690 --> 00:29:07,770
+اثني عشر، ثمانية عشر، تسعة عشر، كل وضع بقدر أعتبره في
+
+463
+00:29:07,770 --> 00:29:11,250
+الـ range لكن زاد عن العشرين تاكيبنيا، نزل عن العشرين
+
+464
+00:29:11,250 --> 00:29:15,520
+برديبنيا. ما أحد يخربط المقرر ويقول لي  bradycardia، no
+
+465
+00:29:15,520 --> 00:29:20,140
+tachypnea طيب، الآن palpation، بدنا نمد أيدينا و
+
+466
+00:29:20,140 --> 00:29:23,060
+نشوف palpate areas of the chest، يعني بنحط أيدينا
+
+467
+00:29:23,060 --> 00:29:26,320
+ونشوف كيف المنطقة حوالين الصدر هل في
+
+468
+00:29:26,320 --> 00:29:30,320
+abnormalities، في tumors، في nodules، في أي شيء
+
+469
+00:29:30,320 --> 00:29:33,460
+يعني اللي هو سبحان الله عامل مشكلة عشان إحنا نسجله
+
+470
+00:29:33,460 --> 00:29:36,960
+إيه في clients’ complaints؟ إذا وأنا .. اللي جيت
+
+471
+00:29:36,960 --> 00:29:40,870
+أنا قاعد إيش؟ بعمل palpation أفرضه وأنا قاعد بعمله
+
+472
+00:29:40,870 --> 00:29:43,810
+palpation شكل المريض يعني أنا قاعد بعمل assessment
+
+473
+00:29:43,810 --> 00:29:47,950
+وصلت لمنطقة الصدر الأيمن الأيسر أي مكان قال لي لأ
+
+474
+00:29:47,950 --> 00:29:52,570
+stop أنا هنا اتوجعت شوية هنا، بيقول لي must be palpated
+
+475
+00:29:52,570 --> 00:29:56,670
+carefully إيش يعني carefully؟ على مهل بعناية و
+
+476
+00:29:56,670 --> 00:30:00,350
+براحة خاصة مناطق الـ tenderness المناطق اللي فيها
+
+477
+00:30:00,350 --> 00:30:03,410
+ألم، والمناطق اللي فيها bulges إيش يعني bulges؟
+
+478
+00:30:03,410 --> 00:30:07,660
+يعني حاجات طالعة برا، أو إيش هنا movements of all
+
+479
+00:30:07,660 --> 00:30:09,320
+movements إيش هنا all movements؟ بتأكد تشوف كل
+
+480
+00:30:09,320 --> 00:30:12,860
+الحركات يعني كأنه بيقول لي أنت بتأكد تعمل palpation
+
+481
+00:30:12,860 --> 00:30:17,560
+normally لكل الـ areas اللي موجودة حوالين الـ chest
+
+482
+00:30:17,560 --> 00:30:21,220
+لكن إذا اتقلم المريض اصبر إذا لاجيت فيه
+
+483
+00:30:21,220 --> 00:30:24,100
+abnormalities اصبر إذا لاجيت bulging اصبر واهدأ
+
+484
+00:30:24,100 --> 00:30:26,980
+عمل assessment بعناية عشان تقدر تدوّن، عشان هيك
+
+485
+00:30:26,980 --> 00:30:31,860
+بتلاحظ الطبيب لما بيعمل assessment للمريض ممكن يكون
+
+486
+00:30:31,860 --> 00:30:34,280
+عنده appendicitis، ما بيعملوش assessment بس لما يكتشف
+
+487
+00:30:34,280 --> 00:30:37,080
+الـ appendicitis، بيعمل له complete abdominal
+
+488
+00:30:37,080 --> 00:30:40,280
+assessment و ultrasound وبيعمله وممكن يعمله
+
+489
+00:30:40,280 --> 00:30:44,360
+standing chest x-ray أو abdomen x-ray وبعدها
+
+490
+00:30:44,360 --> 00:30:49,160
+بيبدأ further examination أو assessment في مناطق
+
+491
+00:30:49,160 --> 00:30:51,480
+اللي هو الـ right اللي هو الـ hypochondrium عشان
+
+492
+00:30:51,480 --> 00:30:54,260
+يعمل assessment للمنطقة المؤلمة عشان بيخليها في
+
+493
+00:30:54,260 --> 00:30:59,690
+الآخر assessment of thoracic expansion خلّيني إحنا
+
+494
+00:30:59,690 --> 00:31:03,390
+نتوقف عشان إحنا بدنا نلتزم بالنصف ساعة بالظبط عشان
+
+495
+00:31:03,390 --> 00:31:05,990
+نكمل في المحاضرة القادمة إن شاء الله، السلام عليكم
+
+496
+00:31:05,990 --> 00:31:06,830
+ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..c2aade7a9b14364e6d9b6859404fdf8db1c54877
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_postprocess.srt
@@ -0,0 +1,1984 @@
+1
+00:00:01,180 --> 00:00:07,020
+بسم الله الرحمن الرحيم أبنائي و بنات الطلبة خلينا
+
+2
+00:00:07,020 --> 00:00:12,420
+الآن نكمل مع محاضرات التقييم الصحي التمريضي فاليوم
+
+3
+00:00:12,420 --> 00:00:16,780
+ان شاء الله ال chapter السابع هنتكلم على موضوع ال
+
+4
+00:00:16,780 --> 00:00:22,160
+assessment of respiratory system طبعا احنا في
+
+5
+00:00:22,160 --> 00:00:27,580
+الأول كانت كلها يمكنلما بدينا المقدمات ثم اتجهنا ل
+
+6
+00:00:27,580 --> 00:00:30,040
+system by system احنا حكينا قولنا بدنا نبدأ من
+
+7
+00:00:30,040 --> 00:00:33,920
+head to toe و بدينا شوية من ال hair assessment و
+
+8
+00:00:33,920 --> 00:00:37,020
+ال skin assessment و شوية اتكلمنا عن ال vital
+
+9
+00:00:37,020 --> 00:00:39,320
+signs و شوية و اتكلمنا عن ال positions و اتكلمنا
+
+10
+00:00:39,320 --> 00:00:42,360
+عن ال influence خلينا نتكلم الآن على موضوع ال
+
+11
+00:00:42,360 --> 00:00:46,620
+respiratory system بشكل عام هذه بتذكرنا يعني و
+
+12
+00:00:46,620 --> 00:00:51,380
+أخدنا كلنا في ال anatomy هذه بس التشريح لأي جهاز
+
+13
+00:00:51,380 --> 00:00:56,930
+التنفسي بشكل عامبداية طبعا هو مش محطوط هنا النوز
+
+14
+00:00:56,930 --> 00:00:59,850
+على اعتبار انه بداية سواء كان النوز او المعطف على
+
+15
+00:00:59,850 --> 00:01:03,470
+اعتبار انه air entrance يعني دخول لمجرى الهواء لكن
+
+16
+00:01:03,470 --> 00:01:06,870
+هي قدامنا في ال larynx و في ال main bronchus و
+
+17
+00:01:06,870 --> 00:01:11,590
+بعدين التراكية و ننزل شوية بتلاقي كمان هنا إيش هنا
+
+18
+00:01:11,590 --> 00:01:15,530
+طبعا هنا اللي هو ال tertiary و ال secondary
+
+19
+00:01:15,530 --> 00:01:18,890
+bronchi بعدين هنا ال bronchioles لما تنتهي في
+
+20
+00:01:18,890 --> 00:01:22,290
+الحواي الصلاة الأخيرةلما بيصير بعض الناس في عندهم
+
+21
+00:01:22,290 --> 00:01:26,270
+inflammation فيها بنسميها برونكولايتس أو بنطلع فوق
+
+22
+00:01:26,270 --> 00:01:30,950
+بنقول برونكايتس أو أكتر Tracheitis و هكذا خلينا
+
+23
+00:01:30,950 --> 00:01:33,150
+الآن احنا مش موضوع التشريح لأن الحمد لله انتوا
+
+24
+00:01:33,150 --> 00:01:37,550
+كلكوا أخدتوا في التشريح مع الدكتورة التشريح بإذن
+
+25
+00:01:37,550 --> 00:01:40,910
+الله تكونوا انتوا يعني ذاكرين الان ال subjective
+
+26
+00:01:40,910 --> 00:01:44,110
+data you must ask ايه؟ احنا بنسأل عن ايه؟ عن ال
+
+27
+00:01:44,110 --> 00:01:47,470
+cuffing أول حاجة قبل ما نبدأ نعمل assessmentبنسأل
+
+28
+00:01:47,470 --> 00:01:52,790
+على ال cuffing هل في عندك انت سعلة في جحة هل هي
+
+29
+00:01:52,790 --> 00:01:54,770
+productive or not productive طبعا لما نقول
+
+30
+00:01:54,770 --> 00:01:57,650
+productive يعني الجحة كلكم عارفين يعني في بلغا
+
+31
+00:01:57,650 --> 00:02:00,890
+بيطلع معاك في secretion ولا بتطلع جحة ناشفة طبعا
+
+32
+00:02:00,890 --> 00:02:04,790
+إلى اعتبار لما نجي نعمل أساسية لقدام شوية ال
+
+33
+00:02:04,790 --> 00:02:08,450
+sputum طبعا نسأل اذا قالي اه والله في sputum بتطلع
+
+34
+00:02:08,450 --> 00:02:11,770
+يعني طب ايش لونه؟ ايش نوعه؟ ايش شكله؟ طبعا
+
+35
+00:02:11,770 --> 00:02:16,240
+الدكاترة المتخصين في الأمر هذايجيب يقولك يعني كان
+
+36
+00:02:16,240 --> 00:02:18,380
+إذا كان green معناته في infection، إذا كان yellow
+
+37
+00:02:18,380 --> 00:02:21,300
+والله كان شويه nearly infection، والله إذا كان
+
+38
+00:02:21,300 --> 00:02:24,800
+clear معناته فيه، لأ ممكن يكون عنده rhinitis أو
+
+39
+00:02:24,800 --> 00:02:29,000
+يعني عنده بشكل عام يعني allergic condition، كل
+
+40
+00:02:29,000 --> 00:02:32,520
+حاجة إلها معناه، ممكن يقولك sputum with blood
+
+41
+00:02:32,520 --> 00:02:36,140
+وهاكذا، طيب ال allergies ده نسأله عن إيش؟ عن
+
+42
+00:02:36,140 --> 00:02:40,120
+الحسية، هل عندك حسية معينة زي حسية الربو اللي
+
+43
+00:02:40,120 --> 00:02:44,120
+بتصير عن بعض الناس ضيق في التنفس، في عندك dyspnea؟
+
+44
+00:02:44,580 --> 00:02:47,340
+في عندك shortness of breath، هذا اختصار عالمي، يا
+
+45
+00:02:47,340 --> 00:02:50,600
+أخي اذا كنين S.O.B shortness of breath، هل عندك
+
+46
+00:02:50,600 --> 00:02:54,280
+يعني دايما ضيق في النفس؟ولا بيصير معايا اذا جالك
+
+47
+00:02:54,280 --> 00:02:57,800
+اه بصير معايا نروح نسأله طيب وانت مرتاح ولا لما
+
+48
+00:02:57,800 --> 00:03:01,940
+انت تكون تعبان on rest او on exertion طبعا اللي هو
+
+49
+00:03:01,940 --> 00:03:06,140
+معنى الانسان هو مرتاح وعنده ضيقة نفس أخطر بكتير من
+
+50
+00:03:06,140 --> 00:03:09,340
+اللي تعبان وعنده ضيقة نفس معناته ان الانسان هو
+
+51
+00:03:09,340 --> 00:03:13,380
+مرتاح وعضلات جسمه مرتاحة وعنده ضيق نفس معناته
+
+52
+00:03:13,380 --> 00:03:18,340
+الأمر مش سهل الأمر التاني بسأل علاش ال chest pain
+
+53
+00:03:18,340 --> 00:03:22,800
+طبعا ال chest pain بهمني في ايه عشان انا اعرفهل في
+
+54
+00:03:22,800 --> 00:03:27,200
+عنده history of يعني مثلا أزمة أو لا قدر الله أي
+
+55
+00:03:27,200 --> 00:03:30,700
+حتى مش بس أزمة يعني ال pain ما بتيجي بس من الأزمة
+
+56
+00:03:30,700 --> 00:03:33,780
+نقول لا ممكن يكون عنده trauma ممكن لا قدر الله
+
+57
+00:03:33,780 --> 00:03:37,820
+tumor ممكن لا قدر الله يعني عنده sharp pain يعني
+
+58
+00:03:37,820 --> 00:03:41,080
+عنده شيء يعني originated from أي blood يعني جاي من
+
+59
+00:03:41,080 --> 00:03:46,700
+وين من ال from ال heart أقصد هنا يعني كيفكيف يعني
+
+60
+00:03:46,700 --> 00:03:49,500
+from heart؟ يعني بيكون ال origin تبع ال brain اللي
+
+61
+00:03:49,500 --> 00:03:51,880
+هو ال chest جاي من أين من القلب فاحنا مابناش
+
+62
+00:03:51,880 --> 00:03:54,620
+نستعجب، يمكن جاي من ال muscle، احنا بنسأل بس الآن
+
+63
+00:03:54,620 --> 00:03:58,460
+أسئلة عامة في ألم؟ أه في ألم، وين ماكانوا، وبعدين
+
+64
+00:03:58,460 --> 00:04:01,560
+بنكمل، وبعدين بنسأل على ال history إيه، على الأزمة
+
+65
+00:04:01,560 --> 00:04:05,120
+أو ال bronchitis أو الالتهاب في الشعب الهوائي، هل
+
+66
+00:04:05,120 --> 00:04:07,360
+عنده emphysema؟ هو اللي كانت بنقولش وقعدت
+
+67
+00:04:07,360 --> 00:04:10,560
+emphysema أو tuberculosis، ال tuberculosis يعني ال
+
+68
+00:04:10,560 --> 00:04:14,320
+TB اللي بيسموه السلل الرئوي، طبعا هو مرض قديمانقرض
+
+69
+00:04:14,320 --> 00:04:16,760
+وإن كان في بعض الدول اللي لا يزال موجود زي جنوب
+
+70
+00:04:16,760 --> 00:04:20,420
+أفريقيا أو الدول الفقيرة نوعا ما لا يزال موجودون
+
+71
+00:04:20,420 --> 00:04:25,040
+وعمراض خطيرة ومعضية كمان الانفزيما هي عبارة عن
+
+72
+00:04:25,040 --> 00:04:27,640
+rapture في ال AMC و rapture في ال alveoli في
+
+73
+00:04:27,640 --> 00:04:31,620
+الحواصلات الهوائية في بعض الحالات من كتر ما بيصير
+
+74
+00:04:31,620 --> 00:04:35,440
+يعني دخول ال oxygen مثلا الحواصلات وعدم الاستطاع
+
+75
+00:04:35,440 --> 00:04:41,630
+على عملية اللي هو ال oxygen exchangeفبصير احتباس
+
+76
+00:04:41,630 --> 00:04:45,010
+في داخل حواصلات الأكسجين أو الهواء بشكل عام وبقدرش
+
+77
+00:04:45,010 --> 00:04:49,290
+الإنسان يطلعه لظروف معينة في foreign body في أزمة
+
+78
+00:04:49,290 --> 00:04:51,950
+في أي شيء فممكن يصير إيش rupture و ال rupture
+
+79
+00:04:51,950 --> 00:04:56,210
+بيطلع الهواء طبعا ممكن تحت ال skin ممكن يعمل زي
+
+80
+00:04:56,210 --> 00:04:59,970
+نوع من إيش أنه تنفخ في الرقبة أو في منطقة ال chest
+
+81
+00:04:59,970 --> 00:05:02,710
+أو حتى في منطقة كل ال .. ال .. ال .. ال .. ال ..
+
+82
+00:05:02,710 --> 00:05:02,810
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+83
+00:05:02,810 --> 00:05:02,870
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+84
+00:05:02,870 --> 00:05:03,690
+ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال
+
+85
+00:05:03,690 --> 00:05:05,170
+.. ال .. ال .. ال .. ال .. ال .. ال .. ال .. ال ..
+
+86
+00:05:05,170 --> 00:05:11,880
+ال .. ال .. ال .. ال .. ال .. الفي زرقاء بالورق
+
+87
+00:05:11,880 --> 00:05:14,800
+نسأله إذا في عندك شحوب معين طبعا الشحوب هنا مش
+
+88
+00:05:14,800 --> 00:05:18,200
+معناته اللي علاقة بالبرد لأ أنا بتتكلم عليه كله
+
+89
+00:05:18,200 --> 00:05:20,800
+اللي باسمه ولا ال sinusis أنا كل اللي بتكلمه انه
+
+90
+00:05:20,800 --> 00:05:23,800
+له علاقة بالاش بال respiratory system problems
+
+91
+00:05:23,800 --> 00:05:27,520
+اللي قدامش و هنفهم إيش اللي بنقصده exposure to
+
+92
+00:05:27,520 --> 00:05:32,980
+environmental inhalants هل اتعرض لأي أشياء من
+
+93
+00:05:32,980 --> 00:05:36,920
+البيئة بس ممكن تكون أثرت عليه inhalants يعني
+
+94
+00:05:36,920 --> 00:05:41,170
+استنشق أشياء ضارةزي ال chemicals كيمويات، زي ال
+
+95
+00:05:41,170 --> 00:05:45,350
+fumes، أي .. مش أي عطور معينة، لأ، ممكن يكون في
+
+96
+00:05:45,350 --> 00:05:50,250
+بعض أشياء volatile يعني متطايرة لكن مؤذية زي ال
+
+97
+00:05:50,250 --> 00:05:54,090
+tenure يعني اللي باسمها الترابنتينة هذه أو زي مثلا
+
+98
+00:05:54,090 --> 00:05:58,810
+مرات رائحة الكحول اللي هو المركز جدا ممكن يصل ل 90
+
+99
+00:05:58,810 --> 00:06:03,210
+%لو استنشق ريحة شديدة منه او بنزين او سلر او كذا،
+
+100
+00:06:03,210 --> 00:06:06,710
+هذا ممكن يتعيش و هو كان عنده استعداد انه ممكن يصير
+
+101
+00:06:06,710 --> 00:06:12,470
+عنده اي مشكلة فممكن دغري تصير عنده هذه المشكلةطيب
+
+102
+00:06:12,470 --> 00:06:16,150
+history of smoking نسأله بتدخن اه جدش بتدخن زي ما
+
+103
+00:06:16,150 --> 00:06:18,770
+احنا اتعلمنا في السنة الأولى لما شوفنا في ال
+
+104
+00:06:18,770 --> 00:06:22,630
+nursing care plan كنا دايما يعلمونا نسأل المريض
+
+105
+00:06:22,630 --> 00:06:27,990
+اذا بدخن جدش بدخن و هل في عنده يعني اليوم زمان مش
+
+106
+00:06:27,990 --> 00:06:31,410
+بس جدش بدخن في اليوم لأ هل هو يعني addict هل هو
+
+107
+00:06:31,410 --> 00:06:35,770
+chronic هل هو acute case يعني له يومين له شهرين
+
+108
+00:06:35,770 --> 00:06:39,660
+تلاتة مش زي اللي هو سنوات طويلةطبعا من ناحية ال
+
+109
+00:06:39,660 --> 00:06:42,420
+Anatomy احنا بس تذكير لأ اكتر ولا اقل لإن انتوا ما
+
+110
+00:06:42,420 --> 00:06:46,180
+شاء الله كلكوا أخدتوا اللي هو التشريح ويعني اللي
+
+111
+00:06:46,180 --> 00:06:49,320
+انا نريد انه احنا .. يعني و كأنه بدنا نعيد العلم
+
+112
+00:06:49,320 --> 00:06:52,820
+من أول و جديد لكن بندكر انه ال respiratory tract
+
+113
+00:06:52,820 --> 00:06:56,080
+هي extends بتمتد من وين من ال mouth أو النزل اتنين
+
+114
+00:06:56,080 --> 00:07:00,020
+على اعتبارهم مدخل الهواء نزوفرانستراجي لما نصل في
+
+115
+00:07:00,020 --> 00:07:03,860
+الأخر لإيه الفلويزي كما حكينا على الرسمة احنا الآن
+
+116
+00:07:03,860 --> 00:07:07,440
+بهمنا انه في حاجة اسمها upper airwayو lower airway
+
+117
+00:07:07,440 --> 00:07:10,940
+فى upper airway و فى lower airway طبعا سامحونا
+
+118
+00:07:10,940 --> 00:07:14,880
+عشان الصوت شوية لإنه مح شوية الواحد يمكن مع الشتاء
+
+119
+00:07:14,880 --> 00:07:19,860
+بس شوية الآن upper airway ال upper airway ليش هذا
+
+120
+00:07:19,860 --> 00:07:22,880
+موجود سبحان الله بقول لي filters air pore يعني هو
+
+121
+00:07:22,880 --> 00:07:26,080
+بيعمل filters اللي إيه لل particles يعني كل الهواء
+
+122
+00:07:26,080 --> 00:07:30,410
+اللي مابيدخل عليناإذا في أي حاجة محمول معاه
+
+123
+00:07:30,410 --> 00:07:35,790
+الهواء، أي molecules، أي غبار، أي أشياء ممكن
+
+124
+00:07:35,790 --> 00:07:39,130
+تضرنا، بروح إشمع ملانة تنقية ومش بس هيك،
+
+125
+00:07:39,130 --> 00:07:42,390
+humidifies، humidifies يعني أيه؟ بيعمل ترطيب،
+
+126
+00:07:42,390 --> 00:07:47,050
+warm، برضه إشمع، تدفئة، لإيه؟ لل gases، ليه؟ لأنه
+
+127
+00:07:47,050 --> 00:07:50,290
+على إتباع إحنا .. إحنا قاعدين بنتنفس، أخد نكسوجين
+
+128
+00:07:50,290 --> 00:07:53,970
+مثلا، أخدنا هيدروجين، هيدروجين، أيا كان، وإحنا
+
+129
+00:07:53,970 --> 00:07:58,410
+قاعدين بناخده، ممكن يكون الهواء الخارجي ساجعأو سخن
+
+130
+00:07:58,410 --> 00:08:02,830
+بيقدرش يكون اللي سبحان الله يدخل على ما هو لجسم
+
+131
+00:08:02,830 --> 00:08:05,350
+الإنسان وإيه اللي هيضره فسبحان الله للإنسان إيش
+
+132
+00:08:05,350 --> 00:08:09,390
+بيصير هنا؟ إنه هذا بيعمله عملية تلطيف وترتيب
+
+133
+00:08:09,390 --> 00:08:12,810
+وإزالة من الشوائب طب ال lower airway لإيه؟ دُغري
+
+134
+00:08:12,810 --> 00:08:16,150
+نحط في بالنا ال lower لإيه؟ لل gas exchange لإيه؟
+
+135
+00:08:16,150 --> 00:08:19,070
+مجرد ما ننزل تحت لل bronchioles أو الفلاي روحنا
+
+136
+00:08:19,070 --> 00:08:22,670
+واشبقنا فيه أننا .. إيش هنا؟ إيه علاقة بال gas
+
+137
+00:08:22,670 --> 00:08:28,350
+exchange؟ طيبtechnique for respiratory exam كيف
+
+138
+00:08:28,350 --> 00:08:31,450
+بنعمل احنا respiratory exam لو أمامنا المريض و
+
+139
+00:08:31,450 --> 00:08:34,550
+بدنا نحاول نعمله assessment أول حاجة قبل ما نبدأ
+
+140
+00:08:34,550 --> 00:08:37,330
+إذا كان بالإمكان بقول if possible يعني إذا مش
+
+141
+00:08:37,330 --> 00:08:41,650
+بالإمكان خلاص بس إذا قدرت تعمل مكون كويس أول حاجة
+
+142
+00:08:41,650 --> 00:08:47,090
+quiet environment لازم تكون البيئة هادئة ماتأثرش
+
+143
+00:08:47,090 --> 00:08:51,330
+على المريض ماتخلوش نفسه يزيد أو ينقص أو تجد قلبه
+
+144
+00:08:51,330 --> 00:08:54,780
+تزيد proper positionإيه؟ لما أقول كلمة proper
+
+145
+00:08:54,780 --> 00:08:58,800
+position يعني الوضع المناسب للمريض نفسه هو الصح
+
+146
+00:08:58,800 --> 00:09:02,200
+يكون إيه؟ setting هو الصح يكون إيه؟ setting لكن
+
+147
+00:09:02,200 --> 00:09:05,680
+إذا ماقدرش يكون setting مش مشكلة نخليه subine بس
+
+148
+00:09:05,680 --> 00:09:09,100
+أحنا بنقول أحسن ألجيته بيقول إيه؟ ألجيته إذا بدك
+
+149
+00:09:09,100 --> 00:09:12,440
+تعمل ال posterior thorax بيقول إيه؟ ممكن أنت كمان
+
+150
+00:09:12,440 --> 00:09:15,120
+مش بس posterior حتى ال anterior thorax ممكن تعمل و
+
+151
+00:09:15,120 --> 00:09:18,660
+أنت قاعد و المريض قاعد طب إذا ماقدرش أشوف يومار
+
+152
+00:09:18,660 --> 00:09:23,540
+ودانا ال subineفعشانك اعطاني وضعين جالي ده مش جادر
+
+153
+00:09:23,540 --> 00:09:26,560
+انت ممكن تجاعده شوية بتشوف صدره من ورا عشانك بتشوف
+
+154
+00:09:26,560 --> 00:09:30,260
+الطبيب مرات بيجاعد المريض بيفحص صدره من ورا وبعدين
+
+155
+00:09:30,260 --> 00:09:34,000
+بنايم على دهره عشان يفحصه من الأمام لكن اذا دلق
+
+156
+00:09:34,000 --> 00:09:36,300
+مستطيع و جادر يتحمل مافي مشكلة يعني ممكن واحد
+
+157
+00:09:36,300 --> 00:09:40,800
+يفحصه ايش اجيتين و هو جاعد expose skin بدنا نكشف
+
+158
+00:09:40,800 --> 00:09:45,100
+ايش الجلد ليه عشان auscultation بس خلينا هنا في
+
+159
+00:09:45,100 --> 00:09:48,300
+هذا المكان بالذات بدي احكي كلمةإنه إذا كان اللي
+
+160
+00:09:48,300 --> 00:09:51,320
+قدامنا طفل مانكشفوش كله على الآخر أو يعني كبير في
+
+161
+00:09:51,320 --> 00:09:54,440
+السن Geriatric clients بقى بالفعل أنه هيكون
+
+162
+00:09:54,440 --> 00:09:57,040
+بالنسبة له يعني ممكن يكون exaggerated لأنه هيعمله
+
+163
+00:09:57,040 --> 00:10:02,900
+مشكلة لأن حسية البرد أو حسية السماعة نفسها اللي
+
+164
+00:10:02,900 --> 00:10:07,460
+بتستخدمها الطبيب علشان هيك بيفضل دايما الطبيب أنه
+
+165
+00:10:07,460 --> 00:10:14,020
+هنا على مهل و لو استخدم مع الطفل مش غلط إما بيدفع
+
+166
+00:10:14,020 --> 00:10:18,240
+زي ما اتعلمنا زماناللي هو ال pill تبعت اللي هو او
+
+167
+00:10:18,240 --> 00:10:21,820
+ال diaphragm تبعت السماعة نفسها او بيخلي الفانيلا
+
+168
+00:10:21,820 --> 00:10:27,100
+اللي تحتانيه تعطي المريض عشان ما يعملش زي يعني
+
+169
+00:10:27,100 --> 00:10:31,720
+تحسس للمريض نفسه من شروره بالسماعة طيب patient
+
+170
+00:10:31,720 --> 00:10:36,980
+comfort نريح المريض اولش ندفع ادينا بعدين ال
+
+171
+00:10:36,980 --> 00:10:40,470
+diaphragm زي ما احنا قلنا تعت استيسكوببعدين هنا
+
+172
+00:10:40,470 --> 00:10:43,430
+إذا في عندنا women النساء بدنا نعرف إنه دائما
+
+173
+00:10:43,430 --> 00:10:46,690
+نعملها drop لما نقول drop يعني بدنا نغطيها في كتير
+
+174
+00:10:46,690 --> 00:10:50,530
+بعض الناس مفكر إنه لازم أنه نعمل uncover نهو احنا
+
+175
+00:10:50,530 --> 00:10:53,330
+قلنا في البداية ال assessment أول ما بدنا نشرحه
+
+176
+00:10:53,330 --> 00:10:57,310
+قلنا إنه you should uncover the area assisted only
+
+177
+00:10:57,310 --> 00:11:00,710
+يعني فقط كشف المنطقة اللي بدك تعملها assessment
+
+178
+00:11:00,710 --> 00:11:05,550
+فقط مابدك تكشف أكتر من اللي لازم ليه؟ على اعتبار
+
+179
+00:11:05,550 --> 00:11:07,850
+أنه أول حاجة embarrassing و بعدين حتى في عروفنا و
+
+180
+00:11:07,850 --> 00:11:11,590
+في ديننايعني الصح إن الإنسان يسطر المريض قدر
+
+181
+00:11:11,590 --> 00:11:15,990
+الإمكان حتى الميت بنسطره الآن إيش نبدأ؟
+
+182
+00:11:15,990 --> 00:11:19,490
+inspection, palpation, percussion, escalation طبعا
+
+183
+00:11:19,490 --> 00:11:22,790
+ليش escalation هنا في الآخر؟ أكيد هتعرفوا ليش لأن
+
+184
+00:11:22,790 --> 00:11:26,410
+هي high skill إيش يعني high skill؟ يعني تحتاج
+
+185
+00:11:26,410 --> 00:11:29,810
+لمهارة عالية وممكن يعني إحنا الشغلات العامة بس
+
+186
+00:11:29,810 --> 00:11:33,850
+نستفيد .. يعني نفهمها لكن الشغلات الدقيقة جدا لازم
+
+187
+00:11:33,850 --> 00:11:37,740
+الطبيب المتخصص فقط هو اللييعني ال chest disease
+
+188
+00:11:37,740 --> 00:11:43,100
+specialist هو اللي بيقدر يعني يسمع أصوات النفس أو
+
+189
+00:11:43,100 --> 00:11:46,900
+أصوات اللي موجودة عند المريض طب initial .. initial
+
+190
+00:11:46,900 --> 00:11:51,080
+.. الآن نتكلم عن ال initial respiratory survey أول
+
+191
+00:11:51,080 --> 00:11:55,880
+حاجة، بدنا نعمل هنا survey .. observe طبعا معنى
+
+192
+00:11:55,880 --> 00:11:59,860
+كلمة survey يعني زي لمحة عامة، أيش لمحة عامة؟يعني
+
+193
+00:11:59,860 --> 00:12:02,400
+انك انت بتاخد ايش تقييم عام لكل ال respiratory
+
+194
+00:12:02,400 --> 00:12:05,680
+system بشكل عام قبل ما تبدأ يعني specifically قبل
+
+195
+00:12:05,680 --> 00:12:11,140
+ما تبدأ في شغلات يعني محددة بعينها، اول حاجة بنشوف
+
+196
+00:12:11,140 --> 00:12:13,340
+و احنا قاعدين عند المريض لسه احنا مابدناش نعمل
+
+197
+00:12:13,340 --> 00:12:16,660
+assessment، اول حاجة بنشوف ال breathing better و
+
+198
+00:12:16,660 --> 00:12:18,780
+انا قاعد جانبه و انا قاعد بحكي معاه، باخد منه
+
+199
+00:12:18,780 --> 00:12:21,840
+assessment، بعمل معاه مثلا باخد منه report، باخد
+
+200
+00:12:21,840 --> 00:12:26,020
+له vital signs، بشوف كيف ايش ال pattern تبع النفس
+
+201
+00:12:26,020 --> 00:12:29,840
+يعني كيف نفسهطبعا ال pattern يعني تلت أشياء، أول
+
+202
+00:12:29,840 --> 00:12:34,500
+حاجة ال rate، إيش معدله؟ يعني بتنفس على مهل؟ ولا
+
+203
+00:12:34,500 --> 00:12:39,280
+نفسه سريع؟ ولا نفسه .. بيقولوها بالاختيارية أو بعض
+
+204
+00:12:39,280 --> 00:12:41,860
+الناس كان بيقولوا نفسه مطرود، بيحس حاله ان يعني
+
+205
+00:12:41,860 --> 00:12:46,660
+نفسه يعني مش قادر يحاول ياخد نفسه الطبيعي تبعه، هو
+
+206
+00:12:46,660 --> 00:12:51,580
+بيقول نفسي مطرود. بنشوف ال depth العمق، هل هو نفسه
+
+207
+00:12:51,580 --> 00:12:55,360
+shallow or deep؟ shallow يعني هل هو بتنفس نفس بسيط
+
+208
+00:12:55,360 --> 00:12:58,470
+يعني ما .. وانتوا عارفين إيش معاد shallow؟بهذا
+
+209
+00:12:58,470 --> 00:13:02,310
+الشكل او deep .. deep يعني هل هو بيحكي معاك كأنه
+
+210
+00:13:02,310 --> 00:13:07,530
+كل شوية بتنهد .. كأنه كل شوية بيسحب .. كأنه بتنفس
+
+211
+00:13:07,530 --> 00:13:10,490
+ايش .. نفس طويل .. كل هذا ايه له معنى؟ ال effort
+
+212
+00:13:10,490 --> 00:13:15,170
+.. هل لما بتنفس فيه جهد؟ هل في .. يعني كيف الجهد؟
+
+213
+00:13:15,170 --> 00:13:16,970
+بتطلع لحاجة ده اسمها ال accessory muscles اللي
+
+214
+00:13:16,970 --> 00:13:20,230
+العضلات المساعدة كلكوا عارفينها اللي أخدناها زمان
+
+215
+00:13:20,230 --> 00:13:24,010
+في التشريح يعني بتطلع في .. بتطلع في ال neck ..
+
+216
+00:13:24,010 --> 00:13:27,500
+بتطلع في ال shoulder .. بتطلع في ال faceهو عماله
+
+217
+00:13:27,500 --> 00:13:31,600
+بياخد النفس .. هو عماله بياخد النفس .. هل بياخد ..
+
+218
+00:13:31,600 --> 00:13:35,340
+بيعمل جهود ولا النفس تلقائي عماله بروح و بيجي ..
+
+219
+00:13:35,340 --> 00:13:37,920
+طبعا إذا باخد جهود و باخد نفس .. يعني هو باخد
+
+220
+00:13:37,920 --> 00:13:41,760
+النفس .. معناته في مشكلة .. يمكن في obstruction ..
+
+221
+00:13:41,760 --> 00:13:45,280
+يمكن في abnormalities و مش قادر المريض ياخد نفس ..
+
+222
+00:13:45,280 --> 00:13:48,880
+طيب assist declines إيش؟ skin color .. بعد هيك
+
+223
+00:13:48,880 --> 00:13:51,860
+خلصنا من النفس بروح على إيش؟ لون الجلد .. وين
+
+224
+00:13:51,860 --> 00:13:55,300
+اللون الجلد؟ مش في جسمه كله .. لأأفضل شي نشوف
+
+225
+00:13:55,300 --> 00:13:58,700
+اللون الجلد في منطقة ال respiratory system، يعني
+
+226
+00:13:58,700 --> 00:14:02,840
+باطلع في منطقة ال nose، منطقة ال mouth و منطقة
+
+227
+00:14:02,840 --> 00:14:06,320
+الرقبة، هل في sinuses، هل مافيش منطقة ال mouth
+
+228
+00:14:06,320 --> 00:14:09,700
+نفسه حتى من جوا، ولا مافي، كيف وضعوا بشكل عام؟
+
+229
+00:14:09,700 --> 00:14:12,900
+اللي بعدها؟ الآن بدنا نشوف النور ماريته كلكم،
+
+230
+00:14:12,900 --> 00:14:16,500
+أنتوا عارفين، بس نذكركم، ألجيتم مش كل اللي هو
+
+231
+00:14:16,500 --> 00:14:20,660
+المعدلات النفس تعتبر نفس المعدلة، أكيد طبعاالانسان
+
+232
+00:14:20,660 --> 00:14:24,060
+سبحان الله هو صغير نفسه بيكون سريع جدا و هذا لا
+
+233
+00:14:24,060 --> 00:14:28,120
+يعتبر شيء مرضى و انما يعتبر شيء طبيعى لأنه سبحان
+
+234
+00:14:28,120 --> 00:14:32,000
+الله على اعتبار ان قلب الطفل لسه قلب صغير و ال
+
+235
+00:14:32,000 --> 00:14:35,940
+body surface area كبيرة شوية فبديكون سريع جدا عشان
+
+236
+00:14:35,940 --> 00:14:39,460
+يقدر يعوض و ي ايه و يعمل gas exchange و يعملوا ضخ
+
+237
+00:14:39,460 --> 00:14:43,580
+الدم لكل أنحاء الجسم طيب ال infant بيقوللي ايش هنا
+
+238
+00:14:44,230 --> 00:14:47,270
+اللي هو من عند الولاد اللي عند سنتين تلاتين لستين
+
+239
+00:14:47,270 --> 00:14:50,830
+طبعا بتكلم على beat per minute كلكوا اذكرواها beat
+
+240
+00:14:50,830 --> 00:14:55,070
+per minute يعني اللي بيسموها بي بي بي اش يعني لما
+
+241
+00:14:55,070 --> 00:14:58,130
+نقول بي اللي اولا بي بوك اللي هو beat يعني اما
+
+242
+00:14:58,130 --> 00:15:02,110
+التانية اللي هو per اللي هو بال P اللي هو beat per
+
+243
+00:15:02,110 --> 00:15:05,910
+minute الان قديش بقول تلاتين لستين اللي هو نفس في
+
+244
+00:15:05,910 --> 00:15:09,570
+الدقيقة في منطقة الدودلر لما نقول الدودلر هنا اللي
+
+245
+00:15:09,570 --> 00:15:12,710
+المرحلة او المنطقة اللي واقع ما بين سنتين لتلت
+
+246
+00:15:12,710 --> 00:15:18,110
+سنواتاللي هي اش بنسميها هنا اسمها مرحلة الدرج، ليش
+
+247
+00:15:18,110 --> 00:15:21,570
+سموها الدرج؟ على اعتبار ان الطفل بيسير درج في هذه
+
+248
+00:15:21,570 --> 00:15:26,650
+الفترة و عماله يعني بجيز حفظ بدهو يسير درج و يسير
+
+249
+00:15:26,650 --> 00:15:30,390
+يمشي و في منهم بيكونوا يعني مشهر و خلص و بيكون
+
+250
+00:15:30,390 --> 00:15:34,990
+مشغل على سنة حتى ممكن يكون مشهر طيب اربعة و عشرين
+
+251
+00:15:34,990 --> 00:15:39,570
+لاربعين طيب pre school قبل المدرسة تلت لاربع سنوات
+
+252
+00:15:39,940 --> 00:15:45,120
+من 22 ل 34 اللي هو نفس في الدقيقة لو لاحظنا .. لو
+
+253
+00:15:45,120 --> 00:15:51,020
+لاحظنا هلجأت .. الامر اختلف عماله بجل شوية هنا نفس
+
+254
+00:15:51,020 --> 00:15:55,780
+.. هنا نفس بزيد لأ بجل و هنا عماله بجل يعني معناته
+
+255
+00:15:55,780 --> 00:15:59,600
+كل ما بيكبر شوية الطفل كل ما عماله ايه؟ كل ما
+
+256
+00:15:59,600 --> 00:16:05,180
+عماله اللي هو نفسه بخف في الدقيقة طب ال school age
+
+257
+00:16:05,180 --> 00:16:08,540
+بقولي اه هذه معلش ال school age اللي هو من صف أول
+
+258
+00:16:08,540 --> 00:16:14,230
+لصف سادسبصير من 18 ل 30 breathing per minute يعني
+
+259
+00:16:14,230 --> 00:16:16,930
+اللي هو breathing per minute اللي هو يعني التنفس
+
+260
+00:16:16,930 --> 00:16:21,570
+فيه الدقيقة طيب ادولس انت مرحلة ايه المراهقة من 13
+
+261
+00:16:21,570 --> 00:16:24,690
+ل 19 اللي هي على اعتبار اسمها ال teen age ال teen
+
+262
+00:16:24,690 --> 00:16:29,410
+age اللي هو بيصير 12 ل 16 عشان يصل لمرحلة الأدلة و
+
+263
+00:16:29,410 --> 00:16:33,870
+المرحلة الطبيعية اللي هو من 20 ل 40 طبعا plus or
+
+264
+00:16:33,870 --> 00:16:38,260
+minus بيصير من 16 ل 20 breathing per minuteاللي
+
+265
+00:16:38,260 --> 00:16:42,060
+بتقوله انا انه احنا بشكل عام .. احنا هنتعامل معظم
+
+266
+00:16:42,060 --> 00:16:45,340
+تعاملنا هيكون في هذه .. في هذه خليني أقول اللي هو
+
+267
+00:16:45,340 --> 00:16:50,620
+ال area ممكن لما يصير سنة تالتة هنتعامل مع ال
+
+268
+00:16:50,620 --> 00:16:54,860
+infant و شوية ربما مع الدودلر، مدونة لو حد قال طب
+
+269
+00:16:54,860 --> 00:16:58,320
+ليش ماتتعاملش مع دودلر؟ لأخليني أقول منطقة محايدة
+
+270
+00:16:58,320 --> 00:17:03,460
+على اعتبار أن معظم الأطفال بتصير دائما عندهم
+
+271
+00:17:03,460 --> 00:17:06,760
+الأمراض دائما في بداية أعمارهم كل ما بيكبر الطفل
+
+272
+00:17:06,760 --> 00:17:10,920
+حتى سبحان الله و كأنه مانعته بزيد فبيصير حتى مرضه
+
+273
+00:17:10,920 --> 00:17:14,820
+يعني بيخف كتير يعني بيلاقي الأم في هذه الأعمار
+
+274
+00:17:14,820 --> 00:17:18,200
+يعني سبحان الله يسهل أنه التعامل و التغلب على أي
+
+275
+00:17:18,200 --> 00:17:21,920
+شيء بيجي للطفل فمش هيجيك على المستشفى لكن بعد هيك
+
+276
+00:17:21,920 --> 00:17:24,520
+لما يصيروا adults لأ بيصيروا احنا بدنا نصيروا
+
+277
+00:17:24,520 --> 00:17:27,620
+دائما نراقبهم نشوف كده شعار نفسهمطبعا زاد او نقص
+
+278
+00:17:27,620 --> 00:17:31,520
+كله له ايش تشخيص خليني نمشي شوية inspection اول
+
+279
+00:17:31,520 --> 00:17:34,380
+حاجة ايش تشوف ال measurement and assessment of a
+
+280
+00:17:34,380 --> 00:17:38,920
+respiration patterns بتاكي تشوف قداش حجم وقداش ايش
+
+281
+00:17:38,920 --> 00:17:43,220
+وقداش اللي هو كمية واسلوب النفس اللي بيصير عند ايش
+
+282
+00:17:43,220 --> 00:17:47,400
+حجم اللي هو النفس وكمية النفس اللي بتدخل المريض مش
+
+283
+00:17:47,400 --> 00:17:50,740
+بس هيك بقولي بتاكي تشوف ال skin على المنطقة كلها
+
+284
+00:17:50,740 --> 00:17:53,740
+اللي احنا حاكين عنها لان في كل منطقة ال thorax
+
+285
+00:17:53,740 --> 00:17:58,230
+اللي هو منطقة الصدرطيب و بعدين أسس ايش هنا .. ثروس
+
+286
+00:17:58,230 --> 00:18:00,990
+ال configuration .. إيش يعني ال configuration ..
+
+287
+00:18:00,990 --> 00:18:03,510
+ال configuration معناه تتدريس .. إيش يعني التدريس
+
+288
+00:18:03,510 --> 00:18:07,210
+أو بيسموه يعني زي ما نشوف زي هضبات أو نزلات أو
+
+289
+00:18:07,210 --> 00:18:10,950
+شغلات يعني .. يعني خلينا نقول out of normal أو
+
+290
+00:18:10,950 --> 00:18:15,750
+abnormalبنبطلع على منطقة الصدر، هل في أي شيء انبين
+
+291
+00:18:15,750 --> 00:18:19,370
+على منطقة الصدر عنده أشياء مش طبيعية؟ طبعا إذا
+
+292
+00:18:19,370 --> 00:18:22,590
+واحد قال لي إيه؟ إيش جصدك فيها؟ لقدام هقولكوا أن
+
+293
+00:18:22,590 --> 00:18:25,150
+في بعض الناس بيقولك صدره عامل زي الحمامة، اسمه
+
+294
+00:18:25,150 --> 00:18:27,930
+pigeon chest، في ناس بيقولك والله صدره حاسس زي
+
+295
+00:18:27,930 --> 00:18:31,930
+المفلطح، اسمه barrel chest، كل حاجة إلها مسمة على
+
+296
+00:18:31,930 --> 00:18:35,770
+حسب ال .. ال .. خليني أقول ال .. يعني المشكلة
+
+297
+00:18:35,770 --> 00:18:38,810
+الصحية اللي موجودة عندهمThe client must be
+
+298
+00:18:38,810 --> 00:18:41,210
+uncovered حاضرا يعني انا بقول ياريت انت لما تعمل
+
+299
+00:18:41,210 --> 00:18:44,610
+assessment كامل لمنطقة الصدر، بدك تكشفه من إيش
+
+300
+00:18:44,610 --> 00:18:47,550
+هنا؟ من ال waist، إيش يعني ال waist؟ you get
+
+301
+00:18:47,550 --> 00:18:50,410
+uncovered to the waist يعني لعند الخسر، من الصدر
+
+302
+00:18:50,410 --> 00:18:53,490
+لعند الخسر، لو حد جاي يقول لي طيب ليش يا أستاذ أنت
+
+303
+00:18:53,490 --> 00:18:57,030
+كشفته شوية لتحت، لعند البطل كله؟ لأن في بعض الناس
+
+304
+00:18:57,030 --> 00:18:59,470
+عندهم حاجة بسمها abdominal breathing يعني بتحسه
+
+305
+00:18:59,470 --> 00:19:03,310
+لما بتنفس باستخدام ال accessory musclesفبروح ال
+
+306
+00:19:03,310 --> 00:19:05,290
+diaphragm اللي هو الحجاب الحاسسي بتغطي على عضلات
+
+307
+00:19:05,290 --> 00:19:09,410
+البطن فانا بده أشوف هل البطن بيتحرك بيستجيب ولا
+
+308
+00:19:09,410 --> 00:19:12,570
+فيه مشكلة معينة عند المريض، لازم يكون مرضيش بقولنا
+
+309
+00:19:12,570 --> 00:19:16,750
+setting position without support، بدون ما احنا
+
+310
+00:19:16,750 --> 00:19:20,210
+ندعمه، كيف يعني .. يعني حاول نجعد المريض و نقوله
+
+311
+00:19:20,210 --> 00:19:25,290
+لو سمحت اجلس لوحدك، مابده أحط إيدي يعني أدعمك أو
+
+312
+00:19:25,290 --> 00:19:29,410
+أركزك أو تركز على كرسيعشان تشوف المريض كيف قدرته
+
+313
+00:19:29,410 --> 00:19:33,330
+على انه جالس يقدر ياخد النفس و كيف النفس بيعمل في
+
+314
+00:19:33,330 --> 00:19:39,350
+جسمه في كل تقسيم جسمه بشكل عام طيب observation of
+
+315
+00:19:39,350 --> 00:19:42,770
+skin ليش بدعمله لأنه بيقول لي ممكن يعطيني
+
+316
+00:19:42,770 --> 00:19:46,810
+knowledge معرفة جداش كمية ال nutrition الموجودة
+
+317
+00:19:46,810 --> 00:19:52,350
+عند ال client كتير من الناس بيبينش نصحته اضعفه مش
+
+318
+00:19:52,350 --> 00:19:55,980
+في الأديان ولا في ال abdomen في منطقة الصدرنيجي
+
+319
+00:19:55,980 --> 00:19:59,540
+نطلع حتى بسمع ابن اقوله فلان الصدر تبقى و بحس
+
+320
+00:19:59,540 --> 00:20:01,880
+عضامه و هو بيقول عضامه يعني احنا عارفين اللي هي ال
+
+321
+00:20:01,880 --> 00:20:05,880
+cartilage بيقولك انا حاسس عضامه مبينات يعني طلعات
+
+322
+00:20:05,880 --> 00:20:10,160
+كأن طلعات بدن يطلع من الجلد هذا بدل انه لأ very
+
+323
+00:20:10,160 --> 00:20:12,860
+thin person يعني القصة مش في العبرة في العضلات
+
+324
+00:20:12,860 --> 00:20:15,940
+الخارجية اللي مبينة و الواضحة كتير من الناس خاصة
+
+325
+00:20:15,940 --> 00:20:17,820
+ال heavy smokers كمان موجودين عندهم هذا الكلام و
+
+326
+00:20:17,820 --> 00:20:21,180
+في العكس في عندهم skin deposition يعني ال skin
+
+327
+00:20:21,180 --> 00:20:26,030
+ممكن يكون كمان فت دييعني فيه ترصبات دنيا موجودة في
+
+328
+00:20:26,030 --> 00:20:30,530
+هذا المنطقه بشكل عام طيب بدنا نشوف ال anterior
+
+329
+00:20:30,530 --> 00:20:33,130
+posterior diameter ايش يعني anterior posterior
+
+330
+00:20:33,130 --> 00:20:37,830
+diameter الان الصورة اللي هي جاي بعد شوية هتبين
+
+331
+00:20:37,830 --> 00:20:42,450
+ايش بنقصد فيها anterior posterior diameter بقول
+
+332
+00:20:42,450 --> 00:20:49,770
+هنا خلينا نركز مع بعض الان الصدر في diameter لما
+
+333
+00:20:49,770 --> 00:20:53,230
+يكون الانسان واقف بالامام اتخيله كأنه انسان امامك
+
+334
+00:20:53,230 --> 00:20:57,420
+واقفاللي واقف أمامك فيه إله يمين وفيه إله يسار
+
+335
+00:20:57,420 --> 00:21:02,960
+وفيه إله يمين ويسار وفيه إله اللي هو الأمام وفيه
+
+336
+00:21:02,960 --> 00:21:06,740
+إله خلف هلجدها ما بين اللي هو الأمام اللي هو
+
+337
+00:21:06,740 --> 00:21:10,140
+قدامنا الصدر من الأمام ومن الخلف منطقة الظهر اللي
+
+338
+00:21:10,140 --> 00:21:13,950
+ع جبال الصدر هذا إيش اسمها؟اسمها anterior
+
+339
+00:21:13,950 --> 00:21:17,170
+posterior diameter تمام هداش اسمها anterior
+
+340
+00:21:17,170 --> 00:21:20,810
+posterior diameter طيب بين اليمين و بين الشمال بين
+
+341
+00:21:20,810 --> 00:21:23,770
+اليمين و بين الشمال يعني هاي الصدر أمامي و بتطلع
+
+342
+00:21:23,770 --> 00:21:27,690
+لإنسان قدامي بين اليمين و بين الشمال من تحت طبعا
+
+343
+00:21:27,690 --> 00:21:32,310
+اللي هو ال .. خلنا نقول مثلا under axilla تحت
+
+344
+00:21:32,310 --> 00:21:34,750
+القبط من اليمين و تحت القبط من الشمال على الجهتين
+
+345
+00:21:34,750 --> 00:21:37,950
+ايش اسم المقياس transverse diameter اللي بيسموه
+
+346
+00:21:37,950 --> 00:21:41,310
+المقياس المستعراض عشان تفهمون الصح تتخيلوا اللي
+
+347
+00:21:41,310 --> 00:21:45,190
+أنا بقولهشوفتوا كيف تعيين الخياطين كيف بيستخدم لما
+
+348
+00:21:45,190 --> 00:21:50,090
+بيجي بده يفصل لبعض الناس بدلة او بده يفصله جميس او
+
+349
+00:21:50,090 --> 00:21:54,590
+بده يفصل لبنت معينة مثلا فستان او شي بتاخد الخياطة
+
+350
+00:21:54,590 --> 00:21:59,010
+مقاييس معينة الان المقياس الأمامي من اليمين لليسار
+
+351
+00:21:59,010 --> 00:22:03,690
+اسمه transfers والمقياس من الأمام للخلف ها الامام
+
+352
+00:22:03,690 --> 00:22:07,630
+للخلف اسمه ايه اسمه posterior diameter طب السؤال
+
+353
+00:22:07,630 --> 00:22:12,940
+لو حد سألنا هل التنتين زي بعض لأبقولي من واحد
+
+354
+00:22:12,940 --> 00:22:16,280
+لاتنين، ايش يعني من واحد لاتنين الطبيعي؟ يعني لو
+
+355
+00:22:16,280 --> 00:22:21,520
+جسنا الآن أمامي إنسان و جسنا من يمينه ليساره،
+
+356
+00:22:21,520 --> 00:22:24,700
+بالظبط حطينا مصطرة على اليمين و مصطرة على اليسار
+
+357
+00:22:24,700 --> 00:22:28,340
+على الجنبين، على الجنبين حطنا طبقنا المصطرتين هيك
+
+358
+00:22:28,340 --> 00:22:32,500
+على الجنبين و جسنا المسافة بينهم، هلاجي ايه؟ هلاجي
+
+359
+00:22:32,500 --> 00:22:36,600
+مثلا جول نعتبر اربعين صنطي، مثلا، فليكن اربعين
+
+360
+00:22:36,600 --> 00:22:42,300
+صنطي و لو جسنا الآن ما بينه الأمام و الخلفالجسد لو
+
+361
+00:22:42,300 --> 00:22:45,900
+حطينا برضه مصطرتين واحدة على الأمام صدر من الأمام
+
+362
+00:22:45,900 --> 00:22:49,060
+و واحدة على منطقة الظهر من الخلف اللي هو مقابلة
+
+363
+00:22:49,060 --> 00:22:52,980
+لنفس المصطرة وجسد المسافة بينهم حتى تجيه عشرين
+
+364
+00:22:52,980 --> 00:22:57,820
+عشرين صندوق ايش يعني معناته اللي قدام ضعف ايه اللي
+
+365
+00:22:57,820 --> 00:23:01,140
+قدام المقياس ضعف اللي هو الخلف اللي هو من الأمام
+
+366
+00:23:01,140 --> 00:23:04,580
+الى الخلف هذا بيسموها posterior diameter لل
+
+367
+00:23:04,580 --> 00:23:08,240
+transfer diameter واحد الى اتنين طبعا لو كان اكتر
+
+368
+00:23:08,240 --> 00:23:12,410
+من هيك معناته فيه مشكلة زي ايش اعطالي مثالجلة في
+
+369
+00:23:12,410 --> 00:23:15,950
+مرات abnormality زي مين زي حاجة بيجون chest بيجون
+
+370
+00:23:15,950 --> 00:23:18,930
+chest يعني بعض الناس بيقولك هذا الصدر زي الحمامة
+
+371
+00:23:18,930 --> 00:23:22,850
+طب ليش زي الحمامة؟ اللي ربي حمامي بيعرف و اللي ما
+
+372
+00:23:22,850 --> 00:23:25,510
+ربيهاش أنا بدي أقولكوا الحمامة سبحان الله بطبيعة
+
+373
+00:23:25,510 --> 00:23:29,950
+دائما .. دائما لما بيجوا يشتريوا الزغليل بيحسوهاش
+
+374
+00:23:29,950 --> 00:23:33,960
+من ظهرها ولا من ثمه، لأ بيحسوها من صدرهاعلى اعتبار
+
+375
+00:23:33,960 --> 00:23:37,360
+انه هل فيها مثلا هالي لإن اللحمة بتكون جليلة جدا
+
+376
+00:23:37,360 --> 00:23:41,080
+فيها فايدتها عالي لكن قليلة شوية اللحمة فبيحسها من
+
+377
+00:23:41,080 --> 00:23:44,580
+الصدر فدائما الحمامة صدرها بيكون مرتفع يعني زي
+
+378
+00:23:44,580 --> 00:23:48,900
+اللي شاهقة لفوق شوية هذه ال issue او الارتفاع
+
+379
+00:23:48,900 --> 00:23:52,000
+بيخلق بعض الناس من كتر ما بيدخل او عنده COPD
+
+380
+00:23:52,000 --> 00:23:55,980
+chronic obstructive pulmonary disease او عنده ازمة
+
+381
+00:23:55,980 --> 00:24:00,100
+معضيقة نفس دائم واستخدام العضلات التنفسية لمساعدة
+
+382
+00:24:00,480 --> 00:24:04,220
+بصير صدره من قدام عامل زي صدر الحمامة طالع لفوق،
+
+383
+00:24:04,220 --> 00:24:08,100
+ليه؟ لأنه استخدم عضلات كتير زيادة على زوم أثناء
+
+384
+00:24:08,100 --> 00:24:12,120
+تنفس حياته، بعض الناس عندهم funnel زي البرميل،
+
+385
+00:24:12,120 --> 00:24:15,260
+صدره يكونفيه بعد .. بعد المرة بيكونوا spinal
+
+386
+00:24:15,260 --> 00:24:19,040
+deformity ايش؟ ال spinal نفس بيكون ايش؟ يعني بيصير
+
+387
+00:24:19,040 --> 00:24:23,900
+بعض التشوات اللي موجودة في العمود الفقري سموها
+
+388
+00:24:23,900 --> 00:24:28,140
+spinal deformities زي يمكن بعضكم ذكروا و اللي
+
+389
+00:24:28,140 --> 00:24:32,040
+ماذكرش انا بقوله اذا مامردش عليه زي حاجة اسمها
+
+390
+00:24:32,040 --> 00:24:37,560
+musculosis او kyphosis او lordosis اللي هو هذا كل
+
+391
+00:24:37,560 --> 00:24:41,540
+التلاتة lordosis او مثلامثلا scoliosis او kyphosis
+
+392
+00:24:41,540 --> 00:24:45,160
+هذول التلاتة اسم من ايه spinal deformities على
+
+393
+00:24:45,160 --> 00:24:48,800
+اعتبار ان بعض الناس بيكون مثنى للامام او بيكون
+
+394
+00:24:48,800 --> 00:24:52,380
+مثنى للخلف او مثنى على الجانب هذا العمود بيأثر على
+
+395
+00:24:52,380 --> 00:24:57,760
+تضاريس اللي هو منطقة الصدر للمريض طيب و اللي اسس
+
+396
+00:24:57,760 --> 00:25:01,920
+ribs ايش and anterior space on aspiration والانسان
+
+397
+00:25:01,920 --> 00:25:05,570
+بتنفسها وجد في anterior ribs في قدامي ايش هنافي
+
+398
+00:25:05,570 --> 00:25:08,410
+أمامي و أنا بتطلع في ال .. ال .. ال .. كلكم عارفين
+
+399
+00:25:08,410 --> 00:25:11,970
+الكارت ليش؟ لجيت في جنب الرياش، الرياش، هالجنب
+
+400
+00:25:11,970 --> 00:25:14,210
+الرياش هذي اللي موجودة في الصدر عامة في القفص
+
+401
+00:25:14,210 --> 00:25:17,570
+الصدري اللي يسمى القفص، بيطلع و ينزل، بقوللي في
+
+402
+00:25:17,570 --> 00:25:19,690
+بينهم ال inter spaces كلكم عارفين اللي ماخدنا في
+
+403
+00:25:19,690 --> 00:25:22,790
+ال anatomy، ال inter spaces بيقوللي يا نتوا إيه هو
+
+404
+00:25:22,790 --> 00:25:26,850
+بتنفس، اتشوف أنه لما بتنفس إيش بيصير؟ بيعطيك
+
+405
+00:25:26,850 --> 00:25:30,370
+معلومات أنه هل في obstruction ولا لأ في ال air
+
+406
+00:25:30,370 --> 00:25:34,060
+flow، يعني افرضوا الحوار الانسان قاعد بتنفسالان هو
+
+407
+00:25:34,060 --> 00:25:38,360
+مابتنفس اما لو ايش بيدغط الصدر .. بيدغط الصدر على
+
+408
+00:25:38,360 --> 00:25:42,160
+العضلات تبعته عشان يسحب النفس طيب لكن لو صار
+
+409
+00:25:42,160 --> 00:25:45,560
+bulging ايش يعني bulging يعني بدل ما ان ال inter
+
+410
+00:25:45,560 --> 00:25:48,640
+spaces تدخل لجوه صار bulging طالع لبره يعني طزت
+
+411
+00:25:48,640 --> 00:25:52,700
+لبره طيب ما زال طلعت لبره سواء اللي جت فيه مشكلة
+
+412
+00:25:52,700 --> 00:25:55,940
+خاصة في ال on expiration خاصة الإنسان اللي جت لما
+
+413
+00:25:55,940 --> 00:25:59,560
+احنا نقول العضلات شدت حالها سحبت النفس بعدين
+
+414
+00:25:59,560 --> 00:26:03,820
+العضلات بدأت تضغط عشان تطلع النفسالان انت الاصل
+
+415
+00:26:03,820 --> 00:26:07,060
+مانشوفش بالظبط إيش بيصير لإن دي حاجات داخلية، لكن
+
+416
+00:26:07,060 --> 00:26:10,820
+افرض وشوفنا إن في حاجة تطلع bulging خارجيا، معناه
+
+417
+00:26:10,820 --> 00:26:13,780
+في إيش هنا؟ إذا لاجينا إيش بتطلع لبرا، في
+
+418
+00:26:13,780 --> 00:26:17,800
+obstruction طب ال obstruction في حالة النفس الداخل
+
+419
+00:26:17,800 --> 00:26:22,600
+أو في حالة النفس اللي طالع، إيش بيعني هنا؟ بيعني
+
+420
+00:26:22,600 --> 00:26:26,360
+يمكن يكون في tumor، يمكن يكون في aneurysm، فتق
+
+421
+00:26:26,360 --> 00:26:31,370
+معين موجود في أي منطقة في ال respiratory systemأو
+
+422
+00:26:31,370 --> 00:26:34,630
+لا قدر الله cardiac enlargement زي في حالات ايش
+
+423
+00:26:34,630 --> 00:26:38,450
+فشل القلب و الفشل القلب هذا اللي هو فشل عضلة القلب
+
+424
+00:26:38,450 --> 00:26:42,490
+ممكن برضه تعمل ايش لأنه مش قادر تاخد النفس الطبيعي
+
+425
+00:26:42,490 --> 00:26:45,610
+اللي احنا بناخده مش قادر يعمل gas exchange فال
+
+426
+00:26:45,610 --> 00:26:48,950
+heart بيصير يسرع اكتر و اكتر و اكتر عشان يقدر يعمل
+
+427
+00:26:48,950 --> 00:26:51,570
+ايش compensatory mechanism فبيصير للأسف cardiac
+
+428
+00:26:51,570 --> 00:26:55,970
+failure طيب assess pattern of respiration بقولي
+
+429
+00:26:55,970 --> 00:26:59,890
+بدك تشوف ايه شرجت كيف النفس بقولي normally بشكل
+
+430
+00:26:59,890 --> 00:27:03,740
+طبيعيالرجال والأطفال يعني انا جيت ال pattern هذي
+
+431
+00:27:03,740 --> 00:27:06,840
+بشكل عام للحياة احنا قلنا دائما لما سقط الحياتنا
+
+432
+00:27:06,840 --> 00:27:10,800
+بدنا نفع مش بس للنجاح الرجال والأطفال بشكل عام
+
+433
+00:27:10,800 --> 00:27:14,760
+بيقولوا ليه النافس تبعهم diaphragmatically ايش انت
+
+434
+00:27:14,760 --> 00:27:17,600
+diaphragmatically طبعا أنا لفستها الاصل اقول
+
+435
+00:27:17,600 --> 00:27:21,760
+diaphragma ولكن لما تكون كلمة كاملة واضيف عليها
+
+436
+00:27:21,760 --> 00:27:25,800
+ماقدرش اقول diaphragmatically no diaphragmatically
+
+437
+00:27:25,800 --> 00:27:29,540
+على اعتبار ان سكن الأولى وحركنا الثانية واخدتها في
+
+438
+00:27:29,540 --> 00:27:33,420
+ال terminologyالان اش بقول يتنفس الأطفال و الرجال
+
+439
+00:27:33,420 --> 00:27:36,700
+انه الحجاب الحاجز هو اللي بتنفس يعني بتحس انه
+
+440
+00:27:36,700 --> 00:27:39,640
+بيطلع و بينزل بيطلع و بينزل هذا اسمه
+
+441
+00:27:39,640 --> 00:27:43,740
+diaphragmatically طيب النساء لأ سبحان الله بقول
+
+442
+00:27:43,740 --> 00:27:46,220
+النساء breathe ايه thoracically ايش هذا
+
+443
+00:27:46,220 --> 00:27:49,900
+thoracically و لكن النساء يتنفسوا في منطقة الصدر
+
+444
+00:27:49,900 --> 00:27:52,680
+and costally اول شيء يعني costally اللي هو ال
+
+445
+00:27:52,680 --> 00:27:56,130
+cartilageيعني اللي هو الغضايف، يعني بتحس الأم
+
+446
+00:27:56,130 --> 00:28:00,470
+سبحان الله والست بشكل عام والبنت تنافسها في منطقة
+
+447
+00:28:00,470 --> 00:28:04,190
+الصدر، هذا رحمة ربنا، يعني من الإعجاز العلمي في
+
+448
+00:28:04,190 --> 00:28:09,790
+هذه النقطة سبحان الله، أنه الست مرشحة تحمل، وصير
+
+449
+00:28:09,790 --> 00:28:13,670
+عندها بكرا زواج وحمل وولادة، اتخيلوا أن مقدش
+
+450
+00:28:13,670 --> 00:28:19,170
+الجنين وصل لـ 36، 37، 40 أسبوعضغط على النفس ربما
+
+451
+00:28:19,170 --> 00:28:23,230
+أكتر من ذلك فمش قادر يتخذ نفسه لو تخيلنا أن النفس
+
+452
+00:28:23,230 --> 00:28:26,550
+بتظل دهيه pragmatic زي الرجال بيصير كل ما تتنفس
+
+453
+00:28:26,550 --> 00:28:29,210
+تضغط على الجنين، تضغط على الجنين وممكن الجنين يموت
+
+454
+00:28:29,210 --> 00:28:33,350
+لكن رحمة ربنا أعطاها هذه الخاصية أنها تتنفس
+
+455
+00:28:33,350 --> 00:28:37,250
+بالتساع الصدر أو بالتساع القفص الصدري أكتر من قضية
+
+456
+00:28:37,250 --> 00:28:42,010
+اللي هو المزول للأسفل استجابة زي إيه للحجاب الحشد
+
+457
+00:28:42,010 --> 00:28:47,250
+زي الرجال، هذه من الأجازة العلمية طيبإذا عماله زاد
+
+458
+00:28:47,250 --> 00:28:50,690
+النفس كتير، إيش اسمه؟ تاكيبنية طبعا تاكيبنية وقت
+
+459
+00:28:50,690 --> 00:28:55,090
+إيش بنقولها إذا كان النفس أكتر من عشرين، عشرين نفس
+
+460
+00:28:55,090 --> 00:29:00,130
+في الدقيقة بردبنية إذا كان أقل من إيش، عشر يعني
+
+461
+00:29:00,130 --> 00:29:03,690
+كأنه بيقولي أنا بقدر أصبر لعند عشرة، أحداشر،
+
+462
+00:29:03,690 --> 00:29:07,770
+أتناشر، تمانتاشر، تسعتاشر، كل وضع بقدر أعتبره في
+
+463
+00:29:07,770 --> 00:29:11,250
+ال range لكن زاد عن العشرين تاكي، نزل عن العشرين
+
+464
+00:29:11,250 --> 00:29:15,520
+بردبنيةماحد يخربط المقرر يقولي predicardia، no
+
+465
+00:29:15,520 --> 00:29:20,140
+predipnia طيب، الآن palpation، بدنا نمد إيدينا و
+
+466
+00:29:20,140 --> 00:29:23,060
+نشوف palpate areas of the chest، يعني بنحط إيدينا
+
+467
+00:29:23,060 --> 00:29:26,320
+و نشوف كيف المنطقة حوالين الصدر هل في
+
+468
+00:29:26,320 --> 00:29:30,320
+abnormalities، في tumors، في nodules، في أي إشي
+
+469
+00:29:30,320 --> 00:29:33,460
+يعني اللي هو سبحان الله عامل مشكلة عشان إحنا نسجله
+
+470
+00:29:33,460 --> 00:29:36,960
+إيه في clients complaints؟ إذا و أنا .. اللي جيت
+
+471
+00:29:36,960 --> 00:29:40,870
+أنا قاعد إيش؟ بعمل palpationافرضه و انا قاعد بعمله
+
+472
+00:29:40,870 --> 00:29:43,810
+palpation شكل المريض يعني انا قاعد بعمل assessment
+
+473
+00:29:43,810 --> 00:29:47,950
+وصلت لمنطقة الصدر الأيمن الأيسر اي مكان قال لي لأ
+
+474
+00:29:47,950 --> 00:29:52,570
+stop انا هنا اتوجعت شوية هناش بقولي must palpated
+
+475
+00:29:52,570 --> 00:29:56,670
+carefully ايش يعني carefully على مهل بعناية و
+
+476
+00:29:56,670 --> 00:30:00,350
+براحة خاصة مناطق ال tenderness المناطق اللي فين
+
+477
+00:30:00,350 --> 00:30:03,410
+قلم و المناطق اللي فيها bulges ايش يعني bulges
+
+478
+00:30:03,410 --> 00:30:07,660
+يعني حاجات طالعة براأو ايش هنا movements of all
+
+479
+00:30:07,660 --> 00:30:09,320
+movements ايش هنا all movements بتاكى تشوف كل
+
+480
+00:30:09,320 --> 00:30:12,860
+الحركات يعني كأنه بيقوللي انت بتاكى تعمل palpation
+
+481
+00:30:12,860 --> 00:30:17,560
+normally لكل ال areas اللي موجودة حوالين ال chest
+
+482
+00:30:17,560 --> 00:30:21,220
+لكن اذا اتقلم المريض اصبر اذا لاجيت فيه
+
+483
+00:30:21,220 --> 00:30:24,100
+abnormalities اصبر اذا لاجيت bulging اصبر و هادى
+
+484
+00:30:24,100 --> 00:30:26,980
+عمل assessment بعناية عشان تقدر تدوّن عشان هيك
+
+485
+00:30:26,980 --> 00:30:31,860
+بتلاحظ الطبيب لما بيعمل assessment للمريضممكن يكون
+
+486
+00:30:31,860 --> 00:30:34,280
+عنده appendicitis، ماعملهوش assessment بس لما تخد
+
+487
+00:30:34,280 --> 00:30:37,080
+ال appendicitis، بيعمله complete abdominal
+
+488
+00:30:37,080 --> 00:30:40,280
+assessment و ultrasound و بيعمله و ممكن يعمله
+
+489
+00:30:40,280 --> 00:30:44,360
+standing chest x-ray أو abdomen x-ray و بعد هي
+
+490
+00:30:44,360 --> 00:30:49,160
+بيبدأ further examination أو assessment في منطقات
+
+491
+00:30:49,160 --> 00:30:51,480
+اللي هو ال right اللي هو ال hypochondrium عشان
+
+492
+00:30:51,480 --> 00:30:54,260
+يعمل assessment للمنطقة المؤلمة عشان بيخليها في
+
+493
+00:30:54,260 --> 00:30:59,690
+الآخر assessment of thoracic expansionخلّيني احنا
+
+494
+00:30:59,690 --> 00:31:03,390
+نتوقف عشان احنا بدنا نلتزم بالنصف ساعة بالظبط عشان
+
+495
+00:31:03,390 --> 00:31:05,990
+نكمل في المحاضرة القادمة ان شاء الله السلام عليكم
+
+496
+00:31:05,990 --> 00:31:06,830
+ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..02cf7f841972be91cc6256c1e81b697e5b4c6466
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xOAa7GrQdQU_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2352, "start": 1.18, "end": 23.52, "text": "بسم الله الرحمن الرحيم أبنائي و بنات الطلبة خلينا الآن نكمل مع محاضرات التقييم الصحي التمريضي فاليوم ان شاء الله ال chapter السابع هنتكلم على موضوع ال assessment of respiratory system طبعا احنا في الأول كانت كلها يمكن", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 5551, 3555, 1863, 16373, 1829, 4032, 4724, 8315, 2655, 41950, 46152, 3660, 16490, 1211, 9957, 995, 6024, 48506, 8717, 24793, 1211, 20449, 3714, 5016, 46958, 2288, 9307, 16712, 38436, 32640, 31767, 5016, 1829, 16712, 29973, 1829, 11242, 1829, 6156, 6027, 1829, 20498, 16472, 13412, 16606, 21984, 2423, 7187, 21136, 16758, 3615, 8032, 29399, 4117, 19528, 15844, 3714, 2407, 11242, 45367, 2423, 9687, 295, 27038, 1185, 23032, 3555, 3615, 995, 1975, 5016, 8315, 8978, 16247, 12610, 25961, 2655, 28242, 11296, 7251, 43020], "avg_logprob": -0.1111778878903651, "compression_ratio": 1.6409090909090909, "no_speech_prob": 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1832.04, "end": 1832.68, "word": " appendicitis،", "probability": 0.50054931640625}, {"start": 1832.68, "end": 1833.16, "word": " ماعملهوش", "probability": 0.71025390625}, {"start": 1833.16, "end": 1833.62, "word": " assessment", "probability": 0.7177734375}, {"start": 1833.62, "end": 1833.88, "word": " بس", "probability": 0.789794921875}, {"start": 1833.88, "end": 1834.1, "word": " لما", "probability": 0.80078125}, {"start": 1834.1, "end": 1834.28, "word": " تخد", "probability": 0.6774088541666666}, {"start": 1834.28, "end": 1834.34, "word": " ال", "probability": 0.10906982421875}, {"start": 1834.34, "end": 1834.9, "word": " appendicitis،", "probability": 0.759521484375}, {"start": 1834.9, "end": 1836.02, "word": " بيعمله", "probability": 0.70941162109375}, {"start": 1836.02, "end": 1836.58, "word": " complete", "probability": 0.73583984375}, {"start": 1836.58, "end": 1837.08, "word": " abdominal", "probability": 0.681640625}, {"start": 1837.08, "end": 1837.58, "word": " assessment", "probability": 0.85595703125}, {"start": 1837.58, "end": 1837.78, "word": " و", "probability": 0.8203125}, {"start": 1837.78, "end": 1838.24, "word": " ultrasound", "probability": 0.71044921875}, {"start": 1838.24, "end": 1838.62, "word": " و", "probability": 0.86328125}, {"start": 1838.62, "end": 1839.1, "word": " بيعمله", "probability": 0.874267578125}, {"start": 1839.1, "end": 1839.74, "word": " و", "probability": 0.560546875}, {"start": 1839.74, "end": 1839.98, "word": " ممكن", "probability": 0.9482421875}, {"start": 1839.98, "end": 1840.28, "word": " يعمله", "probability": 0.9840494791666666}, {"start": 1840.28, "end": 1841.06, "word": " standing", "probability": 0.489990234375}, {"start": 1841.06, "end": 1841.72, "word": " chest", "probability": 0.884765625}, {"start": 1841.72, "end": 1841.92, "word": " x", "probability": 0.66357421875}, {"start": 1841.92, "end": 1842.18, "word": "-ray", "probability": 0.876708984375}, {"start": 1842.18, "end": 1842.5, "word": " أو", "probability": 0.68701171875}, {"start": 1842.5, "end": 1842.86, "word": " abdomen", "probability": 0.935546875}, {"start": 1842.86, "end": 1843.08, "word": " x", "probability": 0.94873046875}, {"start": 1843.08, "end": 1843.3, "word": "-ray", "probability": 0.97802734375}, {"start": 1843.3, "end": 1843.94, "word": " و", "probability": 0.58544921875}, {"start": 1843.94, "end": 1844.14, "word": " بعد", "probability": 0.951171875}, {"start": 1844.14, "end": 1844.36, "word": " هي", "probability": 0.421875}, {"start": 1844.36, "end": 1846.28, "word": " بيبدأ", "probability": 0.8963623046875}, {"start": 1846.28, "end": 1847.02, "word": " further", "probability": 0.2034912109375}, {"start": 1847.02, "end": 1847.8, "word": " examination", "probability": 0.9599609375}, {"start": 1847.8, "end": 1847.98, "word": " أو", "probability": 0.67431640625}, {"start": 1847.98, "end": 1848.26, "word": " assessment", "probability": 0.86767578125}, {"start": 1848.26, "end": 1848.54, "word": " في", "probability": 0.92138671875}, {"start": 1848.54, "end": 1849.16, "word": " منطقات", "probability": 0.9395751953125}, {"start": 1849.16, "end": 1849.74, "word": " اللي", "probability": 0.93115234375}, {"start": 1849.74, "end": 1849.9, "word": " هو", "probability": 0.8837890625}, {"start": 1849.9, "end": 1849.94, "word": " ال", "probability": 0.89599609375}, {"start": 1849.94, "end": 1850.22, "word": " right", "probability": 0.8193359375}, {"start": 1850.22, "end": 1850.52, "word": " اللي", "probability": 0.938232421875}, {"start": 1850.52, "end": 1850.64, "word": " هو", "probability": 0.71875}, {"start": 1850.64, "end": 1850.74, "word": " ال", "probability": 0.5078125}, {"start": 1850.74, "end": 1851.14, "word": " hypochondrium", "probability": 0.6660400390625}, {"start": 1851.14, "end": 1851.48, "word": " عشان", "probability": 0.9192708333333334}, {"start": 1851.48, "end": 1851.7, "word": " يعمل", "probability": 0.9806315104166666}, {"start": 1851.7, "end": 1851.96, "word": " assessment", "probability": 0.9013671875}, {"start": 1851.96, "end": 1853.2, "word": " للمنطقة", "probability": 0.86181640625}, {"start": 1853.2, "end": 1853.64, "word": " المؤلمة", "probability": 0.87939453125}, {"start": 1853.64, "end": 1853.78, "word": " عشان", "probability": 0.9609375}, {"start": 1853.78, "end": 1854.16, "word": " بيخليها", "probability": 0.756005859375}, {"start": 1854.16, "end": 1854.26, "word": " في", "probability": 0.919921875}, {"start": 1854.26, "end": 1854.6, "word": " الآخر", "probability": 0.9226888020833334}, {"start": 1854.6, "end": 1856.32, "word": " assessment", "probability": 0.129638671875}, {"start": 1856.32, "end": 1856.7, "word": " of", "probability": 0.9677734375}, {"start": 1856.7, "end": 1857.24, "word": " thoracic", "probability": 0.9807942708333334}, {"start": 1857.24, "end": 1857.86, "word": " expansion", "probability": 0.96484375}], "temperature": 1.0}, {"id": 72, "seek": 186683, "start": 1858.97, "end": 1866.83, "text": "خلّيني احنا نتوقف عشان احنا بدنا نلتزم بالنصف ساعة بالظبط عشان نكمل في المحاضرة القادمة ان شاء الله السلام عليكم ورحمة الله وبركاته", "tokens": [9778, 1211, 11703, 9957, 1829, 1975, 5016, 8315, 8717, 2655, 30543, 5172, 6225, 8592, 7649, 1975, 5016, 8315, 47525, 8315, 8717, 1211, 2655, 11622, 2304, 20666, 1863, 9381, 5172, 8608, 995, 27884, 20666, 19913, 3555, 9566, 6225, 8592, 7649, 8717, 24793, 1211, 8978, 9673, 5016, 46958, 25720, 25062, 18513, 46007, 16472, 13412, 16606, 21984, 21136, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.13032155192416647, "compression_ratio": 1.6666666666666667, "no_speech_prob": 2.980232238769531e-07, "words": [{"start": 1858.97, "end": 1859.57, "word": "خلّيني", "probability": 0.80078125}, {"start": 1859.57, "end": 1859.69, "word": " احنا", "probability": 0.6389973958333334}, {"start": 1859.69, "end": 1860.09, "word": " نتوقف", "probability": 0.990234375}, {"start": 1860.09, "end": 1860.35, "word": " عشان", "probability": 0.96240234375}, {"start": 1860.35, "end": 1860.55, "word": " احنا", "probability": 0.8714192708333334}, {"start": 1860.55, "end": 1860.79, "word": " بدنا", "probability": 0.778076171875}, {"start": 1860.79, "end": 1861.17, "word": " نلتزم", "probability": 0.9912109375}, {"start": 1861.17, "end": 1861.81, "word": " بالنصف", "probability": 0.940673828125}, {"start": 1861.81, "end": 1862.39, "word": " ساعة", "probability": 0.9552408854166666}, {"start": 1862.39, "end": 1862.89, "word": " بالظبط", "probability": 0.9937744140625}, {"start": 1862.89, "end": 1863.39, "word": " عشان", "probability": 0.718505859375}, {"start": 1863.39, "end": 1863.71, "word": " نكمل", "probability": 0.9807942708333334}, {"start": 1863.71, "end": 1863.79, "word": " في", "probability": 0.92822265625}, {"start": 1863.79, "end": 1864.23, "word": " المحاضرة", "probability": 0.9735107421875}, {"start": 1864.23, "end": 1865.11, "word": " القادمة", "probability": 0.9737955729166666}, {"start": 1865.11, "end": 1865.19, "word": " ان", "probability": 0.41259765625}, {"start": 1865.19, "end": 1865.37, "word": " شاء", "probability": 0.969482421875}, {"start": 1865.37, "end": 1865.45, "word": " الله", "probability": 0.94482421875}, {"start": 1865.45, "end": 1865.75, "word": " السلام", "probability": 0.83447265625}, {"start": 1865.75, "end": 1865.99, "word": " عليكم", "probability": 0.902099609375}, {"start": 1865.99, "end": 1866.21, "word": " ورحمة", "probability": 0.873046875}, {"start": 1866.21, "end": 1866.35, "word": " الله", "probability": 0.96533203125}, {"start": 1866.35, "end": 1866.83, "word": " وبركاته", "probability": 0.9869140625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1867.627375, "duration_after_vad": 1841.7934687499956}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1130446b4f0a83203235c741533d66f18bd2140e
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4.srt
@@ -0,0 +1,1725 @@
+1
+00:00:01,550 --> 00:00:05,550
+بسم الله الرحمن الرحيم اليوم طبعا هنبدأ في ال
+
+2
+00:00:05,550 --> 00:00:10,490
+chapter السادس ونبدأ
+
+3
+00:00:10,490 --> 00:00:13,690
+طبعا بالـ إيه؟ زي ما أنتم شايفين أنا قدامكم head
+
+4
+00:00:13,690 --> 00:00:17,750
+assessment طبعا احنا الحمد لله خلصنا في الـ chapter
+
+5
+00:00:17,750 --> 00:00:22,610
+السابق لما تكلمنا على الـ position بشكل عام، ولما
+
+6
+00:00:22,610 --> 00:00:27,030
+بدينا في الـ assessment، أخدنا الـ hair، أخدنا الـ skin
+
+7
+00:00:27,030 --> 00:00:31,710
+طبعا بداية من الـ head tattoo زي ما احنا قلنا، بعدين
+
+8
+00:00:31,710 --> 00:00:36,890
+كدا ندخل شوية شوية في إيش؟ في أجزاء الجسم، طبعا احنا
+
+9
+00:00:36,890 --> 00:00:39,790
+بنتكلم على physical examination عشان احنا نكون
+
+10
+00:00:39,790 --> 00:00:43,410
+عارفين من الـ physical assessment، أول حاجة في الـ
+
+11
+00:00:43,410 --> 00:00:47,550
+head assessment، إيش بقول هنا؟ بقول inspects for size
+
+12
+00:00:47,550 --> 00:00:52,510
+أول حاجة، تطلع على حجم الرأس، shape الشكل، الـ contour
+
+13
+00:00:52,510 --> 00:00:57,370
+يعني كيف تضاريس الرأس يعني، ولقدام هقول لكم إيش
+
+14
+00:00:57,370 --> 00:01:01,360
+بنقصد فيه الـ contour، الـ Skull جنرالي، إيش بقول هنا؟
+
+15
+00:01:01,360 --> 00:01:04,660
+هنا؟ round، يبقى هي الـ contours بقول هنا round
+
+16
+00:01:04,660 --> 00:01:07,900
+anterior and posterior prominences، إيش يعني
+
+17
+00:01:07,900 --> 00:01:10,980
+anterior and posterior prominences؟ يعني سبحان الله
+
+18
+00:01:10,980 --> 00:01:16,120
+كأنه بيقول الرأس يعني أقرب للبيضاوي، فيه نتوئات
+
+19
+00:01:16,120 --> 00:01:20,660
+أمامية، ونتوءات في الخلف، بعض الناس طبعا مختلفة
+
+20
+00:01:20,660 --> 00:01:25,500
+ممكن يكون يعني بشكل دائري، أكبر في شكل زي مستطيل، أو
+
+21
+00:01:25,500 --> 00:01:29,680
+مطاول أكثر، وهكذا، الـ large infants head يعني الرأس
+
+22
+00:01:29,680 --> 00:01:34,100
+الكبير في الأطفال، في الصغار، إيش اسمه؟ بيكون السبب
+
+23
+00:01:34,100 --> 00:01:37,760
+هيدروسيفيلس، استسقاء الرأس، يعني لو شفنا طفل صغير
+
+24
+00:01:37,760 --> 00:01:41,620
+جدا، لما راح نضربه، ممكن نشوف حالات زي هيك، ولجينا
+
+25
+00:01:41,620 --> 00:01:45,700
+إن الرأس تبعه يعني أكبر من اللازم، بنقول عنده
+
+26
+00:01:45,700 --> 00:01:49,220
+هيدروسيفيلس، أما ده شفناه عند الكبار، يعني إنسان
+
+27
+00:01:49,220 --> 00:01:55,100
+كبير في السن، لكن إيه؟ عنده large large size of the
+
+28
+00:01:55,100 --> 00:01:59,480
+head، إيش بنقول عنه؟ أنا خاصة يعني هو بيقول ممكن يكون
+
+29
+00:01:59,480 --> 00:02:02,500
+إيش؟ خاصة الـ head، والـ facial bones، إيش بيكون عنده؟
+
+30
+00:02:02,500 --> 00:02:06,980
+أكروميجالي، أكروميجالي يعني إيش؟ العمالقة، بيكون هو
+
+31
+00:02:06,980 --> 00:02:11,060
+يعني هذا عنده نوع من شوية hormonal disturbance، و
+
+32
+00:02:11,060 --> 00:02:15,080
+عمل له إيش؟ وعمل له إيش؟ زي عملاقة، وكبر في الرأس، و
+
+33
+00:02:15,080 --> 00:02:19,960
+محيط الرأس، زي باقي أعضاء الجسم، أول شيء، ببقى الـ base
+
+34
+00:02:19,960 --> 00:02:24,340
+of the skull for nodules or masses، بنحط دي هنا
+
+35
+00:02:24,340 --> 00:02:27,980
+بنبدأ نحس اللي هو فروة الرأس، والمنطقة بتاعة
+
+36
+00:02:27,980 --> 00:02:33,260
+الرأس نفسها، هل في nodules؟ يعني حاجات طالعة بارزة؟
+
+37
+00:02:33,260 --> 00:02:38,120
+هل في في الجلد خاصة؟ هل في masses لا قدر الله؟ هل في
+
+38
+00:02:38,120 --> 00:02:41,760
+عنده tumors أو شيء من هذا القبيل؟ أو لأ، طيب
+
+39
+00:02:41,760 --> 00:02:46,560
+assessment of the eye، لقيت أول شيء موجود عندنا في
+
+40
+00:02:46,560 --> 00:02:50,740
+الـ head، وهو الرأس، العين، طبعا هذه بس من باب
+
+41
+00:02:50,740 --> 00:02:55,780
+التشريح، ونذكركم تذكرة، طبعا أنا أعتقد أخذتوها في
+
+42
+00:02:55,780 --> 00:03:01,120
+التشريح أنتم، في تشريح واحد، و.. و يعني مروا
+
+43
+00:03:01,120 --> 00:03:03,980
+عليكم كثير، وإن شاء الله لما تروحوا العملي هتشوفوا
+
+44
+00:03:03,980 --> 00:03:07,280
+كمان يعني، بعضكم اللي ما نسيش في العيون هيتذكر كمان
+
+45
+00:03:07,280 --> 00:03:10,740
+هذه الكلمات باختصار، احنا هذا اللي أنتم شايفينه
+
+46
+00:03:10,740 --> 00:03:13,960
+إيه؟ العين بشكل عام، اللي يهمنا الآن، طبعا هذه
+
+47
+00:03:13,960 --> 00:03:17,660
+القرنية اللي هي قدام، الأمام، وهذا.. هذه القرنية
+
+48
+00:03:17,660 --> 00:03:22,850
+زي ما تشوفوها، طبعا هذه المنطقة اللي هنا كلها اللي
+
+49
+00:03:22,850 --> 00:03:26,270
+بتلمس اللي جوا، بتتكلم اللي من هذا الطرف، هذا اسمه
+
+50
+00:03:26,270 --> 00:03:30,610
+الـ sclera، الصلبة، اللي هي الجسم الأبيض، طبعا جوا في
+
+51
+00:03:30,610 --> 00:03:34,530
+السائل الزجاجي، في هذا المكان اسمه vitreous، في هنا
+
+52
+00:03:34,530 --> 00:03:38,850
+.. هنا اللي ملتصق من الداخل، اللي ملتصق من الداخل
+
+53
+00:03:38,850 --> 00:03:43,650
+هذا اسمه retina، اللي هو الشبكية، وهنا إيه؟ الـ optic
+
+54
+00:03:43,650 --> 00:03:48,350
+nerve، اللي هو العصب البصري، الـ optic nerve، في هنا
+
+55
+00:03:48,350 --> 00:03:52,840
+حاجة اسمها إيش؟ الجسم الأصفر، اسمها الماكولا، اللي هو
+
+56
+00:03:52,840 --> 00:03:56,820
+مركز الإبصار، مركز الإبصار، الإنسان بيقدر يشوف كل
+
+57
+00:03:56,820 --> 00:04:00,420
+شيء بينعكس جوا، إلا إذا انعكس على هذا المكان، بيقدرش
+
+58
+00:04:00,420 --> 00:04:04,060
+يشوفه، لإيه؟ لأن الإنسان ما يقدرش يعني، زي حكاية المعدة
+
+59
+00:04:04,060 --> 00:04:08,320
+ما بتهضم حالها، والعين ما بتشوف حالها، طبعا هذا بيكون
+
+60
+00:04:08,320 --> 00:04:12,340
+الـ pupil، وهذا الـ lens، وراها هذه العدسة، اللي
+
+61
+00:04:12,340 --> 00:04:15,280
+لما شوية بيصير فيها شوية deformity، أو فيها
+
+62
+00:04:15,280 --> 00:04:19,300
+discoloration، بيصير عندهم بعض الناس، كاتراكت، اللي هو
+
+63
+00:04:19,300 --> 00:04:25,410
+الماء الأبيض، وطبعا في حواليها يعني دائرة حواليها
+
+64
+00:04:25,410 --> 00:04:30,490
+ماسكة الـ lens، اسمها الـ iris، اللي هي القزحية، اللي بتعمل
+
+65
+00:04:30,490 --> 00:04:33,810
+لون العين، هذا فقط من باب التشريح تبع العين، اللي
+
+66
+00:04:33,810 --> 00:04:37,270
+يهمنا هنا إن أنا كيف بتعمل assessment للعين، أول
+
+67
+00:04:37,270 --> 00:04:39,970
+حاجة، عشان بتعمل assessment، بتستخدم حاجة اسمها
+
+68
+00:04:39,970 --> 00:04:43,430
+Snellen chart، الـ Snellen chart، كلكم بتعرفوها، هي
+
+69
+00:04:43,430 --> 00:04:47,830
+عبارة عن لوحة النظر، بيسموها، اللي دائما بتطلع عليه
+
+70
+00:04:47,830 --> 00:04:51,930
+الإنسان، إما حرف زي الـ E، أو حرف C، أو مثلا أشكال
+
+71
+00:04:51,930 --> 00:04:55,450
+معينة، وبيجي.. بيسأل المريض، بيسأل.. بيسأل الطبيب
+
+72
+00:04:55,450 --> 00:04:59,370
+بيسأل المريض، وين فتحة هذا الحرف؟ وين اتجاه هذا
+
+73
+00:04:59,370 --> 00:05:03,290
+الحرف؟ عشان يقدر يأكد إنه كده في عنده مشكلة أو لأ
+
+74
+00:05:03,290 --> 00:05:08,270
+طبعا احنا، وإحنا بنعمل assessment للعيون، طب افرض
+
+75
+00:05:08,270 --> 00:05:12,970
+أنا ما عنديش Snellen chart، ما عنديش Snellen chart
+
+76
+00:05:14,600 --> 00:05:18,320
+يعني أنا موجود في المستشفى، اتفاجأت إنه إيش؟ طب بده
+
+77
+00:05:18,320 --> 00:05:21,520
+أشوف إنه بصر المريض كويس ولا ما عنده؟ لوحة إشارات زي
+
+78
+00:05:21,520 --> 00:05:25,060
+الشفاء، أو مستشفى ناصر، أو أي مستشفى، بقول لي في مرات
+
+79
+00:05:25,060 --> 00:05:29,280
+بنعمل حاجة اسمها chart إيش هنا؟ أو newsprint، إيش
+
+80
+00:05:29,280 --> 00:05:33,120
+newsprint؟ يعني احنا ممكن نجيب له جريدة زي جريدة، أو
+
+81
+00:05:33,120 --> 00:05:37,720
+بنعمل له ملف، يعني احنا ممكن آجي أقول له: لو سمحت، ممكن
+
+82
+00:05:37,720 --> 00:05:40,120
+تقرا.. ممكن.. عشان أنا بدي أشوف المريض بيشوف
+
+83
+00:05:40,120 --> 00:05:44,220
+كويس ولا لأ، بقول: ممكن تقرأ اللي في الملف، ممكن أنتَ
+
+84
+00:05:44,220 --> 00:05:48,320
+تتطلع في هذه الورقة، أو في هذه الجريدة، الطبيعي
+
+85
+00:05:48,320 --> 00:05:52,000
+البني آدم الطبيعي، يكون البعد بين اللي بديه يقراه، وبين
+
+86
+00:05:52,000 --> 00:05:55,200
+بين عينه، 25 سم، يعني خلينا نقول زي شبر
+
+87
+00:05:55,200 --> 00:05:58,640
+يعني لما نقول شبر، هيك كبير تقريبا، وزيادة 2
+
+88
+00:05:58,640 --> 00:06:01,920
+3 سم، هيك الطبيعي، لكن لو قريب معناته مشكلة، و
+
+89
+00:06:01,920 --> 00:06:05,440
+لو بعيد معناته مشكلة، طبعا في بعض الحالات، بنعمل حاجة
+
+90
+00:06:05,440 --> 00:06:09,380
+بسموها cover card، إيش cover card؟ عشان نتأكد إن
+
+91
+00:06:09,380 --> 00:06:15,800
+العينين كويسات، بنفحص العين، وبعدين بنفحص العين
+
+92
+00:06:15,800 --> 00:06:19,380
+التانية، كيف يعني؟ يعني إحنا بنغطي مثلا العين
+
+93
+00:06:19,380 --> 00:06:23,000
+الشمال، وبنفحص اليمين، وبعدين بنغطي العين اليمين، و
+
+94
+00:06:23,000 --> 00:06:26,900
+بنفحص الشمال، هذا اسمه cover card، طبعا بعدين
+
+95
+00:06:26,900 --> 00:06:30,200
+بنستخدم الـ penlight اللي قلنا عنه، احنا مش شغلنا
+
+96
+00:06:30,200 --> 00:06:34,740
+شغل طبيب اختصاصي، بنستخدم الـ ophthalmoscope، بقول: ask
+
+97
+00:06:34,740 --> 00:06:38,460
+your client about، لازم نسأل المريض عن إيش؟ history
+
+98
+00:06:38,460 --> 00:06:42,580
+of previous eye surgery، هل عمرك عملت عملية جراحية
+
+99
+00:06:42,580 --> 00:06:47,860
+في عينك؟ هل اتعرضت لـ trauma؟ يعني اتعرضت لإصابة، ضربة؟
+
+100
+00:06:47,860 --> 00:06:51,820
+هل استخدمت حاجة اسمها corrective glass؟ اللي هي
+
+101
+00:06:51,820 --> 00:06:57,060
+النضارات اللي بتعمل تصحيح، النضارات المصححة، زي بعض
+
+102
+00:06:57,060 --> 00:07:02,120
+النضارات الطبية يعني، أو لبست contact lenses، الـ
+
+103
+00:07:02,120 --> 00:07:04,600
+contact lenses، أنا ما بأقصد العدسات اللاصقة
+
+104
+00:07:04,600 --> 00:07:09,260
+التجميلية، وإنما العدسات اللاصقة العلاجية، اللي ممكن
+
+105
+00:07:09,260 --> 00:07:13,760
+إيش؟ تعالج بعض العيوب الانكسارية اللي موجودة عند
+
+106
+00:07:13,760 --> 00:07:17,320
+الإنسان، بنسأله: هل عندك blurred vision؟ عمره كان
+
+107
+00:07:17,320 --> 00:07:21,360
+زغللة في النظر؟ دبلوبيا، ازدواجية في النظر؟
+
+108
+00:07:21,360 --> 00:07:25,520
+Strabismus، Strabismus معناته squint، معناته بالعربي
+
+109
+00:07:25,520 --> 00:07:30,550
+الحول، هل في عندك حول؟ recent changes in vision؟ هل
+
+110
+00:07:30,550 --> 00:07:36,470
+اتغير حديثا النظر عندك؟ حسيت نظرك ضعف آخر أشهر، خاصة
+
+111
+00:07:36,470 --> 00:07:41,150
+آخر ست شهور؟ آه، والله صار، طب متى؟ طب وقت إيش أنتَ
+
+112
+00:07:41,150 --> 00:07:46,010
+عملت vision test؟ متعملت فحص للنظر؟ في عندك
+
+113
+00:07:46,010 --> 00:07:49,890
+allergies معينة؟ طبعا إيش allergies هنا؟ دخلة في
+
+114
+00:07:49,890 --> 00:07:53,660
+العين، في بعض الناس عندهم حساسية في عينهم
+
+115
+00:07:53,660 --> 00:07:57,620
+لأشياء محددة، بقول لك: والله أنا إذا اجى غبار على عيني
+
+116
+00:07:57,620 --> 00:08:00,880
+بيصير عندي حساسية، أنا لو أنا أخدت أي جودر معينة
+
+117
+00:08:00,880 --> 00:08:03,380
+بيصير عندي حساسية، بدنا نسأل في شكل عام: هل في عندك
+
+118
+00:08:03,380 --> 00:08:08,920
+حساسية ولا لأ؟ بيصير عندك احمرار في العين؟ أو frequent
+
+119
+00:08:08,920 --> 00:08:12,830
+watering discharge؟ يعني هل بتحسوا إن هيك كتير
+
+120
+00:08:12,830 --> 00:08:16,710
+بتدمعوا؟ طبعا لما نكون كتير بندمع، مش يجيب بالنا
+
+121
+00:08:16,710 --> 00:08:21,610
+إنّه بس هي دموعه فقط، لأ، ممكن تكون القناة مجرد دمع
+
+122
+00:08:21,610 --> 00:08:26,190
+مغلقة، مش موضوعنا الآن، later on هنتكلم عنها، طيب
+
+123
+00:08:26,190 --> 00:08:30,430
+العيون، أول حاجة فيه external organs، وفي internal
+
+124
+00:08:30,430 --> 00:08:33,690
+organs، أنا بتكلم بنفس الـ eye، الـ external eye
+
+125
+00:08:33,690 --> 00:08:37,390
+structure، زي إيش اللي أنا بشوفه من بره؟ هذا اسمه
+
+126
+00:08:37,390 --> 00:08:41,290
+external، أول ما أطلع في عين المريض، وبقدر أشوفه
+
+127
+00:08:41,290 --> 00:08:45,690
+الـ eyelids، والـ pupil، العين، الـ iris، القزحية، الـ visual acuity
+
+128
+00:08:45,690 --> 00:08:49,690
+حدة الإبصار، اسمها كده، بصرف أشوفها كويسة ولا لأ
+
+129
+00:08:49,690 --> 00:08:54,670
+ocular movements، ocular movements يعني بإيش؟ بأشوف
+
+130
+00:08:54,670 --> 00:08:59,550
+إيه؟ بأشوف كده حركة العين، هي الصححات، يعني بتحرك شمال
+
+131
+00:08:59,550 --> 00:09:02,590
+يمين، فوق، لتحت، اللي فيه مشكلة، بدي أشوف حاجة اسمها
+
+132
+00:09:02,590 --> 00:09:06,220
+peripheral vision، اللي هو visual peripheral vision
+
+133
+00:09:06,220 --> 00:09:10,400
+اسمها مجال الرؤية، أو الرؤية الطرفية، يعني لما بتطلع
+
+134
+00:09:10,400 --> 00:09:14,420
+فيه، شايف اللي حواليه، هذا اسمه peripheral vision، ولا
+
+135
+00:09:14,420 --> 00:09:18,420
+بس بتطلع، بشوف اللي قدامه فقط، أما الـ internal eye
+
+136
+00:09:18,420 --> 00:09:22,820
+structure ما بقدرش أشوفهم، زي إيش؟ ممكن الـ iris أنا
+
+137
+00:09:22,820 --> 00:09:26,500
+أشوفه، الـ retina لأ، by the ophthalmoscope
+
+138
+00:09:26,500 --> 00:09:30,660
+الـ macula، اللي جوا، عن الجسم الأصفر، والـ optic
+
+139
+00:09:30,660 --> 00:09:35,070
+nerve، وهكذا، كلّه ما بقدرش أشوفه، إلا بالـ ophthalmoscope
+
+140
+00:09:35,070 --> 00:09:38,890
+- ophthalmoscope، مش شغلي أنا، بس أقدر أعمل assessment
+
+141
+00:09:38,890 --> 00:09:44,510
+for external eye organs، بيكون كويس، طيب consider the
+
+142
+00:09:44,510 --> 00:09:48,790
+following factors، يجب أن تأخذ باعتبار العوامل
+
+143
+00:09:48,790 --> 00:09:54,510
+التالية، الـ age، use of corrective lens، متى استخدمت
+
+144
+00:09:54,510 --> 00:09:59,830
+في عمرك النضارات الطبية والتصحيحية؟ هل ركبت عين
+
+145
+00:09:59,830 --> 00:10:04,660
+يعني كان عندك إصابة؟ بعض الناس بيصير الـ gun shot، أو
+
+146
+00:10:04,660 --> 00:10:08,120
+لا سمح الله، الـ severe trauma، بتروح العين، فبركّبوا له
+
+147
+00:10:08,120 --> 00:10:11,860
+artificial eye، عين زجاجية، إحنا بيقولوا عين زجاجية
+
+148
+00:10:11,860 --> 00:10:14,440
+ممكن تكون أي مادة، plastic كده، بس المهم عين
+
+149
+00:10:14,440 --> 00:10:18,960
+allergies؟ عندك حساسية؟ عندك ألم؟ بين visual
+
+150
+00:10:18,960 --> 00:10:23,990
+disturbances؟ طيب، أي اضطراب في إيه؟ في الرؤية؟ الـ
+
+151
+00:10:23,990 --> 00:10:27,130
+health related factors، يعني يقصد هنا: هل في عندك
+
+152
+00:10:27,130 --> 00:10:30,170
+أمراض معينة أثرت على النظر؟ زي موضوع الـ blood
+
+153
+00:10:30,170 --> 00:10:33,930
+pressure، وزي موضوع الـ diabetes mellitus، مع الـ
+
+154
+00:10:33,930 --> 00:10:37,790
+chronicity، يعني مع الزمان، المرض المزمن الطويل
+
+155
+00:10:37,790 --> 00:10:42,190
+بيأثر برضه على العين، وعلى حدة البصر، وعلى شبكية
+
+156
+00:10:42,190 --> 00:10:46,930
+العين، assessment of external eye structure، أول
+
+157
+00:10:46,930 --> 00:10:50,760
+حاجة، بدنا نشوف الـ position، يعني وضع العين، الـ
+
+158
+00:10:50,760 --> 00:10:54,300
+alignment، جاي وين بالظبط؟ كلمة alignment يعني وين
+
+159
+00:10:54,300 --> 00:10:57,640
+in general؟ وين بالظبط؟ يعني هل هي central or not؟
+
+160
+00:10:57,640 --> 00:11:01,260
+يعني وين بالظبط جاي شكل العين وتركيبة العين؟ في
+
+161
+00:11:01,260 --> 00:11:05,220
+الوسط ولا لأ؟ بنشوف الـ eyebrows، إيش كمان؟ الـ
+
+162
+00:11:05,220 --> 00:11:10,240
+eyebrows، اللي هو الحواجب تبعات العين، الـ eyelids
+
+163
+00:11:10,240 --> 00:11:14,790
+بعدين الرموش، الـ eyelashes، يعني احنا بنتكلم الـ
+
+164
+00:11:14,790 --> 00:11:20,390
+eyelashes، رموش العين، والـ eyelids اللي هو الجفون
+
+165
+00:11:20,390 --> 00:11:25,510
+العين، الأعلى والأسفل، الـ lacrimal glands، الغدد اللي
+
+166
+00:11:25,510 --> 00:11:29,670
+هي الدمعية، الـ pupils and iris، كل هذا بقدر أشوفه، و
+
+167
+00:11:29,670 --> 00:11:32,690
+أنا بعمل إيش assessment؟ احنا عارفين إنه مش شغلنا
+
+168
+00:11:32,690 --> 00:11:36,370
+الأساسي، واحنا مش تمريض عيون، ولكن أنا كويس إنّي
+
+169
+00:11:36,370 --> 00:11:40,450
+أقدر أقارن، إذا في كان gross abnormality، يعني شيء
+
+170
+00:11:
+
+223
+00:15:22,840 --> 00:15:25,960
+نجي يغطي ما يضغطش كتير على عينه لأنه ممكن مع
+
+224
+00:15:25,960 --> 00:15:28,840
+الضغط كتير على العين لما يفتح ما يقدرش يشوف كويس
+
+225
+00:15:28,840 --> 00:15:31,460
+بس مجرد أنه just to cover يعني ممكن يكون بورقة
+
+226
+00:15:31,460 --> 00:15:36,200
+خارجية ما تكونش ضغطة على العين نفسها، واحنا بنعمل إيه؟
+
+227
+00:15:36,200 --> 00:15:39,900
+كمان assessment of extraocular movement بنشوف
+
+228
+00:15:39,900 --> 00:15:42,900
+الحركات الخارجية في العين طبعا، كيف بنشوفها by
+
+229
+00:15:42,900 --> 00:15:46,500
+asking the client زي ما هو كاتب هنا، اللغة كتبت لـ
+
+230
+00:15:46,500 --> 00:15:49,380
+hold his head and follow movements of your
+
+231
+00:15:49,380 --> 00:15:53,840
+forefinger، بنرفع إصبعنا وبنقول لو سمحت اتطلع في
+
+232
+00:15:53,840 --> 00:15:57,760
+إصبعنا وحاول تلف عينك حوالين إيش الأصبع، وإين
+
+233
+00:15:57,760 --> 00:16:02,080
+بيلف، يعني كأنه بنقوله ألحج الأصبع، طبعا مش يلحج
+
+234
+00:16:02,080 --> 00:16:05,510
+بالأصبع، يعني كأنه بدي يجي يلحج الأصبع، لأ، عينه
+
+235
+00:16:05,510 --> 00:16:09,590
+تتجه مرة شمال، مرة يمين، مرة لفوق، لتحت عشان نشوف إيه
+
+236
+00:16:09,590 --> 00:16:13,470
+الـ extraocular movements، هل في عنده حركات زائدة
+
+237
+00:16:13,470 --> 00:16:17,990
+للعين عشان نكشف عنده حول ولا لأ؟ طيب الـ visual
+
+238
+00:16:17,990 --> 00:16:21,590
+field اللي بيسموه إيش هنا؟ مجال الرؤية لما نقول
+
+239
+00:16:21,590 --> 00:16:25,160
+peripheral vision أو visual field، مجال الرؤية، الأمر
+
+240
+00:16:25,160 --> 00:16:29,100
+...الأمر مش صعب كتير ولو كنا احنا أمامكم هتكون
+
+241
+00:16:29,100 --> 00:16:32,680
+الأمور بسيطة جدا وممكن احنا... يعني نلاقيها على
+
+242
+00:16:32,680 --> 00:16:36,040
+اليوتيوب ببعض الفيديوهات البسيطة جدا، عموما باختصار
+
+243
+00:16:36,040 --> 00:16:40,620
+عشان احنا نفهم بيكون إيه المريض والطبيب واقفين على
+
+244
+00:16:40,620 --> 00:16:44,420
+بعد بعض، المسافة اللي بينهم تقريبا نقول حوالي متر
+
+245
+00:16:44,420 --> 00:16:47,480
+وعشرين سنتي، زي مائة وعشرين سنتي، الإتنين
+
+246
+00:16:47,480 --> 00:16:50,080
+بيتطلعوا في بعض، تخيلوا معايا كأنه احنا فتحنا إيدينا
+
+247
+00:16:50,080 --> 00:16:54,420
+الإتنين، الإيد اليمين هي المريض، والإيد اليسار هو
+
+248
+00:16:54,420 --> 00:16:57,600
+الطبيب، إذا وجدت المسافة بين الإتنين، الإتنين بتطلع
+
+249
+00:16:57,600 --> 00:17:01,820
+في بعض، المسافة بينهم متر وعشرين سنتي تقريبا،
+
+250
+00:17:01,820 --> 00:17:05,800
+الآن إيش بقوله؟ الطبيب بيغطي عينه، إيه؟ الطبيب
+
+251
+00:17:05,800 --> 00:17:10,180
+بيغطي عينه اليمين، والمريض اللي على جمبَه بيغطي
+
+252
+00:17:10,180 --> 00:17:14,000
+عينه الشمال، نتخيل ممكن نعمله وأنا على المرايا، و
+
+253
+00:17:14,000 --> 00:17:17,040
+أنا على المرايا الآن، أول حاجة بيغطي إيه؟ إتقولنا
+
+254
+00:17:17,040 --> 00:17:21,530
+الطبيب عينه إيه؟ اليمين، لكن المريض بيغطي عينه
+
+255
+00:17:21,530 --> 00:17:26,390
+الشمال، وإيش بيقوله الآن؟ بيمسك قلم بإيده اللي هو
+
+256
+00:17:26,390 --> 00:17:30,690
+الطبيب، وبيقعد يلف الآن، يلف القلم، وبيقوله إيش؟
+
+257
+00:17:30,690 --> 00:17:35,190
+اتطلع بعينك اليمين، بيقول للمريض، اتطلع بعينك
+
+258
+00:17:35,190 --> 00:17:38,370
+اليمين على القلم، وين بيلف، ليه مهم إني بيحكي زي
+
+259
+00:17:38,370 --> 00:17:42,810
+ذلك؟ كل واحد فينا، اتخيل معايا إيش المقصود، لحركة
+
+260
+00:17:42,810 --> 00:17:46,890
+هتفهمها الآن، لو أنا بتطلع قاعد على التلفزيون قدامي
+
+261
+00:17:46,890 --> 00:17:51,170
+أو أنا بتطلع على الجوال، وأنا بنظر للجوال شايف
+
+262
+00:17:51,170 --> 00:17:55,470
+الجوال، لكن لو واحد فتح الباب ودخل، برضه أنا شايف إن
+
+263
+00:17:55,470 --> 00:18:01,090
+في واحد دخل، طيب لو ابني، أخويا، عمي، زعجني أو مر
+
+264
+00:18:01,090 --> 00:18:04,850
+من قدامي، هشوفه، الآن أنا الـ central of vision، مركز
+
+265
+00:18:04,850 --> 00:18:10,620
+النظر بتطلع على الجوال، لكن مجال الرؤية بكون منتبه
+
+266
+00:18:10,620 --> 00:18:15,340
+للي حواليه، هذا إيش اسمه؟ اسمه peripheral vision،
+
+267
+00:18:15,340 --> 00:18:18,820
+أو اسمه visual fields، إن الإنسان هو بتطلع على
+
+268
+00:18:18,820 --> 00:18:21,900
+التلفاز أو جواله أو أي شيء، بيشوف اللي حواليه علشان
+
+269
+00:18:21,900 --> 00:18:24,560
+هيك، دايما الإنسان بيكون... مش بيقول الإنسان بيكون
+
+270
+00:18:24,560 --> 00:18:27,920
+منتبه للي حواليه، هذا معناه مجال الرؤية، في بعض
+
+271
+00:18:27,920 --> 00:18:34,720
+الناس عنده نص مجال الرؤية مش شايف، كيف يعني؟ يعني
+
+272
+00:18:34,720 --> 00:18:38,920
+نص مجال الرؤية شايفه ونص مجال الرؤية مش شايفه، يعني
+
+273
+00:18:38,920 --> 00:18:42,820
+خليني أقول زي كأنها دائرة، الدائرة نصها الشمال مش
+
+274
+00:18:42,820 --> 00:18:46,740
+شايفها ونصها اليمين مش شايفها، إذا كان في عنده زي كده
+
+275
+00:18:46,740 --> 00:18:51,640
+اسم المصطلح Hemianopsia، إيش اسمها؟ Hemianopsia، يبقى
+
+276
+00:18:51,640 --> 00:18:56,680
+معناته Hemianopsia يعني إيش؟ اللي هو وسط مجال
+
+277
+00:18:56,680 --> 00:19:01,100
+الرؤية، لما نكون وسط مجال الرؤية، وسط مجال الرؤية
+
+278
+00:19:01,540 --> 00:19:06,480
+شافه ووسط مجال الرؤية ما شافوش، بنسميه hemianopsia،
+
+279
+00:19:06,480 --> 00:19:10,460
+عشان كده سموه إيش هنا؟ blindness عامة، ونص مجال
+
+280
+00:19:10,460 --> 00:19:15,580
+الرؤية، طب لو شاف جزء وما شافش الجزء اللي بعده، يعني
+
+281
+00:19:15,580 --> 00:19:19,120
+جهة شاف ربع، كيف يعني؟ يعني خلي الدائرة أمامنا،
+
+282
+00:19:19,120 --> 00:19:23,520
+اتخيلنا إن الدائرة مجسمة لأربعة أقسام، هذه الدائرة
+
+283
+00:19:23,520 --> 00:19:27,220
+قسمناها أربعة أقسام، وضعنا في ربع، زائد مثل الشخص في
+
+284
+00:19:27,220 --> 00:19:31,800
+ربع ما شافوش، بنقول إيش اسم إيش عنده؟ Quadrantopsia،
+
+285
+00:19:31,800 --> 00:19:35,780
+إيش؟ Quadrantopsia، يعني عنده ربع مجال الرؤية أعمى،
+
+286
+00:19:35,780 --> 00:19:41,280
+مش شايفه، ربع مجال الرؤية مش شايفه، طيب إذا في نقطة
+
+287
+00:19:41,280 --> 00:19:45,720
+معينة ما شافهاش، نقطة معينة في مجال الرؤية ما شافهاش،
+
+288
+00:19:45,720 --> 00:19:50,540
+اسمها Scotoma، الـ Scotoma يعني اسمها island like
+
+289
+00:19:50,540 --> 00:19:54,980
+blindness، island زي من كلمة، مش ice no island، تلفظ
+
+290
+00:19:54,980 --> 00:19:58,560
+اللي هي زي جزيرة، اللي هو الـ island، يعني هذه نقطة
+
+291
+00:19:58,560 --> 00:20:02,500
+بتكون إيش؟ بيكون في بعض الناس بقولك أنا بشوف كل شيء،
+
+292
+00:20:02,500 --> 00:20:05,240
+بيجينا المريض، أعطيكم مثال، ليه هذه المصطلحات
+
+293
+00:20:05,240 --> 00:20:09,800
+الغريبة؟ بعض الناس بيقولك سبحان الله، أنا لما بكون
+
+294
+00:20:09,800 --> 00:20:12,680
+ماشي في الطريق بشوف كل السيارات على اليمين، بشوفش
+
+295
+00:20:12,680 --> 00:20:16,340
+على الشمال، بقول عنده إيش؟ hemianopsia، أو بعض الناس
+
+296
+00:20:16,340 --> 00:20:19,560
+بيقول أنا بشوف اليمين، بشوف الشمال، بس في جزء هيك
+
+297
+00:20:19,560 --> 00:20:25,080
+بشوفوش، الجزء هذا يعني زي حاجة هيك ربع، الناس هذا
+
+298
+00:20:25,080 --> 00:20:27,920
+اسمه الـ quadrantanopsia، لكن لو قال لي سبحان الله
+
+299
+00:20:27,920 --> 00:20:31,400
+دايما بشوف زي نقطة سوداء قدامي، في نقطة سوداء مش
+
+300
+00:20:31,400 --> 00:20:34,960
+قادر أشوف منها، هذا إيش اسمها؟ Scotoma، اسمها
+
+301
+00:20:34,960 --> 00:20:38,710
+إيه؟ Scotoma، أعرف إنه مصطلحات غريبة، لكن احنا
+
+302
+00:20:38,710 --> 00:20:43,410
+بنعيد وبنكرر حتى لو ما عرفناش، عشان نقدر نحفظ
+
+303
+00:20:43,410 --> 00:20:46,570
+المصطلحات، عشان إذا مرت علينا يعني ما بدي حد يقول
+
+304
+00:20:46,570 --> 00:20:49,410
+يعني إن هذا كبير، لأ، أنا لازم أعطيكم الشغلات
+
+305
+00:20:49,410 --> 00:20:52,450
+الكبيرة، ما بحبش أعطيكم الحاجات البسيطة، لوحة
+
+306
+00:20:52,450 --> 00:20:56,470
+الإشارات أما بتكون بهذا الشكل، حرف الـ E ومعناه L أو
+
+307
+00:20:56,470 --> 00:20:59,610
+T، إيش بتسأل المريض؟ بتقوله بعد ما غطى عينه مثلا
+
+308
+00:20:59,610 --> 00:21:02,590
+الشمال، إيش هذا الحرف؟ إيش هذا الحرف؟ إذا طالع يقول لي
+
+309
+00:21:02,590 --> 00:21:06,630
+كويس، إذا بقوله خلاص تمام، أخرش، إذا عندنا طبعا هذا
+
+310
+00:21:06,630 --> 00:21:11,110
+بالقدم، عموما احنا ننسى كلمة قدم وفي الآخر إيش
+
+311
+00:21:11,110 --> 00:21:16,050
+بنقول؟ بنقول إن هذا متر، نفس اللوحة هي موجودة، عموما لو
+
+312
+00:21:16,050 --> 00:21:20,050
+شاف آخر خط، إيش بقول؟ بقول النظر عنده ستة على ستة، طب
+
+313
+00:21:20,050 --> 00:21:25,720
+افرضه في اليمين، في اليمين شاف النظر كويس لكن في
+
+314
+00:21:25,720 --> 00:21:30,580
+اليسار، في اليمين شاف كويس لكن في اليسار ما شافوش،
+
+315
+00:21:30,580 --> 00:21:35,720
+بروحي بقول اليمين ستة على ستة، واليسار ستة على تسعة، طب
+
+316
+00:21:35,720 --> 00:21:39,060
+ليه قلنا ستة على تسعة؟ احنا قلنا احنا إذا ستة على ستة
+
+317
+00:21:39,060 --> 00:21:43,420
+يعني شاف كل الأشياء اللي على ستة متر شافني كويس لكن
+
+318
+00:21:43,420 --> 00:21:48,940
+لو لو لو بس بعد هيك ما قدرش، بس الناس الطبيعيين
+
+319
+00:21:48,940 --> 00:21:52,240
+اللي بيشوفوه على 9 متر، الناس الطبيعيين هيشوفوا على 6
+
+320
+00:21:52,240 --> 00:21:55,240
+أو 9، الناس الطبيعيين اللي بيشوفوه على 9، المريض
+
+321
+00:21:55,240 --> 00:21:58,780
+ما بيقدرش يشوفه ولا على 6 متر، طب 6 على 12 معناه
+
+322
+00:21:58,780 --> 00:22:01,220
+الناس الطبيعيين اللي بيشوفوه على أشياء على 12 متر
+
+323
+00:22:01,220 --> 00:22:07,680
+هو بيقدر يشوفه على وين؟ بس على 6 متر وكذا، طيب نشوف
+
+324
+00:22:07,680 --> 00:22:10,120
+الـ eye pathologies، إيش الأمراض اللي بتصيب في العين؟
+
+325
+00:22:10,120 --> 00:22:13,200
+أنا عارف إنه هو مصطلحات غريبة لكن معلش نتطور احنا
+
+326
+00:22:13,830 --> 00:22:17,370
+ما هي الأمراض اللي ممكن تصيب العين وأنا أحكي عنها
+
+327
+00:22:17,370 --> 00:22:19,970
+خاصة للطبيب، أنا ما بدي آخد لا anatomy ولا
+
+328
+00:22:19,970 --> 00:22:24,290
+physiology ولا بدي آخد علاج ولا complications، أنا
+
+329
+00:22:24,290 --> 00:22:28,810
+بس كل اللي بدي أحكيه بشكل عام إنه بس مصطلحات في
+
+330
+00:22:28,810 --> 00:22:34,550
+حاجة اسمها orbital hematoma، اللي هي الكدمة اللي بتصير
+
+331
+00:22:34,550 --> 00:22:37,570
+في العين، وبتلاقي بيقولك عينك اتورمت من الصدمة،
+
+332
+00:22:37,570 --> 00:22:42,260
+اسمها hematoma، في حاجة اسمها orbital fractures، لا
+
+333
+00:22:42,260 --> 00:22:46,340
+قدر الله، كسر في إيش؟ عظمة المحجر، محجر العين، زي الـ
+
+334
+00:22:46,340 --> 00:22:49,420
+blowout إيش؟ fracture، زي لا قدر الله صدمة شديدة
+
+335
+00:22:49,420 --> 00:22:53,540
+بتصير أو أخد box شديد أو انصدم في حديد أو شيء من
+
+336
+00:22:53,540 --> 00:22:58,580
+هذا القبيل، هذا، أصحاب ruptured globe، انفجار مقلة
+
+337
+00:22:58,580 --> 00:23:01,780
+العين، بتصير زي في حالات اللي هو الـ gun shot أو لا
+
+338
+00:23:01,780 --> 00:23:06,160
+قدر الله في صابة حجر أو هكذا، الـ corneal abrasion،
+
+339
+00:23:06,160 --> 00:23:09,920
+اللي هو القرنية نفسها، جرح القرنية، corneal
+
+340
+00:23:09,920 --> 00:23:13,700
+laceration، انزلاق جزء من القرنية، بيسموها جزء من
+
+341
+00:23:13,700 --> 00:23:16,860
+القرنية، زي واحد هو مش شايف ممكن ينزلق نفسه، برفع
+
+342
+00:23:16,860 --> 00:23:21,400
+إدفر زي هيك بتلاقي جرح عامل زي جشرة للإيش؟ للقرنية،
+
+343
+00:23:21,400 --> 00:23:25,800
+hyphema، hyphema اللي هو نزيف العين الداخلي، نزيف
+
+344
+00:23:25,800 --> 00:23:29,840
+العين الداخلي اسمه hyphema، نزيف العين الداخلي اسمه
+
+345
+00:23:29,840 --> 00:23:36,050
+hyphema، iritis، التهاب القزحية، Detached retina،
+
+346
+00:23:36,050 --> 00:23:41,130
+انفصال الشبكية، conjunctivitis، التهاب ملتحمة
+
+347
+00:23:41,130 --> 00:23:46,030
+العين، hordeolum أو بيسموها stye، hordeolum أو
+
+348
+00:23:46,030 --> 00:23:49,490
+بيسموها stye، أو بيسموها بالعربي الشحاطة، إيش عن
+
+349
+00:23:49,490 --> 00:23:52,710
+الشحاطة؟ ناسيك، بتقول لي عن الشحاطة، هي عبارة عن حاجة
+
+350
+00:23:52,710 --> 00:23:56,510
+يعني بتكون زي شوية bacterial infection في الـ
+
+351
+00:23:56,510 --> 00:24:00,050
+eyelids، موجودة، زي بعض يعني، دم صغير موجود في الـ
+
+352
+00:24:00,050 --> 00:24:02,750
+eyelids، فبقولك إيش عنده؟ حتى لو عندش حد زمان، كان
+
+353
+00:24:02,750 --> 00:24:05,010
+يقول عن كلمة شحاطة إن الطفل إذا كان عنده، يعني
+
+354
+00:24:05,010 --> 00:24:08,350
+بقولك هذا معناه تعميق أو خليه يروح يجيب له خبزة أو
+
+355
+00:24:08,350 --> 00:24:12,930
+يودي خبزة، يعني من بعض التقاليد اللي هي القديمة في
+
+356
+00:24:12,930 --> 00:24:18,070
+بعض الخاصة اللي هو أكابر السن، الحاجة بسموها اللي
+
+357
+00:24:18,070 --> 00:24:22,030
+بعدها، Calcium، إيش قلت؟ Calcium، Calcium أو بسموها
+
+358
+00:24:22,030 --> 00:24:27,030
+cyst، اللي هو الكيس الدهني، الجفن نفسه، بنعص إيدنا
+
+359
+00:24:27,030 --> 00:24:30,790
+عليه شوية، بنلاقي فيه تحت الجفن إشي زي طازج شوية
+
+360
+00:24:30,790 --> 00:24:34,450
+طالع لفوق، إيش هو؟ لو جلبنا الجفن، هنلاقي فيه تحته إيش؟
+
+361
+00:24:34,450 --> 00:24:38,850
+تحته فيه زي كيس أو تجمع دهني، وهذا برضه بيرتفع لما
+
+362
+00:24:38,850 --> 00:24:42,590
+نروح على الطبيب، برفع له، يعني Peri-orbital laceration،
+
+363
+00:24:42,590 --> 00:24:46,090
+تقرحات،
+
+364
+00:24:46,090 --> 00:24:49,590
+يعني
+
+365
+00:24:49,590 --> 00:24:53,770
+بيكون تقرحات حوالين اللي هو هاي الـ orbital اللي هو
+
+366
+00:24:53,770 --> 00:24:57,350
+محجر العين من بره، في بعض الناس بيصير عندهم نوع من
+
+367
+00:24:57,350 --> 00:25:02,290
+الخدش، الخدش أو نزع البسيط، بيكون حوالين الجلد اللي
+
+368
+00:25:02,290 --> 00:25:06,720
+حوالين محجر العين، الـ foreign bodies يعني زي الأجسام
+
+369
+00:25:06,720 --> 00:25:09,740
+الغريبة اللي بتصير، كيف لا قدر الله، في بعض الناس
+
+370
+00:25:09,740 --> 00:25:14,700
+بيجي ويقولك والله أنا كنت ماشي، فجأة أجت زي شغل
+
+371
+00:25:14,700 --> 00:25:17,680
+شائب في عيني، foreign body، أو واحد لا سمح الله
+
+372
+00:25:17,680 --> 00:25:22,640
+كان يلحم جنبه شيء، أجت شَنْطيرة أو نتفِتة، أي شيء حديدية،
+
+373
+00:25:22,640 --> 00:25:26,300
+هذا اسمه هو برضه إيش؟ foreign body، أو لا قدر الله من
+
+374
+00:25:26,300 --> 00:25:29,350
+أجزاز أو من أي شيء، كله اسمه foreign body، contact
+
+375
+00:25:29,350 --> 00:25:34,030
+lens removal، يعني بعض العدسات اللي موجودة عنده هل
+
+376
+00:25:34,030 --> 00:25:38,950
+مرفوعة؟ مش مرفوعة؟ في لابس هذه، كلها لابس عدسات أثرت
+
+377
+00:25:38,950 --> 00:25:42,810
+علينا، كلها اسم إيش هذه؟ eye pathologies، مش شرط أنا
+
+378
+00:25:42,810 --> 00:25:46,210
+كمان مرة بقول، ما بدنا نقول إنه إيش الـ
+
+379
+00:25:46,210 --> 00:25:49,110
+pathophysiology ولا الـ anatomy، لكن نعرف إيش المصطلحات
+
+380
+00:25:49,110 --> 00:25:53,530
+بشكل عام، الآن إيه الـ assessment؟ الآن بدنا نعمل
+
+381
+00:25:53,530 --> 00:25:58,450
+assessment لمنطقة إيش؟ الأذن، أول حاجة بدنا ask the
+
+382
+00:25:58,450 --> 00:26:03,210
+history، ... history of ear surgery، ... ear surgery،
+
+383
+00:26:03,210 --> 00:26:06,830
+بدنا نسأل، أول حاجة، هل عمل عمليات عمره في حياته في
+
+384
+00:26:06,830 --> 00:26:12,170
+الأذن؟ هل عنده trauma؟ هل عنده فيها infection زي
+
+385
+00:26:12,170 --> 00:26:15,130
+التهاب الأذن الوسطى أو الأذن الخارجية أو الأذن
+
+386
+00:26:15,130 --> 00:26:19,010
+الداخلية؟ هل عنده ear ache، ألم في الأذن؟ هل في
+
+387
+00:26:19,010 --> 00:26:22,690
+drainage، يعني بيطلع منه discharge ولا لأ؟ هل في عنده
+
+388
+00:26:22,690 --> 00:26:
+
+445
+00:30:12,100 --> 00:30:15,700
+اللي تحت اللي هي هذه الأذن الصيوان، الأذن اللي
+
+446
+00:30:15,700 --> 00:30:20,810
+شايفينه من برا، من فوق هذا اسمه الأركيل، الدهن اللي
+
+447
+00:30:20,810 --> 00:30:24,690
+تحت اللي عاملة .. حتى عاملة زي الهلال الصغير هذا
+
+448
+00:30:24,690 --> 00:30:28,770
+إيش اسمها؟ اسمها تراكس، لو إحنا سحبنا الأركيل
+
+449
+00:30:28,770 --> 00:30:33,030
+وضغطنا على منطقة التراكس اللي هو إيش بقول لي أنا؟
+
+450
+00:30:33,030 --> 00:30:36,330
+وخاصة عايش، أنا بقولها and behind there، وكمان ورا
+
+451
+00:30:36,330 --> 00:30:39,930
+الدهن وإحنا شدينه الآن، إيش بقول لي؟ إذا الألم زاد
+
+452
+00:30:39,930 --> 00:30:44,350
+يعني ده شدينا الدهن وضغطنا ورا الأذن وتحت على
+
+453
+00:30:44,350 --> 00:30:49,710
+منطقة التراكس، إذا الألم زاد، بنقول عنده external ear
+
+454
+00:30:49,710 --> 00:30:52,450
+infection، يعني بنقول هذا الأيش؟ عنده التهاب في
+
+455
+00:30:52,450 --> 00:30:56,410
+الأذن الخارجية. طيب، إذا الألم ما زادش
+
+456
+00:30:56,410 --> 00:31:00,650
+ماتأثرش، إيش بقول؟ عنده إيش؟ middle ear infection
+
+457
+00:31:00,650 --> 00:31:05,250
+اللي بتسمع عنها، اسمها otitis media. يبقى شغلة بسيطة
+
+458
+00:31:05,250 --> 00:31:09,330
+كتير، شدينا الأذن وعصينا حولها، إذا الألم زاد otitis
+
+459
+00:31:09,330 --> 00:31:12,910
+external، إذا الألم ما زادش otitis media، بقول و
+
+460
+00:31:12,910 --> 00:31:17,210
+أتطلع على الـ ear canal، شوف كيف القناة تبعت الأذن، و
+
+461
+00:31:17,210 --> 00:31:20,530
+الـ size والـ discharge، إذا بتطيل، بتسيل وبنسأله
+
+462
+00:31:20,530 --> 00:31:24,590
+كيف بتسيل؟ كيف يعني؟ طبيعتها، assessment of cerumen
+
+463
+00:31:24,590 --> 00:31:28,210
+اللي هو الشحمة، شحمة الأذن، الشحمة الصفراء اللي في الداخل
+
+464
+00:31:28,210 --> 00:31:34,450
+إذا صفراء زيادة، if it is yellow، if it is yellow or
+
+465
+00:31:34,450 --> 00:31:37,730
+green، يعني إذا كان صفراء كتير أو لونها أخضر كتير
+
+466
+00:31:37,730 --> 00:31:41,570
+غامق، معناته في infection. بدنا نسأله برضه ع الـ
+
+467
+00:31:41,570 --> 00:31:44,810
+hearing acuity، كيف حاسة السمع؟ زي ما كنا في حاسة بصر
+
+468
+00:31:44,810 --> 00:31:48,950
+في حاسة سمع، طيب كيف أنا في المستشفى بدي أقدر أعرف
+
+469
+00:31:48,950 --> 00:31:52,210
+إنه بسمع كويس ولا لأ، ولا حاجة، أنا كتمريض باجي
+
+470
+00:31:52,210 --> 00:31:55,710
+بتكلم معاه بكلمة، بقوله إيش؟ أنا بروح بتخبى في مكان، و
+
+471
+00:31:55,710 --> 00:31:59,390
+بحكي كلمة، بخليه يرددها، الـ voice tone، إيش يعني الـ
+
+472
+00:31:59,390 --> 00:32:03,250
+voice tone؟ حتة السماعة، يسمعه وبعملي repeating، و
+
+473
+00:32:03,250 --> 00:32:06,090
+بكرر الكلمات اللي أنا قلتها، يعني زي ما أنا أقف ع
+
+474
+00:32:06,090 --> 00:32:09,310
+جانب وأقول له مثلاً الحمد لله رب العالمين، إذا
+
+475
+00:32:09,310 --> 00:32:12,370
+قال لي نفس الكلمة وبنفس الوثيرة، بعرف إن السمع
+
+476
+00:32:12,370 --> 00:32:16,550
+كويسة. دير بالكم، مجرد ما الإنسان يعلي صوته، معناته
+
+477
+00:32:16,550 --> 00:32:19,370
+إيه؟ مجرد ما يعلي صوته، بنعرف إنه في إيش؟ عنده
+
+478
+00:32:19,370 --> 00:32:24,310
+هنا defects في الـ hearing، يعني عنده تعب وضرر في
+
+479
+00:32:24,310 --> 00:32:27,250
+إيش؟ في السماع، عشان إيه؟ بنشوف دائماً اللي سماعهم
+
+480
+00:32:27,250 --> 00:32:32,320
+ضعيف صوتهم عالي، وهكذا، لو كان العكس. طيب، notabene
+
+481
+00:32:32,320 --> 00:32:34,640
+بيقول لي إيش هنا؟ deeper structure، إيش أنا؟ deeper
+
+482
+00:32:34,640 --> 00:32:40,100
+يعني التركيبات الداخلية العميقة في الأذن، ما بقدر
+
+483
+00:32:40,100 --> 00:32:42,900
+أشوفها بالعين المجردة، هبقى أشوفها بإيش؟ بالـ
+
+484
+00:32:42,900 --> 00:32:47,120
+otoscope، وهذا مش شغلي، شغل الطبيب الأخصائي طبعاً
+
+485
+00:32:47,120 --> 00:32:53,390
+هنا معلش شوي، هنا، يعني هو باختصار هذا يخليكم ذاكرين
+
+486
+00:32:53,390 --> 00:32:57,310
+بس عشان أنا بشرحها، هي هو حاطط الـ otoscope طبعاً، هو
+
+487
+00:32:57,310 --> 00:33:00,750
+الآن هي المريضة قاعدة أمامه، وهذا المشهد اللي هو
+
+488
+00:33:00,750 --> 00:33:04,870
+مبين من جوا كأنه يعني مصور لنا يعني مقطع زي شريحة
+
+489
+00:33:04,870 --> 00:33:08,490
+يفهمنا إن الأذن هي شكلها من جوا، هو أنا بس بقول لكم
+
+490
+00:33:08,490 --> 00:33:12,030
+استخدم الـ use of the otoscope، choose largest
+
+491
+00:33:12,030 --> 00:33:15,290
+speculum، speculum اللي بيكون محطوط جوا قدام ..
+
+492
+00:33:15,290 --> 00:33:17,430
+قدام اللي هو هذا، وأنا عايد .. عايد كم مرة
+
+493
+00:33:17,880 --> 00:33:20,820
+السبيكلام؟ في المرات نستخدم السبيكلام من قدام
+
+494
+00:33:20,820 --> 00:33:25,020
+عشان يفتح الأذن كويس، وبنستخدم واحد كبير عشان يقدر
+
+495
+00:33:25,020 --> 00:33:28,940
+خاصة لما يكون adult، choose، هنا choose
+
+496
+00:33:28,940 --> 00:33:32,400
+largest speculum، head toward opposite shoulder، إيش
+
+497
+00:33:32,400 --> 00:33:36,580
+يعني toward opposite shoulder؟ بنخلي الـ head الآن
+
+498
+00:33:36,580 --> 00:33:42,160
+يعني معاكس مع إيش؟ يعني معاكس الـ shoulder، الكتف
+
+499
+00:33:42,160 --> 00:33:46,290
+يعني ما بنخليهوش يدير رأسه مع اتجاه اللي هو يعني مثلاً
+
+500
+00:33:46,290 --> 00:33:50,970
+قاعد زي هيك، أنا مثلاً بدي أشوف الأيمن، بخليه يطلع
+
+501
+00:33:50,970 --> 00:33:54,730
+قدام، عكس الكتف، ما بنخليه يدير على اليمين، لأن هو
+
+502
+00:33:54,730 --> 00:33:58,310
+هيتعبني، مش هقدر، وهيتعب نفسه ويدير حاله، خليه زي
+
+503
+00:33:58,310 --> 00:34:03,050
+ما هو، ما أقدر أعمله assessment، بقول طبعاً
+
+504
+00:34:03,050 --> 00:34:07,390
+adult ear، اللي بين upper and back، يعني لما نكون في
+
+505
+00:34:07,390 --> 00:34:11,330
+الـ adult، بدنا نفحص الأذن، خاصة الطبيب الشاطر، لما
+
+506
+00:34:11,330 --> 00:34:15,330
+بيفحص الأذن كويس، بيسحب البنة لوين؟ البنة اللي هو
+
+507
+00:34:15,330 --> 00:34:18,690
+أعلى الأذن، لفوق، upper and back، يعني بيسحبها لفوق
+
+508
+00:34:18,690 --> 00:34:22,530
+وورا، لما تكون، اسحبها لفوق ولا ورا، بتفتح الأذن
+
+509
+00:34:22,530 --> 00:34:26,430
+كويس، أما في الأطفال، لسه الأذن ما اتمتلتش، ما اتمتلتش
+
+510
+00:34:26,430 --> 00:34:30,650
+الأناتومية تبعها، فبقولي لأ، خاصة إيش هنا؟ الأجل من
+
+511
+00:34:30,650 --> 00:34:34,010
+ثلاث سنين، بقولي في الأجل من ثلاث سنين، معلش، اعمل
+
+512
+00:34:34,010 --> 00:34:38,630
+العكس، إيش العكس؟ بقول لأ، اسحب البنة down، لتحت، مش
+
+513
+00:34:38,630 --> 00:34:42,930
+لفوق، وبقول hold otoscope upside down، إيش upside
+
+514
+00:34:42,930 --> 00:34:46,270
+down؟ يعني اللي لازم تمسك الـ otoscope من الأعلى
+
+515
+00:34:46,270 --> 00:34:50,170
+للأسفل، ما تمسكوش مائل ولا كده، طبعاً هذه الشغلة
+
+516
+00:34:50,170 --> 00:34:53,290
+بالذات، يعني هي بس من باب المعرفة، لكن هي شغل الطبيب
+
+517
+00:34:53,290 --> 00:34:57,710
+مش شغلنا أكثر، طيب، الـ external canal، عشان أخلص
+
+518
+00:34:57,710 --> 00:35:02,730
+لأن أنا بدأت أُقترب للنصف ساعة، الـ external canal
+
+519
+00:35:02,730 --> 00:35:09,190
+بشوف إذا في redness، أو مثلاً في allegiance، أو في
+
+520
+00:35:09,190 --> 00:35:13,210
+foreign body، أو في discharge، يعني أنا بتسأل، خاصة
+
+521
+00:35:13,210 --> 00:35:17,330
+هذا بيسموه إيش؟ الأذن الخارجية، بروح بدونها وبكتبها،
+
+522
+00:35:17,330 --> 00:35:21,030
+الـ tympanic membrane، اللي هو الطبلة، طبلة الأذن
+
+523
+00:35:21,030 --> 00:35:24,210
+يعني الداخلية. لو أنا .. طبعاً أنا مش هقدر آخد
+
+524
+00:35:24,210 --> 00:35:27,870
+otoscope، لكن لازم نعرف إنه الـ doctor تبعه لازم يحكي لنا
+
+525
+00:35:27,870 --> 00:35:31,070
+يا الطبيب أو يكون مكتوب، وكيف الـ character، وهل لا
+
+526
+00:35:31,070 --> 00:35:34,570
+سَمح الله في عنده perforation، perforation يعني ثقب
+
+527
+00:35:34,570 --> 00:35:38,130
+في الطبلة، زي بعض الحالات اللي باخد هواية جامدة
+
+528
+00:35:38,130 --> 00:35:43,060
+فبيصير ثقوب في الطبلة، طبلة الأذن، بنسأله هل هي
+
+529
+00:35:43,060 --> 00:35:48,020
+translucent؟ يعني هل بتعبر ضوء ولا ما بتعبرش؟ بقوله
+
+530
+00:35:48,020 --> 00:35:50,840
+إنها بتشبه الـ pearly grey، الـ pearly grey زي حاجة
+
+531
+00:35:50,840 --> 00:35:56,220
+بسمها اللؤلؤية، زي الـ .. زي الـ .. الـ .. الرمادي
+
+532
+00:35:56,220 --> 00:36:00,680
+على لون زي الذهب، اللي لونه الرمادي، يعني كأنه
+
+533
+00:36:00,680 --> 00:36:05,000
+بديقولي، الأصفر بيكون على .. على اللون orange، بس
+
+534
+00:36:05,000 --> 00:36:09,170
+قاتم شوية، gray color، هذا طبيعي. طبعاً كيف بيكون
+
+535
+00:36:09,170 --> 00:36:14,390
+المنظر؟ كون شبه زي القمع، من قدام واسع، ورا من الداخل
+
+536
+00:36:14,390 --> 00:36:19,150
+أضيق شوية، وفيه light reflex، بيصير انعكاس
+
+537
+00:36:19,150 --> 00:36:23,230
+للضوء، خاصة في الأذن الطبيعية. خليني أقفل هنا لأنه
+
+538
+00:36:23,230 --> 00:36:27,170
+أنا يعني معلش، يبدو الوقت بياخدنا ستة وثلاثين
+
+539
+00:36:27,170 --> 00:36:29,750
+دقيقة، معلش سامحونا، ونكمل إن شاء الله المحاضرة
+
+540
+00:36:29,750 --> 00:36:33,170
+القادمة، والسلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..76e07d841c8508b6b6a24f11f0287005bd0244cc
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_postprocess.srt
@@ -0,0 +1,2160 @@
+1
+00:00:01,550 --> 00:00:05,550
+بسم الله الرحمن الرحيم اليوم طبعا هنبدأ في ال
+
+2
+00:00:05,550 --> 00:00:10,490
+chapter السادس ونبدأ
+
+3
+00:00:10,490 --> 00:00:13,690
+طبعا بال إيه؟ زي ما انتوا شايفين أنا قدامكم head
+
+4
+00:00:13,690 --> 00:00:17,750
+assessment طبعا احنا الحمد لله خلصنا في ال chapter
+
+5
+00:00:17,750 --> 00:00:22,610
+السابق لما تكلمنا على ال position بشكل عام و لما
+
+6
+00:00:22,610 --> 00:00:27,030
+بدينا في ال assessment أخدنا ال hair أخدنا ال skin
+
+7
+00:00:27,030 --> 00:00:31,710
+طبعا بداية من ال head tattoo زي ما احنا قلنابعدين
+
+8
+00:00:31,710 --> 00:00:36,890
+كدا ندخل شوية شوية في ايش في اجزاء الجسم طبعا احنا
+
+9
+00:00:36,890 --> 00:00:39,790
+بنتكلم على physical examination عشان احنا نكون
+
+10
+00:00:39,790 --> 00:00:43,410
+عارفين من ال physical assessment اول حاجة في ال
+
+11
+00:00:43,410 --> 00:00:47,550
+head assessment اش بقول هنا بقول inspects for size
+
+12
+00:00:47,550 --> 00:00:52,510
+اول حاجة تطلع على حجم الرقص shape الشكل ال contour
+
+13
+00:00:52,510 --> 00:00:57,370
+يعني كيف تضاريس الرقص يعني و لقدام هقولكوا ايش
+
+14
+00:00:57,370 --> 00:01:01,360
+بنقصد فيه ال contourالـ Skull جنرالي ايش بقولي
+
+15
+00:01:01,360 --> 00:01:04,660
+هنا؟ round يبقى هى ال contours بقولي هنا round
+
+16
+00:01:04,660 --> 00:01:07,900
+anterior and posterior prominences ايش يعني
+
+17
+00:01:07,900 --> 00:01:10,980
+anterior and posterior prominences يعني سبحان الله
+
+18
+00:01:10,980 --> 00:01:16,120
+كأنه بيقول الرأس يعني اقرب للبيضاوي فيه نتوئات
+
+19
+00:01:16,120 --> 00:01:20,660
+أماميه و نتوئات في الخلف بعض الناس طبعا مختلفة
+
+20
+00:01:20,660 --> 00:01:25,500
+ممكن يكون يعني بشكل دائر اكبر في شكل زى مستطيل او
+
+21
+00:01:25,500 --> 00:01:29,680
+مطاول اكتر و هكذاال large infants head يعني الرأس
+
+22
+00:01:29,680 --> 00:01:34,100
+الكبير في الأطفال في الصغار ايش اسمه بكون السبب
+
+23
+00:01:34,100 --> 00:01:37,760
+هيدرو سيفلس استسقاء الرأس يعني لو شفنا طفل صغير
+
+24
+00:01:37,760 --> 00:01:41,620
+جدا لما راح نضربه ممكن نشوف حالات زي هيك و لجينا
+
+25
+00:01:41,620 --> 00:01:45,700
+انه الرأس تبعه يعني اكبر من اللازم بنقول عنده
+
+26
+00:01:45,700 --> 00:01:49,220
+هيدرو سيفلس اما ده شفناه عند الكبار يعني انسان
+
+27
+00:01:49,220 --> 00:01:55,100
+كبير في السن لكن ايه عنده large large size of the
+
+28
+00:01:55,100 --> 00:01:59,480
+head ايش بنقول عنه اناخاصة يعني هو بيقول ممكن يكون
+
+29
+00:01:59,480 --> 00:02:02,500
+ايش خاصة ال head و ال facial bones ايش بيكون عنده
+
+30
+00:02:02,500 --> 00:02:06,980
+اكروميجالي اكروميجالي يعني ايش العملقة بيكون هو
+
+31
+00:02:06,980 --> 00:02:11,060
+يعني هذا عنده نوع من شوية hormonal disturbance و
+
+32
+00:02:11,060 --> 00:02:15,080
+عملاله ايش و عملاله ايش زي عملقة و كبر في الرأس و
+
+33
+00:02:15,080 --> 00:02:19,960
+محيط الرأس زي باقي عضاء الجسم اول شي ببقى ال base
+
+34
+00:02:19,960 --> 00:02:24,340
+of the skull for nodules or masses بنحط دي هنا
+
+35
+00:02:24,340 --> 00:02:27,980
+بنبدأ نحس اللي هو فروة الرأسو المنطقة وقتها بتاعة
+
+36
+00:02:27,980 --> 00:02:33,260
+الرأس نفسها هل في nodules يعني حاجات طالعة بارزة
+
+37
+00:02:33,260 --> 00:02:38,120
+هل في في الجلد خاصة هل في masses لا قدر الله هل في
+
+38
+00:02:38,120 --> 00:02:41,760
+عنده tumors او شي من هذا القبيل او لأ طيب
+
+39
+00:02:41,760 --> 00:02:46,560
+assessment of the eye لقيت اول شي موجود عندنا في
+
+40
+00:02:46,560 --> 00:02:50,740
+ال head و هو الرأس العين طبعا هذه بس من باب
+
+41
+00:02:50,740 --> 00:02:55,780
+التشريح و نذكركم التذكرة طبعا احنااعتقد اخدتوا في
+
+42
+00:02:55,780 --> 00:03:01,120
+التشريح انتوا في تشريح واحد و .. و يعني مروا
+
+43
+00:03:01,120 --> 00:03:03,980
+عليكوا كتير و ان شاء الله لما تروحوا العملي هتشوف
+
+44
+00:03:03,980 --> 00:03:07,280
+كمان يعني بعضكم اللي ما نسيش في العيون هيتذكر كمان
+
+45
+00:03:07,280 --> 00:03:10,740
+هذه الكلمات باختصار احنا هذا اللي انتوا شايفينه
+
+46
+00:03:10,740 --> 00:03:13,960
+ايه العين بشكل عام اللي بهمنا الان طبعا هذه
+
+47
+00:03:13,960 --> 00:03:17,660
+القرانية اللي هي قدام الأمام وهذا .. هذه القرانية
+
+48
+00:03:17,660 --> 00:03:22,850
+زي ما تشايفينها طبعا هذا المنطقه اللي هنا كلهاللي
+
+49
+00:03:22,850 --> 00:03:26,270
+بتلمش اللي جوا بتتكلم اللي من هذا الطرف هذا اسمه
+
+50
+00:03:26,270 --> 00:03:30,610
+ال sclera الصلبة اللي هي الجسم الأبيض طبعا جوا في
+
+51
+00:03:30,610 --> 00:03:34,530
+السائل الزجاجي في هذا المكان اسمه vitreous في هنا
+
+52
+00:03:34,530 --> 00:03:38,850
+.. هنا اللي ملتزق من الداخل اللي ملتزق من الداخل
+
+53
+00:03:38,850 --> 00:03:43,650
+هذا اسمه retina اللي هو الشبكية و هنا ايه ال optic
+
+54
+00:03:43,650 --> 00:03:48,350
+nerve اللي هو العصب البصري ال optic nerve في هنا
+
+55
+00:03:48,350 --> 00:03:52,840
+حاجة اسمها ايش الجسم الأصفر اسمها الماكولااللي هو
+
+56
+00:03:52,840 --> 00:03:56,820
+مركز الإبصار مركز الإبصار الإنسان بيقدر يشوف كل
+
+57
+00:03:56,820 --> 00:04:00,420
+شيء بينعكس جوا إلا إذا عكس على هذا المكان بيقدرش
+
+58
+00:04:00,420 --> 00:04:04,060
+يشوفه لإيه؟ لأن الإنسان مقدرش يعني زي حكاية المعدة
+
+59
+00:04:04,060 --> 00:04:08,320
+بتهضومش حالها و العين بتشوفش حالها طبعا هذا بقبق
+
+60
+00:04:08,320 --> 00:04:12,340
+العين ال pupil و هذا ال lens وراها هذه العدسة اللي
+
+61
+00:04:12,340 --> 00:04:15,280
+لما شوية بيصير فيها شوية deformity أو فيها
+
+62
+00:04:15,280 --> 00:04:19,300
+discoloration بيصير عندهم بعض الناس مكتركت اللي هو
+
+63
+00:04:19,300 --> 00:04:25,410
+المياه البيضاءوطبعا في حواليها يعني دائرة حواليها
+
+64
+00:04:25,410 --> 00:04:30,490
+ماسكة ال lens اسمها ال iris اللي قزحية اللي بتعمل
+
+65
+00:04:30,490 --> 00:04:33,810
+لون العين هذا فقط من باب التشريح تبع العين اللي
+
+66
+00:04:33,810 --> 00:04:37,270
+بهمنا هنا ان انا كيف بتعمل assessment للعين اول
+
+67
+00:04:37,270 --> 00:04:39,970
+حاجة عشان بتعمل assessment بتستخدم حاجة اسمها
+
+68
+00:04:39,970 --> 00:04:43,430
+Snelling chart ال snelling chart كلكم بتعرفوها هي
+
+69
+00:04:43,430 --> 00:04:47,830
+عبارة عن لوحة النظر بيسموهااللي دايما بتطلع عليه
+
+70
+00:04:47,830 --> 00:04:51,930
+الإنسان إما حرف زي ال E أو حرف C أو مثلا أشكال
+
+71
+00:04:51,930 --> 00:04:55,450
+معينة و بيجي .. بيسأل المريض بيسأل .. بيسأل الطبيب
+
+72
+00:04:55,450 --> 00:04:59,370
+بيسأل المريض وين فتحت هذه الحرف و وين اتجاه هذا
+
+73
+00:04:59,370 --> 00:05:03,290
+الحرف عشان يقدر يأكد انه كدهش في عنده مشكلة أو لا
+
+74
+00:05:03,290 --> 00:05:08,270
+طبعا احنا و احنا بنعمل assessment للآيط طب افرضه
+
+75
+00:05:08,270 --> 00:05:12,970
+انا ماعنديش اسنين ال chart ماعنديش اسنين ال chart
+
+76
+00:05:14,600 --> 00:05:18,320
+يعني انا موجود في المستشفى اتفاجأت انه ايش طب بده
+
+77
+00:05:18,320 --> 00:05:21,520
+اشوف انه بصر المريض كويس ولا ماعندش لوحة اشارات زى
+
+78
+00:05:21,520 --> 00:05:25,060
+الشفاء او مستشفى ناصر او اي مستشفى بقول لي في مرات
+
+79
+00:05:25,060 --> 00:05:29,280
+ابنى عمل حاجة بسمها chart ايش هنا او newsprint ايش
+
+80
+00:05:29,280 --> 00:05:33,120
+newsprint يعني احنا ممكن نجيبله جريدة زى جريدة او
+
+81
+00:05:33,120 --> 00:05:37,720
+بنجيبله ملف يعني احنا ممكن اجي اقوله لو سمحتممكن
+
+82
+00:05:37,720 --> 00:05:40,120
+تقرأ .. ممكن .. عشان انا بدي أشوف المريض بيشوف
+
+83
+00:05:40,120 --> 00:05:44,220
+كويس ولا لأ بقول ممكن تقرأ اللي في الملف ممكن أنت
+
+84
+00:05:44,220 --> 00:05:48,320
+تتطلع في هذه الورقة أو في هذه الجريدة الطبيعي
+
+85
+00:05:48,320 --> 00:05:52,000
+البني أدم الطبيعي يكون البعد بين اللي بديه يقراه و
+
+86
+00:05:52,000 --> 00:05:55,200
+بين عينه خمسة و عشرين سانتي يعني خلينا نقول زي شبر
+
+87
+00:05:55,200 --> 00:05:58,640
+يعني لما نقول شبر هيك كبير تقريبا وزيادة اتنين
+
+88
+00:05:58,640 --> 00:06:01,920
+تلاتة سانتي هيك الطبيعي لكن لو جرب معناته مشكلة و
+
+89
+00:06:01,920 --> 00:06:05,440
+لو بعد معناته مشكلةطبعا في بعض الحلقات بنعمل حاجة
+
+90
+00:06:05,440 --> 00:06:09,380
+بسموها cover card ايش cover card عشان نتأكد ان
+
+91
+00:06:09,380 --> 00:06:15,800
+العين تان كويسات بنفحص العين و بعدين بنفحص العين
+
+92
+00:06:15,800 --> 00:06:19,380
+التانية كيف يعني؟ يعني احنا بنغطي مثلا العين
+
+93
+00:06:19,380 --> 00:06:23,000
+الشمال و بنفحص اليمين و بعدين بنغطي العين اليمين و
+
+94
+00:06:23,000 --> 00:06:26,900
+بنفحص الشمال هذا اسمه cover card طبعا بعدين
+
+95
+00:06:26,900 --> 00:06:30,200
+بنستخدم ال penlight اللي قلنا عنه احنا مش شغلنا
+
+96
+00:06:30,200 --> 00:06:34,740
+شغل طبيب لخصائي بستخدم ال ophthalmoscopeبقولي ask
+
+97
+00:06:34,740 --> 00:06:38,460
+your client about لازم نسأل المريض عن ايش history
+
+98
+00:06:38,460 --> 00:06:42,580
+of previous eye surgery هل عمرك عملت عملية جراحية
+
+99
+00:06:42,580 --> 00:06:47,860
+في عينك هل اتعرضت ل trauma يعني اتعرضت لاصابة ضربة
+
+100
+00:06:47,860 --> 00:06:51,820
+هل استخدمت حاجة اسمها corrective glass اللي هي
+
+101
+00:06:51,820 --> 00:06:57,060
+النضارات اللي بتعمل تصحيح النضارات المصححة زي بعض
+
+102
+00:06:57,060 --> 00:07:02,120
+النضارات الطبية يعنيأو لبسة contact lenses ال
+
+103
+00:07:02,120 --> 00:07:04,600
+contact lenses أنا مابقصد العدسات اللاصقة
+
+104
+00:07:04,600 --> 00:07:09,260
+التجميلية وانما العدسات اللاصقة العلاجية اللي ممكن
+
+105
+00:07:09,260 --> 00:07:13,760
+ايش اتعالج بعض العيوب الانكسار اللي موجودة عند
+
+106
+00:07:13,760 --> 00:07:17,320
+الإنسان بنسأله هل عندك blurred vision عمره كان
+
+107
+00:07:17,320 --> 00:07:21,360
+زغلالة في النظر دبلوبيا إزدواجية في النظر
+
+108
+00:07:21,360 --> 00:07:25,520
+Strabismus Strabismus معناته squint معناته بالعرب
+
+109
+00:07:25,520 --> 00:07:30,550
+الحوال هل في عندك حوال؟recent changes in vision هل
+
+110
+00:07:30,550 --> 00:07:36,470
+اتغير حديثا النظر عندك حسيت نظرك ضعف اخر اشهر خاصة
+
+111
+00:07:36,470 --> 00:07:41,150
+اخر ست شهر اه و الله صار طب متصار طب وقت ايش انت
+
+112
+00:07:41,150 --> 00:07:46,010
+عملت vision test متعملت فحص للنظر في عندك
+
+113
+00:07:46,010 --> 00:07:49,890
+allergies معينة طبعا ايش allergies هنا دخلة في
+
+114
+00:07:49,890 --> 00:07:53,660
+العين في بعض الناس عندهم حساسيةاللي في عينهم
+
+115
+00:07:53,660 --> 00:07:57,620
+لأشياء محددة بقولك والله انا اذا اجى غبار علي عيني
+
+116
+00:07:57,620 --> 00:08:00,880
+بيصير عنده حسية انا لو انا اخدت اي جدرة معينة
+
+117
+00:08:00,880 --> 00:08:03,380
+بيصير عنده حسية بدنا نسأل في شكل عام هل في عندك
+
+118
+00:08:03,380 --> 00:08:08,920
+حسية ولا لأ بيصير عندك احمرار في العين او frequent
+
+119
+00:08:08,920 --> 00:08:12,830
+watering dischargeيعني هل بتحسوا ان هيك كتير
+
+120
+00:08:12,830 --> 00:08:16,710
+بدمعوا طبعا لما نكونوا كتير بدمعوا مش يجيب بالنا
+
+121
+00:08:16,710 --> 00:08:21,610
+انه بس هي دموعه فقط لأ ممكن تكون القناة مجرد دمع
+
+122
+00:08:21,610 --> 00:08:26,190
+مغلقة مش موضوعنا الآن later on هنتكلم عنها طيب
+
+123
+00:08:26,190 --> 00:08:30,430
+السس أول حاجة فيه external organs وفي internal
+
+124
+00:08:30,430 --> 00:08:33,690
+organs انا بتكلم بنفس ال eye ال external eye
+
+125
+00:08:33,690 --> 00:08:37,390
+structure زي ايش اللي انا بشوفه من براهذا اسمه
+
+126
+00:08:37,390 --> 00:08:41,290
+external اول ما اطلع في عين المريض و بقدر اشوفه
+
+127
+00:08:41,290 --> 00:08:45,690
+البيوب والبقبق العين عيرس قزحية ال visual equity
+
+128
+00:08:45,690 --> 00:08:49,690
+كده حدث الإبصار اسمها كده بصرف اشوفه كويسه ولا لأ
+
+129
+00:08:49,690 --> 00:08:54,670
+اوكيولار موفمنس اوكيولار موفمنس يعني باشي باشوف
+
+130
+00:08:54,670 --> 00:08:59,550
+ايه باشوف كده حركة اين هي الصحيحات يعني بتحرك شمال
+
+131
+00:08:59,550 --> 00:09:02,590
+يمين فوق لتحت اللي فيه مشكلة بدي اشوف حاجة اسمها
+
+132
+00:09:02,590 --> 00:09:06,220
+peripheral visionاللي هو Asian peripheral vision
+
+133
+00:09:06,220 --> 00:09:10,400
+اسمها مجال الرؤية او الرؤية الطرفية يعني لما بتطلع
+
+134
+00:09:10,400 --> 00:09:14,420
+فيا شايف اللي حوليا هذا اسمه peripheral vision ولا
+
+135
+00:09:14,420 --> 00:09:18,420
+بس بتطلع بشوف اللي قدامه فقط اما ال internal eye
+
+136
+00:09:18,420 --> 00:09:22,820
+structure بقدرش اشوفهم زي ايش ممكن ال iris انا
+
+137
+00:09:22,820 --> 00:09:26,500
+اشوفه ال retina لأ ب the edge of the thermoscope
+
+138
+00:09:26,500 --> 00:09:30,660
+ال macula اللي جونا عن الجسم الأصفر و ال optic
+
+139
+00:09:30,660 --> 00:09:35,070
+nerve و هكذا كله مقدرش اشوفهلنترك طبعا إلا بال off
+
+140
+00:09:35,070 --> 00:09:38,890
+-thalmoscope مش شغلي أنا بس أقدر أعمل assessment
+
+141
+00:09:38,890 --> 00:09:44,510
+for external eye organs بكون كويس طيب consider the
+
+142
+00:09:44,510 --> 00:09:48,790
+following factors يجب أن تأخذ باعتبار العوامل
+
+143
+00:09:48,790 --> 00:09:54,510
+التالية ال age use of corrective lens متى استخدمت
+
+144
+00:09:54,510 --> 00:09:59,830
+في عمرك النضارات الطبية والتصحيحية هل ركبت عين
+
+145
+00:09:59,830 --> 00:10:04,660
+يعني كان عندك إصابةبعض الناس بيصير ال gun shot او
+
+146
+00:10:04,660 --> 00:10:08,120
+لا سمح الله ال severe trauma بتروح العين فبركبوله
+
+147
+00:10:08,120 --> 00:10:11,860
+artificial eye عين زجاجية احنا بيقولوا عين زجاجية
+
+148
+00:10:11,860 --> 00:10:14,440
+ممكن تكون اي مادة plastic كده بس المهم عين
+
+149
+00:10:14,440 --> 00:10:18,960
+allergies عندك حسية عندك ألم بين visual
+
+150
+00:10:18,960 --> 00:10:23,990
+disturbances طيب اي اضطراب في ايه في الرؤية؟ال
+
+151
+00:10:23,990 --> 00:10:27,130
+health related factors يعني يقصد هنا هل في عندك
+
+152
+00:10:27,130 --> 00:10:30,170
+أمراض معينة أثرت على النظر زي موضوع ال blood
+
+153
+00:10:30,170 --> 00:10:33,930
+pressure و زي موضوع ال diabetes mellitus مع ال
+
+154
+00:10:33,930 --> 00:10:37,790
+chronicity يعني مع الإزمان المرض المزمن الطويل
+
+155
+00:10:37,790 --> 00:10:42,190
+بيأثر برضه على العين و على حدة البصر و على شبكية
+
+156
+00:10:42,190 --> 00:10:46,930
+العين assessment of external eye structure أول
+
+157
+00:10:46,930 --> 00:10:50,760
+حاجة بدنا نشوف ال position يعني وضع العينال
+
+158
+00:10:50,760 --> 00:10:54,300
+alignment جاي وين بالظبط كلمة alignment يعني وين
+
+159
+00:10:54,300 --> 00:10:57,640
+in general وين بالظبط يعني هل هي central or not
+
+160
+00:10:57,640 --> 00:11:01,260
+يعني وين بالظبط جاي شكل العين و تركيبة العين في
+
+161
+00:11:01,260 --> 00:11:05,220
+الوسط و لا لأ بنتشوف ال ال eyebrow ايش كمان ال
+
+162
+00:11:05,220 --> 00:11:10,240
+eyebrow اللي هو الحواجب تبعات العين ال eyelids
+
+163
+00:11:10,240 --> 00:11:14,790
+بعدين الرموش ال eyelashesيعني احنا بتكلم ال
+
+164
+00:11:14,790 --> 00:11:20,390
+eyelashes رموش العين وال eyelids اللي هو الجفون
+
+165
+00:11:20,390 --> 00:11:25,510
+العين الأعلى والأسفل ال lacrimal glands الغدد اللي
+
+166
+00:11:25,510 --> 00:11:29,670
+هو الدمعيةالـ pupils and iris كل هذا بقدر اشوفه و
+
+167
+00:11:29,670 --> 00:11:32,690
+انا بعمل أياش assessment احنا عارفين انه مش شغلنا
+
+168
+00:11:32,690 --> 00:11:36,370
+الأساسي و احنا مش تمريض عيون ولكن انا اكويس ان
+
+169
+00:11:36,370 --> 00:11:40,450
+اقدر اقارن اذا في كان gross abnormality يعني اشي
+
+170
+00:11:40,450 --> 00:11:44,290
+مش طبيعي و واضح جدا او في severe defects عشان اقدر
+
+171
+00:11:44,290 --> 00:11:48,430
+ابلغ الطبيب لو انا رأيته ممكن اكون من عندى بداية
+
+172
+00:11:48,430 --> 00:11:52,230
+ايه بداية ال discover of something يعني اكتشاف شيء
+
+173
+00:11:52,230 --> 00:11:56,500
+معينassessment of pupils done by a كيف بده اشوف ال
+
+174
+00:11:56,500 --> 00:11:59,620
+pupils كلكم عارفينه اللي بيسموه reaction ال bin
+
+175
+00:11:59,620 --> 00:12:03,240
+light انا بطلع مباشرة بحط الضوء في العين و بعدين
+
+176
+00:12:03,240 --> 00:12:06,900
+بخليه يغمض او بحط الضوء في العين و بجيبه لما احط
+
+177
+00:12:06,900 --> 00:12:09,620
+الضوء و ارفعه بيصير انه ايش حاجة بيسموها
+
+178
+00:12:09,620 --> 00:12:13,100
+construction of the pupil لما نيجي نحط الإضاءة
+
+179
+00:12:13,100 --> 00:12:16,020
+المباشرة في العين بنلاقي ال pupil بقبق العين
+
+180
+00:12:16,020 --> 00:12:20,540
+بيسموه ايش يتلاقي سكر شوية رفعنا عنه الإضاءة
+
+181
+00:12:20,540 --> 00:12:24,060
+بتلاقيه فتحعشان هيك بقول دايما في 3R بقول عنها
+
+182
+00:12:24,060 --> 00:12:29,080
+اللي هي ايش 3R round reactive response ايش يعني
+
+183
+00:12:29,080 --> 00:12:32,980
+round reactive response يعني بيقول بقبل عين دائري
+
+184
+00:12:32,980 --> 00:12:37,200
+reactive يعني reactive بيصير عنده ايش استجابة
+
+185
+00:12:37,200 --> 00:12:40,800
+للضوء response عنده استجابة بشكل عام الان
+
+186
+00:12:40,800 --> 00:12:45,100
+assessment must do for ايهaccommodation and
+
+187
+00:12:45,100 --> 00:12:50,720
+convergence of pupils يعني اللي احنا بنعمله بنكشف
+
+188
+00:12:50,720 --> 00:12:55,040
+accommodation تحور اللي هو ال pupil كده ممكن يزخر
+
+189
+00:12:55,040 --> 00:12:57,940
+حجمه و يكبر حجمه ال pupil اسمه accommodation
+
+190
+00:12:57,940 --> 00:13:02,970
+convergenceكداش بيقدر يحول يعني اللي قدر الله يصير
+
+191
+00:13:02,970 --> 00:13:07,530
+عنده التحول في ال pupil نفسه يصير الحجم يختلف أو
+
+192
+00:13:07,530 --> 00:13:11,330
+عين عن عين أو يصير الله سمح الله يروح على جنب او
+
+193
+00:13:11,330 --> 00:13:15,130
+يروح سواء right او left هذا اسمه convergence of
+
+194
+00:13:15,130 --> 00:13:21,310
+pupils طيب assessment of visual equity نرجع لنفس
+
+195
+00:13:21,310 --> 00:13:24,190
+الموضوع اللي احنا قلناه كيف بنجيز حدة الإبصار انا
+
+196
+00:13:24,190 --> 00:13:30,230
+الآن موجودمثلا عندي فى مجال يكون فى لوحة بصر أو
+
+197
+00:13:30,230 --> 00:13:33,810
+لوحة النظر زى اللى موجودة عندنا فى الجامعة لكن
+
+198
+00:13:33,810 --> 00:13:37,990
+احنا ممكن اكون اروح اتدرب فى مستشفى العيون وبدأ
+
+199
+00:13:37,990 --> 00:13:40,970
+اجهز النظر للمريض أمامى سواء كان المريض فى
+
+200
+00:13:40,970 --> 00:13:44,350
+المستشفى او فى المركز او فى اى مكان الصح ان المريض
+
+201
+00:13:44,350 --> 00:13:47,470
+يكون بينه بنسمع كلمة بعض الناس بيقول قداش النظر
+
+202
+00:13:47,470 --> 00:13:50,970
+عندك بيقولك النظر تبعى 6 ع 6 التانى بيقول لأ والله
+
+203
+00:13:50,970 --> 00:13:54,140
+النظر عندى 6 ع 12التالت بيقول لأ و الله انا عندي
+
+204
+00:13:54,140 --> 00:13:59,720
+للأسف انا عندي 6 على 24 ايش يعني 6 ع 6 و ايش 6؟
+
+205
+00:13:59,720 --> 00:14:05,920
+ايش الرقم هذا 6؟ 6 يعني 6 متر علشان انجيز للمريض
+
+206
+00:14:05,920 --> 00:14:10,740
+كويس لازم المريض يجف ابعيد عن إشارة الإشارة اللي
+
+207
+00:14:10,740 --> 00:14:17,880
+هو اللي فيها الرموز تبعت النظر لازم تكون 6 متر
+
+208
+00:14:17,880 --> 00:14:21,160
+يعني اللوحة اللي فيها الإشارات تكون بعيدة عنها
+
+209
+00:14:21,160 --> 00:14:26,050
+جديش 6 مترطب في بعض الحالات الغرفة مش كبيرة مش ست
+
+210
+00:14:26,050 --> 00:14:30,570
+متر فبيضطروا يحطوا مراية المراية بتكون ورا ..
+
+211
+00:14:30,570 --> 00:14:34,930
+المراية بتكون يعني خليني أقول يعني زي ما تقولوا في
+
+212
+00:14:34,930 --> 00:14:38,430
+أمام المريض المريض لما نكون لجيتها نتخيل انه في
+
+213
+00:14:38,430 --> 00:14:42,270
+ورا لوحة النظر و جدامه مراية فيها تلاتة متر واخدت
+
+214
+00:14:42,270 --> 00:14:46,590
+كمان تلاتة متر طبعا هذا يقصد يعني عشان احنا بأي ان
+
+215
+00:14:46,590 --> 00:14:51,900
+كان الطريقة المهم تكون بين لوحة الإشاراتو بين
+
+216
+00:14:51,900 --> 00:14:55,860
+المريض اللى بدنا نفحصله لازم تكون 6 متر عشان ايه
+
+217
+00:14:55,860 --> 00:15:00,120
+دايما نفكر كلمة 6 متر ايش اسم اللى بحث نيلين
+
+218
+00:15:00,120 --> 00:15:03,620
+اتشارد خلاص بنعرف على اسم ايه العالم اللى اكتشفها
+
+219
+00:15:03,620 --> 00:15:09,840
+طيب بقول الصح انه اول حاجة لازم نعمل testing each
+
+220
+00:15:09,840 --> 00:15:14,080
+eye alone ماتيجي ده واحد تقوله يلا تطلع لأ لازم
+
+221
+00:15:14,080 --> 00:15:17,740
+نغطي عين زي ما اتفقنا و الأفضل نغطي الشمال قبل
+
+222
+00:15:17,740 --> 00:15:22,840
+نجيس اليمينبعدين بنغطى اليمين و بنجيس الشمال لما
+
+223
+00:15:22,840 --> 00:15:25,960
+نيجى يغطى ما يضغطش كتير على عينه لأنه ممكن مع
+
+224
+00:15:25,960 --> 00:15:28,840
+الضغط كتير على العين لما يفتح مايقدرش يشوف كويسة
+
+225
+00:15:28,840 --> 00:15:31,460
+بس مجرد انه just to cover يعني ممكن يكون بورقة
+
+226
+00:15:31,460 --> 00:15:36,200
+خارجية ماتكونش ضغطة على عين نفسها و احنا بنعمل أيه
+
+227
+00:15:36,200 --> 00:15:39,900
+كمان assessment of extraocular movement بنشوف
+
+228
+00:15:39,900 --> 00:15:42,900
+الحركات الخارجية في العين طبعا كيف بنشوفها by
+
+229
+00:15:42,900 --> 00:15:46,500
+asking the client زي ما هو الكاتب هنااللغة كتبت لـ
+
+230
+00:15:46,500 --> 00:15:49,380
+hold his head and follow movements of your
+
+231
+00:15:49,380 --> 00:15:53,840
+forefinger، بنرفع أصبعنا و بنقول لو سمحت اتطلع في
+
+232
+00:15:53,840 --> 00:15:57,760
+أصبعنا و حاول تلف عينك حوالين ايش الأصبع و اين
+
+233
+00:15:57,760 --> 00:16:02,080
+بيلف، يعني كأنه بنقوله ألحج الأصبع، طبعا مش يلحج
+
+234
+00:16:02,080 --> 00:16:05,510
+بالأصبع يعني كأنه بدي يجوم يلحج الأصبع، لأبعينه
+
+235
+00:16:05,510 --> 00:16:09,590
+يتجه مرة شمال مرة يمين مرة لفوق لتحت عشان نشوف ايه
+
+236
+00:16:09,590 --> 00:16:13,470
+ال extra ocular movements هل في عنده حركات زائدة
+
+237
+00:16:13,470 --> 00:16:17,990
+للعين عشان نكشف عنده حول ولا لا طيب ال visual
+
+238
+00:16:17,990 --> 00:16:21,590
+field اللي بيسموه ايش هنا مجال الرؤية لما نقول
+
+239
+00:16:21,590 --> 00:16:25,160
+peripheral vision او visual field مجال الرؤيةالامر
+
+240
+00:16:25,160 --> 00:16:29,100
+.. الامر مش صعب كتير و لو كنا احنا امامكوا هتكون
+
+241
+00:16:29,100 --> 00:16:32,680
+الأمور بسيطة جدا و ممكن احنا .. يعني نلاقيها على
+
+242
+00:16:32,680 --> 00:16:36,040
+اليوتيوب ببعض الفيديوهات البسيطة جدا عموما باختصار
+
+243
+00:16:36,040 --> 00:16:40,620
+عشان احنا نفهم بكون ايه المريض والطبيب واقفين على
+
+244
+00:16:40,620 --> 00:16:44,420
+أكبر بعض المسافة اللي بينهم تقريبا نقول حوالي متر
+
+245
+00:16:44,420 --> 00:16:47,480
+و عشرين سانتي زي مائة و عشرين سانتي الاتنين
+
+246
+00:16:47,480 --> 00:16:50,080
+بيتطلعوا في بعض تخيلوا معاه كأنه احنا فتحنا اديان
+
+247
+00:16:50,080 --> 00:16:54,420
+التنتينالايد اليامين هي المريض والايد اليسار هو
+
+248
+00:16:54,420 --> 00:16:57,600
+الطبيب اذا وجدت المسافة بين الاتنين الاتنين بتطلع
+
+249
+00:16:57,600 --> 00:17:01,820
+في بعض الان المسافة بينهم متر و عشرين سنتة تقريبا
+
+250
+00:17:01,820 --> 00:17:05,800
+الان ايش بقوله الطبيب بيغطي عينه ايه الطبيبها
+
+251
+00:17:05,800 --> 00:17:10,180
+بيغطي عينه اليمين والمريض اللي على جباله بيغطي
+
+252
+00:17:10,180 --> 00:17:14,000
+عينه الشمال نتخيل ممكن نعمله و انا على المرايا و
+
+253
+00:17:14,000 --> 00:17:17,040
+انا على المرايا الان اول حاجة بيغطي ايه اتقولنا
+
+254
+00:17:17,040 --> 00:17:21,530
+الطبيب عينه ايه اليمينلكن المريض بيغطي عينه
+
+255
+00:17:21,530 --> 00:17:26,390
+الشمال، و إيش بيقوله الآن؟ بيمسك جلم بإيده اللي هو
+
+256
+00:17:26,390 --> 00:17:30,690
+الطبيب، و بقعد يلف الآن، يلف الجلم، و بيقوله إيش؟
+
+257
+00:17:30,690 --> 00:17:35,190
+اتطلع بعينك اليمين، بيقول للمريض، اتطلع بعينك
+
+258
+00:17:35,190 --> 00:17:38,370
+اليمين على الجلم وين بيلف، ليش مهم أني بيحكي زي
+
+259
+00:17:38,370 --> 00:17:42,810
+ذلك؟ كل واحد فينا، اتخيل معايا إيش المقصود، لحرك
+
+260
+00:17:42,810 --> 00:17:46,890
+هتفهمهاالان لو انا بتطلع قاعد على التلفزيون قدامي
+
+261
+00:17:46,890 --> 00:17:51,170
+او انا بتطلع على الجوال وانا بانظر للجوال شايف
+
+262
+00:17:51,170 --> 00:17:55,470
+الجوال لكن لو واحد فتح الباب ودخل برضه انا شايف ان
+
+263
+00:17:55,470 --> 00:18:01,090
+في واحد دخل طيب لو ابني اخويا عمي زعج علي او مرج
+
+264
+00:18:01,090 --> 00:18:04,850
+من قدامي هشوفه الان انا ال central of vision مركز
+
+265
+00:18:04,850 --> 00:18:10,620
+النظر بتطلع على الجوال لكن مجال الرؤيةبكون منتبه
+
+266
+00:18:10,620 --> 00:18:15,340
+لللي حواليه، هذا ايش اسمه؟ اسمه peripheral vision
+
+267
+00:18:15,340 --> 00:18:18,820
+أو اسمه visual fields ان الإنسان هو بتطلع على
+
+268
+00:18:18,820 --> 00:18:21,900
+التلفاز أو جواله أو أي شيء بيشوف اللي حواليه علشان
+
+269
+00:18:21,900 --> 00:18:24,560
+هيك دايما الإنسان يكون .. مش بيقوله الإنسان يكون
+
+270
+00:18:24,560 --> 00:18:27,920
+منتبه لللي حواليه هذا معناته مجال الرؤية في بعض
+
+271
+00:18:27,920 --> 00:18:34,720
+الناس عنده نص مجال الرؤية مش شايف كيف يعني؟ يعني
+
+272
+00:18:34,720 --> 00:18:38,920
+نص مجال الرؤية شايفه و نص مجال الرؤية مش شايفهيعني
+
+273
+00:18:38,920 --> 00:18:42,820
+خلّيني أقول زي كأنها دائرة الدائرة نصها الشمال مش
+
+274
+00:18:42,820 --> 00:18:46,740
+شايفها و نصها اليمين مش شايفها إذا كان في عنده زيك
+
+275
+00:18:46,740 --> 00:18:51,640
+اسم المصطلح Hemianopsia إيش اسمها Hemianopsia يبقى
+
+276
+00:18:51,640 --> 00:18:56,680
+معناته Hemianopsia يعني إيش اللي هو وسط مجال
+
+277
+00:18:56,680 --> 00:19:01,100
+الرؤية لما نكون وسط مجال الرؤية وسط مجال الرؤية
+
+278
+00:19:01,540 --> 00:19:06,480
+شافه ووسط مجال الرؤية ما شافوش بنسميه hemianopsia
+
+279
+00:19:06,480 --> 00:19:10,460
+عشانك ساموه ايش هنا blindness عامة و نص مجال
+
+280
+00:19:10,460 --> 00:19:15,580
+الرؤية طب لو شاف جزء و ماشافش الجزء اللي بعده يعني
+
+281
+00:19:15,580 --> 00:19:19,120
+جهة شاف ربعة كيف يعني؟ يعني خلي الدائرة امامنا
+
+282
+00:19:19,120 --> 00:19:23,520
+اتخيلنا ان الدائرة مجسمة لاربع اقسامهذه الدائرة
+
+283
+00:19:23,520 --> 00:19:27,220
+قسمناها أربع قسم وضعنا في جلبة زائد مثل الشخص في
+
+284
+00:19:27,220 --> 00:19:31,800
+رُبع ما شافوش بنقول ايش اسم ايش عنده Quadrantopsy
+
+285
+00:19:31,800 --> 00:19:35,780
+ايش Quadrantopsy يعني عنده رُبع مجال الرؤية أعمى
+
+286
+00:19:35,780 --> 00:19:41,280
+مش شايفه رُبع مجال الرؤية مش شايفه طيب إذا في نقطة
+
+287
+00:19:41,280 --> 00:19:45,720
+معينة ما شفهاش نقطة معينة في مجال الرؤية ما شفهاش
+
+288
+00:19:45,720 --> 00:19:50,540
+اسمها Ascotomaالـ Ascotoma يعني اسمها island like
+
+289
+00:19:50,540 --> 00:19:54,980
+blindness island زي من كلمة مش ice no island تلفز
+
+290
+00:19:54,980 --> 00:19:58,560
+اللي هي زي جزيرة اللي هو ال island يعني هذه نقطة
+
+291
+00:19:58,560 --> 00:20:02,500
+بتكون ايش بكون في بعض الناس بقولك انا بشوف كل شي
+
+292
+00:20:02,500 --> 00:20:05,240
+بيجينا المريض اعطيكوا مثال ليش هذه المصطلحات
+
+293
+00:20:05,240 --> 00:20:09,800
+الغريبة بعض الناس بيقولك سبحان الله انا لما بكون
+
+294
+00:20:09,800 --> 00:20:12,680
+ماشي في الطريق بشوف كل السيارات على اليمين بشوفش
+
+295
+00:20:12,680 --> 00:20:16,340
+على الشمال بقول عنده ايش hemanopsiaأو بعض الناس
+
+296
+00:20:16,340 --> 00:20:19,560
+بيقول أنا بشوف اليمين، بشوف الشمال، بس في جزء هيك
+
+297
+00:20:19,560 --> 00:20:25,080
+بشوفوهش، الجزء هذا يعني زي حاجة هيك ربع الناس، هذا
+
+298
+00:20:25,080 --> 00:20:27,920
+اسمه ال quadrant nausea، لكن لو قاللي سبحان الله
+
+299
+00:20:27,920 --> 00:20:31,400
+دائما بشوف زي نقطة سوداء قدامي، في نقطة سوداء مش
+
+300
+00:20:31,400 --> 00:20:34,960
+قادر أشوف منها، هذا ايش اسمها؟ Ascotoma، اسمها
+
+301
+00:20:34,960 --> 00:20:38,710
+ايه؟ Ascotoma، أعرف إنه مصطلحات غريبة؟لكن احنا
+
+302
+00:20:38,710 --> 00:20:43,410
+بنعيد و بنكرر حتى لو ماعرفناش عشان نقدر نحفظ
+
+303
+00:20:43,410 --> 00:20:46,570
+المصطلحات عشان اذا مرت علينا يعني مابدي حد يقول
+
+304
+00:20:46,570 --> 00:20:49,410
+يعني ان هذا كبير لأ انا لازم اعطيكوا الشغلات
+
+305
+00:20:49,410 --> 00:20:52,450
+الكبيرة مابحب اعطيكوا الحاجات البسيطة لوحة
+
+306
+00:20:52,450 --> 00:20:56,470
+الإشارات اما بتكون بهذا الشكلحرف ال E ومعناه L او
+
+307
+00:20:56,470 --> 00:20:59,610
+T ايش بتسأل المريض بتقوله بعد ما مغطى عينه مثلا
+
+308
+00:20:59,610 --> 00:21:02,590
+الشمال ايش هذا الحرف ايش هذا الحرف اذا طالع يقولي
+
+309
+00:21:02,590 --> 00:21:06,630
+كويس اذا بقوله خلاص تمام اخرش اذا عندنا طبعا هذا
+
+310
+00:21:06,630 --> 00:21:11,110
+بالقدم عموما احنا ننسى كلمة قدم و في الآخر ايش
+
+311
+00:21:11,110 --> 00:21:16,050
+نقول نقول ان هذا متر نفس اللوحة هي موجودة عموما لو
+
+312
+00:21:16,050 --> 00:21:20,050
+شاف اخر خط ايش بقول بقول النظر عنده ستة ع ستة طب
+
+313
+00:21:20,050 --> 00:21:25,720
+افرضه في اليمين في اليمين شاف النظر كويسلكن في
+
+314
+00:21:25,720 --> 00:21:30,580
+اليسار في اليمين شاف كويس لكن في اليسار ما شافوش
+
+315
+00:21:30,580 --> 00:21:35,720
+بروحش بقول اليمين ستة ع ستة و اليسار ستة ع تسعة طب
+
+316
+00:21:35,720 --> 00:21:39,060
+ليش قلنا ستة ع تسعة احنا قلنا احنا اذا ستة ع ستة
+
+317
+00:21:39,060 --> 00:21:43,420
+يعني شاف كل الأشياء اللي ع ستة متر شافني كويس لكن
+
+318
+00:21:43,420 --> 00:21:48,940
+لو لو لو بس بعد هيك ماجدرش بسيرالناس الطبيعيين
+
+319
+00:21:48,940 --> 00:21:52,240
+اللي بيشوفوه على 9 متر الناس الطبيعيين هيما على 6
+
+320
+00:21:52,240 --> 00:21:55,240
+أو 9 الناس الطبيعيين اللي بيشوفه على 9 المريض
+
+321
+00:21:55,240 --> 00:21:58,780
+بيقدرش يشوفه ولا على 6 متر طب 6 على 12 معناته
+
+322
+00:21:58,780 --> 00:22:01,220
+الناس الطبيعيين اللي بيشوفه على أشياء على 12 متر
+
+323
+00:22:01,220 --> 00:22:07,680
+هو بيقدر يشوفه على وين بس على 6 متر وكذا طيب نشوف
+
+324
+00:22:07,680 --> 00:22:10,120
+ال eye pathologies إيش الأمراض اللي بتسيب في العين
+
+325
+00:22:10,120 --> 00:22:13,200
+أنا عارف إن هو مصطلحات ذريبة لكن ماعليش نتطور أحنا
+
+326
+00:22:13,830 --> 00:22:17,370
+ما هي الأمراض اللي ممكن تصيب العين و انا احكي عنها
+
+327
+00:22:17,370 --> 00:22:19,970
+خاصة للطبيب انا مابدي ااخد لا anatomy ولا
+
+328
+00:22:19,970 --> 00:22:24,290
+physiology ولا بدي ااخد علاج ولا complications انا
+
+329
+00:22:24,290 --> 00:22:28,810
+بس كل اللي بدي احكيه بشكل عام انه بس مصطلحات في
+
+330
+00:22:28,810 --> 00:22:34,550
+حاجة اسمها orbital hematoma اللي الكدمة اللي بتسير
+
+331
+00:22:34,550 --> 00:22:37,570
+في العين و بتلاقي بيقولك عينك اتورمت من الصدمة
+
+332
+00:22:37,570 --> 00:22:42,260
+اسمها hematoma في حاجة اسمها orbitalfractures لا
+
+333
+00:22:42,260 --> 00:22:46,340
+قدر الله كسر في ايش عظمة المحجر، محجر العين زي ال
+
+334
+00:22:46,340 --> 00:22:49,420
+blowout ايش؟ fracture زي لا سبحان الله صدمة شديدة
+
+335
+00:22:49,420 --> 00:22:53,540
+بتسير او اخد box شديد او انصدم في حديد او شي من
+
+336
+00:22:53,540 --> 00:22:58,580
+هذا القبيل هذا اصحاب ruptured globe انفجار مقلة
+
+337
+00:22:58,580 --> 00:23:01,780
+العين بتسير زي في حالات اللي هو ال gun shot او لا
+
+338
+00:23:01,780 --> 00:23:06,160
+قدر الله في صابة حجر او هكذاالـ corneal abrasion
+
+339
+00:23:06,160 --> 00:23:09,920
+اللي هو القرانية نفسها جرح القرانية corneal
+
+340
+00:23:09,920 --> 00:23:13,700
+laceration انزلاع جزء من الزلعة بيسموها جزء من
+
+341
+00:23:13,700 --> 00:23:16,860
+القرانية زي واحد هو مش شايف ممكن ينزلع نفسه برفع
+
+342
+00:23:16,860 --> 00:23:21,400
+أدفر زي هيك بتلاقي جشر عامل زي جشرة للإيش للكورنيا
+
+343
+00:23:21,400 --> 00:23:25,800
+hyphema hyphema اللي هو نزيف العين الداخلي نزيف
+
+344
+00:23:25,800 --> 00:23:29,840
+العين الداخلي اسمه hyphema نزيف العين الداخلي اسمه
+
+345
+00:23:29,840 --> 00:23:36,050
+hyphema arthritis التهاب القزحيةDetached retina،
+
+346
+00:23:36,050 --> 00:23:41,130
+انفصال الشبكية، conjunctivitis، التهاب ملتحمة
+
+347
+00:23:41,130 --> 00:23:46,030
+العين، hordulam أو بيسموها sty، hordulam أو
+
+348
+00:23:46,030 --> 00:23:49,490
+بيسموها sty، أو بيسموها بالعرب الشحاتإيش عن
+
+349
+00:23:49,490 --> 00:23:52,710
+الشحاد؟ ناسيك بتقولي عن الشحاد، هي عبارة عن حاجة
+
+350
+00:23:52,710 --> 00:23:56,510
+يعني بتكون زي شوية bacterial infection في ال
+
+351
+00:23:56,510 --> 00:24:00,050
+eyelids موجودة، زي بعض يعني دم لصغير موجود في ال
+
+352
+00:24:00,050 --> 00:24:02,750
+eyelids، فبقولك إيش عنده حتى لو عندش حد زمان، كان
+
+353
+00:24:02,750 --> 00:24:05,010
+يقول عن كلمة شحاد انه الطفل إذا كان عنده يعني
+
+354
+00:24:05,010 --> 00:24:08,350
+بقولك هذا معناته تعميق أو خليه يروح يجيبله خبزة أو
+
+355
+00:24:08,350 --> 00:24:12,930
+يودي خبزة، يعني من بعض التقاليد اللي هي القديمة في
+
+356
+00:24:12,930 --> 00:24:18,070
+بعض الخاصة اللي هو أكبار السنالحاجة بسموها اللي
+
+357
+00:24:18,070 --> 00:24:22,030
+بعدها Calcium ايش قلت Calcium Calcium أو بسموها
+
+358
+00:24:22,030 --> 00:24:27,030
+Cyst اللي اسمه الكيس الدهني الجفن نفسه بنعص إيدنا
+
+359
+00:24:27,030 --> 00:24:30,790
+عليه شوية بنلاقي فيه تحت الجفن إشي زي طازج شوية
+
+360
+00:24:30,790 --> 00:24:34,450
+طالع لفوق إيش هو لو جلبنا الجفن هلاقي فيه تحته إيش
+
+361
+00:24:34,450 --> 00:24:38,850
+تحته فيه زي كيس أو تجمع دهني وهذا برضه برتفع لما
+
+362
+00:24:38,850 --> 00:24:42,590
+نروح على الطبيب برفعله يعنيPeri-orbital laceration
+
+363
+00:24:42,590 --> 00:24:46,090
+تقرحات
+
+364
+00:24:46,090 --> 00:24:49,590
+يعني
+
+365
+00:24:49,590 --> 00:24:53,770
+بيكون تقرحات حوالين اللي هو هاي ال orbital اللي هو
+
+366
+00:24:53,770 --> 00:24:57,350
+محجر العين من برا في بعض الناس بيصير عندهم نوع من
+
+367
+00:24:57,350 --> 00:25:02,290
+الخدش الخدش أو تزلع البسيط بيكون حوالين الجلد اللي
+
+368
+00:25:02,290 --> 00:25:06,720
+حوالين محجر العينال foreign bodies يعني زي الأجسام
+
+369
+00:25:06,720 --> 00:25:09,740
+الغريبة اللي بتسير كيف لا قدر الله في بعض الناس
+
+370
+00:25:09,740 --> 00:25:14,700
+بيجيب و يقولك والله أنا كنت ماشي فجأة أجت زي شغل
+
+371
+00:25:14,700 --> 00:25:17,680
+شائب في عيني foreign body او واحد اللي سمح الله
+
+372
+00:25:17,680 --> 00:25:22,640
+كان يلحم جنبه اشي أجت شانطيرة او نتفتة اي شي حدديه
+
+373
+00:25:22,640 --> 00:25:26,300
+هذا اسم هو برضه ايش foreign body او لا قدر الله من
+
+374
+00:25:26,300 --> 00:25:29,350
+اجزاز او من اي شي كله اسمه foreign bodycontact
+
+375
+00:25:29,350 --> 00:25:34,030
+lens removal يعني بعض العدسات اللى موجودة عنده هل
+
+376
+00:25:34,030 --> 00:25:38,950
+مرفوعة مش مرفوعة في لابس هذه كلها لابس عدسات اثرت
+
+377
+00:25:38,950 --> 00:25:42,810
+علينا كلها اسم ايش هذه eye pathologies مش شرط انا
+
+378
+00:25:42,810 --> 00:25:46,210
+كمان مرة بقول مابدنا نقول انه ايش ال
+
+379
+00:25:46,210 --> 00:25:49,110
+pathophysiology ولا الانتم لكن نعرف ايش المصطلحات
+
+380
+00:25:49,110 --> 00:25:53,530
+بشكل عام الان ايه ال assessment الان بدنا نعمل
+
+381
+00:25:53,530 --> 00:25:58,450
+assessment لمنطقة ايش الأذنأول حاجة بدنا ask the
+
+382
+00:25:58,450 --> 00:26:03,210
+history .. history of ear surgery .. ear surgery
+
+383
+00:26:03,210 --> 00:26:06,830
+بدنا نسأل أول حاجة هل عمل عمليات عمره في حياته في
+
+384
+00:26:06,830 --> 00:26:12,170
+الأذن؟ هل عنده trauma؟ هل عنده فيه infection زي
+
+385
+00:26:12,170 --> 00:26:15,130
+التناب الأذن الوسطى أو الأذن الخارجية أو الأذن
+
+386
+00:26:15,130 --> 00:26:19,010
+الداخلية؟ هل عنده air ache ألم في الأذن؟ هل في
+
+387
+00:26:19,010 --> 00:26:22,690
+drainage يعني بطلع منه discharge ولا لأ؟هل في عنده
+
+388
+00:26:22,690 --> 00:26:25,790
+hearing loss لا سمح الله فقد في السماء؟ في عنده
+
+389
+00:26:25,790 --> 00:26:30,130
+Tinnitus طانين؟ Vertigo؟ بيحس يعني بدوخة أو إشي في
+
+390
+00:26:30,130 --> 00:26:33,950
+دونه يعني بيحس يعني زي ضوضاء؟ هل عنده autotoxic
+
+391
+00:26:33,950 --> 00:26:38,300
+medications؟ هل عمره استخدم أدوية؟بتعمل تسمم أو
+
+392
+00:26:38,300 --> 00:26:42,240
+خاصة بعض البُكر بتاخدوها و أنت بتاخدوها في ال
+
+393
+00:26:42,240 --> 00:26:46,080
+pharmacology في عنها دوة زي الgen tamicin بنقول
+
+394
+00:26:46,080 --> 00:26:49,440
+عنه autotoxic يعني أن هذا الدواء من ال side effect
+
+395
+00:26:49,440 --> 00:26:53,820
+تبعته أنه بتعمل تسمم لإيش لمنطقة الأذن last
+
+396
+00:26:53,820 --> 00:26:58,200
+hearing examination نسأله متى عملت أخر فحص متى
+
+397
+00:26:58,200 --> 00:27:02,540
+عملت أخر فحص للسمع assess hearing in sitting
+
+398
+00:27:02,540 --> 00:27:06,980
+positionبدنا نسمع .. اللي هالجيتنا بتطلع انا الان
+
+399
+00:27:06,980 --> 00:27:12,000
+بدي اشوف و اقيم الأذن، مالعش نخلي المريض يعني نايم
+
+400
+00:27:12,000 --> 00:27:15,140
+على دهره او على بطنه، دايما حتى لما نروح او نشوف
+
+401
+00:27:15,140 --> 00:27:18,940
+طبيب تبقى أنف أذن حنجرة، بتلاقيه مجاعد المريض،
+
+402
+00:27:18,940 --> 00:27:21,660
+الان لما مجاعد المريض بيجي أول حاجة بيشوف ال ايش
+
+403
+00:27:21,660 --> 00:27:25,120
+ال oracles أخدتوها كل كفاش، في ال anatom of the
+
+404
+00:27:25,120 --> 00:27:27,580
+oracles اللي هو الأذن الخارجية بيمسكها، بيشوف ال
+
+405
+00:27:27,580 --> 00:27:32,570
+sizeو بشوف ايش هنا ال symmetry هل هم متشابهات زي
+
+406
+00:27:32,570 --> 00:27:37,790
+بعض منسجمات ال color اللون لو حد سألنا طب يا أستاذ
+
+407
+00:27:37,790 --> 00:27:41,690
+ايش اللون تبع الأذن عشان يكون عندنا علم كلنا دائما
+
+408
+00:27:41,690 --> 00:27:45,670
+اللون الأذن هو نفس اللون الوجه يبقى الأذن الخارجية
+
+409
+00:27:45,670 --> 00:27:50,550
+نفس اللون الوجه لكن مرات بيصير شوية اختلفات خجل
+
+410
+00:27:50,550 --> 00:27:53,890
+بني أدم صار عنده سخونة صار اتعرض لشيء ماتلاقي دنيا
+
+411
+00:27:53,890 --> 00:27:58,460
+حتى بقولك دنيا صاروا حمر أو صار عندهم سخونةبعض
+
+412
+00:27:58,460 --> 00:28:02,460
+الحالات بيصير redness احمرار مجرد ما يصير redness
+
+413
+00:28:03,330 --> 00:28:07,330
+بدون اي .. يعني اي سبب معين بنقول هذا ايش علامة
+
+414
+00:28:07,330 --> 00:28:12,190
+انه في fever عشان في .. من الدلالات سبحان الله انه
+
+415
+00:28:12,190 --> 00:28:15,550
+صار حرارة بنلاقي الأذن .. الأذنين صار فيه سخونة
+
+416
+00:28:15,550 --> 00:28:18,670
+وهذا رحمه من ربنا ان الدم صار .. صح ذاكرين لما
+
+417
+00:28:18,670 --> 00:28:22,130
+نقول في ال vascular it changes بروح الدم كله بيصل
+
+418
+00:28:22,130 --> 00:28:25,210
+لل .. للأوعية الدموية اللي تحت الجلد فعشان تصير
+
+419
+00:28:25,210 --> 00:28:30,560
+فقد الحرارة مع التناسق اللي هو مباشرةPalor اللي هو
+
+420
+00:28:30,560 --> 00:28:35,260
+ايش يعني Palor هنا اللي هو الشحوب الأذن خاصة في ..
+
+421
+00:28:35,260 --> 00:28:39,540
+في لما يكون البرد قارس بيسموه frostbite، frostbite
+
+422
+00:28:39,540 --> 00:28:43,920
+يعني عضة البرد، كيف يعني عضة البرد؟ عضة البرد في
+
+423
+00:28:43,920 --> 00:28:47,080
+بعض الحالات احنا بنسميه مش يعني عضة البرد كأنه
+
+424
+00:28:47,080 --> 00:28:51,540
+البرد له فم وجاعة بعض، لا بس بيسموها بعض الناس
+
+425
+00:28:51,540 --> 00:28:55,750
+جرسة البردبتلاقي الإنسان صار إيش دنيا لون بيض بشكل
+
+426
+00:28:55,750 --> 00:28:58,130
+كبير و بيقولك أنا مش جاد عشان ايه في بعض الناس و
+
+427
+00:28:58,130 --> 00:29:00,570
+خاص الأجانب صاروا يعملوا على فكرة أجت على غزان
+
+428
+00:29:00,570 --> 00:29:04,990
+بيلبسوا الشغل اللي بتغطي مش عارف ايش اسمها اللي
+
+429
+00:29:04,990 --> 00:29:09,750
+بتغطي الأذنين التنتين مع بعض في أثناء البرد القارس
+
+430
+00:29:09,750 --> 00:29:16,050
+بالبيت oracles لل texture و احنا ماقلناش texture و
+
+431
+00:29:16,050 --> 00:29:19,150
+بشوف ال tenderness و بشوف أيش هنا ال skin lesions
+
+432
+00:29:19,150 --> 00:29:24,580
+إذا في أي علامات أو أي ..شاطب يعني أي الألم درر
+
+433
+00:29:24,580 --> 00:29:28,280
+موجود في وين في الأذن if the client complains إذا
+
+434
+00:29:28,280 --> 00:29:30,880
+المريض شكالي .. إيش يعني شكالي .. شكالي من الألم
+
+435
+00:29:30,880 --> 00:29:35,320
+.. يعني if ال مريض قال لي انا الدنيا بجعوني طبعا
+
+436
+00:29:35,320 --> 00:29:40,780
+أنا حكيم و أنا و حكيمة و أنا ماعنديش طبيب أنفذ من
+
+437
+00:29:40,780 --> 00:29:44,640
+الحنجرة طب كيف بتحكم على اللي أمامي أنه هذا فيه
+
+438
+00:29:44,640 --> 00:29:49,660
+عنده مشكلة أحكم على الأقل أنه من الألماللي موجود
+
+439
+00:29:49,660 --> 00:29:55,200
+من القلم اللي موجود هل هذا الاتهاب أذن خارجية ولا
+
+440
+00:29:55,200 --> 00:29:59,280
+أذن داخلية مش عارف الانش بيقولي pull the oracle
+
+441
+00:29:59,280 --> 00:30:03,140
+ايش يعني pull اسحب ال oracle لفوق يعني نسحب الدهن
+
+442
+00:30:03,140 --> 00:30:06,840
+الخارجي لفوق وإيش بيقولي and press on the tragus
+
+443
+00:30:06,840 --> 00:30:08,980
+كلكم عارفين ما أخدتها في ال Anatomy Tragus يعني
+
+444
+00:30:08,980 --> 00:30:12,100
+الأذن اللي تحت يعني اللي هو قطعة اللحمية الصغيرة
+
+445
+00:30:12,100 --> 00:30:15,700
+اللي تحت اللي هي هذه الأذن الصيوان الأذن اللي
+
+446
+00:30:15,700 --> 00:30:20,810
+شايفينه من برامن فوق هذا اسم الاركيل الدهن اللي
+
+447
+00:30:20,810 --> 00:30:24,690
+تحت اللي عاملة .. حتى عاملة زي الهلال الصغير هذا
+
+448
+00:30:24,690 --> 00:30:28,770
+إيش اسمها؟ اسمها لتراكس لو إحنا سحبنا الاركيل
+
+449
+00:30:28,770 --> 00:30:33,030
+وضغطنا على منطقة التراكس اللي هو إيش بقولي أنا؟
+
+450
+00:30:33,030 --> 00:30:36,330
+وخاص عايش أنا بقولها and behind there وكمان ورا
+
+451
+00:30:36,330 --> 00:30:39,930
+الدهن وإحنا شدينه الآن إيش بقولي؟ إذا الألم زاد
+
+452
+00:30:39,930 --> 00:30:44,350
+يعني ده شدينا الدهن وضغطنا ورا الأذن و تحت على
+
+453
+00:30:44,350 --> 00:30:49,710
+منطقة التراكس إذا الألم زادبنقول عنده external ear
+
+454
+00:30:49,710 --> 00:30:52,450
+infection يعني بنقول هذا الأيش عنده التهاب في
+
+455
+00:30:52,450 --> 00:30:56,410
+الأذن الخارجية بيخوفش طيب إذا الألم ما زادش
+
+456
+00:30:56,410 --> 00:31:00,650
+ماتأثرش إيش بقول عنده إيش middle ear infection
+
+457
+00:31:00,650 --> 00:31:05,250
+اللي بتسمع عنها اسمها otitis media يبقى شغلة بسيطة
+
+458
+00:31:05,250 --> 00:31:09,330
+كتير شدنا الأذن و عصينا حولها إذا الألم زاد otitis
+
+459
+00:31:09,330 --> 00:31:12,910
+external إذا الألم ما زادش otitis media بقولي و
+
+460
+00:31:12,910 --> 00:31:17,210
+اتطلع على ال ear canal شوف كيف القناة تبعت الأذنو
+
+461
+00:31:17,210 --> 00:31:20,530
+ال size و ال discharge إذا بتطيل بتسيل و بنسأله
+
+462
+00:31:20,530 --> 00:31:24,590
+كيف بتسيل كيف يعني طبيعته assessment of cerumen
+
+463
+00:31:24,590 --> 00:31:28,210
+اللي هو الشحمة الأذن الشحمة الأصفر اللي في الداخل
+
+464
+00:31:28,210 --> 00:31:34,450
+إذا أصفر زيادة if it is yellow if it is yellow or
+
+465
+00:31:34,450 --> 00:31:37,730
+green يعني إذا كان أصفر كتير أو لونه أخضر كتير
+
+466
+00:31:37,730 --> 00:31:41,570
+غامق معناته في infectionبدنا نسأله برضه ع ال
+
+467
+00:31:41,570 --> 00:31:44,810
+hearing equity كيف حدث السمع زي ما كنا في حدث بصر
+
+468
+00:31:44,810 --> 00:31:48,950
+في حدث سمع طب كيف انا في المستشفى بدي اقدر اعرف
+
+469
+00:31:48,950 --> 00:31:52,210
+انه بسمع كويس ولا لأ ولا حاجة انا كتمريض باجي
+
+470
+00:31:52,210 --> 00:31:55,710
+بتكلم مع كلمة بقوله ايش انا بروح بتخبى في مكان و
+
+471
+00:31:55,710 --> 00:31:59,390
+بحكي كلمةبخليه يردد ال voice tone، إيش يعني ال
+
+472
+00:31:59,390 --> 00:32:03,250
+voice tone؟ حتة السماعة ليسمعه و بعملي repeating و
+
+473
+00:32:03,250 --> 00:32:06,090
+بكرر الكلمات اللي أنا قلتها، يعني زي ما أنا أقف ع
+
+474
+00:32:06,090 --> 00:32:09,310
+جانب و أقول له مثلا الحمد لله رب العالمين، إذا
+
+475
+00:32:09,310 --> 00:32:12,370
+قاللي نفس الكلمة و بنفس الوثيرة، بعرف إن السماعة
+
+476
+00:32:12,370 --> 00:32:16,550
+كويسة، دير بالكم مجرد ما الإنسان يعلي صوتهمعناته
+
+477
+00:32:16,550 --> 00:32:19,370
+إيه؟ مجرد ما نعالج صوته، بناعرف إنه في إيش عنده
+
+478
+00:32:19,370 --> 00:32:24,310
+هنا defects في ال hearing، يعني عنده تعب و ضرر في
+
+479
+00:32:24,310 --> 00:32:27,250
+إيش في السماع، عشان إيه بنشوف دايما اللي سماعهم
+
+480
+00:32:27,250 --> 00:32:32,320
+ضعيف صوتهم عالي، و هكذا لو كان العكسطب notabene
+
+481
+00:32:32,320 --> 00:32:34,640
+بيقوللي إيش هنا deeper structure إيش أنا deeper
+
+482
+00:32:34,640 --> 00:32:40,100
+يعني التركيبات الداخلية العميقة في الأذن ما بقدر
+
+483
+00:32:40,100 --> 00:32:42,900
+أشوفها بالعين المجردة هبقى أشوفها بإيش بال
+
+484
+00:32:42,900 --> 00:32:47,120
+autoscope و هذا مش شغلي شغل الطبيب الأخصائي طبعا
+
+485
+00:32:47,120 --> 00:32:53,390
+هنا معلش شوي هنايعني هو باختصار هذا يخليكوا ذاكرين
+
+486
+00:32:53,390 --> 00:32:57,310
+بس عشان انا بتشرحها هي هو حطت ال autoscope طبعا هو
+
+487
+00:32:57,310 --> 00:33:00,750
+الآن هي المريضة قاعدة أمامه و هذا المشهد اللي هو
+
+488
+00:33:00,750 --> 00:33:04,870
+مبين من جوا كأنه يعني مصور لنا يعني مقطع زي شريحي
+
+489
+00:33:04,870 --> 00:33:08,490
+يفهمنا ان الأذن هي شكلها من جوا هو أنا بس بقولنا
+
+490
+00:33:08,490 --> 00:33:12,030
+استخدم ال use of the autoscope choose largest
+
+491
+00:33:12,030 --> 00:33:15,290
+speculum .. speculum اللي بيكون محطوط جوا قدام ..
+
+492
+00:33:15,290 --> 00:33:17,430
+قدام اللي هو هذا و أنا عايد .. عايد كم مرة
+
+493
+00:33:17,880 --> 00:33:20,820
+السبيكلام فيها المرات نستخدم السبيكلام من قدام
+
+494
+00:33:20,820 --> 00:33:25,020
+عشان يفتح الأذن كويس و بنستخدم واحد كبير عشان يقدر
+
+495
+00:33:25,020 --> 00:33:28,940
+خاصة لما يكون adult ا choose ا هنا ا choose
+
+496
+00:33:28,940 --> 00:33:32,400
+largestسبيكلام head toward opposite shoulder ايش
+
+497
+00:33:32,400 --> 00:33:36,580
+يعني toward opposite shoulder بنخلي ال head الآن
+
+498
+00:33:36,580 --> 00:33:42,160
+يعني معاكس مع ايش يعني معاكس ال shoulder الكتف
+
+499
+00:33:42,160 --> 00:33:46,290
+يعني بنخليهوش ادير راسه مع اتجاهاللي هو يعني مثلا
+
+500
+00:33:46,290 --> 00:33:50,970
+قاعد زي هيكة أنا مثلا بده أشوف الأيمن، بخليه يطلع
+
+501
+00:33:50,970 --> 00:33:54,730
+قدام، عكس الكتف ما بنخليه يدير على اليمين لإن هو
+
+502
+00:33:54,730 --> 00:33:58,310
+هيتعبني مش هقدر و هيتعب نفسه و يدير حاله، خليه زي
+
+503
+00:33:58,310 --> 00:34:03,050
+ما هو مبقاش ما أقدر أعمله assessment، بقول طبعا
+
+504
+00:34:03,050 --> 00:34:07,390
+adult ear اللي بين upper and back يعني لما نكون في
+
+505
+00:34:07,390 --> 00:34:11,330
+ال adult بدنا نفحص الأذن خاصة الطبيب الشاطرلما
+
+506
+00:34:11,330 --> 00:34:15,330
+بتفحص الأذن كويس بيسحب البنة لوين؟ البنة اللي هو
+
+507
+00:34:15,330 --> 00:34:18,690
+أعلى الأذن لفوق upper and back يعني بيسحبها لافوق
+
+508
+00:34:18,690 --> 00:34:22,530
+ولا ورا لما تكون اسحبها لافوق ولا ورا بتفتح الأذن
+
+509
+00:34:22,530 --> 00:34:26,430
+كويس أما في الأطفال لسه الأذن ماجتملش ماجتملش
+
+510
+00:34:26,430 --> 00:34:30,650
+الاناطمية تبعها فبقولي لأ خاصة إيش هنا الأجل من
+
+511
+00:34:30,650 --> 00:34:34,010
+تلت سنين بقولي في الأجل من تلت سنين معلش اعمل
+
+512
+00:34:34,010 --> 00:34:38,630
+العكس إيش العكس؟ بقول لأ اسحب البنة down لتحت مش
+
+513
+00:34:38,630 --> 00:34:42,930
+لفوقو بقول hold otoscope upside down ايش upside
+
+514
+00:34:42,930 --> 00:34:46,270
+down يعني اللي لازم تمسك ال otoscope من الأعلى
+
+515
+00:34:46,270 --> 00:34:50,170
+للأسفل ماتمسكوش لا مائل ولا كده طبعا هذه الشغلة
+
+516
+00:34:50,170 --> 00:34:53,290
+بالذات يعني هي بس من باب المعرفة لكن هي شغل الطبيب
+
+517
+00:34:53,290 --> 00:34:57,710
+مش شغل احنا اكتر طيب ال external canal عشان اخلص
+
+518
+00:34:57,710 --> 00:35:02,730
+لان انا بدأت اقترب للنصف ساعة ال external canal
+
+519
+00:35:02,730 --> 00:35:09,190
+بشوف اذا في readinessاو مثلا في allegiance او في
+
+520
+00:35:09,190 --> 00:35:13,210
+foreign body او في discharge يعني انا بتسأله خاصة
+
+521
+00:35:13,210 --> 00:35:17,330
+هذا بيسموه ايش الأذن الخارجية بروح بدونها و بكتبها
+
+522
+00:35:17,330 --> 00:35:21,030
+ال timpanic membrane اللي هو الطبلة طبلة الأذن
+
+523
+00:35:21,030 --> 00:35:24,210
+يعني الداخليةلو انا .. طبعا أنا مش هقدر اخد
+
+524
+00:35:24,210 --> 00:35:27,870
+اوتسكوب لكن نعرف انه ال killer تبعه لازم يحكي لنا
+
+525
+00:35:27,870 --> 00:35:31,070
+يا الطبيب او يكون مكتوب و كيف ال character و هل لا
+
+526
+00:35:31,070 --> 00:35:34,570
+سمح الله في عنده perforation، perforation يعني رشح
+
+527
+00:35:34,570 --> 00:35:38,130
+في الطابلة زي بعض الحالات اللي باخد هواية جامدة
+
+528
+00:35:38,130 --> 00:35:43,060
+فبصير ثقوب في الطابلة، طابلة الأذنبنسأله هل هي
+
+529
+00:35:43,060 --> 00:35:48,020
+translucent يعني هل بتعبر ضوء و لا مابتعبروش بقوله
+
+530
+00:35:48,020 --> 00:35:50,840
+انها بتشبه ال pearly grey ال pearly grey زي حاجة
+
+531
+00:35:50,840 --> 00:35:56,220
+بسمها الأرجوانية زي ال .. زي ال .. ال .. الرماد
+
+532
+00:35:56,220 --> 00:36:00,680
+على لون زي الذهب اللي لونه الرمادي يعني كأنه
+
+533
+00:36:00,680 --> 00:36:05,000
+بديقولي الأصفر بيكون على .. على اللون orange بس
+
+534
+00:36:05,000 --> 00:36:09,170
+قاتم شوية gray color هذا طبيعيطبعا كيف بيكون
+
+535
+00:36:09,170 --> 00:36:14,390
+المنظر كون شبه زي القمع من قدام واسع ورا من الداخل
+
+536
+00:36:14,390 --> 00:36:19,150
+اشماله ضيق شوية وفيه light reflex بيصير انعكاس
+
+537
+00:36:19,150 --> 00:36:23,230
+للضوء خاصة في الأذن الطبيعية خليني اقفل هنا لانه
+
+538
+00:36:23,230 --> 00:36:27,170
+انا يعني معلش يبدو الوقت بياخدنا ستة و تلاتين
+
+539
+00:36:27,170 --> 00:36:29,750
+دقيقة معلش سامحونا ونكمل ان ش الله المحاضرة
+
+540
+00:36:29,750 --> 00:36:33,170
+القادمة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..0c4d07d4d3f46411e063f351949529619d1ae779
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 3051, "start": 1.55, "end": 30.51, "text": "بسم الله الرحمن الرحيم اليوم طبعا هنبدأ في ال chapter السادس ونبدأ طبعا بال إيه؟ زي ما انتوا شايفين أنا قدامكم head assessment طبعا احنا الحمد لله خلصنا في ال chapter السابق لما تكلمنا على ال position بشكل عام و لما بدينا في ال assessment أخدنا ال hair أخدنا ال skin طبعا بداية من ال head tattoo زي ما احنا قلنا", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 45595, 20498, 23032, 3555, 3615, 995, 8032, 1863, 44510, 10721, 8978, 2423, 7187, 21136, 18513, 3794, 4032, 1863, 44510, 10721, 23032, 3555, 3615, 995, 20666, 11933, 1829, 3224, 22807, 30767, 1829, 19446, 16472, 2655, 14407, 13412, 995, 33911, 9957, 41850, 12174, 3215, 10943, 24793, 1378, 9687, 23032, 3555, 3615, 995, 1975, 5016, 8315, 21542, 2304, 3215, 24976, 3224, 16490, 1211, 9381, 8315, 8978, 2423, 7187, 21136, 16758, 4587, 5296, 15042, 6055, 4117, 19528, 8315, 15844, 2423, 2535, 4724, 8592, 28820, 6225, 10943, 4032, 5296, 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عنده نوع من شوية hormonal disturbance و عملاله ايش و عملاله ايش زي عملقة و كبر في الرأس و محيط الرأس زي باقي عضاء الجسم اول شي ببقى ال base of the skull for nodules or masses بنحط دي هنا بنبدأ نحس اللي هو فروة الرأس", "tokens": [9778, 33546, 3660, 37495, 22653, 31439, 4724, 1829, 39648, 3714, 43020, 7251, 30544, 1975, 1829, 8592, 16490, 33546, 3660, 2423, 1378, 4032, 2423, 15642, 10491, 1975, 1829, 8592, 4724, 1829, 30544, 43242, 3224, 1975, 4117, 2288, 20498, 1829, 7435, 6027, 1829, 1975, 37983, 20498, 1829, 7435, 6027, 1829, 37495, 22653, 1975, 1829, 8592, 18863, 2304, 1211, 28671, 4724, 1829, 30544, 31439, 37495, 22653, 23758, 43242, 3224, 8717, 45367, 9154, 13412, 2407, 10632, 11876, 21523, 35684, 4032, 6225, 42213, 6027, 3224, 1975, 1829, 8592, 4032, 6225, 42213, 6027, 3224, 1975, 1829, 8592, 30767, 1829, 6225, 2304, 1211, 28671, 4032, 9122, 26890, 8978, 34892, 10721, 3794, 4032, 3714, 5016, 1829, 9566, 34892, 10721, 3794, 30767, 1829, 4724, 995, 38436, 6225, 11242, 16606, 25724, 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"end": 135.08, "word": " و", "probability": 0.99462890625}, {"start": 135.08, "end": 135.38, "word": " محيط", "probability": 0.94580078125}, {"start": 135.38, "end": 135.68, "word": " الرأس", "probability": 0.98681640625}, {"start": 135.68, "end": 135.9, "word": " زي", "probability": 0.989990234375}, {"start": 135.9, "end": 136.28, "word": " باقي", "probability": 0.9615885416666666}, {"start": 136.28, "end": 136.96, "word": " عضاء", "probability": 0.9378255208333334}, {"start": 136.96, "end": 138.16, "word": " الجسم", "probability": 0.97412109375}, {"start": 138.16, "end": 139.34, "word": " اول", "probability": 0.8935546875}, {"start": 139.34, "end": 139.46, "word": " شي", "probability": 0.6845703125}, {"start": 139.46, "end": 139.7, "word": " ببقى", "probability": 0.61431884765625}, {"start": 139.7, "end": 139.96, "word": " ال", "probability": 0.634765625}, {"start": 139.96, "end": 139.96, "word": " base", "probability": 0.68017578125}, {"start": 139.96, "end": 140.16, "word": " of", "probability": 0.7216796875}, {"start": 140.16, "end": 140.46, "word": " the", "probability": 0.89794921875}, {"start": 140.46, "end": 140.88, "word": " skull", "probability": 0.92333984375}, {"start": 140.88, "end": 141.28, "word": " for", "probability": 0.671875}, {"start": 141.28, "end": 142.0, "word": " nodules", "probability": 0.921142578125}, {"start": 142.0, "end": 142.46, "word": " or", "probability": 0.87451171875}, {"start": 142.46, "end": 142.94, "word": " masses", "probability": 0.9208984375}, {"start": 142.94, "end": 144.06, "word": " بنحط", "probability": 0.7755533854166666}, {"start": 144.06, "end": 144.24, "word": " دي", "probability": 0.74609375}, {"start": 144.24, "end": 144.34, "word": " هنا", "probability": 0.96923828125}, {"start": 144.34, "end": 144.7, "word": " بنبدأ", "probability": 0.736572265625}, {"start": 144.7, "end": 145.04, "word": " نحس", "probability": 0.9925130208333334}, {"start": 145.04, "end": 145.22, "word": " اللي", "probability": 0.953369140625}, 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{"start": 2170.25, "end": 2170.63, "word": " شبه", "probability": 0.61083984375}, {"start": 2170.63, "end": 2170.89, "word": " زي", "probability": 0.85107421875}, {"start": 2170.89, "end": 2171.45, "word": " القمع", "probability": 0.9431966145833334}, {"start": 2171.45, "end": 2172.13, "word": " من", "probability": 0.93701171875}, {"start": 2172.13, "end": 2172.63, "word": " قدام", "probability": 0.9342447916666666}, {"start": 2172.63, "end": 2173.09, "word": " واسع", "probability": 0.9718424479166666}, {"start": 2173.09, "end": 2173.79, "word": " ورا", "probability": 0.63037109375}, {"start": 2173.79, "end": 2173.97, "word": " من", "probability": 0.98681640625}, {"start": 2173.97, "end": 2174.39, "word": " الداخل", "probability": 0.99072265625}, {"start": 2174.39, "end": 2174.85, "word": " اشماله", "probability": 0.8833984375}, {"start": 2174.85, "end": 2175.69, "word": " ضيق", "probability": 0.96484375}, {"start": 2175.69, "end": 2176.15, "word": " شوية", "probability": 0.84912109375}, {"start": 2176.15, "end": 2177.09, "word": " وفيه", "probability": 0.7080078125}, {"start": 2177.09, "end": 2177.57, "word": " light", "probability": 0.88818359375}, {"start": 2177.57, "end": 2178.15, "word": " reflex", "probability": 0.806640625}, {"start": 2178.15, "end": 2178.63, "word": " بيصير", "probability": 0.8397216796875}, {"start": 2178.63, "end": 2179.15, "word": " انعكاس", "probability": 0.9588623046875}, {"start": 2179.15, "end": 2179.81, "word": " للضوء", "probability": 0.9375}, {"start": 2179.81, "end": 2180.33, "word": " خاصة", "probability": 0.9554036458333334}, {"start": 2180.33, "end": 2180.41, "word": " في", "probability": 0.92138671875}, {"start": 2180.41, "end": 2180.69, "word": " الأذن", "probability": 0.9314778645833334}, {"start": 2180.69, "end": 2181.19, "word": " الطبيعية", "probability": 0.9185791015625}, {"start": 2181.19, "end": 2181.91, "word": " خليني", "probability": 0.69482421875}, {"start": 2181.91, "end": 2182.25, "word": " اقفل", "probability": 0.53607177734375}, {"start": 2182.25, "end": 2182.47, "word": " هنا", "probability": 0.9443359375}, {"start": 2182.47, "end": 2183.23, "word": " لانه", "probability": 0.6650390625}, {"start": 2183.23, "end": 2183.67, "word": " انا", "probability": 0.724609375}, {"start": 2183.67, "end": 2184.25, "word": " يعني", "probability": 0.855712890625}, {"start": 2184.25, "end": 2184.65, "word": " معلش", "probability": 0.7036946614583334}, {"start": 2184.65, "end": 2185.71, "word": " يبدو", "probability": 0.8502604166666666}, {"start": 2185.71, "end": 2186.15, "word": " الوقت", "probability": 0.8238932291666666}, {"start": 2186.15, "end": 2186.61, "word": " بياخدنا", "probability": 0.941015625}, {"start": 2186.61, "end": 2186.87, "word": " ستة", "probability": 0.8474934895833334}, {"start": 2186.87, "end": 2186.97, "word": " و", "probability": 0.62939453125}, {"start": 2186.97, "end": 2187.17, "word": " تلاتين", "probability": 0.9537353515625}, {"start": 2187.17, "end": 2187.43, "word": " دقيقة", "probability": 0.84130859375}, {"start": 2187.43, "end": 2187.69, "word": " معلش", "probability": 0.9217122395833334}, {"start": 2187.69, "end": 2188.17, "word": " سامحونا", "probability": 0.9509765625}, {"start": 2188.17, "end": 2189.13, "word": " ونكمل", "probability": 0.910888671875}, {"start": 2189.13, "end": 2189.23, "word": " ان", "probability": 0.65185546875}, {"start": 2189.23, "end": 2189.23, "word": " ش", "probability": 0.96923828125}, {"start": 2189.23, "end": 2189.33, "word": " الله", "probability": 0.294921875}, {"start": 2189.33, "end": 2189.75, "word": " المحاضرة", "probability": 0.9786376953125}, {"start": 2189.75, "end": 2190.65, "word": " القادمة", "probability": 0.9607747395833334}, {"start": 2190.65, "end": 2191.05, "word": " والسلام", "probability": 0.8533528645833334}, {"start": 2191.05, "end": 2191.37, "word": " عليكم", "probability": 0.9287109375}, {"start": 2191.37, "end": 2191.77, "word": " ورحمة", "probability": 0.951416015625}, {"start": 2191.77, "end": 2192.03, "word": " الله", "probability": 0.9755859375}, {"start": 2192.03, "end": 2193.17, "word": " وبركاته", "probability": 0.9873046875}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2195.2841875, "duration_after_vad": 2163.159999999992}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..76e07d841c8508b6b6a24f11f0287005bd0244cc
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/xT1YjAJidk4_raw.srt
@@ -0,0 +1,2160 @@
+1
+00:00:01,550 --> 00:00:05,550
+بسم الله الرحمن الرحيم اليوم طبعا هنبدأ في ال
+
+2
+00:00:05,550 --> 00:00:10,490
+chapter السادس ونبدأ
+
+3
+00:00:10,490 --> 00:00:13,690
+طبعا بال إيه؟ زي ما انتوا شايفين أنا قدامكم head
+
+4
+00:00:13,690 --> 00:00:17,750
+assessment طبعا احنا الحمد لله خلصنا في ال chapter
+
+5
+00:00:17,750 --> 00:00:22,610
+السابق لما تكلمنا على ال position بشكل عام و لما
+
+6
+00:00:22,610 --> 00:00:27,030
+بدينا في ال assessment أخدنا ال hair أخدنا ال skin
+
+7
+00:00:27,030 --> 00:00:31,710
+طبعا بداية من ال head tattoo زي ما احنا قلنابعدين
+
+8
+00:00:31,710 --> 00:00:36,890
+كدا ندخل شوية شوية في ايش في اجزاء الجسم طبعا احنا
+
+9
+00:00:36,890 --> 00:00:39,790
+بنتكلم على physical examination عشان احنا نكون
+
+10
+00:00:39,790 --> 00:00:43,410
+عارفين من ال physical assessment اول حاجة في ال
+
+11
+00:00:43,410 --> 00:00:47,550
+head assessment اش بقول هنا بقول inspects for size
+
+12
+00:00:47,550 --> 00:00:52,510
+اول حاجة تطلع على حجم الرقص shape الشكل ال contour
+
+13
+00:00:52,510 --> 00:00:57,370
+يعني كيف تضاريس الرقص يعني و لقدام هقولكوا ايش
+
+14
+00:00:57,370 --> 00:01:01,360
+بنقصد فيه ال contourالـ Skull جنرالي ايش بقولي
+
+15
+00:01:01,360 --> 00:01:04,660
+هنا؟ round يبقى هى ال contours بقولي هنا round
+
+16
+00:01:04,660 --> 00:01:07,900
+anterior and posterior prominences ايش يعني
+
+17
+00:01:07,900 --> 00:01:10,980
+anterior and posterior prominences يعني سبحان الله
+
+18
+00:01:10,980 --> 00:01:16,120
+كأنه بيقول الرأس يعني اقرب للبيضاوي فيه نتوئات
+
+19
+00:01:16,120 --> 00:01:20,660
+أماميه و نتوئات في الخلف بعض الناس طبعا مختلفة
+
+20
+00:01:20,660 --> 00:01:25,500
+ممكن يكون يعني بشكل دائر اكبر في شكل زى مستطيل او
+
+21
+00:01:25,500 --> 00:01:29,680
+مطاول اكتر و هكذاال large infants head يعني الرأس
+
+22
+00:01:29,680 --> 00:01:34,100
+الكبير في الأطفال في الصغار ايش اسمه بكون السبب
+
+23
+00:01:34,100 --> 00:01:37,760
+هيدرو سيفلس استسقاء الرأس يعني لو شفنا طفل صغير
+
+24
+00:01:37,760 --> 00:01:41,620
+جدا لما راح نضربه ممكن نشوف حالات زي هيك و لجينا
+
+25
+00:01:41,620 --> 00:01:45,700
+انه الرأس تبعه يعني اكبر من اللازم بنقول عنده
+
+26
+00:01:45,700 --> 00:01:49,220
+هيدرو سيفلس اما ده شفناه عند الكبار يعني انسان
+
+27
+00:01:49,220 --> 00:01:55,100
+كبير في السن لكن ايه عنده large large size of the
+
+28
+00:01:55,100 --> 00:01:59,480
+head ايش بنقول عنه اناخاصة يعني هو بيقول ممكن يكون
+
+29
+00:01:59,480 --> 00:02:02,500
+ايش خاصة ال head و ال facial bones ايش بيكون عنده
+
+30
+00:02:02,500 --> 00:02:06,980
+اكروميجالي اكروميجالي يعني ايش العملقة بيكون هو
+
+31
+00:02:06,980 --> 00:02:11,060
+يعني هذا عنده نوع من شوية hormonal disturbance و
+
+32
+00:02:11,060 --> 00:02:15,080
+عملاله ايش و عملاله ايش زي عملقة و كبر في الرأس و
+
+33
+00:02:15,080 --> 00:02:19,960
+محيط الرأس زي باقي عضاء الجسم اول شي ببقى ال base
+
+34
+00:02:19,960 --> 00:02:24,340
+of the skull for nodules or masses بنحط دي هنا
+
+35
+00:02:24,340 --> 00:02:27,980
+بنبدأ نحس اللي هو فروة الرأسو المنطقة وقتها بتاعة
+
+36
+00:02:27,980 --> 00:02:33,260
+الرأس نفسها هل في nodules يعني حاجات طالعة بارزة
+
+37
+00:02:33,260 --> 00:02:38,120
+هل في في الجلد خاصة هل في masses لا قدر الله هل في
+
+38
+00:02:38,120 --> 00:02:41,760
+عنده tumors او شي من هذا القبيل او لأ طيب
+
+39
+00:02:41,760 --> 00:02:46,560
+assessment of the eye لقيت اول شي موجود عندنا في
+
+40
+00:02:46,560 --> 00:02:50,740
+ال head و هو الرأس العين طبعا هذه بس من باب
+
+41
+00:02:50,740 --> 00:02:55,780
+التشريح و نذكركم التذكرة طبعا احنااعتقد اخدتوا في
+
+42
+00:02:55,780 --> 00:03:01,120
+التشريح انتوا في تشريح واحد و .. و يعني مروا
+
+43
+00:03:01,120 --> 00:03:03,980
+عليكوا كتير و ان شاء الله لما تروحوا العملي هتشوف
+
+44
+00:03:03,980 --> 00:03:07,280
+كمان يعني بعضكم اللي ما نسيش في العيون هيتذكر كمان
+
+45
+00:03:07,280 --> 00:03:10,740
+هذه الكلمات باختصار احنا هذا اللي انتوا شايفينه
+
+46
+00:03:10,740 --> 00:03:13,960
+ايه العين بشكل عام اللي بهمنا الان طبعا هذه
+
+47
+00:03:13,960 --> 00:03:17,660
+القرانية اللي هي قدام الأمام وهذا .. هذه القرانية
+
+48
+00:03:17,660 --> 00:03:22,850
+زي ما تشايفينها طبعا هذا المنطقه اللي هنا كلهاللي
+
+49
+00:03:22,850 --> 00:03:26,270
+بتلمش اللي جوا بتتكلم اللي من هذا الطرف هذا اسمه
+
+50
+00:03:26,270 --> 00:03:30,610
+ال sclera الصلبة اللي هي الجسم الأبيض طبعا جوا في
+
+51
+00:03:30,610 --> 00:03:34,530
+السائل الزجاجي في هذا المكان اسمه vitreous في هنا
+
+52
+00:03:34,530 --> 00:03:38,850
+.. هنا اللي ملتزق من الداخل اللي ملتزق من الداخل
+
+53
+00:03:38,850 --> 00:03:43,650
+هذا اسمه retina اللي هو الشبكية و هنا ايه ال optic
+
+54
+00:03:43,650 --> 00:03:48,350
+nerve اللي هو العصب البصري ال optic nerve في هنا
+
+55
+00:03:48,350 --> 00:03:52,840
+حاجة اسمها ايش الجسم الأصفر اسمها الماكولااللي هو
+
+56
+00:03:52,840 --> 00:03:56,820
+مركز الإبصار مركز الإبصار الإنسان بيقدر يشوف كل
+
+57
+00:03:56,820 --> 00:04:00,420
+شيء بينعكس جوا إلا إذا عكس على هذا المكان بيقدرش
+
+58
+00:04:00,420 --> 00:04:04,060
+يشوفه لإيه؟ لأن الإنسان مقدرش يعني زي حكاية المعدة
+
+59
+00:04:04,060 --> 00:04:08,320
+بتهضومش حالها و العين بتشوفش حالها طبعا هذا بقبق
+
+60
+00:04:08,320 --> 00:04:12,340
+العين ال pupil و هذا ال lens وراها هذه العدسة اللي
+
+61
+00:04:12,340 --> 00:04:15,280
+لما شوية بيصير فيها شوية deformity أو فيها
+
+62
+00:04:15,280 --> 00:04:19,300
+discoloration بيصير عندهم بعض الناس مكتركت اللي هو
+
+63
+00:04:19,300 --> 00:04:25,410
+المياه البيضاءوطبعا في حواليها يعني دائرة حواليها
+
+64
+00:04:25,410 --> 00:04:30,490
+ماسكة ال lens اسمها ال iris اللي قزحية اللي بتعمل
+
+65
+00:04:30,490 --> 00:04:33,810
+لون العين هذا فقط من باب التشريح تبع العين اللي
+
+66
+00:04:33,810 --> 00:04:37,270
+بهمنا هنا ان انا كيف بتعمل assessment للعين اول
+
+67
+00:04:37,270 --> 00:04:39,970
+حاجة عشان بتعمل assessment بتستخدم حاجة اسمها
+
+68
+00:04:39,970 --> 00:04:43,430
+Snelling chart ال snelling chart كلكم بتعرفوها هي
+
+69
+00:04:43,430 --> 00:04:47,830
+عبارة عن لوحة النظر بيسموهااللي دايما بتطلع عليه
+
+70
+00:04:47,830 --> 00:04:51,930
+الإنسان إما حرف زي ال E أو حرف C أو مثلا أشكال
+
+71
+00:04:51,930 --> 00:04:55,450
+معينة و بيجي .. بيسأل المريض بيسأل .. بيسأل الطبيب
+
+72
+00:04:55,450 --> 00:04:59,370
+بيسأل المريض وين فتحت هذه الحرف و وين اتجاه هذا
+
+73
+00:04:59,370 --> 00:05:03,290
+الحرف عشان يقدر يأكد انه كدهش في عنده مشكلة أو لا
+
+74
+00:05:03,290 --> 00:05:08,270
+طبعا احنا و احنا بنعمل assessment للآيط طب افرضه
+
+75
+00:05:08,270 --> 00:05:12,970
+انا ماعنديش اسنين ال chart ماعنديش اسنين ال chart
+
+76
+00:05:14,600 --> 00:05:18,320
+يعني انا موجود في المستشفى اتفاجأت انه ايش طب بده
+
+77
+00:05:18,320 --> 00:05:21,520
+اشوف انه بصر المريض كويس ولا ماعندش لوحة اشارات زى
+
+78
+00:05:21,520 --> 00:05:25,060
+الشفاء او مستشفى ناصر او اي مستشفى بقول لي في مرات
+
+79
+00:05:25,060 --> 00:05:29,280
+ابنى عمل حاجة بسمها chart ايش هنا او newsprint ايش
+
+80
+00:05:29,280 --> 00:05:33,120
+newsprint يعني احنا ممكن نجيبله جريدة زى جريدة او
+
+81
+00:05:33,120 --> 00:05:37,720
+بنجيبله ملف يعني احنا ممكن اجي اقوله لو سمحتممكن
+
+82
+00:05:37,720 --> 00:05:40,120
+تقرأ .. ممكن .. عشان انا بدي أشوف المريض بيشوف
+
+83
+00:05:40,120 --> 00:05:44,220
+كويس ولا لأ بقول ممكن تقرأ اللي في الملف ممكن أنت
+
+84
+00:05:44,220 --> 00:05:48,320
+تتطلع في هذه الورقة أو في هذه الجريدة الطبيعي
+
+85
+00:05:48,320 --> 00:05:52,000
+البني أدم الطبيعي يكون البعد بين اللي بديه يقراه و
+
+86
+00:05:52,000 --> 00:05:55,200
+بين عينه خمسة و عشرين سانتي يعني خلينا نقول زي شبر
+
+87
+00:05:55,200 --> 00:05:58,640
+يعني لما نقول شبر هيك كبير تقريبا وزيادة اتنين
+
+88
+00:05:58,640 --> 00:06:01,920
+تلاتة سانتي هيك الطبيعي لكن لو جرب معناته مشكلة و
+
+89
+00:06:01,920 --> 00:06:05,440
+لو بعد معناته مشكلةطبعا في بعض الحلقات بنعمل حاجة
+
+90
+00:06:05,440 --> 00:06:09,380
+بسموها cover card ايش cover card عشان نتأكد ان
+
+91
+00:06:09,380 --> 00:06:15,800
+العين تان كويسات بنفحص العين و بعدين بنفحص العين
+
+92
+00:06:15,800 --> 00:06:19,380
+التانية كيف يعني؟ يعني احنا بنغطي مثلا العين
+
+93
+00:06:19,380 --> 00:06:23,000
+الشمال و بنفحص اليمين و بعدين بنغطي العين اليمين و
+
+94
+00:06:23,000 --> 00:06:26,900
+بنفحص الشمال هذا اسمه cover card طبعا بعدين
+
+95
+00:06:26,900 --> 00:06:30,200
+بنستخدم ال penlight اللي قلنا عنه احنا مش شغلنا
+
+96
+00:06:30,200 --> 00:06:34,740
+شغل طبيب لخصائي بستخدم ال ophthalmoscopeبقولي ask
+
+97
+00:06:34,740 --> 00:06:38,460
+your client about لازم نسأل المريض عن ايش history
+
+98
+00:06:38,460 --> 00:06:42,580
+of previous eye surgery هل عمرك عملت عملية جراحية
+
+99
+00:06:42,580 --> 00:06:47,860
+في عينك هل اتعرضت ل trauma يعني اتعرضت لاصابة ضربة
+
+100
+00:06:47,860 --> 00:06:51,820
+هل استخدمت حاجة اسمها corrective glass اللي هي
+
+101
+00:06:51,820 --> 00:06:57,060
+النضارات اللي بتعمل تصحيح النضارات المصححة زي بعض
+
+102
+00:06:57,060 --> 00:07:02,120
+النضارات الطبية يعنيأو لبسة contact lenses ال
+
+103
+00:07:02,120 --> 00:07:04,600
+contact lenses أنا مابقصد العدسات اللاصقة
+
+104
+00:07:04,600 --> 00:07:09,260
+التجميلية وانما العدسات اللاصقة العلاجية اللي ممكن
+
+105
+00:07:09,260 --> 00:07:13,760
+ايش اتعالج بعض العيوب الانكسار اللي موجودة عند
+
+106
+00:07:13,760 --> 00:07:17,320
+الإنسان بنسأله هل عندك blurred vision عمره كان
+
+107
+00:07:17,320 --> 00:07:21,360
+زغلالة في النظر دبلوبيا إزدواجية في النظر
+
+108
+00:07:21,360 --> 00:07:25,520
+Strabismus Strabismus معناته squint معناته بالعرب
+
+109
+00:07:25,520 --> 00:07:30,550
+الحوال هل في عندك حوال؟recent changes in vision هل
+
+110
+00:07:30,550 --> 00:07:36,470
+اتغير حديثا النظر عندك حسيت نظرك ضعف اخر اشهر خاصة
+
+111
+00:07:36,470 --> 00:07:41,150
+اخر ست شهر اه و الله صار طب متصار طب وقت ايش انت
+
+112
+00:07:41,150 --> 00:07:46,010
+عملت vision test متعملت فحص للنظر في عندك
+
+113
+00:07:46,010 --> 00:07:49,890
+allergies معينة طبعا ايش allergies هنا دخلة في
+
+114
+00:07:49,890 --> 00:07:53,660
+العين في بعض الناس عندهم حساسيةاللي في عينهم
+
+115
+00:07:53,660 --> 00:07:57,620
+لأشياء محددة بقولك والله انا اذا اجى غبار علي عيني
+
+116
+00:07:57,620 --> 00:08:00,880
+بيصير عنده حسية انا لو انا اخدت اي جدرة معينة
+
+117
+00:08:00,880 --> 00:08:03,380
+بيصير عنده حسية بدنا نسأل في شكل عام هل في عندك
+
+118
+00:08:03,380 --> 00:08:08,920
+حسية ولا لأ بيصير عندك احمرار في العين او frequent
+
+119
+00:08:08,920 --> 00:08:12,830
+watering dischargeيعني هل بتحسوا ان هيك كتير
+
+120
+00:08:12,830 --> 00:08:16,710
+بدمعوا طبعا لما نكونوا كتير بدمعوا مش يجيب بالنا
+
+121
+00:08:16,710 --> 00:08:21,610
+انه بس هي دموعه فقط لأ ممكن تكون القناة مجرد دمع
+
+122
+00:08:21,610 --> 00:08:26,190
+مغلقة مش موضوعنا الآن later on هنتكلم عنها طيب
+
+123
+00:08:26,190 --> 00:08:30,430
+السس أول حاجة فيه external organs وفي internal
+
+124
+00:08:30,430 --> 00:08:33,690
+organs انا بتكلم بنفس ال eye ال external eye
+
+125
+00:08:33,690 --> 00:08:37,390
+structure زي ايش اللي انا بشوفه من براهذا اسمه
+
+126
+00:08:37,390 --> 00:08:41,290
+external اول ما اطلع في عين المريض و بقدر اشوفه
+
+127
+00:08:41,290 --> 00:08:45,690
+البيوب والبقبق العين عيرس قزحية ال visual equity
+
+128
+00:08:45,690 --> 00:08:49,690
+كده حدث الإبصار اسمها كده بصرف اشوفه كويسه ولا لأ
+
+129
+00:08:49,690 --> 00:08:54,670
+اوكيولار موفمنس اوكيولار موفمنس يعني باشي باشوف
+
+130
+00:08:54,670 --> 00:08:59,550
+ايه باشوف كده حركة اين هي الصحيحات يعني بتحرك شمال
+
+131
+00:08:59,550 --> 00:09:02,590
+يمين فوق لتحت اللي فيه مشكلة بدي اشوف حاجة اسمها
+
+132
+00:09:02,590 --> 00:09:06,220
+peripheral visionاللي هو Asian peripheral vision
+
+133
+00:09:06,220 --> 00:09:10,400
+اسمها مجال الرؤية او الرؤية الطرفية يعني لما بتطلع
+
+134
+00:09:10,400 --> 00:09:14,420
+فيا شايف اللي حوليا هذا اسمه peripheral vision ولا
+
+135
+00:09:14,420 --> 00:09:18,420
+بس بتطلع بشوف اللي قدامه فقط اما ال internal eye
+
+136
+00:09:18,420 --> 00:09:22,820
+structure بقدرش اشوفهم زي ايش ممكن ال iris انا
+
+137
+00:09:22,820 --> 00:09:26,500
+اشوفه ال retina لأ ب the edge of the thermoscope
+
+138
+00:09:26,500 --> 00:09:30,660
+ال macula اللي جونا عن الجسم الأصفر و ال optic
+
+139
+00:09:30,660 --> 00:09:35,070
+nerve و هكذا كله مقدرش اشوفهلنترك طبعا إلا بال off
+
+140
+00:09:35,070 --> 00:09:38,890
+-thalmoscope مش شغلي أنا بس أقدر أعمل assessment
+
+141
+00:09:38,890 --> 00:09:44,510
+for external eye organs بكون كويس طيب consider the
+
+142
+00:09:44,510 --> 00:09:48,790
+following factors يجب أن تأخذ باعتبار العوامل
+
+143
+00:09:48,790 --> 00:09:54,510
+التالية ال age use of corrective lens متى استخدمت
+
+144
+00:09:54,510 --> 00:09:59,830
+في عمرك النضارات الطبية والتصحيحية هل ركبت عين
+
+145
+00:09:59,830 --> 00:10:04,660
+يعني كان عندك إصابةبعض الناس بيصير ال gun shot او
+
+146
+00:10:04,660 --> 00:10:08,120
+لا سمح الله ال severe trauma بتروح العين فبركبوله
+
+147
+00:10:08,120 --> 00:10:11,860
+artificial eye عين زجاجية احنا بيقولوا عين زجاجية
+
+148
+00:10:11,860 --> 00:10:14,440
+ممكن تكون اي مادة plastic كده بس المهم عين
+
+149
+00:10:14,440 --> 00:10:18,960
+allergies عندك حسية عندك ألم بين visual
+
+150
+00:10:18,960 --> 00:10:23,990
+disturbances طيب اي اضطراب في ايه في الرؤية؟ال
+
+151
+00:10:23,990 --> 00:10:27,130
+health related factors يعني يقصد هنا هل في عندك
+
+152
+00:10:27,130 --> 00:10:30,170
+أمراض معينة أثرت على النظر زي موضوع ال blood
+
+153
+00:10:30,170 --> 00:10:33,930
+pressure و زي موضوع ال diabetes mellitus مع ال
+
+154
+00:10:33,930 --> 00:10:37,790
+chronicity يعني مع الإزمان المرض المزمن الطويل
+
+155
+00:10:37,790 --> 00:10:42,190
+بيأثر برضه على العين و على حدة البصر و على شبكية
+
+156
+00:10:42,190 --> 00:10:46,930
+العين assessment of external eye structure أول
+
+157
+00:10:46,930 --> 00:10:50,760
+حاجة بدنا نشوف ال position يعني وضع العينال
+
+158
+00:10:50,760 --> 00:10:54,300
+alignment جاي وين بالظبط كلمة alignment يعني وين
+
+159
+00:10:54,300 --> 00:10:57,640
+in general وين بالظبط يعني هل هي central or not
+
+160
+00:10:57,640 --> 00:11:01,260
+يعني وين بالظبط جاي شكل العين و تركيبة العين في
+
+161
+00:11:01,260 --> 00:11:05,220
+الوسط و لا لأ بنتشوف ال ال eyebrow ايش كمان ال
+
+162
+00:11:05,220 --> 00:11:10,240
+eyebrow اللي هو الحواجب تبعات العين ال eyelids
+
+163
+00:11:10,240 --> 00:11:14,790
+بعدين الرموش ال eyelashesيعني احنا بتكلم ال
+
+164
+00:11:14,790 --> 00:11:20,390
+eyelashes رموش العين وال eyelids اللي هو الجفون
+
+165
+00:11:20,390 --> 00:11:25,510
+العين الأعلى والأسفل ال lacrimal glands الغدد اللي
+
+166
+00:11:25,510 --> 00:11:29,670
+هو الدمعيةالـ pupils and iris كل هذا بقدر اشوفه و
+
+167
+00:11:29,670 --> 00:11:32,690
+انا بعمل أياش assessment احنا عارفين انه مش شغلنا
+
+168
+00:11:32,690 --> 00:11:36,370
+الأساسي و احنا مش تمريض عيون ولكن انا اكويس ان
+
+169
+00:11:36,370 --> 00:11:40,450
+اقدر اقارن اذا في كان gross abnormality يعني اشي
+
+170
+00:11:40,450 --> 00:11:44,290
+مش طبيعي و واضح جدا او في severe defects عشان اقدر
+
+171
+00:11:44,290 --> 00:11:48,430
+ابلغ الطبيب لو انا رأيته ممكن اكون من عندى بداية
+
+172
+00:11:48,430 --> 00:11:52,230
+ايه بداية ال discover of something يعني اكتشاف شيء
+
+173
+00:11:52,230 --> 00:11:56,500
+معينassessment of pupils done by a كيف بده اشوف ال
+
+174
+00:11:56,500 --> 00:11:59,620
+pupils كلكم عارفينه اللي بيسموه reaction ال bin
+
+175
+00:11:59,620 --> 00:12:03,240
+light انا بطلع مباشرة بحط الضوء في العين و بعدين
+
+176
+00:12:03,240 --> 00:12:06,900
+بخليه يغمض او بحط الضوء في العين و بجيبه لما احط
+
+177
+00:12:06,900 --> 00:12:09,620
+الضوء و ارفعه بيصير انه ايش حاجة بيسموها
+
+178
+00:12:09,620 --> 00:12:13,100
+construction of the pupil لما نيجي نحط الإضاءة
+
+179
+00:12:13,100 --> 00:12:16,020
+المباشرة في العين بنلاقي ال pupil بقبق العين
+
+180
+00:12:16,020 --> 00:12:20,540
+بيسموه ايش يتلاقي سكر شوية رفعنا عنه الإضاءة
+
+181
+00:12:20,540 --> 00:12:24,060
+بتلاقيه فتحعشان هيك بقول دايما في 3R بقول عنها
+
+182
+00:12:24,060 --> 00:12:29,080
+اللي هي ايش 3R round reactive response ايش يعني
+
+183
+00:12:29,080 --> 00:12:32,980
+round reactive response يعني بيقول بقبل عين دائري
+
+184
+00:12:32,980 --> 00:12:37,200
+reactive يعني reactive بيصير عنده ايش استجابة
+
+185
+00:12:37,200 --> 00:12:40,800
+للضوء response عنده استجابة بشكل عام الان
+
+186
+00:12:40,800 --> 00:12:45,100
+assessment must do for ايهaccommodation and
+
+187
+00:12:45,100 --> 00:12:50,720
+convergence of pupils يعني اللي احنا بنعمله بنكشف
+
+188
+00:12:50,720 --> 00:12:55,040
+accommodation تحور اللي هو ال pupil كده ممكن يزخر
+
+189
+00:12:55,040 --> 00:12:57,940
+حجمه و يكبر حجمه ال pupil اسمه accommodation
+
+190
+00:12:57,940 --> 00:13:02,970
+convergenceكداش بيقدر يحول يعني اللي قدر الله يصير
+
+191
+00:13:02,970 --> 00:13:07,530
+عنده التحول في ال pupil نفسه يصير الحجم يختلف أو
+
+192
+00:13:07,530 --> 00:13:11,330
+عين عن عين أو يصير الله سمح الله يروح على جنب او
+
+193
+00:13:11,330 --> 00:13:15,130
+يروح سواء right او left هذا اسمه convergence of
+
+194
+00:13:15,130 --> 00:13:21,310
+pupils طيب assessment of visual equity نرجع لنفس
+
+195
+00:13:21,310 --> 00:13:24,190
+الموضوع اللي احنا قلناه كيف بنجيز حدة الإبصار انا
+
+196
+00:13:24,190 --> 00:13:30,230
+الآن موجودمثلا عندي فى مجال يكون فى لوحة بصر أو
+
+197
+00:13:30,230 --> 00:13:33,810
+لوحة النظر زى اللى موجودة عندنا فى الجامعة لكن
+
+198
+00:13:33,810 --> 00:13:37,990
+احنا ممكن اكون اروح اتدرب فى مستشفى العيون وبدأ
+
+199
+00:13:37,990 --> 00:13:40,970
+اجهز النظر للمريض أمامى سواء كان المريض فى
+
+200
+00:13:40,970 --> 00:13:44,350
+المستشفى او فى المركز او فى اى مكان الصح ان المريض
+
+201
+00:13:44,350 --> 00:13:47,470
+يكون بينه بنسمع كلمة بعض الناس بيقول قداش النظر
+
+202
+00:13:47,470 --> 00:13:50,970
+عندك بيقولك النظر تبعى 6 ع 6 التانى بيقول لأ والله
+
+203
+00:13:50,970 --> 00:13:54,140
+النظر عندى 6 ع 12التالت بيقول لأ و الله انا عندي
+
+204
+00:13:54,140 --> 00:13:59,720
+للأسف انا عندي 6 على 24 ايش يعني 6 ع 6 و ايش 6؟
+
+205
+00:13:59,720 --> 00:14:05,920
+ايش الرقم هذا 6؟ 6 يعني 6 متر علشان انجيز للمريض
+
+206
+00:14:05,920 --> 00:14:10,740
+كويس لازم المريض يجف ابعيد عن إشارة الإشارة اللي
+
+207
+00:14:10,740 --> 00:14:17,880
+هو اللي فيها الرموز تبعت النظر لازم تكون 6 متر
+
+208
+00:14:17,880 --> 00:14:21,160
+يعني اللوحة اللي فيها الإشارات تكون بعيدة عنها
+
+209
+00:14:21,160 --> 00:14:26,050
+جديش 6 مترطب في بعض الحالات الغرفة مش كبيرة مش ست
+
+210
+00:14:26,050 --> 00:14:30,570
+متر فبيضطروا يحطوا مراية المراية بتكون ورا ..
+
+211
+00:14:30,570 --> 00:14:34,930
+المراية بتكون يعني خليني أقول يعني زي ما تقولوا في
+
+212
+00:14:34,930 --> 00:14:38,430
+أمام المريض المريض لما نكون لجيتها نتخيل انه في
+
+213
+00:14:38,430 --> 00:14:42,270
+ورا لوحة النظر و جدامه مراية فيها تلاتة متر واخدت
+
+214
+00:14:42,270 --> 00:14:46,590
+كمان تلاتة متر طبعا هذا يقصد يعني عشان احنا بأي ان
+
+215
+00:14:46,590 --> 00:14:51,900
+كان الطريقة المهم تكون بين لوحة الإشاراتو بين
+
+216
+00:14:51,900 --> 00:14:55,860
+المريض اللى بدنا نفحصله لازم تكون 6 متر عشان ايه
+
+217
+00:14:55,860 --> 00:15:00,120
+دايما نفكر كلمة 6 متر ايش اسم اللى بحث نيلين
+
+218
+00:15:00,120 --> 00:15:03,620
+اتشارد خلاص بنعرف على اسم ايه العالم اللى اكتشفها
+
+219
+00:15:03,620 --> 00:15:09,840
+طيب بقول الصح انه اول حاجة لازم نعمل testing each
+
+220
+00:15:09,840 --> 00:15:14,080
+eye alone ماتيجي ده واحد تقوله يلا تطلع لأ لازم
+
+221
+00:15:14,080 --> 00:15:17,740
+نغطي عين زي ما اتفقنا و الأفضل نغطي الشمال قبل
+
+222
+00:15:17,740 --> 00:15:22,840
+نجيس اليمينبعدين بنغطى اليمين و بنجيس الشمال لما
+
+223
+00:15:22,840 --> 00:15:25,960
+نيجى يغطى ما يضغطش كتير على عينه لأنه ممكن مع
+
+224
+00:15:25,960 --> 00:15:28,840
+الضغط كتير على العين لما يفتح مايقدرش يشوف كويسة
+
+225
+00:15:28,840 --> 00:15:31,460
+بس مجرد انه just to cover يعني ممكن يكون بورقة
+
+226
+00:15:31,460 --> 00:15:36,200
+خارجية ماتكونش ضغطة على عين نفسها و احنا بنعمل أيه
+
+227
+00:15:36,200 --> 00:15:39,900
+كمان assessment of extraocular movement بنشوف
+
+228
+00:15:39,900 --> 00:15:42,900
+الحركات الخارجية في العين طبعا كيف بنشوفها by
+
+229
+00:15:42,900 --> 00:15:46,500
+asking the client زي ما هو الكاتب هنااللغة كتبت لـ
+
+230
+00:15:46,500 --> 00:15:49,380
+hold his head and follow movements of your
+
+231
+00:15:49,380 --> 00:15:53,840
+forefinger، بنرفع أصبعنا و بنقول لو سمحت اتطلع في
+
+232
+00:15:53,840 --> 00:15:57,760
+أصبعنا و حاول تلف عينك حوالين ايش الأصبع و اين
+
+233
+00:15:57,760 --> 00:16:02,080
+بيلف، يعني كأنه بنقوله ألحج الأصبع، طبعا مش يلحج
+
+234
+00:16:02,080 --> 00:16:05,510
+بالأصبع يعني كأنه بدي يجوم يلحج الأصبع، لأبعينه
+
+235
+00:16:05,510 --> 00:16:09,590
+يتجه مرة شمال مرة يمين مرة لفوق لتحت عشان نشوف ايه
+
+236
+00:16:09,590 --> 00:16:13,470
+ال extra ocular movements هل في عنده حركات زائدة
+
+237
+00:16:13,470 --> 00:16:17,990
+للعين عشان نكشف عنده حول ولا لا طيب ال visual
+
+238
+00:16:17,990 --> 00:16:21,590
+field اللي بيسموه ايش هنا مجال الرؤية لما نقول
+
+239
+00:16:21,590 --> 00:16:25,160
+peripheral vision او visual field مجال الرؤيةالامر
+
+240
+00:16:25,160 --> 00:16:29,100
+.. الامر مش صعب كتير و لو كنا احنا امامكوا هتكون
+
+241
+00:16:29,100 --> 00:16:32,680
+الأمور بسيطة جدا و ممكن احنا .. يعني نلاقيها على
+
+242
+00:16:32,680 --> 00:16:36,040
+اليوتيوب ببعض الفيديوهات البسيطة جدا عموما باختصار
+
+243
+00:16:36,040 --> 00:16:40,620
+عشان احنا نفهم بكون ايه المريض والطبيب واقفين على
+
+244
+00:16:40,620 --> 00:16:44,420
+أكبر بعض المسافة اللي بينهم تقريبا نقول حوالي متر
+
+245
+00:16:44,420 --> 00:16:47,480
+و عشرين سانتي زي مائة و عشرين سانتي الاتنين
+
+246
+00:16:47,480 --> 00:16:50,080
+بيتطلعوا في بعض تخيلوا معاه كأنه احنا فتحنا اديان
+
+247
+00:16:50,080 --> 00:16:54,420
+التنتينالايد اليامين هي المريض والايد اليسار هو
+
+248
+00:16:54,420 --> 00:16:57,600
+الطبيب اذا وجدت المسافة بين الاتنين الاتنين بتطلع
+
+249
+00:16:57,600 --> 00:17:01,820
+في بعض الان المسافة بينهم متر و عشرين سنتة تقريبا
+
+250
+00:17:01,820 --> 00:17:05,800
+الان ايش بقوله الطبيب بيغطي عينه ايه الطبيبها
+
+251
+00:17:05,800 --> 00:17:10,180
+بيغطي عينه اليمين والمريض اللي على جباله بيغطي
+
+252
+00:17:10,180 --> 00:17:14,000
+عينه الشمال نتخيل ممكن نعمله و انا على المرايا و
+
+253
+00:17:14,000 --> 00:17:17,040
+انا على المرايا الان اول حاجة بيغطي ايه اتقولنا
+
+254
+00:17:17,040 --> 00:17:21,530
+الطبيب عينه ايه اليمينلكن المريض بيغطي عينه
+
+255
+00:17:21,530 --> 00:17:26,390
+الشمال، و إيش بيقوله الآن؟ بيمسك جلم بإيده اللي هو
+
+256
+00:17:26,390 --> 00:17:30,690
+الطبيب، و بقعد يلف الآن، يلف الجلم، و بيقوله إيش؟
+
+257
+00:17:30,690 --> 00:17:35,190
+اتطلع بعينك اليمين، بيقول للمريض، اتطلع بعينك
+
+258
+00:17:35,190 --> 00:17:38,370
+اليمين على الجلم وين بيلف، ليش مهم أني بيحكي زي
+
+259
+00:17:38,370 --> 00:17:42,810
+ذلك؟ كل واحد فينا، اتخيل معايا إيش المقصود، لحرك
+
+260
+00:17:42,810 --> 00:17:46,890
+هتفهمهاالان لو انا بتطلع قاعد على التلفزيون قدامي
+
+261
+00:17:46,890 --> 00:17:51,170
+او انا بتطلع على الجوال وانا بانظر للجوال شايف
+
+262
+00:17:51,170 --> 00:17:55,470
+الجوال لكن لو واحد فتح الباب ودخل برضه انا شايف ان
+
+263
+00:17:55,470 --> 00:18:01,090
+في واحد دخل طيب لو ابني اخويا عمي زعج علي او مرج
+
+264
+00:18:01,090 --> 00:18:04,850
+من قدامي هشوفه الان انا ال central of vision مركز
+
+265
+00:18:04,850 --> 00:18:10,620
+النظر بتطلع على الجوال لكن مجال الرؤيةبكون منتبه
+
+266
+00:18:10,620 --> 00:18:15,340
+لللي حواليه، هذا ايش اسمه؟ اسمه peripheral vision
+
+267
+00:18:15,340 --> 00:18:18,820
+أو اسمه visual fields ان الإنسان هو بتطلع على
+
+268
+00:18:18,820 --> 00:18:21,900
+التلفاز أو جواله أو أي شيء بيشوف اللي حواليه علشان
+
+269
+00:18:21,900 --> 00:18:24,560
+هيك دايما الإنسان يكون .. مش بيقوله الإنسان يكون
+
+270
+00:18:24,560 --> 00:18:27,920
+منتبه لللي حواليه هذا معناته مجال الرؤية في بعض
+
+271
+00:18:27,920 --> 00:18:34,720
+الناس عنده نص مجال الرؤية مش شايف كيف يعني؟ يعني
+
+272
+00:18:34,720 --> 00:18:38,920
+نص مجال الرؤية شايفه و نص مجال الرؤية مش شايفهيعني
+
+273
+00:18:38,920 --> 00:18:42,820
+خلّيني أقول زي كأنها دائرة الدائرة نصها الشمال مش
+
+274
+00:18:42,820 --> 00:18:46,740
+شايفها و نصها اليمين مش شايفها إذا كان في عنده زيك
+
+275
+00:18:46,740 --> 00:18:51,640
+اسم المصطلح Hemianopsia إيش اسمها Hemianopsia يبقى
+
+276
+00:18:51,640 --> 00:18:56,680
+معناته Hemianopsia يعني إيش اللي هو وسط مجال
+
+277
+00:18:56,680 --> 00:19:01,100
+الرؤية لما نكون وسط مجال الرؤية وسط مجال الرؤية
+
+278
+00:19:01,540 --> 00:19:06,480
+شافه ووسط مجال الرؤية ما شافوش بنسميه hemianopsia
+
+279
+00:19:06,480 --> 00:19:10,460
+عشانك ساموه ايش هنا blindness عامة و نص مجال
+
+280
+00:19:10,460 --> 00:19:15,580
+الرؤية طب لو شاف جزء و ماشافش الجزء اللي بعده يعني
+
+281
+00:19:15,580 --> 00:19:19,120
+جهة شاف ربعة كيف يعني؟ يعني خلي الدائرة امامنا
+
+282
+00:19:19,120 --> 00:19:23,520
+اتخيلنا ان الدائرة مجسمة لاربع اقسامهذه الدائرة
+
+283
+00:19:23,520 --> 00:19:27,220
+قسمناها أربع قسم وضعنا في جلبة زائد مثل الشخص في
+
+284
+00:19:27,220 --> 00:19:31,800
+رُبع ما شافوش بنقول ايش اسم ايش عنده Quadrantopsy
+
+285
+00:19:31,800 --> 00:19:35,780
+ايش Quadrantopsy يعني عنده رُبع مجال الرؤية أعمى
+
+286
+00:19:35,780 --> 00:19:41,280
+مش شايفه رُبع مجال الرؤية مش شايفه طيب إذا في نقطة
+
+287
+00:19:41,280 --> 00:19:45,720
+معينة ما شفهاش نقطة معينة في مجال الرؤية ما شفهاش
+
+288
+00:19:45,720 --> 00:19:50,540
+اسمها Ascotomaالـ Ascotoma يعني اسمها island like
+
+289
+00:19:50,540 --> 00:19:54,980
+blindness island زي من كلمة مش ice no island تلفز
+
+290
+00:19:54,980 --> 00:19:58,560
+اللي هي زي جزيرة اللي هو ال island يعني هذه نقطة
+
+291
+00:19:58,560 --> 00:20:02,500
+بتكون ايش بكون في بعض الناس بقولك انا بشوف كل شي
+
+292
+00:20:02,500 --> 00:20:05,240
+بيجينا المريض اعطيكوا مثال ليش هذه المصطلحات
+
+293
+00:20:05,240 --> 00:20:09,800
+الغريبة بعض الناس بيقولك سبحان الله انا لما بكون
+
+294
+00:20:09,800 --> 00:20:12,680
+ماشي في الطريق بشوف كل السيارات على اليمين بشوفش
+
+295
+00:20:12,680 --> 00:20:16,340
+على الشمال بقول عنده ايش hemanopsiaأو بعض الناس
+
+296
+00:20:16,340 --> 00:20:19,560
+بيقول أنا بشوف اليمين، بشوف الشمال، بس في جزء هيك
+
+297
+00:20:19,560 --> 00:20:25,080
+بشوفوهش، الجزء هذا يعني زي حاجة هيك ربع الناس، هذا
+
+298
+00:20:25,080 --> 00:20:27,920
+اسمه ال quadrant nausea، لكن لو قاللي سبحان الله
+
+299
+00:20:27,920 --> 00:20:31,400
+دائما بشوف زي نقطة سوداء قدامي، في نقطة سوداء مش
+
+300
+00:20:31,400 --> 00:20:34,960
+قادر أشوف منها، هذا ايش اسمها؟ Ascotoma، اسمها
+
+301
+00:20:34,960 --> 00:20:38,710
+ايه؟ Ascotoma، أعرف إنه مصطلحات غريبة؟لكن احنا
+
+302
+00:20:38,710 --> 00:20:43,410
+بنعيد و بنكرر حتى لو ماعرفناش عشان نقدر نحفظ
+
+303
+00:20:43,410 --> 00:20:46,570
+المصطلحات عشان اذا مرت علينا يعني مابدي حد يقول
+
+304
+00:20:46,570 --> 00:20:49,410
+يعني ان هذا كبير لأ انا لازم اعطيكوا الشغلات
+
+305
+00:20:49,410 --> 00:20:52,450
+الكبيرة مابحب اعطيكوا الحاجات البسيطة لوحة
+
+306
+00:20:52,450 --> 00:20:56,470
+الإشارات اما بتكون بهذا الشكلحرف ال E ومعناه L او
+
+307
+00:20:56,470 --> 00:20:59,610
+T ايش بتسأل المريض بتقوله بعد ما مغطى عينه مثلا
+
+308
+00:20:59,610 --> 00:21:02,590
+الشمال ايش هذا الحرف ايش هذا الحرف اذا طالع يقولي
+
+309
+00:21:02,590 --> 00:21:06,630
+كويس اذا بقوله خلاص تمام اخرش اذا عندنا طبعا هذا
+
+310
+00:21:06,630 --> 00:21:11,110
+بالقدم عموما احنا ننسى كلمة قدم و في الآخر ايش
+
+311
+00:21:11,110 --> 00:21:16,050
+نقول نقول ان هذا متر نفس اللوحة هي موجودة عموما لو
+
+312
+00:21:16,050 --> 00:21:20,050
+شاف اخر خط ايش بقول بقول النظر عنده ستة ع ستة طب
+
+313
+00:21:20,050 --> 00:21:25,720
+افرضه في اليمين في اليمين شاف النظر كويسلكن في
+
+314
+00:21:25,720 --> 00:21:30,580
+اليسار في اليمين شاف كويس لكن في اليسار ما شافوش
+
+315
+00:21:30,580 --> 00:21:35,720
+بروحش بقول اليمين ستة ع ستة و اليسار ستة ع تسعة طب
+
+316
+00:21:35,720 --> 00:21:39,060
+ليش قلنا ستة ع تسعة احنا قلنا احنا اذا ستة ع ستة
+
+317
+00:21:39,060 --> 00:21:43,420
+يعني شاف كل الأشياء اللي ع ستة متر شافني كويس لكن
+
+318
+00:21:43,420 --> 00:21:48,940
+لو لو لو بس بعد هيك ماجدرش بسيرالناس الطبيعيين
+
+319
+00:21:48,940 --> 00:21:52,240
+اللي بيشوفوه على 9 متر الناس الطبيعيين هيما على 6
+
+320
+00:21:52,240 --> 00:21:55,240
+أو 9 الناس الطبيعيين اللي بيشوفه على 9 المريض
+
+321
+00:21:55,240 --> 00:21:58,780
+بيقدرش يشوفه ولا على 6 متر طب 6 على 12 معناته
+
+322
+00:21:58,780 --> 00:22:01,220
+الناس الطبيعيين اللي بيشوفه على أشياء على 12 متر
+
+323
+00:22:01,220 --> 00:22:07,680
+هو بيقدر يشوفه على وين بس على 6 متر وكذا طيب نشوف
+
+324
+00:22:07,680 --> 00:22:10,120
+ال eye pathologies إيش الأمراض اللي بتسيب في العين
+
+325
+00:22:10,120 --> 00:22:13,200
+أنا عارف إن هو مصطلحات ذريبة لكن ماعليش نتطور أحنا
+
+326
+00:22:13,830 --> 00:22:17,370
+ما هي الأمراض اللي ممكن تصيب العين و انا احكي عنها
+
+327
+00:22:17,370 --> 00:22:19,970
+خاصة للطبيب انا مابدي ااخد لا anatomy ولا
+
+328
+00:22:19,970 --> 00:22:24,290
+physiology ولا بدي ااخد علاج ولا complications انا
+
+329
+00:22:24,290 --> 00:22:28,810
+بس كل اللي بدي احكيه بشكل عام انه بس مصطلحات في
+
+330
+00:22:28,810 --> 00:22:34,550
+حاجة اسمها orbital hematoma اللي الكدمة اللي بتسير
+
+331
+00:22:34,550 --> 00:22:37,570
+في العين و بتلاقي بيقولك عينك اتورمت من الصدمة
+
+332
+00:22:37,570 --> 00:22:42,260
+اسمها hematoma في حاجة اسمها orbitalfractures لا
+
+333
+00:22:42,260 --> 00:22:46,340
+قدر الله كسر في ايش عظمة المحجر، محجر العين زي ال
+
+334
+00:22:46,340 --> 00:22:49,420
+blowout ايش؟ fracture زي لا سبحان الله صدمة شديدة
+
+335
+00:22:49,420 --> 00:22:53,540
+بتسير او اخد box شديد او انصدم في حديد او شي من
+
+336
+00:22:53,540 --> 00:22:58,580
+هذا القبيل هذا اصحاب ruptured globe انفجار مقلة
+
+337
+00:22:58,580 --> 00:23:01,780
+العين بتسير زي في حالات اللي هو ال gun shot او لا
+
+338
+00:23:01,780 --> 00:23:06,160
+قدر الله في صابة حجر او هكذاالـ corneal abrasion
+
+339
+00:23:06,160 --> 00:23:09,920
+اللي هو القرانية نفسها جرح القرانية corneal
+
+340
+00:23:09,920 --> 00:23:13,700
+laceration انزلاع جزء من الزلعة بيسموها جزء من
+
+341
+00:23:13,700 --> 00:23:16,860
+القرانية زي واحد هو مش شايف ممكن ينزلع نفسه برفع
+
+342
+00:23:16,860 --> 00:23:21,400
+أدفر زي هيك بتلاقي جشر عامل زي جشرة للإيش للكورنيا
+
+343
+00:23:21,400 --> 00:23:25,800
+hyphema hyphema اللي هو نزيف العين الداخلي نزيف
+
+344
+00:23:25,800 --> 00:23:29,840
+العين الداخلي اسمه hyphema نزيف العين الداخلي اسمه
+
+345
+00:23:29,840 --> 00:23:36,050
+hyphema arthritis التهاب القزحيةDetached retina،
+
+346
+00:23:36,050 --> 00:23:41,130
+انفصال الشبكية، conjunctivitis، التهاب ملتحمة
+
+347
+00:23:41,130 --> 00:23:46,030
+العين، hordulam أو بيسموها sty، hordulam أو
+
+348
+00:23:46,030 --> 00:23:49,490
+بيسموها sty، أو بيسموها بالعرب الشحاتإيش عن
+
+349
+00:23:49,490 --> 00:23:52,710
+الشحاد؟ ناسيك بتقولي عن الشحاد، هي عبارة عن حاجة
+
+350
+00:23:52,710 --> 00:23:56,510
+يعني بتكون زي شوية bacterial infection في ال
+
+351
+00:23:56,510 --> 00:24:00,050
+eyelids موجودة، زي بعض يعني دم لصغير موجود في ال
+
+352
+00:24:00,050 --> 00:24:02,750
+eyelids، فبقولك إيش عنده حتى لو عندش حد زمان، كان
+
+353
+00:24:02,750 --> 00:24:05,010
+يقول عن كلمة شحاد انه الطفل إذا كان عنده يعني
+
+354
+00:24:05,010 --> 00:24:08,350
+بقولك هذا معناته تعميق أو خليه يروح يجيبله خبزة أو
+
+355
+00:24:08,350 --> 00:24:12,930
+يودي خبزة، يعني من بعض التقاليد اللي هي القديمة في
+
+356
+00:24:12,930 --> 00:24:18,070
+بعض الخاصة اللي هو أكبار السنالحاجة بسموها اللي
+
+357
+00:24:18,070 --> 00:24:22,030
+بعدها Calcium ايش قلت Calcium Calcium أو بسموها
+
+358
+00:24:22,030 --> 00:24:27,030
+Cyst اللي اسمه الكيس الدهني الجفن نفسه بنعص إيدنا
+
+359
+00:24:27,030 --> 00:24:30,790
+عليه شوية بنلاقي فيه تحت الجفن إشي زي طازج شوية
+
+360
+00:24:30,790 --> 00:24:34,450
+طالع لفوق إيش هو لو جلبنا الجفن هلاقي فيه تحته إيش
+
+361
+00:24:34,450 --> 00:24:38,850
+تحته فيه زي كيس أو تجمع دهني وهذا برضه برتفع لما
+
+362
+00:24:38,850 --> 00:24:42,590
+نروح على الطبيب برفعله يعنيPeri-orbital laceration
+
+363
+00:24:42,590 --> 00:24:46,090
+تقرحات
+
+364
+00:24:46,090 --> 00:24:49,590
+يعني
+
+365
+00:24:49,590 --> 00:24:53,770
+بيكون تقرحات حوالين اللي هو هاي ال orbital اللي هو
+
+366
+00:24:53,770 --> 00:24:57,350
+محجر العين من برا في بعض الناس بيصير عندهم نوع من
+
+367
+00:24:57,350 --> 00:25:02,290
+الخدش الخدش أو تزلع البسيط بيكون حوالين الجلد اللي
+
+368
+00:25:02,290 --> 00:25:06,720
+حوالين محجر العينال foreign bodies يعني زي الأجسام
+
+369
+00:25:06,720 --> 00:25:09,740
+الغريبة اللي بتسير كيف لا قدر الله في بعض الناس
+
+370
+00:25:09,740 --> 00:25:14,700
+بيجيب و يقولك والله أنا كنت ماشي فجأة أجت زي شغل
+
+371
+00:25:14,700 --> 00:25:17,680
+شائب في عيني foreign body او واحد اللي سمح الله
+
+372
+00:25:17,680 --> 00:25:22,640
+كان يلحم جنبه اشي أجت شانطيرة او نتفتة اي شي حدديه
+
+373
+00:25:22,640 --> 00:25:26,300
+هذا اسم هو برضه ايش foreign body او لا قدر الله من
+
+374
+00:25:26,300 --> 00:25:29,350
+اجزاز او من اي شي كله اسمه foreign bodycontact
+
+375
+00:25:29,350 --> 00:25:34,030
+lens removal يعني بعض العدسات اللى موجودة عنده هل
+
+376
+00:25:34,030 --> 00:25:38,950
+مرفوعة مش مرفوعة في لابس هذه كلها لابس عدسات اثرت
+
+377
+00:25:38,950 --> 00:25:42,810
+علينا كلها اسم ايش هذه eye pathologies مش شرط انا
+
+378
+00:25:42,810 --> 00:25:46,210
+كمان مرة بقول مابدنا نقول انه ايش ال
+
+379
+00:25:46,210 --> 00:25:49,110
+pathophysiology ولا الانتم لكن نعرف ايش المصطلحات
+
+380
+00:25:49,110 --> 00:25:53,530
+بشكل عام الان ايه ال assessment الان بدنا نعمل
+
+381
+00:25:53,530 --> 00:25:58,450
+assessment لمنطقة ايش الأذنأول حاجة بدنا ask the
+
+382
+00:25:58,450 --> 00:26:03,210
+history .. history of ear surgery .. ear surgery
+
+383
+00:26:03,210 --> 00:26:06,830
+بدنا نسأل أول حاجة هل عمل عمليات عمره في حياته في
+
+384
+00:26:06,830 --> 00:26:12,170
+الأذن؟ هل عنده trauma؟ هل عنده فيه infection زي
+
+385
+00:26:12,170 --> 00:26:15,130
+التناب الأذن الوسطى أو الأذن الخارجية أو الأذن
+
+386
+00:26:15,130 --> 00:26:19,010
+الداخلية؟ هل عنده air ache ألم في الأذن؟ هل في
+
+387
+00:26:19,010 --> 00:26:22,690
+drainage يعني بطلع منه discharge ولا لأ؟هل في عنده
+
+388
+00:26:22,690 --> 00:26:25,790
+hearing loss لا سمح الله فقد في السماء؟ في عنده
+
+389
+00:26:25,790 --> 00:26:30,130
+Tinnitus طانين؟ Vertigo؟ بيحس يعني بدوخة أو إشي في
+
+390
+00:26:30,130 --> 00:26:33,950
+دونه يعني بيحس يعني زي ضوضاء؟ هل عنده autotoxic
+
+391
+00:26:33,950 --> 00:26:38,300
+medications؟ هل عمره استخدم أدوية؟بتعمل تسمم أو
+
+392
+00:26:38,300 --> 00:26:42,240
+خاصة بعض البُكر بتاخدوها و أنت بتاخدوها في ال
+
+393
+00:26:42,240 --> 00:26:46,080
+pharmacology في عنها دوة زي الgen tamicin بنقول
+
+394
+00:26:46,080 --> 00:26:49,440
+عنه autotoxic يعني أن هذا الدواء من ال side effect
+
+395
+00:26:49,440 --> 00:26:53,820
+تبعته أنه بتعمل تسمم لإيش لمنطقة الأذن last
+
+396
+00:26:53,820 --> 00:26:58,200
+hearing examination نسأله متى عملت أخر فحص متى
+
+397
+00:26:58,200 --> 00:27:02,540
+عملت أخر فحص للسمع assess hearing in sitting
+
+398
+00:27:02,540 --> 00:27:06,980
+positionبدنا نسمع .. اللي هالجيتنا بتطلع انا الان
+
+399
+00:27:06,980 --> 00:27:12,000
+بدي اشوف و اقيم الأذن، مالعش نخلي المريض يعني نايم
+
+400
+00:27:12,000 --> 00:27:15,140
+على دهره او على بطنه، دايما حتى لما نروح او نشوف
+
+401
+00:27:15,140 --> 00:27:18,940
+طبيب تبقى أنف أذن حنجرة، بتلاقيه مجاعد المريض،
+
+402
+00:27:18,940 --> 00:27:21,660
+الان لما مجاعد المريض بيجي أول حاجة بيشوف ال ايش
+
+403
+00:27:21,660 --> 00:27:25,120
+ال oracles أخدتوها كل كفاش، في ال anatom of the
+
+404
+00:27:25,120 --> 00:27:27,580
+oracles اللي هو الأذن الخارجية بيمسكها، بيشوف ال
+
+405
+00:27:27,580 --> 00:27:32,570
+sizeو بشوف ايش هنا ال symmetry هل هم متشابهات زي
+
+406
+00:27:32,570 --> 00:27:37,790
+بعض منسجمات ال color اللون لو حد سألنا طب يا أستاذ
+
+407
+00:27:37,790 --> 00:27:41,690
+ايش اللون تبع الأذن عشان يكون عندنا علم كلنا دائما
+
+408
+00:27:41,690 --> 00:27:45,670
+اللون الأذن هو نفس اللون الوجه يبقى الأذن الخارجية
+
+409
+00:27:45,670 --> 00:27:50,550
+نفس اللون الوجه لكن مرات بيصير شوية اختلفات خجل
+
+410
+00:27:50,550 --> 00:27:53,890
+بني أدم صار عنده سخونة صار اتعرض لشيء ماتلاقي دنيا
+
+411
+00:27:53,890 --> 00:27:58,460
+حتى بقولك دنيا صاروا حمر أو صار عندهم سخونةبعض
+
+412
+00:27:58,460 --> 00:28:02,460
+الحالات بيصير redness احمرار مجرد ما يصير redness
+
+413
+00:28:03,330 --> 00:28:07,330
+بدون اي .. يعني اي سبب معين بنقول هذا ايش علامة
+
+414
+00:28:07,330 --> 00:28:12,190
+انه في fever عشان في .. من الدلالات سبحان الله انه
+
+415
+00:28:12,190 --> 00:28:15,550
+صار حرارة بنلاقي الأذن .. الأذنين صار فيه سخونة
+
+416
+00:28:15,550 --> 00:28:18,670
+وهذا رحمه من ربنا ان الدم صار .. صح ذاكرين لما
+
+417
+00:28:18,670 --> 00:28:22,130
+نقول في ال vascular it changes بروح الدم كله بيصل
+
+418
+00:28:22,130 --> 00:28:25,210
+لل .. للأوعية الدموية اللي تحت الجلد فعشان تصير
+
+419
+00:28:25,210 --> 00:28:30,560
+فقد الحرارة مع التناسق اللي هو مباشرةPalor اللي هو
+
+420
+00:28:30,560 --> 00:28:35,260
+ايش يعني Palor هنا اللي هو الشحوب الأذن خاصة في ..
+
+421
+00:28:35,260 --> 00:28:39,540
+في لما يكون البرد قارس بيسموه frostbite، frostbite
+
+422
+00:28:39,540 --> 00:28:43,920
+يعني عضة البرد، كيف يعني عضة البرد؟ عضة البرد في
+
+423
+00:28:43,920 --> 00:28:47,080
+بعض الحالات احنا بنسميه مش يعني عضة البرد كأنه
+
+424
+00:28:47,080 --> 00:28:51,540
+البرد له فم وجاعة بعض، لا بس بيسموها بعض الناس
+
+425
+00:28:51,540 --> 00:28:55,750
+جرسة البردبتلاقي الإنسان صار إيش دنيا لون بيض بشكل
+
+426
+00:28:55,750 --> 00:28:58,130
+كبير و بيقولك أنا مش جاد عشان ايه في بعض الناس و
+
+427
+00:28:58,130 --> 00:29:00,570
+خاص الأجانب صاروا يعملوا على فكرة أجت على غزان
+
+428
+00:29:00,570 --> 00:29:04,990
+بيلبسوا الشغل اللي بتغطي مش عارف ايش اسمها اللي
+
+429
+00:29:04,990 --> 00:29:09,750
+بتغطي الأذنين التنتين مع بعض في أثناء البرد القارس
+
+430
+00:29:09,750 --> 00:29:16,050
+بالبيت oracles لل texture و احنا ماقلناش texture و
+
+431
+00:29:16,050 --> 00:29:19,150
+بشوف ال tenderness و بشوف أيش هنا ال skin lesions
+
+432
+00:29:19,150 --> 00:29:24,580
+إذا في أي علامات أو أي ..شاطب يعني أي الألم درر
+
+433
+00:29:24,580 --> 00:29:28,280
+موجود في وين في الأذن if the client complains إذا
+
+434
+00:29:28,280 --> 00:29:30,880
+المريض شكالي .. إيش يعني شكالي .. شكالي من الألم
+
+435
+00:29:30,880 --> 00:29:35,320
+.. يعني if ال مريض قال لي انا الدنيا بجعوني طبعا
+
+436
+00:29:35,320 --> 00:29:40,780
+أنا حكيم و أنا و حكيمة و أنا ماعنديش طبيب أنفذ من
+
+437
+00:29:40,780 --> 00:29:44,640
+الحنجرة طب كيف بتحكم على اللي أمامي أنه هذا فيه
+
+438
+00:29:44,640 --> 00:29:49,660
+عنده مشكلة أحكم على الأقل أنه من الألماللي موجود
+
+439
+00:29:49,660 --> 00:29:55,200
+من القلم اللي موجود هل هذا الاتهاب أذن خارجية ولا
+
+440
+00:29:55,200 --> 00:29:59,280
+أذن داخلية مش عارف الانش بيقولي pull the oracle
+
+441
+00:29:59,280 --> 00:30:03,140
+ايش يعني pull اسحب ال oracle لفوق يعني نسحب الدهن
+
+442
+00:30:03,140 --> 00:30:06,840
+الخارجي لفوق وإيش بيقولي and press on the tragus
+
+443
+00:30:06,840 --> 00:30:08,980
+كلكم عارفين ما أخدتها في ال Anatomy Tragus يعني
+
+444
+00:30:08,980 --> 00:30:12,100
+الأذن اللي تحت يعني اللي هو قطعة اللحمية الصغيرة
+
+445
+00:30:12,100 --> 00:30:15,700
+اللي تحت اللي هي هذه الأذن الصيوان الأذن اللي
+
+446
+00:30:15,700 --> 00:30:20,810
+شايفينه من برامن فوق هذا اسم الاركيل الدهن اللي
+
+447
+00:30:20,810 --> 00:30:24,690
+تحت اللي عاملة .. حتى عاملة زي الهلال الصغير هذا
+
+448
+00:30:24,690 --> 00:30:28,770
+إيش اسمها؟ اسمها لتراكس لو إحنا سحبنا الاركيل
+
+449
+00:30:28,770 --> 00:30:33,030
+وضغطنا على منطقة التراكس اللي هو إيش بقولي أنا؟
+
+450
+00:30:33,030 --> 00:30:36,330
+وخاص عايش أنا بقولها and behind there وكمان ورا
+
+451
+00:30:36,330 --> 00:30:39,930
+الدهن وإحنا شدينه الآن إيش بقولي؟ إذا الألم زاد
+
+452
+00:30:39,930 --> 00:30:44,350
+يعني ده شدينا الدهن وضغطنا ورا الأذن و تحت على
+
+453
+00:30:44,350 --> 00:30:49,710
+منطقة التراكس إذا الألم زادبنقول عنده external ear
+
+454
+00:30:49,710 --> 00:30:52,450
+infection يعني بنقول هذا الأيش عنده التهاب في
+
+455
+00:30:52,450 --> 00:30:56,410
+الأذن الخارجية بيخوفش طيب إذا الألم ما زادش
+
+456
+00:30:56,410 --> 00:31:00,650
+ماتأثرش إيش بقول عنده إيش middle ear infection
+
+457
+00:31:00,650 --> 00:31:05,250
+اللي بتسمع عنها اسمها otitis media يبقى شغلة بسيطة
+
+458
+00:31:05,250 --> 00:31:09,330
+كتير شدنا الأذن و عصينا حولها إذا الألم زاد otitis
+
+459
+00:31:09,330 --> 00:31:12,910
+external إذا الألم ما زادش otitis media بقولي و
+
+460
+00:31:12,910 --> 00:31:17,210
+اتطلع على ال ear canal شوف كيف القناة تبعت الأذنو
+
+461
+00:31:17,210 --> 00:31:20,530
+ال size و ال discharge إذا بتطيل بتسيل و بنسأله
+
+462
+00:31:20,530 --> 00:31:24,590
+كيف بتسيل كيف يعني طبيعته assessment of cerumen
+
+463
+00:31:24,590 --> 00:31:28,210
+اللي هو الشحمة الأذن الشحمة الأصفر اللي في الداخل
+
+464
+00:31:28,210 --> 00:31:34,450
+إذا أصفر زيادة if it is yellow if it is yellow or
+
+465
+00:31:34,450 --> 00:31:37,730
+green يعني إذا كان أصفر كتير أو لونه أخضر كتير
+
+466
+00:31:37,730 --> 00:31:41,570
+غامق معناته في infectionبدنا نسأله برضه ع ال
+
+467
+00:31:41,570 --> 00:31:44,810
+hearing equity كيف حدث السمع زي ما كنا في حدث بصر
+
+468
+00:31:44,810 --> 00:31:48,950
+في حدث سمع طب كيف انا في المستشفى بدي اقدر اعرف
+
+469
+00:31:48,950 --> 00:31:52,210
+انه بسمع كويس ولا لأ ولا حاجة انا كتمريض باجي
+
+470
+00:31:52,210 --> 00:31:55,710
+بتكلم مع كلمة بقوله ايش انا بروح بتخبى في مكان و
+
+471
+00:31:55,710 --> 00:31:59,390
+بحكي كلمةبخليه يردد ال voice tone، إيش يعني ال
+
+472
+00:31:59,390 --> 00:32:03,250
+voice tone؟ حتة السماعة ليسمعه و بعملي repeating و
+
+473
+00:32:03,250 --> 00:32:06,090
+بكرر الكلمات اللي أنا قلتها، يعني زي ما أنا أقف ع
+
+474
+00:32:06,090 --> 00:32:09,310
+جانب و أقول له مثلا الحمد لله رب العالمين، إذا
+
+475
+00:32:09,310 --> 00:32:12,370
+قاللي نفس الكلمة و بنفس الوثيرة، بعرف إن السماعة
+
+476
+00:32:12,370 --> 00:32:16,550
+كويسة، دير بالكم مجرد ما الإنسان يعلي صوتهمعناته
+
+477
+00:32:16,550 --> 00:32:19,370
+إيه؟ مجرد ما نعالج صوته، بناعرف إنه في إيش عنده
+
+478
+00:32:19,370 --> 00:32:24,310
+هنا defects في ال hearing، يعني عنده تعب و ضرر في
+
+479
+00:32:24,310 --> 00:32:27,250
+إيش في السماع، عشان إيه بنشوف دايما اللي سماعهم
+
+480
+00:32:27,250 --> 00:32:32,320
+ضعيف صوتهم عالي، و هكذا لو كان العكسطب notabene
+
+481
+00:32:32,320 --> 00:32:34,640
+بيقوللي إيش هنا deeper structure إيش أنا deeper
+
+482
+00:32:34,640 --> 00:32:40,100
+يعني التركيبات الداخلية العميقة في الأذن ما بقدر
+
+483
+00:32:40,100 --> 00:32:42,900
+أشوفها بالعين المجردة هبقى أشوفها بإيش بال
+
+484
+00:32:42,900 --> 00:32:47,120
+autoscope و هذا مش شغلي شغل الطبيب الأخصائي طبعا
+
+485
+00:32:47,120 --> 00:32:53,390
+هنا معلش شوي هنايعني هو باختصار هذا يخليكوا ذاكرين
+
+486
+00:32:53,390 --> 00:32:57,310
+بس عشان انا بتشرحها هي هو حطت ال autoscope طبعا هو
+
+487
+00:32:57,310 --> 00:33:00,750
+الآن هي المريضة قاعدة أمامه و هذا المشهد اللي هو
+
+488
+00:33:00,750 --> 00:33:04,870
+مبين من جوا كأنه يعني مصور لنا يعني مقطع زي شريحي
+
+489
+00:33:04,870 --> 00:33:08,490
+يفهمنا ان الأذن هي شكلها من جوا هو أنا بس بقولنا
+
+490
+00:33:08,490 --> 00:33:12,030
+استخدم ال use of the autoscope choose largest
+
+491
+00:33:12,030 --> 00:33:15,290
+speculum .. speculum اللي بيكون محطوط جوا قدام ..
+
+492
+00:33:15,290 --> 00:33:17,430
+قدام اللي هو هذا و أنا عايد .. عايد كم مرة
+
+493
+00:33:17,880 --> 00:33:20,820
+السبيكلام فيها المرات نستخدم السبيكلام من قدام
+
+494
+00:33:20,820 --> 00:33:25,020
+عشان يفتح الأذن كويس و بنستخدم واحد كبير عشان يقدر
+
+495
+00:33:25,020 --> 00:33:28,940
+خاصة لما يكون adult ا choose ا هنا ا choose
+
+496
+00:33:28,940 --> 00:33:32,400
+largestسبيكلام head toward opposite shoulder ايش
+
+497
+00:33:32,400 --> 00:33:36,580
+يعني toward opposite shoulder بنخلي ال head الآن
+
+498
+00:33:36,580 --> 00:33:42,160
+يعني معاكس مع ايش يعني معاكس ال shoulder الكتف
+
+499
+00:33:42,160 --> 00:33:46,290
+يعني بنخليهوش ادير راسه مع اتجاهاللي هو يعني مثلا
+
+500
+00:33:46,290 --> 00:33:50,970
+قاعد زي هيكة أنا مثلا بده أشوف الأيمن، بخليه يطلع
+
+501
+00:33:50,970 --> 00:33:54,730
+قدام، عكس الكتف ما بنخليه يدير على اليمين لإن هو
+
+502
+00:33:54,730 --> 00:33:58,310
+هيتعبني مش هقدر و هيتعب نفسه و يدير حاله، خليه زي
+
+503
+00:33:58,310 --> 00:34:03,050
+ما هو مبقاش ما أقدر أعمله assessment، بقول طبعا
+
+504
+00:34:03,050 --> 00:34:07,390
+adult ear اللي بين upper and back يعني لما نكون في
+
+505
+00:34:07,390 --> 00:34:11,330
+ال adult بدنا نفحص الأذن خاصة الطبيب الشاطرلما
+
+506
+00:34:11,330 --> 00:34:15,330
+بتفحص الأذن كويس بيسحب البنة لوين؟ البنة اللي هو
+
+507
+00:34:15,330 --> 00:34:18,690
+أعلى الأذن لفوق upper and back يعني بيسحبها لافوق
+
+508
+00:34:18,690 --> 00:34:22,530
+ولا ورا لما تكون اسحبها لافوق ولا ورا بتفتح الأذن
+
+509
+00:34:22,530 --> 00:34:26,430
+كويس أما في الأطفال لسه الأذن ماجتملش ماجتملش
+
+510
+00:34:26,430 --> 00:34:30,650
+الاناطمية تبعها فبقولي لأ خاصة إيش هنا الأجل من
+
+511
+00:34:30,650 --> 00:34:34,010
+تلت سنين بقولي في الأجل من تلت سنين معلش اعمل
+
+512
+00:34:34,010 --> 00:34:38,630
+العكس إيش العكس؟ بقول لأ اسحب البنة down لتحت مش
+
+513
+00:34:38,630 --> 00:34:42,930
+لفوقو بقول hold otoscope upside down ايش upside
+
+514
+00:34:42,930 --> 00:34:46,270
+down يعني اللي لازم تمسك ال otoscope من الأعلى
+
+515
+00:34:46,270 --> 00:34:50,170
+للأسفل ماتمسكوش لا مائل ولا كده طبعا هذه الشغلة
+
+516
+00:34:50,170 --> 00:34:53,290
+بالذات يعني هي بس من باب المعرفة لكن هي شغل الطبيب
+
+517
+00:34:53,290 --> 00:34:57,710
+مش شغل احنا اكتر طيب ال external canal عشان اخلص
+
+518
+00:34:57,710 --> 00:35:02,730
+لان انا بدأت اقترب للنصف ساعة ال external canal
+
+519
+00:35:02,730 --> 00:35:09,190
+بشوف اذا في readinessاو مثلا في allegiance او في
+
+520
+00:35:09,190 --> 00:35:13,210
+foreign body او في discharge يعني انا بتسأله خاصة
+
+521
+00:35:13,210 --> 00:35:17,330
+هذا بيسموه ايش الأذن الخارجية بروح بدونها و بكتبها
+
+522
+00:35:17,330 --> 00:35:21,030
+ال timpanic membrane اللي هو الطبلة طبلة الأذن
+
+523
+00:35:21,030 --> 00:35:24,210
+يعني الداخليةلو انا .. طبعا أنا مش هقدر اخد
+
+524
+00:35:24,210 --> 00:35:27,870
+اوتسكوب لكن نعرف انه ال killer تبعه لازم يحكي لنا
+
+525
+00:35:27,870 --> 00:35:31,070
+يا الطبيب او يكون مكتوب و كيف ال character و هل لا
+
+526
+00:35:31,070 --> 00:35:34,570
+سمح الله في عنده perforation، perforation يعني رشح
+
+527
+00:35:34,570 --> 00:35:38,130
+في الطابلة زي بعض الحالات اللي باخد هواية جامدة
+
+528
+00:35:38,130 --> 00:35:43,060
+فبصير ثقوب في الطابلة، طابلة الأذنبنسأله هل هي
+
+529
+00:35:43,060 --> 00:35:48,020
+translucent يعني هل بتعبر ضوء و لا مابتعبروش بقوله
+
+530
+00:35:48,020 --> 00:35:50,840
+انها بتشبه ال pearly grey ال pearly grey زي حاجة
+
+531
+00:35:50,840 --> 00:35:56,220
+بسمها الأرجوانية زي ال .. زي ال .. ال .. الرماد
+
+532
+00:35:56,220 --> 00:36:00,680
+على لون زي الذهب اللي لونه الرمادي يعني كأنه
+
+533
+00:36:00,680 --> 00:36:05,000
+بديقولي الأصفر بيكون على .. على اللون orange بس
+
+534
+00:36:05,000 --> 00:36:09,170
+قاتم شوية gray color هذا طبيعيطبعا كيف بيكون
+
+535
+00:36:09,170 --> 00:36:14,390
+المنظر كون شبه زي القمع من قدام واسع ورا من الداخل
+
+536
+00:36:14,390 --> 00:36:19,150
+اشماله ضيق شوية وفيه light reflex بيصير انعكاس
+
+537
+00:36:19,150 --> 00:36:23,230
+للضوء خاصة في الأذن الطبيعية خليني اقفل هنا لانه
+
+538
+00:36:23,230 --> 00:36:27,170
+انا يعني معلش يبدو الوقت بياخدنا ستة و تلاتين
+
+539
+00:36:27,170 --> 00:36:29,750
+دقيقة معلش سامحونا ونكمل ان ش الله المحاضرة
+
+540
+00:36:29,750 --> 00:36:33,170
+القادمة والسلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..e2892975e96ad25c689ddd03e2011cdbe2af2d85
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4.srt
@@ -0,0 +1,1626 @@
+1
+00:00:01,010 --> 00:00:04,350
+اعوذ بالله، مش طارئين، بسم الله الرحمن الرحيم، طيب
+
+2
+00:00:04,350 --> 00:00:07,810
+أبنائي وبناتي، طلبة المستوى الثاني في مساق التقييم
+
+3
+00:00:07,810 --> 00:00:12,350
+الصحي التمريضي، خلينا نكمل مع بعض اليوم في ال
+
+4
+00:00:12,350 --> 00:00:20,050
+chapter الجديد، الآن طبعًا بتكلم أنا psychosocial
+
+5
+00:00:20,050 --> 00:00:24,090
+احنا قلنا بس نذكر تذكيرًا، احنا لازم بنقول مش
+
+6
+00:00:24,090 --> 00:00:27,030
+physical examination، وإنما biopsychosocial and
+
+7
+00:00:27,030 --> 00:00:29,710
+spiritual، الـ chapter الثاني بيقول لي psychosocial
+
+8
+00:00:29,710 --> 00:00:33,930
+nutritional and sleep weakness assessment، حاضر، أول
+
+9
+00:00:33,930 --> 00:00:37,430
+حاجة، psychosocial assessment، بقول بيشمل إيه؟
+
+10
+00:00:37,430 --> 00:00:42,090
+involves person's growth، بتكلم على نمو الإنسان،
+
+11
+00:00:42,090 --> 00:00:45,790
+development، من تطوره throughout his life، في خلال مراحل
+
+12
+00:00:45,790 --> 00:00:49,930
+الحياة اللي مرّ فيها، وبتكلم على discuss crisis،
+
+13
+00:00:49,930 --> 00:00:54,390
+crises، الأزمات اللي هو مرّ فيها، with the clients،
+
+14
+00:00:54,390 --> 00:00:57,070
+assessed relationship between health and illness،
+
+15
+00:00:57,070 --> 00:01:00,330
+يعني كأنه بقول: أنا في الـ psychosocial assessment،
+
+16
+00:01:00,330 --> 00:01:04,690
+بدي أقيم إيش العلاقة بين صحة الإنسان وبين مرضه، و
+
+17
+00:01:04,690 --> 00:01:07,750
+التغيرات اللي صارت فيه في مراحل حياته، سواء كان هو
+
+18
+00:01:07,750 --> 00:01:12,210
+طفلًا، أو سواء كان لما كبر، إذا اتعرض لأي حوادث، اتعرض
+
+19
+00:01:12,210 --> 00:01:15,110
+لأي أمراض، اتعرض لأي التهابات أو أي شغلات من هذا
+
+20
+00:01:15,110 --> 00:01:18,850
+القريب، طيب قبل كل حاجة بدي أشوف stages of age،
+
+21
+00:01:18,850 --> 00:01:23,690
+stages of age، يعني أول حاجة حتى لو كانت في، أظن في
+
+22
+00:01:23,690 --> 00:01:27,200
+بعض الكتب ممكن تكون مش موجودة، لكن مش مشكلة لو مش
+
+23
+00:01:27,200 --> 00:01:30,120
+موجودة، هيغيرت نكتب، عشان نكون عارفينها، مراحل الحياة،
+
+24
+00:01:30,120 --> 00:01:33,820
+حسب اللي هو مقرّأ، يعني خلّيني أقول المنظمات
+
+25
+00:01:33,820 --> 00:01:37,820
+العالمية اللي تعنى بالأمور الصحية، أول حاجة مرحلة
+
+26
+00:01:37,820 --> 00:01:42,200
+بيسموها infancy، infancy يعني مرحلة الرضاعة، يعني الطفل
+
+27
+00:01:42,200 --> 00:01:45,140
+الصغير، يعني اللي هو بداية، ما قبل لسه ما صار اسم الـ
+
+28
+00:01:45,140 --> 00:01:49,500
+child، اللي هو من 0 لـ 18 شهر، من عند ولادته لسنة وثمان
+
+29
+00:01:49,500 --> 00:01:53,260
+شهور، اسمه infant، early childhood، اسم الطفولة
+
+30
+00:01:53,260 --> 00:01:59,670
+المبكرة، من 18 شهر بتروح لـ 6 سنوات، و
+
+31
+00:01:59,670 --> 00:02:02,310
+كإني بقول، يعني بيعينكم الله نكتب جنب هنا اسمه pre،
+
+32
+00:02:02,310 --> 00:02:05,150
+school، إيش اسمه pre-school، إيه؟ يعني ما قبل
+
+33
+00:02:05,150 --> 00:02:08,670
+المدرسة، لإنه على اعتبار المدرسة صف أول في الـ
+
+34
+00:02:08,670 --> 00:02:12,750
+middle childhood، 6 لـ 9 سنوات، كلام بسيط، بتوش يعني
+
+35
+00:02:12,750 --> 00:02:16,850
+ترجمة، بعدين هذا اللي هو يعني الصف الأول والثاني و
+
+36
+00:02:16,850 --> 00:02:20,850
+الثالث، هنا اسمها إيش هنا؟ pre-adolescence، ما قبل
+
+37
+00:02:20,850 --> 00:02:25,870
+المراهقة، يعني، وهذه الفترة من 9 لـ 12، اللي هي الرابع،
+
+38
+00:02:25,870 --> 00:02:29,870
+خامس، سادس، اللي بعدين هنا adolescence، مرحلة الـ
+
+39
+00:02:29,870 --> 00:02:32,330
+teenage، بدينا في الثالثة عشر، اللي بيسميها الـ teenage،
+
+40
+00:02:32,330 --> 00:02:35,490
+هنا، هنا بعض اللي ممكن احنا نستخدم… نعتبر هدول
+
+41
+00:02:35,490 --> 00:02:38,710
+المرحلتين، اللي هي الـ middle والـ… التنتين هتسموها
+
+42
+00:02:38,710 --> 00:02:41,890
+school age، على اعتبار إنه بيعتبروا الـ 6 سنوات هي
+
+43
+00:02:41,890 --> 00:02:44,290
+الـ school age، اللي هي السنوات الابتدائية، الـ
+
+44
+00:02:44,290 --> 00:02:46,530
+adolescence، طبعًا بيعتبروا الـ teenage اللي هي العام
+
+45
+00:02:46,530 --> 00:02:49,610
+التاسع عشر، في الـ young adult، اللي هو بيسموه الشباب
+
+46
+00:02:49,610 --> 00:02:53,930
+المبكر، أو يعني بيسموه شباب، يعني من عشرين لأربعين،
+
+47
+00:02:54,300 --> 00:02:56,760
+وفيها اللي بيسموه الـ middle adulthood، يعني هم اللي
+
+48
+00:02:56,760 --> 00:03:00,440
+بيعتبروا أواسط العمر، أربعين لخمس وستين سنة، طبعًا
+
+49
+00:03:00,440 --> 00:03:02,960
+هذا حسب الأجانب، لكن احنا عندنا فيه مختلف، احنا أنا
+
+50
+00:03:02,960 --> 00:03:06,800
+للأسف ممكن نكون أربعين، ونتطلع فيه تفكير عمره ستين،
+
+51
+00:03:06,800 --> 00:03:09,640
+وعمرها خمسة وأربعين، وتفكيرًا عمرها سبعين سنة،
+
+52
+00:03:09,640 --> 00:03:12,900
+الظروف صعبة، والله يعين الناس، في الـ late adulthood،
+
+53
+00:03:12,900 --> 00:03:16,740
+خمس وستين and more، يعني من خمس وستين وفوق، احنا
+
+54
+00:03:16,740 --> 00:03:20,510
+عندنا للأسف عند الستين، بسبب للأسف كان بيقول لك expired،
+
+55
+00:03:20,510 --> 00:03:24,150
+ولازم يخلص وسنة تقاعد وممنوحة، ده يعني لا يروح
+
+56
+00:03:24,150 --> 00:03:28,050
+يشتغل ولا كده، طبعًا احنا ما ننساش هذه اسمها مراحل،
+
+57
+00:03:28,050 --> 00:03:32,370
+الأعمار اللي احنا بنتكلم عنها خلال حياة الإنسان،
+
+58
+00:03:32,370 --> 00:03:36,750
+منذ الولادة حتى الوفاة، طيب، nutrition assessment، يا
+
+59
+00:03:36,750 --> 00:03:41,350
+أستاذ، الـ nutrition، بقول لي هنا plays، إيش، a major،
+
+60
+00:03:41,350 --> 00:03:44,830
+role، بالدور مهم كثير، للـ nutrition، ليش أنا بعمله
+
+61
+00:03:44,830 --> 00:03:48,670
+assessment؟ لإنه بقول الدور أساس كبير جدًا في
+
+62
+00:03:48,670 --> 00:03:53,260
+حياتنا، إيش هي؟ هو اللي بيخلّينا… بيقول لي أنا how I
+
+63
+00:03:53,260 --> 00:03:56,060
+look، كيف أنا بقى أنظر يعني في حياتي، how I feel،
+
+64
+00:03:56,060 --> 00:04:00,520
+كيف أنا بشعر، how I behave، كيف أنا بتصرف، زمان
+
+65
+00:04:00,520 --> 00:04:03,680
+كان يقول مثلًا الجوع كافر، أو الجوع كذا، بغض النظر،
+
+66
+00:04:03,680 --> 00:04:06,400
+احنا بنتكلم لما تكون في مشكلة في الـ nutrition بشكل
+
+67
+00:04:06,400 --> 00:04:10,900
+عام، معناته صحة الإنسان فيها مشكلة، معناته مشاعر
+
+68
+00:04:10,900 --> 00:04:13,520
+الإنسان، سلوكيات الإنسان، مشاهد الإنسان، كل شيء
+
+69
+00:04:13,520 --> 00:04:16,640
+فيه مشكلة، أكيد أنتم مقرّرين معايا في هذا الكلام،
+
+70
+00:04:16,640 --> 00:04:20,320
+مش معقول يكون في عنده يعني مشكلة غذائية وهو عامله
+
+71
+00:04:20,320 --> 00:04:23,800
+يعني كثير ومنيح ومنصحّته منيح، لأ أبدًا، ليه؟ على
+
+72
+00:04:23,800 --> 00:04:27,540
+اعتبار إنه يعني… اعتبر إنه أصلًا… أصلًا احنا بنعتبر
+
+73
+00:04:27,540 --> 00:04:31,320
+إنّه الـ diet defense يعني، مقاوم لكثير من الـ
+
+74
+00:04:31,320 --> 00:04:34,140
+disorders والـ disease، the ability to fight
+
+75
+00:04:34,140 --> 00:04:37,240
+disease، هي لحالها قالت لي، إنه أنا كثير بخلينا نقاوم
+
+76
+00:04:37,240 --> 00:04:40,850
+إيش الأمراض، greatly depends، بيعتمد كثير على الـ
+
+77
+00:04:40,850 --> 00:04:46,450
+individuals، إيش يعني، وكثير من الأمراض ومقاومتها
+
+78
+00:04:46,450 --> 00:04:52,010
+تعتمد على قوّتك وطاقتك الغذائية، حتى شوفوا الموضوع
+
+79
+00:04:52,010 --> 00:04:55,190
+الكرونا اللي احنا بقى له الآن في الصحة، ده بيقول لك
+
+80
+00:04:55,190 --> 00:04:58,210
+دايمًا ارفع المناعة، ارفع المناعة، كيف بنرفع المناعة؟
+
+81
+00:04:58,210 --> 00:05:00,570
+معظم الناس صحيح بياخذوا فيتامين C وبياخذوا زنك و
+
+82
+00:05:00,570 --> 00:05:03,270
+شكلها زي هي، أنا لما بسألهم بقول لهم مش مشكلة حتى لو
+
+83
+00:05:03,270 --> 00:05:06,990
+أخذت Omega، مش مشكلة، خذ Omega، هيقول لك خذ مكملات على
+
+84
+00:05:06,990 --> 00:05:10,610
+اعتبار إنه كل ما زادت القيمة الغذائية، مش الكمية،
+
+85
+00:05:10,610 --> 00:05:14,990
+القيمة الغذائية، كل ما زادت اللي هو عندك قوة المناعة،
+
+86
+00:05:14,990 --> 00:05:19,590
+طيب، major goals of nutritional assessment، إيش الـ
+
+87
+00:05:19,590 --> 00:05:22,410
+major goals؟ ليش الوظائف الأساسية أو الهداف
+
+88
+00:05:22,410 --> 00:05:26,550
+الأساسية؟ إيش اللي أنتَ تقصده عشان تعمل nutritional
+
+89
+00:05:26,550 --> 00:05:29,570
+assessment؟ بقول لي أنا بعمل nutritional assessment
+
+90
+00:05:29,570 --> 00:05:33,590
+لثلاث أمور مهمة، إما بشوف identification of
+
+91
+00:05:33,590 --> 00:05:37,260
+malnutrition، طبعًا إما بحدد سوء التغذية، لما نقول
+
+92
+00:05:37,260 --> 00:05:40,560
+malnutrition، سوء التغذية، ما يجي واحد يا أستاذ
+
+93
+00:05:40,560 --> 00:05:44,440
+يقول لي الـ malnutrition، وكأني بقول يعني سوء التغذية،
+
+94
+00:05:44,440 --> 00:05:47,940
+يعني قلة التغذية، لأ، سوء التغذية، إما over وإما under،
+
+95
+00:05:47,940 --> 00:05:50,540
+ما الثانية، سوء التغذية، يعني الطفل الصغير اللي قاعد
+
+96
+00:05:50,540 --> 00:05:53,620
+بياكل خبز وشاي، خبز وشاي، خبز وشاي، وصار منتفخ،
+
+97
+00:05:53,620 --> 00:05:57,040
+مسكين، وهي اللي بتأكل كربوهيدرات وكثير كثير، نصحته أو
+
+98
+00:05:57,040 --> 00:05:59,600
+نصح، ما هذا برضه malnutrition، واللي ما بياكل
+
+99
+00:05:59,600 --> 00:06:02,840
+malnutrition، اثنين، identification of over
+
+100
+00:06:02,840 --> 00:06:06,950
+consumption، الاستهلاك الزائد عن حده، ثلاثة،
+
+101
+00:06:06,950 --> 00:06:09,630
+identification of optimal nutrition status، عشان
+
+102
+00:06:09,630 --> 00:06:14,650
+نحدد وين الـ optimum أو الـ optimal body، يعني كأنه
+
+103
+00:06:14,650 --> 00:06:19,550
+بقول أنا اللي بهدفه يا بدي أشوف الفلان اللي أنا
+
+104
+00:06:19,550 --> 00:06:21,870
+بدي أعمله الـ nutritional assessment، إما عنده سوء
+
+105
+00:06:21,870 --> 00:06:26,250
+تغذية، أو عنده استهلاك زائد، أو عنده إيه؟ أو عنده
+
+106
+00:06:26,250 --> 00:06:29,790
+استهلاك زائد، أو عنده صحة طبيعية، وهيك بنقوله
+
+107
+00:06:29,790 --> 00:06:33,130
+ما تعملش لا رجيم ولا شيء، components of nutritional
+
+108
+00:06:33,130 --> 00:06:36,690
+assessment، كيف بنعمل nutritional assessment، أول
+
+109
+00:06:36,690 --> 00:06:40,450
+حاجة بالمقياس، حاجة اسمها anthropometric measures،
+
+110
+00:06:40,450 --> 00:06:43,670
+لما نقول anthropometric measures، يعني بالمقياس
+
+111
+00:06:43,670 --> 00:06:47,110
+الجسدية، طبعًا إيش يعني بالمقياس الجسدية، وأنا إن شاء
+
+112
+00:06:47,110 --> 00:06:52,190
+الله هأزوّدكم… هو موجود على كثير على الجوالات،
+
+113
+00:06:52,190 --> 00:06:54,830
+ممكن الـ google play، وأنا حاليًا هأحطه برضه على الـ
+
+114
+00:06:54,830 --> 00:07:00,810
+model، هذا برنامج احنا بنحط عليه مقاييسنا، الطول مع
+
+115
+00:07:00,810 --> 00:07:04,490
+الوزن، وهو بيعطينا احنا وين بالضبط على الـ range،
+
+116
+00:07:04,490 --> 00:07:07,550
+الطبيعي اللي في البشر، هذا اسمه anthropometric،
+
+117
+00:07:07,550 --> 00:07:10,350
+measurement، هلّأ هأتكلم فيه، المقياس هنا… هنا
+
+118
+00:07:10,350 --> 00:07:13,370
+biochemical… هنا مقياس بالصندوق، وبالأمتار، و
+
+119
+00:07:13,370 --> 00:07:16,890
+بالميليجرامات، وكام… هنا لأ… هنا biochemical،
+
+120
+00:07:16,890 --> 00:07:19,710
+بالفحوصات الكيميائية اللي موجودة عند جسم الإنسان،
+
+121
+00:07:19,710 --> 00:07:23,410
+زي ما أنا أعمله واحد مثلًا kidney function، أعمله
+
+122
+00:07:23,410 --> 00:07:26,630
+مثلًا liver function، وهكذا، اللي بعده clinical،
+
+123
+00:07:26,630 --> 00:07:29,790
+examination، اسمه الفحص السريري، واللي أخر حاجة
+
+124
+00:07:29,790 --> 00:07:33,650
+اسمها dietary analysis، التحليل الغذائي، اللي هو
+
+125
+00:07:33,650 --> 00:07:36,630
+أكثر شيء بيهتموا فيه الناس، مين اللي درسوا clinical،
+
+126
+00:07:36,630 --> 00:07:41,990
+nutrition، خاصة أخصائيو التغذية، طيب، أول حاجة الـ
+
+127
+00:07:41,990 --> 00:07:44,330
+anthropometric measurement، بقول الـ anthropometric،
+
+128
+00:07:44,330 --> 00:07:48,510
+measurement، أنا بأهتم بالـ size، الحجم، بالـ weight،
+
+129
+00:07:48,510 --> 00:07:52,430
+الوزن، والـ proportions of human body، إيش إن الـ
+
+130
+00:07:52,430 --> 00:07:54,900
+proportions of human body، يعني أنا أيضًا بشوف
+
+131
+00:07:54,900 --> 00:07:58,640
+التناسب أعضاء الجسم مع بعضها البعض، يعني ما يجي واحد
+
+132
+00:07:58,640 --> 00:08:02,560
+من الناس يقول لي يا أستاذ، طب ما أنا شايف إن جسمه كويس،
+
+133
+00:08:02,560 --> 00:08:05,380
+ما فيش فيه كلمة أنا شايف جسمه كويس، احنا بنشوف
+
+134
+00:08:05,380 --> 00:08:11,020
+التناسب مثلًا مع بعض، يعني ب… بقارن جِداش البنية،
+
+135
+00:08:11,020 --> 00:08:14,020
+جِداش الـ abdomen، جِداش مثلًا الـ leg، جِداش مثلًا الـ
+
+136
+00:08:14,020 --> 00:08:16,660
+hands، بيقارنهم مع بعض، بقول لي الـ measurement
+
+137
+00:08:16,660 --> 00:08:20,260
+include، إيش هنا height… height، في فرق بين الـ
+
+138
+00:08:20,260 --> 00:08:23,170
+height، اه، والـ length، خارج الذاكرة، ممكن لو جاء في
+
+139
+00:08:23,170 --> 00:08:26,250
+امتحان، خربتك، height، معناه الارتفاع، يعني بنقيس
+
+140
+00:08:26,250 --> 00:08:30,230
+طول الإنسان وهو واقف، length، بنقيس الطول وهو نايم،
+
+141
+00:08:30,230 --> 00:08:33,890
+طبعًا لازم نعرف أنه لما نعمل assessment لمرحلة
+
+142
+00:08:33,890 --> 00:08:36,510
+الأطفال، خاصة اللي بيروحوا عيادات، بتشوفوا أكيد
+
+143
+00:08:36,510 --> 00:08:40,600
+حد عندكم أخ صغير أو كده، بتعرفوه، لمّا بيروحوا العيادات،
+
+144
+00:08:40,600 --> 00:08:44,220
+عمره مثلًا في أشهر، أو سنة، أو سنتين، أو ثلاث سنين، أو
+
+145
+00:08:44,220 --> 00:08:48,320
+بداية بتيجي الممرضة بتنامّه على سريره، وبتجيب ستوله،
+
+146
+00:08:48,320 --> 00:08:52,080
+ما ينفعش بواقفه، طبعًا هو الاختلاف من نصف سنتيمتر، لكن
+
+147
+00:08:52,080 --> 00:08:55,280
+ما يجيش واحد يقول لي مش مهم، لأ، كل شيء له معياره،
+
+148
+00:08:55,280 --> 00:09:00,120
+…كلّ…كلّ شيء له معياره، height, weight, skin fold،
+
+149
+00:09:00,660 --> 00:09:04,840
+skin fold thickness، إيش يعني؟ يعني بنشوف كثافة…
+
+150
+00:09:04,840 --> 00:09:08,440
+اه، كثافة الجلد اللي موجود في جسم الإنسان، يعني لما
+
+151
+00:09:08,440 --> 00:09:12,320
+الواحد بنطلع بنقوله فلان مليان جلد، بنقول الـ skin،
+
+152
+00:09:12,320 --> 00:09:15,360
+fold، يعني high thickness، high thickness، يعني عنده
+
+153
+00:09:15,360 --> 00:09:19,460
+تلافيف موجودة أكثر في جسمه، وفي بعض الناس بيكون thin،
+
+154
+00:09:19,460 --> 00:09:21,920
+يعني رفيع، والـ circumferences، إيش يعني الـ
+
+155
+00:09:21,920 --> 00:09:25,180
+circumferences؟ اللي هو المحيطات، إيش المحيطات؟ محيط
+
+156
+00:09:25,180 --> 00:09:29,100
+الرأس، محيط الصدر، محيط الجسم، محيط الـ trunk، اللي
+
+157
+00:09:29,100 --> 00:09:33,280
+هو الجذع، وهكذا، الـ body parts، طيب، إيه بنتكلم على
+
+158
+00:09:33,280 --> 00:09:37,000
+الـ head، والـ chest، والـ arms؟ هدول أكثر شيء، زي لما
+
+159
+00:09:37,000 --> 00:09:42,460
+واحد بيروح بيتفصل، حتى لما المرأه بتتفصل، يعني جاكيت،
+
+160
+00:09:42,460 --> 00:09:46,220
+بلوزة، جلباب، أي شيء بتلاقي بيجي الخياط الشاطر،
+
+161
+00:09:46,220 --> 00:09:50,900
+بيعمل له مقياس واضح جدًا، علشان يقدر إيش…يكون ينسج
+
+162
+00:09:50,900 --> 00:09:55,460
+معاه في عملية التفصيل، طيب، assessment of body mass،
+
+163
+00:09:55,460 --> 00:09:58,280
+index، وأنا هذا إن شاء الله هو بتكلم عنه البرنامج،
+
+164
+00:09:58,280 --> 00:10:01,980
+اللي أنا هأحطه، وعلى فكرة ممكن أي واحد فيكم يبحث،
+
+165
+00:10:01,980 --> 00:10:04,540
+على جوجل، وبرنامج صغير أظن اللي هو نوع أحمر أيقونته،
+
+166
+00:10:04,540 --> 00:10:09,820
+اسمه BMI، بس BMI، body mass index، هذا بنحط فيه الطول،
+
+167
+00:10:09,820 --> 00:10:12,620
+والوزن، وهو لحاله بيعطينا الـ range، وبيقول لنا أين أنا
+
+168
+00:10:12,620 --> 00:10:16,280
+بالضبط موجود في الميزان اللي هو خليني أقول يعني في،
+
+169
+00:10:16,280 --> 00:10:20,380
+الـ average of the body، يعني weight، لو four people،
+
+170
+00:10:20,380 --> 00:10:25,250
+للناس بشكل عام، هانشرح
+
+223
+00:13:40,170 --> 00:13:44,650
+بدكراه يمكن اليوم اسمه مش غريب علينا الفحص لكن لأ
+
+224
+00:13:44,650 --> 00:13:47,350
+هعرف إيش معناه اليوريا و إيش الكرياتينين وهكذا
+
+225
+00:13:47,350 --> 00:13:51,350
+and urine اللي هو.. اللي هو.. ده شوف كمان تحليل
+
+226
+00:13:51,350 --> 00:13:54,650
+الـ bone commonly used for biochemical assessment
+
+227
+00:13:55,130 --> 00:13:58,870
+أول حاجة أشبه أقول هنا أنا مهم كتير أشوف ال.. و
+
+228
+00:13:58,870 --> 00:14:01,890
+أنا بعمل الـ biochemical measurement فيه مرات over
+
+229
+00:14:01,890 --> 00:14:04,130
+consumption في بعض الناس يا جماعة بتكونوا تفهمون
+
+230
+00:14:04,130 --> 00:14:07,110
+إيه؟ أكلهم مش طبيعي يعني أنا معتمد في حياته على
+
+231
+00:14:07,110 --> 00:14:10,990
+مثلا.. مثلا على الـ.. المرتدالة مثلا أنا ماقدرش
+
+232
+00:14:10,990 --> 00:14:13,690
+أقول سيئة أو.. مش هيكوا سيئة أو مثلا معتمد..
+
+233
+00:14:13,690 --> 00:14:16,450
+معتمد على الـ endome مثلا كتير من الحالات يعني أنا
+
+234
+00:14:16,450 --> 00:14:18,510
+مرة طالب عجبته وأنا بتكلم على طالب واتكلمت على
+
+235
+00:14:18,510 --> 00:14:21,590
+درس يعني من الجامعة الإسلامية وجهه شاحب وكذا
+
+236
+00:14:21,590 --> 00:14:24,370
+قلت له بس أول حاجة عمل لي الفحص الدم والتحليل ما
+
+237
+00:14:24,370 --> 00:14:27,070
+راجتني تاني يوم اللي بتقول لي أنا عندي دم ثمانية
+
+238
+00:14:27,070 --> 00:14:30,010
+وسبعه من عشرة، قلت لها أنا متوقع ده الكلام، عملنا
+
+239
+00:14:30,010 --> 00:14:32,250
+فحصات تانية عشان نتأكد لازم الله ت roll out other
+
+240
+00:14:32,250 --> 00:14:34,430
+things يعني لازم نكون عندها مشاكل تانية، قلت لها
+
+241
+00:14:34,430 --> 00:14:38,470
+لأ، وين المشكلة؟ قالت لي أنا مدمنة.. مدمنة إدمان
+
+242
+00:14:38,470 --> 00:14:41,690
+كامل على اندومي، لدرجة إنه بشتريه مرات بالكاسة و
+
+243
+00:14:41,690 --> 00:14:44,350
+بشتري.. أنا ماأعرفش إيش كاسة بالكاسة، مش فاهم، لما
+
+244
+00:14:44,350 --> 00:14:47,010
+نويل في الآخر عرفت إيش لما شوفت ولادي مرات بيجيبوه
+
+245
+00:14:47,320 --> 00:14:50,240
+وأنا قلت لرجالاتي حتى لما بيعملوا أي أكلة من
+
+246
+00:14:50,240 --> 00:14:53,260
+أفضل ما يكون أنا وكأنها مش موجودة طب وهذا إيش صارت
+
+247
+00:14:53,260 --> 00:14:57,400
+over consumption for إيش abnormal nutrients مغذيات
+
+248
+00:14:57,400 --> 00:15:00,760
+مش طبيعية يبقى الـ minerals اللي أنا بديها أين راحت
+
+249
+00:15:00,760 --> 00:15:03,620
+الـ proteins اللي بديها أين راحت الـ calories اللي
+
+250
+00:15:03,620 --> 00:15:06,160
+بديها أين راحت هنا المشكلة يبقى أنا بستخدم الـ
+
+251
+00:15:06,160 --> 00:15:10,180
+urine وبستخدم الـ blood عشان أعمل فحصات طيب تكملي
+
+252
+00:15:10,180 --> 00:15:13,500
+أستاذي الـ clinical examination بيبقى مال إيش أنا
+
+253
+00:15:13,500 --> 00:15:19,120
+هنا مش هتكلم فيها الآن بزيادة لكن من قدامها هأعطيكم
+
+254
+00:15:19,120 --> 00:15:23,060
+مش واجب أكثر من أنه يعني نوع من العصف الذهني
+
+255
+00:15:23,060 --> 00:15:26,260
+هأعطيكم شغلات إيش الفحصات اللي بنعملها وقداش الـ
+
+256
+00:15:26,260 --> 00:15:28,940
+normal وقداش الـ abnormal بعرف أنه الآن مش رايحين
+
+257
+00:15:28,940 --> 00:15:34,120
+على مستشفى لكن كويس نستفسر نطلع يعني مثلا حاجة كل
+
+258
+00:15:34,120 --> 00:15:36,960
+واحد بنشوف قداش الأملاح عند فلان طبعا قبل ما
+
+259
+00:15:36,960 --> 00:15:39,340
+تقول لي إيش الأملاح قداش قداش الطبيعية يمكن واحد
+
+260
+00:15:39,340 --> 00:15:42,800
+يقول لي قداش يا أستاذ الـ sodium لازم يكون، وأنا قبل
+
+261
+00:15:42,800 --> 00:15:45,660
+ما تقول لي قداش sodium أنا هأسألك، ففي القدام راح أحط
+
+262
+00:15:45,660 --> 00:15:49,940
+شغلات على الـ model عشان نقدر إحنا نقدر نحلها و
+
+263
+00:15:49,940 --> 00:15:52,760
+اللي بيحلها لوحده وبيبعتها لي كمان على الـ WhatsApp
+
+264
+00:15:52,760 --> 00:15:55,500
+أو بيبعتها على المجموعة عن طريق النادر وبيبعتها لي
+
+265
+00:15:55,500 --> 00:15:58,400
+بكون أنا مبسوط عشان أعرف قداش الحمد لله متابعتكم
+
+266
+00:15:58,400 --> 00:16:02,200
+أنا متأكد إنكم شاطرين الـ clinical examination
+
+267
+00:16:02,200 --> 00:16:05,700
+involve إيش هنا بيقول لي close physical evaluation
+
+268
+00:16:06,140 --> 00:16:09,280
+ماذا يعني close physical evaluation؟ هذا تقييم عن
+
+269
+00:16:09,280 --> 00:16:13,580
+قرب جسدي، بيجي الطبيب نفسه أو الأخصائي التغذية أو
+
+270
+00:16:13,580 --> 00:16:16,140
+حتى الأخصائيين الطبي.. أخصائي التغذية بده يشوف الـ
+
+271
+00:16:16,140 --> 00:16:19,380
+signs، يعني العلامات suggesting اللي بتخليني
+
+272
+00:16:19,380 --> 00:16:22,320
+أقترح أن في عنده malnutrition أو over consumption
+
+273
+00:16:22,320 --> 00:16:25,560
+of الـ nutrients، يعني طبعا الفرق بينهم، malnutrition
+
+274
+00:16:25,560 --> 00:16:28,340
+سوء التغذية، over consumption استهلاك
+
+275
+00:16:28,340 --> 00:16:32,700
+غير طبيعي لبعض الأيه اللي هو المغذيات اللي هي مش
+
+276
+00:16:32,700 --> 00:16:37,350
+.. مش تمام، مش هي اللي مطلوبة، examination alone
+
+277
+00:16:37,350 --> 00:16:41,210
+does not permit definitive diagnosis of
+
+278
+00:16:41,210 --> 00:16:43,990
+nutritional problems المقصود هنا أنه مش الـ
+
+279
+00:16:43,990 --> 00:16:46,970
+examination لوحده بيحدد أن فلان عنده مال التغذية
+
+280
+00:16:46,970 --> 00:16:50,130
+يعني قصدي إذا بدنا نقول عشان هيك سموّه
+
+281
+00:16:50,130 --> 00:16:53,710
+complete assessment لما نبدأ نعمل complete
+
+282
+00:16:53,710 --> 00:16:57,020
+nutritional assessment، الـ Anthropometric والـ
+
+283
+00:16:57,020 --> 00:17:00,080
+biochemical والـ clinical examination بقدر أحلف
+
+284
+00:17:00,080 --> 00:17:04,100
+يمين وأقول إنه هذا عنده مشكلة غذائية أما أجي
+
+285
+00:17:04,100 --> 00:17:06,920
+أقرر إنه بس من الـ clinical examination لأ، في بعض
+
+286
+00:17:06,920 --> 00:17:10,760
+الناس رفعة وضعف لكن لما عملت له كل الفحوصات التانية
+
+287
+00:17:10,760 --> 00:17:14,580
+كانت طبيعية ما أقدرش أقول عنه abnormal person، طيب
+
+288
+00:17:14,580 --> 00:17:18,860
+بيقول الـ nutritional assessment techniques طريقة
+
+289
+00:17:18,860 --> 00:17:21,200
+اللي بنعمل فيها.. الطريقة اللي بنعمل فيها
+
+290
+00:17:21,200 --> 00:17:25,670
+nutritional assessment، أول حاجة بعدين أروح
+
+291
+00:17:25,670 --> 00:17:28,230
+للمريض، إحنا كأطباء مرضى الآن، أنا مش أخص أي طرف دي
+
+292
+00:17:28,230 --> 00:17:31,750
+يعني، أول سؤال إيش بقوله؟ describe the type،
+
+293
+00:17:31,750 --> 00:17:37,450
+تشرح لي نوع الأكل، هل هو regular or not، منظم ولا
+
+294
+00:17:37,450 --> 00:17:40,930
+لأ، special ولا عنده special إيه زي ذاك باكل
+
+295
+00:17:40,930 --> 00:17:44,110
+شغلات أو عنده شغلات خاصة في حياته أو مثلا عنده
+
+296
+00:17:44,110 --> 00:17:48,410
+مشكلة صحية زي عنده أسنان وما يقدرش يأكل حاجات كتير
+
+297
+00:17:48,410 --> 00:17:53,110
+يمكن يقول لي أنا ما بأكلش الشغلات البسيطة والمكسرة و
+
+298
+00:17:53,110 --> 00:17:56,050
+المطحونة، طب ليه؟ لأنه عنده مثلا notes of cheating
+
+299
+00:17:56,050 --> 00:17:59,410
+يعني من الأسف عنده.. أنا مركب ضبة dead sharks
+
+300
+00:17:59,410 --> 00:18:02,690
+أو عنده مشكلة، في بعض الناس بيقول لك أنا ما أقدرش آكل
+
+301
+00:18:02,690 --> 00:18:06,270
+السمك أنا عندي sensitive أو عندي مثلا أني ما أقدرش
+
+302
+00:18:06,270 --> 00:18:08,690
+آكل الموالح في عندي sensitive mouth، كل وقت أنا
+
+303
+00:18:08,690 --> 00:18:12,190
+بسأله من مين؟ بسأله المريض وبسأل السؤال الثاني الـ
+
+304
+00:18:12,190 --> 00:18:15,590
+usual meal times، لماذا بسأل السؤال الثاني؟ قداش
+
+305
+00:18:15,590 --> 00:18:20,010
+وقتاش أنت عندك دائما بتأكل الوجبات بشكل طبيعي
+
+306
+00:18:20,010 --> 00:18:23,970
+قداش بتأكل وجبة في اليوم وهل بتكونهم بشكل
+
+307
+00:18:23,970 --> 00:18:28,270
+منتظم، وين and which are heavy meals، أي وجبة عندك
+
+308
+00:18:28,270 --> 00:18:32,470
+الأساسية وأكون أنسى لما أخدها في الـ interview أنه
+
+309
+00:18:32,470 --> 00:18:36,090
+نعطي leading question سؤال موجه أو biased question
+
+310
+00:18:36,090 --> 00:18:39,110
+هو على طول هتقول له أكيد الوجبة الأساسية عندك
+
+311
+00:18:39,110 --> 00:18:42,030
+الغداء، لأ، ممكن تكون الوجبة الأساسية عنده الفطور
+
+312
+00:18:42,030 --> 00:18:46,330
+أنا شخصيا أنا وأستاذكم بعترف عادي أنا الوجبة
+
+313
+00:18:46,330 --> 00:18:48,510
+الأساسية عندي مش الغداء ولا العشاء، أنا عندي
+
+314
+00:18:48,510 --> 00:18:51,490
+الوجبة الأساسية والرئيسية في حياتي هي الفطور، أنا
+
+315
+00:18:51,490 --> 00:18:54,350
+لما بأكل الفطور عندي يعني هو مركزية طول اليوم لأنه
+
+316
+00:18:54,350 --> 00:18:57,290
+بيعطيني زي الفول يعني زي الطاقة طول النهار، الـ
+
+317
+00:18:57,290 --> 00:19:00,870
+appetite، أبدأ أسأله، هل عنده good appetite؟ عنده
+
+318
+00:19:00,870 --> 00:19:04,630
+good appetite or not؟ ولا fair، عادية؟ ولا poor؟
+
+319
+00:19:04,630 --> 00:19:08,710
+يعني ضعيفة؟ ولا too good؟ ولا عنده فتح شهية
+
+320
+00:19:08,710 --> 00:19:13,640
+مفتوحة؟ زي بعض الناس، بيجي يقول لي مثلا بسأله أنا كيف
+
+321
+00:19:13,640 --> 00:19:16,380
+شايف أكل الأكل؟ بيقول لك أنا.. أنا بكره الصحن الفاضي
+
+322
+00:19:16,380 --> 00:19:20,120
+بس ما زال قال لي هيك.. يعني أنتم شوفوا رد فعله
+
+323
+00:19:20,120 --> 00:19:23,200
+بيجيب عليك.. صح، أنت حتضحك أو حتضحك لكن خلاص كأنه
+
+324
+00:19:23,200 --> 00:19:26,500
+أجاب عن.. يعني بعض ممكن تقول له للمريض أنت كيف أنت
+
+325
+00:19:26,500 --> 00:19:29,200
+والأكل؟ يقول لك أنا الأكل.. أنا الأكل يعني أنا
+
+326
+00:19:29,200 --> 00:19:31,720
+بحبه.. أنا بكره الصحن الفاضي.. معناه خلاص تسألوش
+
+327
+00:19:31,720 --> 00:19:34,120
+إن أنت يبقى خلاص أجاوب إنه الافيتاز عنده ما شاء
+
+328
+00:19:34,120 --> 00:19:38,920
+الله، الـ weight الوزن نيجي نسأله.. هل هو وزنه
+
+329
+00:19:38,920 --> 00:19:43,090
+ثابت؟ ولا.. how it is changing؟ ولا اتغير؟ بس
+
+330
+00:19:43,090 --> 00:19:46,890
+بالمناسبة إذا قال لي اتغير بسألهوش عن تغيير زمان
+
+331
+00:19:46,890 --> 00:19:51,830
+بسأله متى اتغير في آخر ست شهور أنا ما ليش في زمان
+
+332
+00:19:51,830 --> 00:19:55,990
+ولا إني في سنين لأ، بس جيب لي ست شهور لإنه ممكن
+
+333
+00:19:55,990 --> 00:19:58,750
+في خلال الست شهور الأخيرة عمل لي regime أو عمل
+
+334
+00:19:58,750 --> 00:20:03,070
+حمية أو عمل شغل زيّه أو أخد مثلا يعني مثلا عمل
+
+335
+00:20:03,070 --> 00:20:06,990
+جلسات رياضية أو هكذا، الـ food preferences تفضيلات
+
+336
+00:20:06,990 --> 00:20:12,310
+الغذائية إيش بفضل آكل؟ هل بفضل مثلا لحمة العجل؟ to
+
+337
+00:20:12,310 --> 00:20:16,050
+other meats أنا ما بعطيهوش الجيش أسئلة ولا لو عنده
+
+338
+00:20:16,050 --> 00:20:19,150
+food dislike ولا فيه شغلات بيكرهها من الأكل إذا
+
+339
+00:20:19,150 --> 00:20:23,370
+بيكره شغلات من الأكل what؟ إيش هي؟ وليه؟ why؟ والـ
+
+340
+00:20:23,370 --> 00:20:26,650
+culture related يمكن مرتبطة بثقافته يعني أنا ممكن
+
+341
+00:20:26,650 --> 00:20:29,090
+يجي واحد يقول لي أنا والله بحب اللحمة بس اللحمة إيش
+
+342
+00:20:29,090 --> 00:20:33,030
+اللحمة البيضاء أنا بكره اللحمة الحمراء، وبالمناسبة
+
+343
+00:20:33,030 --> 00:20:35,590
+اللحمة البيضاء أحسن من اللحمة الحمراء، اللحمة الحمراء
+
+344
+00:20:35,590 --> 00:20:40,190
+acid، اللحمة البيضاء alkaline، قاعدية وأنا بدي لجسمكم
+
+345
+00:20:40,190 --> 00:20:43,230
+ولجسمنا يكون دائما قاعدي، كل ما كان جسمنا فيه
+
+346
+00:20:43,230 --> 00:20:46,170
+قاعدة أكثر كل ما كان فيه إيه، شهلة defense for
+
+347
+00:20:46,170 --> 00:20:50,990
+disease، يعني بتقاوم الأمراض، بسأل المريض هل في
+
+348
+00:20:50,990 --> 00:20:54,610
+عندك بتكره شغلات في الأكل؟ آه والله بكره كده كده،
+
+349
+00:20:54,610 --> 00:20:58,270
+ماحي يقول لي، بقول طب إيش؟ يمكن يقعد يقول لي أنا ما بحبش
+
+350
+00:20:58,270 --> 00:21:01,390
+السمك، يمكن كل علاقة بالـ culture، بقول أنا ما عايشتش
+
+351
+00:21:01,390 --> 00:21:06,470
+في حياتي أهلي ما بيأكلو سمك، خلصنا، usual eating
+
+352
+00:21:06,470 --> 00:21:12,830
+places، usual eating places يعني وين بتأكل؟ هل
+
+353
+00:21:12,830 --> 00:21:16,750
+دائما بتعتمد في الـ home ولا للأسف من يوم أنا رحت
+
+354
+00:21:16,750 --> 00:21:19,590
+على المدرسة وجيت على الجامعة في للأسف عندي snack
+
+355
+00:21:19,590 --> 00:21:22,170
+shops يعني و restaurants، أنا بحب.. يعني أنا
+
+356
+00:21:22,170 --> 00:21:25,170
+ما بأكلش دائما، بحب آكل هالسندوش في هالجامعة أو
+
+357
+00:21:25,170 --> 00:21:28,530
+هالسندوش في ناس يعني انفجعوني خصوصا السنة الأولى
+
+358
+00:21:28,530 --> 00:21:31,310
+بيقولوا أصلا أنا كنت أحب الجامعة ونفسي فيها عشان
+
+359
+00:21:31,310 --> 00:21:34,970
+الكفتيريا تبعتها وعشان شفت الناس طلاب بيروحوا و
+
+360
+00:21:34,970 --> 00:21:38,860
+بيقولوا، أما هذا مهم، أكل الطعام البيت بيختلف،
+
+361
+00:21:38,860 --> 00:21:42,020
+معروف، حتى لو جيبنا الفلافل في البيت وأكلناها برّا
+
+362
+00:21:42,020 --> 00:21:45,160
+بيختلف، حتى لو كان بيختلف يعني في شكله، الأكل
+
+363
+00:21:45,160 --> 00:21:48,980
+سبحان الله أريحية البيت ومذاق البيت له يعني، و
+
+364
+00:21:48,980 --> 00:21:51,400
+دائما الراحة النفسية علاقة بموضوع اللي هو
+
+365
+00:21:51,400 --> 00:21:55,040
+الاستجابة للطعام أكثر، ability to eat القدرة على
+
+366
+00:21:55,040 --> 00:21:58,760
+إيش؟ على الأكل، بيقدر يأكل؟ ولا في عنده
+
+367
+00:21:58,760 --> 00:22:01,920
+inabilities؟ describe هل في عنده dental problems؟
+
+368
+00:22:01,920 --> 00:22:06,210
+بسأله، في عندك مشكلة في سنانك؟ الـ fitting dentures
+
+369
+00:22:06,210 --> 00:22:09,930
+.. fitting dentures معناته ضبة اللي بيكون ثابتة، طب
+
+370
+00:22:09,930 --> 00:22:13,490
+الـ fitting يعني مش.. مش ثابتة كويس، بقول لك أنا ركب
+
+371
+00:22:13,490 --> 00:22:16,550
+ضبة الأسنان هي عبارة عن الـ إيش اللي بيحطوها في فمهم
+
+372
+00:22:16,550 --> 00:22:19,330
+لما بيكون خلصوا أكل الأسنان فبيجي بقول لك والله
+
+373
+00:22:19,330 --> 00:22:22,550
+ما أقدرش أنا.. يعني آكلها إنه ما أقدرش أضغط عليها في
+
+374
+00:22:22,550 --> 00:22:24,690
+عند الـ difficulties، في بعض الناس عندهم
+
+375
+00:22:24,690 --> 00:22:27,110
+difficulties في الـ chewing، chewing يعني إيش هنا
+
+376
+00:22:27,110 --> 00:22:30,910
+المضغ، في الـ following زي مين زي حالات اللي عندهم
+
+377
+00:22:30,910 --> 00:22:34,210
+إيش لا قدر الله في حالات زي الحالات اللي عندهم
+
+378
+00:22:34,210 --> 00:22:38,750
+paralysis الشلل، من يوم ما صار عنده شلل مثلا في عصب
+
+379
+00:22:38,750 --> 00:22:42,470
+معين، فبقول لك بطل يقدر يمضغ الأكل منيح فبنضطر إحنا
+
+380
+00:22:42,470 --> 00:22:47,350
+نعطيه solutions سوائل، فلازم نسأل، في بعض الناس
+
+381
+00:22:47,350 --> 00:22:50,130
+عندهم مالي nutrition يعني يوم من الأيام إجتنا يعني
+
+382
+00:22:50,130 --> 00:22:55,090
+طفلة كانت عندها مالي nutrition وأمها تعبت على
+
+383
+00:22:55,090 --> 00:22:58,120
+المستشفيات، صارت كل مشكلة تعرفين في أين؟ مشكلة الـ
+
+384
+00:22:58,120 --> 00:23:02,580
+swallowing، ليه؟ الطفل هذا ما يمضغش كويس، طبعا مش
+
+385
+00:23:02,580 --> 00:23:06,620
+يمضغش إنه صناعة ما فيش فيه مشكلة، لأ، الصناعة كويسة
+
+386
+00:23:06,620 --> 00:23:09,620
+ما فيش فيه ولا حاجة، بس الولد سريع جدا جدا جدا، بيحب
+
+387
+00:23:09,620 --> 00:23:12,800
+يأكل بسرعة، يعني لدرجة أن أمه بتقول في خمس دقائق،
+
+388
+00:23:12,800 --> 00:23:16,420
+بيحس يعني كأنه بيتغول ويتنمر على أخته لما يكون فيه
+
+389
+00:23:16,420 --> 00:23:19,320
+أكل، إذا خلاص لما يكون فيه لحمة ورز وشغلات زي كده و
+
+390
+00:23:19,320 --> 00:23:22,780
+بتقول لأمه فمباشرة يعني.. يعني الظلط بيسلم..
+
+391
+00:23:22,780 --> 00:23:24,500
+بيسلم على البلاء زي ما بقول لها الظلط بيسلم على
+
+392
+00:23:24,500 --> 00:23:26,900
+البلاء، ما نحطش.. ما نحطوش في طمع، بيبلع كيف؟ ما بعرفش
+
+393
+00:23:26
+
+445
+00:26:22,140 --> 00:26:25,240
+حبوب علشان يعمليني رجيم حسب ما بقول ليه laboratory
+
+446
+00:26:25,240 --> 00:26:30,020
+determinations بجيب أسئلة هل عملت فحصات خاصة بـ ال
+
+447
+00:26:30,020 --> 00:26:35,720
+hemoglobin؟ قد ايش كان عندك الدم؟ قد ايش كان الـ protein؟ و
+
+448
+00:26:35,720 --> 00:26:37,560
+أنا اللي قدامي إن شاء الله أحطه .. أحطه في الـ model
+
+449
+00:26:37,560 --> 00:26:41,080
+اللي أنا حكيت لكم عنه قد ايش الـ albumin؟ قد ايش الـ
+
+450
+00:26:41,080 --> 00:26:43,860
+cholesterol؟ تحليل الـ ball اللي
+
+451
+00:26:43,860 --> 00:26:48,400
+عندك؟ قد ايش عندك الـ height؟ قد ايش طولك و التوازن؟ قد ايش
+
+452
+00:26:48,400 --> 00:26:51,800
+الـ weight و وزنك؟ هل الـ body type تبعك يعتبر طبعا
+
+453
+00:26:51,800 --> 00:26:55,470
+.. هنا كاتب لي small و medium و large مش يا جماعة
+
+454
+00:26:55,470 --> 00:26:58,570
+بَقصد small و medium و large زي الملابس يعني الجاكت
+
+455
+00:26:58,570 --> 00:27:01,010
+أو البنطلون تقول small و medium و large لأ أنا
+
+456
+00:27:01,010 --> 00:27:03,130
+بتكلم عن طبيعي طبعا عشان تعرف small و medium و
+
+457
+00:27:03,130 --> 00:27:07,570
+large لما تنزل برنامج بي ام آي body mass index هتعرف
+
+458
+00:27:07,570 --> 00:27:10,970
+إيش المقصود فيها طبعا إحنا صح كلنا بنتمنى نكون في
+
+459
+00:27:10,970 --> 00:27:14,510
+الـ medium لكن لو كان nearly small ماشي الحال و لو
+
+460
+00:27:14,510 --> 00:27:19,150
+كان nearly large ماشي الحال بس over large مشكلة و
+
+461
+00:27:19,150 --> 00:27:24,430
+under small يعني مشكلة finally إيش بقول هنا you
+
+462
+00:27:24,430 --> 00:27:27,830
+must summarize إيش يعني summarize؟ أخدت المعلومات
+
+463
+00:27:27,830 --> 00:27:32,290
+كلها بقول لك لخص المعلومات اللي أنت خدتها من المريض
+
+464
+00:27:32,290 --> 00:27:35,750
+to determine the nutritional diagnosis and nutritional plan of care طبعا بعد ما
+
+465
+00:27:35,750 --> 00:27:40,370
+أخذت المعلومات الكاملة من المريض بلخص المعلومات
+
+466
+00:27:40,370 --> 00:27:44,350
+عشان أعرف إيش المريض المشكلة عنده الغذائية اللي
+
+467
+00:27:44,350 --> 00:27:46,930
+موجودة هل هي malnutrition optimal ولا over
+
+468
+00:27:46,930 --> 00:27:51,230
+consumption؟ الـ laboratory test هل بتدل على اللي فيه
+
+469
+00:27:51,230 --> 00:27:55,220
+حاجة راحة شمال أو يمين أو حد يستهتر كتير من
+
+470
+00:27:55,220 --> 00:27:59,260
+الحالات كتير جدا طلاب ما شاء الله اكتشفوا شغلات
+
+471
+00:27:59,260 --> 00:28:03,540
+الطبيب ما كانش اكتشفها يعني من ضمن الشغلات اللي
+
+472
+00:28:03,540 --> 00:28:06,900
+أنا بانسهاش كان في مريض كان فيه عنده مشكلة دائما
+
+473
+00:28:06,900 --> 00:28:10,340
+جسمه متنفخ وكل ما بيطلب يقول لك أنا بطل عندي نفس
+
+474
+00:28:10,340 --> 00:28:14,300
+كتير للأكل ليش متنفخ وعندي نفس كتير للأكل كان زمان
+
+475
+00:28:14,300 --> 00:28:18,260
+مرة فيه عنده حساسية معينة من شجر كانت عند
+
+476
+00:28:18,260 --> 00:28:22,880
+هالحساسية فوصفوا له كورتيزون، الكورتيزون هذا من الـ anti
+
+477
+00:28:22,880 --> 00:28:27,980
+-inflammatory drugs وهو يعتبر anti-allergic هو
+
+478
+00:28:27,980 --> 00:28:30,440
+magic drug، بكرة هتاخذوه في الـ pharmacology،
+
+479
+00:28:30,440 --> 00:28:32,820
+بيسموه يعني الدواء الساحر، له عدة مفعولات يعني
+
+480
+00:28:32,820 --> 00:28:41,020
+له، فأخذوه ارتاح عليه، فنسي الطبيب يقول له بس دي
+
+481
+00:28:41,020 --> 00:28:44,380
+بالك بعد أسبوع بتخفضوه شوي شوي شوي وبعدين بتقطعوه،
+
+482
+00:28:44,380 --> 00:28:48,680
+نسي فظل المريض كل ما يتعب ياخد منه ياخد منه فزاد
+
+483
+00:28:48,680 --> 00:28:51,460
+طبعا الكورتيزون مبرمج موجود من كثر اللي ما كان
+
+484
+00:28:51,460 --> 00:28:54,420
+ياخده للأسف استمر عليه عمره صار جسمه يتنفخ كتير صار
+
+485
+00:28:54,420 --> 00:28:58,100
+عنده severe constipation إمساك شبه دائم بطل يعرف
+
+486
+00:28:58,100 --> 00:29:01,520
+يأكل طبعا صاروا الأطباء يعملوا له nutrition
+
+487
+00:29:01,520 --> 00:29:04,820
+assessment و يحاولوا يعطوه علاجات و يعطوه مغذيات و
+
+488
+00:29:04,820 --> 00:29:07,120
+.. لما يوم من الأيام أحد الطلاب الله يرضى عليه و أنا
+
+489
+00:29:07,120 --> 00:29:10,600
+بَسِط جدا من الجامعة ف هو بيعمل nutrition
+
+490
+00:29:10,600 --> 00:29:14,540
+assessment و بيذكر فمسك الفحصات بتطلع فيها وبقى
+
+491
+00:29:14,540 --> 00:29:16,980
+سأله سؤال، جاله طب أنت فيه عندك مشكلة؟ جاله والله
+
+492
+00:29:16,980 --> 00:29:20,320
+أنا عندي مشكلة عملت تحليل في تحليل الـ بول دايما
+
+493
+00:29:20,320 --> 00:29:23,260
+بطلع عندي مشاكل عشان ما بشربش مية كتيرة فجاله ليش؟
+
+494
+00:29:23,260 --> 00:29:26,320
+جاله والله الدواء مرات بتعبني، جاله الدواء إيش؟ هو
+
+495
+00:29:26,320 --> 00:29:29,540
+بسأله، جاله هذا الدواء طبعا هو ما بيعرفش
+
+496
+00:29:29,540 --> 00:29:33,380
+إيش هو اسمه فجاله هذا، طبعا الطالب كان ذكي وشاطر
+
+497
+00:29:33,380 --> 00:29:36,660
+و نَجَنّ و مكتوب عليه prednisone  عشرين ملي جرام
+
+498
+00:29:36,660 --> 00:29:40,220
+فدغري مباشرة راح للطبيب، الطبيب يعنى هيك زي يحط
+
+499
+00:29:40,220 --> 00:29:43,550
+إيده على راسه و خبط حاله وراح مباشرة وقال له قد ايش إيه
+
+500
+00:29:43,550 --> 00:29:46,150
+لك في الموضوع هذا؟ قال له لساني قال له حسنًا من الله
+
+501
+00:29:46,150 --> 00:29:48,930
+ونعم الوكيل طبعا تدارك الموضوع صح، أنا ما أقدرش أقول
+
+502
+00:29:48,930 --> 00:29:52,010
+إن هو medical error، ما أقدرش أدخل في تفاصيل، يمكن كان
+
+503
+00:29:52,010 --> 00:29:55,170
+خطأ، يمكن الطبيب قاله، يمكن نسي، ووقف العلاج
+
+504
+00:29:55,170 --> 00:29:59,950
+والحمد لله انتهت كل القصة عند الطالب، مجرد ما وقف،
+
+505
+00:29:59,950 --> 00:30:03,270
+راح الـ malnutrition، راح الـ obesity للأسف، راح الـ
+
+506
+00:30:03,270 --> 00:30:06,430
+constipation، والحمد لله يعني ما صارش عند المريض
+
+507
+00:30:06,430 --> 00:30:09,520
+أي مشاكل في مبادرة صحية. أنا خليني أكمل عشان صار
+
+508
+00:30:09,520 --> 00:30:12,780
+ثلاثين دقيقة لأن ما بدي أتخطى الثلاثين حسب
+
+509
+00:30:12,780 --> 00:30:15,820
+تعليمات الجامعة وإن شاء الله نكمل في المحاضرة
+
+510
+00:30:15,820 --> 00:30:18,560
+القادمة السلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..4950a5568c9914b919fe63b38c29684bc81728d6
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_postprocess.srt
@@ -0,0 +1,2044 @@
+1
+00:00:01,010 --> 00:00:04,350
+اعود بالله مش طارجين بسم الله الرحمن الرحيم طيب
+
+2
+00:00:04,350 --> 00:00:07,810
+أبنائي وابناتي طلبت المستوى التاني في مساق التقيوم
+
+3
+00:00:07,810 --> 00:00:12,350
+الصحي التمريدي خلينا نكمل مع بعض اليوم في ال
+
+4
+00:00:12,350 --> 00:00:20,050
+chapter الجديد الآن طبعا بتكلم انا psychosocial
+
+5
+00:00:20,050 --> 00:00:24,090
+احنا قلنا بس نذكر تذكير احنا لازم بنقول مش
+
+6
+00:00:24,090 --> 00:00:27,030
+physical examination وانما biopsychosocial and
+
+7
+00:00:27,030 --> 00:00:29,710
+spiritual ال chapter التاني بيقوليpsychosocial
+
+8
+00:00:29,710 --> 00:00:33,930
+nutritional and sleep weakness assessment حاضر أول
+
+9
+00:00:33,930 --> 00:00:37,430
+حاجة psychosocial assessment بقول بيشمل إيه
+
+10
+00:00:37,430 --> 00:00:42,090
+involves person's growth بتكلم على نمو الإنسان
+
+11
+00:00:42,090 --> 00:00:45,790
+develop من تطوره throughout his life في خلال مراحل
+
+12
+00:00:45,790 --> 00:00:49,930
+الحياة اللي مر فيها وبتكلم على discuss crisis
+
+13
+00:00:49,930 --> 00:00:54,390
+crisis الأزمات اللي هو مر فيها with the clients
+
+14
+00:00:54,390 --> 00:00:57,070
+assessed relationship between health and illness
+
+15
+00:00:57,070 --> 00:01:00,330
+يعني كأنه بقولأنا في ال psychosocial assessment
+
+16
+00:01:00,330 --> 00:01:04,690
+بدي أقيم إيش العلاقة بين صحة الإنسان و بين مرضه و
+
+17
+00:01:04,690 --> 00:01:07,750
+التغيرات اللي صارت فيه في مراحل حياته سواء كان هو
+
+18
+00:01:07,750 --> 00:01:12,210
+طفل أو سواء كان لما كبر إذا اتعرض لأي حوادث اتعرض
+
+19
+00:01:12,210 --> 00:01:15,110
+لأي أمراض اتعرض لأي التهابات أو أي شغلات من هذا
+
+20
+00:01:15,110 --> 00:01:18,850
+القربي طيب قبل كل حاجة بدي أشوف stages of age
+
+21
+00:01:18,850 --> 00:01:23,690
+stages of age يعني أول حاجة حتى لو كانت في أظن في
+
+22
+00:01:23,690 --> 00:01:27,200
+بعض الكتب ممكن تكون مش موجودةلكن مش مشكلة لو مش
+
+23
+00:01:27,200 --> 00:01:30,120
+موجودة هيغيرت نكتب عشان نكون عارفينها مرحل الحياة
+
+24
+00:01:30,120 --> 00:01:33,820
+حسب اللي هو مقرا يعني خلّيني أقول المنظمات
+
+25
+00:01:33,820 --> 00:01:37,820
+العالمية اللي تعنى بالأمور الصحية أول حاجة مرحلة
+
+26
+00:01:37,820 --> 00:01:42,200
+بيسموها infancy infancy يعني مرحلة الاش يعني الطفل
+
+27
+00:01:42,200 --> 00:01:45,140
+الصغير يعني اللي هو بداية ما قبل لسه ماصارش اسم ال
+
+28
+00:01:45,140 --> 00:01:49,500
+child اللي هو من 0 ل 18 شهر من عند مين ولد لسنة و
+
+29
+00:01:49,500 --> 00:01:53,260
+تمانة شهور اسمه infant early childhood اسم الطفولة
+
+30
+00:01:53,260 --> 00:01:59,670
+المبكرة من 18هو من 18 شهر بتروح نوعين ل 6 سنوات و
+
+31
+00:01:59,670 --> 00:02:02,310
+كإني بقول يعني بيعينكوا الله نكتب جنب هنا اسمه pre
+
+32
+00:02:02,310 --> 00:02:05,150
+school ايش اسمه pre school ايه؟ يعني ما قبل
+
+33
+00:02:05,150 --> 00:02:08,670
+المدرسة لإنه على اعتبار المدرسة صف أول في ال
+
+34
+00:02:08,670 --> 00:02:12,750
+middle childhood 6 ل 9 سنوات كلام بسيط بتوش يعني
+
+35
+00:02:12,750 --> 00:02:16,850
+ترجمة بعدين هذا اللي هو يعني الصف أول و تاني و
+
+36
+00:02:16,850 --> 00:02:20,850
+تالت هنا اسمها ايش هنا؟ pre adolescence ما قبل
+
+37
+00:02:20,850 --> 00:02:25,870
+المراهقة يعني و هذه الفترة من 9 ل 12اللي هي الرابع
+
+38
+00:02:25,870 --> 00:02:29,870
+خامس سادس اللي بعدين هنا adolescence مرحلة ال
+
+39
+00:02:29,870 --> 00:02:32,330
+teenage بدينا في التلتاشر اللي بيسميها ال teenage
+
+40
+00:02:32,330 --> 00:02:35,490
+هنا هنا بعض اللي ممكن احنا نستخدم .. نعتبر هدول
+
+41
+00:02:35,490 --> 00:02:38,710
+المرحلتين اللي هي ال middle والتنتين هتسموها
+
+42
+00:02:38,710 --> 00:02:41,890
+school age على اعتبار انه بيعتبروا ال six سنوات هي
+
+43
+00:02:41,890 --> 00:02:44,290
+ال school age اللي هي السنوات الابتدائية ال
+
+44
+00:02:44,290 --> 00:02:46,530
+adolescence طبعا بيعتبروا ال teenage اللي هي العام
+
+45
+00:02:46,530 --> 00:02:49,610
+تسعتاش في ال young adult اللي هو بيسموه الشباب
+
+46
+00:02:49,610 --> 00:02:53,930
+المبكر او يعني بيسموه شباب يعني من عشرين لاربعين
+
+47
+00:02:54,300 --> 00:02:56,760
+وفيها اللي بيسموه ال middle adulthood يعني هم اللي
+
+48
+00:02:56,760 --> 00:03:00,440
+بيعتبروا أواسط العمر أربعين لخمس و ستين سنة طبعا
+
+49
+00:03:00,440 --> 00:03:02,960
+هذا حسب الأجانب لكن احنا عندنا فيه مختلف احنا انا
+
+50
+00:03:02,960 --> 00:03:06,800
+للأسف ممكن نكون أربعين و نتطلع فيه تفكر عمره ستين
+
+51
+00:03:06,800 --> 00:03:09,640
+و عمرها خمسة و أربعين و تفكريا عمرها سبعين سنة
+
+52
+00:03:09,640 --> 00:03:12,900
+الظروف صعبة و الله يغين الناس في ال late adulthood
+
+53
+00:03:12,900 --> 00:03:16,740
+خمسة و ستين and more يعني من خمس ستين و أعلى احنا
+
+54
+00:03:16,740 --> 00:03:20,510
+عندنا للأسف ع ستين بالسبب للأسفكان بيقولك expired
+
+55
+00:03:20,510 --> 00:03:24,150
+و لازم يخلص و سنة تقاعد و ممنوحة ده يعني لا يروح
+
+56
+00:03:24,150 --> 00:03:28,050
+يشتغل ولا كده طبعا احنا ننساش هذه اسمها مراحل
+
+57
+00:03:28,050 --> 00:03:32,370
+الأعمار اللي احنا بنتكلم عنها خلال حياة الإنسان
+
+58
+00:03:32,370 --> 00:03:36,750
+منذ الولادة حتى الوفاة طيب nutrition assessment يا
+
+59
+00:03:36,750 --> 00:03:41,350
+أستاذ ال nutrition بقولي هنا plays ايش a major
+
+60
+00:03:41,350 --> 00:03:44,830
+role بالعبدور مهم كتير لل nutrition ليش انا بتعمله
+
+61
+00:03:44,830 --> 00:03:48,670
+assessment لأنه بقول العبدور أساس كبير جدا في
+
+62
+00:03:48,670 --> 00:03:53,260
+حياتناإيش هي؟ هو اللي بيخلنا .. بيقولي أنا how I
+
+63
+00:03:53,260 --> 00:03:56,060
+look كيف أنا بقى انظر يعني في حياتي، how I feel
+
+64
+00:03:56,060 --> 00:04:00,520
+كيف أنا بشعر، how I behave، كيف أنا بتصرف، زمان
+
+65
+00:04:00,520 --> 00:04:03,680
+كان يقول مثلا الجوع كافر أو الجوع كذا، بغض النظر،
+
+66
+00:04:03,680 --> 00:04:06,400
+احنا بنتكلم لما تكون في مشكلة في ال nutrition بشكل
+
+67
+00:04:06,400 --> 00:04:10,900
+عام، معناته صحة الإنسان فيها مشكلة، معناته مشاعر
+
+68
+00:04:10,900 --> 00:04:13,520
+الإنسان، سلوكيات الإنسان، مشاهد الإنسان، كل شي
+
+69
+00:04:13,520 --> 00:04:16,640
+فيها مشكلةأكيد انتوا مقررين معايا في هذا الكلام،
+
+70
+00:04:16,640 --> 00:04:20,320
+مش معقول يكون في عنده يعني مشكلة غذائية و هو عامله
+
+71
+00:04:20,320 --> 00:04:23,800
+يعني كتير و منيح و منصحته منيح، لأ أبدا، ليه؟ على
+
+72
+00:04:23,800 --> 00:04:27,540
+اعتبار انه يعني اعتبر انه أصلا .. أصلا احنا بنعتبر
+
+73
+00:04:27,540 --> 00:04:31,320
+انه ال diet defense يعني، مقاوم لكتير من ال
+
+74
+00:04:31,320 --> 00:04:34,140
+disorders و ال disease، the ability to fight
+
+75
+00:04:34,140 --> 00:04:37,240
+disease هي لحاله قاللي، انه انا كتير بخلينا قاوم
+
+76
+00:04:37,240 --> 00:04:40,850
+إيش الأمراضgreatly depends بيعتمد كتير على ال
+
+77
+00:04:40,850 --> 00:04:46,450
+individuals إيش يعني و كتير من الأمراض و مقاومتها
+
+78
+00:04:46,450 --> 00:04:52,010
+تعتمد على قوتك و طاقتك الغذائية حتى شوفوا الموضوع
+
+79
+00:04:52,010 --> 00:04:55,190
+الكورونا اللي احنا بقايله الآن في الصحة ده بيقولك
+
+80
+00:04:55,190 --> 00:04:58,210
+دايما ارفع المناعة ارفع المناعة كيف بنرفع المناعة؟
+
+81
+00:04:58,210 --> 00:05:00,570
+معظم الناس صحيح باخدوا فيتامين C و باخدوا زنكو و
+
+82
+00:05:00,570 --> 00:05:03,270
+شكلها زي هي أنا لما بسألهم بقولهم مش مشكلة حتى لو
+
+83
+00:05:03,270 --> 00:05:06,990
+أخدت Omega مش مشكلة خد Omegaهيقولك خد مكملات على
+
+84
+00:05:06,990 --> 00:05:10,610
+اعتبار انه كل ما زادت القيمة الغذائية مش الكميها
+
+85
+00:05:10,610 --> 00:05:14,990
+القيمة الغذائية كل ما زادت اللي هو عندك قوة الملعب
+
+86
+00:05:14,990 --> 00:05:19,590
+طيب major goals of nutritional assessment ايش ال
+
+87
+00:05:19,590 --> 00:05:22,410
+major goals؟ ليش الوظائف الأساسية او الهداف
+
+88
+00:05:22,410 --> 00:05:26,550
+الأساسية؟ ايش اللي انت تقصده عشان تعمل nutritional
+
+89
+00:05:26,550 --> 00:05:29,570
+assessment؟ بقوللي انا بعمل nutritional assessment
+
+90
+00:05:29,570 --> 00:05:33,590
+لتلت أمور مهمة اما بشوف identification of
+
+91
+00:05:33,590 --> 00:05:37,260
+malnutritionطبعا إما بحدد سوء التخزيه لما نقول
+
+92
+00:05:37,260 --> 00:05:40,560
+malnutrition سوء التخزيه مايجين واحد يا أستاذ
+
+93
+00:05:40,560 --> 00:05:44,440
+يقوللي ال malnutrition وكأني بقول يعني سوء التخزيه
+
+94
+00:05:44,440 --> 00:05:47,940
+يعني قل التخزيه لأ سوء التخزيه إما over وإما under
+
+95
+00:05:47,940 --> 00:05:50,540
+ما التانية سوء التخزيه يعني الطفل الصغير اللي قاعد
+
+96
+00:05:50,540 --> 00:05:53,620
+بأكل خبزة وشاي خبزة وشاي خبزة وشاي وصار انتفخ
+
+97
+00:05:53,620 --> 00:05:57,040
+مسكين وهي اللي بتاكل كربايترات وكتير كتير نصحت أو
+
+98
+00:05:57,040 --> 00:05:59,600
+نصح ما هذا برضه malnutrition ولي مابيكلش
+
+99
+00:05:59,600 --> 00:06:02,840
+malnutrition اتنين identification of over
+
+100
+00:06:02,840 --> 00:06:06,950
+consumptionالاستهلاك الزائد عن حده تلاتة
+
+101
+00:06:06,950 --> 00:06:09,630
+identification of optimal nutrition status عشان
+
+102
+00:06:09,630 --> 00:06:14,650
+نحدد وين ال optimum او ال optimal body يعني كأنه
+
+103
+00:06:14,650 --> 00:06:19,550
+بقول انا اللي بهدفه يا بده اشوف الفلان اللي انا
+
+104
+00:06:19,550 --> 00:06:21,870
+بده اعمله ال nutritional assessment اما عنده سوق
+
+105
+00:06:21,870 --> 00:06:26,250
+تخضيه او عنده استهلاك زائد او عنده ايه او عنده
+
+106
+00:06:26,250 --> 00:06:29,790
+استهلاك زائد او عنده صحة طبيعية و هيك بنقوله
+
+107
+00:06:29,790 --> 00:06:33,130
+ماتعملش لا رجيم ولا شيءcomponents of nutritional
+
+108
+00:06:33,130 --> 00:06:36,690
+assessment كيف بنعمل nutritional assessment أول
+
+109
+00:06:36,690 --> 00:06:40,450
+حاجة بالمقييس حاجة اسمها anthropometric measures
+
+110
+00:06:40,450 --> 00:06:43,670
+لما نقول anthropometric measures يعني بالمقييس
+
+111
+00:06:43,670 --> 00:06:47,110
+الجسدية طبعا ايش يعني بالمقييس الجسدية وانا ان شاء
+
+112
+00:06:47,110 --> 00:06:52,190
+الله هزودكوا .. هو موجود على الكتير على الجوالات
+
+113
+00:06:52,190 --> 00:06:54,830
+ممكن ال google play وا انا حاليا هحطه برضه على ال
+
+114
+00:06:54,830 --> 00:07:00,810
+modelهذا برنامج احنا بنحط عليه مقييصنا الطول مع
+
+115
+00:07:00,810 --> 00:07:04,490
+الوزن و هو بيعطينا احنا وين بالظبط على ال range
+
+116
+00:07:04,490 --> 00:07:07,550
+الطبيعي اللي في البشر هذا اسمه anthropometric
+
+117
+00:07:07,550 --> 00:07:10,350
+measurement هلجت هتكلم بيه؟ المقييس هنا .. هنا
+
+118
+00:07:10,350 --> 00:07:13,370
+biochemical .. هنا مقييس بالصندت و بالمتر و
+
+119
+00:07:13,370 --> 00:07:16,890
+بالمليجرامات و كام .. هنا لأ .. هنا biochemical
+
+120
+00:07:16,890 --> 00:07:19,710
+بالفحوصات الكيميائية اللي موجودة عند جسم الإنسان
+
+121
+00:07:19,710 --> 00:07:23,410
+زي ما انا اعمله واحد مثلا kidney function اعمله
+
+122
+00:07:23,410 --> 00:07:26,630
+مثلا liver function و هكذااللي بعده clinical
+
+123
+00:07:26,630 --> 00:07:29,790
+examination اسمه الفحص الكليكي و اللي اخر حاجة
+
+124
+00:07:29,790 --> 00:07:33,650
+اسمها dietary analysis التحليل الغذائي اللي هو
+
+125
+00:07:33,650 --> 00:07:36,630
+اكتر شي بيهتموا فيه الناس مين اللي درسوا clinical
+
+126
+00:07:36,630 --> 00:07:41,990
+nutrition خاصة اخصائين التخزينية طيب اول حاجة ال
+
+127
+00:07:41,990 --> 00:07:44,330
+anthropometric measurement بقول ال anthropometric
+
+128
+00:07:44,330 --> 00:07:48,510
+measurement انا باهتم بال size الحجم بال weight
+
+129
+00:07:48,510 --> 00:07:52,430
+الوزن و ال proportions of human body ايش ان ال
+
+130
+00:07:52,430 --> 00:07:54,900
+proportions of human bodyيعني انا ايضا بشوف
+
+131
+00:07:54,900 --> 00:07:58,640
+التناسب اعضاء الجسم مع بعض البعض يعني مايجيش بعض
+
+132
+00:07:58,640 --> 00:08:02,560
+الناس يقولني يا استاذ طب ما انا شايف ان جسمه كويس
+
+133
+00:08:02,560 --> 00:08:05,380
+مافيش فيه كلمة انا شايف جسمه كويس احنا بنشوف
+
+134
+00:08:05,380 --> 00:08:11,020
+التناسب مثلا مع بعض يعني ب .. بقارن جداش البنيه
+
+135
+00:08:11,020 --> 00:08:14,020
+جداش ال abdomen جداش مثلا ال leg جداش مثلا ال
+
+136
+00:08:14,020 --> 00:08:16,660
+hands بيقارنهم مع بعض بقوللي ال measurement
+
+137
+00:08:16,660 --> 00:08:20,260
+include ايش هنا height .. height في فرق بين ال
+
+138
+00:08:20,260 --> 00:08:23,170
+height اه و ال length خارج الذاكرينممكن لو أجى في
+
+139
+00:08:23,170 --> 00:08:26,250
+انتحار، خربك، height معناه الترتفاع، يعني بنجيز
+
+140
+00:08:26,250 --> 00:08:30,230
+طول الإنسان و هو واقف، length بنجيز طول هو نايم،
+
+141
+00:08:30,230 --> 00:08:33,890
+طبعا لازم نعرف أنه لما نعمل assessment لمرحلة
+
+142
+00:08:33,890 --> 00:08:36,510
+الأطفال، خاصة اللي بروح براديو ليادات، بتشوف أكيد
+
+143
+00:08:36,510 --> 00:08:40,600
+حد عندك أخ صغير أو كده بتعرفوهلمّا بيروح العيادات
+
+144
+00:08:40,600 --> 00:08:44,220
+عمره مثلا في أشهر أو سنة أو سنتين أو تلات سنين أو
+
+145
+00:08:44,220 --> 00:08:48,320
+بداية بتيجي الممرضة بتناعم على سريره و بتجيب سطوله
+
+146
+00:08:48,320 --> 00:08:52,080
+ما بينفعه بواكفه طبعا هو الاختلاف من نص لصنتى لكن
+
+147
+00:08:52,080 --> 00:08:55,280
+مايديش واحد يقوللي مش مستهلات لأ كل شيء له معيارة
+
+148
+00:08:55,280 --> 00:09:00,120
+.. كل كل شيء له معيارة height, weight, skin fold
+
+149
+00:09:00,660 --> 00:09:04,840
+skin fold thickness إيش يعني؟ يعني بنشوف كثافة ..
+
+150
+00:09:04,840 --> 00:09:08,440
+أه كثافة الجلد اللي موجود في جسم الإنسان يعني لما
+
+151
+00:09:08,440 --> 00:09:12,320
+الواحد بنطلع بنقوله فلان مليان الجلد بنقول ال skin
+
+152
+00:09:12,320 --> 00:09:15,360
+fold يعني high thickness high thickness يعني عنده
+
+153
+00:09:15,360 --> 00:09:19,460
+تلافيف موجودة أكتر في جسمه وفي بعض الناس بكون thin
+
+154
+00:09:19,460 --> 00:09:21,920
+يعني رفية و ال circumferences إيش يعني ال
+
+155
+00:09:21,920 --> 00:09:25,180
+circumferences؟ اللي هو المحيطات إيش المحيطات؟محيط
+
+156
+00:09:25,180 --> 00:09:29,100
+الرأس، محيط الصدر، محيط الجسم، محيط ال trunk اللي
+
+157
+00:09:29,100 --> 00:09:33,280
+هو الجذع و هكذا ال body parts طيب إيه بنتكلم على
+
+158
+00:09:33,280 --> 00:09:37,000
+ال head و ال chest و ال arms؟ هذول أكتر شي زي لما
+
+159
+00:09:37,000 --> 00:09:42,460
+واحد بروح بتفصل حتى لما المرات بتفصل يعني جاكета،
+
+160
+00:09:42,460 --> 00:09:46,220
+بلوزة، جلباب، أي شيء بتلاقي بيجي الخياط الشاطر
+
+161
+00:09:46,220 --> 00:09:50,900
+بيعمله مقييز واضح جدا علشان يقدر ايش .. يكون ينسجن
+
+162
+00:09:50,900 --> 00:09:55,460
+معاه في عملية التفصيل طيبassessment of body mass
+
+163
+00:09:55,460 --> 00:09:58,280
+index وانا هذا ان شاء الله هو بتكلم عنه البرنامج
+
+164
+00:09:58,280 --> 00:10:01,980
+اللي أنا هحاطه وعلى فكرة ممكن أي واحد فيكوا يبحث
+
+165
+00:10:01,980 --> 00:10:04,540
+على جوجل وبرنامج صغير أظن اللي هو نوع أحمر أيقونته
+
+166
+00:10:04,540 --> 00:10:09,820
+اسمه BMI بس BMI body mass index هذا بنحط فيه الطول
+
+167
+00:10:09,820 --> 00:10:12,620
+والوزن وهو لحاله بيعطينا ال range وبيقولنا أين أنا
+
+168
+00:10:12,620 --> 00:10:16,280
+بالظبط موجود في الميزان اللي هو خليني أقول يعني في
+
+169
+00:10:16,280 --> 00:10:20,380
+ال average of the body يعني weight لو four people
+
+170
+00:10:20,380 --> 00:10:25,250
+للناس بشكل عام هانش بقول ليهفي حاجة ال high ratio
+
+171
+00:10:25,250 --> 00:10:29,010
+بس في مشكلة ال high ratio of waist hip
+
+172
+00:10:29,010 --> 00:10:32,610
+circumference are associated with higher risk of
+
+173
+00:10:32,610 --> 00:10:38,170
+illness and decreased lifespan ايش بقصد هنا في بعض
+
+174
+00:10:38,170 --> 00:10:41,370
+الناس في عندهم مشكلة وين المشكلة انه عندهم التناسب
+
+175
+00:10:41,370 --> 00:10:44,670
+ما بين ال waist الخسر يعني وما بين ال hip
+
+176
+00:10:44,670 --> 00:10:49,800
+circumferences بتلاقي الخسر تمامبيقوم الناس جلالهم
+
+177
+00:10:49,800 --> 00:10:53,720
+و طبعا ربنا اللي بيعلن بالأعمار احنا ما بنقرر ده
+
+178
+00:10:53,720 --> 00:10:56,360
+الكلام بيقولوا انه من الناس اللي عندهم ال waist
+
+179
+00:10:56,360 --> 00:11:01,540
+كبير يعني اقصد المنطقة الوسط و الخسر كبيرة كتير
+
+180
+00:11:01,540 --> 00:11:05,120
+يعني و highly obese ومنطقة ال hip من تحت شوية
+
+181
+00:11:05,120 --> 00:11:08,840
+بتلاقي ايش لأ small يعني ال circumference يعني زي
+
+182
+00:11:08,840 --> 00:11:12,540
+مش عارف اذا بتتذكروا معايا زي لما كانوا يجيبوا
+
+183
+00:11:12,540 --> 00:11:17,250
+البوباي هذا اللي تبع ال ..اللي كان ييجي في الصورة
+
+184
+00:11:17,250 --> 00:11:20,130
+المتحركة، اللي كان من فوق يكون متفق ومن تحت يكون
+
+185
+00:11:20,130 --> 00:11:23,850
+مش مبين يعني، اللي لا يحب ولا غيره، فهنا إيش بقول؟
+
+186
+00:11:23,850 --> 00:11:28,430
+هدول الناس مرتبط عندهم أنه بوجود الأمراض أكتر
+
+187
+00:11:28,430 --> 00:11:32,250
+عندهم وع كلامهم الأجانب، لإن ال life span بتقلب
+
+188
+00:11:32,250 --> 00:11:35,570
+واحنا بنقول لأ، الأعمار بيد الله وما بيبقى حد
+
+189
+00:11:35,570 --> 00:11:39,160
+بيقدر يحدد أن هو هيموت واكتش أو غيرهطيب كيف انا
+
+190
+00:11:39,160 --> 00:11:42,120
+بعمل ال BMI ال body mass index ال body mass index
+
+191
+00:11:42,120 --> 00:11:44,900
+لو انا بده اعمله ع الجوال او بده اعمله يدويا
+
+192
+00:11:44,900 --> 00:11:49,020
+بقوللي انا بدك تجيب ال weight في ال kilogramers
+
+193
+00:11:49,020 --> 00:11:51,640
+تجيش على ال weight يعني الوزن مثلا بيجي واحد
+
+194
+00:11:51,640 --> 00:11:54,840
+بيقولي انا وزن ستين وزن خمس وسبعين وزن خمس و
+
+195
+00:11:54,840 --> 00:11:58,660
+تمانين بقوله خمس و تمانين على ايه على الوزن بالايه
+
+196
+00:11:58,660 --> 00:12:02,220
+على الطول بالمتر جداش طولك بيقولي طولي مثلا انا
+
+197
+00:12:02,220 --> 00:12:05,480
+طولي مية و ستين صنطي بقوله يعني واحد و ست من عشرة
+
+198
+00:12:05,480 --> 00:12:09,000
+هي معناته بالمترواحد بيقولي انا طولي 170 وواحد
+
+199
+00:12:09,000 --> 00:12:12,000
+وسبعة من عشرة او تيجي الطالب بتقولي لأ انا طولي
+
+200
+00:12:12,000 --> 00:12:16,440
+مثلا 155 وواحد وخمسة وخمسين من مية بس المربع تبعهم
+
+201
+00:12:16,440 --> 00:12:20,220
+أُس اتنين شايفين كيف يبقى بقالته بحط الوزن فوق
+
+202
+00:12:20,220 --> 00:12:23,620
+بالكيلو جرامات يعني سبعين مثلا واحد واحد نعتبر
+
+203
+00:12:23,620 --> 00:12:29,240
+واحد وزنه سبعين وطوله مية وستين بقول سبعين على
+
+204
+00:12:29,240 --> 00:12:32,560
+واحد وستة من عشرة أُس اتنين بيطلع الرقم الرقم اللي
+
+205
+00:12:32,560 --> 00:12:36,080
+بيطلع يعني اذا طلع تلاتة وعشرين اربع عشرين جليل
+
+206
+00:12:36,390 --> 00:12:38,930
+يعني وصل لخمس عشرين .. ستة عشرين .. كويس .. سبع
+
+207
+00:12:38,930 --> 00:12:42,010
+عشرين .. لأ .. تمان عشرين لأ .. obese .. اتساع
+
+208
+00:12:42,010 --> 00:12:44,690
+عشرين بدأ .. و highly obese .. و هكذا عشان نعرف
+
+209
+00:12:44,690 --> 00:12:48,390
+كده المقاييس أنا ريحتكم بنزل برنامج و انا هحطه على
+
+210
+00:12:48,390 --> 00:12:52,310
+ال model عشان تقدروا تستفيدوا منه ان شاء الله طيب
+
+211
+00:12:52,310 --> 00:12:55,890
+.. biochemical measurement انت قلتلي يا أستاذ عن
+
+212
+00:12:55,890 --> 00:12:58,030
+المقاييس ال anthropometric .. نيجي جيت ال
+
+213
+00:12:58,030 --> 00:13:00,490
+biochemical .. إيش تقصدك فيها؟ بقوللي هنا
+
+214
+00:13:00,490 --> 00:13:03,230
+indicating .. آه .. للمالي nutrition عشان نعرف إن
+
+215
+00:13:03,230 --> 00:13:05,960
+أنا عنده سوق تغذية ولا لأdevelopment of disease
+
+216
+00:13:05,960 --> 00:13:09,240
+تطور الأمراض result in a over consumption of
+
+217
+00:13:09,240 --> 00:13:14,160
+nutrients استهلاك زائد لبعض المغذيات اللي هي للأسف
+
+218
+00:13:14,160 --> 00:13:17,960
+مش طبيعية زي ايش هجيتها دلوقتي هحقول زي موضوع ال
+
+219
+00:13:17,960 --> 00:13:23,640
+serum and urine serum يعني الدم اللي بسحبه من جسم
+
+220
+00:13:23,640 --> 00:13:29,040
+الإنسان و بفحصله بعض الشغلات اللي أنا بدياه أشوف
+
+221
+00:13:29,040 --> 00:13:36,270
+الأملاح أشوف كدهشارتفاع مثلا اليوريك أسد، جداش
+
+222
+00:13:36,270 --> 00:13:40,170
+ارتفاع مثلا عنده اليوريا و هكذا طبعا هذه اللي أنا
+
+223
+00:13:40,170 --> 00:13:44,650
+بدكراه يمكن اليوم اسمه مش غريب علي الفحص لكن لأ
+
+224
+00:13:44,650 --> 00:13:47,350
+هعرف إيش معناه اليوريا و إيش الكرياتينين و هكذا
+
+225
+00:13:47,350 --> 00:13:51,350
+and urine اللي هو .. اللي هو .. ده شوف كمان تحليل
+
+226
+00:13:51,350 --> 00:13:54,650
+ال bone commonly used for biochemical assessment
+
+227
+00:13:55,130 --> 00:13:58,870
+أول حاجة أشبه قولي هنا أنا مهم كتير أشوف ال .. و
+
+228
+00:13:58,870 --> 00:14:01,890
+أنا بعمل ال biochemical measurement فيه مرات over
+
+229
+00:14:01,890 --> 00:14:04,130
+consumption في بعض الناس يا جماعة بتكونوا تفهمون
+
+230
+00:14:04,130 --> 00:14:07,110
+أيه؟ أكلهم مش طبيعي يعني أنا معتمد في حياته على
+
+231
+00:14:07,110 --> 00:14:10,990
+مثلا .. مثلا على ال .. المرتدالة مثلا أنا ماقدرش
+
+232
+00:14:10,990 --> 00:14:13,690
+أقول سيئة أو .. مش هيكوا سيئة أو مثلا معتمد ..
+
+233
+00:14:13,690 --> 00:14:16,450
+معتمد على ال endome مثلا كتير من الحلات يعني أنا
+
+234
+00:14:16,450 --> 00:14:18,510
+مرة طالب عجبته و أنا بتكلم على طالب و اتكلمت على
+
+235
+00:14:18,510 --> 00:14:21,590
+درس يعني من الجامعة الإسلامية وجهة شاحب و كذا
+
+236
+00:14:21,590 --> 00:14:24,370
+قلتله بس أول حاجة عمللي الفحص الدم و التعامللما
+
+237
+00:14:24,370 --> 00:14:27,070
+راجتني تاني يوم اللي بتقولي أنا عند دم تمانية
+
+238
+00:14:27,070 --> 00:14:30,010
+وسبعة من عشرة، قلتلها أنا متوقع ده الكلام، عملنا
+
+239
+00:14:30,010 --> 00:14:32,250
+فحصات تانية عشان نتأكد لازم الله ت roll out other
+
+240
+00:14:32,250 --> 00:14:34,430
+things يعني لازم نكون عندها مشاكل تانية، قلتلها
+
+241
+00:14:34,430 --> 00:14:38,470
+لأ، وين المشكلة؟ قالتلي أنا مدمنة .. مدمنة إدمان
+
+242
+00:14:38,470 --> 00:14:41,690
+كامل على اندومي، لدرجة إنه بشتريه مرات بالكاسة و
+
+243
+00:14:41,690 --> 00:14:44,350
+بشتري .. أنا ماعرفش إيش كاسة بالكاسة، مش فاهم، لما
+
+244
+00:14:44,350 --> 00:14:47,010
+نويل في الآخر عرفت إيش لما شوفت ولادي مرات بيجيبوه
+
+245
+00:14:47,320 --> 00:14:50,240
+وأنا قلت لرجالات لي حتى لما بيعملوا أي أكلة من
+
+246
+00:14:50,240 --> 00:14:53,260
+أفضل ما يكون أنا وكأنها مش موجودة طب وهذا إيش صارت
+
+247
+00:14:53,260 --> 00:14:57,400
+over consumption for إيش abnormal nutrients مغادير
+
+248
+00:14:57,400 --> 00:15:00,760
+مش طبيعية يبقى ال minerals اللي أنا بديها أين راحت
+
+249
+00:15:00,760 --> 00:15:03,620
+ال proteins اللي بديها أين راحت ال calories اللي
+
+250
+00:15:03,620 --> 00:15:06,160
+بديها أين راحت هنا المشكلة يبقى أنا بستخدم ال
+
+251
+00:15:06,160 --> 00:15:10,180
+urine و بستخدم ال blood عشان أعمل فحصات طيب تكملي
+
+252
+00:15:10,180 --> 00:15:13,500
+أستاذي ال clinical examination بيبش مال إيش أنا
+
+253
+00:15:13,500 --> 00:15:19,120
+هناكمش هتكلم فيها الآن بزيادة لكن من قدامها هأعطي
+
+254
+00:15:19,120 --> 00:15:23,060
+مش واجب أكتر من أنه يعني نوع من العصف الذهني
+
+255
+00:15:23,060 --> 00:15:26,260
+هأعطيكوا شغلات ايش الفحصات اللي بنعملها وقداشي ال
+
+256
+00:15:26,260 --> 00:15:28,940
+normal وقداشي ال abnormal بعرف أنه الآن مش رايينا
+
+257
+00:15:28,940 --> 00:15:34,120
+على مستشفى لكن كويس نستفسر نطلع يعني مثلا حاجة كل
+
+258
+00:15:34,120 --> 00:15:36,960
+واحد بنشوف قداشي الأملاح عند فلان طبعا قبل ما
+
+259
+00:15:36,960 --> 00:15:39,340
+تقولي ايش الأملاح قداشي قداشي الطبيعية يمكن واحد
+
+260
+00:15:39,340 --> 00:15:42,800
+يقولي قداشي يا أستاذ ال sodium لازم يكونمانا قبل
+
+261
+00:15:42,800 --> 00:15:45,660
+ما تقولي جديش Sodium انا هأسألك فلاقدامش راح أحط
+
+262
+00:15:45,660 --> 00:15:49,940
+شغلات على ال model عشان نقدر احنا نقدر نحلها و
+
+263
+00:15:49,940 --> 00:15:52,760
+اللي بيحلها لوحده و بيبعتليها كمان على ال WhatsApp
+
+264
+00:15:52,760 --> 00:15:55,500
+أو بيبعتها على المجموعة عن طريق النادر و بيبعتليها
+
+265
+00:15:55,500 --> 00:15:58,400
+بكون أنا مبسوط عشان اعرف جديش الحمد لله متابعتكوا
+
+266
+00:15:58,400 --> 00:16:02,200
+انا متأكد انكوا شاطرين ال clinical examination
+
+267
+00:16:02,200 --> 00:16:05,700
+involve ايش هنا بيقولي close physical evaluation
+
+268
+00:16:06,140 --> 00:16:09,280
+ماذا يعني Closed Physical Evaluation؟ هذا تقييم عن
+
+269
+00:16:09,280 --> 00:16:13,580
+قرب جسدي، بيجي الطبيب نفسه أو الأخصائي التخزيه أو
+
+270
+00:16:13,580 --> 00:16:16,140
+حتى الأخصيات الطبي .. أخصائي الطبي بده يشوف ال
+
+271
+00:16:16,140 --> 00:16:19,380
+science، يعني العلمات suggesting اللي بتخليني
+
+272
+00:16:19,380 --> 00:16:22,320
+أقترح أن في عنده malnutrition أو over consumption
+
+273
+00:16:22,320 --> 00:16:25,560
+of ال nutrients، يعني تجمع طبعا الفرق بينهم المال
+
+274
+00:16:25,560 --> 00:16:28,340
+ال nutrition سوء التخزيه، over consumption استغلال
+
+275
+00:16:28,340 --> 00:16:32,700
+غير طبيعي لبعض الأيه اللي هو المغاديات اللي هي مش
+
+276
+00:16:32,700 --> 00:16:37,350
+.. مش تمام، مش هي اللي مطلوبةexamination alone
+
+277
+00:16:37,350 --> 00:16:41,210
+does not permit definitive diagnosis of
+
+278
+00:16:41,210 --> 00:16:43,990
+nutritional problems المقصود هنا أنه مش ال
+
+279
+00:16:43,990 --> 00:16:46,970
+examination لوحده بيحدد أن فلان عنده مال ال
+
+280
+00:16:46,970 --> 00:16:50,130
+nutrition يعني قصدي إذا بدنا نقول عشان هيك سموه
+
+281
+00:16:50,130 --> 00:16:53,710
+complete assessment لما نبدأ نعمل complete
+
+282
+00:16:53,710 --> 00:16:57,020
+nutritional assessmentالـ Anthropometric و ال
+
+283
+00:16:57,020 --> 00:17:00,080
+biochemical و ال clinical examination بقدر أحلف
+
+284
+00:17:00,080 --> 00:17:04,100
+يمين و أقول إنه هذا له عنده مشكلة غذائية أما أجي
+
+285
+00:17:04,100 --> 00:17:06,920
+أركن إنه بس من ال clinical examination لأ في بعض
+
+286
+00:17:06,920 --> 00:17:10,760
+الناس رفعة و ضعافة لكن لما حصلها لكل فحصات التانية
+
+287
+00:17:10,760 --> 00:17:14,580
+كانت طبيعية بقدرش أقول عنه abnormal person طيب
+
+288
+00:17:14,580 --> 00:17:18,860
+بيقول ال nutritional assessment technique طريقة
+
+289
+00:17:18,860 --> 00:17:21,200
+اللي بنعمل فيها .. الطريقة اللي بنعمل فيها
+
+290
+00:17:21,200 --> 00:17:25,670
+nutritional assessment أول حاجة تاعةبعدين أروح
+
+291
+00:17:25,670 --> 00:17:28,230
+للمريض، احنا كطاب مريض الآن، أنا مش أخص أي طرف دي
+
+292
+00:17:28,230 --> 00:17:31,750
+يعني، أول سؤال إيش بقوله؟ describe the type،
+
+293
+00:17:31,750 --> 00:17:37,450
+تشرحلي نوع الأكل، هل هو regular or not، منظم ولا
+
+294
+00:17:37,450 --> 00:17:40,930
+لأ، special ولا عنده special ايه زي ذاك باوكل
+
+295
+00:17:40,930 --> 00:17:44,110
+شغلات أو عنده شغلات خاصة في حياته أو مثلا عنده
+
+296
+00:17:44,110 --> 00:17:48,410
+مشكلة صحيةزي عنده أسنان و مابقدرش أكل حاجات كتير
+
+297
+00:17:48,410 --> 00:17:53,110
+يمكن يقولي أنا ماأكلش الشغلات البسيطة و المكسرة و
+
+298
+00:17:53,110 --> 00:17:56,050
+المطحونة طب ليه؟ لأنه عندي مثلا notes of cheating
+
+299
+00:17:56,050 --> 00:17:59,410
+يعني من الأسف عندي .. أنا مركّف ضبّة dead sharks
+
+300
+00:17:59,410 --> 00:18:02,690
+أو عندي مشكلة في بعض الناس بيقولك أنا ماقدرش أكل
+
+301
+00:18:02,690 --> 00:18:06,270
+السمك أنا عندي sensitive أو عندي مثلا أني ماقدرش
+
+302
+00:18:06,270 --> 00:18:08,690
+أكل الموالح في عندي sensitive mouth كلوقت أنا
+
+303
+00:18:08,690 --> 00:18:12,190
+بسأله من مين؟ بسأله المريض و بسأل السؤال التاني ال
+
+304
+00:18:12,190 --> 00:18:15,590
+usual meal times لماذا بسأل السؤال التاني؟قداش
+
+305
+00:18:15,590 --> 00:18:20,010
+وقتاش أنت عندك دائما بتاكل الواجبات بشكل طبيعي
+
+306
+00:18:20,010 --> 00:18:23,970
+قداش بتاكل أكمل واجبة في اليوم و هل بتكونهم بشكل
+
+307
+00:18:23,970 --> 00:18:28,270
+منتظم وين and which are heavy meals أي واجبة عندك
+
+308
+00:18:28,270 --> 00:18:32,470
+الأساسية و أكون انسى لما أخدها في ال interview أنه
+
+309
+00:18:32,470 --> 00:18:36,090
+نعطي leading question سؤال بقود أو biased question
+
+310
+00:18:36,090 --> 00:18:39,110
+هو على طول هتقوله أكيد الواجبة الأساسية عندك
+
+311
+00:18:39,110 --> 00:18:42,030
+الغداء لأ ممكن تكون الواجبة الأساسية عنده الفطور
+
+312
+00:18:42,030 --> 00:18:46,330
+أنا شخصيا انا و أستاذكمو بعترف عادي أنا الواجبة
+
+313
+00:18:46,330 --> 00:18:48,510
+الأساسية عندي مش الغداء ولا العشاء أنا عنده
+
+314
+00:18:48,510 --> 00:18:51,490
+الواجبة الأساسية و الرئيسية في حياتي هي الفطور أنا
+
+315
+00:18:51,490 --> 00:18:54,350
+لما بأكل الفطور عندي يعني هو مركزية طول اليوم لأنه
+
+316
+00:18:54,350 --> 00:18:57,290
+بيعطيني زي الفول يعني زي الطاقة طول النهار ال
+
+317
+00:18:57,290 --> 00:19:00,870
+appetite، بدأ أسأله، هل عنده good appetite؟ عندها
+
+318
+00:19:00,870 --> 00:19:04,630
+good appetite or not؟ ولا fair، عادية؟ ولا poor؟
+
+319
+00:19:04,630 --> 00:19:08,710
+يعني ضعيفة؟ ولا too good؟ ولا عندها فتح، شهيدة
+
+320
+00:19:08,710 --> 00:19:13,640
+مفتوحة؟ زي بعض الناس، بيجب أقول مثلا بسألهأنا كيف
+
+321
+00:19:13,640 --> 00:19:16,380
+شايت أكل أكل؟ بيقولك أنا .. أنا بكره الصحن الفاضي
+
+322
+00:19:16,380 --> 00:19:20,120
+بس ما زال قال لي هيك .. يعني انتوا شوفوا رضماني
+
+323
+00:19:20,120 --> 00:19:23,200
+بتجيب عليك .. صح انت حتضحك أو حتضحك لكن خلاص كأنه
+
+324
+00:19:23,200 --> 00:19:26,500
+أجاب عن .. يعني بعض ممكن تقوله للمريض انت كيف انت
+
+325
+00:19:26,500 --> 00:19:29,200
+و الأكل؟ يقولك أنا الأكل .. انا الأكل يعني انا
+
+326
+00:19:29,200 --> 00:19:31,720
+بحبه .. انا بكره الصحن الفاضي ..معناه خلاص تسألوش
+
+327
+00:19:31,720 --> 00:19:34,120
+ان انت يبقى لعاله أجاوب انه الافيتاز عنده ما شاء
+
+328
+00:19:34,120 --> 00:19:38,920
+الله ال weight .. الوزن .. نيجي نسأله .. هل هو وزن
+
+329
+00:19:38,920 --> 00:19:43,090
+اختابت؟ ولا .. how it is changing؟ ولا اتغير؟بس
+
+330
+00:19:43,090 --> 00:19:46,890
+بالمناسبة إذا جالي اتغير بسألوش عن تغيير زمان
+
+331
+00:19:46,890 --> 00:19:51,830
+بسأله متى اتغير في آخر ست شهر أنا ماليش في زمان
+
+332
+00:19:51,830 --> 00:19:55,990
+ولا إلي إنه في سنين لأ بس جيبلي ست شهر لإنه ممكن
+
+333
+00:19:55,990 --> 00:19:58,750
+في خلال الست شهر الأخيرة أعمللي regime أو أعمل
+
+334
+00:19:58,750 --> 00:20:03,070
+حمية أو أعمل شغل زيه أو أخد مثلا يعني مثلا أعمل
+
+335
+00:20:03,070 --> 00:20:06,990
+جلسات رياضية أو هكذا ال food preferences تفضيلات
+
+336
+00:20:06,990 --> 00:20:12,310
+الغذية إيش بفضل أكل؟ هل بفضل مثلا لحمة العجل؟to
+
+337
+00:20:12,310 --> 00:20:16,050
+other meats أنا بعطيهوش بجيش أسأله و لا لو عنده
+
+338
+00:20:16,050 --> 00:20:19,150
+food dislike و لا فيه شغلات بكرهها من الأكل إذا
+
+339
+00:20:19,150 --> 00:20:23,370
+بكره شغلات من الأكل what؟ إيش هي؟ و ليش؟ why؟ و ال
+
+340
+00:20:23,370 --> 00:20:26,650
+culture related يمكن مرتبطة بثقافته يعني أنا ممكن
+
+341
+00:20:26,650 --> 00:20:29,090
+ييجي واحد يقولي أنا بالله بحب اللحمة بس اللحمة إيش
+
+342
+00:20:29,090 --> 00:20:33,030
+اللحمة البيضة أنا بكره اللحمة طبيعي و بالمناسبة
+
+343
+00:20:33,030 --> 00:20:35,590
+اللحمة البيضة أحسن من اللحمة الحمرا اللحمة الحمرا
+
+344
+00:20:35,590 --> 00:20:40,190
+acid اللحمة البيضة alkaline قاعديو أنا بدي لجسمكوا
+
+345
+00:20:40,190 --> 00:20:43,230
+و لجسمنا يكون دايما قاعدى، كل ما كان جسمنا فيه
+
+346
+00:20:43,230 --> 00:20:46,170
+قاعدة أكتر، كل ما كان فيه ايه شهلة defense for
+
+347
+00:20:46,170 --> 00:20:50,990
+disease، يعني بتقاوم الأمراض، بسأل المريض هل في
+
+348
+00:20:50,990 --> 00:20:54,610
+عندك بتكره شغلات في الأكل؟ أه والله بكره كده كده،
+
+349
+00:20:54,610 --> 00:20:58,270
+ماحي يقولي، بقول طب إيش؟ يمكن يقعد يقولي أنا بحبش
+
+350
+00:20:58,270 --> 00:21:01,390
+السمكة، يمكن كل علاقة بال culture، بقول أنا موعيتش
+
+351
+00:21:01,390 --> 00:21:06,470
+في حياتي لجأت أهلي بيأكل سمكتي، خلصنا، usualeating
+
+352
+00:21:06,470 --> 00:21:12,830
+places usual eating places يعني وين بتاكل؟ هل
+
+353
+00:21:12,830 --> 00:21:16,750
+دايما بتعتمد في ال home ولا للأسف من يوم انا روحت
+
+354
+00:21:16,750 --> 00:21:19,590
+على المدرسة و جيت على الجامعة في للأسف عندي snack
+
+355
+00:21:19,590 --> 00:21:22,170
+shops يعني و restaurants أنا بحب .. يعني أنا
+
+356
+00:21:22,170 --> 00:21:25,170
+ماأكلش دايما بحب أكل هالسندوش في هالجامعة أو
+
+357
+00:21:25,170 --> 00:21:28,530
+هالسندوش في ناس يعني انفجعوني خصوصا السنة الأولى
+
+358
+00:21:28,530 --> 00:21:31,310
+بيقولوا أصلا أنا كنت أحب الجامعة و نفسي فيها عشان
+
+359
+00:21:31,310 --> 00:21:34,970
+الكفتيرة تبعتها و عشان شوفتهم الناس طلاب بيروحوا و
+
+360
+00:21:34,970 --> 00:21:38,860
+بيقولوا لأما هذا مهم، أكل الطعام البيت بيختلف،
+
+361
+00:21:38,860 --> 00:21:42,020
+معروف، حتى لو جلينا الفلافل في البيت و أكلناها برا
+
+362
+00:21:42,020 --> 00:21:45,160
+بيختلف، حتى لو كان بيختلف يعني في شكله، الأكل
+
+363
+00:21:45,160 --> 00:21:48,980
+سبحان الله أريحية البيت و مذاق البيت له يعني و
+
+364
+00:21:48,980 --> 00:21:51,400
+دائما الراحة النفسية لعلاقة بموضوع اللي هو
+
+365
+00:21:51,400 --> 00:21:55,040
+الاستجابة للطعام أكتر ability to eat القدرة على
+
+366
+00:21:55,040 --> 00:21:58,760
+إيش؟ على الأكل، بيقدر يأكل؟ ولا في عنده
+
+367
+00:21:58,760 --> 00:22:01,920
+inabilities؟ describe هل في عنده dental problems؟
+
+368
+00:22:01,920 --> 00:22:06,210
+بسأله، في أنك مشكلة في سنانك؟ال fitting dentures
+
+369
+00:22:06,210 --> 00:22:09,930
+.. fitting dentures معناته ضبة اللي بيكون ثبتها طب
+
+370
+00:22:09,930 --> 00:22:13,490
+ال fitting يعني مش .. مش مثبتها كويس بقولك أنا ركب
+
+371
+00:22:13,490 --> 00:22:16,550
+ضبة الأسنان هي عبارة عن ال إيش اللي بحطوها في فمهم
+
+372
+00:22:16,550 --> 00:22:19,330
+لما بكون خلويني أكل الأسنان فبيجي بقولك والله
+
+373
+00:22:19,330 --> 00:22:22,550
+مابقدر أنا .. يعني أكلها إنه مابقدرش أضغط عليها في
+
+374
+00:22:22,550 --> 00:22:24,690
+عند ال difficulties في بعض الناس عندهم
+
+375
+00:22:24,690 --> 00:22:27,110
+difficulties في ال chewing chewing يعني إيش هنا
+
+376
+00:22:27,110 --> 00:22:30,910
+المضغفى ال following زى مين زى حالات اللى عندهم
+
+377
+00:22:30,910 --> 00:22:34,210
+ايش لا قدر الله فى حالات زى الحالات اللى عندهم
+
+378
+00:22:34,210 --> 00:22:38,750
+paralysis الشلل من يوم ما صار عنده شلل مثلا فى عصب
+
+379
+00:22:38,750 --> 00:22:42,470
+معين فبقولك بطل يقدر يمدغ الأكل منيح فبنضطر احنا
+
+380
+00:22:42,470 --> 00:22:47,350
+نعطيه solutions سوائل فلازم نسأل فى بعض الناس
+
+381
+00:22:47,350 --> 00:22:50,130
+عندهم مالي nutrition يعني يوم الأيان أجتنا يعني
+
+382
+00:22:50,130 --> 00:22:55,090
+طفل كان عنده مالي nutrition وامه تعبت على
+
+383
+00:22:55,090 --> 00:22:58,120
+المستشفياتصارت كل مشكلة تعرفين في أين؟ مشكلة ال
+
+384
+00:22:58,120 --> 00:23:02,580
+swallowing، ليه؟ الطفل هذا بامدغش كويس، طبعا مش
+
+385
+00:23:02,580 --> 00:23:06,620
+بامدغش أنه صناعه مافيش فيه مشكلة، لأ الصناعه كويسة
+
+386
+00:23:06,620 --> 00:23:09,620
+مافيش فيه ولا حاجة، بس الولد سريق جدا جدا جدا بحب
+
+387
+00:23:09,620 --> 00:23:12,800
+يأكل بسرعة، يعني لدرجة أن أمه بتقول في خمس دقايق،
+
+388
+00:23:12,800 --> 00:23:16,420
+بيحس يعني كأنه يتغول ويتنمر على أخته لما يكون فيه
+
+389
+00:23:16,420 --> 00:23:19,320
+أكلإذا خلاص لما يكون فيه لحمة و رز وشغلاء زيك و
+
+390
+00:23:19,320 --> 00:23:22,780
+بتقول لإمه فمباشرة يعني .. يعني الظلط بيسلم ..
+
+391
+00:23:22,780 --> 00:23:24,500
+بيسلم على البلاء زي ما بقولها الظلط بيسلم على
+
+392
+00:23:24,500 --> 00:23:26,900
+البلاء مانحط .. مانحطه في طمع بيبلع كيف؟ مابعرفش
+
+393
+00:23:26,900 --> 00:23:30,740
+في الآخر مالي ال nutrition لإنه أصلا المعدة في
+
+394
+00:23:30,740 --> 00:23:34,260
+منها استعداد أن تتكلم على .. في .. عامل ما يصير ال
+
+395
+00:23:34,260 --> 00:23:36,560
+parietal cells تشتغل في المعدة و تخبطها في ال
+
+396
+00:23:36,560 --> 00:23:40,260
+Anatomy و تشتغل عشان ال HCL يطلع و ال suffagus
+
+397
+00:23:40,260 --> 00:23:43,060
+ينزل شوي شوي أما يبلعليها مرة واحدة كتل كتل
+
+398
+00:23:43,060 --> 00:23:45,040
+مابينفعل هذا الكلام ب
+
+399
+00:23:48,570 --> 00:23:51,390
+كيف عملت ال urination؟ هل بروح الحمام و لا بقولك
+
+400
+00:23:51,390 --> 00:23:53,010
+طول النهار و لا بروحش لها مرتين؟ معناه ده مش صار
+
+401
+00:23:53,010 --> 00:23:56,290
+مش مرة ناية، في عنده مشكلة ال stool؟ والله معلش يا
+
+402
+00:23:56,290 --> 00:23:59,010
+أستاذ أنا .. والله أنا كل يومين، كل تلتة بيجيب
+
+403
+00:23:59,010 --> 00:24:01,570
+يقوللي بروح الحمام مرة أو بيجي واحد بيقوللي لأ
+
+404
+00:24:01,570 --> 00:24:03,450
+بروح على تلتة اربعة مرات في اليوم، كل واحد على حسب
+
+405
+00:24:03,450 --> 00:24:05,870
+ال nature؟ كيف طبيعته؟ شو ال frequency؟ شو ال
+
+406
+00:24:05,870 --> 00:24:09,070
+problems؟ ليه؟ ال frequent problems إذا في مشكلة
+
+407
+00:24:09,070 --> 00:24:12,490
+مشاكل عشان بتكون مرتبطة نعرف في بعض الناس عنده
+
+408
+00:24:12,490 --> 00:24:15,650
+constipation بس عشان عنده مالي ال nutritionفي ناس
+
+409
+00:24:15,650 --> 00:24:18,650
+عندهم loss of urination او عندهم burning sensation
+
+410
+00:24:18,650 --> 00:24:22,470
+يعني إحساس بالحرجان لأنه أصلا ماروحش على الحملة
+
+411
+00:24:22,470 --> 00:24:24,790
+لإن ما بشربش مية كويس أوي و انا كنت فاكر لما واحد
+
+412
+00:24:24,790 --> 00:24:27,290
+بيقولك لأ بشرب كتير و بيروح بيقوللي بشرب سوال و
+
+413
+00:24:27,290 --> 00:24:30,950
+بشرب كولة و بعتبرها سوال بالعكس، هذا بتدمر أنا لما
+
+414
+00:24:30,950 --> 00:24:35,610
+أقول مية يعني مية بس، بدنا نسأل عن ال exercise و
+
+415
+00:24:35,610 --> 00:24:38,490
+ال physical activity كيف نشاطك بشكل عام؟ أنا مابدي
+
+416
+00:24:38,490 --> 00:24:41,210
+أروح ألعب football أو ألعب رياضة لكن هو نشاط ولا
+
+417
+00:24:41,210 --> 00:24:44,030
+sedentary life؟ لما أقول sedentary يعني قاعد،
+
+418
+00:24:44,030 --> 00:24:48,200
+خامل، في البيتhow extensive هل هي extensive يعني
+
+419
+00:24:48,200 --> 00:24:51,660
+عنده رياضة و لياقة و بروح بالعق ولا deficient يعني
+
+420
+00:24:51,660 --> 00:24:55,800
+ولا قليلة طبعا دي مرتبطة اللي بيأكل و بيشرب كويس و
+
+421
+00:24:55,800 --> 00:24:59,480
+عاملا و بتحرك معناته إيش good body health و للأسف
+
+422
+00:24:59,480 --> 00:25:02,980
+بأكل و بشرب و قاعد بعد body health و في الآخر
+
+423
+00:25:02,980 --> 00:25:06,460
+انتوا عارفين إيش اللي حيصير بعدها بسأل ال psycho
+
+424
+00:25:06,460 --> 00:25:09,980
+-social طب إيش دخل ال psycho-social مرتبطة كتير
+
+425
+00:25:09,980 --> 00:25:14,840
+جدا بعملية ال food بال culture factorsالطعام كله
+
+426
+00:25:14,840 --> 00:25:18,800
+مرتبط من ناحية النفسية والاجتماعية زي إيش؟ بقولي
+
+427
+00:25:18,800 --> 00:25:22,140
+بدنا نشوف بعض الناس بتأثر على ال proper nutrition،
+
+428
+00:25:22,140 --> 00:25:25,360
+في بعض الناس عندهم طقوس معينة نفسية واجتماعية، أنا
+
+429
+00:25:25,360 --> 00:25:29,920
+مثلا في شغلات في بعض الناس عنده مرتبط الأكل، يعني
+
+430
+00:25:29,920 --> 00:25:33,260
+ممكن تقوله معلش تعال لو سمحت بده أعطيكأنا أعمل لك
+
+431
+00:25:33,260 --> 00:25:36,160
+سمك، يقولك لأ والله أنا السمك ما بحب أكله إلا من
+
+432
+00:25:36,160 --> 00:25:40,560
+وين؟ من إيد أمي لإيه بتعمله، طب تعب تشويلك دجاج،
+
+433
+00:25:40,560 --> 00:25:44,440
+بقولك لأ أنا بحب الشو من كده، أنا عندك طب في مفتول
+
+434
+00:25:44,440 --> 00:25:47,040
+احنا عندك، انا بقولك لأ احنا أصحاب المفتول، ها
+
+435
+00:25:47,040 --> 00:25:50,460
+culture ها، احنا أصحاب المفتول، زي أهل الدراسة
+
+436
+00:25:50,460 --> 00:25:53,060
+مثلا، ما شاء الله مشترين، شاطرين، وطبعا كل الناس
+
+437
+00:25:53,060 --> 00:25:55,520
+شاطرين، بس يعني زمان كنا بيقولوا أنهم أشتر ناس في
+
+438
+00:25:55,520 --> 00:25:58,100
+عمل المفتول، بيقولك احنا لا أشتر منكوا في عمل
+
+439
+00:25:58,100 --> 00:25:58,560
+المفتول، ب
+
+440
+00:26:02,400 --> 00:26:06,920
+أو اجتماعي أو ثقافي بطعام أو معكول معين هذا بنسأل
+
+441
+00:26:06,920 --> 00:26:11,220
+المريض بدون ما نعمله bias طيب taking medications
+
+442
+00:26:11,220 --> 00:26:14,800
+أخد ملاش بياخد أدوية بتأثر على الأكل تبعه ولا
+
+443
+00:26:14,800 --> 00:26:18,920
+بياخدش؟ يمكن تقول اه والله أنا باخد مكملات العلاقة
+
+444
+00:26:18,920 --> 00:26:22,140
+والله أنا باخد دوة علشان هي كده مابديش أكل أو باخد
+
+445
+00:26:22,140 --> 00:26:25,240
+حبوب علشان يعمليني رجيم حسب ما بقولليه laboratory
+
+446
+00:26:25,240 --> 00:26:30,020
+determinations بجيب أسأله هل عملت فحصات خاصة ال
+
+447
+00:26:30,020 --> 00:26:35,720
+hemoglobinجدش كان عندك الدم؟ جدش كان ال protein؟ و
+
+448
+00:26:35,720 --> 00:26:37,560
+انا اللي قدامي ان شاء الله احطه .. احطه ال model
+
+449
+00:26:37,560 --> 00:26:41,080
+اللي انا حكيتلكوا عنه جدش ال albumin؟ جدش ال
+
+450
+00:26:41,080 --> 00:26:43,860
+cholesterol؟ your analysis تحليل ال ball اللي
+
+451
+00:26:43,860 --> 00:26:48,400
+عندك؟ جدش عندك ال height؟ جدش طولك و التواجف؟ جدش
+
+452
+00:26:48,400 --> 00:26:51,800
+ال weight و وزنك؟ هل ال body type تبعك يعتبر طبعا
+
+453
+00:26:51,800 --> 00:26:55,470
+.. هانا كاتبلي small و medium و largeمش يا جماعة
+
+454
+00:26:55,470 --> 00:26:58,570
+بقصد small و medium و large زي الملابس يعني الجميس
+
+455
+00:26:58,570 --> 00:27:01,010
+أو البنطانو تقول small و medium و large لأ انا
+
+456
+00:27:01,010 --> 00:27:03,130
+بتكلم عن طبيبط طبعا عشان تعرف small و medium و
+
+457
+00:27:03,130 --> 00:27:07,570
+large لما تنزل برنامج بي ام ايباد ماس اندكس هتعرف
+
+458
+00:27:07,570 --> 00:27:10,970
+ايش المقصود فيها طبعا احنا صح كلنا بنتمنى نكون في
+
+459
+00:27:10,970 --> 00:27:14,510
+ال medium لكن لو كان nearly small ماشي الحال و لو
+
+460
+00:27:14,510 --> 00:27:19,150
+كان nearly large ماشي الحال بس over large مشكلة و
+
+461
+00:27:19,150 --> 00:27:24,430
+under small يعني مشكلة finally ايش بقولي هناyou
+
+462
+00:27:24,430 --> 00:27:27,830
+must summarize ايش يعني summarize اخدت المعلومات
+
+463
+00:27:27,830 --> 00:27:32,290
+كلها بقول للخص المعلومات اللي انت خدتها من المريض
+
+464
+00:27:32,290 --> 00:27:35,750
+to determine the nutritional nutritional ايه
+
+465
+00:27:35,750 --> 00:27:40,370
+diagnosis and nutritional plan of care طبعا بعد ما
+
+466
+00:27:40,370 --> 00:27:44,350
+اخدت المعلومات الكاملة من المريض بلخص المعلومات
+
+467
+00:27:44,350 --> 00:27:46,930
+عشان اعرف ايش المريض المشكلة عنده الغذائية اللي
+
+468
+00:27:46,930 --> 00:27:51,230
+موجودة هل هي malnutrition optimal ولا over
+
+469
+00:27:51,230 --> 00:27:55,220
+consumptionال laboratory test هل بتدل اللي فيه
+
+470
+00:27:55,220 --> 00:27:59,260
+حاجة راحة شمال او يمين و او حد يستهتر كتير من
+
+471
+00:27:59,260 --> 00:28:03,540
+الحالات كتير جدا طلاب ما شاء الله اكتشفوا شغلات
+
+472
+00:28:03,540 --> 00:28:06,900
+الطبيب كانش ما اكتشفها يعني من ضمن الشغلات اللي
+
+473
+00:28:06,900 --> 00:28:10,340
+انا بانسهاش كان في مريض كان في عنده مشكلة دايما
+
+474
+00:28:10,340 --> 00:28:14,300
+جسمه متنفخ وكل ما بيطلب يقولك انا بطل عندي نفس
+
+475
+00:28:14,300 --> 00:28:18,260
+كتير للأكل ليش متنفخ وعندي نفس كتير للأكل كان زمان
+
+476
+00:28:18,260 --> 00:28:22,880
+مرة في عنده حساسية معينةفعزيزي من الشجر كانت عند
+
+477
+00:28:22,880 --> 00:28:27,980
+الحسية فوصفوله كورتازون، الكورتازون هذا من ال anti
+
+478
+00:28:27,980 --> 00:28:30,440
+-inflammatory drugs وهو يعتبر anti-allergic هو
+
+479
+00:28:30,440 --> 00:28:32,820
+magic drug، بكرا هتاخدوه في ال pharmacology،
+
+480
+00:28:32,820 --> 00:28:36,220
+بيسموه يعني الدوة الساحر، إله عدة مفعولات يعني
+
+481
+00:28:36,220 --> 00:28:41,020
+إله، فأخدوه اتريح عليه، فنسي الطبيب يقوله بس دي
+
+482
+00:28:41,020 --> 00:28:44,380
+بالك بعد أسبوع بتخفضوا شوي شوي شوي وبعدين بتقطعوا،
+
+483
+00:28:44,380 --> 00:28:48,680
+نسيفظلوا المريض كل ما يتعب ياخد منه ياخد منه فزود
+
+484
+00:28:48,680 --> 00:28:51,460
+طبعا الكورتزولو مربانيا موجود من كتر اللي ما كان
+
+485
+00:28:51,460 --> 00:28:54,420
+ياخد للأسف استمر علي عمر صار جسمه يتنفخ كتير صار
+
+486
+00:28:54,420 --> 00:28:58,100
+عنده severe constipation امسكت شبه دائم بطل يعرف
+
+487
+00:28:58,100 --> 00:29:01,520
+يأكل طبعا صاروا الأطباء يعملوا له nutrition
+
+488
+00:29:01,520 --> 00:29:04,820
+assessment و يحاولوا يعطوه علاجات و يعطوه مغذيات و
+
+489
+00:29:04,820 --> 00:29:07,120
+.. لما يوم الأيام أحد الطلاب الله يرضى ليه و أنا
+
+490
+00:29:07,120 --> 00:29:10,600
+بسط جدا من الجامعة فو هو بيعمل nutrition
+
+491
+00:29:10,600 --> 00:29:14,540
+assessment و بيذكر فمسك الفحصات بتطلع فيهاوبقى
+
+492
+00:29:14,540 --> 00:29:16,980
+سأله سؤال، جاله طب أنت فيه عندك مشكلة؟ جاله والله
+
+493
+00:29:16,980 --> 00:29:20,320
+أنا عندي مشكلة عملت تحليل في تحليل ال بولب دايما
+
+494
+00:29:20,320 --> 00:29:23,260
+بطلع عندي مشاكل عشان مشربش مية كتيرة فجاله ليش؟
+
+495
+00:29:23,260 --> 00:29:26,320
+جاله والله الدواء مرات بتعبني، جاله الدواء إيش؟ ه
+
+496
+00:29:26,320 --> 00:29:29,540
+و بسأله، جاله هذا الدواء طبعا الاختيار مابيعرفش
+
+497
+00:29:29,540 --> 00:29:33,380
+إيش هو اسمه فجاله هذا، طبعا الطالب كان ذكي وشاطر
+
+498
+00:29:33,380 --> 00:29:36,660
+ونجن ومكتوب عليه prednisone عزيزي عشرين ميلي جرام
+
+499
+00:29:36,660 --> 00:29:40,220
+فدغري مباشرة راح للطبيب، الطبيب يعنغ هيك زي يحط
+
+500
+00:29:40,220 --> 00:29:43,550
+إيده على راسوخبط حاله وراح مباشرة وقالله قدش إيه
+
+501
+00:29:43,550 --> 00:29:46,150
+لك في الموضوع هذا؟ قالله لساني قالله حسن من الله
+
+502
+00:29:46,150 --> 00:29:48,930
+ونعم الوكيل طبعا تدارك الموضوع صح، أنا ماقدرش أقول
+
+503
+00:29:48,930 --> 00:29:52,010
+إن هو medical error، ماقدرش أدخل تفاصيل، يمكن كان
+
+504
+00:29:52,010 --> 00:29:55,170
+خطأ، يمكن الطبيب قاله، يمكن نسي، ووقف العلاج
+
+505
+00:29:55,170 --> 00:29:59,950
+والحمد لله انتهت كل القصة عند الطالب، مجرد ما وقف،
+
+506
+00:29:59,950 --> 00:30:03,270
+راح المالي nutrition، راح ال obesity للأسف، راح ال
+
+507
+00:30:03,270 --> 00:30:06,430
+constipation، والحمد لله يعني ما صارش عند المريض
+
+508
+00:30:06,430 --> 00:30:09,520
+أي مشاكل في مبادرة صحيةأنا خلّيني أكمل عشان صار
+
+509
+00:30:09,520 --> 00:30:12,780
+تلاتين دقيقة لإن ما بدي أن اتخطط تلاتين حسب
+
+510
+00:30:12,780 --> 00:30:15,820
+تعليمات الجامعة وإن شاء الله نكمل في المحاضرة
+
+511
+00:30:15,820 --> 00:30:18,560
+القادمة السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..4950a5568c9914b919fe63b38c29684bc81728d6
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zCgbodswsj4_raw.srt
@@ -0,0 +1,2044 @@
+1
+00:00:01,010 --> 00:00:04,350
+اعود بالله مش طارجين بسم الله الرحمن الرحيم طيب
+
+2
+00:00:04,350 --> 00:00:07,810
+أبنائي وابناتي طلبت المستوى التاني في مساق التقيوم
+
+3
+00:00:07,810 --> 00:00:12,350
+الصحي التمريدي خلينا نكمل مع بعض اليوم في ال
+
+4
+00:00:12,350 --> 00:00:20,050
+chapter الجديد الآن طبعا بتكلم انا psychosocial
+
+5
+00:00:20,050 --> 00:00:24,090
+احنا قلنا بس نذكر تذكير احنا لازم بنقول مش
+
+6
+00:00:24,090 --> 00:00:27,030
+physical examination وانما biopsychosocial and
+
+7
+00:00:27,030 --> 00:00:29,710
+spiritual ال chapter التاني بيقوليpsychosocial
+
+8
+00:00:29,710 --> 00:00:33,930
+nutritional and sleep weakness assessment حاضر أول
+
+9
+00:00:33,930 --> 00:00:37,430
+حاجة psychosocial assessment بقول بيشمل إيه
+
+10
+00:00:37,430 --> 00:00:42,090
+involves person's growth بتكلم على نمو الإنسان
+
+11
+00:00:42,090 --> 00:00:45,790
+develop من تطوره throughout his life في خلال مراحل
+
+12
+00:00:45,790 --> 00:00:49,930
+الحياة اللي مر فيها وبتكلم على discuss crisis
+
+13
+00:00:49,930 --> 00:00:54,390
+crisis الأزمات اللي هو مر فيها with the clients
+
+14
+00:00:54,390 --> 00:00:57,070
+assessed relationship between health and illness
+
+15
+00:00:57,070 --> 00:01:00,330
+يعني كأنه بقولأنا في ال psychosocial assessment
+
+16
+00:01:00,330 --> 00:01:04,690
+بدي أقيم إيش العلاقة بين صحة الإنسان و بين مرضه و
+
+17
+00:01:04,690 --> 00:01:07,750
+التغيرات اللي صارت فيه في مراحل حياته سواء كان هو
+
+18
+00:01:07,750 --> 00:01:12,210
+طفل أو سواء كان لما كبر إذا اتعرض لأي حوادث اتعرض
+
+19
+00:01:12,210 --> 00:01:15,110
+لأي أمراض اتعرض لأي التهابات أو أي شغلات من هذا
+
+20
+00:01:15,110 --> 00:01:18,850
+القربي طيب قبل كل حاجة بدي أشوف stages of age
+
+21
+00:01:18,850 --> 00:01:23,690
+stages of age يعني أول حاجة حتى لو كانت في أظن في
+
+22
+00:01:23,690 --> 00:01:27,200
+بعض الكتب ممكن تكون مش موجودةلكن مش مشكلة لو مش
+
+23
+00:01:27,200 --> 00:01:30,120
+موجودة هيغيرت نكتب عشان نكون عارفينها مرحل الحياة
+
+24
+00:01:30,120 --> 00:01:33,820
+حسب اللي هو مقرا يعني خلّيني أقول المنظمات
+
+25
+00:01:33,820 --> 00:01:37,820
+العالمية اللي تعنى بالأمور الصحية أول حاجة مرحلة
+
+26
+00:01:37,820 --> 00:01:42,200
+بيسموها infancy infancy يعني مرحلة الاش يعني الطفل
+
+27
+00:01:42,200 --> 00:01:45,140
+الصغير يعني اللي هو بداية ما قبل لسه ماصارش اسم ال
+
+28
+00:01:45,140 --> 00:01:49,500
+child اللي هو من 0 ل 18 شهر من عند مين ولد لسنة و
+
+29
+00:01:49,500 --> 00:01:53,260
+تمانة شهور اسمه infant early childhood اسم الطفولة
+
+30
+00:01:53,260 --> 00:01:59,670
+المبكرة من 18هو من 18 شهر بتروح نوعين ل 6 سنوات و
+
+31
+00:01:59,670 --> 00:02:02,310
+كإني بقول يعني بيعينكوا الله نكتب جنب هنا اسمه pre
+
+32
+00:02:02,310 --> 00:02:05,150
+school ايش اسمه pre school ايه؟ يعني ما قبل
+
+33
+00:02:05,150 --> 00:02:08,670
+المدرسة لإنه على اعتبار المدرسة صف أول في ال
+
+34
+00:02:08,670 --> 00:02:12,750
+middle childhood 6 ل 9 سنوات كلام بسيط بتوش يعني
+
+35
+00:02:12,750 --> 00:02:16,850
+ترجمة بعدين هذا اللي هو يعني الصف أول و تاني و
+
+36
+00:02:16,850 --> 00:02:20,850
+تالت هنا اسمها ايش هنا؟ pre adolescence ما قبل
+
+37
+00:02:20,850 --> 00:02:25,870
+المراهقة يعني و هذه الفترة من 9 ل 12اللي هي الرابع
+
+38
+00:02:25,870 --> 00:02:29,870
+خامس سادس اللي بعدين هنا adolescence مرحلة ال
+
+39
+00:02:29,870 --> 00:02:32,330
+teenage بدينا في التلتاشر اللي بيسميها ال teenage
+
+40
+00:02:32,330 --> 00:02:35,490
+هنا هنا بعض اللي ممكن احنا نستخدم .. نعتبر هدول
+
+41
+00:02:35,490 --> 00:02:38,710
+المرحلتين اللي هي ال middle والتنتين هتسموها
+
+42
+00:02:38,710 --> 00:02:41,890
+school age على اعتبار انه بيعتبروا ال six سنوات هي
+
+43
+00:02:41,890 --> 00:02:44,290
+ال school age اللي هي السنوات الابتدائية ال
+
+44
+00:02:44,290 --> 00:02:46,530
+adolescence طبعا بيعتبروا ال teenage اللي هي العام
+
+45
+00:02:46,530 --> 00:02:49,610
+تسعتاش في ال young adult اللي هو بيسموه الشباب
+
+46
+00:02:49,610 --> 00:02:53,930
+المبكر او يعني بيسموه شباب يعني من عشرين لاربعين
+
+47
+00:02:54,300 --> 00:02:56,760
+وفيها اللي بيسموه ال middle adulthood يعني هم اللي
+
+48
+00:02:56,760 --> 00:03:00,440
+بيعتبروا أواسط العمر أربعين لخمس و ستين سنة طبعا
+
+49
+00:03:00,440 --> 00:03:02,960
+هذا حسب الأجانب لكن احنا عندنا فيه مختلف احنا انا
+
+50
+00:03:02,960 --> 00:03:06,800
+للأسف ممكن نكون أربعين و نتطلع فيه تفكر عمره ستين
+
+51
+00:03:06,800 --> 00:03:09,640
+و عمرها خمسة و أربعين و تفكريا عمرها سبعين سنة
+
+52
+00:03:09,640 --> 00:03:12,900
+الظروف صعبة و الله يغين الناس في ال late adulthood
+
+53
+00:03:12,900 --> 00:03:16,740
+خمسة و ستين and more يعني من خمس ستين و أعلى احنا
+
+54
+00:03:16,740 --> 00:03:20,510
+عندنا للأسف ع ستين بالسبب للأسفكان بيقولك expired
+
+55
+00:03:20,510 --> 00:03:24,150
+و لازم يخلص و سنة تقاعد و ممنوحة ده يعني لا يروح
+
+56
+00:03:24,150 --> 00:03:28,050
+يشتغل ولا كده طبعا احنا ننساش هذه اسمها مراحل
+
+57
+00:03:28,050 --> 00:03:32,370
+الأعمار اللي احنا بنتكلم عنها خلال حياة الإنسان
+
+58
+00:03:32,370 --> 00:03:36,750
+منذ الولادة حتى الوفاة طيب nutrition assessment يا
+
+59
+00:03:36,750 --> 00:03:41,350
+أستاذ ال nutrition بقولي هنا plays ايش a major
+
+60
+00:03:41,350 --> 00:03:44,830
+role بالعبدور مهم كتير لل nutrition ليش انا بتعمله
+
+61
+00:03:44,830 --> 00:03:48,670
+assessment لأنه بقول العبدور أساس كبير جدا في
+
+62
+00:03:48,670 --> 00:03:53,260
+حياتناإيش هي؟ هو اللي بيخلنا .. بيقولي أنا how I
+
+63
+00:03:53,260 --> 00:03:56,060
+look كيف أنا بقى انظر يعني في حياتي، how I feel
+
+64
+00:03:56,060 --> 00:04:00,520
+كيف أنا بشعر، how I behave، كيف أنا بتصرف، زمان
+
+65
+00:04:00,520 --> 00:04:03,680
+كان يقول مثلا الجوع كافر أو الجوع كذا، بغض النظر،
+
+66
+00:04:03,680 --> 00:04:06,400
+احنا بنتكلم لما تكون في مشكلة في ال nutrition بشكل
+
+67
+00:04:06,400 --> 00:04:10,900
+عام، معناته صحة الإنسان فيها مشكلة، معناته مشاعر
+
+68
+00:04:10,900 --> 00:04:13,520
+الإنسان، سلوكيات الإنسان، مشاهد الإنسان، كل شي
+
+69
+00:04:13,520 --> 00:04:16,640
+فيها مشكلةأكيد انتوا مقررين معايا في هذا الكلام،
+
+70
+00:04:16,640 --> 00:04:20,320
+مش معقول يكون في عنده يعني مشكلة غذائية و هو عامله
+
+71
+00:04:20,320 --> 00:04:23,800
+يعني كتير و منيح و منصحته منيح، لأ أبدا، ليه؟ على
+
+72
+00:04:23,800 --> 00:04:27,540
+اعتبار انه يعني اعتبر انه أصلا .. أصلا احنا بنعتبر
+
+73
+00:04:27,540 --> 00:04:31,320
+انه ال diet defense يعني، مقاوم لكتير من ال
+
+74
+00:04:31,320 --> 00:04:34,140
+disorders و ال disease، the ability to fight
+
+75
+00:04:34,140 --> 00:04:37,240
+disease هي لحاله قاللي، انه انا كتير بخلينا قاوم
+
+76
+00:04:37,240 --> 00:04:40,850
+إيش الأمراضgreatly depends بيعتمد كتير على ال
+
+77
+00:04:40,850 --> 00:04:46,450
+individuals إيش يعني و كتير من الأمراض و مقاومتها
+
+78
+00:04:46,450 --> 00:04:52,010
+تعتمد على قوتك و طاقتك الغذائية حتى شوفوا الموضوع
+
+79
+00:04:52,010 --> 00:04:55,190
+الكورونا اللي احنا بقايله الآن في الصحة ده بيقولك
+
+80
+00:04:55,190 --> 00:04:58,210
+دايما ارفع المناعة ارفع المناعة كيف بنرفع المناعة؟
+
+81
+00:04:58,210 --> 00:05:00,570
+معظم الناس صحيح باخدوا فيتامين C و باخدوا زنكو و
+
+82
+00:05:00,570 --> 00:05:03,270
+شكلها زي هي أنا لما بسألهم بقولهم مش مشكلة حتى لو
+
+83
+00:05:03,270 --> 00:05:06,990
+أخدت Omega مش مشكلة خد Omegaهيقولك خد مكملات على
+
+84
+00:05:06,990 --> 00:05:10,610
+اعتبار انه كل ما زادت القيمة الغذائية مش الكميها
+
+85
+00:05:10,610 --> 00:05:14,990
+القيمة الغذائية كل ما زادت اللي هو عندك قوة الملعب
+
+86
+00:05:14,990 --> 00:05:19,590
+طيب major goals of nutritional assessment ايش ال
+
+87
+00:05:19,590 --> 00:05:22,410
+major goals؟ ليش الوظائف الأساسية او الهداف
+
+88
+00:05:22,410 --> 00:05:26,550
+الأساسية؟ ايش اللي انت تقصده عشان تعمل nutritional
+
+89
+00:05:26,550 --> 00:05:29,570
+assessment؟ بقوللي انا بعمل nutritional assessment
+
+90
+00:05:29,570 --> 00:05:33,590
+لتلت أمور مهمة اما بشوف identification of
+
+91
+00:05:33,590 --> 00:05:37,260
+malnutritionطبعا إما بحدد سوء التخزيه لما نقول
+
+92
+00:05:37,260 --> 00:05:40,560
+malnutrition سوء التخزيه مايجين واحد يا أستاذ
+
+93
+00:05:40,560 --> 00:05:44,440
+يقوللي ال malnutrition وكأني بقول يعني سوء التخزيه
+
+94
+00:05:44,440 --> 00:05:47,940
+يعني قل التخزيه لأ سوء التخزيه إما over وإما under
+
+95
+00:05:47,940 --> 00:05:50,540
+ما التانية سوء التخزيه يعني الطفل الصغير اللي قاعد
+
+96
+00:05:50,540 --> 00:05:53,620
+بأكل خبزة وشاي خبزة وشاي خبزة وشاي وصار انتفخ
+
+97
+00:05:53,620 --> 00:05:57,040
+مسكين وهي اللي بتاكل كربايترات وكتير كتير نصحت أو
+
+98
+00:05:57,040 --> 00:05:59,600
+نصح ما هذا برضه malnutrition ولي مابيكلش
+
+99
+00:05:59,600 --> 00:06:02,840
+malnutrition اتنين identification of over
+
+100
+00:06:02,840 --> 00:06:06,950
+consumptionالاستهلاك الزائد عن حده تلاتة
+
+101
+00:06:06,950 --> 00:06:09,630
+identification of optimal nutrition status عشان
+
+102
+00:06:09,630 --> 00:06:14,650
+نحدد وين ال optimum او ال optimal body يعني كأنه
+
+103
+00:06:14,650 --> 00:06:19,550
+بقول انا اللي بهدفه يا بده اشوف الفلان اللي انا
+
+104
+00:06:19,550 --> 00:06:21,870
+بده اعمله ال nutritional assessment اما عنده سوق
+
+105
+00:06:21,870 --> 00:06:26,250
+تخضيه او عنده استهلاك زائد او عنده ايه او عنده
+
+106
+00:06:26,250 --> 00:06:29,790
+استهلاك زائد او عنده صحة طبيعية و هيك بنقوله
+
+107
+00:06:29,790 --> 00:06:33,130
+ماتعملش لا رجيم ولا شيءcomponents of nutritional
+
+108
+00:06:33,130 --> 00:06:36,690
+assessment كيف بنعمل nutritional assessment أول
+
+109
+00:06:36,690 --> 00:06:40,450
+حاجة بالمقييس حاجة اسمها anthropometric measures
+
+110
+00:06:40,450 --> 00:06:43,670
+لما نقول anthropometric measures يعني بالمقييس
+
+111
+00:06:43,670 --> 00:06:47,110
+الجسدية طبعا ايش يعني بالمقييس الجسدية وانا ان شاء
+
+112
+00:06:47,110 --> 00:06:52,190
+الله هزودكوا .. هو موجود على الكتير على الجوالات
+
+113
+00:06:52,190 --> 00:06:54,830
+ممكن ال google play وا انا حاليا هحطه برضه على ال
+
+114
+00:06:54,830 --> 00:07:00,810
+modelهذا برنامج احنا بنحط عليه مقييصنا الطول مع
+
+115
+00:07:00,810 --> 00:07:04,490
+الوزن و هو بيعطينا احنا وين بالظبط على ال range
+
+116
+00:07:04,490 --> 00:07:07,550
+الطبيعي اللي في البشر هذا اسمه anthropometric
+
+117
+00:07:07,550 --> 00:07:10,350
+measurement هلجت هتكلم بيه؟ المقييس هنا .. هنا
+
+118
+00:07:10,350 --> 00:07:13,370
+biochemical .. هنا مقييس بالصندت و بالمتر و
+
+119
+00:07:13,370 --> 00:07:16,890
+بالمليجرامات و كام .. هنا لأ .. هنا biochemical
+
+120
+00:07:16,890 --> 00:07:19,710
+بالفحوصات الكيميائية اللي موجودة عند جسم الإنسان
+
+121
+00:07:19,710 --> 00:07:23,410
+زي ما انا اعمله واحد مثلا kidney function اعمله
+
+122
+00:07:23,410 --> 00:07:26,630
+مثلا liver function و هكذااللي بعده clinical
+
+123
+00:07:26,630 --> 00:07:29,790
+examination اسمه الفحص الكليكي و اللي اخر حاجة
+
+124
+00:07:29,790 --> 00:07:33,650
+اسمها dietary analysis التحليل الغذائي اللي هو
+
+125
+00:07:33,650 --> 00:07:36,630
+اكتر شي بيهتموا فيه الناس مين اللي درسوا clinical
+
+126
+00:07:36,630 --> 00:07:41,990
+nutrition خاصة اخصائين التخزينية طيب اول حاجة ال
+
+127
+00:07:41,990 --> 00:07:44,330
+anthropometric measurement بقول ال anthropometric
+
+128
+00:07:44,330 --> 00:07:48,510
+measurement انا باهتم بال size الحجم بال weight
+
+129
+00:07:48,510 --> 00:07:52,430
+الوزن و ال proportions of human body ايش ان ال
+
+130
+00:07:52,430 --> 00:07:54,900
+proportions of human bodyيعني انا ايضا بشوف
+
+131
+00:07:54,900 --> 00:07:58,640
+التناسب اعضاء الجسم مع بعض البعض يعني مايجيش بعض
+
+132
+00:07:58,640 --> 00:08:02,560
+الناس يقولني يا استاذ طب ما انا شايف ان جسمه كويس
+
+133
+00:08:02,560 --> 00:08:05,380
+مافيش فيه كلمة انا شايف جسمه كويس احنا بنشوف
+
+134
+00:08:05,380 --> 00:08:11,020
+التناسب مثلا مع بعض يعني ب .. بقارن جداش البنيه
+
+135
+00:08:11,020 --> 00:08:14,020
+جداش ال abdomen جداش مثلا ال leg جداش مثلا ال
+
+136
+00:08:14,020 --> 00:08:16,660
+hands بيقارنهم مع بعض بقوللي ال measurement
+
+137
+00:08:16,660 --> 00:08:20,260
+include ايش هنا height .. height في فرق بين ال
+
+138
+00:08:20,260 --> 00:08:23,170
+height اه و ال length خارج الذاكرينممكن لو أجى في
+
+139
+00:08:23,170 --> 00:08:26,250
+انتحار، خربك، height معناه الترتفاع، يعني بنجيز
+
+140
+00:08:26,250 --> 00:08:30,230
+طول الإنسان و هو واقف، length بنجيز طول هو نايم،
+
+141
+00:08:30,230 --> 00:08:33,890
+طبعا لازم نعرف أنه لما نعمل assessment لمرحلة
+
+142
+00:08:33,890 --> 00:08:36,510
+الأطفال، خاصة اللي بروح براديو ليادات، بتشوف أكيد
+
+143
+00:08:36,510 --> 00:08:40,600
+حد عندك أخ صغير أو كده بتعرفوهلمّا بيروح العيادات
+
+144
+00:08:40,600 --> 00:08:44,220
+عمره مثلا في أشهر أو سنة أو سنتين أو تلات سنين أو
+
+145
+00:08:44,220 --> 00:08:48,320
+بداية بتيجي الممرضة بتناعم على سريره و بتجيب سطوله
+
+146
+00:08:48,320 --> 00:08:52,080
+ما بينفعه بواكفه طبعا هو الاختلاف من نص لصنتى لكن
+
+147
+00:08:52,080 --> 00:08:55,280
+مايديش واحد يقوللي مش مستهلات لأ كل شيء له معيارة
+
+148
+00:08:55,280 --> 00:09:00,120
+.. كل كل شيء له معيارة height, weight, skin fold
+
+149
+00:09:00,660 --> 00:09:04,840
+skin fold thickness إيش يعني؟ يعني بنشوف كثافة ..
+
+150
+00:09:04,840 --> 00:09:08,440
+أه كثافة الجلد اللي موجود في جسم الإنسان يعني لما
+
+151
+00:09:08,440 --> 00:09:12,320
+الواحد بنطلع بنقوله فلان مليان الجلد بنقول ال skin
+
+152
+00:09:12,320 --> 00:09:15,360
+fold يعني high thickness high thickness يعني عنده
+
+153
+00:09:15,360 --> 00:09:19,460
+تلافيف موجودة أكتر في جسمه وفي بعض الناس بكون thin
+
+154
+00:09:19,460 --> 00:09:21,920
+يعني رفية و ال circumferences إيش يعني ال
+
+155
+00:09:21,920 --> 00:09:25,180
+circumferences؟ اللي هو المحيطات إيش المحيطات؟محيط
+
+156
+00:09:25,180 --> 00:09:29,100
+الرأس، محيط الصدر، محيط الجسم، محيط ال trunk اللي
+
+157
+00:09:29,100 --> 00:09:33,280
+هو الجذع و هكذا ال body parts طيب إيه بنتكلم على
+
+158
+00:09:33,280 --> 00:09:37,000
+ال head و ال chest و ال arms؟ هذول أكتر شي زي لما
+
+159
+00:09:37,000 --> 00:09:42,460
+واحد بروح بتفصل حتى لما المرات بتفصل يعني جاكета،
+
+160
+00:09:42,460 --> 00:09:46,220
+بلوزة، جلباب، أي شيء بتلاقي بيجي الخياط الشاطر
+
+161
+00:09:46,220 --> 00:09:50,900
+بيعمله مقييز واضح جدا علشان يقدر ايش .. يكون ينسجن
+
+162
+00:09:50,900 --> 00:09:55,460
+معاه في عملية التفصيل طيبassessment of body mass
+
+163
+00:09:55,460 --> 00:09:58,280
+index وانا هذا ان شاء الله هو بتكلم عنه البرنامج
+
+164
+00:09:58,280 --> 00:10:01,980
+اللي أنا هحاطه وعلى فكرة ممكن أي واحد فيكوا يبحث
+
+165
+00:10:01,980 --> 00:10:04,540
+على جوجل وبرنامج صغير أظن اللي هو نوع أحمر أيقونته
+
+166
+00:10:04,540 --> 00:10:09,820
+اسمه BMI بس BMI body mass index هذا بنحط فيه الطول
+
+167
+00:10:09,820 --> 00:10:12,620
+والوزن وهو لحاله بيعطينا ال range وبيقولنا أين أنا
+
+168
+00:10:12,620 --> 00:10:16,280
+بالظبط موجود في الميزان اللي هو خليني أقول يعني في
+
+169
+00:10:16,280 --> 00:10:20,380
+ال average of the body يعني weight لو four people
+
+170
+00:10:20,380 --> 00:10:25,250
+للناس بشكل عام هانش بقول ليهفي حاجة ال high ratio
+
+171
+00:10:25,250 --> 00:10:29,010
+بس في مشكلة ال high ratio of waist hip
+
+172
+00:10:29,010 --> 00:10:32,610
+circumference are associated with higher risk of
+
+173
+00:10:32,610 --> 00:10:38,170
+illness and decreased lifespan ايش بقصد هنا في بعض
+
+174
+00:10:38,170 --> 00:10:41,370
+الناس في عندهم مشكلة وين المشكلة انه عندهم التناسب
+
+175
+00:10:41,370 --> 00:10:44,670
+ما بين ال waist الخسر يعني وما بين ال hip
+
+176
+00:10:44,670 --> 00:10:49,800
+circumferences بتلاقي الخسر تمامبيقوم الناس جلالهم
+
+177
+00:10:49,800 --> 00:10:53,720
+و طبعا ربنا اللي بيعلن بالأعمار احنا ما بنقرر ده
+
+178
+00:10:53,720 --> 00:10:56,360
+الكلام بيقولوا انه من الناس اللي عندهم ال waist
+
+179
+00:10:56,360 --> 00:11:01,540
+كبير يعني اقصد المنطقة الوسط و الخسر كبيرة كتير
+
+180
+00:11:01,540 --> 00:11:05,120
+يعني و highly obese ومنطقة ال hip من تحت شوية
+
+181
+00:11:05,120 --> 00:11:08,840
+بتلاقي ايش لأ small يعني ال circumference يعني زي
+
+182
+00:11:08,840 --> 00:11:12,540
+مش عارف اذا بتتذكروا معايا زي لما كانوا يجيبوا
+
+183
+00:11:12,540 --> 00:11:17,250
+البوباي هذا اللي تبع ال ..اللي كان ييجي في الصورة
+
+184
+00:11:17,250 --> 00:11:20,130
+المتحركة، اللي كان من فوق يكون متفق ومن تحت يكون
+
+185
+00:11:20,130 --> 00:11:23,850
+مش مبين يعني، اللي لا يحب ولا غيره، فهنا إيش بقول؟
+
+186
+00:11:23,850 --> 00:11:28,430
+هدول الناس مرتبط عندهم أنه بوجود الأمراض أكتر
+
+187
+00:11:28,430 --> 00:11:32,250
+عندهم وع كلامهم الأجانب، لإن ال life span بتقلب
+
+188
+00:11:32,250 --> 00:11:35,570
+واحنا بنقول لأ، الأعمار بيد الله وما بيبقى حد
+
+189
+00:11:35,570 --> 00:11:39,160
+بيقدر يحدد أن هو هيموت واكتش أو غيرهطيب كيف انا
+
+190
+00:11:39,160 --> 00:11:42,120
+بعمل ال BMI ال body mass index ال body mass index
+
+191
+00:11:42,120 --> 00:11:44,900
+لو انا بده اعمله ع الجوال او بده اعمله يدويا
+
+192
+00:11:44,900 --> 00:11:49,020
+بقوللي انا بدك تجيب ال weight في ال kilogramers
+
+193
+00:11:49,020 --> 00:11:51,640
+تجيش على ال weight يعني الوزن مثلا بيجي واحد
+
+194
+00:11:51,640 --> 00:11:54,840
+بيقولي انا وزن ستين وزن خمس وسبعين وزن خمس و
+
+195
+00:11:54,840 --> 00:11:58,660
+تمانين بقوله خمس و تمانين على ايه على الوزن بالايه
+
+196
+00:11:58,660 --> 00:12:02,220
+على الطول بالمتر جداش طولك بيقولي طولي مثلا انا
+
+197
+00:12:02,220 --> 00:12:05,480
+طولي مية و ستين صنطي بقوله يعني واحد و ست من عشرة
+
+198
+00:12:05,480 --> 00:12:09,000
+هي معناته بالمترواحد بيقولي انا طولي 170 وواحد
+
+199
+00:12:09,000 --> 00:12:12,000
+وسبعة من عشرة او تيجي الطالب بتقولي لأ انا طولي
+
+200
+00:12:12,000 --> 00:12:16,440
+مثلا 155 وواحد وخمسة وخمسين من مية بس المربع تبعهم
+
+201
+00:12:16,440 --> 00:12:20,220
+أُس اتنين شايفين كيف يبقى بقالته بحط الوزن فوق
+
+202
+00:12:20,220 --> 00:12:23,620
+بالكيلو جرامات يعني سبعين مثلا واحد واحد نعتبر
+
+203
+00:12:23,620 --> 00:12:29,240
+واحد وزنه سبعين وطوله مية وستين بقول سبعين على
+
+204
+00:12:29,240 --> 00:12:32,560
+واحد وستة من عشرة أُس اتنين بيطلع الرقم الرقم اللي
+
+205
+00:12:32,560 --> 00:12:36,080
+بيطلع يعني اذا طلع تلاتة وعشرين اربع عشرين جليل
+
+206
+00:12:36,390 --> 00:12:38,930
+يعني وصل لخمس عشرين .. ستة عشرين .. كويس .. سبع
+
+207
+00:12:38,930 --> 00:12:42,010
+عشرين .. لأ .. تمان عشرين لأ .. obese .. اتساع
+
+208
+00:12:42,010 --> 00:12:44,690
+عشرين بدأ .. و highly obese .. و هكذا عشان نعرف
+
+209
+00:12:44,690 --> 00:12:48,390
+كده المقاييس أنا ريحتكم بنزل برنامج و انا هحطه على
+
+210
+00:12:48,390 --> 00:12:52,310
+ال model عشان تقدروا تستفيدوا منه ان شاء الله طيب
+
+211
+00:12:52,310 --> 00:12:55,890
+.. biochemical measurement انت قلتلي يا أستاذ عن
+
+212
+00:12:55,890 --> 00:12:58,030
+المقاييس ال anthropometric .. نيجي جيت ال
+
+213
+00:12:58,030 --> 00:13:00,490
+biochemical .. إيش تقصدك فيها؟ بقوللي هنا
+
+214
+00:13:00,490 --> 00:13:03,230
+indicating .. آه .. للمالي nutrition عشان نعرف إن
+
+215
+00:13:03,230 --> 00:13:05,960
+أنا عنده سوق تغذية ولا لأdevelopment of disease
+
+216
+00:13:05,960 --> 00:13:09,240
+تطور الأمراض result in a over consumption of
+
+217
+00:13:09,240 --> 00:13:14,160
+nutrients استهلاك زائد لبعض المغذيات اللي هي للأسف
+
+218
+00:13:14,160 --> 00:13:17,960
+مش طبيعية زي ايش هجيتها دلوقتي هحقول زي موضوع ال
+
+219
+00:13:17,960 --> 00:13:23,640
+serum and urine serum يعني الدم اللي بسحبه من جسم
+
+220
+00:13:23,640 --> 00:13:29,040
+الإنسان و بفحصله بعض الشغلات اللي أنا بدياه أشوف
+
+221
+00:13:29,040 --> 00:13:36,270
+الأملاح أشوف كدهشارتفاع مثلا اليوريك أسد، جداش
+
+222
+00:13:36,270 --> 00:13:40,170
+ارتفاع مثلا عنده اليوريا و هكذا طبعا هذه اللي أنا
+
+223
+00:13:40,170 --> 00:13:44,650
+بدكراه يمكن اليوم اسمه مش غريب علي الفحص لكن لأ
+
+224
+00:13:44,650 --> 00:13:47,350
+هعرف إيش معناه اليوريا و إيش الكرياتينين و هكذا
+
+225
+00:13:47,350 --> 00:13:51,350
+and urine اللي هو .. اللي هو .. ده شوف كمان تحليل
+
+226
+00:13:51,350 --> 00:13:54,650
+ال bone commonly used for biochemical assessment
+
+227
+00:13:55,130 --> 00:13:58,870
+أول حاجة أشبه قولي هنا أنا مهم كتير أشوف ال .. و
+
+228
+00:13:58,870 --> 00:14:01,890
+أنا بعمل ال biochemical measurement فيه مرات over
+
+229
+00:14:01,890 --> 00:14:04,130
+consumption في بعض الناس يا جماعة بتكونوا تفهمون
+
+230
+00:14:04,130 --> 00:14:07,110
+أيه؟ أكلهم مش طبيعي يعني أنا معتمد في حياته على
+
+231
+00:14:07,110 --> 00:14:10,990
+مثلا .. مثلا على ال .. المرتدالة مثلا أنا ماقدرش
+
+232
+00:14:10,990 --> 00:14:13,690
+أقول سيئة أو .. مش هيكوا سيئة أو مثلا معتمد ..
+
+233
+00:14:13,690 --> 00:14:16,450
+معتمد على ال endome مثلا كتير من الحلات يعني أنا
+
+234
+00:14:16,450 --> 00:14:18,510
+مرة طالب عجبته و أنا بتكلم على طالب و اتكلمت على
+
+235
+00:14:18,510 --> 00:14:21,590
+درس يعني من الجامعة الإسلامية وجهة شاحب و كذا
+
+236
+00:14:21,590 --> 00:14:24,370
+قلتله بس أول حاجة عمللي الفحص الدم و التعامللما
+
+237
+00:14:24,370 --> 00:14:27,070
+راجتني تاني يوم اللي بتقولي أنا عند دم تمانية
+
+238
+00:14:27,070 --> 00:14:30,010
+وسبعة من عشرة، قلتلها أنا متوقع ده الكلام، عملنا
+
+239
+00:14:30,010 --> 00:14:32,250
+فحصات تانية عشان نتأكد لازم الله ت roll out other
+
+240
+00:14:32,250 --> 00:14:34,430
+things يعني لازم نكون عندها مشاكل تانية، قلتلها
+
+241
+00:14:34,430 --> 00:14:38,470
+لأ، وين المشكلة؟ قالتلي أنا مدمنة .. مدمنة إدمان
+
+242
+00:14:38,470 --> 00:14:41,690
+كامل على اندومي، لدرجة إنه بشتريه مرات بالكاسة و
+
+243
+00:14:41,690 --> 00:14:44,350
+بشتري .. أنا ماعرفش إيش كاسة بالكاسة، مش فاهم، لما
+
+244
+00:14:44,350 --> 00:14:47,010
+نويل في الآخر عرفت إيش لما شوفت ولادي مرات بيجيبوه
+
+245
+00:14:47,320 --> 00:14:50,240
+وأنا قلت لرجالات لي حتى لما بيعملوا أي أكلة من
+
+246
+00:14:50,240 --> 00:14:53,260
+أفضل ما يكون أنا وكأنها مش موجودة طب وهذا إيش صارت
+
+247
+00:14:53,260 --> 00:14:57,400
+over consumption for إيش abnormal nutrients مغادير
+
+248
+00:14:57,400 --> 00:15:00,760
+مش طبيعية يبقى ال minerals اللي أنا بديها أين راحت
+
+249
+00:15:00,760 --> 00:15:03,620
+ال proteins اللي بديها أين راحت ال calories اللي
+
+250
+00:15:03,620 --> 00:15:06,160
+بديها أين راحت هنا المشكلة يبقى أنا بستخدم ال
+
+251
+00:15:06,160 --> 00:15:10,180
+urine و بستخدم ال blood عشان أعمل فحصات طيب تكملي
+
+252
+00:15:10,180 --> 00:15:13,500
+أستاذي ال clinical examination بيبش مال إيش أنا
+
+253
+00:15:13,500 --> 00:15:19,120
+هناكمش هتكلم فيها الآن بزيادة لكن من قدامها هأعطي
+
+254
+00:15:19,120 --> 00:15:23,060
+مش واجب أكتر من أنه يعني نوع من العصف الذهني
+
+255
+00:15:23,060 --> 00:15:26,260
+هأعطيكوا شغلات ايش الفحصات اللي بنعملها وقداشي ال
+
+256
+00:15:26,260 --> 00:15:28,940
+normal وقداشي ال abnormal بعرف أنه الآن مش رايينا
+
+257
+00:15:28,940 --> 00:15:34,120
+على مستشفى لكن كويس نستفسر نطلع يعني مثلا حاجة كل
+
+258
+00:15:34,120 --> 00:15:36,960
+واحد بنشوف قداشي الأملاح عند فلان طبعا قبل ما
+
+259
+00:15:36,960 --> 00:15:39,340
+تقولي ايش الأملاح قداشي قداشي الطبيعية يمكن واحد
+
+260
+00:15:39,340 --> 00:15:42,800
+يقولي قداشي يا أستاذ ال sodium لازم يكونمانا قبل
+
+261
+00:15:42,800 --> 00:15:45,660
+ما تقولي جديش Sodium انا هأسألك فلاقدامش راح أحط
+
+262
+00:15:45,660 --> 00:15:49,940
+شغلات على ال model عشان نقدر احنا نقدر نحلها و
+
+263
+00:15:49,940 --> 00:15:52,760
+اللي بيحلها لوحده و بيبعتليها كمان على ال WhatsApp
+
+264
+00:15:52,760 --> 00:15:55,500
+أو بيبعتها على المجموعة عن طريق النادر و بيبعتليها
+
+265
+00:15:55,500 --> 00:15:58,400
+بكون أنا مبسوط عشان اعرف جديش الحمد لله متابعتكوا
+
+266
+00:15:58,400 --> 00:16:02,200
+انا متأكد انكوا شاطرين ال clinical examination
+
+267
+00:16:02,200 --> 00:16:05,700
+involve ايش هنا بيقولي close physical evaluation
+
+268
+00:16:06,140 --> 00:16:09,280
+ماذا يعني Closed Physical Evaluation؟ هذا تقييم عن
+
+269
+00:16:09,280 --> 00:16:13,580
+قرب جسدي، بيجي الطبيب نفسه أو الأخصائي التخزيه أو
+
+270
+00:16:13,580 --> 00:16:16,140
+حتى الأخصيات الطبي .. أخصائي الطبي بده يشوف ال
+
+271
+00:16:16,140 --> 00:16:19,380
+science، يعني العلمات suggesting اللي بتخليني
+
+272
+00:16:19,380 --> 00:16:22,320
+أقترح أن في عنده malnutrition أو over consumption
+
+273
+00:16:22,320 --> 00:16:25,560
+of ال nutrients، يعني تجمع طبعا الفرق بينهم المال
+
+274
+00:16:25,560 --> 00:16:28,340
+ال nutrition سوء التخزيه، over consumption استغلال
+
+275
+00:16:28,340 --> 00:16:32,700
+غير طبيعي لبعض الأيه اللي هو المغاديات اللي هي مش
+
+276
+00:16:32,700 --> 00:16:37,350
+.. مش تمام، مش هي اللي مطلوبةexamination alone
+
+277
+00:16:37,350 --> 00:16:41,210
+does not permit definitive diagnosis of
+
+278
+00:16:41,210 --> 00:16:43,990
+nutritional problems المقصود هنا أنه مش ال
+
+279
+00:16:43,990 --> 00:16:46,970
+examination لوحده بيحدد أن فلان عنده مال ال
+
+280
+00:16:46,970 --> 00:16:50,130
+nutrition يعني قصدي إذا بدنا نقول عشان هيك سموه
+
+281
+00:16:50,130 --> 00:16:53,710
+complete assessment لما نبدأ نعمل complete
+
+282
+00:16:53,710 --> 00:16:57,020
+nutritional assessmentالـ Anthropometric و ال
+
+283
+00:16:57,020 --> 00:17:00,080
+biochemical و ال clinical examination بقدر أحلف
+
+284
+00:17:00,080 --> 00:17:04,100
+يمين و أقول إنه هذا له عنده مشكلة غذائية أما أجي
+
+285
+00:17:04,100 --> 00:17:06,920
+أركن إنه بس من ال clinical examination لأ في بعض
+
+286
+00:17:06,920 --> 00:17:10,760
+الناس رفعة و ضعافة لكن لما حصلها لكل فحصات التانية
+
+287
+00:17:10,760 --> 00:17:14,580
+كانت طبيعية بقدرش أقول عنه abnormal person طيب
+
+288
+00:17:14,580 --> 00:17:18,860
+بيقول ال nutritional assessment technique طريقة
+
+289
+00:17:18,860 --> 00:17:21,200
+اللي بنعمل فيها .. الطريقة اللي بنعمل فيها
+
+290
+00:17:21,200 --> 00:17:25,670
+nutritional assessment أول حاجة تاعةبعدين أروح
+
+291
+00:17:25,670 --> 00:17:28,230
+للمريض، احنا كطاب مريض الآن، أنا مش أخص أي طرف دي
+
+292
+00:17:28,230 --> 00:17:31,750
+يعني، أول سؤال إيش بقوله؟ describe the type،
+
+293
+00:17:31,750 --> 00:17:37,450
+تشرحلي نوع الأكل، هل هو regular or not، منظم ولا
+
+294
+00:17:37,450 --> 00:17:40,930
+لأ، special ولا عنده special ايه زي ذاك باوكل
+
+295
+00:17:40,930 --> 00:17:44,110
+شغلات أو عنده شغلات خاصة في حياته أو مثلا عنده
+
+296
+00:17:44,110 --> 00:17:48,410
+مشكلة صحيةزي عنده أسنان و مابقدرش أكل حاجات كتير
+
+297
+00:17:48,410 --> 00:17:53,110
+يمكن يقولي أنا ماأكلش الشغلات البسيطة و المكسرة و
+
+298
+00:17:53,110 --> 00:17:56,050
+المطحونة طب ليه؟ لأنه عندي مثلا notes of cheating
+
+299
+00:17:56,050 --> 00:17:59,410
+يعني من الأسف عندي .. أنا مركّف ضبّة dead sharks
+
+300
+00:17:59,410 --> 00:18:02,690
+أو عندي مشكلة في بعض الناس بيقولك أنا ماقدرش أكل
+
+301
+00:18:02,690 --> 00:18:06,270
+السمك أنا عندي sensitive أو عندي مثلا أني ماقدرش
+
+302
+00:18:06,270 --> 00:18:08,690
+أكل الموالح في عندي sensitive mouth كلوقت أنا
+
+303
+00:18:08,690 --> 00:18:12,190
+بسأله من مين؟ بسأله المريض و بسأل السؤال التاني ال
+
+304
+00:18:12,190 --> 00:18:15,590
+usual meal times لماذا بسأل السؤال التاني؟قداش
+
+305
+00:18:15,590 --> 00:18:20,010
+وقتاش أنت عندك دائما بتاكل الواجبات بشكل طبيعي
+
+306
+00:18:20,010 --> 00:18:23,970
+قداش بتاكل أكمل واجبة في اليوم و هل بتكونهم بشكل
+
+307
+00:18:23,970 --> 00:18:28,270
+منتظم وين and which are heavy meals أي واجبة عندك
+
+308
+00:18:28,270 --> 00:18:32,470
+الأساسية و أكون انسى لما أخدها في ال interview أنه
+
+309
+00:18:32,470 --> 00:18:36,090
+نعطي leading question سؤال بقود أو biased question
+
+310
+00:18:36,090 --> 00:18:39,110
+هو على طول هتقوله أكيد الواجبة الأساسية عندك
+
+311
+00:18:39,110 --> 00:18:42,030
+الغداء لأ ممكن تكون الواجبة الأساسية عنده الفطور
+
+312
+00:18:42,030 --> 00:18:46,330
+أنا شخصيا انا و أستاذكمو بعترف عادي أنا الواجبة
+
+313
+00:18:46,330 --> 00:18:48,510
+الأساسية عندي مش الغداء ولا العشاء أنا عنده
+
+314
+00:18:48,510 --> 00:18:51,490
+الواجبة الأساسية و الرئيسية في حياتي هي الفطور أنا
+
+315
+00:18:51,490 --> 00:18:54,350
+لما بأكل الفطور عندي يعني هو مركزية طول اليوم لأنه
+
+316
+00:18:54,350 --> 00:18:57,290
+بيعطيني زي الفول يعني زي الطاقة طول النهار ال
+
+317
+00:18:57,290 --> 00:19:00,870
+appetite، بدأ أسأله، هل عنده good appetite؟ عندها
+
+318
+00:19:00,870 --> 00:19:04,630
+good appetite or not؟ ولا fair، عادية؟ ولا poor؟
+
+319
+00:19:04,630 --> 00:19:08,710
+يعني ضعيفة؟ ولا too good؟ ولا عندها فتح، شهيدة
+
+320
+00:19:08,710 --> 00:19:13,640
+مفتوحة؟ زي بعض الناس، بيجب أقول مثلا بسألهأنا كيف
+
+321
+00:19:13,640 --> 00:19:16,380
+شايت أكل أكل؟ بيقولك أنا .. أنا بكره الصحن الفاضي
+
+322
+00:19:16,380 --> 00:19:20,120
+بس ما زال قال لي هيك .. يعني انتوا شوفوا رضماني
+
+323
+00:19:20,120 --> 00:19:23,200
+بتجيب عليك .. صح انت حتضحك أو حتضحك لكن خلاص كأنه
+
+324
+00:19:23,200 --> 00:19:26,500
+أجاب عن .. يعني بعض ممكن تقوله للمريض انت كيف انت
+
+325
+00:19:26,500 --> 00:19:29,200
+و الأكل؟ يقولك أنا الأكل .. انا الأكل يعني انا
+
+326
+00:19:29,200 --> 00:19:31,720
+بحبه .. انا بكره الصحن الفاضي ..معناه خلاص تسألوش
+
+327
+00:19:31,720 --> 00:19:34,120
+ان انت يبقى لعاله أجاوب انه الافيتاز عنده ما شاء
+
+328
+00:19:34,120 --> 00:19:38,920
+الله ال weight .. الوزن .. نيجي نسأله .. هل هو وزن
+
+329
+00:19:38,920 --> 00:19:43,090
+اختابت؟ ولا .. how it is changing؟ ولا اتغير؟بس
+
+330
+00:19:43,090 --> 00:19:46,890
+بالمناسبة إذا جالي اتغير بسألوش عن تغيير زمان
+
+331
+00:19:46,890 --> 00:19:51,830
+بسأله متى اتغير في آخر ست شهر أنا ماليش في زمان
+
+332
+00:19:51,830 --> 00:19:55,990
+ولا إلي إنه في سنين لأ بس جيبلي ست شهر لإنه ممكن
+
+333
+00:19:55,990 --> 00:19:58,750
+في خلال الست شهر الأخيرة أعمللي regime أو أعمل
+
+334
+00:19:58,750 --> 00:20:03,070
+حمية أو أعمل شغل زيه أو أخد مثلا يعني مثلا أعمل
+
+335
+00:20:03,070 --> 00:20:06,990
+جلسات رياضية أو هكذا ال food preferences تفضيلات
+
+336
+00:20:06,990 --> 00:20:12,310
+الغذية إيش بفضل أكل؟ هل بفضل مثلا لحمة العجل؟to
+
+337
+00:20:12,310 --> 00:20:16,050
+other meats أنا بعطيهوش بجيش أسأله و لا لو عنده
+
+338
+00:20:16,050 --> 00:20:19,150
+food dislike و لا فيه شغلات بكرهها من الأكل إذا
+
+339
+00:20:19,150 --> 00:20:23,370
+بكره شغلات من الأكل what؟ إيش هي؟ و ليش؟ why؟ و ال
+
+340
+00:20:23,370 --> 00:20:26,650
+culture related يمكن مرتبطة بثقافته يعني أنا ممكن
+
+341
+00:20:26,650 --> 00:20:29,090
+ييجي واحد يقولي أنا بالله بحب اللحمة بس اللحمة إيش
+
+342
+00:20:29,090 --> 00:20:33,030
+اللحمة البيضة أنا بكره اللحمة طبيعي و بالمناسبة
+
+343
+00:20:33,030 --> 00:20:35,590
+اللحمة البيضة أحسن من اللحمة الحمرا اللحمة الحمرا
+
+344
+00:20:35,590 --> 00:20:40,190
+acid اللحمة البيضة alkaline قاعديو أنا بدي لجسمكوا
+
+345
+00:20:40,190 --> 00:20:43,230
+و لجسمنا يكون دايما قاعدى، كل ما كان جسمنا فيه
+
+346
+00:20:43,230 --> 00:20:46,170
+قاعدة أكتر، كل ما كان فيه ايه شهلة defense for
+
+347
+00:20:46,170 --> 00:20:50,990
+disease، يعني بتقاوم الأمراض، بسأل المريض هل في
+
+348
+00:20:50,990 --> 00:20:54,610
+عندك بتكره شغلات في الأكل؟ أه والله بكره كده كده،
+
+349
+00:20:54,610 --> 00:20:58,270
+ماحي يقولي، بقول طب إيش؟ يمكن يقعد يقولي أنا بحبش
+
+350
+00:20:58,270 --> 00:21:01,390
+السمكة، يمكن كل علاقة بال culture، بقول أنا موعيتش
+
+351
+00:21:01,390 --> 00:21:06,470
+في حياتي لجأت أهلي بيأكل سمكتي، خلصنا، usualeating
+
+352
+00:21:06,470 --> 00:21:12,830
+places usual eating places يعني وين بتاكل؟ هل
+
+353
+00:21:12,830 --> 00:21:16,750
+دايما بتعتمد في ال home ولا للأسف من يوم انا روحت
+
+354
+00:21:16,750 --> 00:21:19,590
+على المدرسة و جيت على الجامعة في للأسف عندي snack
+
+355
+00:21:19,590 --> 00:21:22,170
+shops يعني و restaurants أنا بحب .. يعني أنا
+
+356
+00:21:22,170 --> 00:21:25,170
+ماأكلش دايما بحب أكل هالسندوش في هالجامعة أو
+
+357
+00:21:25,170 --> 00:21:28,530
+هالسندوش في ناس يعني انفجعوني خصوصا السنة الأولى
+
+358
+00:21:28,530 --> 00:21:31,310
+بيقولوا أصلا أنا كنت أحب الجامعة و نفسي فيها عشان
+
+359
+00:21:31,310 --> 00:21:34,970
+الكفتيرة تبعتها و عشان شوفتهم الناس طلاب بيروحوا و
+
+360
+00:21:34,970 --> 00:21:38,860
+بيقولوا لأما هذا مهم، أكل الطعام البيت بيختلف،
+
+361
+00:21:38,860 --> 00:21:42,020
+معروف، حتى لو جلينا الفلافل في البيت و أكلناها برا
+
+362
+00:21:42,020 --> 00:21:45,160
+بيختلف، حتى لو كان بيختلف يعني في شكله، الأكل
+
+363
+00:21:45,160 --> 00:21:48,980
+سبحان الله أريحية البيت و مذاق البيت له يعني و
+
+364
+00:21:48,980 --> 00:21:51,400
+دائما الراحة النفسية لعلاقة بموضوع اللي هو
+
+365
+00:21:51,400 --> 00:21:55,040
+الاستجابة للطعام أكتر ability to eat القدرة على
+
+366
+00:21:55,040 --> 00:21:58,760
+إيش؟ على الأكل، بيقدر يأكل؟ ولا في عنده
+
+367
+00:21:58,760 --> 00:22:01,920
+inabilities؟ describe هل في عنده dental problems؟
+
+368
+00:22:01,920 --> 00:22:06,210
+بسأله، في أنك مشكلة في سنانك؟ال fitting dentures
+
+369
+00:22:06,210 --> 00:22:09,930
+.. fitting dentures معناته ضبة اللي بيكون ثبتها طب
+
+370
+00:22:09,930 --> 00:22:13,490
+ال fitting يعني مش .. مش مثبتها كويس بقولك أنا ركب
+
+371
+00:22:13,490 --> 00:22:16,550
+ضبة الأسنان هي عبارة عن ال إيش اللي بحطوها في فمهم
+
+372
+00:22:16,550 --> 00:22:19,330
+لما بكون خلويني أكل الأسنان فبيجي بقولك والله
+
+373
+00:22:19,330 --> 00:22:22,550
+مابقدر أنا .. يعني أكلها إنه مابقدرش أضغط عليها في
+
+374
+00:22:22,550 --> 00:22:24,690
+عند ال difficulties في بعض الناس عندهم
+
+375
+00:22:24,690 --> 00:22:27,110
+difficulties في ال chewing chewing يعني إيش هنا
+
+376
+00:22:27,110 --> 00:22:30,910
+المضغفى ال following زى مين زى حالات اللى عندهم
+
+377
+00:22:30,910 --> 00:22:34,210
+ايش لا قدر الله فى حالات زى الحالات اللى عندهم
+
+378
+00:22:34,210 --> 00:22:38,750
+paralysis الشلل من يوم ما صار عنده شلل مثلا فى عصب
+
+379
+00:22:38,750 --> 00:22:42,470
+معين فبقولك بطل يقدر يمدغ الأكل منيح فبنضطر احنا
+
+380
+00:22:42,470 --> 00:22:47,350
+نعطيه solutions سوائل فلازم نسأل فى بعض الناس
+
+381
+00:22:47,350 --> 00:22:50,130
+عندهم مالي nutrition يعني يوم الأيان أجتنا يعني
+
+382
+00:22:50,130 --> 00:22:55,090
+طفل كان عنده مالي nutrition وامه تعبت على
+
+383
+00:22:55,090 --> 00:22:58,120
+المستشفياتصارت كل مشكلة تعرفين في أين؟ مشكلة ال
+
+384
+00:22:58,120 --> 00:23:02,580
+swallowing، ليه؟ الطفل هذا بامدغش كويس، طبعا مش
+
+385
+00:23:02,580 --> 00:23:06,620
+بامدغش أنه صناعه مافيش فيه مشكلة، لأ الصناعه كويسة
+
+386
+00:23:06,620 --> 00:23:09,620
+مافيش فيه ولا حاجة، بس الولد سريق جدا جدا جدا بحب
+
+387
+00:23:09,620 --> 00:23:12,800
+يأكل بسرعة، يعني لدرجة أن أمه بتقول في خمس دقايق،
+
+388
+00:23:12,800 --> 00:23:16,420
+بيحس يعني كأنه يتغول ويتنمر على أخته لما يكون فيه
+
+389
+00:23:16,420 --> 00:23:19,320
+أكلإذا خلاص لما يكون فيه لحمة و رز وشغلاء زيك و
+
+390
+00:23:19,320 --> 00:23:22,780
+بتقول لإمه فمباشرة يعني .. يعني الظلط بيسلم ..
+
+391
+00:23:22,780 --> 00:23:24,500
+بيسلم على البلاء زي ما بقولها الظلط بيسلم على
+
+392
+00:23:24,500 --> 00:23:26,900
+البلاء مانحط .. مانحطه في طمع بيبلع كيف؟ مابعرفش
+
+393
+00:23:26,900 --> 00:23:30,740
+في الآخر مالي ال nutrition لإنه أصلا المعدة في
+
+394
+00:23:30,740 --> 00:23:34,260
+منها استعداد أن تتكلم على .. في .. عامل ما يصير ال
+
+395
+00:23:34,260 --> 00:23:36,560
+parietal cells تشتغل في المعدة و تخبطها في ال
+
+396
+00:23:36,560 --> 00:23:40,260
+Anatomy و تشتغل عشان ال HCL يطلع و ال suffagus
+
+397
+00:23:40,260 --> 00:23:43,060
+ينزل شوي شوي أما يبلعليها مرة واحدة كتل كتل
+
+398
+00:23:43,060 --> 00:23:45,040
+مابينفعل هذا الكلام ب
+
+399
+00:23:48,570 --> 00:23:51,390
+كيف عملت ال urination؟ هل بروح الحمام و لا بقولك
+
+400
+00:23:51,390 --> 00:23:53,010
+طول النهار و لا بروحش لها مرتين؟ معناه ده مش صار
+
+401
+00:23:53,010 --> 00:23:56,290
+مش مرة ناية، في عنده مشكلة ال stool؟ والله معلش يا
+
+402
+00:23:56,290 --> 00:23:59,010
+أستاذ أنا .. والله أنا كل يومين، كل تلتة بيجيب
+
+403
+00:23:59,010 --> 00:24:01,570
+يقوللي بروح الحمام مرة أو بيجي واحد بيقوللي لأ
+
+404
+00:24:01,570 --> 00:24:03,450
+بروح على تلتة اربعة مرات في اليوم، كل واحد على حسب
+
+405
+00:24:03,450 --> 00:24:05,870
+ال nature؟ كيف طبيعته؟ شو ال frequency؟ شو ال
+
+406
+00:24:05,870 --> 00:24:09,070
+problems؟ ليه؟ ال frequent problems إذا في مشكلة
+
+407
+00:24:09,070 --> 00:24:12,490
+مشاكل عشان بتكون مرتبطة نعرف في بعض الناس عنده
+
+408
+00:24:12,490 --> 00:24:15,650
+constipation بس عشان عنده مالي ال nutritionفي ناس
+
+409
+00:24:15,650 --> 00:24:18,650
+عندهم loss of urination او عندهم burning sensation
+
+410
+00:24:18,650 --> 00:24:22,470
+يعني إحساس بالحرجان لأنه أصلا ماروحش على الحملة
+
+411
+00:24:22,470 --> 00:24:24,790
+لإن ما بشربش مية كويس أوي و انا كنت فاكر لما واحد
+
+412
+00:24:24,790 --> 00:24:27,290
+بيقولك لأ بشرب كتير و بيروح بيقوللي بشرب سوال و
+
+413
+00:24:27,290 --> 00:24:30,950
+بشرب كولة و بعتبرها سوال بالعكس، هذا بتدمر أنا لما
+
+414
+00:24:30,950 --> 00:24:35,610
+أقول مية يعني مية بس، بدنا نسأل عن ال exercise و
+
+415
+00:24:35,610 --> 00:24:38,490
+ال physical activity كيف نشاطك بشكل عام؟ أنا مابدي
+
+416
+00:24:38,490 --> 00:24:41,210
+أروح ألعب football أو ألعب رياضة لكن هو نشاط ولا
+
+417
+00:24:41,210 --> 00:24:44,030
+sedentary life؟ لما أقول sedentary يعني قاعد،
+
+418
+00:24:44,030 --> 00:24:48,200
+خامل، في البيتhow extensive هل هي extensive يعني
+
+419
+00:24:48,200 --> 00:24:51,660
+عنده رياضة و لياقة و بروح بالعق ولا deficient يعني
+
+420
+00:24:51,660 --> 00:24:55,800
+ولا قليلة طبعا دي مرتبطة اللي بيأكل و بيشرب كويس و
+
+421
+00:24:55,800 --> 00:24:59,480
+عاملا و بتحرك معناته إيش good body health و للأسف
+
+422
+00:24:59,480 --> 00:25:02,980
+بأكل و بشرب و قاعد بعد body health و في الآخر
+
+423
+00:25:02,980 --> 00:25:06,460
+انتوا عارفين إيش اللي حيصير بعدها بسأل ال psycho
+
+424
+00:25:06,460 --> 00:25:09,980
+-social طب إيش دخل ال psycho-social مرتبطة كتير
+
+425
+00:25:09,980 --> 00:25:14,840
+جدا بعملية ال food بال culture factorsالطعام كله
+
+426
+00:25:14,840 --> 00:25:18,800
+مرتبط من ناحية النفسية والاجتماعية زي إيش؟ بقولي
+
+427
+00:25:18,800 --> 00:25:22,140
+بدنا نشوف بعض الناس بتأثر على ال proper nutrition،
+
+428
+00:25:22,140 --> 00:25:25,360
+في بعض الناس عندهم طقوس معينة نفسية واجتماعية، أنا
+
+429
+00:25:25,360 --> 00:25:29,920
+مثلا في شغلات في بعض الناس عنده مرتبط الأكل، يعني
+
+430
+00:25:29,920 --> 00:25:33,260
+ممكن تقوله معلش تعال لو سمحت بده أعطيكأنا أعمل لك
+
+431
+00:25:33,260 --> 00:25:36,160
+سمك، يقولك لأ والله أنا السمك ما بحب أكله إلا من
+
+432
+00:25:36,160 --> 00:25:40,560
+وين؟ من إيد أمي لإيه بتعمله، طب تعب تشويلك دجاج،
+
+433
+00:25:40,560 --> 00:25:44,440
+بقولك لأ أنا بحب الشو من كده، أنا عندك طب في مفتول
+
+434
+00:25:44,440 --> 00:25:47,040
+احنا عندك، انا بقولك لأ احنا أصحاب المفتول، ها
+
+435
+00:25:47,040 --> 00:25:50,460
+culture ها، احنا أصحاب المفتول، زي أهل الدراسة
+
+436
+00:25:50,460 --> 00:25:53,060
+مثلا، ما شاء الله مشترين، شاطرين، وطبعا كل الناس
+
+437
+00:25:53,060 --> 00:25:55,520
+شاطرين، بس يعني زمان كنا بيقولوا أنهم أشتر ناس في
+
+438
+00:25:55,520 --> 00:25:58,100
+عمل المفتول، بيقولك احنا لا أشتر منكوا في عمل
+
+439
+00:25:58,100 --> 00:25:58,560
+المفتول، ب
+
+440
+00:26:02,400 --> 00:26:06,920
+أو اجتماعي أو ثقافي بطعام أو معكول معين هذا بنسأل
+
+441
+00:26:06,920 --> 00:26:11,220
+المريض بدون ما نعمله bias طيب taking medications
+
+442
+00:26:11,220 --> 00:26:14,800
+أخد ملاش بياخد أدوية بتأثر على الأكل تبعه ولا
+
+443
+00:26:14,800 --> 00:26:18,920
+بياخدش؟ يمكن تقول اه والله أنا باخد مكملات العلاقة
+
+444
+00:26:18,920 --> 00:26:22,140
+والله أنا باخد دوة علشان هي كده مابديش أكل أو باخد
+
+445
+00:26:22,140 --> 00:26:25,240
+حبوب علشان يعمليني رجيم حسب ما بقولليه laboratory
+
+446
+00:26:25,240 --> 00:26:30,020
+determinations بجيب أسأله هل عملت فحصات خاصة ال
+
+447
+00:26:30,020 --> 00:26:35,720
+hemoglobinجدش كان عندك الدم؟ جدش كان ال protein؟ و
+
+448
+00:26:35,720 --> 00:26:37,560
+انا اللي قدامي ان شاء الله احطه .. احطه ال model
+
+449
+00:26:37,560 --> 00:26:41,080
+اللي انا حكيتلكوا عنه جدش ال albumin؟ جدش ال
+
+450
+00:26:41,080 --> 00:26:43,860
+cholesterol؟ your analysis تحليل ال ball اللي
+
+451
+00:26:43,860 --> 00:26:48,400
+عندك؟ جدش عندك ال height؟ جدش طولك و التواجف؟ جدش
+
+452
+00:26:48,400 --> 00:26:51,800
+ال weight و وزنك؟ هل ال body type تبعك يعتبر طبعا
+
+453
+00:26:51,800 --> 00:26:55,470
+.. هانا كاتبلي small و medium و largeمش يا جماعة
+
+454
+00:26:55,470 --> 00:26:58,570
+بقصد small و medium و large زي الملابس يعني الجميس
+
+455
+00:26:58,570 --> 00:27:01,010
+أو البنطانو تقول small و medium و large لأ انا
+
+456
+00:27:01,010 --> 00:27:03,130
+بتكلم عن طبيبط طبعا عشان تعرف small و medium و
+
+457
+00:27:03,130 --> 00:27:07,570
+large لما تنزل برنامج بي ام ايباد ماس اندكس هتعرف
+
+458
+00:27:07,570 --> 00:27:10,970
+ايش المقصود فيها طبعا احنا صح كلنا بنتمنى نكون في
+
+459
+00:27:10,970 --> 00:27:14,510
+ال medium لكن لو كان nearly small ماشي الحال و لو
+
+460
+00:27:14,510 --> 00:27:19,150
+كان nearly large ماشي الحال بس over large مشكلة و
+
+461
+00:27:19,150 --> 00:27:24,430
+under small يعني مشكلة finally ايش بقولي هناyou
+
+462
+00:27:24,430 --> 00:27:27,830
+must summarize ايش يعني summarize اخدت المعلومات
+
+463
+00:27:27,830 --> 00:27:32,290
+كلها بقول للخص المعلومات اللي انت خدتها من المريض
+
+464
+00:27:32,290 --> 00:27:35,750
+to determine the nutritional nutritional ايه
+
+465
+00:27:35,750 --> 00:27:40,370
+diagnosis and nutritional plan of care طبعا بعد ما
+
+466
+00:27:40,370 --> 00:27:44,350
+اخدت المعلومات الكاملة من المريض بلخص المعلومات
+
+467
+00:27:44,350 --> 00:27:46,930
+عشان اعرف ايش المريض المشكلة عنده الغذائية اللي
+
+468
+00:27:46,930 --> 00:27:51,230
+موجودة هل هي malnutrition optimal ولا over
+
+469
+00:27:51,230 --> 00:27:55,220
+consumptionال laboratory test هل بتدل اللي فيه
+
+470
+00:27:55,220 --> 00:27:59,260
+حاجة راحة شمال او يمين و او حد يستهتر كتير من
+
+471
+00:27:59,260 --> 00:28:03,540
+الحالات كتير جدا طلاب ما شاء الله اكتشفوا شغلات
+
+472
+00:28:03,540 --> 00:28:06,900
+الطبيب كانش ما اكتشفها يعني من ضمن الشغلات اللي
+
+473
+00:28:06,900 --> 00:28:10,340
+انا بانسهاش كان في مريض كان في عنده مشكلة دايما
+
+474
+00:28:10,340 --> 00:28:14,300
+جسمه متنفخ وكل ما بيطلب يقولك انا بطل عندي نفس
+
+475
+00:28:14,300 --> 00:28:18,260
+كتير للأكل ليش متنفخ وعندي نفس كتير للأكل كان زمان
+
+476
+00:28:18,260 --> 00:28:22,880
+مرة في عنده حساسية معينةفعزيزي من الشجر كانت عند
+
+477
+00:28:22,880 --> 00:28:27,980
+الحسية فوصفوله كورتازون، الكورتازون هذا من ال anti
+
+478
+00:28:27,980 --> 00:28:30,440
+-inflammatory drugs وهو يعتبر anti-allergic هو
+
+479
+00:28:30,440 --> 00:28:32,820
+magic drug، بكرا هتاخدوه في ال pharmacology،
+
+480
+00:28:32,820 --> 00:28:36,220
+بيسموه يعني الدوة الساحر، إله عدة مفعولات يعني
+
+481
+00:28:36,220 --> 00:28:41,020
+إله، فأخدوه اتريح عليه، فنسي الطبيب يقوله بس دي
+
+482
+00:28:41,020 --> 00:28:44,380
+بالك بعد أسبوع بتخفضوا شوي شوي شوي وبعدين بتقطعوا،
+
+483
+00:28:44,380 --> 00:28:48,680
+نسيفظلوا المريض كل ما يتعب ياخد منه ياخد منه فزود
+
+484
+00:28:48,680 --> 00:28:51,460
+طبعا الكورتزولو مربانيا موجود من كتر اللي ما كان
+
+485
+00:28:51,460 --> 00:28:54,420
+ياخد للأسف استمر علي عمر صار جسمه يتنفخ كتير صار
+
+486
+00:28:54,420 --> 00:28:58,100
+عنده severe constipation امسكت شبه دائم بطل يعرف
+
+487
+00:28:58,100 --> 00:29:01,520
+يأكل طبعا صاروا الأطباء يعملوا له nutrition
+
+488
+00:29:01,520 --> 00:29:04,820
+assessment و يحاولوا يعطوه علاجات و يعطوه مغذيات و
+
+489
+00:29:04,820 --> 00:29:07,120
+.. لما يوم الأيام أحد الطلاب الله يرضى ليه و أنا
+
+490
+00:29:07,120 --> 00:29:10,600
+بسط جدا من الجامعة فو هو بيعمل nutrition
+
+491
+00:29:10,600 --> 00:29:14,540
+assessment و بيذكر فمسك الفحصات بتطلع فيهاوبقى
+
+492
+00:29:14,540 --> 00:29:16,980
+سأله سؤال، جاله طب أنت فيه عندك مشكلة؟ جاله والله
+
+493
+00:29:16,980 --> 00:29:20,320
+أنا عندي مشكلة عملت تحليل في تحليل ال بولب دايما
+
+494
+00:29:20,320 --> 00:29:23,260
+بطلع عندي مشاكل عشان مشربش مية كتيرة فجاله ليش؟
+
+495
+00:29:23,260 --> 00:29:26,320
+جاله والله الدواء مرات بتعبني، جاله الدواء إيش؟ ه
+
+496
+00:29:26,320 --> 00:29:29,540
+و بسأله، جاله هذا الدواء طبعا الاختيار مابيعرفش
+
+497
+00:29:29,540 --> 00:29:33,380
+إيش هو اسمه فجاله هذا، طبعا الطالب كان ذكي وشاطر
+
+498
+00:29:33,380 --> 00:29:36,660
+ونجن ومكتوب عليه prednisone عزيزي عشرين ميلي جرام
+
+499
+00:29:36,660 --> 00:29:40,220
+فدغري مباشرة راح للطبيب، الطبيب يعنغ هيك زي يحط
+
+500
+00:29:40,220 --> 00:29:43,550
+إيده على راسوخبط حاله وراح مباشرة وقالله قدش إيه
+
+501
+00:29:43,550 --> 00:29:46,150
+لك في الموضوع هذا؟ قالله لساني قالله حسن من الله
+
+502
+00:29:46,150 --> 00:29:48,930
+ونعم الوكيل طبعا تدارك الموضوع صح، أنا ماقدرش أقول
+
+503
+00:29:48,930 --> 00:29:52,010
+إن هو medical error، ماقدرش أدخل تفاصيل، يمكن كان
+
+504
+00:29:52,010 --> 00:29:55,170
+خطأ، يمكن الطبيب قاله، يمكن نسي، ووقف العلاج
+
+505
+00:29:55,170 --> 00:29:59,950
+والحمد لله انتهت كل القصة عند الطالب، مجرد ما وقف،
+
+506
+00:29:59,950 --> 00:30:03,270
+راح المالي nutrition، راح ال obesity للأسف، راح ال
+
+507
+00:30:03,270 --> 00:30:06,430
+constipation، والحمد لله يعني ما صارش عند المريض
+
+508
+00:30:06,430 --> 00:30:09,520
+أي مشاكل في مبادرة صحيةأنا خلّيني أكمل عشان صار
+
+509
+00:30:09,520 --> 00:30:12,780
+تلاتين دقيقة لإن ما بدي أن اتخطط تلاتين حسب
+
+510
+00:30:12,780 --> 00:30:15,820
+تعليمات الجامعة وإن شاء الله نكمل في المحاضرة
+
+511
+00:30:15,820 --> 00:30:18,560
+القادمة السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc.srt
new file mode 100644
index 0000000000000000000000000000000000000000..9b82ed761403d0ce2ca62932cd553de65f7ebd9f
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc.srt
@@ -0,0 +1,1569 @@
+1
+00:00:01,430 --> 00:00:05,050
+بسم الله الرحمن الرحيم. نبدأ طبعاً في الـ chapter
+
+2
+00:00:05,050 --> 00:00:08,810
+الرابع اليوم، في مساق التقييم الصحي التمريدي
+
+3
+00:00:08,810 --> 00:00:11,830
+الذي يطلب المستوى الثاني، وهو الموضوع الذي هو
+
+4
+00:00:11,830 --> 00:00:18,090
+physical assessment. طبعاً كانت كل الفصول السابقة
+
+5
+00:00:18,090 --> 00:00:23,550
+يعني هي بمثابة مقدمات أساسية من الـ psycho والـ
+
+6
+00:00:23,550 --> 00:00:27,810
+social، وشوية spiritual،  زي ما احنا قلنا assessment.
+
+7
+00:00:27,810 --> 00:00:32,940
+واحنا حكينا أنّه في حاجة بدنا نبدأ شوية في الـ bio
+
+8
+00:00:32,940 --> 00:00:36,160
+عشان نتوسع أكثر، اللي هو شغلنا الأساسي في
+
+9
+00:00:36,160 --> 00:00:39,580
+المستشفيات والمرافق الصحية، إن شاء الله لما نعود، و
+
+10
+00:00:39,580 --> 00:00:43,120
+نتدرب إن شاء الله في الأيام القادمة بإذن الله.
+
+11
+00:00:43,120 --> 00:00:47,320
+الآن، أول شيء بدنا نقول كلمة health assessment، نذكر
+
+12
+00:00:47,320 --> 00:00:50,180
+تذكير أن هنا في health assessment، وهنا في
+
+13
+00:00:50,180 --> 00:00:52,100
+physical. الـ physical جزء من الـ health assessment.
+
+14
+00:00:52,100 --> 00:00:55,300
+خليكوا ذاكرين، احنا قلنا الـ health assessment يعني
+
+15
+00:00:55,300 --> 00:00:58,860
+complete assessment،  بيدخل فيها كل  الـلقاءات
+
+16
+00:00:58,860 --> 00:01:02,480
+الصحية. هو بتأخذ حاجة بيسموها holistic approach أو
+
+17
+00:01:02,480 --> 00:01:07,200
+يعني بيسموها، يعني إيش؟ التقييم الشمولي. أما التقييم
+
+18
+00:01:07,200 --> 00:01:10,260
+الفيزيائي هو جزء، يعني التقييم البيولوجي أو
+
+19
+00:01:10,260 --> 00:01:15,240
+التقييم الحيوي. طيب، الـ objectives هنا، ليش احنا
+
+20
+00:01:15,240 --> 00:01:18,680
+بنعملها؟ أول حاجة، في عندنا five assessment
+
+21
+00:01:18,680 --> 00:01:21,600
+techniques during physical examination. بنكون
+
+22
+00:01:21,600 --> 00:01:23,940
+عارفين إيش الـ assessment techniques اللي احنا إن
+
+23
+00:01:23,940 --> 00:01:27,340
+شاء الله هنحكي فيها لقدام شوية، وكيف بنعمل إيه؟
+
+24
+00:01:27,340 --> 00:01:30,880
+خاصة لما نقول إننا بنستخدم... يعني، واحنا بنعمل
+
+25
+00:01:30,880 --> 00:01:34,800
+تقييم في five skills. يمكن في بعض الكتب تكتب أربعة.
+
+26
+00:01:34,800 --> 00:01:37,320
+لما كده، قولنا بتبدأ من عند الـ inspection,
+
+27
+00:01:37,540 --> 00:01:40,260
+palpation, percussion, auscultation. ولكن احنا
+
+28
+00:01:40,260 --> 00:01:43,820
+قلنا فيه كمان، احنا هنضيف طريقة اسمها olfaction، اللي
+
+29
+00:01:43,820 --> 00:01:47,920
+هي assessment by the... إيه؟ by smelling for something
+
+30
+00:01:47,920 --> 00:01:52,460
+or abnormal odors from the clients. طيب، يعني اللي
+
+31
+00:01:52,460 --> 00:01:56,580
+بيطلع الروائح اللي مش تمام من المريض. الآن بدنا نعمل
+
+32
+00:01:56,580 --> 00:01:59,240
+differences between subjective and objective data.
+
+33
+00:01:59,240 --> 00:02:02,120
+واحنا بنؤكد كتير، إن هي صارت مذكورة الكلمة، لأن كتير
+
+34
+00:02:02,120 --> 00:02:05,900
+حتى في الامتحانات بكرة، في المستقبل، في توظيف وغيره،
+
+35
+00:02:05,900 --> 00:02:08,120
+بيدققوا على موضوع الـ subjective والـ objective، و
+
+36
+00:02:08,120 --> 00:02:10,680
+انتوا ما شاء الله صرتوا فاهمين إيش اللي بنقصده
+
+37
+00:02:10,680 --> 00:02:14,180
+بالضبط. يعني، بكل ما نذكر كلمة subjective data و
+
+38
+00:02:14,180 --> 00:02:16,200
+objective data. objective بنقدر نجيب الـ subjective،
+
+39
+00:02:16,200 --> 00:02:20,720
+بنقدرش، وبنسمعها من المريض. immediate and mediate
+
+40
+00:02:20,720 --> 00:02:24,580
+percussion technique. هنستخدم ونتعلم حاجة في الـ
+
+41
+00:02:24,580 --> 00:02:29,890
+percussion، اسمها إيه؟ النقر. اسمها التقييم بالنقر. في
+
+42
+00:02:29,890 --> 00:02:35,690
+حساب مدة النقر المباشر، وفي أشهر مديات عن طريق... يعني مش
+
+43
+00:02:35,690 --> 00:02:40,230
+مباشرة على الجلد. ممكن نستخدم... نحط إصبع، زي ما الطبيب
+
+44
+00:02:40,230 --> 00:02:46,110
+بيحط مرات إصبع فوق إصبع، وممكن في بعض الأحوال... يعني
+
+45
+00:02:46,110 --> 00:02:50,150
+زي من فوق الملابس. five percussion sounds. لازم نفهم
+
+46
+00:02:50,150 --> 00:02:55,720
+أنّه في عندنا خمس أصوات بتطلع عن طريق الـ percussion،
+
+47
+00:02:55,720 --> 00:02:59,800
+وكأنّه بيقول لي في خمس أصوات بتطلع من الـ different
+
+48
+00:02:59,800 --> 00:03:04,160
+regions، من المناطق اللي في جسم الإنسان. يعني مش كل
+
+49
+00:03:04,160 --> 00:03:08,280
+صوت بيطلع زي... يعني مثلاً لو نقرنا على الإيد، مش زي
+
+50
+00:03:08,280 --> 00:03:11,760
+ما ننقر على الـ abdomen، على البطن، مش زي ما ننقر على
+
+51
+00:03:11,760 --> 00:03:15,300
+الـ chest، مش زي ما ننقر مثلاً على الـ head، اللي هو الـ
+
+52
+00:03:15,300 --> 00:03:18,460
+skull. يعني اللي بنتكلم فيه، كل صوت يختلف عن الثاني.
+
+53
+00:03:19,040 --> 00:03:21,840
+فبقول كمان هنا، بدنا نستخدم إيش هنا؟ الـ stethoscope.
+
+54
+00:03:21,840 --> 00:03:24,820
+أكيد طبعاً، لأنّه استخدام أساسي في الـ assessment.
+
+55
+00:03:24,820 --> 00:03:28,920
+equipment preparation for health assessment.
+
+56
+00:03:28,920 --> 00:03:33,660
+تحضير كل الأدوات، وإن شاء الله بنعود للجامعة، و
+
+57
+00:03:33,660 --> 00:03:36,700
+هتشوفوا بعض الأدوات اللي بنحكي عنها لما نذكرها.
+
+58
+00:03:36,700 --> 00:03:40,660
+ربما يكون شغل جديد عليكم، وربما... يعني تكون حاجات
+
+59
+00:03:40,660 --> 00:03:43,180
+غريبة، لو حاجة حتى غريبة عليكم، وأنت ما اطلعت
+
+60
+00:03:43,180 --> 00:03:47,680
+مالقيتش أو ما قدرت تساعدها. بإمكانك أي procedure
+
+61
+00:03:47,680 --> 00:03:51,300
+أو أي skills، أو أي instrument، أداة أنا باستخدامها.
+
+62
+00:03:51,300 --> 00:03:54,820
+زي أول حاجة، وهقولك اسمها Tuning Fork. Tuning Fork.
+
+63
+00:03:54,820 --> 00:03:57,420
+اسمها الشوكة الرنانة. أنت لو كتبت الشوكة الرنانة،
+
+64
+00:03:57,420 --> 00:04:00,400
+بيجيك كيف شكلها، وكيف منظرها. يعني أنا قصدي، بدناش
+
+65
+00:04:00,400 --> 00:04:03,440
+الشغلات توقفنا، وكأنّ احنا مش عارفين بالظبط إيش
+
+66
+00:04:03,440 --> 00:04:07,280
+اللي احنا بنشرح عنه. الـ Pyrosis. الغرض الأساسي أول
+
+67
+00:04:07,280 --> 00:04:11,440
+حاجة، a certain client's level of... التقييم،  جوديش حالة
+
+68
+00:04:11,440 --> 00:04:14,540
+الصحية للمريض اللي أمامك. من ناحية إيش هنا؟
+
+69
+00:04:14,540 --> 00:04:17,640
+physiological function. إيش يعني؟ يعني التقييم
+
+70
+00:04:17,640 --> 00:04:21,530
+الفيزيولوجي، إيه؟ لأنّ احنا في عندنا إشكالية، مش هندخل
+
+71
+00:04:21,530 --> 00:04:24,870
+لأن لا في psychology ولا في sociology. أنا بتكلم من
+
+72
+00:04:24,870 --> 00:04:29,690
+إنّ في الـ physical examination، تركيزي أكثر، أكثر شيء
+
+73
+00:04:29,690 --> 00:04:33,350
+على الناحية الفيزيولوجية اللي هي الجسدية. identify
+
+74
+00:04:33,350 --> 00:04:36,690
+important factors. شوف إيش العوامل المهمة اللي بتأثر
+
+75
+00:04:36,690 --> 00:04:40,370
+على صحة المريض، وهي إيش اللي لازم تذكر، وليه حاجات
+
+76
+00:04:40,370 --> 00:04:44,250
+مش لازم تذكر. confirm alterations، تغييرات
+
+77
+00:04:44,250 --> 00:04:48,330
+diseases or inability to perform. إيش اختصار هذا؟
+
+78
+00:04:48,330 --> 00:04:51,890
+ذاكرين أنتو في سنة أولى؟ activity of daily living.
+
+79
+00:04:51,890 --> 00:04:54,870
+اللي هو الأنشطة اليومية. يعني بدنا نأكد اللي بيقوم
+
+80
+00:04:54,870 --> 00:04:57,670
+بيه المريض، هو الإنسان الطبيعي. بدنا نأكد إيش
+
+81
+00:04:57,670 --> 00:05:00,330
+الأشياء اللي بيقوم بيها الإنسان بشكل طبيعي في
+
+82
+00:05:00,330 --> 00:05:03,810
+حياته. هل قادر يقوم بيها ولا مش قادر؟ عشان أقدر أعمل
+
+83
+00:05:03,810 --> 00:05:07,690
+تقييم. identify. النقطة اللي بعدها، اللي رقم 4،
+
+84
+00:05:07,690 --> 00:05:11,230
+identify need for additional testing examination.
+
+85
+00:05:11,230 --> 00:05:16,590
+بيخليني أحدد هل نحتاج أكثر واختبارات، وأفحصات
+
+86
+00:05:16,590 --> 00:05:19,630
+أكثر ولا لأ؟ يعني أنا وأنا بعمل assessment، يمكن
+
+87
+00:05:19,630 --> 00:05:24,150
+ألاقي شيء  يلفت نظر الطبيب، الطبيب الاختصاصي أو الـ
+
+88
+00:05:24,150 --> 00:05:26,030
+instructor اللي معايا. فبروحت بيقول لأ، والله دي ما
+
+89
+00:05:26,030 --> 00:05:28,910
+انتبهنا لها. خلينا نحكي للطبيب الاختصاصي. بنحكي
+
+90
+00:05:28,910 --> 00:05:31,570
+للطبيب الاختصاصي. بيجي إيه؟ بيجي يعمل further
+
+91
+00:05:31,570 --> 00:05:34,710
+examination، عشان يعمل إيش؟ يعني زي ما يسمونه
+
+92
+00:05:34,710 --> 00:05:38,030
+explanation، more explanation، توضيح أكثر، for the
+
+93
+00:05:38,030 --> 00:05:43,470
+case.  يساعد في evaluating outcome وفي
+
+94
+00:05:43,470 --> 00:05:46,570
+treatment.  بشكل دائم، الـ assessment، بيساعد الطبيب
+
+95
+00:05:46,570 --> 00:05:52,970
+كمان في تقييم مدى تقدم حالة المريض، ومدى استجابة
+
+96
+00:05:52,970 --> 00:05:56,510
+المريض للعلاج. هل استجاب؟ هل ما استجابش؟ عشان إذا ما
+
+97
+00:05:56,510 --> 00:06:02,240
+استجابش، إذا ما استجابش، طبعاً... يعني المساعدة إنّ أنا
+
+98
+00:06:02,240 --> 00:06:06,400
+باجي مرات بشوف، يمكن أنا عطيت علاج معين لمريض معين،
+
+99
+00:06:06,400 --> 00:06:10,540
+ما استجابش له، أو المريض استجاب بس عنده side
+
+100
+00:06:10,540 --> 00:06:13,580
+effect. فبنقدر ننقل هذه المعلومات لمين؟ للطبيب
+
+101
+00:06:13,580 --> 00:06:16,840
+المعالِج. بقى أنا بالـ assessment تبعتي، بقدر أنقل
+
+102
+00:06:16,840 --> 00:06:21,780
+معلومات ما انتبه لهاش الطبيب لما مرّ على المريض في
+
+103
+00:06:21,780 --> 00:06:26,180
+... خلال دخوله في القسم. طيب، في النهاية، الـ subjective
+
+104
+00:06:26,180 --> 00:06:27,960
+and objective، ذات اللي احنا حكينا عنها، ما بدنا
+
+105
+00:06:27,960 --> 00:06:30,600
+نحكي فيها كتير، لأنّه حكيناها كتير. خلاص، دائماً نقول
+
+106
+00:06:30,600 --> 00:06:33,940
+الـ subjective نتكلم عن الـ history، يعني بشكل عام،
+
+107
+00:06:33,940 --> 00:06:38,800
+إيش المريض اللي قدامي بيحكي لي؟ شو بيحكي لي؟ يعني أنا
+
+108
+00:06:38,800 --> 00:06:41,780
+بنفس الوقت، إيش أنا؟ الـ objective، أنا exam، يعني
+
+109
+00:06:41,780 --> 00:06:46,520
+أنا باكتشف، أنا قدامه وقاعد بسمع له، لكن باكتشف إنّه
+
+110
+00:06:46,520 --> 00:06:49,440
+عنده مشكلة، واحد، اثنين، ثلاثة. الاكتشاف هذا اللي أنا
+
+111
+00:06:49,440 --> 00:06:52,920
+اكتشفته، بسمّيه objective. الكلام اللي هو حكى له،
+
+112
+00:06:52,920 --> 00:06:57,040
+بسمّيه subjective. طيب، possible client position
+
+113
+00:06:57,040 --> 00:07:01,710
+during an examination. إيش الأوضاع اللي ممكن
+
+114
+00:07:01,710 --> 00:07:06,250
+استخدمها في الـ assessment للمريض؟ طبعاً أنا مش هشرح
+
+115
+00:07:06,250 --> 00:07:09,270
+بزيادة الآن على الأوضاع، اللي أنا بس هذكرها، وإن شاء
+
+116
+00:07:09,270 --> 00:07:13,910
+الله في الـ chapter القادم، هحكي بالضبط طبيعة
+
+117
+00:07:13,910 --> 00:07:18,810
+الأوضاع، وكل وضع، إيش بقدر أعمله examination. طيب،
+
+118
+00:07:18,810 --> 00:07:24,290
+الآن، يمكن هذه الصورة بتوضح لنا كتير كويس حاجات، هي
+
+119
+00:07:24,290 --> 00:07:29,090
+يعني وإن كانت مش كاملة 100%. يعني مثلاً ما فيش لو
+
+120
+00:07:29,090 --> 00:07:33,310
+لاحظتوا، ما فيش standing position. لاحظوا الأوضاع هذه،
+
+121
+00:07:33,310 --> 00:07:36,390
+فيها أول موضوع اسمه Dorsal recumbent position.
+
+122
+00:07:36,390 --> 00:07:41,810
+Dorsal recumbent position. بعدين Supine position.
+
+123
+00:07:41,810 --> 00:07:44,370
+اللي بعدها Supine position، اللي هو النوم على الظهر.
+
+124
+00:07:44,370 --> 00:07:48,430
+بعدين إيش هنا؟ الـ sitting position، اللي هو الجالس.
+
+125
+00:07:48,430 --> 00:07:52,710
+الـ Lithotomy position، أو بيسموها، اللي هو وضع الولادة.
+
+126
+00:07:52,710 --> 00:07:55,570
+Sims position، اللي هو النوم على اليسار، وانتوا
+
+127
+00:07:55,570 --> 00:08:00,640
+عارفينه، اللي هو فرد شوية الرجل اليسرى تحتانية مع ثاني
+
+128
+00:08:00,640 --> 00:08:04,440
+الرجل اليمنى. وطبعاً بيكون عامل إيش؟ إمالته و
+
+129
+00:08:04,440 --> 00:08:07,960
+بيكون إيش؟ فيه وسادة بسيطة، يعني زي مخدة بسيطة تحت إيه؟
+
+130
+00:08:07,960 --> 00:08:11,440
+تحت رأسه. prone position، يعني النوم على البطن، طبعاً
+
+131
+00:08:11,440 --> 00:08:14,780
+أنا مش هندخل في التفاصيل دقيقة، لكن بدي أقول إنّه
+
+132
+00:08:14,780 --> 00:08:18,980
+هاي قدامنا الأوضاع. لما نقول، ناخد مثال، area
+
+133
+00:08:18,980 --> 00:08:21,640
+assisted. يعني أنت إيش بتأخذ، بتقيم... يعني في الـ
+
+134
+00:08:21,640 --> 00:08:24,420
+recumbent position مثلاً، أو في الـ dorsal recumbent
+
+135
+00:08:24,420 --> 00:08:28,260
+position، بقدر أقيم الـ head، صحيح؟ لأنّه مبين الـ head و
+
+136
+00:08:28,260 --> 00:08:30,600
+الـ neck، والـ axilla، والـ anterior thorax، الصدر من
+
+137
+00:08:30,600 --> 00:08:33,600
+الأمام، والـ lungs، والـ breast، والـ heart، والـ
+
+138
+00:08:33,600 --> 00:08:36,840
+extremities، والـ peripheral، برضه كله، الـ pulses، و
+
+139
+00:08:36,840 --> 00:08:40,500
+الغيره، كله بقدر أعمله. لكن لو واحد حكى لي، نقدر
+
+140
+00:08:40,500 --> 00:08:44,780
+نعمل assessment مثلاً للـ buttocks؟ نقدرش. نقدر نعمل
+
+141
+00:08:44,780 --> 00:08:49,560
+assessment مثلاً للـ back؟ نقدرش. نقدر نعمل مثلاً في الـ
+
+142
+00:08:49,560 --> 00:08:53,560
+posterior of the neck، برضه. يبقى في أشياء نعملها، وفي
+
+143
+00:08:53,560 --> 00:08:56,330
+أشياء ما نعملهاش. طيب، لما بقول هنا quotients، إيش
+
+144
+00:08:56,330 --> 00:08:59,510
+يعني quotients؟ يعني هو كأنّه بيقول لي، انتبه في بعض
+
+145
+00:08:59,510 --> 00:09:04,170
+الأشياء هتتعبك وأنت بتعمل assessment لهذا الوضع،
+
+146
+00:09:04,170 --> 00:09:08,730
+هتتعبك بأمرين، إما أن أنت مش قادر تصل للعضو، أو أن
+
+147
+00:09:08,730 --> 00:09:12,570
+المريض نفسه مش قادر يكون يحافظ على نفسه بهذا
+
+148
+00:09:12,570 --> 00:09:16,850
+الوضع، فعشان هيك بدك تكون واخد quotient، احتياطات،
+
+149
+00:09:16,850 --> 00:09:20,410
+زي إيش هنا؟ زي أنا، Contraindicated، ممكن يكون ممنوع
+
+150
+00:09:20,410 --> 00:09:23,730
+للناس اللي عندهم مين؟ cardiopulmonary problems،
+
+151
+00:09:23,730 --> 00:09:26,970
+يعني إيش؟ يعني اللي عنده مشاكل في القلب والرئتين،
+
+152
+00:09:26,970 --> 00:09:31,730
+يعني ما بيقدرش يتنفس كويس، وعنده فشل في عضلة القلب،
+
+153
+00:09:31,730 --> 00:09:36,170
+ما بيقدرش ينام هذه النومة، لأنّه وكأنّك بتضغط على القلب
+
+154
+00:09:36,170 --> 00:09:39,590
+أكثر، وبتجيب الـ load كله في اتجاه القلب، واتجاه
+
+155
+00:09:39,590 --> 00:09:43,440
+الصدر. عشان هيك ما بيقدرش. هيجي بيقول كمان not used for
+
+156
+00:09:43,440 --> 00:09:46,720
+abdomen، إيش كمان؟ ولا بتقدر تعمل assessment للـ
+
+157
+00:09:46,720 --> 00:09:50,600
+abdominal muscles، أو للـ abdominal organs، ليه؟
+
+158
+00:09:50,600 --> 00:09:54,140
+لأنّه أصلاً احنا لما... يعني increased tension of
+
+159
+00:09:54,140 --> 00:09:57,140
+abdominal، إيش شو يعني increased tension؟ أنت كأنّك
+
+160
+00:09:57,140 --> 00:10:01,460
+زودت، لما الإنسان بينام على ظهره وبيثني رجليه بهذا
+
+161
+00:10:01,460 --> 00:10:05,220
+الشكل، زي ما أنتم شايفين، بتلاقي بتضغط على عضلات
+
+162
+00:10:05,220 --> 00:10:08,960
+بطنه، غير لما يكون الإنسان مرتاح على ظهره، وما مدد
+
+163
+00:10:08,960 --> 00:10:13,000
+رجليه، و فاردها زي هذا الشكل، فبكون البطن واخد راحته.
+
+164
+00:10:13,000 --> 00:10:16,860
+يبقى معناته هنا، بقدر أعمل... يعني description هنا،
+
+165
+00:10:16,860 --> 00:10:18,980
+طبعاً العمود ده مش هحسّه، لأنّه موجود، أيام هو
+
+166
+00:10:18,980 --> 00:10:23,420
+يعني الوضع إيه؟ أمامنا. يعني كيف بيوصف الوضع؟ نيجي
+
+167
+00:10:23,420 --> 00:10:26,900
+نضرب مثال، مثلاً الـ setting. معلش، sorry. نيجي نضرب
+
+168
+00:10:26,900 --> 00:10:30,310
+مثلاً الـ setting. مثلاً بيقول لي الـ setting، أنت ممكن
+
+169
+00:10:30,310 --> 00:10:33,630
+تعمل assessment ليه؟ للـ head، تمام؟ والـ neck، والـ
+
+170
+00:10:33,630 --> 00:10:36,650
+posterior، والـ anterior thorax، يعني من قدام ومن
+
+171
+00:10:36,650 --> 00:10:42,530
+ورا، والـ lungs كمان، والـ breast، والـ axilla. طيب، الـ
+
+172
+00:10:42,530 --> 00:10:46,51
+
+223
+00:13:51,960 --> 00:13:55,100
+مكتوب Speculum وهنلاقي مرات هذه الكلمة كمان
+
+224
+00:13:55,100 --> 00:13:58,920
+Speculum لما نسمع كلمة Speculum إذا حد بتذكر معايا
+
+225
+00:13:58,920 --> 00:14:02,560
+الزردية اللي بنستخدمها أو الجطاعة زي ما بتعرفوها
+
+226
+00:14:02,560 --> 00:14:07,220
+في البيوت لما بنضغط عليها بتسكر من قدام هذه اللي
+
+227
+00:14:07,220 --> 00:14:09,640
+بيسموها ذردية أو يعني أي شيء بيستخدمها زي
+
+228
+00:14:09,640 --> 00:14:12,780
+الكهربائيين وغيرهم لكن لما نقول كلمة speculum
+
+229
+00:14:12,780 --> 00:14:16,600
+العكس لما نضغط عليها بتفتح لما نضغط عليها بتفتح
+
+230
+00:14:16,600 --> 00:14:19,760
+اللي لاحظته زي أنا مثلا لاحظوا هنا لو بتستخدموها أنا
+
+231
+00:14:19,760 --> 00:14:24,540
+بتضيق المسافة أكثر بتفتح المسافة من هنا أكثر اللي
+
+232
+00:14:24,540 --> 00:14:27,740
+بدي أتأكد بروح اليوتيوب الـ speculum ده بنستخدمه
+
+233
+00:14:27,740 --> 00:14:30,700
+لأن الأنف عشان مرات أنا بدي أشوف من جوا ف أنا
+
+234
+00:14:30,700 --> 00:14:32,920
+مقدرش أشوف الـ cavity من جوا إلا عن طريق ما أفتح
+
+235
+00:14:32,920 --> 00:14:36,580
+الأنف أكثر أُفثالموسكوب يعني من أُذن أيه؟
+
+236
+00:14:36,580 --> 00:14:40,740
+أُفثالموسكوب من أُذن العين أوتوسكوب أوتو أوتو كلمة
+
+237
+00:14:40,740 --> 00:14:43,580
+لاتنين معناها إيه يعني الـ air اللي هو الـ air يعني
+
+238
+00:14:43,580 --> 00:14:47,820
+اللي هو من أُذن الأذن وليه طبعا عدة مجسات عشان نفحص
+
+239
+00:14:47,820 --> 00:14:50,620
+الصغير والكبير والميل والأنثى الـ
+
+240
+00:14:50,620 --> 00:14:53,400
+percussion بيسموه اللي هو الشكوش اللي بنستخدمه
+
+241
+00:14:53,400 --> 00:14:57,980
+خاصة لإيه؟ للـ reflex الاستجابات العصبية أنه كيف هل
+
+242
+00:14:57,980 --> 00:15:01,100
+في استجابة هل في الأطراف في مشكلة بيبقوا اللي
+
+243
+00:15:01,100 --> 00:15:05,500
+يستجيب الإنسان Tuning fork الشوكة الرنانة نريد أن
+
+244
+00:15:05,500 --> 00:15:09,680
+نشوف قدرة السماع هل يستطيع المريض أن يسمع الذبذبات
+
+245
+00:15:09,680 --> 00:15:13,440
+حول ذهنه.. أذنه بيسمع اليمين والشمال يبعث؟ طبعا هو
+
+246
+00:15:13,440 --> 00:15:17,300
+صح مش شغلنا لكن من باب المعرفة يعني الـ vagina ناسب
+
+247
+00:15:17,300 --> 00:15:19,660
+الكلام اللي هو هذا بنستخدمه في حالة الـ vagina
+
+248
+00:15:19,660 --> 00:15:23,320
+examination للستات وخاصة لما نبدأ نستخدم حاجة
+
+249
+00:15:23,320 --> 00:15:27,160
+بسمها DNC DNC اختصار اسمه dilatation and
+
+250
+00:15:27,160 --> 00:15:32,180
+curettage للمريضات اللي بيصير معاهم في بداية الحمل و
+
+251
+00:15:32,180 --> 00:15:35,220
+بتجهد الست يعني مثلا إن ده abortion اسمعوا
+
+252
+00:15:35,220 --> 00:15:38,520
+بالعامية بيقولوا راحت تعمل عملية تنظيفات فلازم
+
+253
+00:15:38,520 --> 00:15:42,100
+يعملوا يعني يوسعوا المكان عشان يقدر الطبيب يعمل
+
+254
+00:15:42,100 --> 00:15:45,320
+التنظيف cotton application كلكوا عارفينه يعني اللي
+
+255
+00:15:45,320 --> 00:15:48,960
+هو زي الـ cotton stick اللي بيكون مرات بنباع بس مش
+
+256
+00:15:48,960 --> 00:15:52,840
+زي اللي بنباع في الأسواق هذا بيكون مكان شوية و
+
+257
+00:15:52,840 --> 00:15:55,780
+طويل اللي هو عشان ممكن ناخد فيه مساحات على طرفه
+
+258
+00:15:55,780 --> 00:16:01,140
+بيكون يعني زي عود وعلى طرفه قطن يعني فيه هنا الـ pads
+
+259
+00:16:01,140 --> 00:16:04,060
+اللي هو يعني بنستخدم زي الأنسجة أو بنستخدم زي
+
+260
+00:16:04,060 --> 00:16:11,160
+اللفافة معينة أو بنستخدم مثلا جاز عشان نقدر إذا كان
+
+261
+00:16:11,160 --> 00:16:14,320
+فيه solution أو كده ممكن يعني ناخد احتياطاتنا اللي
+
+262
+00:16:14,320 --> 00:16:16,440
+بعدها gloves كلكوا عارفينه بتقولوا إنتوا لبستوا كيف
+
+263
+00:16:16,440 --> 00:16:20,080
+استرال واتعلمتوا كيف طريقته في سنة أولى في طبعا
+
+264
+00:16:20,080 --> 00:16:24,220
+نوعين استرال وأنسترال هنا الـ lubricant يعني الملين
+
+265
+00:16:24,220 --> 00:16:30,210
+سواء كان زي الكيلاك جل اسمه أو يعني أي lubricant
+
+266
+00:16:30,210 --> 00:16:33,530
+جيل بشكل عام بدون الأسماء بنستخدمه في بعض الحالات
+
+267
+00:16:33,530 --> 00:16:38,070
+لأنه ممكن نحتاجه وإحنا بنعمل examination طبعا الـ
+
+268
+00:16:38,070 --> 00:16:43,670
+tongue depressor اللي هو كلكوا عارفينه لما نيجي
+
+269
+00:16:43,670 --> 00:16:47,750
+بنفحص الفم من جوا بنضطر نجيب الـ tongue depressor
+
+270
+00:16:47,750 --> 00:16:51,690
+عشان إيه؟ يعني نحاول نُخفض اللسان نضغط على اللسان
+
+271
+00:16:51,690 --> 00:16:56,270
+لتحت عشان نفحص الـ  oropharynx اللي جوا
+
+272
+00:16:56,270 --> 00:16:58,770
+indications for physical examination ليه يا دكتور؟
+
+273
+00:16:58,770 --> 00:17:02,850
+أنا بعمل physical examination طبعا أنا بعمل أول
+
+274
+00:17:02,850 --> 00:17:06,270
+حاجة routine screening إيه routine يعني البناء
+
+275
+00:17:06,270 --> 00:17:08,130
+الأساسي اللي إحنا حكينا هذا الكلام في البداية
+
+276
+00:17:08,130 --> 00:17:13,290
+يحاول دائما يتذكر نفسه علشان يظلوا دائما يعني صحته
+
+277
+00:17:13,290 --> 00:17:17,430
+مناسبة ويحافظ عليها إذا صار أي شيء يعني ممكن بعض
+
+278
+00:17:17,430 --> 00:17:21,110
+خاصة كبار السن بدأ عندهم أمراض أو أمراض وراثية في
+
+279
+00:17:21,110 --> 00:17:25,060
+العائلة بنضطر نعملهم دائما routine examination هنا
+
+280
+00:17:25,060 --> 00:17:27,960
+بقول الـ eligibility الـ eligibility معناته الأهلية
+
+281
+00:17:27,960 --> 00:17:31,120
+prerequisite لما تقول الـ prerequisite يعني المتطلب
+
+282
+00:17:31,120 --> 00:17:33,940
+السابق للـ health insurance أو military military
+
+283
+00:17:33,940 --> 00:17:37,540
+يعني إيه؟ للعسكرية أو job أو يعني المهن أو الـ
+
+284
+00:17:37,540 --> 00:17:42,840
+sports school يعني باختصار أو المدارس يستخدم الفحص
+
+285
+00:17:42,840 --> 00:17:46,600
+الصحي زي الـ occupational إحنا حكينا عليه زي ما في
+
+286
+00:17:46,600 --> 00:17:51,190
+بداية المحاضرات الأولى والثانية أنه كمان يستخدموا
+
+287
+00:17:51,190 --> 00:17:56,050
+زي قبل وظيفة معينة قبل رياضة قبل اجتياز دور
+
+288
+00:17:56,050 --> 00:18:00,750
+عسكري وهكذا أو لتأمين admission to hospital لما
+
+289
+00:18:00,750 --> 00:18:05,610
+يدخل أي إنسان على المستشفى وخاصة إذا هو يعني أول
+
+290
+00:18:05,610 --> 00:18:10,130
+مرة بيجي عندنا هيظل معنا long-term care facility
+
+291
+00:18:10,130 --> 00:18:14,190
+يعني زي مريض سكر أول مرة اكتشفناه مريض ضغط فبنضطر
+
+292
+00:18:14,190 --> 00:18:17,570
+إحنا في هذه الحالة أن نعمله complete physical
+
+293
+00:18:17,570 --> 00:18:22,430
+examination عشان يظلوا يعني عارفين بداية الوضع كيف
+
+294
+00:18:22,430 --> 00:18:27,030
+كان عندهم نبدأ نقارن فيه ما بعد طيب بقول أنا steps
+
+295
+00:18:27,030 --> 00:18:30,090
+of assessment إيه الخطوات أول حاجة في الـ
+
+296
+00:18:30,090 --> 00:18:33,130
+assessment think إيه يعني think يعني فكر يعني كأنه
+
+297
+00:18:33,130 --> 00:18:36,570
+بقول ما تهجمش على المريض قبل ما إنت تكون فكر إيه
+
+298
+00:18:36,570 --> 00:18:41,620
+اللي بدك تعمله organize نظم إيه بقول أنا don't
+
+299
+00:18:41,620 --> 00:18:44,600
+forget ما تنسى لا الـ nutrition ولا الـ weight ولا الـ
+
+300
+00:18:44,600 --> 00:18:47,860
+weight إحنا حكينا عنها يا إنك تاخد طوله ووزنه و
+
+301
+00:18:47,860 --> 00:18:51,420
+تسأله عن وضعه اللي هو الغذائي بشكل عام الـ
+
+302
+00:18:51,420 --> 00:18:54,180
+environment تكون يعني مريحة كويسة ما فيش حد حواليها
+
+303
+00:18:54,180 --> 00:18:58,000
+accommodated specialists إذا احتجنا في بعض الحالات
+
+304
+00:18:58,000 --> 00:19:01,420
+بدك تعمل accommodation accommodation زي تحوير إيه؟
+
+305
+00:19:01,420 --> 00:19:04,640
+يعني تحوير زي adaptation خاصة في الـ cultural
+
+306
+00:19:04,640 --> 00:19:07,340
+sensitivity يعني إمكان أنا بدي أحتاج هقول للمريض
+
+307
+00:19:07,340 --> 00:19:12,390
+كشف بطن ارفع عن رجلك ارفع عن مثلا صدرك يكون فيه
+
+308
+00:19:12,390 --> 00:19:15,230
+نوع من الـ embarrassment يعني إحراج فبدك تكون عامل
+
+309
+00:19:15,230 --> 00:19:17,850
+حاجة بسمها accommodate إيه accommodate يعني نحور
+
+310
+00:19:17,850 --> 00:19:21,430
+أمور نحط ستائر نحط شاشة نبعد الناس حواليها هذه
+
+311
+00:19:21,430 --> 00:19:25,190
+بتريح المريض وأنت بتعمل examination طبعا حط الـ
+
+312
+00:19:25,190 --> 00:19:28,230
+equipment حضرتها a clean surface يكون المكان نظيف
+
+313
+00:19:28,230 --> 00:19:32,430
+a clean equipment كل الأدوات نظيفة الغرفة تكون
+
+314
+00:19:32,430 --> 00:19:37,960
+هادئة تكون دافئة والـ led مضاءة جيدا ما تكونش يعني
+
+315
+00:19:37,960 --> 00:19:43,200
+لا عتمة ولا مضاءة بإضاءة صفراء أو حمراء لازم تكون
+
+316
+00:19:43,200 --> 00:19:49,140
+إضاءة يعني بيضاء تكون ما بتعكسش أي نور على جسم وجلد
+
+317
+00:19:49,140 --> 00:19:53,680
+المريض maintain privacy المحافظة على إيه؟ المحافظة
+
+318
+00:19:53,680 --> 00:19:57,500
+على سرية إيه؟ المريض أكيد طبعا بعدين إيه؟ بقول أنا
+
+319
+00:19:57,500 --> 00:20:00,980
+observe and listen يا ريت بقول إيه؟ إنتوا لاحظين
+
+320
+00:20:00,980 --> 00:20:03,960
+الذاكرين لما كنا في الـ interview هيحكي المريض و
+
+321
+00:20:03,960 --> 00:20:06,840
+هيكون عنده body language وأنا هنا بقول دائما
+
+322
+00:20:06,840 --> 00:20:10,700
+دائما observe and listen صدق الـ observe و يعني الـ
+
+323
+00:20:10,700 --> 00:20:14,100
+listen إن شاء الله كله صادق لكن لو قلنا مين الأصدق
+
+324
+00:20:14,100 --> 00:20:18,660
+دائما نـ observe لأن body language طيب بقول هنا
+
+325
+00:20:18,660 --> 00:20:23,340
+don't forget اوعى تنسى اوعى تنسى أنك تتراجع
+
+326
+00:20:23,340 --> 00:20:25,540
+المعلومات اللي عندك reviewing general information
+
+327
+00:20:25,540 --> 00:20:29,280
+اللي اتخدتها اوعى تنسى أنك تقدم نفسك للمريض
+
+328
+00:20:29,280 --> 00:20:33,460
+introduction اوعى تنسى أنك تاخد health history،
+
+329
+00:20:33,460 --> 00:20:36,660
+اوعى تنسى أنك تعمل pain assessment تقييم للألم،
+
+330
+00:20:36,660 --> 00:20:40,020
+يعني مش معقول يقولك أنا بطني بيوجعني في هذا المكان،
+
+331
+00:20:40,020 --> 00:20:43,260
+تروح تبدأ الـ assessment في إياك، لأنه إنت هيك
+
+332
+00:20:43,260 --> 00:20:47,200
+بتأذي المريض، هذا كله إيه؟ بيسموه key، إيه يعني key
+
+333
+00:20:47,200 --> 00:20:50,120
+مفتاح، زي مفتاح الباب، كله مفتاح للـ holistic
+
+334
+00:20:50,120 --> 00:20:53,500
+approach اللي هو المدخل الشمولي للرعاية
+
+335
+00:20:59,190 --> 00:21:02,470
+five assessment techniques during physical
+
+336
+00:21:02,470 --> 00:21:05,370
+examination وإحنا حكينا ده كلام وإحنا قلنا قولنا
+
+337
+00:21:05,370 --> 00:21:07,150
+إن الكتب هتكتب لنا Inspection, Palpation,
+
+338
+00:21:07,230 --> 00:21:09,930
+Percussion و Percussion لكن إحنا فيه كمان حاجة
+
+339
+00:21:09,930 --> 00:21:12,910
+جديدة اسمها Auscultation ولما نوصل لكلمة Auscultation
+
+340
+00:21:12,910 --> 00:21:15,930
+هتعرفوا إن أنا كده إيه؟ أهمية مرات كتير و
+
+341
+00:21:15,930 --> 00:21:20,930
+إحنا بنعمل assessment طيب خليني أنا يعني هذه
+
+342
+00:21:20,930 --> 00:21:25,090
+الصورة شوية يعني دائما نذكرها ودائما نحطها في
+
+343
+00:21:25,090 --> 00:21:29,270
+ذهننا وفي بالنا شوية وأنا دائما صدقا بجيب عليها
+
+344
+00:21:29,270 --> 00:21:32,270
+الرسالة عشان أكون واضح يعني مش بجيب وأنا بقولك
+
+345
+00:21:32,270 --> 00:21:34,430
+ارسم وأنا بقولك كده هي ممكن إنتوا شايفينها زي
+
+346
+00:21:34,430 --> 00:21:38,550
+الكتيرة أو صور متحركة لكن هذا مهم شوية الـ
+
+347
+00:21:38,550 --> 00:21:41,770
+بيقول أنا واحد first يعني هنا الـ second يعني
+
+348
+00:21:41,770 --> 00:21:45,190
+إثنين هنا الـ third هنا الـ fourth اعتبر إيه؟ هنا
+
+349
+00:21:45,190 --> 00:21:49,070
+اعتبر إن هذه الشنطة اللي قدامكم هو المريض يعني مش
+
+350
+00:21:49,070 --> 00:21:52,770
+هو مش شنطة هو المريض وكتب لنا tools of physical
+
+351
+00:21:52,770 --> 00:21:56,420
+assessment استبعدوا الـ olfaction لأن قلتلكم الكتاب
+
+352
+00:21:56,420 --> 00:21:59,220
+اللي إحنا بنستخدمه الآن ما بيستخدمش olfaction لكن
+
+353
+00:21:59,220 --> 00:22:02,800
+إحنا خلينا نطلع بقول أول حاجة inspection طبعا
+
+354
+00:22:02,800 --> 00:22:07,140
+مجهزة inspection هي رسملي الرسم للنظر العادي
+
+355
+00:22:07,140 --> 00:22:11,780
+والنظر الثاني طب ليه هو حطلي أنا حطلي أنا عدسة هو
+
+356
+00:22:11,780 --> 00:22:14,580
+مش هتحط عدسة يعني كأنه بيقولك الـ inspection أبعد
+
+357
+00:22:14,580 --> 00:22:17,980
+من كلمة النظر العادي يعني الـ inspection أقرب ما
+
+358
+00:22:17,980 --> 00:22:24,690
+يكون لإيه؟ أقرب ما يكون للنظر بالكيان يعني أنه نلاحظ
+
+359
+00:22:24,690 --> 00:22:30,270
+بإحساساتنا ونكون واضحين الرؤية بحيث أنه أي شيء
+
+360
+00:22:30,270 --> 00:22:34,550
+موجود متغير نقدر ننتبه له بعدين application هانا
+
+361
+00:22:34,550 --> 00:22:38,310
+إيه؟ هانا palpation لأ palpation بعدين هانا اللي هو
+
+362
+00:22:38,310 --> 00:22:41,750
+الـ application تطبيق إثنين palpation مد إيدي مد إيدينا
+
+363
+00:22:41,750 --> 00:22:45,250
+إيدينا على الجسم هذا إثنين تلاتة لحظوا percussion
+
+364
+00:22:45,250 --> 00:22:49,080
+النقر ولو قدامكم وحأشرحلكم كيف النقر لاحظين كيف الإيد
+
+365
+00:22:49,080 --> 00:22:52,240
+اليسرى هنا والإيد اليمنى هنا بقى آخر حاجة
+
+366
+00:22:52,240 --> 00:22:55,400
+auscultation لو حد سألنا طب ليه يا أستاذ ما حطوش
+
+367
+00:22:55,400 --> 00:22:59,700
+auscultation قبل؟ لأ دائما إنت لو طلعت ماشي مع الـ
+
+368
+00:22:59,700 --> 00:23:02,620
+skills ماشي من الـ simple للـ difficult الـ
+
+369
+00:23:02,620 --> 00:23:06,860
+inspection كل الناس بتلاحظ الـ palpation يعني معظم
+
+370
+00:23:06,860 --> 00:23:09,260
+الناس اللي دارسين في التمريض وفي الطب وفي العلوم
+
+371
+00:23:09,260 --> 00:23:12,720
+الصحية بقدر يعمل palpation الـ percussion لأ مش أي
+
+372
+00:23:12,720 --> 00:23:16,330
+واحد بيعملها واحد أخصائي الـ auscultation بده.. لأ بده
+
+373
+00:23:16,330 --> 00:23:20,570
+يعني expert خبير عشان هيك خلينا في الآخر عشان هيك
+
+374
+00:23:20,570 --> 00:23:23,690
+مرات حتى لما بنجيء نضغط لمريض بيجي طالب بيقول
+
+375
+00:23:23,690 --> 00:23:26,310
+والله أنا حسيت إنه مش سامع كويس الضغط أو ضغطه
+
+376
+00:23:26,310 --> 00:23:29,870
+مرتفع شوية بروح بنقوله طيب إذا إنت مش سامع خلي
+
+377
+00:23:29,870 --> 00:23:33,290
+غيرك يسمع ليه على اعتبار إنه مش كل واحد عنده الـ
+
+378
+00:23:33,290 --> 00:23:36,330
+auscultation power أو الـ auscultation يعني.. يعني
+
+379
+00:23:36,330 --> 00:23:41,090
+خلينا نقول skill زيها زي الثانية هذه الـ..الـ..الـ
+
+380
+00:23:41,090 --> 00:23:45,220
+.. اللي حكيت عنها اللي هي الترتيب بيستخدم في كل..
+
+381
+00:23:45,220 --> 00:23:50,420
+في كل الجسم إلا..إلا..إلا في إيه؟ شوفوا الكلام
+
+382
+00:23:50,420 --> 00:23:53,840
+البسيط الحلو إلا في حالة الـ abdomen خاصة الـ
+
+383
+00:23:53,840 --> 00:23:55,480
+abdominal tenderness إيه يعني abdominal
+
+384
+00:23:55,480 --> 00:23:59,400
+tenderness؟ يعني لما يكون فيه ألم في البطن، ما نفعش
+
+385
+00:23:59,400 --> 00:24:02,660
+أمد إيدي، إيه صار طيب هنا؟ بقول ياريت تبدأ بالـ
+
+386
+00:24:02,660 --> 00:24:05,980
+inspection، تبدأ من هنا، وأروحلي على الـ
+
+387
+00:24:05,980 --> 00:24:09,540
+auscultation، آجي هنا، يبقى لحظين في الـ abdomen
+
+388
+00:24:09,540 --> 00:24:14,230
+عكس بعضها inspection, auscultation أشياء زي هيك
+
+389
+00:24:14,230 --> 00:24:17,970
+بعدين إيه؟ قالت هالأت percussion ها برجع ع الجوا
+
+390
+00:24:17,970 --> 00:24:21,430
+inspection, palpation بعدين الـ palpation وإيه
+
+391
+00:24:21,430 --> 00:24:24,930
+الآخر واحدة ده ليه مكتوب هنا palpate بتلعب فوق لو
+
+392
+00:24:24,930 --> 00:24:28,150
+حاسس إنه ليه آخر شيء الـ palpation لأنه هيكون مؤلم
+
+393
+00:24:28,150 --> 00:24:31,710
+جدا للمريض هذا في حالة الـ abdominal examination
+
+394
+00:24:31,710 --> 00:24:34,450
+خليكوا ذاكرين في حالة الـ abdominal examination أما
+
+395
+00:24:34,450 --> 00:24:37,650
+في الحالات الطبيعية دقر تذكروا inspection,
+
+396
+00:24:37
+
+445
+00:27:45,700 --> 00:27:51,940
+مشكلة Expose body parts حاول أنك تتعرى و تكشف أجزاء
+
+446
+00:27:51,940 --> 00:27:55,900
+الجسم من المريض اللي بدك تلاحظها Observed only ما
+
+447
+00:27:55,900 --> 00:27:58,780
+بدنا نكشفه يعني مثلاً بدي أعمل assessment للأبدومين
+
+448
+00:27:58,780 --> 00:28:03,120
+ليش أكشف صدره؟ بدي أعمل assessment لل chest بروح
+
+449
+00:28:03,120 --> 00:28:06,300
+بحطّ يدي بالشرشة في الأبدومين وبعدين أعمل بال chest
+
+450
+00:28:06,300 --> 00:28:10,040
+هذا يعطي اطمئنان وأروح للمريض أكثر look before
+
+451
+00:28:10,040 --> 00:28:13,970
+touching دائماً أُطلِع قبل ما أمدّ يدي أجبن ما تمد يدك
+
+452
+00:28:13,970 --> 00:28:18,590
+warm room يعني الغرفة تكون هادئة ودافئة وكويسة not
+
+453
+00:28:18,590 --> 00:28:21,650
+cold not hot  إيش يعني؟ لا هي باردة ولا هي ساخنة
+
+454
+00:28:21,650 --> 00:28:24,570
+ليه؟ لأنّ المرضى إذا كانت باردة مش هيساعد معاك وإذا
+
+455
+00:28:24,570 --> 00:28:27,710
+كانت حامية كثيراً، العرق وكذا مش هيساعدك فاحنا
+
+456
+00:28:27,710 --> 00:28:31,930
+بالتالي بنُخْلِص الغرفة يعني زي ما يسمونها الحرارة
+
+457
+00:28:31,930 --> 00:28:36,370
+المقبولة observe the four colors أُطلِع على الألوان،
+
+458
+00:28:36,370 --> 00:28:39,930
+size الحجم و location texture أو هكذا، سأقول لكم أشياء
+
+459
+00:28:39,930 --> 00:28:44,380
+معناها texture symmetryالتي تسمى التناسب، الـ odors
+
+460
+00:28:44,380 --> 00:28:49,940
+والأصوات، سنتكلم قليلاً في الأمام، سنشرح لكم هذه أيضاً
+
+461
+00:28:49,940 --> 00:28:53,420
+مرة أخرى،  texture  يُسمّى ماذا؟ أن أرى يعني
+
+462
+00:28:53,420 --> 00:28:58,240
+يُسمّى ماذا؟ عندما أعمل يعني palpation of the
+
+463
+00:28:58,240 --> 00:29:01,540
+skin to assess the underlying tissue إيش يعني؟
+
+464
+00:29:01,540 --> 00:29:05,000
+palpation of the skin to assess the underlying of
+
+465
+00:29:05,000 --> 00:29:09,620
+the tissue  أعطيكم مثالاً، يعني لو مسكت الجلد، أنا أُصِبُّ
+
+466
+00:29:09,620 --> 00:29:13,860
+على الجلد، ليس من أجل أن أحسّ الجلد، بل من أجل أن أحسّ ما تحت الجلد
+
+467
+00:29:13,860 --> 00:29:19,100
+مرة أخرى، لو مسكت الجلد لأحسّ ما تحت الجلد، مثل
+
+468
+00:29:19,100 --> 00:29:21,740
+ما يكون واحد يجي يقول لك: بالله لو سمحت تعال شوف
+
+469
+00:29:21,740 --> 00:29:26,160
+أنا حاسس فيه دمامل، أو حاسس فيه كيس دهني، أو حاسس
+
+470
+00:29:26,160 --> 00:29:28,740
+فيه شيء مثل الورم الصغير هذا، تُسمّى هذه الـ texture
+
+471
+00:29:28,740 --> 00:29:32,520
+تمام، اللي هو الملمس الداخلي اللي تحت الجلد، تمام
+
+472
+00:29:32,520 --> 00:29:37,100
+اللي في بعض الحالات يُسمّى elasticity طبعاً أنا اللي
+
+473
+00:29:37,100 --> 00:29:42,260
+قدامك برضه هتُبيّن أكثر معنا compare قارن Each area
+
+474
+00:29:42,260 --> 00:29:45,380
+inspected أنا أشرح بهدوء لأنّنا بدأنا في
+
+475
+00:29:45,380 --> 00:29:50,520
+عملية الـ assessment الحقيقية، بدنا نعمل مقارنة بين الـ
+
+476
+00:29:50,520 --> 00:29:54,280
+inspected and opposite body side كيف يعني؟ يعني إذا
+
+477
+00:29:54,280 --> 00:29:57,180
+أنت عملت assessment  لـ one side، يعني مثلاً عملت في
+
+478
+00:29:57,180 --> 00:30:01,660
+يدِه اليمنى، ما تيجي تقول: لا، فيه عنده مشكلة في يده
+
+479
+00:30:01,660 --> 00:30:05,620
+اليمنى، فيها مشكلة.  استنى، واطلع على اليد اليسرى
+
+480
+00:30:05,620 --> 00:30:09,170
+إذا لقيته نفس الشيء، نعتبره normal هو اكتشف نعتبره
+
+481
+00:30:09,170 --> 00:30:11,770
+abnormal لما يكون فيه big difference between right
+
+482
+00:30:11,770 --> 00:30:15,950
+and left  استخدم اللي هو قلنا الضوء
+
+483
+00:30:15,950 --> 00:30:20,470
+المباشر، عشان الـ body cavities زي الـ mouth وزي الـ
+
+484
+00:30:20,470 --> 00:30:23,890
+nose، وزي مثلاً آآه إذا بدنا نشوفها، وزي إذا بدنا
+
+485
+00:30:23,890 --> 00:30:28,750
+نشوف إذا في لا سمح الله، يعني أي orifice موجودة، زي
+
+486
+00:30:28,750 --> 00:30:31,030
+في حالات الـ deep abscess أو غيره، ممكن نستخدم
+
+487
+00:30:31,030 --> 00:30:33,490
+الإضاءة palpation
+
+488
+00:30:36,310 --> 00:30:41,010
+أنا شايف عشان احنا ما بدناش نتخطى أكثر من نص ساعة، الـ
+
+489
+00:30:41,010 --> 00:30:43,050
+portion  نخليه نكمل إن شاء الله في المحاضرة
+
+490
+00:30:43,050 --> 00:30:45,770
+القادمة إن شاء الله، وتتابعونا، وإن شاء الله
+
+491
+00:30:45,770 --> 00:30:47,950
+تكونوا استفدتم، السلام عليكم ورحمة الله وبركاته
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_postprocess.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..51ac988a7cf96cbbf25b053a52a0bb813d7e1aed
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_postprocess.srt
@@ -0,0 +1,1964 @@
+1
+00:00:01,430 --> 00:00:05,050
+بسم الله الرحمن الرحيم نبدأ طبعا في ال chapter
+
+2
+00:00:05,050 --> 00:00:08,810
+الرابع اليوم في طبعا مساق التقييم الصحي التمريد
+
+3
+00:00:08,810 --> 00:00:11,830
+اللي طلبت المستوى التاني و هو الموضوع اللي هو
+
+4
+00:00:11,830 --> 00:00:18,090
+physical assessment طبعا كانت كل الشباتر السابقة
+
+5
+00:00:18,090 --> 00:00:23,550
+يعني هي بمثابة مقدمات أساسية من ال psycho و ال
+
+6
+00:00:23,550 --> 00:00:27,810
+social و شوية spiritual زي ما احنا قلنا assessment
+
+7
+00:00:27,810 --> 00:00:32,940
+و احنا حكينا انه في حاجةبدنا نبدأ شوية في ال bio
+
+8
+00:00:32,940 --> 00:00:36,160
+عشان نتوسع أكتر اللي هو شغلنا الأساسي في
+
+9
+00:00:36,160 --> 00:00:39,580
+المستشفيات و المرافق الصحية ان شاء الله لما نعود و
+
+10
+00:00:39,580 --> 00:00:43,120
+نتدرب ان شاء الله في الأيام اللي القادمة بإذن الله
+
+11
+00:00:43,120 --> 00:00:47,320
+الآن أول شيء بدنا نقول كلمة health assessment نذكر
+
+12
+00:00:47,320 --> 00:00:50,180
+تذكير ان هنا في health assessment و هنا في
+
+13
+00:00:50,180 --> 00:00:52,100
+physical ال physical جزء من ال health assessment
+
+14
+00:00:52,100 --> 00:00:55,300
+خليكوا ذاكرين احنا قولنا ال health assessment يعني
+
+15
+00:00:55,300 --> 00:00:58,860
+complete assessment بشتركوا فيها كل هى التلقاءات
+
+16
+00:00:58,860 --> 00:01:02,480
+الصحيةهو بتاخد حاجة بيسموها holistic approach او
+
+17
+00:01:02,480 --> 00:01:07,200
+يعني بيسموها يعني ايش التقييم الشمولي اما التقييم
+
+18
+00:01:07,200 --> 00:01:10,260
+الفيزيائي هو جزء يعني التقييم البيولوجيا او
+
+19
+00:01:10,260 --> 00:01:15,240
+التقييم الحيواني طيب ال objectives هنا ليش احنا
+
+20
+00:01:15,240 --> 00:01:18,680
+بنعملها اول حاجة في عندنا five assessment
+
+21
+00:01:18,680 --> 00:01:21,600
+techniques during physical examination بنكون
+
+22
+00:01:21,600 --> 00:01:23,940
+عارفين ايش ال assessment techniques اللي احنا ان
+
+23
+00:01:23,940 --> 00:01:27,340
+شاء الله هنحكي فيها لقدام شويةوكيف بنعمل إيهته
+
+24
+00:01:27,340 --> 00:01:30,880
+مخاصة لما نقول اننا بنستخدم .. يعني و احنا بنعمل
+
+25
+00:01:30,880 --> 00:01:34,800
+تقييم في five skills يمكن في بعض الكتب تكتب أربعة
+
+26
+00:01:34,800 --> 00:01:37,320
+لما كده قولنا تبدأ من عند ال inspection,
+
+27
+00:01:37,540 --> 00:01:40,260
+palpation, percussion, auscultation و لكن احنا
+
+28
+00:01:40,260 --> 00:01:43,820
+قولنا فيه كمان احنا هانا طريقة اسمه olfaction اللي
+
+29
+00:01:43,820 --> 00:01:47,920
+هي assessment by the ايه by smelling for something
+
+30
+00:01:47,920 --> 00:01:52,460
+or abnormal odors from the clients طيب يعني اللي
+
+31
+00:01:52,460 --> 00:01:56,580
+بيطلع الرواقع اللي مش تمام من المريضالان بدنا نعمل
+
+32
+00:01:56,580 --> 00:01:59,240
+differences between subjective and objective data
+
+33
+00:01:59,240 --> 00:02:02,120
+و احنا بنأكد كتير ان صارت مذكورة الكلمة لأن كتير
+
+34
+00:02:02,120 --> 00:02:05,900
+حتى في الامتحانات بكرا في المستقبل في توظيف و غيره
+
+35
+00:02:05,900 --> 00:02:08,120
+بيدقوا على موضوع ال subjective و ال objective و
+
+36
+00:02:08,120 --> 00:02:10,680
+انتوا ما شاء الله صرتوا فاهمين ايش اللي بنقصده
+
+37
+00:02:10,680 --> 00:02:14,180
+بالظبط يعني بكل ما بندقوا كلمة subjective data و
+
+38
+00:02:14,180 --> 00:02:16,200
+objective data objective بنقدر نجيس ال subjective
+
+39
+00:02:16,200 --> 00:02:20,720
+بنقدرش و بنسمعها من المريض immediate and mediate
+
+40
+00:02:20,720 --> 00:02:24,580
+percussion technique هنستخدم و نتعلم حاجة في ال
+
+41
+00:02:24,580 --> 00:02:29,890
+percussionاسمها ليه النقر اسمها التقييم بالنقر في
+
+42
+00:02:29,890 --> 00:02:35,690
+حساب مدية نقر مباشر وفي اشهر مديات عن طريق يعني مش
+
+43
+00:02:35,690 --> 00:02:40,230
+مباشرة على الجلد ممكن نستخدم نحط إصبع زي ما الطبيب
+
+44
+00:02:40,230 --> 00:02:46,110
+بحط مرات إصبع فوق إصبع وممكن في بعض الأحوال يعني
+
+45
+00:02:46,110 --> 00:02:50,150
+زي من فوق الملابس five percussion sounds لازم نفهم
+
+46
+00:02:50,150 --> 00:02:55,720
+أنه في عندناخمس أصوات بتطلع عن طريق ال percussion
+
+47
+00:02:55,720 --> 00:02:59,800
+وكأنه بيقول لي في خمس أصوات بتطلع من ال different
+
+48
+00:02:59,800 --> 00:03:04,160
+regions من المناطق اللي في جسم الإنسان يعني مش كل
+
+49
+00:03:04,160 --> 00:03:08,280
+صوت بيطلع زي .. يعني مثلا لو نقرنا على الإيد مش زي
+
+50
+00:03:08,280 --> 00:03:11,760
+ما ننقر على ال abdomen على البطن مش زي ما ننقر على
+
+51
+00:03:11,760 --> 00:03:15,300
+ال chest مش زي ما ننقر مثلا على ال head اللي هو ال
+
+52
+00:03:15,300 --> 00:03:18,460
+skull يعني اللي بنتكلم فكل صوت يختلف عن التاني
+
+53
+00:03:19,040 --> 00:03:21,840
+فبقول كمان هنا بدنا نستخدم ايش هنا ال status scope
+
+54
+00:03:21,840 --> 00:03:24,820
+أكيد طبعا لأنها استخدام أساسي في ال assessment
+
+55
+00:03:24,820 --> 00:03:28,920
+تبعتنا equipment preparation for health assessment
+
+56
+00:03:28,920 --> 00:03:33,660
+تحضير كل الأدوات و ان شاء الله بنعود للجامعة و
+
+57
+00:03:33,660 --> 00:03:36,700
+هتشوفوا بعض الأدوات اللي بنحكي عنها لما نذكرها
+
+58
+00:03:36,700 --> 00:03:40,660
+ربما يكون شغلة مقلوفة لكم و ربما يعني تكون حاجات
+
+59
+00:03:40,660 --> 00:03:43,180
+غريبة لو حاجة حتى غريبة عليكم و أنت ماتطلعت
+
+60
+00:03:43,180 --> 00:03:47,680
+مالاقيتش او ماجدرتش تساعدها بإمكانك اي procedure
+
+61
+00:03:47,680 --> 00:03:51,300
+او اي skillsأو أي instrument اداية انا باستخدامها
+
+62
+00:03:51,300 --> 00:03:54,820
+زي بكر حاجة و هقولك اسمها Tuning Fork Tuning Fork
+
+63
+00:03:54,820 --> 00:03:57,420
+اسم الشوكر الرنانة انت لو كتبت الشوكر الرنانة
+
+64
+00:03:57,420 --> 00:04:00,400
+بيجيك كيف شكلها و كيف منظرها يعني انا قصد بدناش
+
+65
+00:04:00,400 --> 00:04:03,440
+الشغلات توقفنا و كإن احنا مش عارفين بالظبط ايش
+
+66
+00:04:03,440 --> 00:04:07,280
+اللي احنا بيشرح عنه ال Pyrosis الغرض الأساسي أول
+
+67
+00:04:07,280 --> 00:04:11,440
+حاجة a certain clients level of التقييم جديش حالة
+
+68
+00:04:11,440 --> 00:04:14,540
+الصحية للمريض اللي أمامك من ناحية ايش هنا
+
+69
+00:04:14,540 --> 00:04:17,640
+physiological function ايش يعني يعني التقييم
+
+70
+00:04:17,640 --> 00:04:21,530
+الفيسيولوجيليه؟ لأن احنا في عنا اشكالية مش هندخل
+
+71
+00:04:21,530 --> 00:04:24,870
+لان لا في psychology ولا في sociology أنا بتكلم من
+
+72
+00:04:24,870 --> 00:04:29,690
+ان في ال physical examination تركيزي اكتر اكتر شي
+
+73
+00:04:29,690 --> 00:04:33,350
+على الناحية الفيسيوجية اللي هي الجسدية identify
+
+74
+00:04:33,350 --> 00:04:36,690
+important factors شوف ايش العوامل الهمة اللي بتأثر
+
+75
+00:04:36,690 --> 00:04:40,370
+على صحة المريض وهي ايش اللي لازم تذكر وليه حاجات
+
+76
+00:04:40,370 --> 00:04:44,250
+مش لازم تذكر confirm اكد alterations تغييرات
+
+77
+00:04:44,250 --> 00:04:48,330
+diseases or inabilityto perform ايش اختصار هذا
+
+78
+00:04:48,330 --> 00:04:51,890
+ذاكرين انتوا في سنة أولى activity of daily living
+
+79
+00:04:51,890 --> 00:04:54,870
+اللي هو الانشطة اليومية يعني بدنا نأكد اللي بيقوم
+
+80
+00:04:54,870 --> 00:04:57,670
+بيه المريض هو الإنسان الطبيعي بدنا نأكد ايش
+
+81
+00:04:57,670 --> 00:05:00,330
+الأشياء اللي بيقوم بيها الإنسان بشكل طبيعي في
+
+82
+00:05:00,330 --> 00:05:03,810
+حياته هل قادر أقوم بيها ولا مش قادر عشان أقدر أعمل
+
+83
+00:05:03,810 --> 00:05:07,690
+تقييم identify النقطة اللي بعدها اللي رقم 4
+
+84
+00:05:07,690 --> 00:05:11,230
+identify need for additional testing examination
+
+85
+00:05:11,230 --> 00:05:16,590
+بيخليني أحدد هل نحتاج أكتر واختبارات أكتروفحصات
+
+86
+00:05:16,590 --> 00:05:19,630
+أكتر ولا لأ؟ يعني أنا و أنا بعمل assessment يمكن
+
+87
+00:05:19,630 --> 00:05:24,150
+ألاقي شيء ألفة نظر الطبيب له الطبيب الخصائي أو ال
+
+88
+00:05:24,150 --> 00:05:26,030
+instructor اللي معايا فبروح بيقول لأ و الله دي ما
+
+89
+00:05:26,030 --> 00:05:28,910
+انتبهناش لها خليني نحكي للطبيب الخصائي بنحكي
+
+90
+00:05:28,910 --> 00:05:31,570
+للطبيب الخصائي بيجي ايه بيجي بعمل further
+
+91
+00:05:31,570 --> 00:05:34,710
+examination عشان يعمل ايش يعني زي ما يسمونه
+
+92
+00:05:34,710 --> 00:05:38,030
+explanation more explanation توضيح أكتر for the
+
+93
+00:05:38,030 --> 00:05:43,470
+case للحالة eight بيساعد in evaluating outcomeوفي
+
+94
+00:05:43,470 --> 00:05:46,570
+treatment شربي دايما ال assessment بساعد الطبيب
+
+95
+00:05:46,570 --> 00:05:52,970
+كمان في تقييم مدى تقدم حالة المريض ومدى استجابة
+
+96
+00:05:52,970 --> 00:05:56,510
+المريض للعلاج هل استجاب هل ما استجابش عشان اذا ما
+
+97
+00:05:56,510 --> 00:06:02,240
+استجابش اذا ما استجابشطبعا يعني المساعدة انه انا
+
+98
+00:06:02,240 --> 00:06:06,400
+باجي مرات بشوف يمكن انا اعطيت علاج معين لمريض معين
+
+99
+00:06:06,400 --> 00:06:10,540
+مااستجابش له او المريض استجاب بس هال عنده side
+
+100
+00:06:10,540 --> 00:06:13,580
+effect فبنقدر ننجل هذه المعلومات لمين للطبيب
+
+101
+00:06:13,580 --> 00:06:16,840
+المعالجي بقى انا بال assessment تبعتي بقدر انجل
+
+102
+00:06:16,840 --> 00:06:21,780
+معلومات ماانتبهلهاش الطبيب لما مار على المريض في
+
+103
+00:06:21,780 --> 00:06:26,180
+.. خلال دخوله في القسم طيب في انها ال subjective
+
+104
+00:06:26,180 --> 00:06:27,960
+and objective ذات اللي احنا حاكينا عنها مابدنا
+
+105
+00:06:27,960 --> 00:06:30,600
+نحكي فيها كتير لأنه حاكيناها كتيرخلاص دايما نقول
+
+106
+00:06:30,600 --> 00:06:33,940
+ال subjective نتكلم عن ال history يعني بشكل عام
+
+107
+00:06:33,940 --> 00:06:38,800
+ايش المريض اللي قدامي بيحكيلي شو بيحكيلي يعني هأنا
+
+108
+00:06:38,800 --> 00:06:41,780
+بنفس الوقت ايش هأنا ال objective هأنا exam يعني
+
+109
+00:06:41,780 --> 00:06:46,520
+انا باكتشف انا قدامه و قاعد بسمعله لكن باكتشف انه
+
+110
+00:06:46,520 --> 00:06:49,440
+عنده مشكلة واحد اتنين تلاتة الاكتشاف هذا اللي انا
+
+111
+00:06:49,440 --> 00:06:52,920
+اكتشفته بسميه objective الكلام اللي هو حكى ليه
+
+112
+00:06:52,920 --> 00:06:57,040
+بسميه subjective طيب possible client position
+
+113
+00:06:57,040 --> 00:07:01,710
+during an examinationإيش الأوضاع اللي ممكن
+
+114
+00:07:01,710 --> 00:07:06,250
+استخدمها في ال assessment للمريض طبعا أنا مش هأشرح
+
+115
+00:07:06,250 --> 00:07:09,270
+بزيادة الأن على الأوضاع اللي أنا بس هذكرها وإن شاء
+
+116
+00:07:09,270 --> 00:07:13,910
+الله في ال chapter القادم هراحكي بالظبط طبيعة
+
+117
+00:07:13,910 --> 00:07:18,810
+الأوضاع وكل وضع إيش بقدر أعمله examination طيب
+
+118
+00:07:18,810 --> 00:07:24,290
+الآن يمكن هذه الصورة بتوضح لنا كتير كويس حاجات هي
+
+119
+00:07:24,290 --> 00:07:29,090
+يعني وإن كانت مش كاملة 100%يعني مثلا مافيش لو
+
+120
+00:07:29,090 --> 00:07:33,310
+لاحظته مافيش standing position لاحظوا الأوضاع هذه
+
+121
+00:07:33,310 --> 00:07:36,390
+فيها أول موضوع اسمه Dorsal recumbent position
+
+122
+00:07:36,390 --> 00:07:41,810
+Dorsal recumbent position بعدين Spine position
+
+123
+00:07:41,810 --> 00:07:44,370
+اللي بعدها Spine position اللي هو النوم على الدهر
+
+124
+00:07:44,370 --> 00:07:48,430
+بعدين إيش هنا ال sitting position اللي هو الجالس
+
+125
+00:07:48,430 --> 00:07:52,710
+ال lithium position أو بيسموها اللي هو وضع الولادة
+
+126
+00:07:52,710 --> 00:07:55,570
+Sims position اللي هو النوم على اليسار وانتوا
+
+127
+00:07:55,570 --> 00:08:00,640
+عارفينهاللي هو فرد شوية الرجل التحت اليسرى مع ثاني
+
+128
+00:08:00,640 --> 00:08:04,440
+الرجل اليمنى وطبعا الناس بيكون عاملها اشماله و
+
+129
+00:08:04,440 --> 00:08:07,960
+بيكون ايش فيه بلو بسيطة يعني زي مخدة بسيطة تحت ايه
+
+130
+00:08:07,960 --> 00:08:11,440
+تحت راسه prone position يعني النوم على البطل طبعا
+
+131
+00:08:11,440 --> 00:08:14,780
+أنا مش هنتخل في التفاصيل عبيقة لكن بدي اقول انه
+
+132
+00:08:14,780 --> 00:08:18,980
+هاي قدامنا الأوضاع لما نقول ناخد مثال area
+
+133
+00:08:18,980 --> 00:08:21,640
+assisted يعني انت ايش بتاكي تقيم يعني في ال
+
+134
+00:08:21,640 --> 00:08:24,420
+recumbent position مثلا او في ال dorsal recumbent
+
+135
+00:08:24,420 --> 00:08:28,260
+positionبقدر أقيم ال head صحيح لأنه مبين ال head و
+
+136
+00:08:28,260 --> 00:08:30,600
+ال neck و ال axilla و ال anterior thorax الصدر من
+
+137
+00:08:30,600 --> 00:08:33,600
+الأمام و ال lungs و ال breast و ال heart و ال
+
+138
+00:08:33,600 --> 00:08:36,840
+extremities و ال peripheral برضه كله ال pulses و
+
+139
+00:08:36,840 --> 00:08:40,500
+الغيرهم كله بقدر أعمله لكن لو واحد حكى ليه نقدر
+
+140
+00:08:40,500 --> 00:08:44,780
+نعمل assessment مثلا لل buttocks نقدرش نقدر نعمل
+
+141
+00:08:44,780 --> 00:08:49,560
+assessment مثلا لل back نقدرش نقدر نعمل مثلا في ال
+
+142
+00:08:49,560 --> 00:08:53,560
+posterior of the neck برضه يبقى في أشياء نعملها و
+
+143
+00:08:53,560 --> 00:08:56,330
+في أشياء نعملهاشطيب لما بقول هنا quotients، إيش
+
+144
+00:08:56,330 --> 00:08:59,510
+يعني quotients؟ يعني هو كأنه بقولي انتبه في بعض
+
+145
+00:08:59,510 --> 00:09:04,170
+الأشياء هتتغلب و أنت بتعمل assessment لهذا الوضع،
+
+146
+00:09:04,170 --> 00:09:08,730
+هتتغلب بأمرين، إما أن أنت مش قادر تصل للعضو أو أن
+
+147
+00:09:08,730 --> 00:09:12,570
+المريض نفسه مش قادر يكون يحافظ على نفسه بهذا
+
+148
+00:09:12,570 --> 00:09:16,850
+الوضع، فعشان هيك بدك تكون ماخد quotient، احتياطات،
+
+149
+00:09:16,850 --> 00:09:20,410
+زي إيش هنا؟زي انا Contradicted ممكن يكون ممنوع
+
+150
+00:09:20,410 --> 00:09:23,730
+للناس اللي عندهم مينانة cardiopulmonary problems
+
+151
+00:09:23,730 --> 00:09:26,970
+يعني ايش يعني اللي عنده مشاكل في القلب والريأتين
+
+152
+00:09:26,970 --> 00:09:31,730
+يعني بقدرش يتنفس كويس وعنده فشل في عضلة القلب
+
+153
+00:09:31,730 --> 00:09:36,170
+بقدرش انام هاد النومة لأنه وكأنك بتضغط على القلب
+
+154
+00:09:36,170 --> 00:09:39,590
+أكتر وبتجيب ال load كله في اتجاه القلب واتجاه
+
+155
+00:09:39,590 --> 00:09:43,440
+الصدر عشان هيك بقدرشهيجيش بيقول كمان not used for
+
+156
+00:09:43,440 --> 00:09:46,720
+abdomen، إيش كمان؟ ولا بتقدر تعمل assessment لل
+
+157
+00:09:46,720 --> 00:09:50,600
+abdominal muscles أو لل abdominal organs، ليه؟
+
+158
+00:09:50,600 --> 00:09:54,140
+لأنه أصلا إحنا لما يعني increased tension of
+
+159
+00:09:54,140 --> 00:09:57,140
+abdominal، إيش شو يعني increased tension؟ أنت كأنك
+
+160
+00:09:57,140 --> 00:10:01,460
+زودت، لما الإنسان بينام على دهره وبيتني رجلي بهذا
+
+161
+00:10:01,460 --> 00:10:05,220
+الشكل، زي ما أنتوا شايفينبتلاقي بتضغط على عضلات
+
+162
+00:10:05,220 --> 00:10:08,960
+بطنه غير لما يكون الإنسان مرتاح على الآخر ومادد
+
+163
+00:10:08,960 --> 00:10:13,000
+رجليه وفاردهم زي هذا الشكل فبكون البطن ماخد راحته
+
+164
+00:10:13,000 --> 00:10:16,860
+يبقى معناته هنا بقدر اعمل يعني description هنا
+
+165
+00:10:16,860 --> 00:10:18,980
+طبعا عمودة ده مش حاسس حالي لإن هو موجود أيام هو
+
+166
+00:10:18,980 --> 00:10:23,420
+يعني الوضع أيه أمامنا يعني كيف بيوصف الوضع نيجي
+
+167
+00:10:23,420 --> 00:10:26,900
+نضرب مثلا مثلا ال setting معلش sorry نيجي نضرب
+
+168
+00:10:26,900 --> 00:10:30,310
+مثلا ال setting مثلابقول لي ال setting انت ممكن
+
+169
+00:10:30,310 --> 00:10:33,630
+تعمل assessment ليه؟ لل head تمام و ال neck و ال
+
+170
+00:10:33,630 --> 00:10:36,650
+posterior و ال anterior thorax يعني من قدام و من
+
+171
+00:10:36,650 --> 00:10:42,530
+ورا و ال lungs كمان و ال breast و ال axilla طيب ال
+
+172
+00:10:42,530 --> 00:10:46,510
+axilla كمان و ايش كمان؟ و ال heart طيب و ال vital
+
+173
+00:10:46,510 --> 00:10:49,810
+هاي ال heart طبعا الشمال و ال ايه كمان و ال vital
+
+174
+00:10:49,810 --> 00:10:53,010
+ال size بقدر اجيزله كمان و ال upper and lower
+
+175
+00:10:53,010 --> 00:10:56,590
+extreme زي ال upper و ال lower كله ايه؟موجود، والـ
+
+176
+00:10:56,590 --> 00:10:59,950
+Reflexes الاستجابات اللي هي ردات الفعل اللي بتصير
+
+177
+00:10:59,950 --> 00:11:03,150
+يعني زي حركة اليد أو حركة الرجل يعني أنا بسموه إيش
+
+178
+00:11:03,150 --> 00:11:06,530
+الـ Reflexes زي لما باجي بعمله نخص، دبوس أو غيره
+
+179
+00:11:06,530 --> 00:11:10,730
+مالي تشوف عنده قداش الاستجابة العصبية طب لمين
+
+180
+00:11:10,730 --> 00:11:13,930
+بنستخدموش أو بدنا نكون فيه عنا cushion بقولي ابعد
+
+181
+00:11:13,930 --> 00:11:18,090
+عن استخدامه في ال elderly مش معقول واحد اختيار مش
+
+182
+00:11:18,090 --> 00:11:23,170
+قادر يقعد الا نسنده بمخدات ويكون قاعد كويس ومثبت
+
+183
+00:11:23,170 --> 00:11:27,310
+نفسه عشان يستوعبواجه يقعد بهذا الشكل و يطيب مرتفعة
+
+184
+00:11:27,310 --> 00:11:30,970
+على الأرض حتى يوقع مباشرة عشان هيك بقول لدرلي ابعد
+
+185
+00:11:30,970 --> 00:11:35,370
+عنه لأنه بده ايش أنا support طبعا انا عشان الامور
+
+186
+00:11:35,370 --> 00:11:38,630
+كلها تكون واضحة و هكذا انا لإنه جاي هشرحه ان شاء
+
+187
+00:11:38,630 --> 00:11:41,990
+الله الهيثة و الهيبوسجين والسمسبوسجين و
+
+188
+00:11:41,990 --> 00:11:45,930
+البرومبوسجين هذا العمود بس انت بتقراهه بتعرفوا ايش
+
+189
+00:11:45,930 --> 00:11:50,390
+الأشياء اللي بنقدر نعملها ايش assessment و هذا
+
+190
+00:11:50,390 --> 00:11:53,670
+العمود الأخيرإيش الأشياء اللي بنبعد عنها أو بنكون
+
+191
+00:11:53,670 --> 00:11:58,530
+بنستخدمه with a caution يعني بنستخدمه بحذر شديد
+
+192
+00:11:58,530 --> 00:12:04,050
+طيب equipment preparation for physical assessment
+
+193
+00:12:04,050 --> 00:12:08,430
+أنا بدي أحضر الأدوات عشان أقدر أعمل physical طبعا
+
+194
+00:12:08,430 --> 00:12:12,110
+خليكوا ذاكرين أنا قلت physical كمان مرة أنا ماجلتش
+
+195
+00:12:12,110 --> 00:12:16,210
+هنا لا health ولا قلت nutrition اللي أنا عملته ولا
+
+196
+00:12:16,210 --> 00:12:18,690
+قلت sleep ولا أي شيء قلت أنا physical يعني شغل
+
+197
+00:12:18,690 --> 00:12:21,770
+بيولوجيةيبقى هيكون عندنا أدوات أنا اللي حكيته في
+
+198
+00:12:21,770 --> 00:12:25,810
+هذه الأدوات في ملوى يمكن .. في ناس منكم يمكن شاف
+
+199
+00:12:25,810 --> 00:12:30,430
+على يوتيوب شاف على موقع أي شيء ممكن يكون شاف معظم
+
+200
+00:12:30,430 --> 00:12:33,310
+هذول الأدوات و بالمناسبة انتوا لو روحتوا على
+
+201
+00:12:33,310 --> 00:12:36,910
+المستشفى تدربتوا ان شاء الله هتروحوا عام قريب يعني
+
+202
+00:12:36,910 --> 00:12:40,430
+إذا كانت أو ان شاء الله ال .. خليني أقول يعني
+
+203
+00:12:40,430 --> 00:12:43,510
+الدلائل اللي واضحة اللي جاية ان شاء الله بتأكدنا
+
+204
+00:12:43,510 --> 00:12:46,870
+ان شاء الله مش هنطول كتير في البعد عن المستشفيات
+
+205
+00:12:46,870 --> 00:12:51,630
+هتشوفوا كل هذه الأدواتيمكن أداة واحدة فقط يعني
+
+206
+00:12:51,630 --> 00:12:54,750
+نادرة تخلقها ليه ال turning fork ليه الشوك
+
+207
+00:12:54,750 --> 00:12:58,490
+الرنانة؟ هذا إيه؟ شكله بإمكانه لو واحد بده أو طالب
+
+208
+00:12:58,490 --> 00:13:02,470
+بده تتأكد كيف تستخدم بإمكانه ندخل على اليوتيوب بس
+
+209
+00:13:02,470 --> 00:13:05,670
+و نفتح كيه استخدام الشوك الرنانة هيوريك بالظبط كل
+
+210
+00:13:05,670 --> 00:13:10,130
+أداة من أدوات كيف بيستخدموهاطبعا اول واحد انا ال
+
+211
+00:13:10,130 --> 00:13:12,070
+flashlight اللي هو ال pen light بسموه الضوء
+
+212
+00:13:12,070 --> 00:13:15,250
+المباشر لما نجلد flashlight او pen light ليش سموه
+
+213
+00:13:15,250 --> 00:13:18,270
+pen زي الكلام يعني كأنه يعني ضوء مباشر مش مش زي
+
+214
+00:13:18,270 --> 00:13:21,490
+الضوء الواسع لأ مش زي ضوء الجوال ال mobile اللي
+
+215
+00:13:21,490 --> 00:13:25,330
+معناه لأ لازم يكون ضوء sharp light عشان اي cavity
+
+216
+00:13:25,330 --> 00:13:29,510
+بدنا نعمله assessment أقدر أضوع عليه ال oriental
+
+217
+00:13:29,510 --> 00:13:31,750
+mirror اللي بيسموه ال مرايا اللي بيستخدموها تبعيني
+
+218
+00:13:31,750 --> 00:13:36,750
+الأسنان عشان يشوف اللي هو الحنجرة البلعوم الأسنان
+
+219
+00:13:37,200 --> 00:13:41,000
+لأنه مقدرش الطبيب يظل يلف و يطلع شمال يمين عن طريق
+
+220
+00:13:41,000 --> 00:13:44,220
+المرايا و المرايا بالمناسبة تكون كمان مكبرة شوية
+
+221
+00:13:44,220 --> 00:13:48,680
+نزل Speculum ايش يعني فحص الأنف من الداخل فتح
+
+222
+00:13:48,680 --> 00:13:51,960
+الأنف طبعا ليش سموها Speculum هنلاقي مرات هان
+
+223
+00:13:51,960 --> 00:13:55,100
+مكتوب Speculum و هنلاقي مرات هذه الكلمة كمان
+
+224
+00:13:55,100 --> 00:13:58,920
+Speculum لما نسمع كلمة Speculum إذا حد بتذكر معايا
+
+225
+00:13:58,920 --> 00:14:02,560
+الزردية اللي بنستخدمها أو الجطاعة زي ما بتعرفوها
+
+226
+00:14:02,560 --> 00:14:07,220
+في البيوت لما بنضغط عليها بتسكر من قدامهذه اللي
+
+227
+00:14:07,220 --> 00:14:09,640
+بيسموها ذردية او يعني اي شيء بيستخدمها زي
+
+228
+00:14:09,640 --> 00:14:12,780
+الكهربائين و غيرهم لكن لما نقول كلمة speculum
+
+229
+00:14:12,780 --> 00:14:16,600
+العكس لما نضغط عليها بتفتح لما نضغط عليها بتفتح
+
+230
+00:14:16,600 --> 00:14:19,760
+اللي لاحظته زي انا مثلا لاحظوا هنا لو بتصيرها انا
+
+231
+00:14:19,760 --> 00:14:24,540
+اتضيق للمسافة اكتر بتفتح المسافة من هنا اكتر اللي
+
+232
+00:14:24,540 --> 00:14:27,740
+بدي اتأكد بروح اليوتيوب ال speculum ده بنستخدمه
+
+233
+00:14:27,740 --> 00:14:30,700
+ليش الأنف لأن عشان مرات انا بده اشوف من جوا فانا
+
+234
+00:14:30,700 --> 00:14:32,920
+مقدرش اشوف ال cavity من جوا اللي عن طريق ما افتح
+
+235
+00:14:32,920 --> 00:14:36,580
+الأنف اكترأفثالموسكوب يعني من ضار أيش؟ ايه
+
+236
+00:14:36,580 --> 00:14:40,740
+افثالموسكوب من ضار العين اوتوسكوب اوتو اوتو كلمة
+
+237
+00:14:40,740 --> 00:14:43,580
+لاتنين معناها أيش يعني ال air اللي هو ال air يعني
+
+238
+00:14:43,580 --> 00:14:47,820
+اللي هو من ضار الأذن ويله طبعا عدة مجسات عشان نفحص
+
+239
+00:14:47,820 --> 00:14:50,620
+اللي الصغير و الكبير و الميل و الفميل ال
+
+240
+00:14:50,620 --> 00:14:53,400
+percussion بيسموه اللي هو الشكوش اللي بنستخدمه
+
+241
+00:14:53,400 --> 00:14:57,980
+خاصة لإيش لل reflex الاستجابات العصبية انه كيف هل
+
+242
+00:14:57,980 --> 00:15:01,100
+في استجابة هل في الأطراف في مشكلة بيبقوا اللي
+
+243
+00:15:01,100 --> 00:15:05,500
+يستجيب الإنسانTunning fork الشوكة الرنانة نريد أن
+
+244
+00:15:05,500 --> 00:15:09,680
+نشوف قدرة السماع هل يستطيع المريض أن يكون الذبذبات
+
+245
+00:15:09,680 --> 00:15:13,440
+حول ذهنه .. أذنه بيسمع اليمين وشماز يبعث؟ طبعا هو
+
+246
+00:15:13,440 --> 00:15:17,300
+صح مش شغلنا لكن من باب المعرفة يعني ال vagina ناسب
+
+247
+00:15:17,300 --> 00:15:19,660
+الكلام اللي هو هذا بنستخدمه في حالة ال vagina
+
+248
+00:15:19,660 --> 00:15:23,320
+examination للستات و خاصة لما نبدأ نستخدم حاجة
+
+249
+00:15:23,320 --> 00:15:27,160
+بسمها DNC DNC اقتصار عالم اسمه dilatation and
+
+250
+00:15:27,160 --> 00:15:32,180
+cortageللمريضات اللى بيصير معاهم فى بداية الحمل و
+
+251
+00:15:32,180 --> 00:15:35,220
+بتجهد الست يعنى مثلا ان ده abortion ابتسمع
+
+252
+00:15:35,220 --> 00:15:38,520
+بالعامية بيقولوا راحت تعمل عملية تنظيفات فلازم
+
+253
+00:15:38,520 --> 00:15:42,100
+يعملوا يعني يوسعوا المكان عشان يقدر الطبيب يعمل
+
+254
+00:15:42,100 --> 00:15:45,320
+التنظيف cotton application كلكوا عارفينه يعنى اللى
+
+255
+00:15:45,320 --> 00:15:48,960
+هو زى ال cotton stick اللى بيكون مرات بنباع بس مش
+
+256
+00:15:48,960 --> 00:15:52,840
+زى اللى بنباع فى الأسواق هذا بيكون مكان شوية و
+
+257
+00:15:52,840 --> 00:15:55,780
+طويل اللى هو عشان ممكن ناخد فيه أسواق على طرفه
+
+258
+00:15:55,780 --> 00:16:01,140
+بيكون يعني زى عودو على طرف قطن يعني فى هنا ال pads
+
+259
+00:16:01,140 --> 00:16:04,060
+اللى هو يعني بنستخدم زى الأنسجة أو بنستخدم زى
+
+260
+00:16:04,060 --> 00:16:11,160
+اللففة معينة أو بنستخدم مثلا جوز عشان نقدر إذا كان
+
+261
+00:16:11,160 --> 00:16:14,320
+فى solution أو كده ممكن يعني ناخد احتياطاتنا اللى
+
+262
+00:16:14,320 --> 00:16:16,440
+بعدها gloves كلكوا عارفينه بتقول انتوا لبستوا كيف
+
+263
+00:16:16,440 --> 00:16:20,080
+استرال واتعلمتوا كيف طريقتا فى سنة أولى فى طبعا
+
+264
+00:16:20,080 --> 00:16:24,220
+نوعين استرال وانسترال هنا ال labricant يعني الملين
+
+265
+00:16:24,220 --> 00:16:30,210
+سواء كانزي الذراكين جيل اسمه او يعني اي labricant
+
+266
+00:16:30,210 --> 00:16:33,530
+جيل بشكل عام بدون الأسماء بنستخدمه في بعض الحالات
+
+267
+00:16:33,530 --> 00:16:38,070
+لإنه ممكن نحتاجه و احنا بنعمل examination طبعا ال
+
+268
+00:16:38,070 --> 00:16:43,670
+tongue depress اللي هو كلكوا عارفينها لما نيجي
+
+269
+00:16:43,670 --> 00:16:47,750
+بنفحص الفم من جوا بنضطر نجيب ال tongue depress
+
+270
+00:16:47,750 --> 00:16:51,690
+عشان إيش يعني نحاول نخافض اللسان نضغط على اللسان
+
+271
+00:16:51,690 --> 00:16:56,270
+لتحت عشان نفحص ال enzygium اللي جواالان
+
+272
+00:16:56,270 --> 00:16:58,770
+indications for physical examination ليش يا تورا
+
+273
+00:16:58,770 --> 00:17:02,850
+انا بعمل physical examination طبعا انا بعمل اول
+
+274
+00:17:02,850 --> 00:17:06,270
+حاجة routine screening ايش routine يعني البناء
+
+275
+00:17:06,270 --> 00:17:08,130
+الأدم الشاطر اللي احنا حكينا هذا الكلام في البداية
+
+276
+00:17:08,130 --> 00:17:13,290
+يحاول دايما يتذكر نفسه علشان يظلوا دايما يعني صحته
+
+277
+00:17:13,290 --> 00:17:17,430
+منيحة ومحافظ عليها اذا صار أي شيء يعني ممكن بعض
+
+278
+00:17:17,430 --> 00:17:21,110
+خاصة كبار السن بدأ عندهم امراض او امراض زارية في
+
+279
+00:17:21,110 --> 00:17:25,060
+العائلة بنضطر نعملهم دايما routine examinationهنا
+
+280
+00:17:25,060 --> 00:17:27,960
+بقول ال eligibility ال eligibility معناته الليقة
+
+281
+00:17:27,960 --> 00:17:31,120
+prerequisite لما تقول ال prerequisite يعني المتطلب
+
+282
+00:17:31,120 --> 00:17:33,940
+السابق for health insurance او military military
+
+283
+00:17:33,940 --> 00:17:37,540
+يعني ايه للعسكرية او job او يعني المهن او ال
+
+284
+00:17:37,540 --> 00:17:42,840
+sports school يعني باختصار او المدارس يستخدم الفحص
+
+285
+00:17:42,840 --> 00:17:46,600
+الصحي زي ال occupational انا حاكينا عليه زيك في
+
+286
+00:17:46,600 --> 00:17:51,190
+بداية المحاضرات الأولى و التانيةانه كمان يستخدموا
+
+287
+00:17:51,190 --> 00:17:56,050
+زي ليقل وظيفة معينة ليقل رياضة ليقل اجتياز دور
+
+288
+00:17:56,050 --> 00:18:00,750
+عسكري و هكذا او لتأمين admission to hospital لما
+
+289
+00:18:00,750 --> 00:18:05,610
+يدخل اي انسان على المستشفى و خاصة اذا هو يعني اول
+
+290
+00:18:05,610 --> 00:18:10,130
+مرة بيجي عنا هيظل معنا long term care facility
+
+291
+00:18:10,130 --> 00:18:14,190
+يعني زي مريض سكر اول مرة اكتشفناه مريض ضغط فبنضطر
+
+292
+00:18:14,190 --> 00:18:17,570
+احنا في هذه الحالةانه نعمله complete physical
+
+293
+00:18:17,570 --> 00:18:22,430
+examination عشان يظلوا يعني عارفين بداية الوضع كيف
+
+294
+00:18:22,430 --> 00:18:27,030
+كان عندهم نبدأ نقارن فيه مابعد طيب بقولي انا steps
+
+295
+00:18:27,030 --> 00:18:30,090
+of assessment ايش الخطوات اول حاجة في ال
+
+296
+00:18:30,090 --> 00:18:33,130
+assessment think ايش يعني think يعني فكر يعني كأنه
+
+297
+00:18:33,130 --> 00:18:36,570
+بقولي ما تهجمش على المريض قبل ما انت تكون مفكر ايش
+
+298
+00:18:36,570 --> 00:18:41,620
+اللي بدك تعمله organize نظمواش بقولي انا don't
+
+299
+00:18:41,620 --> 00:18:44,600
+forget ما تنسى لا ال nutrition ولا ال white ولا ال
+
+300
+00:18:44,600 --> 00:18:47,860
+white احنا حاكيين عنها يا انك تاخد طوله ووزنه و
+
+301
+00:18:47,860 --> 00:18:51,420
+تسأله عنه الوضع اللي هو الغذائي بشكل عام ال
+
+302
+00:18:51,420 --> 00:18:54,180
+environment تكون يعني مريحة وكويسة مافيش حد حواليه
+
+303
+00:18:54,180 --> 00:18:58,000
+accommodated specialists اذا احتجنا في بعض الحالات
+
+304
+00:18:58,000 --> 00:19:01,420
+بدك تعمل accommodation accommodation زي تحوير ايش
+
+305
+00:19:01,420 --> 00:19:04,640
+يعني تحوير زي adaptation خاصة في ال cultural
+
+306
+00:19:04,640 --> 00:19:07,340
+sensitivity يعني امكان انا بدي احتاج هقول للمرض
+
+307
+00:19:07,340 --> 00:19:12,390
+كشف بطنكارفع عن رجلك ارفع عن مثلا صدرك يكون فيها
+
+308
+00:19:12,390 --> 00:19:15,230
+نوع من ال embarrassment يعني احراج فبدك تكون عامل
+
+309
+00:19:15,230 --> 00:19:17,850
+حاجة بسمها accommodate ايش accommodate يعني نحور
+
+310
+00:19:17,850 --> 00:19:21,430
+أمور نحط ستاير نحط شرشة نبعد الناس حواليه هذه
+
+311
+00:19:21,430 --> 00:19:25,190
+بتريح المريض وانت بتعمله examination طبعا حط ال
+
+312
+00:19:25,190 --> 00:19:28,230
+equipment حضرناه a clean surface يكون المكان نظيف
+
+313
+00:19:28,230 --> 00:19:32,430
+a clean equipment كل الأدوات نظيفة الغرفة تكون
+
+314
+00:19:32,430 --> 00:19:37,960
+هاديةتكون دافية و ال led مضاءة جيدا ماتكونش يعني
+
+315
+00:19:37,960 --> 00:19:43,200
+لا عتمة ولا مضاءة بإضاءة صفراء أو حمراء لازم تكون
+
+316
+00:19:43,200 --> 00:19:49,140
+إضاءة يعني أبيض تكون مابتعكسش أي نور على جسم وجلد
+
+317
+00:19:49,140 --> 00:19:53,680
+المريض maintain privacy المحافظة على إيه المحافظة
+
+318
+00:19:53,680 --> 00:19:57,500
+على سرية إيش المريض أكيد طبعا بعدينش بقولي أنا
+
+319
+00:19:57,500 --> 00:20:00,980
+observe anderson يا ريت بقولي إيش أنت لاحظين
+
+320
+00:20:00,980 --> 00:20:03,960
+الذاكرين لما كنا في ال interviewهيحكي المريض و
+
+321
+00:20:03,960 --> 00:20:06,840
+هيكون عنده body language و انا هنا بقول دائما
+
+322
+00:20:06,840 --> 00:20:10,700
+دائما observe and listen صدق ال observe و يعني ال
+
+323
+00:20:10,700 --> 00:20:14,100
+listen ان شاء الله كله صادق لكن لو قلنا مين الأصدق
+
+324
+00:20:14,100 --> 00:20:18,660
+دائما ن observe لان body language طيب بقول هنا
+
+325
+00:20:18,660 --> 00:20:23,340
+don't forget اقعد تنسى اقعد تنسى انه اتراجع
+
+326
+00:20:23,340 --> 00:20:25,540
+المعلومات اللى عندك reviewing general information
+
+327
+00:20:25,540 --> 00:20:29,280
+اللى اتخدتها اقعد تنسى انك تقدم نفسك للمريض
+
+328
+00:20:29,280 --> 00:20:33,460
+introductionاوعى تنسى انك تاخد health history،
+
+329
+00:20:33,460 --> 00:20:36,660
+اوعى تنسى انك تعمل pain assessment تقييم للألم،
+
+330
+00:20:36,660 --> 00:20:40,020
+يعني مش معقول يقولك أنا بطن بيجعني في هذا المكان،
+
+331
+00:20:40,020 --> 00:20:43,260
+اتروح تبدأ ال assessment في إياك، لأنه انت هيك
+
+332
+00:20:43,260 --> 00:20:47,200
+بتأذي المريض، هذا كله اش بيسموه key، اش يعني key
+
+333
+00:20:47,200 --> 00:20:50,120
+مفتاح، زي مفتاح الباب، كله مفتاح لل holistic
+
+334
+00:20:50,120 --> 00:20:53,500
+approach اللي هو المدخل الشمولي للرعاية
+
+335
+00:20:59,190 --> 00:21:02,470
+five assessment techniques during physical
+
+336
+00:21:02,470 --> 00:21:05,370
+examination و احنا حكينا ده كلام و احنا قايل قولنا
+
+337
+00:21:05,370 --> 00:21:07,150
+ان الكتب هتكتب لنا Inspection, Pulpation,
+
+338
+00:21:07,230 --> 00:21:09,930
+Percussion و Scalptation لكن احنا فيه كمان حاجة
+
+339
+00:21:09,930 --> 00:21:12,910
+جديدة اسمها all factions و لما نيصل لكلمة all
+
+340
+00:21:12,910 --> 00:21:15,930
+factions هتعرفوا ان انا كديش اهمية مرات كتير و
+
+341
+00:21:15,930 --> 00:21:20,930
+احنا بنعمل assessment طيب خليني انا يعني هذه
+
+342
+00:21:20,930 --> 00:21:25,090
+الصورة شوية يعني دايما نذكرها و دايما نحطها في
+
+343
+00:21:25,090 --> 00:21:29,270
+ذهننا و في بالنا شويةو أنا دايما صدقا بجيب عليها
+
+344
+00:21:29,270 --> 00:21:32,270
+السيلاية عشان أكون واضح يعني مش بجيب و أنا بقولك
+
+345
+00:21:32,270 --> 00:21:34,430
+ارسم و أنا بقولك كده هي ممكن انتوا شايفينها زي
+
+346
+00:21:34,430 --> 00:21:38,550
+الكتيرة او صور متحركة لكن هذا مهم شوية الانش
+
+347
+00:21:38,550 --> 00:21:41,770
+بيقولي انا واحد first يعني هنا ال second يعني
+
+348
+00:21:41,770 --> 00:21:45,190
+اتنين هنا ال third هنا ال fourth اعتبر ايش هنا
+
+349
+00:21:45,190 --> 00:21:49,070
+اعتبر ان هذا الشنطة اللي قدامكوا هو المريض يعني مش
+
+350
+00:21:49,070 --> 00:21:52,770
+هو مش شنطة هو المريض و كتب لنا tools of physical
+
+351
+00:21:52,770 --> 00:21:56,420
+assessmentاستبعدوا الأولفاكشن لأنه قلتلكوا الكتاب
+
+352
+00:21:56,420 --> 00:21:59,220
+اللي احنا بستخدمه الآن مابيستخدمش أولفاكشن لكن
+
+353
+00:21:59,220 --> 00:22:02,800
+احنا خلّينه نطلع بقوللي أول حاجة inspection طبعا
+
+354
+00:22:02,800 --> 00:22:07,140
+مجهزت inspection هي رسملي الرسم للنظر العادي
+
+355
+00:22:07,140 --> 00:22:11,780
+والنظر التاني طب ليش هو حطلي أنا حطلي أنا عدسة هو
+
+356
+00:22:11,780 --> 00:22:14,580
+مش هتحط عدسة يعني كأنه بيقولك ال inspection أبعد
+
+357
+00:22:14,580 --> 00:22:17,980
+من كلمة النظر العادي يعني ال inspection أقرب ما
+
+358
+00:22:17,980 --> 00:22:24,690
+يكون لإيهأقرب ما يكون للنظر بالكيان يعني أنه نلاحظ
+
+359
+00:22:24,690 --> 00:22:30,270
+بإحساساتنا ونكون واضحين الرؤية بحيث أنه أي شيء
+
+360
+00:22:30,270 --> 00:22:34,550
+موجود متغير نقدر ننتبه له بعدين application هانا
+
+361
+00:22:34,550 --> 00:22:38,310
+ايش هانا palpation لأ palpation بعدين هانا اللي هو
+
+362
+00:22:38,310 --> 00:22:41,750
+ال application تطبيق اتنين palpation مد ايدي مدين
+
+363
+00:22:41,750 --> 00:22:45,250
+ايدينا على الجسم هذا اتنين تلاتة لحظوا percussion
+
+364
+00:22:45,250 --> 00:22:49,080
+النقر ولو قدامش وحشرحلكم كيف النقرلاحظين كيف الإيد
+
+365
+00:22:49,080 --> 00:22:52,240
+الأيسر هنا و الإيد الأيمن هنا بقى أخر حاجة
+
+366
+00:22:52,240 --> 00:22:55,400
+auscultation لو حد سألنا طب ليش أستاذ ماحطوش
+
+367
+00:22:55,400 --> 00:22:59,700
+auscultation قبل؟ لأ دايما انت لو طلعته ماشي مع ال
+
+368
+00:22:59,700 --> 00:23:02,620
+skills ماشي من ال simple ل ال difficult ال
+
+369
+00:23:02,620 --> 00:23:06,860
+inspection كل الناس بتلاحظ ال palpation يعني معظم
+
+370
+00:23:06,860 --> 00:23:09,260
+الناس اللي دارسين في التمرد و في الطب و في العلوم
+
+371
+00:23:09,260 --> 00:23:12,720
+الصحية بقدر يعمل palpation ال percussion لأ مش أي
+
+372
+00:23:12,720 --> 00:23:16,330
+واحد بيدا واحد أخصائيالـ escalation بده .. لأ بده
+
+373
+00:23:16,330 --> 00:23:20,570
+يعني expert، خبير عشان هيك خلنا في الآخر عشان هيك
+
+374
+00:23:20,570 --> 00:23:23,690
+مرات حتى لما بنجيس الضغط لمريد بيجي طالب بيقول
+
+375
+00:23:23,690 --> 00:23:26,310
+والله أنا حسيت انه مش سامع كويس الضغط أو ضغطه
+
+376
+00:23:26,310 --> 00:23:29,870
+مرتفع شوية بروح بنقوله طيب إذا أنت مش سامع خلي
+
+377
+00:23:29,870 --> 00:23:33,290
+غيرك يسمع ليه على اعتبار أنه مش كل واحد عنده ال
+
+378
+00:23:33,290 --> 00:23:36,330
+escalation power أو ال escalation يعني .. يعني
+
+379
+00:23:36,330 --> 00:23:41,090
+خلينا نقول skill زيه زي التاني هذه ال .. ال .. ال
+
+380
+00:23:41,090 --> 00:23:45,220
+.. اللي حكيت عنها اللي هي الترتيبيستخدم في كل ..
+
+381
+00:23:45,220 --> 00:23:50,420
+في كل الجسم إلا .. إلا .. إلا في إيه؟ شوفوا الكلام
+
+382
+00:23:50,420 --> 00:23:53,840
+البسيط الحلو إلا في حالة ال abdomen خاصة ال
+
+383
+00:23:53,840 --> 00:23:55,480
+abdominal tenderness إيش يعني abdominal
+
+384
+00:23:55,480 --> 00:23:59,400
+tenderness؟ يعني لما يكون فيه ألم في البطل، مانفعش
+
+385
+00:23:59,400 --> 00:24:02,660
+أمد إيدي، إيش صار طيب هنا؟ بقول ياريت تبدأ بال
+
+386
+00:24:02,660 --> 00:24:05,980
+inspection، بدأ من هنا، و أروحلي على ال
+
+387
+00:24:05,980 --> 00:24:09,540
+auscultation، أجي هنا، يبقى لحظين في ال abdomen
+
+388
+00:24:09,540 --> 00:24:14,230
+عكبال بعضهي inspection, auscultation أشياء زي هيك
+
+389
+00:24:14,230 --> 00:24:17,970
+بعدين إيش قالت هالأتا percussion ها برجع ع الجوا
+
+390
+00:24:17,970 --> 00:24:21,430
+inspection, palpation بعدين ال palpation و إيش
+
+391
+00:24:21,430 --> 00:24:24,930
+الآخر واحدة ده ليه مكتوب هنا palpate بتلعب فوق لو
+
+392
+00:24:24,930 --> 00:24:28,150
+حاسس إنه ليش آخر شيء ال palpation لأنه هيكون مؤلم
+
+393
+00:24:28,150 --> 00:24:31,710
+جدا للمريض هذا في حالة ال abdominal examination
+
+394
+00:24:31,710 --> 00:24:34,450
+خليكوا ذاكرين في حالة ال abdominal examination أما
+
+395
+00:24:34,450 --> 00:24:37,650
+في الحالات الطبيعية دقر تذكروا inspection,
+
+396
+00:24:37,850 --> 00:24:41,120
+palpation, percussion, auscultationلو حد واحد نسي
+
+397
+00:24:41,120 --> 00:24:47,340
+يكتب IPA بعدين PE بعدين A طبعا ليش قلت انا نكتب PE
+
+398
+00:24:47,340 --> 00:24:51,700
+P لأن هنا P و هنا P فبلاش تخربط فاكر اننا PA و هنا
+
+399
+00:24:51,700 --> 00:24:54,400
+PE يبقى inspection, probation, percussion,
+
+400
+00:24:54,560 --> 00:24:57,900
+auscultation except an abdominal assessment you
+
+401
+00:24:57,900 --> 00:25:05,100
+can inspect and after that auscultate and after
+
+402
+00:25:05,100 --> 00:25:14,150
+that percussion بعدين ايش؟بعدين palpation طيب نيجي
+
+403
+00:25:14,150 --> 00:25:18,350
+أول حاجة عن inspection inspection بيقول use a
+
+404
+00:25:18,350 --> 00:25:21,310
+vision استخدمه بالاسم الكل هذا تعتبر من أيه؟ من
+
+405
+00:25:21,310 --> 00:25:26,170
+الملاحظة always first دائما في الأول look for
+
+406
+00:25:26,170 --> 00:25:29,310
+symmetry أول ما تتطلع يعني هذا أول شي باستخدامها
+
+407
+00:25:29,310 --> 00:25:33,810
+دائما تطلع على التناسب بين أعضاء الجسم symmetry
+
+408
+00:25:33,810 --> 00:25:36,170
+التناسب الانسجام بين الأتنين تطلع على أيدي اليمين
+
+409
+00:25:36,170 --> 00:25:38,230
+و أيدي الشمال رجلي اليمين و رجلي الشمالالدان
+
+410
+00:25:38,230 --> 00:25:41,030
+اليمين الدان الشمالية كذا use good lighting استخدم
+
+411
+00:25:41,030 --> 00:25:45,350
+الإضاءة القوية use good exposure يا ريت المكان
+
+412
+00:25:45,350 --> 00:25:48,490
+اللي بدك تعمله أساساً حاول تكشفه good exposure
+
+413
+00:25:48,490 --> 00:25:52,950
+ماجالش full خليني أذكرين جال good exposure full
+
+414
+00:25:52,950 --> 00:25:56,530
+يعني نشلح المريض أو نعريه كله أما good exposure بس
+
+415
+00:25:56,530 --> 00:26:01,250
+يعني for the examination part طيب لاحظين أنه وين
+
+416
+00:26:01,250 --> 00:26:03,690
+واجف الطبيب الطبيب هي موجود هنا و هذا كلام ده
+
+417
+00:26:03,690 --> 00:26:07,110
+نتذكر دايما كتير من الأطباء بيخطأوا في الأسابق و
+
+418
+00:26:07,110 --> 00:26:12,830
+بيعملواassessment دائما المريض يعني بيكون نايم هيو
+
+419
+00:26:12,830 --> 00:26:16,670
+أمامنا والطبيب الأخصائي وين واقف؟ واقف على يمين
+
+420
+00:26:16,670 --> 00:26:19,170
+وماحد ييجي يسألني يقولي كيف أعرف اليمين من الشمال
+
+421
+00:26:19,170 --> 00:26:22,550
+حتى لو شوفت أي صورة حاول أنك تسلم عليه هي أيدي
+
+422
+00:26:22,550 --> 00:26:25,490
+الطبيب لو بده يسلم عليه هي أيديه اليامين طب لو هو
+
+423
+00:26:25,490 --> 00:26:29,930
+بده يسلم على مثلا المريضة بده يروح ايه؟ بده يسلم
+
+424
+00:26:29,930 --> 00:26:33,430
+عليه؟ مش عارف هل أنا اليامين؟ لأ هي اليامين طب وين
+
+425
+00:26:33,430 --> 00:26:37,910
+واقف المريض؟ المريض يقفعلى ايش؟ يمين زي ما انتوا
+
+426
+00:26:37,910 --> 00:26:42,050
+شايفين المريض مابيكفش على يساره طبعا في بعض الناس
+
+427
+00:26:42,050 --> 00:26:45,670
+كتير دلائل جاعة يقولوا وقوف المريض في بعض الحلات
+
+428
+00:26:45,670 --> 00:26:51,050
+فسروا انه يساره بتعمل خوف للمريض قربه للقلب قربه
+
+429
+00:26:51,050 --> 00:26:54,350
+شوية للمريض بيحس انه كأنه كل شيء يعني كأنه فوقه
+
+430
+00:26:54,350 --> 00:26:57,710
+مباشرة وبيعتبروا انه دايما اللي .. لما يجي في
+
+431
+00:26:57,710 --> 00:27:01,190
+الإنسان على يمينه يعني الشق الأيمن دايما مألوف حتى
+
+432
+00:27:01,190 --> 00:27:04,700
+الإنسة حتى في ديننايعني جميل جدا انه النوم على
+
+433
+00:27:04,700 --> 00:27:09,080
+اليمين وهذا من السنة طيب الان ال principles of a
+
+434
+00:27:09,080 --> 00:27:12,920
+of accurate inspection عشان اعمل انا accurate
+
+435
+00:27:12,920 --> 00:27:16,340
+inspection اول حاجة بتستخدمي شهرنا good lighting
+
+436
+00:27:16,340 --> 00:27:20,080
+يعني إضاءة قوية جدايعني يا بنستخدم ضوء النهار
+
+437
+00:27:20,080 --> 00:27:23,480
+daylight او artificial او حتى لو بنستخدم ضوء يعني
+
+438
+00:27:23,480 --> 00:27:26,180
+صناعي لكن لازم يكون ال suitable مناسب طبعا بحكي
+
+439
+00:27:26,180 --> 00:27:29,320
+هذا الكلام لأن في بعض الناس بيستخدم إضاءات صعبة زي
+
+440
+00:27:29,320 --> 00:27:31,860
+ال fluorescent اللي هي light اللي زي الإضاءة
+
+441
+00:27:31,860 --> 00:27:36,380
+الفسورية المستخدمة في الملاعب و في بعض المطارات او
+
+442
+00:27:36,380 --> 00:27:39,000
+في بعض الأماكن العامة ممكن انت تتطلع في جسمك او في
+
+443
+00:27:39,000 --> 00:27:42,400
+لبسك تقول ما انا مش لابس لون هيك لأنه بيغير
+
+444
+00:27:42,400 --> 00:27:45,700
+الألوان فبالتالي بيصيرنا نحكم على ان المرض في عنده
+
+445
+00:27:45,700 --> 00:27:51,940
+مشكلةExpose body parts حاول انك اتعري و تكشف اجزاء
+
+446
+00:27:51,940 --> 00:27:55,900
+الجسم من المريض اللي بدك تلاحظها Observed only ما
+
+447
+00:27:55,900 --> 00:27:58,780
+بدنا نكشفه يعني مثلا بدي اعمل assessment للأبدومين
+
+448
+00:27:58,780 --> 00:28:03,120
+ليش اكشف صدره بدي اعمل assessment لل chest بروح
+
+449
+00:28:03,120 --> 00:28:06,300
+بحطي بالشرشة في الأبدومين و بعدين اعمل بال chest
+
+450
+00:28:06,300 --> 00:28:10,040
+هذا بيعطي اطمئنان و اروح للمريض اكتر look before
+
+451
+00:28:10,040 --> 00:28:13,970
+touching دايما اتطلع قبل ما انت ايهجبن ما تمد يدك
+
+452
+00:28:13,970 --> 00:28:18,590
+warm room يعني الغرفة تكون هادية ودافعة وكويسة not
+
+453
+00:28:18,590 --> 00:28:21,650
+cold not hot ايش يعني لا هي باردة ولا هي ساخنة
+
+454
+00:28:21,650 --> 00:28:24,570
+ليه؟ لأن المرض إذا كانت باردة مش هيساعد معاك وإذا
+
+455
+00:28:24,570 --> 00:28:27,710
+كانت حامية كتير العرق وكذا مش هيساعدك فاحنا
+
+456
+00:28:27,710 --> 00:28:31,930
+بالتالي بنخل الغرفة يعني زي ما يسمون الحرارة
+
+457
+00:28:31,930 --> 00:28:36,370
+المقبولة observe four colors اتطلع على الألوان
+
+458
+00:28:36,370 --> 00:28:39,930
+size الحجم و location texture او هكذا هقولكوا اش
+
+459
+00:28:39,930 --> 00:28:44,380
+معناه texture symmetryالتي تسمى التناسب الـ odors
+
+460
+00:28:44,380 --> 00:28:49,940
+و الاصوات تكتشر لقدامي شوية هنشرحلكوا حايدة كمان
+
+461
+00:28:49,940 --> 00:28:53,420
+مرة التكتشر بيسموه إيش هانا ان انا أشوف يعني
+
+462
+00:28:53,420 --> 00:28:58,240
+بيسموه إيش هانا لما أعمل يعني palpation of the
+
+463
+00:28:58,240 --> 00:29:01,540
+skin to assist the underlying tissue إيش يعني
+
+464
+00:29:01,540 --> 00:29:05,000
+palpation of the skin to assist the underlying of
+
+465
+00:29:05,000 --> 00:29:09,620
+the tissue أعطيكم مثل يعني لو مسكن الجلد أنا عصيت
+
+466
+00:29:09,620 --> 00:29:13,860
+على الجلدمش عشان احس الجلد عشان احس اللي تحت الجلد
+
+467
+00:29:13,860 --> 00:29:19,100
+كمان مرة لو مسكت الجلد عشان احس اللي تحت الجلد زي
+
+468
+00:29:19,100 --> 00:29:21,740
+ما يكون واحد ييجي يقولك بالله لو سمحت تعالي تشوف
+
+469
+00:29:21,740 --> 00:29:26,160
+انا حاسس فيه دم الهنة او حاسس فيه كيس دهني او حاسس
+
+470
+00:29:26,160 --> 00:29:28,740
+فيه ايش زي الورم الصغير هذا بيسموها ال texture
+
+471
+00:29:28,740 --> 00:29:32,520
+تمام اللي هو الملمس الداخلي اللي تحت الجلد تمام
+
+472
+00:29:32,520 --> 00:29:37,100
+اللي في بعض الحالات سموها elasticity طبعا انا اللي
+
+473
+00:29:37,100 --> 00:29:42,260
+قدامك برضه هتبين اكتر معانا compare قارنEach area
+
+474
+00:29:42,260 --> 00:29:45,380
+inspected أنا بشرح على مهل عشان بدينا بدينا في
+
+475
+00:29:45,380 --> 00:29:50,520
+عملية ال assessment الحقية بدنا نعمل مقارنة بين ال
+
+476
+00:29:50,520 --> 00:29:54,280
+inspected and opposite body side كيف يعني يعني إذا
+
+477
+00:29:54,280 --> 00:29:57,180
+أنت عملت assessment ال one side يعني مثلا عملت في
+
+478
+00:29:57,180 --> 00:30:01,660
+رشاقه الأيمن ماتيجيش تقول لأ في عنده مشكلة ايده
+
+479
+00:30:01,660 --> 00:30:05,620
+اليمنه فيها مشكلة استنى و اطلع على الايد اليسرى
+
+480
+00:30:05,620 --> 00:30:09,170
+إذا لجيته نفس الشيء تعتبر normalهو اكتشف نعتبر
+
+481
+00:30:09,170 --> 00:30:11,770
+abnormal لما يكون فيه big difference between right
+
+482
+00:30:11,770 --> 00:30:15,950
+and left يوزبن لايت استخدم اللي هو قلنا الضوء
+
+483
+00:30:15,950 --> 00:30:20,470
+المباشر عشان ال body cavities زي ال mouth و زي ال
+
+484
+00:30:20,470 --> 00:30:23,890
+nose و زي مثلا اه إذا بدنا نشوفها و زي إذا بدنا
+
+485
+00:30:23,890 --> 00:30:28,750
+نشوف إذا في لا سمح الله يعني أي orifice موجودة زي
+
+486
+00:30:28,750 --> 00:30:31,030
+في حالات ال deep abscess أو غيره ممكن نستخدم
+
+487
+00:30:31,030 --> 00:30:33,490
+الإضاءة palpation
+
+488
+00:30:36,310 --> 00:30:41,010
+أنا شايف عشان احنا بدناش نتخطى اكتر من نص ساعة ال
+
+489
+00:30:41,010 --> 00:30:43,050
+probation نخليه نكمل ان شاء الله في المحاضرة
+
+490
+00:30:43,050 --> 00:30:45,770
+القادمة ان شاء الله و تتابعونا و ان شاء الله
+
+491
+00:30:45,770 --> 00:30:47,950
+تكونوا استفدتوا السلام عليكم ورحمة الله وبركاته
+
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.json b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..417fb68246963303df2c22a974a736d44143d7e2
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2953, "start": 1.43, "end": 29.53, "text": "بسم الله الرحمن الرحيم نبدأ طبعا في ال chapter الرابع اليوم في طبعا مساق التقييم الصحي التمريد اللي طلبت المستوى التاني و هو الموضوع اللي هو physical assessment طبعا كانت كل الشباتر السابقة يعني هي بمثابة مقدمات أساسية من ال psycho و ال social و شوية spiritual زي ما احنا قلنا assessment و احنا حكينا انه في حاجة", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 8717, 44510, 10721, 23032, 3555, 3615, 995, 8978, 2423, 7187, 34892, 16758, 3615, 45595, 20498, 8978, 23032, 3555, 3615, 995, 47524, 995, 4587, 16712, 38436, 32640, 31767, 5016, 1829, 16712, 29973, 25708, 13672, 1829, 23032, 46152, 2655, 9673, 14851, 2407, 7578, 16712, 7649, 1829, 4032, 31439, 9673, 2407, 11242, 45367, 13672, 1829, 31439, 4001, 9687, 23032, 3555, 3615, 995, 25961, 2655, 28242, 25124, 3555, 9307, 2288, 21136, 16758, 28671, 37495, 22653, 39896, 4724, 2304, 12984, 16758, 3660, 3714, 28543, 2304, 9307, 5551, 3794, 32277, 10632, 9154, 2423, 33355, 4032, 2423, 2093, 4032, 13412, 2407, 10632, 6960, 30767, 1829, 19446, 1975, 5016, 8315, 12174, 1211, 8315, 9687, 4032, 1975, 5016, 8315, 11331, 4117, 1829, 8315, 16472, 3224, 8978, 11331, 26108, 3660], "avg_logprob": -0.16274038828336276, "compression_ratio": 1.8381294964028776, "no_speech_prob": 2.3245811462402344e-06, "words": [{"start": 1.43, "end": 1.75, "word": "بسم", "probability": 0.905029296875}, {"start": 1.75, "end": 1.95, "word": " الله", "probability": 0.95263671875}, {"start": 1.95, "end": 2.41, "word": " الرحمن", "probability": 0.9762369791666666}, {"start": 2.41, "end": 2.81, "word": " الرحيم", "probability": 0.99560546875}, {"start": 2.81, "end": 4.27, "word": " نبدأ", "probability": 0.912109375}, {"start": 4.27, "end": 4.61, "word": " طبعا", "probability": 0.931884765625}, {"start": 4.61, "end": 4.75, "word": " في", "probability": 0.80859375}, {"start": 4.75, "end": 4.81, "word": " ال", "probability": 0.7099609375}, {"start": 4.81, "end": 5.05, "word": " chapter", "probability": 0.8369140625}, {"start": 5.05, "end": 5.45, "word": " الرابع", "probability": 0.9654947916666666}, {"start": 5.45, "end": 5.85, "word": " اليوم", "probability": 0.943115234375}, {"start": 5.85, "end": 6.47, "word": " في", "probability": 0.6171875}, {"start": 6.47, "end": 7.25, "word": " طبعا", "probability": 0.83538818359375}, {"start": 7.25, "end": 7.67, "word": " مساق", "probability": 0.584716796875}, {"start": 7.67, "end": 8.07, "word": " التقييم", "probability": 0.8995768229166666}, {"start": 8.07, "end": 8.43, "word": " الصحي", "probability": 0.8694661458333334}, {"start": 8.43, "end": 8.81, "word": " التمريد", "probability": 0.8543294270833334}, {"start": 8.81, "end": 8.95, "word": " اللي", "probability": 0.7421875}, {"start": 8.95, "end": 9.27, "word": " طلبت", "probability": 0.95361328125}, {"start": 9.27, "end": 9.71, "word": " المستوى", "probability": 0.9473876953125}, {"start": 9.71, "end": 10.17, "word": " التاني", "probability": 0.9422200520833334}, {"start": 10.17, "end": 11.01, "word": " و", "probability": 0.498779296875}, {"start": 11.01, "end": 11.13, "word": " هو", "probability": 0.373046875}, {"start": 11.13, "end": 11.51, "word": " الموضوع", "probability": 0.9722900390625}, {"start": 11.51, "end": 11.67, "word": " اللي", "probability": 0.94482421875}, {"start": 11.67, "end": 11.83, "word": " هو", "probability": 0.9677734375}, {"start": 11.83, "end": 12.25, "word": " physical", "probability": 0.73974609375}, {"start": 12.25, "end": 13.09, "word": " assessment", "probability": 0.93994140625}, {"start": 13.09, "end": 15.31, "word": " طبعا", "probability": 0.9891357421875}, {"start": 15.31, "end": 16.31, "word": " كانت", "probability": 0.966796875}, {"start": 16.31, "end": 16.61, "word": " كل", "probability": 0.98193359375}, {"start": 16.61, "end": 17.59, "word": " الشباتر", "probability": 0.6533203125}, {"start": 17.59, "end": 18.09, "word": " السابقة", "probability": 0.9894205729166666}, {"start": 18.09, "end": 18.53, "word": " يعني", "probability": 0.833984375}, {"start": 18.53, "end": 18.69, "word": " هي", "probability": 0.65234375}, {"start": 18.69, "end": 19.37, "word": " بمثابة", "probability": 0.860107421875}, {"start": 19.37, "end": 20.61, "word": " مقدمات", "probability": 0.986328125}, {"start": 20.61, "end": 21.89, "word": " أساسية", "probability": 0.95654296875}, {"start": 21.89, "end": 22.29, "word": " من", "probability": 0.99462890625}, {"start": 22.29, "end": 22.75, "word": " ال", "probability": 0.880859375}, {"start": 22.75, "end": 23.17, "word": " psycho", "probability": 0.76953125}, {"start": 23.17, "end": 23.49, "word": " و", "probability": 0.68798828125}, {"start": 23.49, "end": 23.55, "word": " ال", "probability": 0.94384765625}, {"start": 23.55, "end": 24.01, "word": " social", "probability": 0.9326171875}, {"start": 24.01, "end": 24.93, "word": " و", "probability": 0.99365234375}, {"start": 24.93, "end": 25.23, "word": " شوية", "probability": 0.818359375}, {"start": 25.23, "end": 25.83, "word": " spiritual", "probability": 0.9248046875}, {"start": 25.83, "end": 26.89, "word": " زي", "probability": 0.880615234375}, {"start": 26.89, "end": 26.97, "word": " ما", "probability": 0.96923828125}, {"start": 26.97, "end": 27.07, "word": " احنا", "probability": 0.9010416666666666}, {"start": 27.07, "end": 27.27, "word": " قلنا", "probability": 0.8916015625}, {"start": 27.27, "end": 27.81, "word": " assessment", "probability": 0.91357421875}, {"start": 27.81, "end": 28.03, "word": " و", "probability": 0.85205078125}, {"start": 28.03, "end": 28.27, "word": " احنا", "probability": 0.9051106770833334}, {"start": 28.27, "end": 28.97, "word": " حكينا", "probability": 0.94580078125}, {"start": 28.97, "end": 29.21, "word": " انه", "probability": 0.759033203125}, {"start": 29.21, "end": 29.29, "word": " في", "probability": 0.8916015625}, {"start": 29.29, "end": 29.53, "word": " حاجة", "probability": 0.8660481770833334}], "temperature": 1.0}, {"id": 2, "seek": 5948, "start": 31.52, "end": 59.48, "text": "بدنا نبدأ شوية في ال bio عشان نتوسع أكتر اللي هو شغلنا الأساسي في المستشفيات و المرافق الصحية ان شاء الله لما نعود و نتدرب ان شاء الله في الأيام اللي القادمة بإذن الله الآن أول شيء بدنا نقول كلمة health assessment نذكر تذكير ان هنا في health assessment و هنا في physical ال physical جزء من ال health assessment خليكوا ذاكرين احنا قولنا ال health assessment يعني complete assessment بشتركوا فيها كل هى التلقاءات الصحية", "tokens": [44510, 8315, 8717, 44510, 10721, 13412, 2407, 10632, 8978, 2423, 12198, 6225, 8592, 7649, 8717, 2655, 41779, 3615, 5551, 4117, 2655, 2288, 13672, 1829, 31439, 13412, 17082, 1211, 8315, 16247, 3794, 32277, 1829, 8978, 9673, 14851, 8592, 41185, 9307, 4032, 9673, 23557, 5172, 4587, 31767, 5016, 10632, 16472, 13412, 16606, 21984, 5296, 15042, 8717, 3615, 23328, 4032, 8717, 2655, 3215, 25513, 16472, 13412, 16606, 21984, 8978, 16247, 1829, 10943, 13672, 1829, 25062, 18513, 46007, 4724, 28814, 8848, 1863, 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{"start": 1842.29, "end": 1842.37, "word": " الله", "probability": 0.95166015625}, {"start": 1842.37, "end": 1842.51, "word": " في", "probability": 0.8623046875}, {"start": 1842.51, "end": 1843.05, "word": " المحاضرة", "probability": 0.9852294921875}, {"start": 1843.05, "end": 1843.75, "word": " القادمة", "probability": 0.9866536458333334}, {"start": 1843.75, "end": 1843.89, "word": " ان", "probability": 0.75}, {"start": 1843.89, "end": 1844.01, "word": " شاء", "probability": 0.995361328125}, {"start": 1844.01, "end": 1844.19, "word": " الله", "probability": 0.9609375}, {"start": 1844.19, "end": 1844.87, "word": " و", "probability": 0.6826171875}, {"start": 1844.87, "end": 1845.31, "word": " تتابعونا", "probability": 0.8351236979166666}, {"start": 1845.31, "end": 1845.45, "word": " و", "probability": 0.98876953125}, {"start": 1845.45, "end": 1845.49, "word": " ان", "probability": 0.89453125}, {"start": 1845.49, "end": 1845.67, "word": " شاء", "probability": 0.993408203125}, {"start": 1845.67, "end": 1845.77, "word": " الله", "probability": 0.96337890625}, {"start": 1845.77, "end": 1846.09, "word": " تكونوا", "probability": 0.97607421875}, {"start": 1846.09, "end": 1846.53, "word": " استفدتوا", "probability": 0.92373046875}, {"start": 1846.53, "end": 1846.79, "word": " السلام", "probability": 0.83349609375}, {"start": 1846.79, "end": 1847.03, "word": " عليكم", "probability": 0.9453125}, {"start": 1847.03, "end": 1847.29, "word": " ورحمة", "probability": 0.8809814453125}, {"start": 1847.29, "end": 1847.41, "word": " الله", "probability": 0.96923828125}, {"start": 1847.41, "end": 1847.95, "word": " وبركاته", "probability": 0.9873046875}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1848.2155, "duration_after_vad": 1817.5387499999956}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.srt b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..51ac988a7cf96cbbf25b053a52a0bb813d7e1aed
--- /dev/null
+++ b/PL9fwy3NUQKwazM2HfmgVhHaVOTp3TFPzU/zS63i1FFMYc_raw.srt
@@ -0,0 +1,1964 @@
+1
+00:00:01,430 --> 00:00:05,050
+بسم الله الرحمن الرحيم نبدأ طبعا في ال chapter
+
+2
+00:00:05,050 --> 00:00:08,810
+الرابع اليوم في طبعا مساق التقييم الصحي التمريد
+
+3
+00:00:08,810 --> 00:00:11,830
+اللي طلبت المستوى التاني و هو الموضوع اللي هو
+
+4
+00:00:11,830 --> 00:00:18,090
+physical assessment طبعا كانت كل الشباتر السابقة
+
+5
+00:00:18,090 --> 00:00:23,550
+يعني هي بمثابة مقدمات أساسية من ال psycho و ال
+
+6
+00:00:23,550 --> 00:00:27,810
+social و شوية spiritual زي ما احنا قلنا assessment
+
+7
+00:00:27,810 --> 00:00:32,940
+و احنا حكينا انه في حاجةبدنا نبدأ شوية في ال bio
+
+8
+00:00:32,940 --> 00:00:36,160
+عشان نتوسع أكتر اللي هو شغلنا الأساسي في
+
+9
+00:00:36,160 --> 00:00:39,580
+المستشفيات و المرافق الصحية ان شاء الله لما نعود و
+
+10
+00:00:39,580 --> 00:00:43,120
+نتدرب ان شاء الله في الأيام اللي القادمة بإذن الله
+
+11
+00:00:43,120 --> 00:00:47,320
+الآن أول شيء بدنا نقول كلمة health assessment نذكر
+
+12
+00:00:47,320 --> 00:00:50,180
+تذكير ان هنا في health assessment و هنا في
+
+13
+00:00:50,180 --> 00:00:52,100
+physical ال physical جزء من ال health assessment
+
+14
+00:00:52,100 --> 00:00:55,300
+خليكوا ذاكرين احنا قولنا ال health assessment يعني
+
+15
+00:00:55,300 --> 00:00:58,860
+complete assessment بشتركوا فيها كل هى التلقاءات
+
+16
+00:00:58,860 --> 00:01:02,480
+الصحيةهو بتاخد حاجة بيسموها holistic approach او
+
+17
+00:01:02,480 --> 00:01:07,200
+يعني بيسموها يعني ايش التقييم الشمولي اما التقييم
+
+18
+00:01:07,200 --> 00:01:10,260
+الفيزيائي هو جزء يعني التقييم البيولوجيا او
+
+19
+00:01:10,260 --> 00:01:15,240
+التقييم الحيواني طيب ال objectives هنا ليش احنا
+
+20
+00:01:15,240 --> 00:01:18,680
+بنعملها اول حاجة في عندنا five assessment
+
+21
+00:01:18,680 --> 00:01:21,600
+techniques during physical examination بنكون
+
+22
+00:01:21,600 --> 00:01:23,940
+عارفين ايش ال assessment techniques اللي احنا ان
+
+23
+00:01:23,940 --> 00:01:27,340
+شاء الله هنحكي فيها لقدام شويةوكيف بنعمل إيهته
+
+24
+00:01:27,340 --> 00:01:30,880
+مخاصة لما نقول اننا بنستخدم .. يعني و احنا بنعمل
+
+25
+00:01:30,880 --> 00:01:34,800
+تقييم في five skills يمكن في بعض الكتب تكتب أربعة
+
+26
+00:01:34,800 --> 00:01:37,320
+لما كده قولنا تبدأ من عند ال inspection,
+
+27
+00:01:37,540 --> 00:01:40,260
+palpation, percussion, auscultation و لكن احنا
+
+28
+00:01:40,260 --> 00:01:43,820
+قولنا فيه كمان احنا هانا طريقة اسمه olfaction اللي
+
+29
+00:01:43,820 --> 00:01:47,920
+هي assessment by the ايه by smelling for something
+
+30
+00:01:47,920 --> 00:01:52,460
+or abnormal odors from the clients طيب يعني اللي
+
+31
+00:01:52,460 --> 00:01:56,580
+بيطلع الرواقع اللي مش تمام من المريضالان بدنا نعمل
+
+32
+00:01:56,580 --> 00:01:59,240
+differences between subjective and objective data
+
+33
+00:01:59,240 --> 00:02:02,120
+و احنا بنأكد كتير ان صارت مذكورة الكلمة لأن كتير
+
+34
+00:02:02,120 --> 00:02:05,900
+حتى في الامتحانات بكرا في المستقبل في توظيف و غيره
+
+35
+00:02:05,900 --> 00:02:08,120
+بيدقوا على موضوع ال subjective و ال objective و
+
+36
+00:02:08,120 --> 00:02:10,680
+انتوا ما شاء الله صرتوا فاهمين ايش اللي بنقصده
+
+37
+00:02:10,680 --> 00:02:14,180
+بالظبط يعني بكل ما بندقوا كلمة subjective data و
+
+38
+00:02:14,180 --> 00:02:16,200
+objective data objective بنقدر نجيس ال subjective
+
+39
+00:02:16,200 --> 00:02:20,720
+بنقدرش و بنسمعها من المريض immediate and mediate
+
+40
+00:02:20,720 --> 00:02:24,580
+percussion technique هنستخدم و نتعلم حاجة في ال
+
+41
+00:02:24,580 --> 00:02:29,890
+percussionاسمها ليه النقر اسمها التقييم بالنقر في
+
+42
+00:02:29,890 --> 00:02:35,690
+حساب مدية نقر مباشر وفي اشهر مديات عن طريق يعني مش
+
+43
+00:02:35,690 --> 00:02:40,230
+مباشرة على الجلد ممكن نستخدم نحط إصبع زي ما الطبيب
+
+44
+00:02:40,230 --> 00:02:46,110
+بحط مرات إصبع فوق إصبع وممكن في بعض الأحوال يعني
+
+45
+00:02:46,110 --> 00:02:50,150
+زي من فوق الملابس five percussion sounds لازم نفهم
+
+46
+00:02:50,150 --> 00:02:55,720
+أنه في عندناخمس أصوات بتطلع عن طريق ال percussion
+
+47
+00:02:55,720 --> 00:02:59,800
+وكأنه بيقول لي في خمس أصوات بتطلع من ال different
+
+48
+00:02:59,800 --> 00:03:04,160
+regions من المناطق اللي في جسم الإنسان يعني مش كل
+
+49
+00:03:04,160 --> 00:03:08,280
+صوت بيطلع زي .. يعني مثلا لو نقرنا على الإيد مش زي
+
+50
+00:03:08,280 --> 00:03:11,760
+ما ننقر على ال abdomen على البطن مش زي ما ننقر على
+
+51
+00:03:11,760 --> 00:03:15,300
+ال chest مش زي ما ننقر مثلا على ال head اللي هو ال
+
+52
+00:03:15,300 --> 00:03:18,460
+skull يعني اللي بنتكلم فكل صوت يختلف عن التاني
+
+53
+00:03:19,040 --> 00:03:21,840
+فبقول كمان هنا بدنا نستخدم ايش هنا ال status scope
+
+54
+00:03:21,840 --> 00:03:24,820
+أكيد طبعا لأنها استخدام أساسي في ال assessment
+
+55
+00:03:24,820 --> 00:03:28,920
+تبعتنا equipment preparation for health assessment
+
+56
+00:03:28,920 --> 00:03:33,660
+تحضير كل الأدوات و ان شاء الله بنعود للجامعة و
+
+57
+00:03:33,660 --> 00:03:36,700
+هتشوفوا بعض الأدوات اللي بنحكي عنها لما نذكرها
+
+58
+00:03:36,700 --> 00:03:40,660
+ربما يكون شغلة مقلوفة لكم و ربما يعني تكون حاجات
+
+59
+00:03:40,660 --> 00:03:43,180
+غريبة لو حاجة حتى غريبة عليكم و أنت ماتطلعت
+
+60
+00:03:43,180 --> 00:03:47,680
+مالاقيتش او ماجدرتش تساعدها بإمكانك اي procedure
+
+61
+00:03:47,680 --> 00:03:51,300
+او اي skillsأو أي instrument اداية انا باستخدامها
+
+62
+00:03:51,300 --> 00:03:54,820
+زي بكر حاجة و هقولك اسمها Tuning Fork Tuning Fork
+
+63
+00:03:54,820 --> 00:03:57,420
+اسم الشوكر الرنانة انت لو كتبت الشوكر الرنانة
+
+64
+00:03:57,420 --> 00:04:00,400
+بيجيك كيف شكلها و كيف منظرها يعني انا قصد بدناش
+
+65
+00:04:00,400 --> 00:04:03,440
+الشغلات توقفنا و كإن احنا مش عارفين بالظبط ايش
+
+66
+00:04:03,440 --> 00:04:07,280
+اللي احنا بيشرح عنه ال Pyrosis الغرض الأساسي أول
+
+67
+00:04:07,280 --> 00:04:11,440
+حاجة a certain clients level of التقييم جديش حالة
+
+68
+00:04:11,440 --> 00:04:14,540
+الصحية للمريض اللي أمامك من ناحية ايش هنا
+
+69
+00:04:14,540 --> 00:04:17,640
+physiological function ايش يعني يعني التقييم
+
+70
+00:04:17,640 --> 00:04:21,530
+الفيسيولوجيليه؟ لأن احنا في عنا اشكالية مش هندخل
+
+71
+00:04:21,530 --> 00:04:24,870
+لان لا في psychology ولا في sociology أنا بتكلم من
+
+72
+00:04:24,870 --> 00:04:29,690
+ان في ال physical examination تركيزي اكتر اكتر شي
+
+73
+00:04:29,690 --> 00:04:33,350
+على الناحية الفيسيوجية اللي هي الجسدية identify
+
+74
+00:04:33,350 --> 00:04:36,690
+important factors شوف ايش العوامل الهمة اللي بتأثر
+
+75
+00:04:36,690 --> 00:04:40,370
+على صحة المريض وهي ايش اللي لازم تذكر وليه حاجات
+
+76
+00:04:40,370 --> 00:04:44,250
+مش لازم تذكر confirm اكد alterations تغييرات
+
+77
+00:04:44,250 --> 00:04:48,330
+diseases or inabilityto perform ايش اختصار هذا
+
+78
+00:04:48,330 --> 00:04:51,890
+ذاكرين انتوا في سنة أولى activity of daily living
+
+79
+00:04:51,890 --> 00:04:54,870
+اللي هو الانشطة اليومية يعني بدنا نأكد اللي بيقوم
+
+80
+00:04:54,870 --> 00:04:57,670
+بيه المريض هو الإنسان الطبيعي بدنا نأكد ايش
+
+81
+00:04:57,670 --> 00:05:00,330
+الأشياء اللي بيقوم بيها الإنسان بشكل طبيعي في
+
+82
+00:05:00,330 --> 00:05:03,810
+حياته هل قادر أقوم بيها ولا مش قادر عشان أقدر أعمل
+
+83
+00:05:03,810 --> 00:05:07,690
+تقييم identify النقطة اللي بعدها اللي رقم 4
+
+84
+00:05:07,690 --> 00:05:11,230
+identify need for additional testing examination
+
+85
+00:05:11,230 --> 00:05:16,590
+بيخليني أحدد هل نحتاج أكتر واختبارات أكتروفحصات
+
+86
+00:05:16,590 --> 00:05:19,630
+أكتر ولا لأ؟ يعني أنا و أنا بعمل assessment يمكن
+
+87
+00:05:19,630 --> 00:05:24,150
+ألاقي شيء ألفة نظر الطبيب له الطبيب الخصائي أو ال
+
+88
+00:05:24,150 --> 00:05:26,030
+instructor اللي معايا فبروح بيقول لأ و الله دي ما
+
+89
+00:05:26,030 --> 00:05:28,910
+انتبهناش لها خليني نحكي للطبيب الخصائي بنحكي
+
+90
+00:05:28,910 --> 00:05:31,570
+للطبيب الخصائي بيجي ايه بيجي بعمل further
+
+91
+00:05:31,570 --> 00:05:34,710
+examination عشان يعمل ايش يعني زي ما يسمونه
+
+92
+00:05:34,710 --> 00:05:38,030
+explanation more explanation توضيح أكتر for the
+
+93
+00:05:38,030 --> 00:05:43,470
+case للحالة eight بيساعد in evaluating outcomeوفي
+
+94
+00:05:43,470 --> 00:05:46,570
+treatment شربي دايما ال assessment بساعد الطبيب
+
+95
+00:05:46,570 --> 00:05:52,970
+كمان في تقييم مدى تقدم حالة المريض ومدى استجابة
+
+96
+00:05:52,970 --> 00:05:56,510
+المريض للعلاج هل استجاب هل ما استجابش عشان اذا ما
+
+97
+00:05:56,510 --> 00:06:02,240
+استجابش اذا ما استجابشطبعا يعني المساعدة انه انا
+
+98
+00:06:02,240 --> 00:06:06,400
+باجي مرات بشوف يمكن انا اعطيت علاج معين لمريض معين
+
+99
+00:06:06,400 --> 00:06:10,540
+مااستجابش له او المريض استجاب بس هال عنده side
+
+100
+00:06:10,540 --> 00:06:13,580
+effect فبنقدر ننجل هذه المعلومات لمين للطبيب
+
+101
+00:06:13,580 --> 00:06:16,840
+المعالجي بقى انا بال assessment تبعتي بقدر انجل
+
+102
+00:06:16,840 --> 00:06:21,780
+معلومات ماانتبهلهاش الطبيب لما مار على المريض في
+
+103
+00:06:21,780 --> 00:06:26,180
+.. خلال دخوله في القسم طيب في انها ال subjective
+
+104
+00:06:26,180 --> 00:06:27,960
+and objective ذات اللي احنا حاكينا عنها مابدنا
+
+105
+00:06:27,960 --> 00:06:30,600
+نحكي فيها كتير لأنه حاكيناها كتيرخلاص دايما نقول
+
+106
+00:06:30,600 --> 00:06:33,940
+ال subjective نتكلم عن ال history يعني بشكل عام
+
+107
+00:06:33,940 --> 00:06:38,800
+ايش المريض اللي قدامي بيحكيلي شو بيحكيلي يعني هأنا
+
+108
+00:06:38,800 --> 00:06:41,780
+بنفس الوقت ايش هأنا ال objective هأنا exam يعني
+
+109
+00:06:41,780 --> 00:06:46,520
+انا باكتشف انا قدامه و قاعد بسمعله لكن باكتشف انه
+
+110
+00:06:46,520 --> 00:06:49,440
+عنده مشكلة واحد اتنين تلاتة الاكتشاف هذا اللي انا
+
+111
+00:06:49,440 --> 00:06:52,920
+اكتشفته بسميه objective الكلام اللي هو حكى ليه
+
+112
+00:06:52,920 --> 00:06:57,040
+بسميه subjective طيب possible client position
+
+113
+00:06:57,040 --> 00:07:01,710
+during an examinationإيش الأوضاع اللي ممكن
+
+114
+00:07:01,710 --> 00:07:06,250
+استخدمها في ال assessment للمريض طبعا أنا مش هأشرح
+
+115
+00:07:06,250 --> 00:07:09,270
+بزيادة الأن على الأوضاع اللي أنا بس هذكرها وإن شاء
+
+116
+00:07:09,270 --> 00:07:13,910
+الله في ال chapter القادم هراحكي بالظبط طبيعة
+
+117
+00:07:13,910 --> 00:07:18,810
+الأوضاع وكل وضع إيش بقدر أعمله examination طيب
+
+118
+00:07:18,810 --> 00:07:24,290
+الآن يمكن هذه الصورة بتوضح لنا كتير كويس حاجات هي
+
+119
+00:07:24,290 --> 00:07:29,090
+يعني وإن كانت مش كاملة 100%يعني مثلا مافيش لو
+
+120
+00:07:29,090 --> 00:07:33,310
+لاحظته مافيش standing position لاحظوا الأوضاع هذه
+
+121
+00:07:33,310 --> 00:07:36,390
+فيها أول موضوع اسمه Dorsal recumbent position
+
+122
+00:07:36,390 --> 00:07:41,810
+Dorsal recumbent position بعدين Spine position
+
+123
+00:07:41,810 --> 00:07:44,370
+اللي بعدها Spine position اللي هو النوم على الدهر
+
+124
+00:07:44,370 --> 00:07:48,430
+بعدين إيش هنا ال sitting position اللي هو الجالس
+
+125
+00:07:48,430 --> 00:07:52,710
+ال lithium position أو بيسموها اللي هو وضع الولادة
+
+126
+00:07:52,710 --> 00:07:55,570
+Sims position اللي هو النوم على اليسار وانتوا
+
+127
+00:07:55,570 --> 00:08:00,640
+عارفينهاللي هو فرد شوية الرجل التحت اليسرى مع ثاني
+
+128
+00:08:00,640 --> 00:08:04,440
+الرجل اليمنى وطبعا الناس بيكون عاملها اشماله و
+
+129
+00:08:04,440 --> 00:08:07,960
+بيكون ايش فيه بلو بسيطة يعني زي مخدة بسيطة تحت ايه
+
+130
+00:08:07,960 --> 00:08:11,440
+تحت راسه prone position يعني النوم على البطل طبعا
+
+131
+00:08:11,440 --> 00:08:14,780
+أنا مش هنتخل في التفاصيل عبيقة لكن بدي اقول انه
+
+132
+00:08:14,780 --> 00:08:18,980
+هاي قدامنا الأوضاع لما نقول ناخد مثال area
+
+133
+00:08:18,980 --> 00:08:21,640
+assisted يعني انت ايش بتاكي تقيم يعني في ال
+
+134
+00:08:21,640 --> 00:08:24,420
+recumbent position مثلا او في ال dorsal recumbent
+
+135
+00:08:24,420 --> 00:08:28,260
+positionبقدر أقيم ال head صحيح لأنه مبين ال head و
+
+136
+00:08:28,260 --> 00:08:30,600
+ال neck و ال axilla و ال anterior thorax الصدر من
+
+137
+00:08:30,600 --> 00:08:33,600
+الأمام و ال lungs و ال breast و ال heart و ال
+
+138
+00:08:33,600 --> 00:08:36,840
+extremities و ال peripheral برضه كله ال pulses و
+
+139
+00:08:36,840 --> 00:08:40,500
+الغيرهم كله بقدر أعمله لكن لو واحد حكى ليه نقدر
+
+140
+00:08:40,500 --> 00:08:44,780
+نعمل assessment مثلا لل buttocks نقدرش نقدر نعمل
+
+141
+00:08:44,780 --> 00:08:49,560
+assessment مثلا لل back نقدرش نقدر نعمل مثلا في ال
+
+142
+00:08:49,560 --> 00:08:53,560
+posterior of the neck برضه يبقى في أشياء نعملها و
+
+143
+00:08:53,560 --> 00:08:56,330
+في أشياء نعملهاشطيب لما بقول هنا quotients، إيش
+
+144
+00:08:56,330 --> 00:08:59,510
+يعني quotients؟ يعني هو كأنه بقولي انتبه في بعض
+
+145
+00:08:59,510 --> 00:09:04,170
+الأشياء هتتغلب و أنت بتعمل assessment لهذا الوضع،
+
+146
+00:09:04,170 --> 00:09:08,730
+هتتغلب بأمرين، إما أن أنت مش قادر تصل للعضو أو أن
+
+147
+00:09:08,730 --> 00:09:12,570
+المريض نفسه مش قادر يكون يحافظ على نفسه بهذا
+
+148
+00:09:12,570 --> 00:09:16,850
+الوضع، فعشان هيك بدك تكون ماخد quotient، احتياطات،
+
+149
+00:09:16,850 --> 00:09:20,410
+زي إيش هنا؟زي انا Contradicted ممكن يكون ممنوع
+
+150
+00:09:20,410 --> 00:09:23,730
+للناس اللي عندهم مينانة cardiopulmonary problems
+
+151
+00:09:23,730 --> 00:09:26,970
+يعني ايش يعني اللي عنده مشاكل في القلب والريأتين
+
+152
+00:09:26,970 --> 00:09:31,730
+يعني بقدرش يتنفس كويس وعنده فشل في عضلة القلب
+
+153
+00:09:31,730 --> 00:09:36,170
+بقدرش انام هاد النومة لأنه وكأنك بتضغط على القلب
+
+154
+00:09:36,170 --> 00:09:39,590
+أكتر وبتجيب ال load كله في اتجاه القلب واتجاه
+
+155
+00:09:39,590 --> 00:09:43,440
+الصدر عشان هيك بقدرشهيجيش بيقول كمان not used for
+
+156
+00:09:43,440 --> 00:09:46,720
+abdomen، إيش كمان؟ ولا بتقدر تعمل assessment لل
+
+157
+00:09:46,720 --> 00:09:50,600
+abdominal muscles أو لل abdominal organs، ليه؟
+
+158
+00:09:50,600 --> 00:09:54,140
+لأنه أصلا إحنا لما يعني increased tension of
+
+159
+00:09:54,140 --> 00:09:57,140
+abdominal، إيش شو يعني increased tension؟ أنت كأنك
+
+160
+00:09:57,140 --> 00:10:01,460
+زودت، لما الإنسان بينام على دهره وبيتني رجلي بهذا
+
+161
+00:10:01,460 --> 00:10:05,220
+الشكل، زي ما أنتوا شايفينبتلاقي بتضغط على عضلات
+
+162
+00:10:05,220 --> 00:10:08,960
+بطنه غير لما يكون الإنسان مرتاح على الآخر ومادد
+
+163
+00:10:08,960 --> 00:10:13,000
+رجليه وفاردهم زي هذا الشكل فبكون البطن ماخد راحته
+
+164
+00:10:13,000 --> 00:10:16,860
+يبقى معناته هنا بقدر اعمل يعني description هنا
+
+165
+00:10:16,860 --> 00:10:18,980
+طبعا عمودة ده مش حاسس حالي لإن هو موجود أيام هو
+
+166
+00:10:18,980 --> 00:10:23,420
+يعني الوضع أيه أمامنا يعني كيف بيوصف الوضع نيجي
+
+167
+00:10:23,420 --> 00:10:26,900
+نضرب مثلا مثلا ال setting معلش sorry نيجي نضرب
+
+168
+00:10:26,900 --> 00:10:30,310
+مثلا ال setting مثلابقول لي ال setting انت ممكن
+
+169
+00:10:30,310 --> 00:10:33,630
+تعمل assessment ليه؟ لل head تمام و ال neck و ال
+
+170
+00:10:33,630 --> 00:10:36,650
+posterior و ال anterior thorax يعني من قدام و من
+
+171
+00:10:36,650 --> 00:10:42,530
+ورا و ال lungs كمان و ال breast و ال axilla طيب ال
+
+172
+00:10:42,530 --> 00:10:46,510
+axilla كمان و ايش كمان؟ و ال heart طيب و ال vital
+
+173
+00:10:46,510 --> 00:10:49,810
+هاي ال heart طبعا الشمال و ال ايه كمان و ال vital
+
+174
+00:10:49,810 --> 00:10:53,010
+ال size بقدر اجيزله كمان و ال upper and lower
+
+175
+00:10:53,010 --> 00:10:56,590
+extreme زي ال upper و ال lower كله ايه؟موجود، والـ
+
+176
+00:10:56,590 --> 00:10:59,950
+Reflexes الاستجابات اللي هي ردات الفعل اللي بتصير
+
+177
+00:10:59,950 --> 00:11:03,150
+يعني زي حركة اليد أو حركة الرجل يعني أنا بسموه إيش
+
+178
+00:11:03,150 --> 00:11:06,530
+الـ Reflexes زي لما باجي بعمله نخص، دبوس أو غيره
+
+179
+00:11:06,530 --> 00:11:10,730
+مالي تشوف عنده قداش الاستجابة العصبية طب لمين
+
+180
+00:11:10,730 --> 00:11:13,930
+بنستخدموش أو بدنا نكون فيه عنا cushion بقولي ابعد
+
+181
+00:11:13,930 --> 00:11:18,090
+عن استخدامه في ال elderly مش معقول واحد اختيار مش
+
+182
+00:11:18,090 --> 00:11:23,170
+قادر يقعد الا نسنده بمخدات ويكون قاعد كويس ومثبت
+
+183
+00:11:23,170 --> 00:11:27,310
+نفسه عشان يستوعبواجه يقعد بهذا الشكل و يطيب مرتفعة
+
+184
+00:11:27,310 --> 00:11:30,970
+على الأرض حتى يوقع مباشرة عشان هيك بقول لدرلي ابعد
+
+185
+00:11:30,970 --> 00:11:35,370
+عنه لأنه بده ايش أنا support طبعا انا عشان الامور
+
+186
+00:11:35,370 --> 00:11:38,630
+كلها تكون واضحة و هكذا انا لإنه جاي هشرحه ان شاء
+
+187
+00:11:38,630 --> 00:11:41,990
+الله الهيثة و الهيبوسجين والسمسبوسجين و
+
+188
+00:11:41,990 --> 00:11:45,930
+البرومبوسجين هذا العمود بس انت بتقراهه بتعرفوا ايش
+
+189
+00:11:45,930 --> 00:11:50,390
+الأشياء اللي بنقدر نعملها ايش assessment و هذا
+
+190
+00:11:50,390 --> 00:11:53,670
+العمود الأخيرإيش الأشياء اللي بنبعد عنها أو بنكون
+
+191
+00:11:53,670 --> 00:11:58,530
+بنستخدمه with a caution يعني بنستخدمه بحذر شديد
+
+192
+00:11:58,530 --> 00:12:04,050
+طيب equipment preparation for physical assessment
+
+193
+00:12:04,050 --> 00:12:08,430
+أنا بدي أحضر الأدوات عشان أقدر أعمل physical طبعا
+
+194
+00:12:08,430 --> 00:12:12,110
+خليكوا ذاكرين أنا قلت physical كمان مرة أنا ماجلتش
+
+195
+00:12:12,110 --> 00:12:16,210
+هنا لا health ولا قلت nutrition اللي أنا عملته ولا
+
+196
+00:12:16,210 --> 00:12:18,690
+قلت sleep ولا أي شيء قلت أنا physical يعني شغل
+
+197
+00:12:18,690 --> 00:12:21,770
+بيولوجيةيبقى هيكون عندنا أدوات أنا اللي حكيته في
+
+198
+00:12:21,770 --> 00:12:25,810
+هذه الأدوات في ملوى يمكن .. في ناس منكم يمكن شاف
+
+199
+00:12:25,810 --> 00:12:30,430
+على يوتيوب شاف على موقع أي شيء ممكن يكون شاف معظم
+
+200
+00:12:30,430 --> 00:12:33,310
+هذول الأدوات و بالمناسبة انتوا لو روحتوا على
+
+201
+00:12:33,310 --> 00:12:36,910
+المستشفى تدربتوا ان شاء الله هتروحوا عام قريب يعني
+
+202
+00:12:36,910 --> 00:12:40,430
+إذا كانت أو ان شاء الله ال .. خليني أقول يعني
+
+203
+00:12:40,430 --> 00:12:43,510
+الدلائل اللي واضحة اللي جاية ان شاء الله بتأكدنا
+
+204
+00:12:43,510 --> 00:12:46,870
+ان شاء الله مش هنطول كتير في البعد عن المستشفيات
+
+205
+00:12:46,870 --> 00:12:51,630
+هتشوفوا كل هذه الأدواتيمكن أداة واحدة فقط يعني
+
+206
+00:12:51,630 --> 00:12:54,750
+نادرة تخلقها ليه ال turning fork ليه الشوك
+
+207
+00:12:54,750 --> 00:12:58,490
+الرنانة؟ هذا إيه؟ شكله بإمكانه لو واحد بده أو طالب
+
+208
+00:12:58,490 --> 00:13:02,470
+بده تتأكد كيف تستخدم بإمكانه ندخل على اليوتيوب بس
+
+209
+00:13:02,470 --> 00:13:05,670
+و نفتح كيه استخدام الشوك الرنانة هيوريك بالظبط كل
+
+210
+00:13:05,670 --> 00:13:10,130
+أداة من أدوات كيف بيستخدموهاطبعا اول واحد انا ال
+
+211
+00:13:10,130 --> 00:13:12,070
+flashlight اللي هو ال pen light بسموه الضوء
+
+212
+00:13:12,070 --> 00:13:15,250
+المباشر لما نجلد flashlight او pen light ليش سموه
+
+213
+00:13:15,250 --> 00:13:18,270
+pen زي الكلام يعني كأنه يعني ضوء مباشر مش مش زي
+
+214
+00:13:18,270 --> 00:13:21,490
+الضوء الواسع لأ مش زي ضوء الجوال ال mobile اللي
+
+215
+00:13:21,490 --> 00:13:25,330
+معناه لأ لازم يكون ضوء sharp light عشان اي cavity
+
+216
+00:13:25,330 --> 00:13:29,510
+بدنا نعمله assessment أقدر أضوع عليه ال oriental
+
+217
+00:13:29,510 --> 00:13:31,750
+mirror اللي بيسموه ال مرايا اللي بيستخدموها تبعيني
+
+218
+00:13:31,750 --> 00:13:36,750
+الأسنان عشان يشوف اللي هو الحنجرة البلعوم الأسنان
+
+219
+00:13:37,200 --> 00:13:41,000
+لأنه مقدرش الطبيب يظل يلف و يطلع شمال يمين عن طريق
+
+220
+00:13:41,000 --> 00:13:44,220
+المرايا و المرايا بالمناسبة تكون كمان مكبرة شوية
+
+221
+00:13:44,220 --> 00:13:48,680
+نزل Speculum ايش يعني فحص الأنف من الداخل فتح
+
+222
+00:13:48,680 --> 00:13:51,960
+الأنف طبعا ليش سموها Speculum هنلاقي مرات هان
+
+223
+00:13:51,960 --> 00:13:55,100
+مكتوب Speculum و هنلاقي مرات هذه الكلمة كمان
+
+224
+00:13:55,100 --> 00:13:58,920
+Speculum لما نسمع كلمة Speculum إذا حد بتذكر معايا
+
+225
+00:13:58,920 --> 00:14:02,560
+الزردية اللي بنستخدمها أو الجطاعة زي ما بتعرفوها
+
+226
+00:14:02,560 --> 00:14:07,220
+في البيوت لما بنضغط عليها بتسكر من قدامهذه اللي
+
+227
+00:14:07,220 --> 00:14:09,640
+بيسموها ذردية او يعني اي شيء بيستخدمها زي
+
+228
+00:14:09,640 --> 00:14:12,780
+الكهربائين و غيرهم لكن لما نقول كلمة speculum
+
+229
+00:14:12,780 --> 00:14:16,600
+العكس لما نضغط عليها بتفتح لما نضغط عليها بتفتح
+
+230
+00:14:16,600 --> 00:14:19,760
+اللي لاحظته زي انا مثلا لاحظوا هنا لو بتصيرها انا
+
+231
+00:14:19,760 --> 00:14:24,540
+اتضيق للمسافة اكتر بتفتح المسافة من هنا اكتر اللي
+
+232
+00:14:24,540 --> 00:14:27,740
+بدي اتأكد بروح اليوتيوب ال speculum ده بنستخدمه
+
+233
+00:14:27,740 --> 00:14:30,700
+ليش الأنف لأن عشان مرات انا بده اشوف من جوا فانا
+
+234
+00:14:30,700 --> 00:14:32,920
+مقدرش اشوف ال cavity من جوا اللي عن طريق ما افتح
+
+235
+00:14:32,920 --> 00:14:36,580
+الأنف اكترأفثالموسكوب يعني من ضار أيش؟ ايه
+
+236
+00:14:36,580 --> 00:14:40,740
+افثالموسكوب من ضار العين اوتوسكوب اوتو اوتو كلمة
+
+237
+00:14:40,740 --> 00:14:43,580
+لاتنين معناها أيش يعني ال air اللي هو ال air يعني
+
+238
+00:14:43,580 --> 00:14:47,820
+اللي هو من ضار الأذن ويله طبعا عدة مجسات عشان نفحص
+
+239
+00:14:47,820 --> 00:14:50,620
+اللي الصغير و الكبير و الميل و الفميل ال
+
+240
+00:14:50,620 --> 00:14:53,400
+percussion بيسموه اللي هو الشكوش اللي بنستخدمه
+
+241
+00:14:53,400 --> 00:14:57,980
+خاصة لإيش لل reflex الاستجابات العصبية انه كيف هل
+
+242
+00:14:57,980 --> 00:15:01,100
+في استجابة هل في الأطراف في مشكلة بيبقوا اللي
+
+243
+00:15:01,100 --> 00:15:05,500
+يستجيب الإنسانTunning fork الشوكة الرنانة نريد أن
+
+244
+00:15:05,500 --> 00:15:09,680
+نشوف قدرة السماع هل يستطيع المريض أن يكون الذبذبات
+
+245
+00:15:09,680 --> 00:15:13,440
+حول ذهنه .. أذنه بيسمع اليمين وشماز يبعث؟ طبعا هو
+
+246
+00:15:13,440 --> 00:15:17,300
+صح مش شغلنا لكن من باب المعرفة يعني ال vagina ناسب
+
+247
+00:15:17,300 --> 00:15:19,660
+الكلام اللي هو هذا بنستخدمه في حالة ال vagina
+
+248
+00:15:19,660 --> 00:15:23,320
+examination للستات و خاصة لما نبدأ نستخدم حاجة
+
+249
+00:15:23,320 --> 00:15:27,160
+بسمها DNC DNC اقتصار عالم اسمه dilatation and
+
+250
+00:15:27,160 --> 00:15:32,180
+cortageللمريضات اللى بيصير معاهم فى بداية الحمل و
+
+251
+00:15:32,180 --> 00:15:35,220
+بتجهد الست يعنى مثلا ان ده abortion ابتسمع
+
+252
+00:15:35,220 --> 00:15:38,520
+بالعامية بيقولوا راحت تعمل عملية تنظيفات فلازم
+
+253
+00:15:38,520 --> 00:15:42,100
+يعملوا يعني يوسعوا المكان عشان يقدر الطبيب يعمل
+
+254
+00:15:42,100 --> 00:15:45,320
+التنظيف cotton application كلكوا عارفينه يعنى اللى
+
+255
+00:15:45,320 --> 00:15:48,960
+هو زى ال cotton stick اللى بيكون مرات بنباع بس مش
+
+256
+00:15:48,960 --> 00:15:52,840
+زى اللى بنباع فى الأسواق هذا بيكون مكان شوية و
+
+257
+00:15:52,840 --> 00:15:55,780
+طويل اللى هو عشان ممكن ناخد فيه أسواق على طرفه
+
+258
+00:15:55,780 --> 00:16:01,140
+بيكون يعني زى عودو على طرف قطن يعني فى هنا ال pads
+
+259
+00:16:01,140 --> 00:16:04,060
+اللى هو يعني بنستخدم زى الأنسجة أو بنستخدم زى
+
+260
+00:16:04,060 --> 00:16:11,160
+اللففة معينة أو بنستخدم مثلا جوز عشان نقدر إذا كان
+
+261
+00:16:11,160 --> 00:16:14,320
+فى solution أو كده ممكن يعني ناخد احتياطاتنا اللى
+
+262
+00:16:14,320 --> 00:16:16,440
+بعدها gloves كلكوا عارفينه بتقول انتوا لبستوا كيف
+
+263
+00:16:16,440 --> 00:16:20,080
+استرال واتعلمتوا كيف طريقتا فى سنة أولى فى طبعا
+
+264
+00:16:20,080 --> 00:16:24,220
+نوعين استرال وانسترال هنا ال labricant يعني الملين
+
+265
+00:16:24,220 --> 00:16:30,210
+سواء كانزي الذراكين جيل اسمه او يعني اي labricant
+
+266
+00:16:30,210 --> 00:16:33,530
+جيل بشكل عام بدون الأسماء بنستخدمه في بعض الحالات
+
+267
+00:16:33,530 --> 00:16:38,070
+لإنه ممكن نحتاجه و احنا بنعمل examination طبعا ال
+
+268
+00:16:38,070 --> 00:16:43,670
+tongue depress اللي هو كلكوا عارفينها لما نيجي
+
+269
+00:16:43,670 --> 00:16:47,750
+بنفحص الفم من جوا بنضطر نجيب ال tongue depress
+
+270
+00:16:47,750 --> 00:16:51,690
+عشان إيش يعني نحاول نخافض اللسان نضغط على اللسان
+
+271
+00:16:51,690 --> 00:16:56,270
+لتحت عشان نفحص ال enzygium اللي جواالان
+
+272
+00:16:56,270 --> 00:16:58,770
+indications for physical examination ليش يا تورا
+
+273
+00:16:58,770 --> 00:17:02,850
+انا بعمل physical examination طبعا انا بعمل اول
+
+274
+00:17:02,850 --> 00:17:06,270
+حاجة routine screening ايش routine يعني البناء
+
+275
+00:17:06,270 --> 00:17:08,130
+الأدم الشاطر اللي احنا حكينا هذا الكلام في البداية
+
+276
+00:17:08,130 --> 00:17:13,290
+يحاول دايما يتذكر نفسه علشان يظلوا دايما يعني صحته
+
+277
+00:17:13,290 --> 00:17:17,430
+منيحة ومحافظ عليها اذا صار أي شيء يعني ممكن بعض
+
+278
+00:17:17,430 --> 00:17:21,110
+خاصة كبار السن بدأ عندهم امراض او امراض زارية في
+
+279
+00:17:21,110 --> 00:17:25,060
+العائلة بنضطر نعملهم دايما routine examinationهنا
+
+280
+00:17:25,060 --> 00:17:27,960
+بقول ال eligibility ال eligibility معناته الليقة
+
+281
+00:17:27,960 --> 00:17:31,120
+prerequisite لما تقول ال prerequisite يعني المتطلب
+
+282
+00:17:31,120 --> 00:17:33,940
+السابق for health insurance او military military
+
+283
+00:17:33,940 --> 00:17:37,540
+يعني ايه للعسكرية او job او يعني المهن او ال
+
+284
+00:17:37,540 --> 00:17:42,840
+sports school يعني باختصار او المدارس يستخدم الفحص
+
+285
+00:17:42,840 --> 00:17:46,600
+الصحي زي ال occupational انا حاكينا عليه زيك في
+
+286
+00:17:46,600 --> 00:17:51,190
+بداية المحاضرات الأولى و التانيةانه كمان يستخدموا
+
+287
+00:17:51,190 --> 00:17:56,050
+زي ليقل وظيفة معينة ليقل رياضة ليقل اجتياز دور
+
+288
+00:17:56,050 --> 00:18:00,750
+عسكري و هكذا او لتأمين admission to hospital لما
+
+289
+00:18:00,750 --> 00:18:05,610
+يدخل اي انسان على المستشفى و خاصة اذا هو يعني اول
+
+290
+00:18:05,610 --> 00:18:10,130
+مرة بيجي عنا هيظل معنا long term care facility
+
+291
+00:18:10,130 --> 00:18:14,190
+يعني زي مريض سكر اول مرة اكتشفناه مريض ضغط فبنضطر
+
+292
+00:18:14,190 --> 00:18:17,570
+احنا في هذه الحالةانه نعمله complete physical
+
+293
+00:18:17,570 --> 00:18:22,430
+examination عشان يظلوا يعني عارفين بداية الوضع كيف
+
+294
+00:18:22,430 --> 00:18:27,030
+كان عندهم نبدأ نقارن فيه مابعد طيب بقولي انا steps
+
+295
+00:18:27,030 --> 00:18:30,090
+of assessment ايش الخطوات اول حاجة في ال
+
+296
+00:18:30,090 --> 00:18:33,130
+assessment think ايش يعني think يعني فكر يعني كأنه
+
+297
+00:18:33,130 --> 00:18:36,570
+بقولي ما تهجمش على المريض قبل ما انت تكون مفكر ايش
+
+298
+00:18:36,570 --> 00:18:41,620
+اللي بدك تعمله organize نظمواش بقولي انا don't
+
+299
+00:18:41,620 --> 00:18:44,600
+forget ما تنسى لا ال nutrition ولا ال white ولا ال
+
+300
+00:18:44,600 --> 00:18:47,860
+white احنا حاكيين عنها يا انك تاخد طوله ووزنه و
+
+301
+00:18:47,860 --> 00:18:51,420
+تسأله عنه الوضع اللي هو الغذائي بشكل عام ال
+
+302
+00:18:51,420 --> 00:18:54,180
+environment تكون يعني مريحة وكويسة مافيش حد حواليه
+
+303
+00:18:54,180 --> 00:18:58,000
+accommodated specialists اذا احتجنا في بعض الحالات
+
+304
+00:18:58,000 --> 00:19:01,420
+بدك تعمل accommodation accommodation زي تحوير ايش
+
+305
+00:19:01,420 --> 00:19:04,640
+يعني تحوير زي adaptation خاصة في ال cultural
+
+306
+00:19:04,640 --> 00:19:07,340
+sensitivity يعني امكان انا بدي احتاج هقول للمرض
+
+307
+00:19:07,340 --> 00:19:12,390
+كشف بطنكارفع عن رجلك ارفع عن مثلا صدرك يكون فيها
+
+308
+00:19:12,390 --> 00:19:15,230
+نوع من ال embarrassment يعني احراج فبدك تكون عامل
+
+309
+00:19:15,230 --> 00:19:17,850
+حاجة بسمها accommodate ايش accommodate يعني نحور
+
+310
+00:19:17,850 --> 00:19:21,430
+أمور نحط ستاير نحط شرشة نبعد الناس حواليه هذه
+
+311
+00:19:21,430 --> 00:19:25,190
+بتريح المريض وانت بتعمله examination طبعا حط ال
+
+312
+00:19:25,190 --> 00:19:28,230
+equipment حضرناه a clean surface يكون المكان نظيف
+
+313
+00:19:28,230 --> 00:19:32,430
+a clean equipment كل الأدوات نظيفة الغرفة تكون
+
+314
+00:19:32,430 --> 00:19:37,960
+هاديةتكون دافية و ال led مضاءة جيدا ماتكونش يعني
+
+315
+00:19:37,960 --> 00:19:43,200
+لا عتمة ولا مضاءة بإضاءة صفراء أو حمراء لازم تكون
+
+316
+00:19:43,200 --> 00:19:49,140
+إضاءة يعني أبيض تكون مابتعكسش أي نور على جسم وجلد
+
+317
+00:19:49,140 --> 00:19:53,680
+المريض maintain privacy المحافظة على إيه المحافظة
+
+318
+00:19:53,680 --> 00:19:57,500
+على سرية إيش المريض أكيد طبعا بعدينش بقولي أنا
+
+319
+00:19:57,500 --> 00:20:00,980
+observe anderson يا ريت بقولي إيش أنت لاحظين
+
+320
+00:20:00,980 --> 00:20:03,960
+الذاكرين لما كنا في ال interviewهيحكي المريض و
+
+321
+00:20:03,960 --> 00:20:06,840
+هيكون عنده body language و انا هنا بقول دائما
+
+322
+00:20:06,840 --> 00:20:10,700
+دائما observe and listen صدق ال observe و يعني ال
+
+323
+00:20:10,700 --> 00:20:14,100
+listen ان شاء الله كله صادق لكن لو قلنا مين الأصدق
+
+324
+00:20:14,100 --> 00:20:18,660
+دائما ن observe لان body language طيب بقول هنا
+
+325
+00:20:18,660 --> 00:20:23,340
+don't forget اقعد تنسى اقعد تنسى انه اتراجع
+
+326
+00:20:23,340 --> 00:20:25,540
+المعلومات اللى عندك reviewing general information
+
+327
+00:20:25,540 --> 00:20:29,280
+اللى اتخدتها اقعد تنسى انك تقدم نفسك للمريض
+
+328
+00:20:29,280 --> 00:20:33,460
+introductionاوعى تنسى انك تاخد health history،
+
+329
+00:20:33,460 --> 00:20:36,660
+اوعى تنسى انك تعمل pain assessment تقييم للألم،
+
+330
+00:20:36,660 --> 00:20:40,020
+يعني مش معقول يقولك أنا بطن بيجعني في هذا المكان،
+
+331
+00:20:40,020 --> 00:20:43,260
+اتروح تبدأ ال assessment في إياك، لأنه انت هيك
+
+332
+00:20:43,260 --> 00:20:47,200
+بتأذي المريض، هذا كله اش بيسموه key، اش يعني key
+
+333
+00:20:47,200 --> 00:20:50,120
+مفتاح، زي مفتاح الباب، كله مفتاح لل holistic
+
+334
+00:20:50,120 --> 00:20:53,500
+approach اللي هو المدخل الشمولي للرعاية
+
+335
+00:20:59,190 --> 00:21:02,470
+five assessment techniques during physical
+
+336
+00:21:02,470 --> 00:21:05,370
+examination و احنا حكينا ده كلام و احنا قايل قولنا
+
+337
+00:21:05,370 --> 00:21:07,150
+ان الكتب هتكتب لنا Inspection, Pulpation,
+
+338
+00:21:07,230 --> 00:21:09,930
+Percussion و Scalptation لكن احنا فيه كمان حاجة
+
+339
+00:21:09,930 --> 00:21:12,910
+جديدة اسمها all factions و لما نيصل لكلمة all
+
+340
+00:21:12,910 --> 00:21:15,930
+factions هتعرفوا ان انا كديش اهمية مرات كتير و
+
+341
+00:21:15,930 --> 00:21:20,930
+احنا بنعمل assessment طيب خليني انا يعني هذه
+
+342
+00:21:20,930 --> 00:21:25,090
+الصورة شوية يعني دايما نذكرها و دايما نحطها في
+
+343
+00:21:25,090 --> 00:21:29,270
+ذهننا و في بالنا شويةو أنا دايما صدقا بجيب عليها
+
+344
+00:21:29,270 --> 00:21:32,270
+السيلاية عشان أكون واضح يعني مش بجيب و أنا بقولك
+
+345
+00:21:32,270 --> 00:21:34,430
+ارسم و أنا بقولك كده هي ممكن انتوا شايفينها زي
+
+346
+00:21:34,430 --> 00:21:38,550
+الكتيرة او صور متحركة لكن هذا مهم شوية الانش
+
+347
+00:21:38,550 --> 00:21:41,770
+بيقولي انا واحد first يعني هنا ال second يعني
+
+348
+00:21:41,770 --> 00:21:45,190
+اتنين هنا ال third هنا ال fourth اعتبر ايش هنا
+
+349
+00:21:45,190 --> 00:21:49,070
+اعتبر ان هذا الشنطة اللي قدامكوا هو المريض يعني مش
+
+350
+00:21:49,070 --> 00:21:52,770
+هو مش شنطة هو المريض و كتب لنا tools of physical
+
+351
+00:21:52,770 --> 00:21:56,420
+assessmentاستبعدوا الأولفاكشن لأنه قلتلكوا الكتاب
+
+352
+00:21:56,420 --> 00:21:59,220
+اللي احنا بستخدمه الآن مابيستخدمش أولفاكشن لكن
+
+353
+00:21:59,220 --> 00:22:02,800
+احنا خلّينه نطلع بقوللي أول حاجة inspection طبعا
+
+354
+00:22:02,800 --> 00:22:07,140
+مجهزت inspection هي رسملي الرسم للنظر العادي
+
+355
+00:22:07,140 --> 00:22:11,780
+والنظر التاني طب ليش هو حطلي أنا حطلي أنا عدسة هو
+
+356
+00:22:11,780 --> 00:22:14,580
+مش هتحط عدسة يعني كأنه بيقولك ال inspection أبعد
+
+357
+00:22:14,580 --> 00:22:17,980
+من كلمة النظر العادي يعني ال inspection أقرب ما
+
+358
+00:22:17,980 --> 00:22:24,690
+يكون لإيهأقرب ما يكون للنظر بالكيان يعني أنه نلاحظ
+
+359
+00:22:24,690 --> 00:22:30,270
+بإحساساتنا ونكون واضحين الرؤية بحيث أنه أي شيء
+
+360
+00:22:30,270 --> 00:22:34,550
+موجود متغير نقدر ننتبه له بعدين application هانا
+
+361
+00:22:34,550 --> 00:22:38,310
+ايش هانا palpation لأ palpation بعدين هانا اللي هو
+
+362
+00:22:38,310 --> 00:22:41,750
+ال application تطبيق اتنين palpation مد ايدي مدين
+
+363
+00:22:41,750 --> 00:22:45,250
+ايدينا على الجسم هذا اتنين تلاتة لحظوا percussion
+
+364
+00:22:45,250 --> 00:22:49,080
+النقر ولو قدامش وحشرحلكم كيف النقرلاحظين كيف الإيد
+
+365
+00:22:49,080 --> 00:22:52,240
+الأيسر هنا و الإيد الأيمن هنا بقى أخر حاجة
+
+366
+00:22:52,240 --> 00:22:55,400
+auscultation لو حد سألنا طب ليش أستاذ ماحطوش
+
+367
+00:22:55,400 --> 00:22:59,700
+auscultation قبل؟ لأ دايما انت لو طلعته ماشي مع ال
+
+368
+00:22:59,700 --> 00:23:02,620
+skills ماشي من ال simple ل ال difficult ال
+
+369
+00:23:02,620 --> 00:23:06,860
+inspection كل الناس بتلاحظ ال palpation يعني معظم
+
+370
+00:23:06,860 --> 00:23:09,260
+الناس اللي دارسين في التمرد و في الطب و في العلوم
+
+371
+00:23:09,260 --> 00:23:12,720
+الصحية بقدر يعمل palpation ال percussion لأ مش أي
+
+372
+00:23:12,720 --> 00:23:16,330
+واحد بيدا واحد أخصائيالـ escalation بده .. لأ بده
+
+373
+00:23:16,330 --> 00:23:20,570
+يعني expert، خبير عشان هيك خلنا في الآخر عشان هيك
+
+374
+00:23:20,570 --> 00:23:23,690
+مرات حتى لما بنجيس الضغط لمريد بيجي طالب بيقول
+
+375
+00:23:23,690 --> 00:23:26,310
+والله أنا حسيت انه مش سامع كويس الضغط أو ضغطه
+
+376
+00:23:26,310 --> 00:23:29,870
+مرتفع شوية بروح بنقوله طيب إذا أنت مش سامع خلي
+
+377
+00:23:29,870 --> 00:23:33,290
+غيرك يسمع ليه على اعتبار أنه مش كل واحد عنده ال
+
+378
+00:23:33,290 --> 00:23:36,330
+escalation power أو ال escalation يعني .. يعني
+
+379
+00:23:36,330 --> 00:23:41,090
+خلينا نقول skill زيه زي التاني هذه ال .. ال .. ال
+
+380
+00:23:41,090 --> 00:23:45,220
+.. اللي حكيت عنها اللي هي الترتيبيستخدم في كل ..
+
+381
+00:23:45,220 --> 00:23:50,420
+في كل الجسم إلا .. إلا .. إلا في إيه؟ شوفوا الكلام
+
+382
+00:23:50,420 --> 00:23:53,840
+البسيط الحلو إلا في حالة ال abdomen خاصة ال
+
+383
+00:23:53,840 --> 00:23:55,480
+abdominal tenderness إيش يعني abdominal
+
+384
+00:23:55,480 --> 00:23:59,400
+tenderness؟ يعني لما يكون فيه ألم في البطل، مانفعش
+
+385
+00:23:59,400 --> 00:24:02,660
+أمد إيدي، إيش صار طيب هنا؟ بقول ياريت تبدأ بال
+
+386
+00:24:02,660 --> 00:24:05,980
+inspection، بدأ من هنا، و أروحلي على ال
+
+387
+00:24:05,980 --> 00:24:09,540
+auscultation، أجي هنا، يبقى لحظين في ال abdomen
+
+388
+00:24:09,540 --> 00:24:14,230
+عكبال بعضهي inspection, auscultation أشياء زي هيك
+
+389
+00:24:14,230 --> 00:24:17,970
+بعدين إيش قالت هالأتا percussion ها برجع ع الجوا
+
+390
+00:24:17,970 --> 00:24:21,430
+inspection, palpation بعدين ال palpation و إيش
+
+391
+00:24:21,430 --> 00:24:24,930
+الآخر واحدة ده ليه مكتوب هنا palpate بتلعب فوق لو
+
+392
+00:24:24,930 --> 00:24:28,150
+حاسس إنه ليش آخر شيء ال palpation لأنه هيكون مؤلم
+
+393
+00:24:28,150 --> 00:24:31,710
+جدا للمريض هذا في حالة ال abdominal examination
+
+394
+00:24:31,710 --> 00:24:34,450
+خليكوا ذاكرين في حالة ال abdominal examination أما
+
+395
+00:24:34,450 --> 00:24:37,650
+في الحالات الطبيعية دقر تذكروا inspection,
+
+396
+00:24:37,850 --> 00:24:41,120
+palpation, percussion, auscultationلو حد واحد نسي
+
+397
+00:24:41,120 --> 00:24:47,340
+يكتب IPA بعدين PE بعدين A طبعا ليش قلت انا نكتب PE
+
+398
+00:24:47,340 --> 00:24:51,700
+P لأن هنا P و هنا P فبلاش تخربط فاكر اننا PA و هنا
+
+399
+00:24:51,700 --> 00:24:54,400
+PE يبقى inspection, probation, percussion,
+
+400
+00:24:54,560 --> 00:24:57,900
+auscultation except an abdominal assessment you
+
+401
+00:24:57,900 --> 00:25:05,100
+can inspect and after that auscultate and after
+
+402
+00:25:05,100 --> 00:25:14,150
+that percussion بعدين ايش؟بعدين palpation طيب نيجي
+
+403
+00:25:14,150 --> 00:25:18,350
+أول حاجة عن inspection inspection بيقول use a
+
+404
+00:25:18,350 --> 00:25:21,310
+vision استخدمه بالاسم الكل هذا تعتبر من أيه؟ من
+
+405
+00:25:21,310 --> 00:25:26,170
+الملاحظة always first دائما في الأول look for
+
+406
+00:25:26,170 --> 00:25:29,310
+symmetry أول ما تتطلع يعني هذا أول شي باستخدامها
+
+407
+00:25:29,310 --> 00:25:33,810
+دائما تطلع على التناسب بين أعضاء الجسم symmetry
+
+408
+00:25:33,810 --> 00:25:36,170
+التناسب الانسجام بين الأتنين تطلع على أيدي اليمين
+
+409
+00:25:36,170 --> 00:25:38,230
+و أيدي الشمال رجلي اليمين و رجلي الشمالالدان
+
+410
+00:25:38,230 --> 00:25:41,030
+اليمين الدان الشمالية كذا use good lighting استخدم
+
+411
+00:25:41,030 --> 00:25:45,350
+الإضاءة القوية use good exposure يا ريت المكان
+
+412
+00:25:45,350 --> 00:25:48,490
+اللي بدك تعمله أساساً حاول تكشفه good exposure
+
+413
+00:25:48,490 --> 00:25:52,950
+ماجالش full خليني أذكرين جال good exposure full
+
+414
+00:25:52,950 --> 00:25:56,530
+يعني نشلح المريض أو نعريه كله أما good exposure بس
+
+415
+00:25:56,530 --> 00:26:01,250
+يعني for the examination part طيب لاحظين أنه وين
+
+416
+00:26:01,250 --> 00:26:03,690
+واجف الطبيب الطبيب هي موجود هنا و هذا كلام ده
+
+417
+00:26:03,690 --> 00:26:07,110
+نتذكر دايما كتير من الأطباء بيخطأوا في الأسابق و
+
+418
+00:26:07,110 --> 00:26:12,830
+بيعملواassessment دائما المريض يعني بيكون نايم هيو
+
+419
+00:26:12,830 --> 00:26:16,670
+أمامنا والطبيب الأخصائي وين واقف؟ واقف على يمين
+
+420
+00:26:16,670 --> 00:26:19,170
+وماحد ييجي يسألني يقولي كيف أعرف اليمين من الشمال
+
+421
+00:26:19,170 --> 00:26:22,550
+حتى لو شوفت أي صورة حاول أنك تسلم عليه هي أيدي
+
+422
+00:26:22,550 --> 00:26:25,490
+الطبيب لو بده يسلم عليه هي أيديه اليامين طب لو هو
+
+423
+00:26:25,490 --> 00:26:29,930
+بده يسلم على مثلا المريضة بده يروح ايه؟ بده يسلم
+
+424
+00:26:29,930 --> 00:26:33,430
+عليه؟ مش عارف هل أنا اليامين؟ لأ هي اليامين طب وين
+
+425
+00:26:33,430 --> 00:26:37,910
+واقف المريض؟ المريض يقفعلى ايش؟ يمين زي ما انتوا
+
+426
+00:26:37,910 --> 00:26:42,050
+شايفين المريض مابيكفش على يساره طبعا في بعض الناس
+
+427
+00:26:42,050 --> 00:26:45,670
+كتير دلائل جاعة يقولوا وقوف المريض في بعض الحلات
+
+428
+00:26:45,670 --> 00:26:51,050
+فسروا انه يساره بتعمل خوف للمريض قربه للقلب قربه
+
+429
+00:26:51,050 --> 00:26:54,350
+شوية للمريض بيحس انه كأنه كل شيء يعني كأنه فوقه
+
+430
+00:26:54,350 --> 00:26:57,710
+مباشرة وبيعتبروا انه دايما اللي .. لما يجي في
+
+431
+00:26:57,710 --> 00:27:01,190
+الإنسان على يمينه يعني الشق الأيمن دايما مألوف حتى
+
+432
+00:27:01,190 --> 00:27:04,700
+الإنسة حتى في ديننايعني جميل جدا انه النوم على
+
+433
+00:27:04,700 --> 00:27:09,080
+اليمين وهذا من السنة طيب الان ال principles of a
+
+434
+00:27:09,080 --> 00:27:12,920
+of accurate inspection عشان اعمل انا accurate
+
+435
+00:27:12,920 --> 00:27:16,340
+inspection اول حاجة بتستخدمي شهرنا good lighting
+
+436
+00:27:16,340 --> 00:27:20,080
+يعني إضاءة قوية جدايعني يا بنستخدم ضوء النهار
+
+437
+00:27:20,080 --> 00:27:23,480
+daylight او artificial او حتى لو بنستخدم ضوء يعني
+
+438
+00:27:23,480 --> 00:27:26,180
+صناعي لكن لازم يكون ال suitable مناسب طبعا بحكي
+
+439
+00:27:26,180 --> 00:27:29,320
+هذا الكلام لأن في بعض الناس بيستخدم إضاءات صعبة زي
+
+440
+00:27:29,320 --> 00:27:31,860
+ال fluorescent اللي هي light اللي زي الإضاءة
+
+441
+00:27:31,860 --> 00:27:36,380
+الفسورية المستخدمة في الملاعب و في بعض المطارات او
+
+442
+00:27:36,380 --> 00:27:39,000
+في بعض الأماكن العامة ممكن انت تتطلع في جسمك او في
+
+443
+00:27:39,000 --> 00:27:42,400
+لبسك تقول ما انا مش لابس لون هيك لأنه بيغير
+
+444
+00:27:42,400 --> 00:27:45,700
+الألوان فبالتالي بيصيرنا نحكم على ان المرض في عنده
+
+445
+00:27:45,700 --> 00:27:51,940
+مشكلةExpose body parts حاول انك اتعري و تكشف اجزاء
+
+446
+00:27:51,940 --> 00:27:55,900
+الجسم من المريض اللي بدك تلاحظها Observed only ما
+
+447
+00:27:55,900 --> 00:27:58,780
+بدنا نكشفه يعني مثلا بدي اعمل assessment للأبدومين
+
+448
+00:27:58,780 --> 00:28:03,120
+ليش اكشف صدره بدي اعمل assessment لل chest بروح
+
+449
+00:28:03,120 --> 00:28:06,300
+بحطي بالشرشة في الأبدومين و بعدين اعمل بال chest
+
+450
+00:28:06,300 --> 00:28:10,040
+هذا بيعطي اطمئنان و اروح للمريض اكتر look before
+
+451
+00:28:10,040 --> 00:28:13,970
+touching دايما اتطلع قبل ما انت ايهجبن ما تمد يدك
+
+452
+00:28:13,970 --> 00:28:18,590
+warm room يعني الغرفة تكون هادية ودافعة وكويسة not
+
+453
+00:28:18,590 --> 00:28:21,650
+cold not hot ايش يعني لا هي باردة ولا هي ساخنة
+
+454
+00:28:21,650 --> 00:28:24,570
+ليه؟ لأن المرض إذا كانت باردة مش هيساعد معاك وإذا
+
+455
+00:28:24,570 --> 00:28:27,710
+كانت حامية كتير العرق وكذا مش هيساعدك فاحنا
+
+456
+00:28:27,710 --> 00:28:31,930
+بالتالي بنخل الغرفة يعني زي ما يسمون الحرارة
+
+457
+00:28:31,930 --> 00:28:36,370
+المقبولة observe four colors اتطلع على الألوان
+
+458
+00:28:36,370 --> 00:28:39,930
+size الحجم و location texture او هكذا هقولكوا اش
+
+459
+00:28:39,930 --> 00:28:44,380
+معناه texture symmetryالتي تسمى التناسب الـ odors
+
+460
+00:28:44,380 --> 00:28:49,940
+و الاصوات تكتشر لقدامي شوية هنشرحلكوا حايدة كمان
+
+461
+00:28:49,940 --> 00:28:53,420
+مرة التكتشر بيسموه إيش هانا ان انا أشوف يعني
+
+462
+00:28:53,420 --> 00:28:58,240
+بيسموه إيش هانا لما أعمل يعني palpation of the
+
+463
+00:28:58,240 --> 00:29:01,540
+skin to assist the underlying tissue إيش يعني
+
+464
+00:29:01,540 --> 00:29:05,000
+palpation of the skin to assist the underlying of
+
+465
+00:29:05,000 --> 00:29:09,620
+the tissue أعطيكم مثل يعني لو مسكن الجلد أنا عصيت
+
+466
+00:29:09,620 --> 00:29:13,860
+على الجلدمش عشان احس الجلد عشان احس اللي تحت الجلد
+
+467
+00:29:13,860 --> 00:29:19,100
+كمان مرة لو مسكت الجلد عشان احس اللي تحت الجلد زي
+
+468
+00:29:19,100 --> 00:29:21,740
+ما يكون واحد ييجي يقولك بالله لو سمحت تعالي تشوف
+
+469
+00:29:21,740 --> 00:29:26,160
+انا حاسس فيه دم الهنة او حاسس فيه كيس دهني او حاسس
+
+470
+00:29:26,160 --> 00:29:28,740
+فيه ايش زي الورم الصغير هذا بيسموها ال texture
+
+471
+00:29:28,740 --> 00:29:32,520
+تمام اللي هو الملمس الداخلي اللي تحت الجلد تمام
+
+472
+00:29:32,520 --> 00:29:37,100
+اللي في بعض الحالات سموها elasticity طبعا انا اللي
+
+473
+00:29:37,100 --> 00:29:42,260
+قدامك برضه هتبين اكتر معانا compare قارنEach area
+
+474
+00:29:42,260 --> 00:29:45,380
+inspected أنا بشرح على مهل عشان بدينا بدينا في
+
+475
+00:29:45,380 --> 00:29:50,520
+عملية ال assessment الحقية بدنا نعمل مقارنة بين ال
+
+476
+00:29:50,520 --> 00:29:54,280
+inspected and opposite body side كيف يعني يعني إذا
+
+477
+00:29:54,280 --> 00:29:57,180
+أنت عملت assessment ال one side يعني مثلا عملت في
+
+478
+00:29:57,180 --> 00:30:01,660
+رشاقه الأيمن ماتيجيش تقول لأ في عنده مشكلة ايده
+
+479
+00:30:01,660 --> 00:30:05,620
+اليمنه فيها مشكلة استنى و اطلع على الايد اليسرى
+
+480
+00:30:05,620 --> 00:30:09,170
+إذا لجيته نفس الشيء تعتبر normalهو اكتشف نعتبر
+
+481
+00:30:09,170 --> 00:30:11,770
+abnormal لما يكون فيه big difference between right
+
+482
+00:30:11,770 --> 00:30:15,950
+and left يوزبن لايت استخدم اللي هو قلنا الضوء
+
+483
+00:30:15,950 --> 00:30:20,470
+المباشر عشان ال body cavities زي ال mouth و زي ال
+
+484
+00:30:20,470 --> 00:30:23,890
+nose و زي مثلا اه إذا بدنا نشوفها و زي إذا بدنا
+
+485
+00:30:23,890 --> 00:30:28,750
+نشوف إذا في لا سمح الله يعني أي orifice موجودة زي
+
+486
+00:30:28,750 --> 00:30:31,030
+في حالات ال deep abscess أو غيره ممكن نستخدم
+
+487
+00:30:31,030 --> 00:30:33,490
+الإضاءة palpation
+
+488
+00:30:36,310 --> 00:30:41,010
+أنا شايف عشان احنا بدناش نتخطى اكتر من نص ساعة ال
+
+489
+00:30:41,010 --> 00:30:43,050
+probation نخليه نكمل ان شاء الله في المحاضرة
+
+490
+00:30:43,050 --> 00:30:45,770
+القادمة ان شاء الله و تتابعونا و ان شاء الله
+
+491
+00:30:45,770 --> 00:30:47,950
+تكونوا استفدتوا السلام عليكم ورحمة الله وبركاته
+